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Mumbai mother,diabetic,is second H1N1 death

A 33-year-old housewife from Mumbai died today after contracting the H1N1 virus,becoming the second victim of swine flu in the country...

Written by Swatee Kher | Mumbai |
August 9, 2009 5:16:35 am

A 33-year-old housewife from Mumbai died today after contracting the H1N1 virus,becoming the second victim of swine flu in the country and sparking fresh concerns in Maharashtra,to which both victims belong.

As in the case of 14-year-old Reeda Shaikh,who died in Pune earlier this week,Fehmida Zubin Patanwala was diagnosed as infected by the virus only when she was critical and while she was being treated for other illnesses. Doctors are yet to determine how she contracted the virus.

Patanwala,mother of a 13-year-old boy and resident of the city’s western suburb of Versova,had a history of severe diabetes and hypertension and was taken to a local physician after she got fever a week ago. Like Reeda,she was diagnosed as suffering from bronchitis and was taken to Ruby Nursing Home in Jogeshwari when her condition worsened after four days. Patanwala’s condition,however,turned critical on Friday and she was moved to Lilavati Hospital.

But with doctors there suspecting H1N1,she was moved within three hours to the government Kasturba Hospital,which is the designated centre in Mumbai for suspected swine flu patients. Her throat swab was sent to the National Institute of Virology in Pune. The test results came at about 3 p.m. today,around the same time she died.

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Dr Madhavi Kelkar,who treated Patanwala at Ruby Nursing Home,said that her initial symptoms suggested bronchitis. “She was coughing and seemed to have respiratory problems. She was admitted and her treatment included antibiotics,” Kelkar told The Sunday Express.

On Friday afternoon though,she complained of breathlessness and was moved to the ICU and put on a ventilator. “Once stable,her X-ray and other tests were conducted. The X-ray pointed towards viral pneumonia,” Kelkar said.

With her condition fluctuating,doctors asked her if she had come in contact with anyone who had been abroad recently or was from outside Mumbai,even as they decided to move her to a bigger ICU at the Lilavati Hospital,Kelkar said.

Sources at Kasturba Hospital said Patanwala was short of breath and gasping when she was brought in a cardiac ambulance from Lilavati at 11 p.m. on Friday. She was put on Tamiflu,the drug to treat H1N1,even as her throat swab was sent to Pune for tests.

Patanwala celebrated her birthday last Saturday and her family said she had neither any travel history nor was known to have come in contact with another swine flu suspect.

“On Sunday evening,she developed fever,and was vomiting and coughing. We admitted her to the nursing home in Jogeshwari where she was treated. On Friday morning,she developed Acute Respiratory Distress Syndrome and was rushed to Lilavati hospital. From then her condition worsened,” said her brother Shakeel Patanwala.

Patanwala’s extended family had gathered at the hospital since the morning and she was buried late on Saturday,relatives said.

State health officials convened an emergency meeting after Patanwala’s death and Additional Chief Secretary (Health) Sharvaree Gokhale said it was not yet decided if the emergency Epidemic Act,which gives authorities special powers to stop the spread of the infection,would be imposed in Mumbai like it has been in Pune and Satara. “We will decide on rules for festive gatherings in coming days,” Gokhale said,referring to the Janmashtami and Ganesh Chaturthi celebrations in the state later this month.

“It is again a case of delayed treatment,” said Vineet Chowdhary,Joint Secretary in the Union Ministry of Health in New Delhi. “There was some underlying disease like morbid obesity but we will get the full report tomorrow.” Dr V M Katoch,Director-General of the Indian Council for Medical Research,backed that assessment. “We have been saying again and again that there should be no delay in treatment and if private hospitals suspect something they should refer patients to designated facilities,” he said.

Dr Jairaj Thanekar,the executive health officer for Mumbai at the city corporation,said that an expert had been appointed to investigate the issue of delayed assessment of Patanwala’s H1N1 infection and Chief Minister Ashok Chavan had called a meeting of health officials on Sunday to update plans to tackle the infection.

Officials said that doctors,nurses and wardboys at Ruby Nursing Home had been asked to get themselves tested for the virus at Kasturba Hospital while another patient who was in Patanwala’s proximity could be quarantined.

Meanwhile,71 laboratory-confirmed cases were reported today: Pune (34),Mumbai (2),Chennai (7),Delhi (13),Amritsar (1),Faridabad (1) Bangalore (10),Manipal / Mangalore (3).

Except for a 34-year-old male who travelled from UK,all the other 33 are indigenous cases,most of them reporting social or school contacts. Of the 13 cases in Delhi,two have travel history (an 11-year-old girl who travelled from Singapore and a 13-year-old boy who reached Delhi from Manchester via Doha).

“The more cases reported indigenously means that the spread is now in the community,” said Katoch.

The Ministry made a presentation at the conference of state Chief Secretaries in the capital today. In a letter to states,the Union Health Secretary said that the Ministry is looking at the possibility of involving private labs and hospital in the response mechanism.

All states have been asked to set up their “swine flu helplines” and identify more hospitals for treatment and testing. Private labs suitable for testing H1N1 virus should be verified and accredited,the letter said. All districts have been asked to stockpile Tamiflu to treat 1000 patients at a time. “States should have additional stocks to treat 5000 patients,the number has been increased to 10,000 for metros at any given time,” said the Health Secretary. (with Toufiq Rashid,New Delhi)

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