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swine flu death in pandemic Pune

Pune, Aug 3 (IANS) Days after Pune was declared a pandemic city for swine flu, a 14-year-old girl succumbed to the virus there Monday - making it India’s first death due to influenza A(H1N1). The girl was suffering from the flu for over a fortnight and died due to “delayed treatment”, health officials said.
Meanwhile, seven more people tested positive for the flu Monday, taking the total number of cases to 558 in the country. Of these, 470 patients have been discharged after treatment. About 2,479 people have been tested so far.
Confirming news of the death, union Health Secretary Naresh Dayal said in New Delhi that the girl was given anti-flu medicine at a very late stage.
“It appears she was treated late. If she had been treated earlier, she could have been saved,” Dayal told a news channel. “It is a matter of concern,” he added.
“The deceased patient, Riya Shaikh, had been admitted to Jehangir Hospital, a private hospital, July 21. As per preliminary information, she passed away this evening,” a health official in Pune told IANS.
Pune, which has already become the country’s swine-flu capital, notched 102 patients Monday, of whom 86 are children, mostly school students, he said.
The girl had consulted a general practitioner when she first reported flu-like symptoms - sore throat, runny nose, headache - on July 21. When her condition improved, she joined school on July 23.
“She again developed fever on July 25, for which she consulted another private practitioner. Her fever continued and she was admitted to a private nursing home in Pune July 27,” according to a health ministry statement.
Her condition worsened and she was shifted to the ICU and put on the ventilator on July 29. “The patient’s lung aspirate was sent to the NIV (National Institute of Virology) on July 31 and was tested positive for swine flu.”
She was put on Oseltamivir or Tamiflu on July 30. “Her condition deteriorated again with multi-system involvement and she expired on the evening of August 3,” the statement said.
Health officials are flummoxed how a serious patient of H1N1 could remain under treatment in a private hospital and are inquiring whether the case was notified to the authorities or not, especially since Pune had been declared a ‘pandemic’ city last month.
Dilip Bhan, divisional commissioner of Pune, maintained: “We were not aware of the patient. She had taken private treatment. People should not go to private hospitals and instead get themselves admitted to government hospitals.”
“After the death we have all become very conscious and alert. We are taking every precautionary measure to ensure that no more deaths take place,” he added
The health ministry said the Pune hospital staff, including three doctors and a nurse, who had treated the girl and had developed respiratory symptoms were being treated with Oseltamivir.
“About 85 other hospital contacts have been put on prophylaxis, while 31 contacts, including 11 family contacts, have also been put on chemoprophylaxis,” it added.
Dayal said they have already issued guidelines regarding swine flu to schools as it is mostly affecting children.
Asked if the government has issued any guidelines of closing down the schools, he said: “Guidelines are very clear. If a child is suffering from swine flu virus he should not come to school and get himself isolated. We have not recommended closing down of schools.”
He said they are monitoring the situation and would take action and review the situation following the girl’s death.
Dayal also said the government has enough stock of anti-flu medicines and if the need arose they would be able to acquire more. Since Tamiflu is available only in select government hospitals, Dayal said the government would review the situation.
Most of the cases are being reported from the metros as the infected people were returning from foreign jaunts.
“(More cases) will happen,” he said, adding that at the time people return to India they do not exhibit symptoms of the flu, which has an incubation period of seven-10 days. “The symptoms develop later,” Dayal said.
He added that one third of the people who test positive for swine flu are those identified at the entry point, while the rest are cases who report themselves later.
“The infection is largely from abroad and is mainly confined to cities. No case has been reported from rural areas,” he added.
Dayal stressed that testing for swine flu can’t be done in private hospitals.
“Testing can’t be done in every hospital lab. Certain care has to be taken while taking samples. The doctor or the technician has to wear protective gear. If it is not taken carefully, more people could be infected,” he added.
Asked if India has handled the swine flu cases properly, he said: “We have handled it better than other countries. We have only one death from the virus.”
On Monday, seven positive cases were reported in the country - Delhi (2), Pune (3), Chennai (1) and Ahmedabad (1).
Health officials said an 11-year-old boy in Delhi contracted the virus from another person.
Pune continued to report swine flu, with three new cases, including two children. They contracted the virus in school.
In Chennai, an eight-year-old boy, who had arrived from Muscat on July 29, tested positive.
In Ahmedabad, a 27 year-old woman doctor who was on airport screening duty, reported with flu-like symptoms on July 30.
In Maharashtra, the number of cases rose to 147 Monday - with 102 in Pune, 20 in Mumbai, 23 in the hill-station of Panchgani, and two in Thane.
According to the World Health Organization (WHO) till July 27, about 134,503 laboratory confirmed cases of influenza A (H1N1) have been reported. About 816 deaths have been reported, mostly from Mexico and the US.