They call it the dirty room. It is here,at the clinical specimen handling section of the National Institute of Virology (NIV),Pune,that nasal and throat swabs of people who are suspected to be infected with the H1N1 (swine flu) virus are processed,bottled,made into aliquotes and then dispatched to the cleaner rooms. For the past two months,a team of 25 scientists,technicians and medical experts has been working hard,trying to send reports to the government within 12 hours of handling the virus and testing it for swine flu. It is a virus that is part human,part bird and part swine and one that the world still does not fully understand,says Dr M.S. Chadda,deputy director and scientist-E in charge of the human influenza team at NIV. We dont have antibodies to fight this virusone of the reasons why it is affecting a lot of young people, he says. With 17,000 reported cases across 60 countries and more than 100 deaths,the easy transmissibility of this virus is frightening. The WHO is debating whether it should scale up the level of pandemic from Grade V to VI. Influenza is a virus that keeps on changing. Also,the virus has to keep itself alive in nature. So when the genetic material of the virus comes into a hostbird,human or swinea novel virus is formed and can attack anyone, says Chadda. NIV has been designated by WHO as national influenza centre. So what goes on at the laboratory where virologists have to take utmost precaution to ensure they do not get infected? All the respiratory specimens come to NIV and these are also sent to the National Institute of Communicable Diseases at Delhi, says Chadda. A crucial test is the real-time polymerase chain reaction (PCR) test that detects the virus. After the initial handling of the virus,pathogen-free eggs are used and the virus is grown in MDCK cell lines. NIV has its own cell line but another one has been obtained from the Centre for Disease Control,USA. The characterisation of the virus is nearing completion,says Dr A.C. Mishra,director of NIV. Another week and the full genome analysis of the virus will be complete. So far the virus that was isolated from the throat swab of the patient infected with swine flu from Hyderabad shows similarities to the one in the US and Mexico. We do not expect any notable changes in the virus that infected people in New York or India, he says. The next step,say NIV scientists,is to make a vaccine within six months. They all feel that the pandemic preparedness for the avian influenza (H5N1) has come in handy for detecting and containing the novel H1N1 virus. This has also led them to launch a study to find the disease burden for influenza in the country. Two centresKEM Hospital in Pune and AIIMS in Delhiwill participate in this study. Hospitalised patients who are suffering from severe acute respiratory infection will be studied in this ambitious effort. Presently there are three strains of influenza circulating in the countryA (H1N1) human influenza,A (H3N2) human influenza and Influenza B. An influenza surveillance programme is underway at nine centres in the countryDelhi,Chennai,Kolkata,Nagpur,Vellore,Mumbai,Pune.
