The State’s seasonal battle with dengue fever and leptospirosis is being complicated by the co-circulation of Influenza viruses and SARS CoV2.
The death of a few children following fever in the past few days, is possibly due to the neurological complications like encephalopathy and encephalitis caused by seasonal influenza viruses, especially Influenza A (H1N1), Health officials have confirmed.
“The seasonal rise in dengue cases was an expected phenomenon and after the major outbreak in 2017, we had been anticipating another one this year. It is not true that the Health department did not plan ahead for the seasonal phenomenon. We launched all pre-monsoon preventive activities on schedule and if one were to compare this season’s data with the same season of previous years, it is clear that there has not been an unusual surge in dengue cases this year till now,” points out K. J. Reena, the Director of Health Services.
However, it is the sudden surge in seasonal influenza viruses, especially subtype A H1N1 and deaths, which has taken the Health department by surprise, she says.
Already, 21 confirmed deaths due to H1N1 and eight probable H1N1 deaths have been reported in the State.
“In two or three cases, the patients were young children and doctors reported that they lost the patients even before anything could be done. We have already alerted our doctors that while most infections of H1N1 may be self-limiting, influenza-associated encephalitis should be a concern.
The message to the public is that during this season, every case of fever and fever with cough/cold symptoms should be tested to identify the pathogen. In the case of ILI, starting Oseltamivir immediately can save lives. Children should not be sent to school if they have fever. “We are stressing on the use of masks for children and elderly again because of the surge in influenza,” Dr. Reena added.
It is important that the public seek medical advice at least through the e-Sanjeevani portal, instead of starting antibiotics blindly for every case of fever with respiratory symptoms, she said.
Given the fact that dengue is hyperendemic in Kerala and that the vector control activities can have only limited success, a surge in dengue is not unexpected. The focus is now on reducing mortality due to dengue through early identification and management of the disease.
An academic forum of doctors are now helping the Health department train doctors in secondary hospitals and in the periphery specifically on the red flag signs as to when a dengue patient should be referred to a tertiary care centre.
Health officials pointed out that in all urban areas, especially in Thiruvananthapuram and Ernakulam, indoor breeding of mosquitoes has been found to be quite high. The Aedes mosquito’s flight range is quite limited and if one is bitten by a mosquito inside the house, it is highly likely that there are breeding sites in the home itself. Individual efforts of households in reducing vector breeding is crucial to control dengue numbers.
