Influenza and leptospirosis have emerged as major killers this season in Keralam, with both diseases together claiming close to 300 lives in the State.

As on September 15, the State has reported 10,244 cases of influenza — which includes primarily A H1N1, A H2N3 and Influenza B — and 109 deaths due to the infection, a sharp rise when compared to previous years. Confirmed leptospirosis deaths in the State touched 100 as on September 15, apart from 78 probable leptospirosis deaths. However, health officials maintain that the count is less when compared to previous years.

Influenza cases have seen a steady rise across the nation this year and almost all States have reported a sharp spike in influenza A (H1N1) cases. Unpredictable weather patterns, high temperature and humidity and possible mutations in seasonal flu viruses could have contributed to this sharp spike in cases.

H1N1 cases have been on the rise since the past few months in Keralam and it has been claiming a disproportionately high number of lives of senior citizens, leading public health experts to demand that the government should invest in flu vaccination for the elderly.

While it presents like the common cold, with fever, chills, sore throat, cough and myalgia (body ache), influenza can turn out to be a serious disease amongst the vulnerable population. The Health department’s influenza A H1N1 ABC guidelines do not recommend routine testing for mild cases and only those who reach the outpatient departments of hospitals with serious symptoms are being tested now. Hence, the official tally reported under the Integrated Disease Surveillance Programme does not reflect the actual caseload in the community.

“The virus spreads easily through the respiratory route and through surfaces contaminated by the infected person. Hence, people visiting hospitals with flu symptoms should necesarily wear masks and maintain respiratory hygiene or else hospitals can become huge disease transmisson points,” says a health official.

Patients with mild fever and cold symptoms do not need testing or Oseltamivir and can be managed with home isolation and supportive management. However, pregnant women and those with high-grade fever, persistent symptoms, and other morbidity should see a doctor and start Oseltamivir early.

The red flag signs are breathlessness, chest pain, and low oxygen saturation and these are the patients who would need hospitalisation and intensive care.

Doctors are advising people not to self treat and remain at home if the symptoms are worsening or not subsiding because starting Oseltamivir early can make a huge difference. In the private sector, doctors are advising the elderly and those with comorbidities to opt for the annual flu vaccine if they can afford it as the vaccine can reduce the chances of infection and even when infected, prevent serious disease, hospitalisation, and death.

In the case of leptospirosis, late diagnosis and rapid progression of the disease continue to claim lives. As the symptoms of the disease overlaps with that of any viral fever in the initial days, doctors in the periphery are now being told to start doxycycline in all cases of fever without respiratory symptoms because doxycycline at any point in the course of illness has been found to be effective.

Despite health advisories, people for whom the disease could be an occupational hazard — farmers, manual cleaning workers, gardeners or dairy farmers — continue to ignore the directive to take proper doxycycline prophylaxis. Local self-governing bodies should necessarily provide protective gear to these category of workers, it is pointed out