In the past week, at least 83 people have died of pandemic H1N1 virus infection in India (NetIndian, August 16, 2010). The deaths have occurred throughout India. The largest number of deaths occurred in Maharashtra (51). Over 1,000 new infections have been reported in the last week. Many of the deaths have occurred in pregnant women and middle-aged people. Health care workers are also becoming infected (expressbuzz, August 11, 2010).
A family cluster of deaths has occurred in Orissa. A father and his daughter both died of the disease recently (indiaserver.com, August 13, 2010). A mother and her daughter died of pandemic H1N1 virus in Karnatka (Deccan Herald, August 13, 2010). Clusters of death are always of concern because they may indicate that a more lethal viral strain has evolved. Reports of multiple family clusters of death is new and requires prompt investigation. As always, complete sequences of the viruses causing these clusters of death should be obtained.
Public health measures vary from region to region in India. In Goa, tourists are being warned of the dangers posed by swine flu in the region (RxPG News, August 13, 2010). Public gatherings are being discouraged. Vaccine and Tamiflu appear to be in short supply in some areas (TopNews, August 14, 2010). There is a rush to obtain N95 respirators (Times of India, August 12, 2010).
Despite Margaret Chan’s assertion that the pandemic is over, the situation continues to worsen in India. We should also consider the possibility that neighboring countries, Pakistan, Bangladesh and China have similar outbreaks but which are unreported. It is unlikely that the virus has decided to remain active only within India’s borders. India has a strong democracy with a vibrant, free press. This likely explains why there are reports of large numbers of flu cases and deaths in India, but silence from most of its neighbors.