841 deaths due to swine flu since January 1; 'great concern' says government

841 people have died in the country due to swine flu since January 1 this year, which is a matter of "great concern" and the situation is being monitored closely, the government told Parliament on Tuesday.

Making a statement, Health Minister J P Nadda said from January 1 till February 22, the number of swine flu cases reported by the states stand at 14673.

"The number of deaths for the same period are 841," he said.

The Minister rejected suggestions about shortages of Oseltamivir, drug used for treating Influenza A H1N1 or swine flu, and said it is manufactured in India.

"We have held meetings with the manufacturers on two occasions. These indigenous manufacturers have confirmed that they have sufficient capacity and stock of active pharmaceutical ingredients to meet requirements," he said.

He said the drug, however, cannot be sold over the counter and has to be made available only against prescription and sold through a chemist with license under Schedule X of the Drugs and Cosmetics Act.

"We cannot afford a situation where due to irrational use of the drug, resistance is developed, rendering the drug incapable of fighting the virus. However, to ensure that general public requiring the drug does not face any inconvenience, we have advised the state governments to review the locations of the Schedule X pharmacies and issue fresh licenses for under-represented or not represented locations," he said. Nadda said his ministry is closely monitoring the situation and is in regular contact with the affected states.

"...to prevent transmission of the disease to the healthcare workers who come in contact with patients, N-95 masks and Personal Protective Equipment are required. We are, on a regular basis, ascertaining from the state governments regarding the stock position...We have already supplied to the affected states 58,000 capsules of Oseltamivir, 3000 N-95 masks and 9500 Personal Protective Equipment," he said.

The Health Minister said India, as also other parts of the world, were affected by Influenza A H1N1 pandemic in 2009 and 2010. The number of reported cases in 2009 were 27236 and 20604 in 2010. The number of deaths in 2009 were 981 and in 2010 the deaths increased to 1763, he said in identical statements in both Lok Sabha and Rajya Sabha. He explained that influenza is caused by virus of three types A, B and C. It is the type A virus which has caused major pandemics and epidemics across the globe.

"This is because influenza A type of virus has the tendency to undergo mutation against which the affected population may not have sufficient immunity...while declaring the pandemic to be over in August 2010, WHO had conveyed that the pandemic H1N1 virus would continue to circulate as a seasonal influenza virus for some years to come. Many of these deaths, however, may be due to already present co-morbidities in the patients," he said.

He said the present cases pertain to the 2009 virus and there is no mutation in it. The government has recommended vaccine only for the health workers and the decision was taken after due consultations with experts.

"Vaccination of general public is not advocated as a public health strategy at this juncture...the vaccination becomes effective after about three to four weeks of the injection and the immunity is only for about one year. Moreover, vaccination may not provide full protection against the virus," he pointed out. He said as per information gathered from the states, it appears that many of the deaths may be attributed to the co-morbid conditions of the influenza A H1N1 affected patients.

In this category are the patients with diseases such as cancer, diabetes, tuberculosis, other respiratory diseases. He said the states have also informed that in many cases, the affected persons sought medical intervention at a very late stage resulting in deteriorated health status of patients.