Spreading A(H1N1)-public vigilance needed

by Manjula FERNANDO

Dr. Geethani Galagoda, Consultant Virologist, Medical Research Institute (MRI).	Dr. P. M. Ratnayake, Deputy Director,Medical Research Institute (MRI).

As of Friday Sri Lanka has recorded three confirmed deaths due to the influenza A(H1N1) apart from two more suspected deaths. The pandemic influenza is spreading at an alarming rate worldwide and within Sri Lanka too.

According to Virologist consultant Dr. Geethani Galagoda of the Medical Research Institute (MRI), they have performed 704 laboratory tests since May 2009. The first case of swine flu was reported in Sri Lanka on June 16. Since this first case of an eight-year old boy from Australia, there had been 207 confirmed pandemic influenza cases up to Friday.

The disease has so far spread from Colombo to Kandy, Kurunegala, Galle, Matara and Ratnapura and continuing. Two young children and a pregnant mother with her unborn baby died of the H1N1 within the past weeks.

The rate of community transmission of the disease is perturbing given the fact that there had been just 110 cases of confirmed infections by October 10, according to the Epidemiological Unit of the Health Ministry. A hundred people have been infected within the past one month and the numbers keep swelling by the day.

The epidemiologists warn the impact of this disease, as it turned out to be, could be detrimental if the society neglects this as just another seasonal cough and cold. They say the medical practitioners are too yet to respond positively to the fight against this could-be-deadly viral infection.“There is no cause for panic,” Consultant Epidemiologist Dr. Risintha Premaratne said. “With correct attitude we could minimize the impacts.”He said the viral infection could cause mild symptoms in many, but that is not an excuse to treat this as one.

Even though doctors warn only those in the high risk category could die of the disease, there had been reported deaths of ordinary healthy young adults in other countries.

The best advice is to seek help of a qualified medical practitioner if there is the slightest suspicion. The doctor should then decide if you need hospitalization and testing.

If the symptoms are mild the doctor could treat the patient with ordinary medication. But special treatment is needed for severe cases. All the main hospitals including base hospitals have been supplied with stocks of the anti viral drug to treat infected patients.

However, laboratory diagnosis is vital before proceeding with anti viral treatment as ad-hoc intake of the H1N1 drug could lead to develop resistance and this resistant chain would then start spreading, Dr.Premaratne warned.He said Sri Lanka will soon receive free H1N1 flu vaccine from the WHO. Once it is made available they could fight more effectively to curb the spread of the disease.

Dr. Galagoda said it was essential to be educated on the disease and ensure that first you do not get infected and second you do not infect others.

“This is where the social responsibility comes in.”Parents should keep children with flu symptoms at home and this goes to children in daycare centres as well. The normal incubation period is 1-7 days.

The MRI has been getting inundated by test samples each day with well over 50 samples from hospitals islandwide since the institute is currently the only accredited place for swine flu testing.

“We used to test all the samples we receive at the beginning but now only the samples sent in through the hospitals are tested due to the heightened demand.”

The advice by the MRI to suspected patients is to seek medical advice first.

Let the physician determine if you need hospitalization and testing. Sending hundreds and hundreds of samples of ordinary flu patients will delay identifying the actual patients needing special care. “This is a very expensive and a technically demanding test,” Dr. Geethani explained.

For an accurate reading the sample is subjected to four separate tests. And with the new machine, a Real time RT PCR they have recently acquired and the staff trained specially for this particular task under the celebrated Sri Lankan born Professor who invented the drug for Saars virus Sriyal Peiris in Hong Kong and others in Singapore the results are guaranteed to be 100 per cent accurate.

The MRI is spending about Rs. 20,000 on each sample. This is inclusive of the value of the free re-agents provided by the World Health Organisation but excluding the manpower costs. MRI charges private hospitals a nominal fee of Rs. 10,000 per test to cover up the costs for consumable.

The disease is fast spreading in Sri Lanka. We were caught up in the second wave of the global epidemic. Sri Lanka was successful in preventing the disease from establishing in the country during the first wave early this year.

There has been nearly 5,000 reported deaths around the world since its first detection in Mexico in January 2009 and 414,000 laboratory confirmed cases of H1N1 influenza. The actual figures are thought to be much higher.

With the emerging realities MRI Deputy Director Dr. Priyal Ratnayake suggested training the staff in peripheral hospitals to conduct lab tests for H1N1. Kandy, Galle, Jaffna and Batticaloa hospitals could be equipped to take up the challenge, he observed.