Cases of seasonal influenza are higher than expected this winter but there is nothing life-threatening, say health authorities, brushing off rumours about swine flu. The experts regularly process specimens from across the country and update the influenza laboratory surveillance information at the Global Influenza Surveillance System.

“This is a sensitive public health issue. Irresponsible comments and baseless individual speculations cannot be a replacement for laboratory results,” Dr Harish Chandra Upreti, director at the Nepal Public Health Laboratory told the Post. “What we are seeing now across the country is a common phenomenon that repeats every winter and during the change of seasons. We have recorded more cases than expected for the month of December 2018 but this is not an outbreak and definitely not swine and bird flu,” said Upreti, who added that the central laboratory crosschecked news reports to verify swine and bird flu cases in the Valley but it could not confirm any.

On December 10 last year, senior doctor Sher Bahadur Pun, who is also the chief medical officer at Sukraraj Tropical & Infectious Disease Hospital, posted a tweet warning Valley denizens of a flu outbreak as some 200 students in a school at Tokha had suddenly fallen sick and showed symptoms of high fever, dry cough, headaches, sore throat and body aches.

“Some 30-40 students had a seasonal cough and tonsillitis. We had our visiting doctor inspect the students and they recovered within three to four days,” said Narottam Upadhyaya, principal of Sathya Sai Shikshya Sadan, when the Post enquired to verify Pun’s claims.

In a series of tweets that followed, Pun also claimed that flu was spreading in Kathmandu and neighbouring districts and across the country and some patients had tested positive for Type ‘A’ influenza, resulting in ICU admissions and even one patient’s death in the Capital.

“The public needs to be wary of the influenza virus in circulation. The World Health Organization releases an annual list of the vaccines strains to match the influenza virus in circulation. The government needs to introduce a vaccine policy. It is the sure-shot precaution that can prevent us all,” said Pun after recollecting his tweets to the Post.

On January 6, Pun also filed an alarming public health event in EpiCore, an online system that links worldwide member network of health professionals, in order to provide verification of suspected rumoured outbreaks. 

In the EpiCore Request to Information (RFI) #1127 titled ‘Human, Acute Respiratory-Nepal’ that the Post has obtained, Pun writes, “Affected cases have poultry chicken farm, where nearly 700 chickens have died in the last one-week alone and are still dying (dying in a rate of approx. 150/day). According to them, chickens are coughing, sneezing, throwing nasal discharge and dying quickly. Chickens were tested positive for influenza A by rapid diagnostic test. Samples were further sent to a higher centre to identify its subtypes.”

Pun further writes that a 45-year-old pregnant woman, with two family members, visited the OPD department at Sukraraj Tropical Hospital with a four-day history of fever, cough, sore throat, chest pain and weakness and the chickens at their farm are still dying at a rate of approximately 150 a day but it is unclear if the visiting patients had contracted the avian influenza virus.

“We do not know how he came to that conclusion. However, we did collect samples once we were notified but our laboratory results tested negative. Instead, they showed a naturally occurring low pathogen strain which can be found in poultry across the country and is responsible for the poultry mortality but this is nothing alarming,” Dr Diker Dev Bhatt, chief veterinary officer at Central Veterinary Laboratory told the Post.

On January 7, The Himalayan Times published an opinion piece by Pun titled ‘Swine flu threat: new challenges ahead’, in which he summarised his selected tweets and claimed ‘swine flu is making a comeback in Nepal this winter’. In the same piece, Pun also pointed out that hospitals in Nepal lacked isolated wards for flu-related cases and linked increased hospital admission in flu-related cases with air pollution.

“We regularly monitor the influenza laboratory data. We also collect suspected samples and send it abroad for quality assurance tests if need be but the globally updated surveillance system data so far indicates that these are sporadic events and not an outbreak,” Dr Rajan Bikram Rayamajhi, the focal person for influenza at the WHO-Nepal told the Post. “The government is also fully capable to deal with the situation if there is an outbreak,” Rayamajhi added.

In an e-mailed statement to the Post on Monday, WHO-Nepal further clarified, “Seasonal flu (influenza) is an annually recurring viral respiratory disease, that affects many countries during the winter and monsoon seasons. While mild in most instances, in some cases complications may occur. The WHO works closely with the Government of Nepal to track and respond to outbreaks of influenza. Flu can be prevented by taking care of personal and surrounding hygiene, thoroughly washing hands, covering your mouth when coughing or sneezing, and wearing a face-mask when unwell.”