A persistent cough, sometimes accompanied by fever, running through India for the past two-three months is due to Influenza A subtype H3N2, the Indian Council of Medical Research has confirmed.
The ICMR and the Department of Health Research Organisation have established pan-respiratory virus surveillance across 30 viral research and diagnostic laboratories (VRDLs).
Surveillance data from December 15 to date reflects the rise in the number of cases of Influenza A H3N2. About half of all inpatient severe acute respiratory infections (SARI) and outpatient influenza-like illnesses were found to have Influenza A H3N2.
Major hospitals in Mumbai are recording 10 to 12 cases of influenza every day and most patients are aged between 25 and 50 years. They have reported symptoms such as high fever, throat pain, cough and cold.
“We are witnessing an increase in the number of influenza cases and many of them are quite aggressive. Some patients require hospitalisation and even ICU admissions,” said Dr Sanjith Saseedharan, consultant and head of critical care, SL Raheja Hospital, Mahim.
This year the symptoms seem to be more severe because of multiple reasons, said doctors. Many elderly patients with co-morbidities would have missed out on their annual influenza vaccine. This could also be due to precautionary measures many followed, including avoiding crowded spaces and masking. “The pandemic could have also changed the virulence of the organisms,” said Dr Saseedharan.
Emphasising the clinical features of Influenza A H3N2, ICMR has said that this subtype appears to cause more hospitalisations than other influenza subtypes.
“Out of the hospitalized SARI patients with Influenza A H3N2, about 92% are suffering from fever, 86% from cough, 27% from breathlessness, 16% with wheezing. Additionally, 16% had clinical signs of pneumonia and 6% had seizures. Also, 10% of SARI patients who have H3N2 needed oxygen, and 7% required ICU care,” the ICMR stated.
Paediatricians are also seeing an increase in the number of children coming to the OPD. Dr Soonu Udani, Medical Director, NH SRCC Children’s Hospital, said there are many children being admitted with pneumonia who show adenovirus on the PCR from the lungs.
“Outpatient profile too is of prolonged cough for four to six weeks and high fever lasting for over a week. Most are not tested for the virus. Masking and cough hygiene is the only prevention. Any persistent symptoms must be seen by a doctor. Persistent fever for more than seven days of flu, breathlessness is a danger sign. Disturbed sleep due to coughing may require some symptomatic treatment,” he said.
