Doctors have alleged that guidelines on H1N1 tests lack clarity, especially when it comes to paediatric cases, and that a systematic investigation is missing in the public health system, which often lead to under reporting of swine flu cases, even as Chief Minister Vijay Rupani has rejected the allegations. Doctors feel that swine flu test during stage three — when a patient gets respiratory problems — leads to under-reporting of positive cases.
“For children, waiting from stage one (cold and mild fever) to three is often risky. In children, we should look for symptoms like lethargy instead of waiting till high fever. If we are able to diagnose swine flu in the first stage, then we will not have to give them other medicines as there are side effects,” said Dr Vatsal Shah, a paediatrician at Ahmedabad’s Sydney Hospital. Recently, 17-month-old Darshan Pagi, who was suffering from swine flu, died on August 14 while being transferred from the civil hospital in Sola to that in Asarwa due to lack of oxygen.
According to sources, his swine flu was detected in stage two when he started showing lack of activity. Although, he had fever (stage one symptom) on August 9, a local doctor gave him flu medicines. It was when his condition deteriorated, he was brought to the hospital on August 11. At a press conference following the incident, Chief Minister Vijay Rupani had pointed out the need to immediately identify the H1N1 virus to avert complications. “I am aware that waiting till stage three is is a protocol of the World Health Organisation and the government, but we are a densely populated country,” said Dr Mitesh Shah.
Dr Dileep Mavlankar, director of Indian Institute of Public Health, questioned the private surveillance in the state. “Are all the private hospitals reporting every case and death? We tend to stop with just counting the figures. We have to do a post-mortem of any epidemic. A systematic investigation is missing in the public health system.”
Dr Mavlankar added internal reports are made and discussed. “But there is no public report. We have to have a robust data maintained as it helps in understanding and planning the future course of action,” said Dr Mavlankar.