In the past few weeks, Pakistan like many other countries in the region, has observed an increased incidence of H1N1 cases. WHO wishes to put this H1N1 recrudescence in the right context by reaffirming the following: H1N1 is a seasonal influenza illness showing its most active transmission in the colder months of the year, especially when the air is humid and loaded with aerosols as it is currently the case with persistent fog in the North Western plains of the country.
-- Influenza virus poses an incremented risk of complications (mostly pneumonia and respiratory distress) among the elderly, and patients with underlying conditions that weakens their immunity. In the immense majority of cases the illness develops as flu with the classic pictures of fatigue, joint aches, moderate to severe temperatures, and general alteration.
As for most viruses, there is no radical remedy, and a symptomatic treatment remains the norm. Yet, the administration of Oseltamivir when given within 48 hours after onset may alleviate the severity of the disease and prevent the occurrence of complications within the patients at risk.
-- Neither a mass nor a targeted distribution of Oseltamivir as a measure of prevention would have any significant effect on the incident of H1N1. It is also worth to remind the negative effect of misuse of any antiviral or antibiotics with regard to the development of antimicrobial resistance, a problem that is now taken very seriously by the health authorities of Pakistan within its global health security agenda. The conduction of immunization campaigns at this stage of the season would also divert resources unnecessarily as they would result very poorly in controlling the transmission. The norm is to ensure limited stockpiling of Oseltamivir for patient at risk and early detected. It is also to make available seasonal flu vaccine (which contain H1N1 protection as well) for the people who, despite the very limited efficacy of these vaccines when taken so late in January, wish to be immunized.
The targeted immunization of health personnel would also result mildly for the same late temporality reason. Such measures find their maximum efficacy when administered just before the winter starts, in the September-October period.
-- H1N1 does not require any specific hospital rearrangement in the form of confinement or personal protective equipment (PPE). Rather, a systematic hand washing and mask protection, with basic hospital hygiene are the basic occupational measures that the medical and health professionals must observe.
-- In most of the cases, fatalities associated with H1N1 or any other flu viruses occur among patients with underlying conditions. WHO reiterates its commitment to the Government of Pakistan in addressing H1N1 within the internationally recognised norms and guidance, and wish to express it support to the current awareness campaign initiatives lead by provincial and federal health authorities.
WHO considers paramount the singular role and responsibility of the medical and health professionals to affirm proper messaging regarding H1N1 in order to systematically dispel any misconception about the illness. The role of the press is no less critical in avoiding the spread of false rumour amenable to generate panic and malpractice around the disease.
H1N1 is not Ebola, it is not Dengue, and it is not measles. This is true in term of fatality rate, severity of the disease, complication risk, transmission mode, contagiousness, protection measures, treatment course, patient safety, and prevention measures. H1N1 needs to be identified and notified to health authorities, so that compliance with the International Health Regulation is ensured.-PR