With two deaths due to H3N2 influenza — the first from Karnataka and second from Haryana — and two deaths due to Covid-19 — one each in Karnataka and Himachal Pradesh — on Tuesday, and Delhi hospitals witnessing a 150 per cent hike in H3N2 cases, the viral infections are again on the rise. 

 India reported a single-day rise of 402 coronavirus cases while the active cases have increased to 3,903 in the country, according to the Union Health Ministry on Tuesday.

Reports have surfaced of a 58-year-old woman dying due to H3N2-like symptoms at a State-run hospital in Vadodara city of Gujarat, an official said on Tuesday. When asked if the H3N2 influenza virus was the cause, the official said samples have been sent for testing and a review committee will determine the exact cause of death.

Though Goa has not reported any confirmed H3N2 cases so far this year, the Government held a high-level meeting on Tuesday to discuss monitoring of seasonal influenza subtype H3N2 as directed by the Centre, State Health Minister Vishwajit Rane said.

The H3N2 virus triggers symptoms like fever, cold and body aches, and in certain cases, leaves behind persistent cough making patients extremely weak.

Elaborating the possible reasons behind the surge of influenza cases in Delhi, Dr Viny Kantroo, Consultant, Respiratory, Critical Care and Sleep Medicine Consultant, Indraprastha Apollo Hospitals, said the outbreak could have been triggered by seasonal change, mutation of virus and the economy being fully open.

“Children are going to school and they are transmitting it to the elderly. A lot of cross-country travel is happening. In the last two years, Covid was the dominant virus and there were restrictions but with relaxation of norms and return of normalcy, these outbreaks are being observed,” she opined.

The Delhi Government’s LNJP Hospital has set up a 20-bed isolation ward in the emergency block for such patients.  In accordance with the ICMR guidelines, we have done so and also stocked up medicines. A 15-doctor team has been constituted to monitor the patients, said a senior doctor.

Dr Rajiva Gupta, Senior Consultant, Internal medicine at the CK Birla Hospital, Gurugram and Delhi, said the ILI (influenza like illness) cases have seen a spike in the last few days.  “For instance, if we were seeing two to three patients in OPDs last month, this month there is a one-and-a-half time rise. The symptoms are fever, discomfort, cold, and body aches. In some cases, patients also experience abdominal discomfort, diarrhoea, and even fullness in ears,” he added.

The senior doctor said the treatment approach changes lightly when the patient has comorbidities and stressed that in those cases, they ask the family members to monitor the BP, pulse, oxygen saturation levels and consciousness levels. “If these levels fluctuate, the patient needs hospitalisation,” he stressed.

Explaining the current strain, Dr Vikas Deswal, Senior Consultant, Internal Medicine, Medanta, Gurugram said the influenza virus is the most prevalent virus that affects our respiratory system, and is present in three different types: A, B, and C.

“Among these, subtype A is the most commonly found. One subtype of the influenza A virus is H3N2, which produces symptoms similar to other flu viruses such as cough, fever, cold, sore throat, fatigue, muscle pain, and respiratory complications, especially in children under two years, the elderly, and those with other medical conditions,” he said.

Both the doctors said in some cases, it has been observed that patients have persistent coughs even after the fever subsides. “One of my patients said he had a persistent cough and could not attend meetings because of it. Patients also develop extreme weakness due to it,” said Gupta.

Deswal cautioned against letting down guard at this time and said since viruses mutate over time, it is important to take precautions.  “Antibiotics are not effective in treating viral infections such as H3N2 and can be harmful, so people should avoid taking them, especially if they have H3N2.

“The virus spreads through droplets and direct contact, so it is recommended to follow precautions such as avoid touching surfaces, wash hands, follow Covid-appropriate behaviour, practice social distancing, wear masks, and avoid going out if experiencing viral symptoms. Additionally, it is important for people to get vaccinated against influenza every year,” he said.