Indian officials this week scrambled to cope with a rise in cases of the flu, which they say has sickened thousands of people and caused the deaths of 700 since the beginning of January.
The Health Ministry has deployed teams of experts to five regions where the largest numbers of cases have emerged, and asked state governments to study “patterns in mortality.”
According to the World Health Organization, India is reporting unusually high levels of H1N1 seasonal flu, a descendant of the swine flu that first emerged in Mexico in 2009. That new flu — actually a novel mix of human, bird and pig genes — spread widely enough to be declared a pandemic, but ultimately proved to be no more lethal than other flus. Health Minister J. P. Nadda told reporters on Thursday that “we should not panic, but at the same time, remain alert.”
India’s vast and densely packed population, coupled with an overburdened health care system, has led to fears of epidemics in the past. Though some scientists said the number of cases documented this year indicated nothing more than a bad flu season, news channels have still covered the outbreak breathlessly.
Aligarh Muslim University, in the northern state of Uttar Pradesh, suspended classes until Wednesday after one infected student died and eight students and faculty members tested positive for the virus. The National Law University in Jodhpur, where one student tested positive, has suspended classes until March 1.
A state-level task force assigned to examine the outbreak in the northern state of Rajasthan, where around 200 people have died, concluded that nearly three-quarters of the deaths occurred because patients received treatment for the flu too late, said Dr. Ashok Panagariya, the task force chairman; the remainder were already weakened by other illnesses, like cancer or diabetes.
So far, more than 11,000 people have tested positive, but it is unclear how many more people have been sickened; even in wealthier countries only a tiny fraction of people who get sick are ever tested.
Patients have converged on large government facilities like Sawai Man Singh Hospital in Jaipur. The hospital has 1,953 beds, according to officials, but accommodates an average of 3,000 patients every night. Scores of relatives camped outside its entrance on Wednesday, their mouths covered by handkerchiefs or scarves or cheap paper masks.
One group awaited news about Vishnu Kumar Prajapati, 30, a day laborer who was in the intensive care unit, breathing with the aid of a ventilator. When he fell ill the week before, they said, the doctor in their village, seven miles from Jaipur, did not test him for the H1N1 virus. Days passed before they checked him into a private clinic, which immediately sent him to the government hospital. By then, he was gasping for air, his lungs filling with fluid.
“We cannot say how he is,” said one relative, Prahlad Sahay Prajapati, 40. “He is covered with all kinds of machinery.”
Government scientists sequenced the virus to check for mutations, and found no changes from the original 2009 H1N1 virus, meaning that patients should respond to the antiviral drug Tamiflu.
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“It’s the same virus, the same medication, but the ratio of mortality is higher,” said Dr. Ajeet Singh, a hospital administrator. “These people are taking treatment from the doctor at the village level,” among them homeopaths and other practitioners of traditional medicine, he said, “and that is the main reason.”
“The person is coming to us at a later stage,” Dr. Singh added.
The strain of the H1N1 virus spread to India in 2009, and 2,700 people had died of the infection by the end of 2010. In the years that followed, the death toll fell steeply in India.
The states with high rates of the illness this year are Gujarat, Madhya Pradesh, Maharashtra, Rajasthan and Telangana.
In India, flu infections typically peak in January and February and subside with the summer heat, and some scientists said the public anxiety this year was overblown. A. C. Mishra, the former director of the National Institute of Virology in Pune, said he was “very sure” that the cases would begin to taper off in the coming weeks.
“I think this is just a flu season, the winter is ending and we are moving toward summer,” he said. “There is panic being created because of the name ‘swine flu.’ ”