Mumbai may witness mini swine flu wave, experts warn

BMC's claim of 11 swine flu cases so far this month may not be accurate as many doctors say they see 1-2 cases daily. As the disease has symptoms similar to that of Covid-19, those testing negative for Coronavirus assume it to be the usual viral. Expensive tests also come in the way of accurate reporting of swine flu cases, said experts who worry about a surge in the numbers.

According to the BMC, the city this year has reported 15 cases of swine flu, where symptoms include fever and chills, fatigue, cough, body aches, sore throat, diarrhoea and vomiting. But a few doctors said they are getting 1-2 cases daily. Washing hands with soap and water, the use of sanitiser and masks can slow down the spread of swine flu, said experts.

Also read: Mumbai: City witnesses spike in H1N1 and Leptospirosis cases

Dr Tanu Singhal, consultant, paediatrics and infectious diseases, Kokilaben Hospital, said various influenza viruses are circulating, including H3N2, H1N1, and Influenza B, at the moment and they are focusing on flu. "The test does not differentiate swine flu from other forms of influenza. Most patients getting the flu have a very high fever for a couple of days along with a cold and cough and most patients recover in 2-3 days. Some cases can go on to develop pneumonia and some may also need ventilation. This, however, accounts for only 0.1-1 per cent of the total number of infected people. The symptoms of swine flu are the same as those of Covid, and it is clinically not possible to differentiate between the two. Therefore, many patients undergo a Covid test first and if it comes negative, we think of flu or any respiratory viruses." While 94-98 per cent Covid cases are mild, it is about 80 per cent for swine flu.

Passengers at LTT, Kurla, in January 2021. Doctors say a mask and frequent washing of hands can slow down the spread of swine flu. Pic/Atul Kamble

Dr Rajesh Sharma, head of Pulmonary Medicine at Sir HN Reliance Foundation Hospital, said, "On average, I have seen 1 or 2 swine flu patients every day. Some of my patients' conditions are serious and one of the patients is on a ventilator. What is happening is that lots of people are getting typical viral symptoms of infection in the upper respiratory tract, cough with fever. Generally, people think it is a mild attack of Covid."

After the disease progresses, Dr Sharma said, realize it's something else and visit the hospital. "Most patients are coming with the symptoms of fever, severe body ache, running nose, cough and asthma exacerbations. Due to similar symptoms, people are missing it. There is no need to panic as not all patients are not severe but if a person is having all the above symptoms please don't neglect it." Test rate appears to be another factor behind the likely underreporting, said experts. A swine flu test now costs between Rs 3,500-Rs 4,500 in private setups - a Covid test is about Rs 350.

Dr Manjusha Agarwal, senior consultant-internal medicine at Global Hospital, said more patients with high-grade fever, sore throat, cough, and cold are turning up at their hospital and most test negative for Covid. "Some of these patients have tested for swine flu. Several patients do not want to undergo testing for swine flu due to the cost factor and would prefer empirical treatment. The majority of patients get better immediately when appropriate antiviral therapy has been given. Along with patients, general practitioners must be aware of this non-Covid flu so that there is no delay in treatment. We have not seen any complications of swine flu, like ARDS, which was a dreaded complication during the 2010-12 wave. Vaccination of all beyond 65 years of age with co-morbidities, a younger susceptible population with influenza vaccination is imperative."

Dr Kishore Sathe, an emergency medicine specialist at P D Hinduja Hospital, H1N1 cases have gone up in the past 15 days, though most are mild. "Only elder patients with multiple comorbid conditions require hospital admissions including ICU. Fortunately, we have got Oseltmevir-like drugs to take care of H1N1, hence it's easy to contain the spread."

11
No of swine flu cases in July as per BMC