Tuesday, 11 August 2009

India also treat Swine Flu as milder than Comon Flu

India will pay a severe price as much as Malaysia if they continue to
treat Swine Flu as milder than Common flu.

In USA, flu killed 36,000, an estimate based on 50% of pneumonia

Swine flu already killed 300 in 3 months. In 1 year, it will be
300x300x300x300 = 8, 100,000,000 i.e. 8 billion. I.e. it can wipe out
the entire population of earth.

This is what the rate means. Do you still think that Swine Flu will be

Fatality rate was about 20% in the early days in Mexico when there was
virtually no treatment. Only outpatient treatment as had happened to
most deaths in Malaysia, including a 20 year old student.

The lowest rate (case fatality rate, much lower than true fatality
rate) now is 0.1% but it can jump to 1.4% or 0.7%.

Spanish flu in 1918 has a true fatality rate of 0.67% in Wales, the
highest in UK.

If you take 0.1% fatality rate, the highest death for US will be
300,000 which is achieved in less than 9 months if the current rate
continue at 300 per month, because US had been so lax in preventing
Swine Flu.

China and Japan still have zero fatality rate because they have
enforced strict quarantine procedures and they will be safe with the
least fatality because vaccine will be readily available by 2010.

Doctors must be taught simple mathematics so that they can make
informed judgements and comparison of rates.


Flu view: Do not overdo it

New Delhi, Aug. 10: India may be wasting resources and placing
children at risk of side effects without good reason by giving the
antiviral drug oseltamivir to every child infected with pandemic
influenza, research suggests.

Medical experts also cautioned that India may be using up antiviral
drug stocks without being able to clearly assess the severity of the
pandemic in India because of decades of neglect of viral fevers.

A study released by Oxford University scientists today indicates that
while oseltamivir can shorten the duration of seasonal flu in children
by up to a day, it is unlikely to prevent flu complications. The study
suggests that the antiviral has little effect on asthma flareups,
increased risk of ear infections, or the need for antibiotic treatment
among children with seasonal flu.

The Indian health ministry has been providing antiviral therapy to
every patient -- child or adult -- infected with the pandemic H1N1
virus. Family members with no signs of flu symptoms have also been
asked to take the treatment.

Health officials have argued that this treat-every-case policy is
intended to prevent the spread of H1N1 into the community.

But the Oxford review of several previous trials of flu involving
1,766 children shows that antiviral therapy has only a small effect on
preventing the spread of the virus. The review appears today in the
British Medical Journal.

"It's not very good in preventing spread," said Matthew Thompson,
senior clinical scientist at Oxford University and a research team
member. "You need to treat 13 children to prevent one child from
getting flu," Thompson told The Telegraph.

The review showed that the antiviral is linked to an increased risk of

Sections of India's medical community have also expressed concern
about the government's policy of treating every patient, pointing out
that the majority of patients have mild symptoms that can be treated
just as any other flu.

"Patients with mild symptoms may not need antiviral therapy," said
Randeep Guleria, professor of medicine at the All India Institute of
Medical Sciences, New Delhi.

"Most patients with flu only need to take bed rest, keep themselves
well-hydrated, and use paracetamol to reduce fever -- while keeping
watch for signs of serious illness such as breathlessness or high
fever that doesn't go away or coloured sputum.

A meeting of medical experts called by the government today decided
that India should stockpile an additional 20 million doses of
oseltamivir. It had bought 10 million doses in May this year.

An official told The Telegraph that the issue of treating every case
has been debated during meetings of experts, but there is no change in
the antiviral drug treatment policy yet. More than 200 children have
received the antiviral in India so far since the arrival of H1N1 in
India in May this year.

India's pandemic flu death count rose to seven and the number of
infections climbed to 959 today, but doctors and virologists cautioned
that an effort to assess the severity of this flu in India is
handicapped by the lack of baseline flu mortality data.

"We're groping in the dark," said Thekekkera Jacob John, former head
of virology at the Christian Medical College, Vellore. "Is this virus
causing lower or more mortality than seasonal flu viruses in India? We
don't know."

The US, which maintains a strong surveillance network for flu
estimates, that about 36,000 people die from seasonal flu in that
country every year. Over the first three months of the 2009 pandemic,
302 people had died from H1N1 infection.

The numbers from the US suggest that H1N1 is not any more virulent
than seasonal flu viruses. India has no such numbers to compare. It is
the price India is now paying for dismissing viral fevers for decades,
one expert said.

Limited surveillance over the past five years and accounts from
hospitals suggest India also has peak flu seasons and some patients
have severe illness and pneumonia, said V.K. Vijayan, director of the
Vallabhbhai Patel Chest Institute, New Delhi.

The Indian Council of Medical Research plans to this year launch the
country's first ever study to assess death rates from seasonal flu. A
senior scientist at the ICMR told The Telegraph that influenza was not
viewed as a public health problem in India. "We have had to worry
about dengue, malaria, Japanese encephalitis, diarrhoeal diseases --
they all claim far many more lives every year."

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