Swine Flu in Nepal 2015

Influenza A H1N1 in Nepal 2015

The current swine flu outbreak around the world is caused by influenza A viruses that contain gene elements from swine, avian and humans. It started to affect persons in Mexico in March 2009 and  since then has spread to USA, Canada, several countries in Europe, New Zealand, Israel and many other countries around the world have suspected cases. The virus has demonstrated sustained human to human transmission leading WHO to declare pandemic level 5 with the swine flu as of 29 April 2009. Most human cases of swine flu have occurred in previously healthy children and young adults. Symptoms are similar to classic flu with fever, runny nose, sore throat, cough, vomiting, diarrhea. Most cases have been mild but there have been significant number of deaths in Mexico and a single death in USA.

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
27th Feb. 2015	Kathmandu	17	1
	Pokhara	6	0
	Bharatpur	7	0
	Other	1	0

Latest report of total swine flu here

Screeening of influenza

According to the  National Influenza Surveillance Network (NISN)  the total influenza H1N1 cases has reached 9 in kathmandu and 4 in chitwan  in the period between 15th feb to 24th feb 2015. The Ministry of Health and Population (MoHP) has sounded an alert that the viral Swine Flu, which is spreading in India, has high chances of entering Nepal. A large number of people cross the open border from India and come to Nepal every day. In a statement addressed to the common people, medical authorities and media persons, the MoHP has stressed the need for adopting necessary safety measures to prevent the outbreak and onslaught of Pandemic Influenza A H1N1. Cases of viral flu, reported as increasing in Rajasthan , New Delhi and Madhya Pradesh of India, have already claimed more than 837 lives. Looking at the spread of the disease across the border, the MoHP has placed western Nepal in the vicinity as being at a greater risk of viral outbreak than other parts of the country. In the far-western development region, the District Public Health Office (DPHO), Kanchanpur, has set up health desks at Gaddachauki and Belauri citing high possibility of the disease entering the country owing to the open border with India as hundreds of Nepalese and Indian nationals enter Nepal through these check point every day. Likewise, high alertness has been maintained in Nawalparasi district. Chief of the District Health Office, Jay BahadurKarki, said that all health workers in the health posts and centres and from different organizations bordering to India have been directed to remain in condition. Hundreds of people enter Nepal from India through different entry points as Maheshpur and Triveni.

 Though the people of bordering towns with India were said to be more susceptible to contracting the disease, two people were found to have been 'infected' with H1N1 influenza virus in Pokhara.

According to Bal Krishna Bhusal, chief of the district public health office at Pokhara, the swine flu was detected while conducting tests on the blood sample of two patients admitted at Western Regional Hospital in Pokhara. The infected are 21-year-old male and an 11-year-old child. Since both are residents of Pokhara, Bhusal stressed on the need to intensify the awareness programme about swine flu in the tourist town.

How is it transmitted ?

Electron microscope image of the re assorted H1N1 influenza virus

The transmission of flu is mostly via droplets produced by an infected person when she /he coughs or sneezes. Infected individuals may also contaminate surfaces with their secretions. Surfaces can harbor infectious material for longer periods of time. Because all influenza viruses have the ability to change, scientists are concerned that the current H1N1 virus could change or mutate to a more virulent form that is capable of spreading more easily from person to person and causing severe disease leading to an influenza pandemic that is capable of causing millions of deaths worldwide.  Because swine flu viruses do not commonly infect humans, there is little or no immune protection against them in the human population.

What are the symptoms and can we do to prevent?

If you have a flu like illness without any history of travel to swine flu affected countries in the past one week, it is suggested that you stay away from school or office. Authorities are looking out for cases in travelers who have visited areas with swine flu outbreaks who may have been in contact with persons with the swine flu. If these persons develop  influenza like illness, a certain precautions are followed. Simple measures like washing hands frequently cuts down the rates of infection. Surfaces, door knobs etc. need to be kept clean at home and in the work place.  Alcohol based hand sanitizers can also be used especially if there is water shortage. Obtain the flu vaccine which will not protect you from the swine flu but it will protect against regular flu.

The U.S. Centers for Disease Control and Prevention recommends the use of oseltamivir (Tamiflu) or zanamivir (Relenza) for the treatment and/or prevention of infection with swine influenza viruses; however, the majority of people infected with the virus make a full recovery without requiring medical attention or antiviral drugs. Nepal has a small stock of this antiviral medication with the Health Ministry and it is believed that this or other antiviral medication will be available should there be cases of swine flu in Nepal. CIWEC have a small stock of Oseltamivir and significant amounts of personal protective equipment for clinic use and will continue to monitor the situation around the world closely. In the meantime, if you have a fever, postpone travel to and from countries with swine flu outbreak. Also, find out if there are any travel restrictions in the countries that you plan to visit. If you have traveled to a country experiencing a swine flu outbreak, monitor your health for one  week after return and see a healthcare provider if fever or respiratory symptoms should develop.

Where to go to test for swine flu ?

In Nepal swine flu test is controlled by National Influenza Surveillance Network (NISN) which is a active body of National Public Health Laboratory which works under the supervision of Ministry of Health and Population (MoHP). For the test you can visit Teku Hospital in Teku and goto the top floor of the National Public Health Laboratory. It is necessary you to show the doctor's prescription. Also it is advised to visit only the person has developed symptoms such high fever, cough, sore throat, body aches, headache, chills and fatigue.

Contact Details of the screening center

Coordinate  27.695438° N  85.306321°E