Experts warns of second deadlier wave of swine flu

New Delhi, Oct 1 (PTI) Warning of a second wave of swine
flu pandemic which might be highly pathogenic and have a high
fatality rate, experts have asked the Government to be
prepared to face any eventuality.

"A second wave of pandemic is likely to occur. The virus
may acquire higher pathogenicity and increased case fatality,"
scientists at the Christian Medical College Vellore have said
in a report.

They added that the strain may also become resistant to
antiviral drugs.

With the arrival of the delayed south-west monsoon rainy
season, the virus is likely to spread – and may subsequently
continue as endemic influenza for an unpredictable duration,
the report published in the latest edition of the Indian
Council for Medical Research journal says.

"India must also be prepared for other eventualities," it
warns.
According to the scientists, the Ministry of Health should
be aware of any such possibility so that plans could be made
now to face each of the above eventualities.

The scientists noted that India does not have a public
health infrastructure that could put into practice the
Pandemic Preparedness and Response Plan (PPRP).

"Therefore, ad hoc and make shift plans were made and
implemented in urban communities to fit the available
healthcare facilities, ignoring the majority rural
population," the scientists said.
Steps should also be taken by the government to establish
public health infrastructure for long term benefits and equity
in healthcare services, the scientists said.

Soon after the pandemic declaration by WHO, India began
checking passengers arriving at international airports for
symptoms of influenza and for testing for H1N1 infection.

This process, although well known to be insufficient to
stop the entry of the virus and spread within the country,
gave an additional 2-3 weeks of time to slow down the spread
which should have been sufficient to rapidly activate the PPRP
for systematic interventions.

According to the earlier version of PPRP, a Crisis
Management Committee and a Pandemic Intervention Committee
were to be established as soon as the threat was perceived to
be at our doorsteps.

The experts said that the Government had formulated a
pandemic preparedness plan following a WHO advisory which
failed after the swine flu outbreak as India does not have
sufficient health infrastructure to implement it.

The expectation was that influenza PPRP could be
implemented through the National Institute of Communicable
Diseases (NICD) under the Department of Health Services (DHS)
of the Ministry of Health and Family Welfare supported by the
Indian Council of Medical Research. PTI SPC
JVN