August 25, 2010

H1N1 Pandemic over, but it's just peaking in India

For the World Health Organisation, the H1N1 swine flu pandemic is over. The world is no longer in an influenza pandemic alert and is moving into the post-pandemic period, WHO director general Margaret Chan said this week.

According to the global health watchdog, the new H1N1 virus has largely run its course. But for India, the reality seems to be different. Some say the pandemic is actually peaking in the country now. Take for example the number of new cases in just the past week. Between August 2-8, the number of lab-confirmed cases of H1N1 infection stood at 942. India recorded 83 deaths due to H1N1 during the same period.

The worst affected states include Maharashtra which recorded 400 positive cases and 51 deaths, Karnataka 200 cases and 12 deaths, Andhra Pradesh 105 cases and six deaths and Delhi with 106 cases with no death. Since May 2009, India has recorded nearly 37,000 H1N1 infections and 1,833 deaths.

A health ministry official said, "Many would say the virus has now settled down to replace the seasonal influenza strain. But there is no doubt that H1N1 continues to infect Indians in large numbers. In fact, the highest number of deaths reported of swine flu in a single week, 83, was between August 2 to 8. Majority of those who died were pregnant women and the elderly — the vulnerable group."

According to Dr Chan, the post-pandemic period does not mean that the H1N1 virus has gone away. "Based on experience with past pandemics, we expect the H1N1 virus to take on the behaviour of a seasonal influenza virus and continue to circulate for some years to come. In the post-pandemic period, localised outbreaks of different magnitude may show significant levels of H1N1 transmission," she said.

According to her, the actions of health authorities in India, in terms of vigilance, quick detection and treatment and recommended vaccination, provide a model of how other countries may need to respond in the immediate post-pandemic period.

Globally, the levels and patterns of H1N1 transmission now being seen differ significantly from what was observed during the pandemic. Out-of-season outbreaks are no longer being reported in either the northern or southern hemisphere. Influenza outbreaks, including those primarily caused by the H1N1 virus, show an intensity similar to that seen during seasonal epidemics.

During the pandemic, the H1N1 virus crowded out other influenza viruses to become the dominant virus. This is no longer the case. Many countries are reporting a mix of influenza viruses, again as is typically seen during seasonal epidemics.

"Pandemics, like the viruses that cause them, are unpredictable. So is the immediate post-pandemic period. There will be many questions, and we will have clear answers for only some. Continued vigilance is extremely important, and WHO has issued advice on recommended surveillance, vaccination, and clinical management during the post-pandemic period," Dr Chan said.

Read more: In 7 days, H1N1 claims 83 lives - India - The Times of India

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