[period flu]Kolkata： Flu in the time of pandemic; similar symptoms cause familiar Covid alarm
KOLKATA: Even as the city and the state brace for the third wave of the pandemic, non-Covid influenza, swine flu and cases of Respiratory Syncytial Virus (RSV) have started climbing in Kolkata. Several symptoms are similar to and common with Covid, leading to a scare.
Hospitals and physicians say there has been a five-fold rise in influenza cases and a substantial increase in swine flu, leading to panic and a clamour for admission. About 10%-15% of patients admitted at three leading private hospitals in Kolkata suffer from influenza.
Influenza A, which includes the H1N1 virus and its non-swine flu variants, is fast turning into an “epidemic” in Kolkata, said Raja Dhar, director of pulmonology at CMRI Hospital. “We have been getting 10 cases a week, and these are just the severe ones. Symptoms are respiratory distress, fever, body ache and weakness, which are common with Covid. But RT-PCR tests are mostly ruling out Covid. These patients are responding to oseltamivir (Tamiflu group), which confirms Influenza A,” Dhar told TOI.
A cluster of Influenza A cases have been reported at Belle Vue Clinic over the last one week. “I have come across five, including a swine flu patient. Another has been put on ventilation with swine flu-like symptoms and we are waiting for a confirmation,” said Belle Vue internal medicine consultant Rahul Jain. All Influenza A patients, who turn serious and need hospitalization, should be administered oseltamivir, he said, adding, “For the rest, the ones suffering from just mild fever and cough, paracetamol and symptomatic drugs are enough.”
There has been a sharp spurt in influenza cases because of temperature fluctuations triggered by the onset of monsoon, said Sauren Panja, intensivist, RN Tagore International Institute of Cardiac Sciences (RTIICS). “Influenza, para-influenza and adenovirus are active now due to the seasonal change. Symptoms are innocuous: mild fever, cough and body ache, but since they overlap with that of Covid, patients are often rushing to doctors and hospitals. In most cases, though, RT-PCR tests are ruling out Covid,” he said.
Respiratory Syncytial Virus (RSV) has also been striking children, Panja added. This causes infection in the lungs and respiratory distress, which, again, is causing a Covid scare. “Parents are often bringing their children to hospitals fearing Covid. RSV has been frequently detected since Covid cases started sliding. The initial symptoms are similar and you can’t be sure until you get tested for Covid,” said paediatrician Santanu Ray.
Dhar added that since swine flu tests are expensive, treatment is symptomatic in most cases. “Our microbiologists believe that a majority of those reporting with symptoms have swine flu,” he said.
Once H1N1 strikes, there is a 30%-40% chance of other family members getting affected, say doctors. Transmission happens in two ways: through droplets released by the patient through coughs and sneezes (air-borne) and by contact with the patients’ clothes (fomite transmission). The modes of transmission are similar to Covid’s.
“It is difficult to prevent transmission once you come in close contact with a patient either at home or at work. So, if a family member is affected, hospitalization is recommended, for it ensures isolation. More importantly, it is difficult to predict if the H1N1-triggered illness is going to be serious. Often, it starts with a minor breathing difficulty and severe coughing and again, like Covid, may turn fatal,” said AMRI Hospital consultant Debashish Saha.