The Swine Flu pandemic

Published February 3, 2011

Swine flu is a respiratory illness caused by a strain of influenza virus which has been named pandemic (H1N1) 2009 influenza by the WHO.

The symptoms of this swine flu in people are similar to the symptoms of regular human seasonal flu and include fever, fatigue/unusual tiredness, headache, runny nose, sore throat, shortness of breath or cough, loss of appetite, aching muscles, vomiting or diarrhoea. Swine flu can spread easily from person to person.

Swine flu first emerged in March 2009, initially in Mexico, but spread rapidly across the globe as a pandemic. The first case in Pakistan was in June that year; all the initial cases were reported in travellers returning from the United States. In 2009 alone, more than 600,000 cases and 13,000 deaths were reported across the world, of these there were 1,242 suspected cases of H1N1 reported in Pakistan, with 262 of these being confirmed by laboratories.

Of these 30 per cent were from Islamabad, 35 per cent from Punjab (with the majority being in Rawalpindi), 28 per cent Sindh (the majority being reported in Karachi) and 5 per cent from Peshawar.

However these figures are likely to be grossly underestimated since several illnesses common in Pakistan, such as malaria, typhoid, influenza and hepatitis have similar presentations, as does dengue fever which too is again on the rise. The Pakistan government needs to take a proactive rather than reactive approach to surveillance and disease control. There is need for a cohesive and switched on public health programme in order to maximise resource efficiency and optimal responses.

Health care experts in Pakistan are increasingly concerned about the growing number of Swine flu cases and have asked the government to take urgent steps for controlling the disease. Former general secretary of Pakistan Medical Association and surgeon Dr Qaiser Sajjad said this year many flu cases have been reported in the country, but the government has not taken proper measures for treatment of swine flu patients in the government hospitals, or raising awareness about the disease amongst public.

It is difficult to monitor exact numbers due to poor surveillance but at least 85 people across Pakistan including the Punjab and Sindh have been confirmed positive with swine flu. A 28-year-old man was the first recorded H1N1 fatality in Pakistan this year. Five deaths have been reported so far. Dr Sajjad has urged the government to provide adequate medical facilities for swine flu patients in the government-run hospitals. He advised people with symptoms of swine flu to avoid meeting other people and keep separate their utensils, bedding and towels, etc. and that the people with flu and fever should visit qualified doctors or hospitals instead of going for self-medication and complementary therapies.

Even abroad, children from Bangladeshi and Pakistani communities were hardest hit. In the UK researchers led by the Government’s former Chief Medical Officer, Professor Sir Liam Donaldson, found in the period from June 2009 to March 2010 mortality rates for Bangladeshi children (47 deaths per million population) and Pakistani children (36 deaths per million) were much higher than for Caucasian English children (four deaths per million). These findings were published in the medical journal The Lancet showed those with pre-existing conditions, especially neurological diseases such as cerebral palsy were also at higher risk, but a fifth of the young people who died were previously healthy. Professor Donaldson told Sky News the higher death rate among ethnic minorities was an "unexpected finding", but mirrored similar studies in the USA.

Can we hope that this time enough will be done both in Pakistan and abroad to protect the vulnerable and treat those affected?

Dr. Yasmin Akram obtained her medical qualifications from Cambridge University and St Georges Hospital Medical School, University of London. She now practices medicine in Birmingham, UK.

The views expressed by this blogger and in the following reader comments do not necessarily reflect the views and policies of the Dawn Media Group.

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