NEW DELHI: As the Influenza-like illness (ILI), especially H2N3 and H1N1 and severe acute respiratory infection (SARI) are seeing a surge across India, the centre on Saturday wrote to states and union territories directing them to be alert, take proactive steps and raise community awareness about the viral infection which has "Covid-like symptoms."
In his letter, Union Health Secretary Rajesh Bhushan also said that while the Covid-19 trajectory has decreased substantially in the last few months, the gradual rise in Covid-19 test positivity rates in some states is a matter of concern that needs to be promptly addressed.
He said that while Influenza is an annual seasonal occurrence, this year, a variety of weather conditions and behavioural reasons like less than adequate attention to personal hygiene, sneezing and coughing without proper protection near other people, closed indoor gatherings of people, etc., has made the environment conducive to the circulation of several viral respiratory pathogens like Influenza A(H1N1, H3N2 etc.), Adenoviruses, etc.
He said as per integrated sentinel-based surveillance of ILI and SARI; Influenza A has been up since the latter half of December 2022.
From January 2 to March 5, 451 cases of the very contagious H3N2 Influenza have been reported in India, according to data shared by the union health ministry. So far, a total of 3038 laboratory-confirmed cases of various subtypes of Influenza have been reported till March 9 by the states.
Till February 28, a total of 955 H1N1 cases had been reported. The majority of the H1N1 cases are reported from Tamil Nadu (545), Maharashtra (170), Gujarat (74), Kerala (42) and Punjab (28).
“Of particular concern is the preponderance of Influenza A(H3N2) being detected in the samples being analysed in various labs,” he said in his letter. He said that young children, older people and people with comorbidities are particularly at risk and vulnerable to H1N1, HH3N2, Adenoviruses etc. His letter came after India recorded two deaths due to H2N3 from Karnataka and Haryana.
The letter was sent to the states and UTs after a review meeting was held under NITI Aayog member (Health) Dr V K Paul.
The health secretary also cautioned the states on Covid-19. “Despite a low number of new aces, equally low number of hospitalisations and significant advances in Covid-19 vaccination coverage, there is still a need to remain vigilant and focus on a fivefold strategy of test-track-treat vaccination and adherence to Covid-19 appropriate behaviour.”
Though in most cases, the viral infection, which spreads fast like Covid, has similar symptoms and causes more hospitalisations, it is mild and often self-limiting with people suffering from respiratory disease followed by fever and cough.
But, he said, in some cases, particularly older people, people with obesity, and other comorbidities (like chronic obstructive pulmonary disease, diabetes, cardiovascular diseases, chronic renal and liver disease etc.), as well as pregnant women may suffer from a more severe manifestation of these diseases requiring hospitalisation.
He said there is a need to raise community awareness regarding adherence to respiratory and hand hygiene – like covering one’s mouth and nose with tissue/elbow when coughing or sneezing, avoiding spitting in public places, preferably using of mask in crowded environments, frequent hand wash etc.- promoting early reporting of symptoms and limiting the contact of those people who are suffering from respiratory illness.
The health secretary also asked the states to take stock of hospital preparedness, including drugs, medical equipment, medical oxygen, etc., capacity building of human resources on existing guidelines, and vaccination coverage against Covid-19 and Influenza.
He said the union health ministry will “continue to follow the evolving situation closely and provide all required assistance if needed.”
According to an advisory issued by the Indian Council of Medical Council (ICMR), H3N2 appears to cause more hospitalisations than other influenza subtypes. Of the hospitalised patients with H3N2, about 92 per cent presented with fever, 86 per cent with cough, 27 per cent with breathlessness, and 16 per cent with wheezing.
Additionally, 16 per cent had clinical signs of pneumonia, and six per cent had seizures.