Pakistan's experts warn of swine flu outbreak

KARACHI - Expressing concern over the spread of swine flu in India that has claimed the lives of almost 1,500 people since December, experts have called for precautionary measures against the infection at a personal and government level.

They have also rejected media reports that have linked swine flu with poultry, insisting that swine flu does not infect birds. The influenza virus that infected birds was H5N1.

Swine flu, according to experts, is a respiratory disease caused by the H1N1 strain, a subtype of the influenza A virus, that also circulated among pigs.

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"Swine flu doesn't infect poultry so reports causing alarm regarding poultry food are false.

But, there is a need to be cautious because people are coming from and travelling to the neighbouring country on a regular basis," said Dr Masood Rabbani, Director of the diagnostic laboratory at the University of Veterinary Sciences, Lahore, who is also heading the microbiology department at the university.

On whether it's the same virus that caused a global panic back in 2009-2010, Dr Rabbani said that it seemed to be the same strain but there was international concern regarding whether changes had occurred in the virus.

India, he said, has been reporting mortalities as a result of swine flu since 2009 and it was quite possible that the virus may have become more lethal, or less dangerous.

According to Dr Rabbani, swine flu is said to have been developed due to a re-assortment of bird, swine and human flu influenza viruses, in pigs.

"Swines are susceptible to infection with both avian and human influenza viruses. The mammalian species acts like a mixing vessel. The swine flu virus is a ribonucleic acid-based virus that means it can mutate very quickly.

"Once it takes shape and is transmitted to humans, a pig population is not necessarily required to acquire the infection and the virus is typically contracted by person-to-person transmission through respiratory droplets," he explained.

Responding to questions on swine flu, Director Laboratory Services and Consultant Microbiologist at the Indus Hospital Dr Altaf Ahmed referred to a recent Massachusetts Institute of Technology research paper according to which the Indian strain carried new mutations, which has made the virus more virulent.

"There are many factors that have contributed to the spread of this disease in India that, among other, include lack of easy access to rapid diagnosis and lack of strategy and awareness among patients as well as healthcare workers," he pointed out.

Swine flu, he said, has symptoms similar to human influenza and no serious signs, like bleeding, occurred.

"One has to be aware that the infection could be swine flu and test for the disease. Though disease diagnosis is easy and could be done at any good microbiological laboratory, diagnosis of swine flu in the public sector is only done at the National Institute of Health in Islamabad," he said.

He added that the Indus Hospital had the facility for testing swine flu but there was no demand for testing from doctors.

The government, he said, should set up well-equipped and well-staffed centres for communicable diseases and hold sessions for teaching infection control to nurses and doctors, besides creating public awareness.

Giving feedback on questions relating to swine flu, head of the Infection Control Committee at the Aga Khan University Hospital, Dr Afia Zafar said that no case had been reported from the hospital so far.

"It's a highly contagious disease. The currently available influenza vaccine contains the H1N1 antigen but it's not proving that effective (in India). The elderly, people with compromised immune systems, infants and pregnant women are more vulnerable to the infection," she said.

Simple good health habits like washing hands with soap or sanitisers frequently and covering one's mouth with a tissue while coughing and sneezing could help prevent many infections, she added.

"I have noticed that respiratory infections are becoming severe and patients are taking more time in recovery. The situation could become worse in case of a swine flu outbreak," she said.