The Centers for Disease Control and Prevention (CDC) is
investigating two American Airlines flights after passengers on board complained
of flu-like symptoms, as reported in USA Today on Thursday. Twelve passengers
on two different American Airlines flights between Europe and Philadelphia
reported flu-like symptoms when they arrived in the US. All 250 passengers from
both flights were held at the airport for medical review as a precaution. The
12 sick travelers had sore throat and cough but no fever. The remaining
travelers were then allowed to continue with their journey.
This incident came close on the heels of a similar incident when
11 passengers on an Emirates flight from Dubai to New York were taken to a New
York City hospital with flu-like symptoms - fever, cough and vomiting - on
Wednesday. All the passengers including the crew were screened by officials
from the CDC. Health officials were at the airport, when the flight landed. The
plane was quarantined and the 11 suspected cases were taken to the hospital and
tested for flu and other respiratory viruses. They were retested when testing
for additional viruses Wednesday proved inconclusive.
Following these incidents, the CDC was quick to issue guidance
to all travelers, which said people who “get sick with flu symptoms – fever,
cough, sore throat, runny/stuff nose, body aches, headaches, chills, fatigue,
and sometimes diarrhea and vomiting – should stay home, don’t travel, and avoid
contact with other people except to get medical care. And, everyone six months
and older get a seasonal flu vaccine, preferably by the end of October”.
This is the level of preparedness, the level of response needed
to contain a probable outbreak and prevent it from becoming an epidemic or even
a pandemic.
The number of dengue cases in India increased from 99913 in 2015
to 157996 in 2017. Similarly, the number of clinically suspected Chikungunya
cases reported in the country increased from 27553 in 2015 to 63679 in 2017 (PIB, March 27, 2018). These are entirely
preventable diseases, yet they claim hundreds of lives every year. Outbreaks of
Japanese encephalitis (JE) and acute encephalitis syndrome (AES) have been
occurring every year in JE endemic states for decades, as they did this year
too and take a heavy toll of life, especially of children. Three cases of Zika
virus infection have also been reported in India.
The Nipah virus outbreak in Kerala this year with 12 deaths is
the third outbreak reported in India, with previous ones having occurred in
2001 (45 deaths) and 2007 (5 deaths). Swine flu and Avian flu are becoming
common.
India is a huge and the second most populous country in the
world, where infectious diseases can spread quickly. Travelers can now
introduce diseases in new places outside of the endemic zone. Air travel, in
particular, facilitates rapid dissemination of pathogens. Densely populated urban areas are
also risk factor for disease to spread.
Many zoonotic diseases are emerging and re-emerging in the
country. They are becoming endemic in the country, and rear up ever year and
create panic among the public, especially without timely advisories and
awareness campaigns from the concerned authorities.
As a result, India continues to suffer recurring outbreaks of
infectious diseases with no lessons learnt from the previous ones. We seem to
be caught “unaware” and come across as underprepared every year.
Several factors account for this: Lack of a robust surveillance
and monitoring system even when there is no outbreak, lack of diagnostic labs,
shortage of required medications, lack of awareness about the diseases amongst
the general public, ill-prepared health care providers, poor communication.
We need to invest more in preparedness to be able to respond
promptly and adequately to such threats. Being prepared saves lives.
Active case finding and contact tracing and their timely
treatment are extremely important.
Will we ever be able to achieve this level of preparedness?
Dr KK Aggarwal
Padma
Shri Awardee
Vice
President CMAAO
Group
Editor-in-Chief IJCP Publications
President
Heart Care Foundation of India
Immediate Past National President IMA
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