PUNE: Doctors have expressed concern over a sudden rise in the number of children, especially those aged below 5, landing in the intensive care units (ICUs) of hospitals with acute H3N2 infection. Most of these patients, health experts said, were not responding to medication, especially the antibiotics.
According to National Institute of Virology (NIV) data, 428 (almost 17%) of total 2,529 samples have come positive for in Pune since January this year. The highest number of H3N2 cases, part of the Influenza A virus family, were reported in the second half of February, the data showed.
NIV scientist Dr Varsha Potdar said the samples were of patients hospitalized with severe acute respiratory syndrome (SARI) symptoms in Pune district.


Dr Bhakti Sarangi, in charge of the paediatric ICU at Bharati hospital, said, “Our ICUs have been running full since the past 4-6 weeks. We are seeing a rise in infants and preschool children being affected the most. Some of them are reporting liver issues and even blood pressure anomalies. They need ventilator support, invasive or non-invasive, and a majority of them are under five years of age. The common complaints are breathlessness, cough and fever. Pneumonia-like symptoms are also lasting days. In addition to H3N2, we are seeing ICU admissions due to adenovirus.”
Confirming the trend, Dr Bharat Purandare, intensivist at Deenanath Mangeshkar hospital, said, “There is a rise in not just H3N2 cases, but also Covid-19 and H1N1 patients. All kinds of respiratory ailments are on the rise.”

As per the state health department, H3N2, a subtype of Influenza A, appears to cause more hospitalizations than other influenza subtypes. Out of the current hospitalized patients showing severe acute respiratory syndrome (SARI), about 92% are presented with fever, 86% with cough, 27% with breathlessness, 16% with wheezing, as per the ICMR surveillance.
It stated that additionally 16% had clinical signs of pneumonia and 6% had seizures. About 10% of the SARI patients needed oxygen while 7% required ICU care, it said.

Dr Pradeep Suryavanshi, consultant paediatrician with Sahyadri hospital, said, “We are reporting about 3-4 admissions daily since the past few weeks. We have reported confirmed cases of H3N2 or Influenza A, adenovirus and also bacterial streptococcus pneumoniae mostly in children aged under 5 years. We are confirming these cases through our in-house laboratory. The most common symptoms are high-grade fever, cough, breathing troubles and pneumonia. In the case of these children, fever takes about 4-5 days to be controlled, while cough can last for about 10-14 days. We are also reporting admissions of patients as young as six months.”

Intense cough for over a week: You may have Influenza A H3N2 infection

Intense cough for over a week: You may have Influenza A H3N2 infection

The most common symptoms among children down with H3N2 infection are high-grade fever, cough, breathing problems and pneumonia. The recovery period for such kids is about 7-8 days. In some cases, where the child is malnourished or has immunocompromised condition, it may take almost 10 days for the fever to subside, the health experts said.
Dr Aarti Kinikar, the head of the paediatric department at the Sassoon General Hospital, said, “We are reporting admissions at our hospitals and since Sassoon is a referral hospital most admissions come in late to us. We have a few admissions among kids aged below five years with severe acute respiratory illness (SARI). While Influenza A is reported in younger kids, adenovirus is reported among older kids.”

An 87-year-old man from Karnataka’s Hassan district was the first patients to succumb to H3N2 infections on March 1. The patient had comorbidities, including hypertension, asthma and acute kidney injury. His laboratory test results confirmed H3N2 on March 3, two days after he died.
Paediatrician Dr Sagar Lad said, “The infected children are reporting fever ranging from 101-104°F. Kids aged below 5 years are most vulnerable and require ventilator support. The rising cases can be attributed to drastic drop in immunity among kids due to Covid-19 pandemic. We are providing supportive treatment and anti-viral drugs are working. Most kids are not responsing to antibiotics.”

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