SKIMS treating Swine Flu cases for 5 months
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SKIMS treating Swine Flu cases for 5 months

What could have been a tightly-kept secret on Swine Flu outbreak in Kashmir, this summer capital has been recording the deadly cases, at least since October 2014, at SK Institute of Medical Sciences, Soura, where some 50 patients were treated till last year-end alone.

What could have been a tightly-kept secret on Swine Flu outbreak in Kashmir, this summer capital has been recording the deadly cases, at least since October 2014, at SK Institute of Medical Sciences, Soura, where some 50 patients were treated till last year-end alone.

Maintaining that "influenza has been circulating with varying severity across the globe", Dr Parvaiz Koul, Head of the Internal and Pulmonary Medicine, SKIMS and Principal Investigator for the Influenza Project in Kashmir in an exclusive interview to Greater Kashmir, said: "A heightened awareness among the people is good but sensationalism not only creates undue panic, it turns counter- productive burdening the healthcare resources unnecessarily."

Though dispelling the notion that consumption of mutton or chicken can cause Swine Flu, the medico asked the people to be cautious of the disease symptoms, dos and don'ts.  "A person can infect others from one day before getting sick to five-seven days afterwards," he said adding "people generally get sick within few days of getting infection varying with immune status."

The interview excerpts:
GK: Swine flu outbreak is hogging the headlines. Is it for the first time that Kashmir is in the grip?
PK: See, respiratory infections have plagued people for years contributing to the morbidity and mortality.

The influenza pandemic of 1918 wiped nearly 50 million people from the surface of the Earth.

There have been multiple epidemics since then and the latest one in this regard was in 2009. Since this one occurred in an era of technological advances, the dissemination and hence the panic associated with it spread more rapidly. About 500,000 deaths are otherwise attributable to influenza each year. In the United States alone, there are round 36,000 estimated deaths yearly. 

GK: People say prevalent panic is genuine but many medicos with government call it hype?
PK: It is a mixture of both. The fact is that influenza has been circulating with varying severity in the whole of the world and causing mortality. It has affected India in an unusual severity this year and caused hundreds of deaths.

However, in Kashmir the influenza activity has not been anyway unusual and has certainly been less severe than the rest of the India till date. A heightened awareness among the people is good but sensationalism not only creates undue panic but turns counter- productive burdening the healthcare resources un-necessarily. 

GK:  What are the symptoms of Swine Flu and how is this influenza different from common cold?
PK: The two of these infections resemble each other in presenting with cough, sneezing and fever along with sore throat.

However fever is commoner in influenza and nasal stuffiness in common cold. Further gastrointestinal symptoms and other severe complications can accompany influenza and are not usually seen with common cold. Extreme exhaustion and severe cough is more common in flu. Doctors can distinguish between the two and when in doubt they order testing. 

GK: Advisories for the people as most of them are unaware of the dos and donts?
PK: First of all no one should panic. The healthcare personnel are adequately geared for tackling the problem. Frequent hand-washing and covering of the nose and mouth while coughing and sneezing are paramount so that people do not transmit infection to others.

This is true for all respiratory infections. Aerosols do not travel beyond a meter and we must maintain a distance of at least one meter from infected patients. A sick patient should voluntarily maintain social distancing and avoid congregations and crowded social or religious settings. Adequate rest helps in combating flu in most of the cases and should be undertaken. 

GK: What are the preventive measures?
PK:  We cannot prevent it. If it has to come, it will come. Could it be prevented then US would have been the first but they have witnessed biggest number of recorded deaths.

 If the person with history of close contact with person suffering from respiratory illness gets symptoms of flu, he must immediately consult a doctor for possible testing and treatment. 

GK: Social media is abuzz with different recommendations including avoiding chicken and mutton  as well as some home based remedies? What is your take on that? 
PK: There is no truth in such rumors and there is no reason to avoid chicken and mutton consumption. Lots of fluids and rest helps patients with viral infections and influenza is just one more virus. We all need to be aware but yes panic certainly does not help. 
GK: Who are at the high risk of developing complications? 
PK: Children less than 2 years and adults of 65 years and older, pregnant females and people with chronic lung, heart, liver, kidney , blood or neurological disorders. Diabetics are also at high risk. 
GK: There has been a feeling that healthcare authorities have been concealing the presence of Swine Flu. What's your take?
PK:  Nothing is concealed but we don't want sensations. Recently one of the dailies reported that more than 30 patients were admitted in SKIMS.

Although they did issue a low key denial the next day, the damage was already done. We keep on advising patients regarding the infection control measures. I have personally gone on air on Radio Kashmir as well as Big 92.7 FM advising people of the measures to be adopted.  

Our daily machine log and reports go the relevant Union Health Ministry department of EMR through our National Coordinating Center in Pune. So even if we want to hide it, we cannot. 

GK: The all important question: how many cases have been administered in Kashmir?
PK: We have been recording cases of influenza right since the return of Hajjis from Saudi Arabia last year. Each of the positively tested Haji was treated in accordance with treatment guidelines.

We have observed an increase in activity for the past 4-6 weeks and it is continuing. Without going into exact numbers, I would say that we have seen scores of patients. Fortunately we did not have many severe cases. It is a dynamic process and cases get diagnosed on a regular basis. 

GK: There has been a concern regarding the level of safety in testing labs? 
PK: Kindly be advised that our lab in SKIMS was established after getting designed and stuffed with equipment by the CDC, USA. A team of the CDC came in 2010 to visit our facility. A special space was provided strategically near the OPD area in order to restrict the patient movement from the OPD where they land first.

We participate in external quality assurance and a portion of our tested results are reconfirmed by the CDC. I am proud to state that our concordance with the CDC has been 100%. The lab personnel are vaccinated and adopt recommended safety measures while collecting and processing samples.

The requirement of a BSL 3 facility for testing influenza was scrapped by CDC way back in 2009 only. I would request media to reconfirm stated claims before publishing because statements made on the basis of ignorance create a lot of damage.

GK: Does Kashmir have adequate testing facilities?
PK: I detailed you about our lab capacity. Our administration has been all through supportive and asked us to do testing despite it not being our strict mandate. We have obliged and provide testing facilities as and when required. Our boys work round the clock this time for providing diagnostic reports to the clinicians. We need additional reagents for coping with the increased load but there is no dearth as of now.

It may be prudent to add that the 6000 odd samples that we have tested free of cost would cost Rs three crores in the market. All patients from high profile states like Gujarat and Rajasthan are getting tested in  private labs at a whopping cost. We need to be lauded and not be the recipients of brickbats. Give the devil its due.

GK: What about facilities for treatment at SKIMS?
PK: SKIMS administration ordered drugs when nobody even had a whiff of the presence of the infection in the community. We have stockpiled the required drugs and carved out a special area in the hospital replete with ventilators for anyone who requires advanced respiratory support.

Fortunately we did not need to admit anyone to the facility as yet.

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