Four members of a Kurla family contracted H1N1 infection, and among them, a two-and-a-half-year-old-girl had to remain hospitalised for 33 days as she battled for her life due to secondary complications arising out of the viral infection. The child had to be put on a heart-lung machine for 15 days. According to her family, apart from lung malfunction, she ran a risk of shutdown of other organs. The family footed a bill of Rs 9.3 lakh to treat her, even after the hospital waived 26 per cent of the bill.
Amina Shaikh developed symptoms in July when she started having coughing fits. According to her family, she was initially treated by a local physician and later admitted to Kurla Nursing Home. ECMO, or Extra Corporeal Membrane Oxygenation, is an expensive machine that takes impure blood from the body, purifies it and pumps it back into the body. It is not routinely prescribed, but used when all other options to save life have been exhausted. Amina remained on ECMO support for 15 days, running the risk of excessive bleeding.
“Doctors told us she required ventilator support. Her lung function was worsening,” said her uncle Saqib Khan. The child was shifted to Narayana SRCC Children’s hospital where H1N1 was confirmed. She remained admitted for 33 days until her discharge in September first week.
“She suffered from rapidly progressive hypoxemic respiratory failure to acute respiratory distress due to H1N1. Such complications are rare. But this year, we are seeing an unpredictable pattern of H1N1 disease,” said neonatal intensivist Dr Amish Vora, adding that H1N1 cases were also seen in early summer, which was unusual.
Amina’s mother Naziya, elder brother Ali (4), and eight-month-old younger brother Mohammed also tested positive for the virus in Kasturba hospital. Her family of 15 members in Kurla is currently on preventive medication to avoid the viral infection.
Amina suffered the worst complication of the infectious disease in her family. She was initially put on ventilator support but even intensive care failed to support her lung and heart. “Doctors told us they will have to use ECMO and survival chances were only 25 per cent. We had no option,” Khan added. She suffered seizures during treatment and paralytic attacks, the family said. Her father, Taalim Shaikh, had to borrow money from relatives and friends to pay for her hospital bill that escalated to Rs 9.3 lakh, after a discount.
Amina also had low white blood cell count. Her lungs stopped functioning despite ventilator support. A team of cardiologist Pradeep Kaushik, pediatrician Vinoo Tibriwala, and dietician, anaesthesist, and physiotherapist monitored her. She is currently under home care, visiting doctors for routine checks.
According to Vora, only two percent of H1N1 infections require ICU support of which hardly few need ECMO.
“We use it sparingly when patients need oxygen support. It is also expensive. In our hospital, we used it last year when ventilator setting was not sufficient for lung functioning in H1N1 cases,” said Dr Tanu Singhal, infectious diseases expert at Kokilaben Dhirubhai Ambani hospital.