A serious spike in respiratory infections for the past several weeks, mostly Influenza A (H1N1 and H3N2), respiratory syncytial virus (RSV) and COVID, has had the OP clinics and casualty wings of hospitals getting filled with people rushing in for consultations.
While there has been no spike in unusual or sudden pneumonia or hospitalisations, influenza can take a bad turn in the elderly and those with serious comorbidities, doctors warn.
While this is the normal season of respiratory illnesses, the cooler weather with occasional rainy spells has seen the co-circulation of all viruses, especially Influenza A and RSV, which has been leaving people with persistent cough and fatigue lasting over weeks. The Sabarimala pilgrimage season and crowding are expected to make the situation worse.
Since mid October-November, there is also a spike in COVID, probably because most cases of fever with cold/cough are getting tested now. There is also intense speculation that the new sub variant of Omicron virus variant — JN.1 — which is said to be highly immune evasive and which has been reported detected in Kerala a day ago, could be responsible for the spike in respiratory illnesses.
However, clinicians point out that COVID endemicity is going into the fourth year and that the identification of new virus variants hardly throws up any surprises. The only red flag has to be a spike in hospital admissions or in the severity of cases.
COVID variants
“Hardly any COVID-related genomic sequencing is done now in the State. Even though JN.1 variant is said to have been detected in Kerala first, it might be recalled that this sub variant had been detected by Singapore in November from a traveller in India, during one of its airport screenings, indicating that JN.1 might have been in circulation much earlier and was undetected. COVID variants will keep emerging and co-circulate with influenza, RSV and adenoviruses, making it difficult to distinguish just on the basis of clinical symptoms. Which is why the State brought out the integrated guidelines for the management of all influenza-like illnesses (ILI) and severe acute respiratory infections (SARI) in June this year,” pointed out R. Aravind, Head of Infectious Diseases, Thiruvananthapuram Medical College.
He pointed out that the State continues to follow the ABC guidelines for testing ILI/SARI. Testing patients with fever or flu symptoms of less than three days is not always necessary. But in the case of elderly, those with comorbidities and pregnant women, who are at risk of increased severity due to ILI, the general guidelines recommend early medical consultation and testing.
Three deaths
The State reported three deaths due to COVID in the past few weeks and all three were persons with serious comorbidities, Health officials claimed.
“We are testing everyone who reports with fever and flu symptoms of over three days and all vulnerable/high-risk persons are tested regardless of the duration of symptoms. Hospital admissions have not spiked but there have been quite a few cases wherein the patients required oxygen support. The public should resume masking in crowded places. We have made masking mandatory for all persons stepping into our casualty wing. It is also advisable that the elderly are given the flu vaccine,” said Rajalekshmi A., senior consultant, Infectious Diseases, KIMSHEALTH.
