As Covid-19 cases in India witness a significant increase amid growing H3N2 scare, it is natural for people to worry about another impending health crisis. According to the Indian Council of Medical Research (ICMR), H3N2 may cause more hospitalisations than other influenza subtypes. Seasonal influenza is an acute respiratory infection which is seasonal in nature; India witnesses two peaks of seasonal influenza – one from January to March and another during post monsoon season. In recent days, mild Covid cases are being detected in several parts of the country but are being managed with symptomatic treatment at home. H3N2 on the other hand has resulted in spike in hospitalisation cases. (Also read: H3N2 Influenza: Most effective techniques to diagnose it; know if you are at risk)
Common symptoms in recent Covid spurt
“Recently, we have observed an increase in Covid-positive cases, with most patients having symptoms similar to seasonal flu. Many patients are reporting fever, cough, cold, headache, body aches, and some abdominal discomfort due to ongoing flu. The media has been reporting a lot about H1N1 and H3N2. Testing panels for respiratory viruses and Covid are available, leading to many mild Covid cases being detected and managed with symptomatic treatment at home. However, some patients with medical comorbidities, such as heart disease, diabetes, asthma, lung problems, or elderly patients, are being admitted to hospitals for specific treatment,” says Dr. Sandeep Budhiraja, Group Medical Director – Max Healthcare & Senior Director – Institute of Internal Medicine.
“The H3N2 a variant of Influenza virus found in pigs was first detected in humans in 2011. It started with sporadic outbreaks across globe mostly in farming industry. Lately human to human transmission has been more common. This season it is the most dominant virus in US and most likely in our country as well. There is coexisting of H1N1 with H3N2 which is usually baffling clinicians as well as patients,” says Dr Pragyan Kumar Routray, HOD CriticalCare, CARE Hospitals, Bhubaneswar.
Do we need to worry about rise in Covid cases
Experts say that while one must follow precautions, there isn’t a need to worry about rise in covid cases as they are mild in nature.
“Although the number of seasonal flu cases caused by H3N2 and other viruses has increased, the rise in COVID cases does not seem concerning to me. However, we need to remain cautious and follow preventive measures, including self-isolation if symptomatic, wearing masks in crowded areas, maintaining social distancing, washing hands, and covering sneezes. Additionally, taking the annual flu vaccine is crucial for protection against seasonal flu viruses,” says Dr Budhiraja.
What can be done amid Covid scare
“For Covid, there is no need to take additional doses of the vaccine yet, but those who have not yet completed their three doses should do so. It is essential to remember that prevention is key to avoiding the disease. If you experience symptoms, self-isolate, rest, hydrate, and take paracetamol. Contact your doctor if your symptoms do not resolve, and avoid panicking,” adds Dr Budhiraja.
How Covid-19 and influenza spread
“Both are spread by droplets and aerosols when an infected person coughs, sneezes, speaks, or breathes. the droplet and aerosols can land in the eyes, nose or mouth of people who are nearby-typically within 1 meter of the infected person, but sometimes even further away,” says Dr Routray.
What is worrying about H3N2
While H3N2 flu shares many of its symptoms with common cold, it is the prolonged irritating cough and throat discomfort that is baffling people.
“The symptomatology of H3N2 is like the common flu with fever, myalgia headache and throat pain. Along with this, it causes more prolonged irritating cough that may last for more than 2 weeks. Throat pain is also more severe associated with difficulty in swallowing and pain. Patients may have a lot of gastrointestinal symptoms like nausea, vomiting and loose motion. The fever usually of short duration of 2 to 3 days but prostration and cough may remain for prolonged duration. The immunocompromised patients as well as aged above 65, children below 5, chronic kidney disease, asthma and COPD patients may land up in severe symptoms requiring hospitalization,” says Dr Routray.
Diagnosis of H3N2 can be done in the same way as Covid with PCR methodology in any PCR-enabled lab or a government lab. More important is early seeking of medical help so that the severity of illness can be assessed by a doctor and accordingly treatment planned.
“Mostly treatment is symptomatic with antipyretics, analgesics and gargles. Few medicines have been approved recently for H3N2 which can be used with physician discretion in very severe cases only.
Severe cases may require oxygen support along with respiratory assistance in form of Noninvasive and Invasive ventilation. Also, patients may go for ARDS which will require prolonged hospital stay along with a lot of morbidity and mortality,” says Dr Routray.
How to prevent Covid-19 or H3N2 influenza infections
Covid-19 or H3N2 influenza spread in the same way and thus ways of prevention are also the same.
– Maintain at least 1 meter distance from others and wear a well-fitted mask when that’s not possible.
– Avoid crowded and poorly ventilated places.
– Open windows or doors to keep rooms well-ventilated.
– Cough or sneeze into a bent elbow or tissues and throw the tissue into a closed bin.
– Clean hands frequently.
– Avoid touching your eyes, nose and mouth.
– Stay home if you don’t feel well.
“The basic rule of hand washing, social distancing and putting up masks holds true for H3N2 as well. Along with it if not quarantine, at least we need to isolate these patients and they should avoid contact with other immunocompromised family members. The most important of all is vaccination. Influenza vaccine against H3N2 is readily available in market which has been approved for all immunocompromised patients. So, all patients with asthma, COPD, CKD, Cancer, HIV, aged more than 65, children below 5 years, somebody with repeated attacks of viral illness and immunocompromised should receive yearly dose of Influenza vaccine to keep them safe. Although vaccine may not prevent infection, it will definitely save the vaccinated from severe illness. Along with this, one needs to emphasise on health lifestyle with good food, sunlight, sufficient water and lot of rest with some amount of positivity to get through this season,” says Dr Routray.
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