Cough Etiquette, Affordable Travel and Kanchana’s Death

Tackling influenza

Daily News Editorial

Cartoons added by TW from internet

Sri Lanka has been relatively ‘immune’ from some of the dreaded diseases such as Ebola, Zika and Avian Flu which had affected certain other parts of the world recently, thanks mainly to tight screening and the efficiency of our free healthcare system. However, one cannot expect an island such as ours to be perpetually free of these pathogens. In fact, the first death caused by the influenza virus in Sri Lanka in recent times was reported from Polonnaruwa on December 26 afternoon.

The victim has been identified as D.G. Kanchana, 20, a mother of one from Aluthwewa, Polonnaruwa New Town. She had contracted the disease at child birth and was being treated at the hospital’s ICU. Although President Maithripala Sirisena dispatched a team of specialist doctors and equipment by air from the Karapitiya Hospital to Polonnaruwa to help save her life, the patient died at around 1.30 p.m. on December 26 before the special team arrived in Polonnaruwa. Doctors said death had been caused due to a complication resulting from excessive water accumulation in the lungs.Image result for cartoons on virus

This is a very sad episode, for Kanchana, just 20, had a very bright future ahead of her. Her life was cut short by a dreaded disease that had made inroads into several other parts of the world. It is a variety of sometimes deadly influenza and young adults like Kanchana are said to be particularly vulnerable to the disease. There are several varieties of influenza that has emerged over the years. Influenza A/Swine Flu (H1N1) virus emerged in 2009. It is a new variety that has never before circulated among humans. This virus is not closely related to previous or current human seasonal influenza viruses.

The World Health Organisation (WHO) describes it as an acute respiratory infection of varying severity, ranging from asymptomatic infection to fatal disease. Respiratory transmission occurs mainly by droplets disseminated by unprotected coughs and sneezes. Short-distance airborne transmission of influenza viruses may occur, particularly in crowded enclosed spaces.Image result for cartoons on virus

Typical influenza symptoms include fever with abrupt onset, chills, sore throat, non-productive cough and, often accompanied by headache, coryza, myalgia and prostration. Complications of influenza viral infection include: primary influenza viral pneumonitis and bacterial pneumonia. Influenza A (H1N1) is similar to seasonal influenza but has been characterized by higher activity during the northern summer season, higher fatality rates among healthy young adults and higher incidence of viral pneumonia. Influenza occurs all over the world, with an annual global attack rate estimated at 5–10% in adults and 20–30% in children.

There is one factor that makes it almost impossible to stop pathogens from spreading – international travel. The emergence of Low Cost Carriers (LCCs) around the world means that travel has become affordable to many people with mid-level incomes. There is a general trend of airfares going down and once exotic destinations such as South America are now easily accessible from Asia with direct flights. Africa too has opened up in recent years. With nearly two billion people travelling around the world in a given year, it is a miracle that we are not actually seeing more diseases.

The answer, then, is better screening at airports (for example, travellers coming from South America have to report to the health desk at the Bandaranaike International Airport, Colombo) and vaccination (where available and feasible) before travelling. Many airports now have thermal scanners which can measure the body temperature of travellers from a distance. These passengers are then referred to the medical facilities at the airports for further tests. This makes it easier to identify and isolate potential disease carrying travellers.

The other option – vaccination, is even more beneficial. There are both inactivated and live attenuated influenza vaccines available for many varieties of influenza including H1N1. Travellers heading to a known influenza regions can get this shot. However, the vaccine may not be 100 percent effective in all cases because the viruses keep changing and evolving. The general rate of effectiveness is around 60 percent, which is better than having no protection at all. But travellers in particular have to make sure that they receive the vaccine weeks before the intended date of travel because it can take up to 12 weeks for the body to produce enough antibodies to give maximum protection.

Prevention, they say, is better than cure and H1N1 influenza is no exception, though it can be very difficult to avoid from airborne respiratory diseases. The WHO advises the public to “whenever possible, avoid crowded enclosed spaces and close contact with people suffering from acute respiratory infections. Frequent hand-washing, especially after direct contact with ill persons or their environment, may reduce the risk of acquiring illness. Ill persons should be encouraged to practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, wash hands)”. It is better to seek medical advice if you experience any of the symptoms mentioned above for a couple of days or more. Any delay could prove to be fatal. We must not give these diseases a chance to take over our lives.