H1N1 infects three more in city

Five Cases Reported So Far, Three From Single Family In Mulund

The BMC on Tuesday reported three new swine flu cases. The H1N1 influenza virus has resurfaced in the city after almost a year, infecting five people so far this time around; three of the patients are from one family in Mulund. 

    The new patients, who, according to the BMC, tested positive for H1N1 last week, are a man aged 57 from Bandra, one aged 53 from Elphinstone Road and a man aged 37, who is a member of the Mulund family. The earlier patients are the 37-yearold man's son aged six and mother aged 57. 

    The family has no recent travel history, indicating that the three members contacted the virus in the city. After the family's case was reported, the BMC screened around 150 families in Mulund for H1N1 symptoms. But no more positive cases were found, said additional municipal commissioner Manisha Mhaiskar. 

    The Bandra and Elphinstone Road men, who are friends, have a travel history involving Alibaug. The civic body's executive health officer Dr Anil Bandivadekar said all patients were stable. "They have been put on antiviral drugs and are responding well." 

    A worrying observation by the BMC is that the Mulund man and his mother's cases are asymptomatic, meaning they did not show any classic symptoms of the infection. The infection in them was detected when the man insisted on getting tested. "But this is not surprising," said Dr Abhay Chaudhary, director, Haffkine Research Institute. "H1N1 is more like a seasonal flu now. The more we test people, the more positive cases 

would come. But they 

may be having subclinical infection and not suffering from it." 

    Super Religare Laboratories (SRL), one of the labs accredited to carry out H1N1 testing, has found H1N1 to be the predominant influenza virus in circulation. Out of the 39 samples tested for influenza in the city, five have tested for H1N1 and only one for influenza type A. (Influenza virus types A and B are commonly in circulation and regarded seasonal. H1N1 is a subtype of type A.) In Pune, in a sample size of 325, 68 tested positive for H1N1 and 32 for influenza type A. In light of the fresh cases in Mumbai, surveillance has been intensified, said Mhaiskar. "All hospital outpatient departments and dispensaries have been told to be vigilant." 

She said private laboratories have been told to intimate the civic body about all positive cases they detect. Apparently, the state's epidemiology cell was in the dark about the new cases in Mumbai till they were reported in the media. Bandivadekar, however, said that since the patients were not in a 'serious condition', intimation was not the priority. 

    Meanwhile, Mhaiskar said there was nothing to panic about. But Haffkine's Chaudhary suggested vaccination f o r h e a l t h - c a re wo rke r s as their immune systems might not be geared for viral attacks. WHO SHOULD GO FOR TESTING? 

Category C patients 

SYMPTOMS | Mild fever (below 100°F), cough, throat irritation, body ache, headache, diarrhoea and vomiting 

SWAB COLLECTION | Not recommended 

TREATMENT | Regular drugs. No oseltamivir (anti-viral drug marketed under the trade name Tamiflu). Reassessment of patient after 24 hours 

Category B patients 

SYMPTOMS | Category C symptoms, high fever (above 100°F), severe sore throat, running nose, etc 

SWAB COLLECTION | Only of patients with associated illnesses (comorbid conditions) like diabetes, hypertension, high blood pressure, etc 

TREATMENT | Oseltamivir 

Category A patients 

SYMPTOMS | High fever, runny nose, breathlessness, chest pain, haemoptysis (coughing blood), hypotension (low BP), bluish discolouration of nails, irritation and drowsiness in children 

SWAB COLLECTION | All patients 

TREATMENT | Oseltamivir