Two confirmed deaths of patients from Waling, Syangja because of swine flu have been reported in Kathmandu this past week. There have been similar outbreaks beyond Nepal. In Myanmar, 10 people have died in the past week, with more than 50 confirmed cases. The worst-hit area in the region is clearly the Indian state of Gujarat, where more than 6,500 cases of swine flu have been confirmed—resulting in 439 deaths and counting this year.

This recent outbreak is worrying because it seems to be the same aggressive H1N1 strain that caused a pandemic in 2009, and subsequently a major outbreak in Jarjarkot in 2015. The Centres for Disease Control and Prevention (CDC), the American disease control body, estimated that this strain of swine flu has resulted in the deaths of between 150,000 and 500,000 people, including more than 30 confirmed deaths in Nepal since 2009. Although the H1N1 initially appeared on domesticated swine, it harms humans much more than affected animals. 

The H1N1 virus is non-zoonotic, which means that the strain is contagious through respiratory droplets among humans. This strain, however, is not transmitted from swine products to humans; therefore, pork products are safe for consumption as long as they are cooked well. Still live swine handlers should take precautions. Symptoms of this flu are high fever, cough, fatigue, headaches and mucous secretions. It is terrifying that the initial symptoms are so similar to regular flu that many might just ignore them. Fatality usually occurs due to the late or non-effective treatment of acute pneumonia; the two recent fatalities in Waling are an example of this.

Modern migratory trends, coupled with the ease of finding transportation add another worrying fact: highly contagious diseases do not stay localised for long. Flights and buses bring travellers from flu hit areas of India regularly to Nepal.

Simple precautions such as washing hands with soap, wearing face masks, sneezing under a mask if you have flu-like symptoms, and avoiding travelling to crowded areas are some preventive measures people can take. But there are certain things the governments in the region need to do. For example, they should mandate live swine handlers to take seasonal flu vaccines. Antiviral medication has been proven to treat and prevent the spread of swine flu. Nepal’s Ministry of Health does keep a small stock of antivirals, but it should increase production, purchase and delivery. The government should also spread awareness of the symptoms of the disease, while stressing the risks of ignoring initial symptoms. It may not be economically and logistically viable to upgrade the facilities in rural health posts to treat the disease in time, but steps can be taken to transport and treat affected people at urban centres. Providing urban health centres with adequate resources to admit, isolate and treat affected people is a no brainer.