Tuesday, October 13, 2009

H1N1: What best can we do?

It was the middle of June and I felt prodromal symptoms of incipient viral infections. The other day the symptoms were much prominent with running nose, cough, fever and malaise. I wonder is this the Swine Flu, because I have to be cautions.Known in the medicinal Jargon as “swine-origin influenza A (H1N1) virus” (S-01v), the swine flu agent is a novel variant of the influenza virus to which all human beings represents a virgin (that is, immunological susceptible) population. Like other viruses which cause common cold, the Swine flu virus is also transmitted by the aerosol and fomite route, we know that few months ago it first occurred in Mexico and USA and many European countries, but India has adopted the strategy of screening travelers from these countries in an attempt to prevent its establishment here, but has it proved faithful, absolutely not because till date 277 deaths have been registered (statistics is as on 24th Sep 2009). However it served only to delay not to prevent the infection.Let I come back on my pathetic condition. So then, do I have the Swine flu? Neither I , nor any of my close contacts have traveled abroad or other places in India from the last week (which is the maximum incubation period for the virus. But the nature of my profession (partly I am a student and partly I am an employee, don’t tell me what is that) has put me in casual contact with my colleagues and with some fairly number of unknown people, who may have traveled abroad during this period. Where I met the fairly number of people, of course during my shuttle from lab to office and back from office to my home.Thus there is very small, but infinite chances that I have the Swine flu which makes me contemplate, is this the way that the Swine flu will enter and establish in the country? That is through an unscreened secondary carrier who had put a casual contact with the primary carrier, a traveler returning from abroad. Thus in India screening at international airports will best serve only to delay not to prevent its spread through population. Every individual in the population is a susceptible host. The apparent means to contain its spread and severity is either by vaccination (an approved vaccine is at present not available anywhere in India however “Tamiflu” a substitute is used in different parts of India or by treatment with antiviral drugs. The latter course of action is not practicable in the country given its expense and patients with symptoms of common cold are not likely to be suffering from the Swine flu. Ultimately statistics are for population not for the individual. I still wonder do I have swine flu? Here I became my own doctor and my own patient. In keeping with the best traditions of academic medicine I shall take no antibiotics (since the infection is viral, against which antibiotics are ineffective).The only concession I shall make for possibility is to take my blood sample now and another two weeks later so that a retrospective diagnosis of H1N1 infection can be unequivocally established.Decisions are never easy in the face of uncertainty, I realize not for individuals, nor for institutions, nor even for organizations. Here is a need for active intervention. The world awaits answers to the questions raised by H1N1 infection but not by the media which has given the much and much more speculations about the infection, but I am left hopefully that my optimism above is not misplaced.

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