KARACHI: Amid an alarming rise of flu cases across Karachi, the provincial health department has issued an alert, directing all officials concerned to take effective measures for the disease management, its monitoring and containment, it emerged on Sunday.

Sources said while influenza outbreaks were reported almost every year with the onset of winter, this season, the viral illness, identified as H1N1 (previously called swine flu) in many cases, seemed to be “more intense” in terms of its scale.

“Flu situation this season has been worst in comparison with recent years. I have been daily examining 30 to 40 patients for at least six weeks while a significant number of them are coming with fever, shortness of breath, cough and body aches,” shared Dr Altaf Hussain Khatri, senior general physician practicing in the old city area.

He added that the viral illness was highly contagious, affecting the whole family in many cases.

According to Dr Khatri, also representing the Pakistan Medical Association and the College of Family Medicine Pakistan, health facilities in Karachi have been ‘overwhelmed’ by these patients for weeks.

“We are constantly in touch with our colleagues who are experiencing a similar situation at clinics and hospitals,” he said, while urging the public to use facemask to contain virus transmission.

Meanwhile, the health department has sent a letter to district health officers, medical superintendents of public hospitals, and relevant authorities, outlining immediate actions to be taken to tackle the rising cases of H1N1.

It calls for stringent monitoring of cases in all healthcare facilities, with both suspected and confirmed cases required to be immediately reported to the health department.

The letter lists several measures, including ensuring that healthcare workers are equipped with Personal Protective Equipment (PPE) kits and that infection control protocols are followed in medical centres.

The department also stressed the importance of raising public awareness about preventive measures, such as wearing masks, practicing social distancing, and prioritising vaccinations.

‘Flu can be serious’

Endorsing the opinion that the influenza season has been particularly severe this year, Dr Faisal Mahmood heading the Infectious Diseases Department at the Aga Khan University Hospital said: “We have been seeing patients coming to the emergency room constantly and at any given time have about 20 to 40 people admitted with severe disease. We have also seen deaths which have been either a direct result of influenza or due to complications after the infection.”

Asked about the specific viral strain affecting most patients and whether any Covid cases are seen, he said that there were different types of influenza viruses and that all three of the most common types had been detected in laboratory tests.

“However, H1N1 has been predominant. We have not seen any Covid cases this season. Our current protocol is that anybody coming with a severe respiratory disease gets put into isolation and tested for both influenza and Covid. Most patients have either been negative or tested positive for influenza,” he explained.

According to Dr Mahmood, unlike common perception, flu could be a fairly serious disease.

“People often call any runny nose, cough, or fever ‘flu’. However, in medical terms, flu or influenza is a specific disease caused by the influenza virus. This can be a fairly severe infection, just like Covid. If symptoms do not improve in four to five days, especially in case of shortness of breath, one must report to a doctor.

“Second, people should not take antibiotics, if they have fever, runny nose, or a sore throat, as antibiotics can be harmful. It takes the body almost a year to recover from the effects of using them unnecessarily.”

About severity of the disease being seen over the last two to three years, he said it was hard to make a direct comparison with 2022 and 2023 as an outbreak of influenza was seen in the summer too, which was unusual.

“However, we have seen these sorts of cycles of severe influenza seasons in the past as well.”

Globally, he pointed out, this year had been a more severe influenza season, and there were several reasons for this, including poor vaccine coverage as well as possibly a slight shift in the virus itself, which occurred every year.

Dr Mahmood underscored the need for prevention, highlighting that a safe vaccine was available, which was made slightly different every year as the virus changed.

“One should get one in October every year. It is recommended to all individuals, especially those at high risk, such as the elderly, pregnant women, or those who are obese.”

Published in Dawn, February 17th, 2025