1.30 pm, Basement OPD, Fortis Hospital, Vasant Kunj: There’s a crowd of mothers, trying to calm their restless children in the crook of their arms. They all have varying degrees of fever, cough and stuffy nose, suspected to be suffering from the influenza virus that’s raging through our cities. Dr Manoj Sharma, senior consultant, Internal Medicine, is taking a small break after seeing patients non-stop through the morning. As soon as he resumes his consultation, a 30-year-old woman complains about high fever and is almost convinced it is Covid. He calms her down, saying all she needs to do is take standard medication for fever (Paracetamol), wear a mask and follow hand hygiene. He asks her to wait for three days for the fever to subside and report any breathing abnormalities or other complications that might arise even on Day 5.
“The new strain of the influenza virus, H3N2, has regular flu symptoms like cough, congestion in throat, respiratory tract and lungs, sore throat, fever, headache, chills, body ache and fatigue. So we are asking patients to wear masks in order to prevent transmission and giving them symptomatic treatment,” says he. A senior patient, who has been waiting eagerly for his turn, complains of having extreme coughing bouts that make him retch. Dr Sharma advises him to take a flu vaccine shot. “The manifestation of the virus is severe in the elderly. Existing flu shots are not updated to counter this strain of the virus but if you have had a flu shot earlier, there could be some partial protection. Of course, if you take the flu shot now, it may not work in the current wave as your body would require four to six weeks to develop immunity. But we should all take the flu shots annually and those living with co-morbidities like diabetes and cardiac issues, should actually go for the pneumonia shot each year,” says he. The IMA has also stated that this virus usually preys on individuals below the age of 15 years or above 50 years of age. So vaccines are a must for both age groups.
In between patients. Dr Sharma says that H3N2 is not new. “There was an outbreak in 1968-69 and caused a pandemic just like Covid did this time. It resulted in about four 4 million deaths as well. It remains in the community and whenever the community becomes more vulnerable, it resurfaces. Over a period of time, antigenic variations happen in every virus. The same happened with the influenza virus, which has been categorised into the A,B,C,D types. H3N2 is a sub-type of influenza A,” says he. “It’s not like there’s a resurgence of influenza. It’s just that Covid protocols and a collective preventive behaviour kept us away from it. Now with a less than calibrated social exposure, we have just encouraged the virus to circulate more. Besides, most of us have had Covid, which has compromised our immunity shield. That’s why we are susceptible to not just this strain but other viruses floating about. That’s why people are complaining of relapses because immunity against one kind of virus doesn’t mean you are protected against others,” he adds. Ninety per cent of people are reporting a lingering cough for three to four weeks, indicating how the body defences have weakened and are slowing down recovery.
Do H3N2 patients require antiviral therapy? “Not at all. Only the elderly, the immuno-compromised, pregnant women, diabetics, those suffering from heart, lung and kidney disease need to be watched for such interventions. If the symptoms are mild, we don’t even go for testing. There’s no need to create unnecessary panic,” he adds. But what worries him more is the city’s pollution. “Pollutants scrape the respiratory lining of our lungs and alter it. The flu season will ebb but we will be perennially prone to contracting viral and bacterial infection. So we have to develop a new preventive social behaviour in a post-Covid world,” he says.