After 10 deaths were reported from the outbreak of influenza, residents of the Southern Province are queuing up in front of private hospitals dispensing the flu vaccine, but authorities and medical professionals warn that the costly immunisation may not help since the vaccine addresses a single strain of the virus while doctors believe the current flu is caused by a combination of three viruses
The crippling Southern influenza epidemic continues to grip the Southern Province, fuelled by speculation and contradicting reports on the strength of the virus and the number of deaths, increasing public fear. While primary schools which were closed to contain the spread of the flu virus have since been reopened, attendance in many of these schools in the Southern Province appears to be minimal.
Meanwhile, crowds are lining up at private hospitals and clinics dispensing the influenza vaccines in the hope that it would provide adequate immunisation to prevent the onset of the virus and if contracted, its symptoms would be minimal.
However, confusing the situation, medical professionals are divided on the efficiency of the vaccine since three viruses are at the root of the flu outbreak while the vaccination itself addresses only a single strain of the influenza virus.
Many medical professionals who were spoken to during research for this article did not wish to comment on the record, citing the ongoing controversy.
One consultant even noticed that the flu outbreak issue had become ‘politicised’, while others said the reluctance on the part of health professionals to comment could be linked to the fact that the virus had claimed 14 lives to date, several of them children under the age of two years – and swirling allegations by other patients that the cases had been mishandled medically.
Questions however remain as to the actual cause of the epidemic. While some medical experts in the field say it is influenza, others suspect it is a combination of influenza, Adeno and Respiratory Syncytial Virus (RSV),viruses that are causing the flu. “Consultant Virologists at the Medical Research Institute (MRI) are still experimenting on the samples to identify the cause of the flu. Currently, they have informed that the tests indicate the virus is positive for pneumonia, however it is suspected that this is a combination of viral pneumonia.
Therefore, we can’t announce the virus causing this flu yet,” said Director of Karapitiya Teaching Hospital, Dr. Jayampathy Senanayake.
The Karapitiya Hospital remains the only hospital in the Southern Province with an Intensive Care Unit (ICU) for children.
A senior consultant who does not wish to be named told the Sunday Observer that medical professionals believe the three viruses are at the root of many of the cases reported in the South, namely Adenovirus, RSV and influenza A or the common ‘flu. RSV is a common and very contagious virus that infects the respiratory tract of most children before their second birthday.
Most of the victims of the southern viral outbreak have been children under two years of age. “People develop immunity to viruses over their lifetimes. In the case of very young children, this is the very first time in their lives they were exposed to these viruses,” he said.
The flu gripped the Southern Province for the past few weeks and resulted in 10 confirmed deaths, and three more deaths that is suspected to be caused by viral pneumonia, but yet to be confirmed, according to Dr. Senanayake. Also, there are 48 suspected influenza cases being treated at the Karapitiya Hospital and six critical cases treated at the ICU.
A senior consultant who wishes to remain anonymous said, it appears this time, these viruses are more virulent than usual.
“However, there is no treatment as such for any of these, except for influenza A. The only treatment is to keep the patient rested and ensure supportive treatment is provided,” he said. For instance, if a patient has trouble breathing, they are given oxygen and later put on a ventilator, in the hope that the body eventually musters the defences to fight the virus.
These are only measures taken to help with breathing until the body fights back on its own. “Sometimes, the virus wins. Sometimes, the body wins. These deaths result when the virus has won over the body,” he said.
Vaccination is not an answer
Another controversial area is the influenza vaccine for which a public clamour is building, especially, in the Southern Province. Residents are lining up outside clinics and hospitals dispensing the vaccine in many parts of the South, according to reports by correspondents in the area.
The problem, health professionals and authorities say, is that it is not certain if the vaccine will actually prevent people from contracting the current flu virus.
Health Minister Rajitha Senaratne speaking at a conference at the National Blood Bank last week said, if consultants decide the right course of action was to vaccinate the public in the South against the flu, the Ministry would ensure the vaccines are available. “But, vaccines cannot be provided just because politicians and the media is demanding it. It has to be scientifically decided by the specialists in the field,” he said.
Given the hesitancy by Government authorities, people are turning to purchase vaccinations from private hospitals in the South, despite a secondary concern about possible side effects from the immunisation. Following the deaths of the large numbers of young children, parents have started immunising their children with vaccinations for pneumonia and influenza, in the hope that it would protect them from the flu. However, speaking on the subject, Provincial Health Services Director, Dr. G. Wijesuriya said, these vaccinations have no major contribution towards controlling the disease. “A vaccination provides immunity against a particular viral strain.
This flu is considered to be a combination of three viruses, therefore, vaccinations provided by private hospitals are not very effective in this particular instance,” he said.
Dr. Wijesuriya further added that in Sri Lanka, vaccinations are recommended by a special committee, on a scientific basis and the Government spends a lot of time, effort and funds on this process.
He said, since there is a drug mafia in operation in the country, perhaps, a certain private company importing these vaccinations could be influencing the public.
Pediatrician at the Karapitiya Hospital, Dr. Nayana Liyanarachchi, seconded this saying that it was not necessary for people to spend so much on the vaccinations. “Although the influenza virus is given to a child, there is only a 50 per cent chance of it preventing the contraction of the disease.
Also, there are no vaccinations for Adenovirus or RSV. Thus, even if the influenza vaccination is given to the child, there is still a likelihood of contracting the flu from Adenovirus or RSV,” she said.
Further speaking of the pneumonia vaccination, Dr. Liyanarachchi said, it is given to prevent pneumonia caused by pneumococcal bacteria and it does not prevent the contraction of pneumonia by other causes.
Remain vigilant, do not panic
Nonetheless, public fears about the spread of the harsh flu is very real and is laid bare by poor school attendance in the Southern Province.
According to Southern Province Education Minister, Chandima Rasaputra attendance was very low even in the schools that were not closed in Ambalangoda and Elpitiya areas, due to rumours and deaths. “In Thihagoda, where there were four deaths, there is a primary school with 128 students.
There was zero attendance in this school. Therefore, the fear factor is obvious. It takes time for things to return to normal,” he said.
Minister Rasaputra further said, the second time the schools in the area shut down because of the flu, a certain surgeon from one of the zones contacted him and requested that Sunday Schools and tuition classes be closed as well.
“We discussed with Sunday Schools and they agreed to close,” he said.
The Minister noted that although health officials were saying there is no issue, parents were naturally concerned. “The situation is probably improving, but confidence building has to be done by the Health Ministry.
There should be no more deaths due to this flu, and the number of entry of flu patients to the hospitals should be reducing. Until this happens, there is concern,” he said.
Head of the GMOA Karapitiya Hospital Branch, Dr. Janith Liyanage earlier commented to the media that while influenza has amplified to epidemic proportions the authorities remain silent on this aspect. Later in the week, President Maithripala Sirisena gave special approval for funds for purchasing equipment and drugs needed to control the situation.
The anonymous consultant said, doctors in the South may be reluctant to speak because there has been some criticism about how patients contracting these viral flu were treated, especially, by the other patients in the area.
However, practising medical officers have observed an increase in H1N1 and influenza, even in the hospitals in Colombo. Director General of Public Health Services, Dr. Sarath Amunugama said the numbers suffering from common cough and cold will increase with the prevailing rain, and they should be vigilant, since influenza has similar symptoms.
“With the prevailing monsoons, there is a possibility of influenza spreading to other parts of the country.
Therefore, those suffering with cold, cough and fever for more than two days should consult a medical practitioner,” he requested.
He further said, pregnant mothers and children below two should seek medical advice immediately upon developing these symptoms.
The World Health Organization (WHO) said, that they continue to monitor the situation in cooperation with the Ministry of Health. “As always, the WHO will respond positively to any request for assistance from the Government of Sri Lanka should the need arise,” they said.