Clearing the air on respiratory illnesses

Prof. Nirmal Kumar Ganguly | Updated on June 19, 2020

The Covid-19 crisis has yet again established the fact that respiratory viral infections claims the lives of thousands of people. This includes otherwise healthy individuals, young or elderly. Apart from the current pandemic, there is an equally, if not more, severe respiratory ailment that takes a toll on millions of lives – influenza.

Most of the patients affected by influenza recover in 3-5 days, but in some cases, it can lead to death. Each year, up to 6,50,0001 people die from respiratory complications due to influenza worldwide, including up to 1,11,500 children younger than 5 years. With the monsoons here, we might see an increase in influenza cases, hence we need to be mindful at least of the known respiratory infections.

Both influenza and Covid-19 exhibit similar symptoms, such as difficulty in breathing, fever, pneumonia, etc. However, both the infections, owing to two distinct viruses, need to be diagnosed through differentiated laboratory tests of throat swabs.

Influenza in the times of Covid

Testing is an important element for timely diagnosis of every respiratory disease, be it Covid or influenza. In India, a patient is tested for influenza only if he/she is hospitalised, which is sometimes rendered useless in severe cases. It is essential for PCR (polymerase chain reaction) and RT-PCR (reverse transcription polymerase chain reaction) tests to be conducted to enable timely diagnosis for both influenza and Covid respectively.

It is vital for people to stay healthy and not fall prey to any respiratory illness that may require hospitalisation as this will strain the already burdened healthcare system. This makes it imperative for everyone to be protected against diseases that already have an existing line of vaccination to prevent them against it.

Traditionally, vaccines have been associated with protecting young children, but far too many adults are affected each year from vaccine-preventable respiratory diseases like influenza. While a healthy adult may recover from influenza (commonly known as flu), the elderly or ones with weak immunity succumb to pneumonia or respiratory failure. While there is an expected delay in the development of strain-specific pandemic vaccines, we need to put our existing line of vaccines to action.

How can the Government help?

Along with a huge booster to testing and surveillance, a policy-led vaccination coverage for respiratory diseases like influenza is very crucial. Currently, Rajasthan, Maharashtra and Gujarat are among the top six States with the highest number of deaths due to Covid-19. Data from the Health Ministry’s National Centre for Disease Control (NCDC) show that these States are also amongst the top three for deaths due to the pandemic strain Influenza (H1N1) over the last ten years.

These similar trends can be attributed to multiple factors such as rapid urbanisation, underlying health conditions, large slums with unhygienic living conditions and malnutrition, besides low standards of cleanliness.

There is an existing influenza surveillance network in India, undertaken in collaboration with NCDC. This helps track influenza cases, specifically swine flu. As respiratory pathogens act in a similar pattern, a similar surveillance system can be used in Covid-19 as well. Given the current scenario, it is critical to intensify our surveillance and reporting system for H1N1 (swine flu), H5N1 (Avian flu), other influenza viruses with pandemic potential, measles and polio.

Coupled with leveraging the experience of the Pulse Polio programme, it is recommended to run a mass immunisation programme with influenza vaccine as precursor to a potential immunisation campaign for Covid-19. This can determine the flow of logistics, distribution, cold chain footprint and administration of vaccines for respiratory viruses whilst following social distancing norms. This kind of exercise or campaign will help us to better prepare for future roll-out of new vaccines and interventions.

With the impending influenza season, our protectors need to be protected too — every frontline warrior —including doctors, nurses, paramedical staff, HCWs, police force, municipal workers, etc — is entitled to be protected against the known virus. The need of the hour is a multi-pronged plan where vaccination, health education and precautions are made available to everyone.

The writer is former Director General, Indian Council of Medical Research (ICMR). Views are personal


Published on June 19, 2020

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