Context: There is a growing concern over the escalation of respiratory diseases, particularly Influenza A (H1N1), in India.
- The most recent data from the National Centre for Disease Control (NCDC) suggests a resurgence of Influenza A (H1N1) cases in Kerala, Maharashtra, Punjab, Tamil Nadu, Telangana, Chattisgarh, Sikkim, Uttarakhand and West Bengal, with a few states also reporting deaths related to influenza.
- In response to a rise in influenza infections in the country, the NCDC has recommended the prudent use of the Southern Hemisphere’s 2024 quadrivalent influenza vaccine.
Seasonal influenza:
- Seasonal influenza (the flu) is an acute respiratory infection caused by influenza viruses.
- It is highly contagious, affects the respiratory system, including the nose, throat and lungs, and is common in all parts of the world.
- Seasonal influenza is characterised by a sudden onset of fever, cough (usually dry), headache, muscle and joint pain, severe malaise (feeling unwell), sore throat and a runny nose.
- Most people recover from fever and other symptoms within a week without requiring medical attention. But influenza can cause severe illness or deaths, especially in people at high risk. (Young children and people with co-morbidities like asthma, diabetes, heart disease, weakened immune systems and neurological or neurodevelopmental conditions are at a higher risk).
Influenza viruses are constantly evolving:
- In India, the most prevalent subtypes are influenza A (H1N1), (H3N2), and influenza B viruses. Every year, there are outbreaks of influenza in India, particularly during winter.
- Influenza viruses are constantly evolving, and the factors include:
- High population density, poor hygiene practices, weather conducive to the survival and spread of the virus increase the risk of flu transmission.
- Indiscriminate antimicrobial use: The absence of definitive diagnosis and influenza symptoms coinciding with other acute respiratory infections, makes the clinical differentiation of influenza from other pathogens difficult, leading to indiscriminate outpatient antibiotic prescription.
- Low Vaccination rates: Due to lack of data on morbidity and mortality caused by influenza in India, strategies for influenza prevention and control have not been prioritised by the Indian Medical Association, and influenza vaccine is not included into the government’s Universal Immunisation Programme.
- Climate change:
- Due to climate change, seasonal epidemics of influenza may shift spatially and temporally, with rising temperatures and abnormal rainfall patterns being contributing factors.
- Extreme weather events have the potential to exacerbate risks of influenza and transmission of other respiratory viruses.
Way Forward:
- Implementation of COVID-19 vaccine programme was the beginning of an adult immunisation programme in India which must be leveraged for making other adult vaccines available in the country.
- The expansion of the Universal Immunisation Programme to include influenza vaccines needs to be considered as this will not only benefit those vaccinated, it will also reduce community transmission, unnecessary antimicrobial prescriptions and superimposed bacterial infections that can complicate influenza and require antibiotics.