Hundred and counting: H1N1-hit Pune gears up for a 'chilly' winter

A sneeze here raises eyebrows and coughing makes people nervous. It goes without saying that you are in Pune, which has emerged as the epicentre of swine flu with its 100th victim.

A lurking fear pervading the city for the last three months after the death of 14-year-old school girl Reeda Shaikh on August 3—India's first H1N1 fatality—has hit social life but Pune, with its population of 35 lakh, is braving the pandemic which has killed 206 people in Maharashtra.

When 28-year-old Mohini Undre was declared the 100th victim of H1N1 in Pune on Thursday, turning the toll to a three-digit number, fresh concerns came haunting the health officials and common people alike over the possibility of a more virulent "second wave" with the onset of winter.

Dr Arun Jamkar, dean of the government-run Sassoon Hospital, which has borne the brunt of most swine flu deaths with admission of critical cases, says, "A second wave is totally unpredictable. We have to be completely prepared to meet any eventuality that the virus can bring to us."

The hospital, the main referral centre in Western Maharashtra, has submitted a plan to the State government envisaging a better infrastructure for management of rising swine flu cases in Pune putting up a demand for over 100 ventilators to treat emergencies to save lives.

"We have also asked for starting additional ICU facilities for swine flu patients in other civic and government hospitals and more ambulances to transport patients needing ventilation support," Jamkar said.

Asked about high mortality rate of H1N1 victims, he stuck to the refrain of "early detection and early treatment" to save those infected with the virus.

"A concerted effort is needed to coordinate and direct ventilator management in civic, government and private hospitals towards swine flu patients and employ trained manpower to operate them if we want to save lives," said Jamkar, whose medical staff is periodically engaged in video-conferencing with swine flu treatment experts in the US.

On the delayed H1N1 test reports coming from National Institute of Virology (NIV), which is overburdened with a burgeoning number of samples from private and government hospitals, the dean said, "We have stopped waiting for test reports to start treatment. Tamiflu is administered the moment the patient is perceived as symptomatic."

Dispelling the impression that the H1N1 virus was mutating and becoming resistant to Tamiflu, Jamkar said, "We have been in constant touch with NIV and the scientists studying the behaviour of the virus have not come across any such evidence."

"If suspected patients do not waste first 5-6 days and approach designated hospitals immediately, there will be a perceptible improvement in the mortality rate," he added.

Going in for alternative medicinal treatments such as ayurvedic and homoeopathy can also result in delay in getting standard treatment, Jamkar opined.

Outlining the steps being taken by the government, Dr Pradip Awte, who monitors the swine flu cell in Maharashtra, said a concerted drive had been launched in rural areas to train health workers in detecting H1N1 suspected cases.

"Three batches, each comprising 20 doctors, have already been trained in Pune and Mumbai and sent back to the interior regions."

The awareness level of the general population was going up, and the vital importance of taking Tamiflu tablets within 36 hours of detection of infection was being realised, he added.

"The ventilator support should reach the rural health infrastructure also so that the patients do not have to be transported to cities in a precarious condition risking lives," Awte said.

All said and done, it remains to be seen whether the sunny optimism of those manning the health apparatus comes true in the next three months as the environs get cooler to suit the virus that is on a rampage, claiming lives of children, adults, pregnant women in a merciless march.