Tuesday, August 18, 2009

Flu questions

One's entry back in the homeland is greeted with a line of doctors with masks seated behind the immigration desks. You are directed to go up and present a form you filled up in the plane, about the countries you visited and whether you have certain symptoms.

Its a 5 second meeting, and you go off to collect your baggage, in a chaotic area populated by some in masks, many without, a maze of carts and bags, and a few helpful staff , asking if you wanted help, with swinging your bags of the circulating belt and loading the cart, all , for a price.

With the amount of news trickling in about the closure of markets, schools, colleges , here and there, and rumors about masks disappearing from shops (to enhance illegal profit), thanks to a government making them available only on prescription, I expected some kind of heat sensing probes that someone would track the passengers with, as they came in. I half expected stuff to beep and maybe weed out the "hotter" ones for further investigations.

None observed.

Amidst the massive lethargic flow of traffic , stranded next to a rush hour bus for several minutes, one wonders at the level of protection available to a few masked types, all standees in the bus aisle, about 50 people crushed in an area meant for 22. Like a jigsaw puzzle where the pieces have curves, and they fit in tight against each other. Most without masks. Just worried about their own square foot of floor and the possibility of reaching the exit door in time. The kind of crowd that would have made even the H1N1 virus stare.

Come the monsoon, every year, folks in Mumbai go through a viral scare. Chest experts give interviews and advice in newspapers, statistics are flashed around, water contamination is highlighted, students miss more school than usual. There is talk of water borne diseases and mosquito diseases. Typhoid cholera, leptospirosis, malaria, faliciparum malaria, and various gastroenteric upsets do the rounds. Incidences of these recede with the monsoon, the city cools a bit , and the world carries on.

Just a few questions.

Given our population, our crowds, our levels of city sanitation thanks to homelessness of the worst type, and the little pleasures afforded by vices like tobacco, Tuberculosis (TB) in India currently kills 2 people every 3 minutes. It is spread through the air by a person suffering from TB. A single patient can infect 10 or more people in a year. Every year, 1.8 million persons develop the disease, of which about 800,000 are infectious; and, until recently, 370,000 died of it annually —1,000 every day.

Given that this disease, to mention just one, is so rampant, one never hears of a similar hype regarding it. The The Revised National Tuberculosis Control Programme (RNTCP) based on WHO recommendations, continues to administer, treat, followup and research all aspects of the disease.

No one, including foreign visitors to the worst slum areas in Mumbai wears masks and stuff on an ongoing basis. Our trains carrying several times the number of people they are supposed to, are used everyday by thousands of people of all ages, during epidemics, monsoons, and other crowded occasions. You can actually get lost in a major vegetable market near railway stations at rush hour.

Why is no fuss made about this ? Why are Swine flu fear scenarios being enacted by keeping schools, colleges, and markets closed , in a city like Pune ? Does it behove the Health minister to micromanage and advise schools to stop their morning assemblies and sports (but keep the school classes going), and forget that the same students will sit together in classrooms, which are not exactly sterile ? While we hear of path labs being overburdened by the onslaught of cases that land up more because of fear than actual symptoms, is any thought being given to more staff being sanctioned for the already overburdened government path labs who are testing patients for the disease ?

While Tamiflu has now attained star status, thanks to unscrupulous types hiking the unofficial price consequent to demand outstripping supply, is a strict vigil being maintained on the quality assurance aspect of the medicine , which often appears in rural markets in its counterfeit avatar , to the detriment of a patient?

There is talk of a Swine Flu vaccine . There is also a recent report from Britain about the likelihood of of people using this vaccine developing the Guillaine Barre Syndrome , a paralysing disease . We read about the National Institute of Virology getting this vaccine ready by October 2009 etc . Has the Guillaine Barre aspect of it been verified ?

How come, in a so called pandemic of major proportions, we hear a Health Minister making populist general statements, but there is no authoritative scholarly medical official statement made, by those who are experts, at, say, the All India Institute of Medical Sciences, (hitherto known for disagreements between its erstwhile Head and the former Health Minister) ?

Rumors abound about certain worldly powerful folks on the Boards of pharmaceuticals making a killing in this pandemic ; like they did during the Bird flu/Avian flu earlier . Are there any connections here?

What do we believe ? What do we discard ?

In the meanwhile, it seems that the most sensible thing to do is to avoid contact with a "T" area on the face (across the eyes, and down the nose), with anybody, and wash your hands and feet , thoroughly when you come in from outside.

Colder temperatures supposedly make these virii thrive. We are experiencing a hot non-existent monsoon this year , with drought conditions, with cities having to declare water cuts for the populations. Sanitary conditions in say Mumbai , remain unchanged. Contrast this with the drastic changes effected in Surat, Gujarat, after Plague was supposed to have made an appearance a few years ago. The entire face of Surat changed.

In the meanwhile, Mumbai's always-optimistic entrepreneurs continue to make profits in innovative ways.

A friend who travels daily to work, by suburban train to South Mumbai, mentioned seeing hawkers selling cloth masks in trains.

And you could even bargain .....


  1. This disease is new and it may take some time to develop the Antigens in the body. The worst affected are children, senior persons and persons already ill with some or multiple disesase. Persons having good body resistance may not an easy victim. People suffering from this may feel extremly weak, giddy and irritated as their body energy is fully engaged to locate the nature of new virus and develop the respective antigens. The worst things of this disease it has the same symptoms as ordinary flu and pathological determinationand medical follow up is limited to Govt. Hospitals only. Every body has a right to get his/her doubts checked. But since this is not avaiable panic is getting created.

  2. I have also wondered about all you have mentioned and don't know. They say it will be worse in the fall but in the spring and through the summer pretty much the ones who died have had underlying illnesses-- although not all. They say it's worse on the young which means those who are old probably were exposed to it during another flu outbreak years ago. The fear of another 1918 is a lot of this but that was also pneumonia when there was no treatment for it. Like you, I don't know what to think but read what I can and wait to see what it really is going to be.

  3. "What do we believe ? What do we discard ?"- this is a very good question.

    We see vested interests trying to make a profit taking advantage of scared people. So we tend to doubt whatever anyone tells us!

  4. Hello Suranga, About 6 weeks ago I had it and according to our doctors it is true that older folk (ahem like yours truly) don't seem to suffer as much as the younger ones due to the antibodies still within us. I'm hoping and praying that the next lot of flu infections is not as bad as they fear... It's a horrible thought!

  5. My doctor will have the vaccine in September and I have an appointment to get the shot. I don't believe in taking chances.

    I had not heard of the Guillaine Barre Syndrome side effect. I am sure that is very rare. My daughter had that years ago and described it like walking through mud. Sometimes my energy level is so low I think I must have it too. ;-)

    Our Health Department is not recommending closing schools. They are stressing the washing of hands often (a good idea, anyhow) and staying home if you have any symptoms.

  6. Mom's school was closed for 3 days after a few of the children had colds, but none had the Swine Flu from what we understand. When we were in Maine, there was a lot of talk on the news about Swine Flu. But coming home to New Orleans, nothing about it. In fact, there were rumors that the news reporters weren't to report about any cases in New Orleans at that point because the Jazz Festival was going on and they didn't want to scare the tourists! Who knows what to believe in this day and age. It's business - media, medicine, politicians, anything that can make money does make money and becomes a business.

  7. very pertinent points raised by you.I hope we have answers to these questions too.Another relevant observation was that while swine flu is hyped up to such an extents AIDS receives very little importance.The symptoms are slow to show and kill but are equally if not more dangerous.

  8. I think more people die of other things in India daily than these few swine flu deaths reported by media as breaking news. But sitting so far away from home and only relying on news one cannot understand if the situation is really that bad. In a place like India where people have adapted so well to make a quick buck out of any situation it is hard to believe. But where loved ones are concerned one cannot really take any chances. I keep checking with my parents regularly if things are OK and even asking if they have even slightest of the symptoms. I almost panicked when my mom told that one of my younger cousin had those dreaded symptoms and couldnt rest till i found out the test results were fine.

    Take care all you guys in India!

  9. It is shocking to me that so many die from TB everyday. It is probably the resistant strain, too.
    That has happened here in the US. People with limited means take the medicine until they are feeling better and then stop. That is one way resistant strains develop.

    I have rheumatoid arthritis and am taking some very powerful drugs that suppress the immune system. I must ask my doctor if the vaccine is even a choice for me. I think it is made from a killed vaccine, but it is something to ask about.

    I may be spending the entire winter inside my house ordering gifts from Amazon.

    I think the N-95 masks are the ones we want. Cotton cloths won't work well. I'm off to order up some masks.

    Also, when I took microbiology it seems we learned hot dry climate keeps the virus from replicating, but viruses are very clever. When conditions are not favorable, they encapsulate and wait until the climate is better.

    Wishing you rain soon. We are having a drought in Texas, where I live.

  10. Mumbai air is swirling with not just virii and bacteria and such-like, but with more dangerous stuff like rumours and suspicion and, worse still, profit-mongering.

  11. Pradipda Thank you for this very useful information.

    Rain,Manju,Darlene,Amber star,Sucharita,Aleta,HHG,Enchamted Throughout this whole thing its getting more and more difficult to decide who one should believe. I guess the thing to do is be very careful, and particular about washing hands and stuff, ensure your family members also do the same. Though at the back of mind I still believe that this is a big hype. We have so many viral infections happeneing here in Mumbai every year, no one ever checked which virus it was. Now someone has checked, called it Swine Flu virus, and the excitement has begun. Hmm.

    kate I am so sorry to hear that you had this Flu sometime ago. I hope you are recovering properly and getting your energy back. Thank you for commenting.