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Faulty Surveillance - Influenza

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October 05, 2017

What is the issue?

  • India's surveillance system on the influenza cases seems to be flawed.
  • Given the mortality rate, it is essential to make corrections to take the right policy decisions.

What is the anomaly?

  • Ever since the first occurrence of H1N1 influenza in India during the 2009 pandemic, annual outbreaks are usual.
  • This year the virus has been particularly active.
  • The recent number on mortality is at 1,873.
  • However, the official figures show it to be a relatively better year in terms of low death toll.

What are the flaws in surveillance?

  • Number Data - The problem is that the official figures capture only the H1N1 numbers.
  • But influenza was present in India even before 2009 in the form of H3N2 and Influenza B virus types.
  • Notably, H3N2 is capable of causing outbreaks as big as H1N1.
  • And yet India does not track H3N2 cases as extensively as it does H1N1.
  • Data from other sources have established that influenza accounts for a considerable percentage of fever cases.
  • These are often undiagnosed and classified as “mystery fevers”.
  • Sequence data - India submits a small number of H1N1 genetic sequences to global open-access databases given its size and population.
  • Sequencing is important because it can detect mutations in genetic material.
  • As mutations help the virus evade human immune systems, it is essential for understanding the lethality of the virus.

What is the impact?

  • These flaws consequently translate to the vaccination decisions.
  • e.g India falls out in vaccinating even high-risk groups such as pregnant women and diabetics.
  • The antiviral medicine, Oseltamivir, is of doubtful efficacy unless administered early enough.
  • So vaccination is a crucial instrument for India to handle the influenza menace.
  • A better surveillance of influenza will possibly reveal the true scale of this public health issue and aid in right policy decisions.

 

Source: The Hindu

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