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Five H1N1 deaths in Kerala, surge in Gujarat and Rajasthan push fatality rate to over 20%

Officials in the Health Ministry fear this may be a year in the H1N1 cycle of greater fatalities.

Karnataka reported 11 deaths, followed by Maharashtra (8), Andhra Pradesh (6), Punjab (6), and Tamil Nadu (2). ( source: PTI ) Karnataka reported 11 deaths, followed by Maharashtra (8), Andhra Pradesh (6), Punjab (6), and Tamil Nadu (2). ( Source: PTI )

A 25-year-old woman in Kasaragod district of Kerala died of H1N1 on Thursday, taking this year’s toll in Kerala to five. Health officials expressed concern over the spurt in deaths caused by the influenza in Gujarat and Rajasthan over the past few months.

Officials in the Health Ministry fear this may be a year in the H1N1 cycle of greater fatalities. There has been a 21 per cent fatality rate from the disease this year — or one in every five people who contracted the disease have died.

Until June 8, officials said, 89 deaths had been registered while the total number of H1N1 cases was only 414. Gujarat with 31 deaths and Rajasthan with 22 deaths contributed more than 50 per cent of the deaths reported in the country so far. In Rajasthan, one in every two people who got the disease died, while in Gujarat about one in three succumbed.

Karnataka reported 11 deaths, followed by Maharashtra (8), Andhra Pradesh (6), Punjab (6), and Tamil Nadu (2).

Kerala, which saw three deaths until June 8 and two more after that, has reported 31 cases of H1N1 this year and the number is rising, according to the Disease Surveillance Cell of the state health department. Officials said 18 of the cases were reported in the past three weeks — after the monsoon hit the state.

Kasaragod DMO P Gopinathan identified the latest victim as Nirupama, a housewife from Paivaligae, a village close to Mangalore. She used to travel frequently to Mangalore, where a few cases had been reported. She was admitted to a hospital in Mangalore with fever and cough last week, he said.

Health officials in Delhi said the high fatality rate this year is a cause for concern as compared to last year. In 2013, there were many more cases. Between January and December last year, 5,253 cases were reported. But the fatality rate was far less at 13 per cent. A total of 699 deaths were reported.

While cases are expected to go up — rain always lead to a spike — there are apprehensions in the Health Ministry about the fatality rate shooting even further when cases go up. Officials, however, concede that the actual load of the influenza in both years could be several times more than what the data shows as India since the time of the pandemic in 2009-10 has a policy of testing only those patients who are admitted to the hospital with respiratory distress.

Director General, Health Services, Dr Jagdish Prasad said the higher death rate is because of lack of awareness, which means people are reporting late. “We have written to all state secretaries to step up awareness intiatives, specially states like Rajasthan and Maharashtra were there are higher numbers of deaths. People are coming to the centres late. We have sufficient stocks of medicines both for children and adults and have sent them to whichever state has asked. But it is important that people report early when they have symptoms like cold, respiratory problems, fever etc.”

An interesting feature of H1N1, right from the time the first pandemic was reported in 1917-18, said sources, is the higher fatalities in southern and western states. It is a trend that has continued down the century. All four southern states — Telengana is not factored into the figures yet — have reported deaths as have Rajasthan, Gujarat and Punjab. The 2009 H1N1 pandemic was officially declared over in 2010 but India reported more than 20,000 cases that year. The figure went down dramatically in 2011 to 603 but has hovered around the 5,000 mark since.

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