Miss You Nepal

An interaction program on   current issue influenza H1N1: Risk and Control measure.

   According to shiva belbase,secretary of microbiology and molecular biology research association(MiMRA) , an interaction program on Influenza H1N1: Risk and Control measures was held on 13th August, 2017 at TU Auditorium hall, Kritipur Kathmandu. The program was organized by Microbiology and Molecular Biology Research Association (MiMRA)  in association with Research Center for Applied Science and Technology, Tribhuvan University, (RECAST) Kritipur, Kathmandu. Dr.Buddhi Ratna Khadgi, a member Secretory of Nepal Academy of Science and Technology (NAST) was honorable chief guest of the program along with this, Dr.Guna Niddhi Sharma ,Epidemiology and Disease Control Division(EDCD), Deputy health Administration, Prof. Megh Raj Banjara, Head of Central Department of Microbiology(CDM), Bishnu Upadhya,(Currently working at National public health laboratory,Teku) ,Dr. Era Tuladhar(visiting faculty,CDM) ,Prof. Rabindra Dhakal(senior scientist, NAST) were renowned personnel’s as guest at their respective fields.

  There were nearly 300 participant from school level to University level.Participant were highly interested about this interaction topic so participants were from different institution of Kathmandu,bhaktapur and lalitpur.Active participation were from Trichandra Multiple Campus,Central Department of Tribhuvan University, kathamandu university,Nobel college,ASCOL Campus,P.k. campus,SANN International College,Kist College,National medical college,Balkunj Secondary School,sankerdev campus,etc.

The program was inaugurated with the National Anthem and was proceeded with the welcome speech by Komal Malla (Assistant Professor of School of Health and Allied Science, PU). After the speech Dr.Guna Niddhi Sharma (Deputy health  Administration section , chief of Epidemiology and Disaster Management Section at Epidemiology and Disease Control division, Teku) was handed over the dash  for his presentation and Discussion on the topic. According to him, Influenza, also known as flu mainly affect the upper respiratory tract and lower respiratory tract, wide spread epidemics sometimes pandemics and affects people of all ages. Influenza is sometimes mistaken as ‘swine flu’. But as it rapidly spread from one person to another instead from pigs to persons and is only a seasonal flu, such misconception should be cleared. The flu was first noticed in 1918 which was then known as “Spanish flu” which killed approximately 50 million and outbreaks at different time interval were seen. The case fatality rate of Influenza differs geographically and according to status of the country. But the fact is that the fatality rate till now has not exceeded more than 1%.

  The first case in Nepal was reported in 29 June 2008 but the strain was different from the intial one. Among 31 affected 8 were verified death on the other hand, in Dolakha 5000 were reported to be affected but 3000 deaths. H1N1 Pdm09 occurs every year. According to Dr.Sharma 3 strains were identified at different outbreaks. Beside H1N1, H2N2 and H3N2 are also responsible strains for the outbreaks in Nepal.

The transmission of Influenza virus is primarily through contact with the respiratory droplets and from possible objects like handkerchief and clothes. Symptoms become distinct from 4-5 days of onset. The transmission of the flu is high during it’s incubation period. The group at risk for serious complications are the persons 65 years and above, person with chronic diseases ( heart diseases, chronic respiratory diseases, renal diseases, HIV), children under 5 years especially less than 2 years, pregnant womens, Alcoholics and Smokers. The sign and symptoms of influenza are : Sudden onset high fever, headache, body ache, dry cough, sore throat
, stuffy running nose are common and gastrointestinal symptoms like Nausea, Vomiting, Diarrhoea is prominently seen in childrens. The most possible complications of Influenza – A influenza is pneumonia which progresses to respiratory failure, Acute respiratory distress syndrome (ARDS), multi organ failure(Cardiac and Renal Dysfunction), gastrointestinal involvement and Encephalitis also have been reported.

The diagnosis can be done by the viral isolation from the throat sample of illness and detection of specific RNA from throat swab by Rapid antigen test or Real time PCR assays approx. 5 days from onset of illness. Immunofluorescence test for antigen with use of monoclonal antibody against specific virus can also be done.The treatment of Influenza -A includes the antiviral oral formulation Oseltamivir and Zanamivir is alternative. The treatment should be started as soon as possible. Dr.Sharma focused on difference between seasonal flue and swine flue , According to  WHO SEARO statement on August  2017 the H1N1 virus currently circulating is sometimes mistakenly called “Swine flu”
which is not accurate

While the virus that emerge in 2009 had some swine flu bits, it is also had avian (bird) bits in it too, but most of the virus was actually human influenza, which is spread easily among humans. The preventive measures for H1N1 outbreaks are-

• Self Imposed isolation.

• Avoid unnecessary mass gatherings.

• Maintain Proper hygienic activities.

• Spread true message among the people about influenza.

• Patient should be kept in isolation.

• Vaccination program should be conducted accordingly each year for the genetically modifying influenza-A virus for the risk bearing group of people like pregnant women and immuno compromised people.

The control measures should be implemented before the outbreaks and preventive measures should be carried out with the supervision from authorities department like EDCD, NPHL, RHD, WHO. Public message should be disseminated via media and medicine supply, sample collection and test should be effective as well as regular risk communication and co-ordination should be done. The challenges of such spread of Influenza-A virus should be considered and address during health policies including disease burden, high risk groups, vaccine cost effectiveness, vaccination policies, control and preventive measures implementation.

After this informative presentation by Dr.Sharma, the queries of the participants were addressed by Panel Discussion. All of the participants and guests actively involved in the discussion and some sensible questions were addressed by our guest members.

    Q) Can the Influenza-A virus be antiviral drug resistance?

 According to geographical differences, patient immune capacity and genetical changes of virus can bring such antiviral drug resistance capacity.

 Q) According to the context of Nepal, people in rural areas are deprived of general medicines, if the outbreak of H1N1 observed in such areas than how can it be controlled to save lives or people?

 Vaccination; every year can be the most effective preventive measure.

 Policy discussion should be made by responsible shake holders.

 Public awareness should be launched massively before outbreaks.

Q) What type of researchs are being carried out for Influenza-A virus?

 The research labs are focused mainly on the tests related to strains circulating in Nepal, along with the antiviral drug capacity of the Influenza-A virus is under research.

 After completion of the panel discussion Dr.Buddhi Ratna  Khadgi, the chief guest of the glorious interaction program spoke about the contextual discussion program hold and effort that can be made for more researches about Influenza virus and  expressed gratitude for organizers and co-ordinators of the program.

  Similarly Prof .Dr.Rameshwar Adhikari (Director of RECAST) distributed the token of love to all the guests and expressed his role and contribution about this program also  highlighted  on control measures and public awareness  about influenza-A  H1N1.

Finally, the program was wrapped up with  the vote of thanks by Mr. Sujan Khanal (President of Microbiology and Molecular biology Research Association,MiMRA).