Apr 9, 2012 (CIDRAP News) – Reports of sporadic 2009 H1N1 infections and a few deaths in parts of India have sparked high-profile media coverage of the disease in the country, catching the attention of public health officials and vaccine makers, according to several media reports.
Global health monitoring has not suggested an unusual spike in flu activity in India. The most recent report for India in the World Health Organization (WHO) Global Influenza Surveillance and Response System (GISRS) shows a modest rise in flu activity over the past few weeks, with the 2009 H1N1 virus edging out influenza B as the dominant strain during epidemiologic week 11, which ended the third week of March.
Concerns over a rising number of 2009 H1N1 cases in India have prompted three Indian vaccine makers to resume production of the monovalent vaccine, according to an Apr 7 report in The Economic Times, an English language daily financial newspaper based in Mumbai. It said Zydus Cadila, Panacea Biotech, and Serum Institute are projecting an increase in demand, because over the past 3 months about 281 people have tested positive for the virus, and 21 deaths have been reported.
The companies reported meager sales in 2011, and Serum Institute of India, the country's only maker of the inhaled version of the vaccine, had to destroy 2 million doses because of a lack of demand, the Times reported.
Some Indian media outlets are reporting that health officials are puzzling over the rise in flu activity at a time when the onset of summer brings warmer, less humid weather, and reports are repeating speculation that the pattern might be due to a mutation in the virus. The Asian Age, an Indian daily newspaper, reported yesterday that the Tamil Nadu state government has ordered 25,000 doses of monovalent vaccine for health workers, though no mass vaccination of the public is planned, because H1N1 cases haven't reached epidemic proportions.
Dr V.S. Vijay, Tamil Nadu's health minister, told reporters at a press conference that media hype over 2009 H1N1 infections was creating a disease scare among the public. He downplayed the risk of the virus as a threat only to those with compromised immune status, such as infants, older people, pregnant women, and those with chronic diseases.
Meanwhile, Dr T Jacob John, virology professor emeritus at Christian Medical College in Vellore, questioned the "panic" over the recent H1N1 cases in an Express News Service (ENS) commentary today. ENS is part of an English language newspaper group based in Chennai. He noted that the virus is now a seasonal strain and that it's no surprise that it turns up during testing.
John said India needs more access to better lab tests for infectious diseases, as well as continuous real-time surveillance for reportable diseases.
Peter Sandman, PhD, a risk-communication consultant based in Princeton, N.J., told CIDRAP News that India's reaction to the 2009 H1N1 virus has been consistently unusual. "Long after other countries realized that swine flu was comparatively mild, Indian media have continued to respond as if it were horrific," he said, adding that the country's media seem to stand alone in their use of "dreaded H1N1" or "dreaded swine flu."
"Perhaps in response to this overreaction, Indian officials and infectious disease experts have sometimes gone to the other extreme—for example, trying to reassure the public by insisting falsely that H1N1 cannot make healthy people seriously ill," he said.
However, in other instances, health officials appear to be joining the overreaction, he said. For example, he pointed to a Times of India report on the death of a 75-year-old man from the disease, which noted that health officials collected the dead man's clothes and linens to be burned and destroyed, and they identified 20 of the man's contacts who were given oseltamivir prophylaxis.
Sandman also noted a story in mid March that said health authorities had started screening train passengers traveling between India and Pakistan after two cases were found in a border district. "I know of no other country that still imagines it is in the containment phase of pandemic response," he said.
WHO GISRS FluNet country search tool
Apr 7 Economic Times story
Apr 2 Times of India story