Amid rising H3N2 flu, COVID-19 cases, Centre urges states to boost watch

Along with a rise in the number of H3N2 (seasonal influenza subtype) cases, COVID-19 is raising its ugly head in some states again, prompting the Centre to urge all states and Union Territories (UTs) to address it at once.

Expressing concern over the gradual increase in the COVID-19 positivity rate in some states, the Centre on Saturday (March 11) requested all states and UTs to follow operational guidelines for integrated surveillance of respiratory pathogens presenting as cases of influenza-like illness (ILI) or severe acute respiratory infection (SARI).

The states were also requested to take stock of hospital preparedness, such as the availability of drugs and medical oxygen, and vaccination coverage against COVID-19 and influenza.

Also read: H3N2 virus deaths in Karnataka, Haryana: What experts say about the situation

“While the COVID-19 trajectory has decreased substantially in the past few months, the gradual rise in COVID-19 test positivity rates in some states is a concerning issue that needs to be promptly addressed,” Union Health Secretary Rajesh Bhushan wrote to the states and UTs on Saturday.

Focus on five-fold strategy

Despite a low number of new cases, an equally low number of hospitalisations, and significant advances made in terms of COVID-19 vaccination coverage, there is a need to remain vigilant and focus on the five-fold strategy of test, track, treat, vaccinate, and adhere to COVID-appropriate behaviour, Bhushan said.

Given the increase in other ILIs and SARIs being witnessed in some states and UTs, a meeting was held recently to review the situation with the central ministries, departments, and organisations concerned.

While influenza is an annual seasonal occurrence, in the present season, a variety of weather conditions and behavioural reasons — less than adequate attention to personal hygiene, coughing without adequate protection, closed indoor gatherings of people, etc. — make the environment conducive to the circulation of several viral respiratory pathogens like Influenza A (H1N1, H3N2, etc.) and adenoviruses, he mentioned.

Also read: Influenza cases with Covid-like symptoms surge across India

Increasing trend of ILI/SARI

Under the Integrated Disease Surveillance Programme (IDSP), as reported by states and UTs, an increasing trend of ILI/SARI is being observed across the country, Bhushan stated. Furthermore, according to integrated sentinel based surveillance of ILI and SARI, an upswing of Influenza A is observed since the second half of December.

“Of particular concern is the preponderance of Influenza A (H3N2) being detected in the samples being analysed in various labs. It should also be kept in mind that young children, old people, and people suffering from co-morbidities are particularly vulnerable to H1N1, H3N2, adenoviruses, etc,” he said.

Additionally, since January 1, almost 25.4% of the respiratory samples collected by various viral research and diagnostic labs (VRDLs) have tested positive for adenoviruses, he said.

Also read: Adenovirus spike: Virologists tell us how parents can keep children safe

While most of these agents typically cause a mild and often self-limiting illness manifesting acute respiratory infection with fever and cough, in some cases, particularly in old people, people with obesity, and other co-morbidities, as well as pregnant women, those infected may suffer from a more severe manifestation of these diseases requiring hospitalisation, Bhushan underlined.

Raise community awareness

“In order to limit transmission of these diseases, it is important to raise community awareness regarding adherence to respiratory and hand hygiene and promoting early reporting of symptoms, and limiting contact of those people who are suffering from respiratory illness,” Bhushan wrote in the letter.

In terms of requisite public health actions, it is essential that state and district IDSP units closely follow the trend of ILI and SARI in their respective areas, monitor the proportion of cases and refer sufficient number of samples for testing for influenza, SARS-CoV-2 and adenovirus.

Also read: Influenza A subtype H3N2: Karnataka govt calls meeting with experts

“All states and UTs must in letter and spirit implement Operational Guidelines for Revised Surveillance Strategy in Context of COVID-19, which provides for integrated surveillance of respiratory pathogens presenting as cases of ILI/SARI,” the letter stated.

(With agency inputs)