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Pandemic H1N1 2009
WHO declared the start of the
Influenza A(H1N1) pandemic on June 11, 2009. The
Director-General of WHO raised the influenza
pandemic alert to the highest level - Phase 6 - on the guidance and
advice from an Emergency Committee established for this purpose under the
International Health Regulations (IHR).
In late April, WHO had
announced the emergence of a novel H1N1 virus. This
strain has not circulated previously in humans. It is contagious spreading
easily from one person to another. More than 70 countries are now affected with over 30,000 confirmed
cases Further geographical spread is inevitable.
The declaration of a pandemic
essentially means wide geographic spread and does not indicate any change in
the severity of the illness. Currently the severity of the pandemic has been
assessed as "moderate" globally. In vast majority of cases the
virus produces mild disease. In a small proportion of people the illness can become severe and fatal. While
most persons developing severe disease have underlying conditions such as
respiratory diseases, notably asthma, cardiovascular disease, diabetes,
autoimmune disorders, and obesity, a few young and previously healthy persons
have also developed severe disease.
In a pandemic, all countries
would recalibrate their responses and move from measures to contain the
spread of the illness to measures that mitigate the adverse impacts of the
illness. Such mitigating measures
include increasing surveillance and laboratory capacity for rapid detection
and diagnosis of cases and ensuring that the patients receive prompt care to
prevent severe illness and minimize fatality. Countries which have so far not
experienced community level transmission would need to be vigilant, enhance
surveillance and be prepared for the arrival of the pandemic. The pandemic
spread occurs in waves and the overall impact of the pandemic will thus vary
from country-to-country and over time.
The Government of India is
closely monitoring the situation. The Inter-Ministerial Task Force and the
Joint Monitoring Group for AI/pandemic, comprising representatives from a
number of ministries, have been regularly reviewing the global and national
situation. The Government of India has initiated a series of actions
approved by the Inter-Ministerial Task Force (IMTF). Suspected cases are
being admitted at designated hospitals for testing, isolation, treatment and
follow up. Contacts of cases are being
traced, quarantined and provided preventive treatment. All health care
facilities in states under the country’s Integrated Disease Surveillance
Project (IDSP) and medical colleges have been activated to report on
Influenza like Illness (ILI) and Severe Acute Respiratory Infection (SARI)
/Pneumonia cases. A 24x7 number 011-2391401 has been activated to receive
calls from the public for enquiries about the disease and to report ILI. The IDSP has been tracing and monitoring health
status of passengers who traveled on the flights with co-passengers who were
subsequently confirmed as cases of Influenza A(H1N1).
All samples from suspected
cases are being tested at the National Institute of Communicable Disease
(NICD), New Delhi,
or the National Institute of Virology (NIV), Pune.
Soon 16 more labs would start testing specimens from cases.
The Government is
communicating risks, personal protective measures and preventive guidelines
through the mass media. The Ministry of Health and Family Welfare is rolling
out a structured media campaign on preventive behavior for flu, what people
should do in the event of flu and to whom to report to etc.
Few of the confirmed cases
have acquired infection through close contact with another confirmed cases of
Influenza A(H1N1) with history of travel to an
affected country. Testing, isolation and treatment of cases detected and
quarantine of contacts along with enhanced surveillance for influenza like
illness (ILI), severe acute respiratory illness (SARI) and unusual
absenteeism at work places and educational institutions; enhancement of
anti-viral stockpile and hospital preparedness for handling of cases are some
of the key actions being undertaken in India currently.
WHO is collaborating with the
Government of India for rapid augmentation of the country’s capacity to
implement mitigation measures for the pandemic. The Government has finalized a revised action plan
for pandemic. Under the leadership
of the Government of India, all states in the country have been building
capacity for AI/ pandemic preparedness for the last two years.
As part of capacity building
for Avian/Pandemic Influenza (API), a series of workshops, refresher
trainings for epidemiologists and microbiologists and table top exercises
have been conducted to test response plans of each state. Clinicians and
anesthetists and have been trained on clinical management of cases of API.
The states have been supported to undertake capacity building and trainings
at the district level for public health professionals, clinicians,
anesthetists and microbiologists and on the district level API preparedness
plan, rapid response teams and management of cases.
WHO is also supporting the
Indian Red Cross for strengthening community awareness and preparedness to
deal with Influenza A(H1N1) through the 12 million
members and volunteers of the Indian Red Cross working at the Centre, states
and district levels.
Details about the disease,
its transmission, risk factors, personal protection, treatment etc can be
accessed from the following websites:
1. Ministry of Health and Family Welfare
2. WHO South-East
Asia Regional Office (SEARO)
3. WHO HQ
4. Centers for Disease Control and
Prevention (CDC)
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