Influenza a (H1N1) outbreak and challenges for pharmacotherapy.
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Date
2009-04
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Abstract
Influenza A (H1N1) virus, a genetic reassortment of endemic
strain of human, avian flu and swine flu, with an inherent ability to mutate
continuously has developed a subtype which is causing present flu in
humans. As on 10th May, 2009, twenty nine countries are affected with
officially reported 4379 cases with Mexico – 1626 affected (45 deaths), US
2254 affected (02 deaths); Canada 280 (01 deaths) and Costa Ricia -8 cases
(01 death) respectively. Rest of 15 countries have reported less than 100
officially confirmed cases of H1N1 infection. WHO has already declared
Pandemic Alert V on 29th April, 2009. If the present flu achieves equivalent
virulence to that of 1918-19 pandemic flu, expected deaths will be 62
million people. Travel advisory, stockpiling of antiviral drugs – Tamiflu &
Relenza; vaccine development, activation of business continuity planning
for maintenance of essential serives etc., are some of the important
mitigation approaches, being followed all over the world. WHO has a regional
reserve of 10,000 million doses of anti-viral drugs. National Disaster
Management Authority (NDMA), Government of India, an apex body for
disaster management, in active coordination with Ministry of Health &
other stakeholders/service providers is maintaining a constant state of vigil
on the present Influenza A (H1N1) outbreak. In collaboration with UNDMT,
NDMA has outlined a strategy for Pandemic Preparedness beyond Health
in April, 2008. Various non-pharmaceutical interventions like detection,
isolation and quarantine are required to contain the situation. Accordingly,
stockpiling of 10 million doses of anti viral drugs, surveillance at airports,
isolation with strict enforcement of quarantine procedures, sustained supply
of respiratory masks & other personal protective equipment; deployment of
rapid response teams are some of the activities being undertaken by Indian
Government proactively. As situation goes to Phase VI, there will be a shift
in strategy from active surveillance, detection and quarantine to containment, treatment, prevention of spread of disease and maintenance
of business continuity beyond health sectors. The major concern is to
utilise this latency period, between phase V and VI, to fill the gaps in state
of preparedness. It is also essential to focus on development/procurement
of appropriate vaccine to manage the situation arising from any further
mutation of the existing causative virus to be resistant against existing anti
viral therapies. It is a continued effort which can save many lives around
the world and everyone has to play its assigned role effectively.
Description
Keywords
pandemic, influenza A (H1N1), antigenic recycling, antiviral drugs vaccines
Citation
Chawla Raman, Sharma Rakesh Kumar, Bhardwaj Janak Raj. Influenza a (H1N1) outbreak and challenges for pharmacotherapy. Indian Journal of Physiology and Pharmacology. 2009 Apr-June; 53(2): 113-126.