Colds, fever, coughs are currently the commonest complaint islandwide :It’s a seasonal flu: no need to panic – National Influenza Centre | Sunday Observer

Colds, fever, coughs are currently the commonest complaint islandwide :It’s a seasonal flu: no need to panic – National Influenza Centre

The death of a young 20 year old mother of one, reported to have died of AHINI flu has set off panic waves among the public spiked by myths, confusion and conflicting reports on the nature of her death. A headlined report appearing on the first page of a leading daily newspaper on Wednesday December 26, allegedly quoting the Hospital Director Dr Indika Sampath Kumara saying the death was from the AHINI flu which the woman contracted at birth, and the Epidemiology Unit’s rejection of such claims added to the confusion . Amid this confusion, were fears of a new strain to the virus and rumours of bird flu and swine flu also spreading in the country.

Sourcing its information to a Polonnaruwa correspondent , the news report stated:

D.G. Kanchana from Polonnaruwa New Town died on December 26 at 1.30 p.m , having developed severe complications from AH3N2 , after giving birth to her second child and returning home to Aluthwewa. Suffering from breathing and related respiratory complications, she was rushed to the Polonnaruwa General Hospital. Admitted to the Intensive Care Unit of the hospital, a team of doctors struggled to save her life. When their efforts seemed futile, they requested permission to have a special machine used for critically ill patients with severe respiratory complications airlifted to the hospital. Dispatched with the blessings of President Maithrapala Sirisena, it arrived too late. Dr Kumara had allegedly stated that the death was caused by a complication resulting from excessive water accumulation in the lungs.

To find out exactly what happened this writer tried to contact the Hospital Director or any of the hospital authorities , but was told they were uncontactable. After some confusion on the part of the nursing staff regarding the patient’s identity, we did however manage to find out that the remains of the dead patient had been sent to the Anuradhapura Hospital’s JMO office for the post mortem, on a priority basis due to a delay at the Polonnaruwa hospital. We then telephoned the Anuradhapura Hospital and were informed that the post mortem had been done. JMO office sources said, the causes for the death and exact nature of the influenza she allegedly suffered from, had yet to be confirmed. “ Samples have been sent for examination to the hospital pathology lab, while some samples have also been sent to the Medical Research Institute. We can give you a diagnosis only after we have obtained all the reports”, sources said.

Reacting to the report that the death of the woman at Polonnaruwa was caused by the influenza subtype AHINI , Epidemiology Unit Head Dr Paba Palihawadana said, Sri Lanka had three common subtypes of the prevailing influenza: AHINI, H3N2 and influenza B. “ Right now the predominant strain is H3N2”, she said. “ All three types circulate from time to time during the peak season, December to February and May to July”.

Influenza

To give readers a better understanding of how influenza is caused, its negative health impacts and how it could be prevented, we posed some of the most troubling questions on everyone’s lips: With sixty patients allegedly dying of serious complications of the disease this year, could all those infected with the flu suffer from similar negative impacts?.

Was this year’s outbreak different from previous outbreaks? Was it more serious? Was there a likelihood the virus would mutate?

“Allaying these fears, she said, “The influenza epidemic we now see is a viral flu which is seasonal and occurs in two peak levels, annually. There is no need to panic and be unduly worried..

It can spread to one part of the country or to many areas and can affect all ages. In most cases since it is a self limiting illness, the fever, colds and coughs will disappear in a few days with some bed rest, plenty of fluids and staying away from crowds.” Asked if the Unit had official statistics on suspected cases she replied, “This is a virus where most patients get treated in the Out Patients’ Department. Unless the patient presents more serious symptoms that need diagnosis, there is no need for tests to confirm if you have the flu as it is treated clinically and can be managed at the OPD.

The attending medical officer will examine the patient and if uncomplicated, send him/her home after providing necessary supportive therapy and medication such as, antipyretuics , antihistamines and rehydration”.

Causes

In response to our question on the probable causes for the spreading epidemic she said,

“The three main causes are; change of climate, chilly weather and festive gatherings. Avoid crowds and large gatherings where you may be in close contact with an infected person. Follow basic guidelines on hygiene etiquette, Hand etiquette, cough etiquette. Wash hands with soap and water. Clean and disinfect frequently touched surfaces at home and office, Cover the mouth with a handkerchief or mask when in direct contact with an infected person. Use a disposable tissue when sneezing and cover mouth when coughing . Discard the tissues in a closed bin.”

On treatment , she said, “ Get medical advice if you have high fever for over 48 hours or breathing difficulties . If you feel unwell, stay at home without going to work or school, The best and most effective way to treat a flu at home is to use home based remedies - hot water, soups , and keep yourself well hydrated. Take plenty of rest.”

Were there drugs to be used as a preventive or curative measure? we asked.

“Treatment for influenza is mostly supportive therapy as in the case of most respiratory diseases .

There is also a specific antiviral treatment called Oseltamivir which is however, not given to OPD patients but only for those with severe diseases who are admitted to the hospital and managed as in patients.”

Medical Supplies Division sources when contacted on the availability of adequate stocks of drugs for in patients said, they had enough at present and were well prepared for any emergency.

Surveillance

At present there is no official reporting of OPD cases. So how did the Epidemiology Unit monitor the influenza status in the country? How did it know where the circulating virus sub types were at a specific time?

“ We have a surveillance system where samples are collected from out patients and in- ward patients is in place to monitor that the circulating virus types is in place in 19 sentinel hospitals. Necessary guidelines and disease prevention and management have also been issued.

In addition, all our nurses and health staff at grassroots level have been getting regular refresher courses on how to identify the influenza pandemic”, she said.

Network

The National Influenza Center at the MRI, was the next leading authority on viral flu which we contacted. Head and Consultant Virologist, Dr Jude Jayamaha explaining the role of the Center said, it was affiliated to the World Health Organisation and part of a wide network circulating updated information on influenza outbreaks in different parts of the world..

Asked if the flu currently prevailing was highly contagious, he said, “Although it is infectious it is much less contagious than measles, which is also seen at this time around”

Complications? “Only if the patients, usually those over 65 or under two years develop viral pneumonia .

When pneumonia settles many things can happen as Influenza destroys our normal protection cell layers. Transmission is by direct close contact and droplets.”

Rejecting claims of swine flu and avian flu circulating in the country, he said, there were no reports at anytime, of these two diseases ever found in Sri Lanka.

Responding to a question on whether symptoms of dengue could be mistaken for influenza and vice versa, he said, there were some similarities such as fever, body ache, headache, whereas, dengue fever could suddenly rise to a high and cause bleeding under the skin and shock in the more severe cases of Dengue Haemoraghic Fever and Dengue Shock Syndrome, there were no such complications in influenza. “ Besides, the mode of transmission is also different.

Dengue is transmitted by the aegypti mosquito while influenza is from human to human, through close direct contact. But, like dengue not everyone who comes in close contact with patients will get the disease. Only a handful will be infected”. Responding to our question on whether uncomplicated cases of influenza could suddenly become severe, even causing death.

‘ But it is difficult to predict as influenza is a very complex disease.”

Q: Pregnant women and women after childbirth, like the 20 year old who died at Polonnaruwa on December 26?

A. I cannot comment as I don’t have the full details. But, if she had over tired herself after she returned home, and neglected her health, the baby’s health being the focal point of her attention, then it is possible she could have developed complications, as she was still recovering from childbirth, even though it was 21 days after the event.

Most pregnant women and those who have just given birth are particularly vulnerable due to their lowered immune status.

Anyone who has fever continuously for over 72 hours should seek medical advice.”

For further clarification on influenza from the Epid. Unit, the hotline to call is 2681548

For more clarification from the Influenza Center at the MRI, call 2693532-4 Ext. 431 

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