Swine flu paranoia sends city into a tizzy

Even a few months ago, a runny nose or a bad cough was brushed aside with a shrug and at the most treated with some cough syrup. But thanks to the paranoia surrounding swine flu, the usual post-monsoon viral flu outbreak has sent the city into a tizzy! At the slightest sniffle or the first sign of a scratchy throat, paranoid Hyderabadis are rushing to the nearest hospital for a “thorough check up” and even a swine-flu screening.
Not a surprise then, that general physicians across the city are now wearing a hassled look. The docs are an overworked lot these days, admits Dr. Rajesh Chabra, a general physician. “symptoms like cough, cold and fever are similar to that of swine flu and people are assuming the worst.”
Recalling a curious case where one of his patients just refused to believe what he had contracted was a normal cold, he adds, “I had to hospitalise one of my patients because no amount of tests would convince him that he had a simple viral fever and not swine flu.” The 23-year-old software engineer left only after two days of hospitalisation and counselling.
his is not a one off case. Dr Dinakar of Mediciti Hospital had similar experiences. “Most patients arrive looking very perplexed and demand immediate hospitalisation and swab tests,” says the hassled doctor, adding, “A 40-year-old businessman, who had recently travelled to Mumbai, came down with a fever and was sanguine he had swine flu. He could be convinced to go home only after his fever came down four days later.”
joining the throng of people queuing up for tests are members of the city’s medical fraternity. “being in constant contact with infected people, doctors are now panicking at the first sign of a stuffy nose,” points out Dr Dinakar. What’s worse, the fact they are more aware of the symptoms only adds to their paranoia.
Trying to stem the hysteria, Dr Chabra points out the difference between the regular flu and the deadly variety. “Swine flu symptoms develop gradually and worsen slowly, unlike a regular viral fever,” he says, adding that even with swine flu there is no need to panic unless you fall under the ‘high risk’ category.
“If the person is not on steroids, pregnant, a diabetic, or has advanced organ diseases, the paranoia is unwarranted.”

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A(H1N1): general practitioners need to be sensitised

Worried over the increasing number of A(H1N1) deaths in the State, experts in the frontline of combating the disease now feel that general practitioners should be sensitised on how to identify A(H1N1) symptoms in patients and provide them timely treatment.
“The role of general practitioners is important now because treatment can be effective only if it is started on time. Tamiflu, the only anti-viral drug for A(H1N1) can be effective only if it is administered within 48 hours of the person developing symptoms. It is dangerous to lose even one day because the patient might develop pneumonia and related complications,” Shashidhar Buggi, Director of Rajiv Gandhi Institute of Chest Diseases (RGICD), said.
Citing the example of his daughter, Arundathi Buggi, who had tested positive for the flu and was successfully treated, Dr. Buggi said: “None of the 2,700 and odd patients who visited our institute for screening and were administered Tamiflu came back to us with complications. All those who died in RGICD were those who had gone to other hospitals before and came to us in the last stage.”
Medical Director of Lakeside Hospital H. Paramesh said the deaths were occurring because the virus has a tendency to spread rapidly. “There have been cases wherein the patient has developed pneumonia within 24 hours of getting infected. The death of a techie in our hospital is one classic case. This person, who was hale and hearty before he got infected, died within five days of getting the virus,” he said.
But at least two patients, who had reported to the hospital in the last stage when there were no hopes of their survival, are on the road to recovery.
While an 18-month-old baby from Dharwad was successfully treated and discharged from the hospital a week ago, another 40-year-old woman from Haveri is recovering.
The woman was brought to the hospital 10 days ago. “She had developed bilateral pneumonia and her lungs were in a bad shape. She was on the ventilator for almost 10 days and we had lost hopes. She is recovering now and we have removed the ventilator. She will be discharged soon,” he said.
“The patients themselves are aware now. If their symptoms continue for more than two days, they ask the doctor whether it is A(H1N1), who in turn does not want to take any chance. They are referred to bigger hospitals,” he added.
Although no deaths were reported on Monday and the death toll remains 64, 14 more persons tested positive for the disease taking the total number of confirmed cases to 774. While 13 of the fresh cases are from Bangalore, one is from Belgaum.


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Three more die of A(H1N1) in Bangalore

Three more A(HINI)-related deaths were reported in the State on Sunday taking the number of people who have died of the flu to 64.
Those who died on Sunday are a five-year-old boy in Gulbarga, a 60-year-old man in Kolar and a 29-year-old woman in Bangalore.


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Delhi pvt labs begin swine flu tests

Private labs opened their doors to swine flu testing on Thursday, giving Delhiites an alternative to government-run screening centres
for detecting the disease. Three private labs have begun testing for the flu while another is expected to launch the facility from Friday.

The city government on Thursday gave permission to the fourth private lab - Super Religare Laboratories (SRL) - to test for H1N1 influenza, triggering a price war of sorts. SRL has priced the test at half of what the other three approved labs are charging.

The state health department is working out a mechanism for reporting positive H1N1 cases discovered by these labs. Meanwhile, these private centres have started collecting samples for testing. One lab, Auroprobe, began on Wednesday itself when it collected four samples. On Thursday, Auroprobe collected close to 20 samples, Dang's lab had eight and SRL got 4-5 samples. Dr Lal's pathlab will start from Friday. All four labs are promising results within 48 hours.

The three labs approved for testing on Tuesday had unanimously decided to charge Rs 9,000 flat for the test. But SRL announced that it would do the same test for Rs 4,500. ``It is a national emergency and we can't be fighting over the cost of the test. The test is expensive, as the reagents, testing kits and other material are imported and we are not exempted from custom duty. It is costing us close to Rs 8,000 or more,'' said Dr Navin Dang, director, Dr Dang's Lab.

According to sources in AIIMS, it costs the government around Rs 4,000-Rs 5,000 for each test. ``The custom duty on reagents, enzymes, testing kits etc used by us is less as compared to what private labs have to pay. The cost is high as the material used in testing is very expensive. The cost of the test is also high because we have to test for at least four factors - influenza A, swine A, swine H1 and RnT,'' said a senior doctor at AIIMS.

On being asked about the drastic difference in pricing, Dr Sanjeev Choudhry, CEO, SRL, said, ``Profit margins in these tests are very low. Our price is low as we are buying the reagents and kits in large quantities. Our testing capacity is also more and there are several other factors that affect the cost of any test.'' Choudhry said SRL would soon press 10 mobile vans into service for collecting samples.

The other three labs say that they are not likely to bring down the cost of the test any further. ``When it is costing the government close to Rs 5,000, how can it cost the private sector less? We have worked out the price after much debate and can't bring it down further,'' said Dr Arvind Lal, chairman and managing director, Dr Lal's Pathlabs.

Said Dr Nimrat Bawa, director, Auroprobe lab, which is offering home collection service, ``Our people have to wear personal protection equipment while taking the sample. If we collect samples from home, the PPE has to be discarded after taking one sample. There is no way that we can bring down the cost.''

The state health department, meanwhile, is concerned about the reporting mechanism of positive cases found by these labs. On Thursday, a 80-year-old woman who was admitted at Max hospital in Saket, tested positive for H1N1 influenza. Her sample was tested at Auroprobe lab. She was shifted to RML hospital late at night. The state health department is working out a way to ensure that positive cases from these labs are sent to government hospitals for treatment.

``We have to address this problem. At present, private hospitals are not allowed to keep any swine flu patient. Now that these labs will be testing samples, we will ask them to advice the patient to go to a government hospital. It is the government hospital doctor who will decide whether the patient needs hospital admission or can stay in home quarantine,'' said Kiran Walia, Delhi's health
minister.

The health department also plans to increase the strength of its tracking teams. ``We have asked these private labs to report positive cases to us and our teams will then visit patient. We are thinking of increasing the strength of our tracking team. It is clear that private hospital doctors can't treat swine flu patients,'' said Walia.

7 new cases of swine flu in AP

Seven confirmed cases of swine flu were reported from Andhra Pradesh on Tuesday, a health official said here.

With this, the total number of H1N1 infections in the state has shot up to 116, Ms Jayakumari, the district health and medical officer (DHMO) said here.

She said 92 samples were tested on Tuesday. Twenty-three confirmed cases are undergoing treatment in various hospitals.

Meanwhile, Mr S.V. Prasad, the superintendent of the AP Chest Hospital, said of the seven new positive cases, four have been admitted to the government-run medical facility. This includes a two-year-old girl and her 34-year-old father, Mr Prasad said.

A 26-year-old critically ill H1N1 patient, undergoing treatment at the hospital, is recovering, he added.

Indian dies of swine flu in Saudi Arabia

Saudi health authorities have announced three new swine flu deaths, including of an Indian expatriate, taking the country's toll to 14.
The three included a Saudi woman of 28 and a Saudi girl of 11, both of whom died on Friday, and the Indian expatriate man who died Thursday, the health ministry said.

The ministry said that the spread of the A(H1N1) flu virus remains relatively slow and that fatalities are low in the country. Official infection figures have not been updated for nearly two weeks but reports put them over 700.

Saudi Arabia has been stepping up surveillance and treatment activities with the approach of the holy month of Ramadan, when normally hundreds of thousands of foreign Muslims arrive in the country to undertake the umrah minor pilgrimage to Mecca.

But hotels in the Mecca region are reporting large cancellations due to the fear of flu. Iran, Iraq and Egypt have all announced restrictions on who can travel for umrah, and the Saudi government has discouraged the elderly and children from coming.

Meanwhile Saudi King Abdullah has ordered that all cases of swine flu be treated for free, whether for Saudis or foreigners.

Indian natural herb Tulsi to fight back swine flu

Ayurveda, the traditional 'science of life', has a remedy for diseases when every other stream of medicine fails. Now, at a time when swine flu is spreading like wildfire across the world, Ayurveda has the remedy in the form of the miraculous herb, the basil leaves commonly known as Tulsi.

Tulsi, the purest and most sublime plant, has been known and worshipped in India for more than five millennia for its remarkable healing properties. Considered as an 'Elixir of Life', this wonder herb has now been claimed to keep the deadly swine flu at bay and help fast recovery in afflicted persons.

"The anti-flu property of Tulsi has been discovered by medical experts across the world quite recently. Tulsi improves the body's overall defence mechanism including its ability to fight viral diseases. It was successfully used in combating Japanese Encephalitis and the same theory applies to swine flu," Dr U K Tiwari, a herbal medicine practitioner says.

Apart from acting as a preventive medicine in case of swine flu, Tulsi can help the patient recover faster.

"Even when a person has already contracted swine flu, Tulsi can help in speeding up the recovery process and also help in strengthening the immune system of the body," he claims.

Dr Bhupesh Patel, a lecturer at Gujarat Ayurved University, Jamnagar is also of the view that Tulsi can play an important role in controlling swine flu.

"Tulsi can control swine flu and it should be taken in fresh form. Juice or paste of at least 20-25 medium sized leaves should be consumed twice a day on an empty stomach." This increases the resistance of the body and, thereby, reduces the chances of inviting swine flu," believes Patel.

As its name suggests, Tulsi has again proved to be the 'the incomparable' medicine - this time, in the prevention and cure of swine flu.

The symptoms of the H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with novel H1N1 flu virus also have reported diarrhea and vomiting. The high risk groups for novel H1N1 flu are not known at this time, but it's possible that they may be the same as for seasonal influenza. However, Please consult a practitioner in case of any such symptoms. Doctors have strictly advised against self medication.

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People throng Chest Hospital

Long queues, heated exchange of words and anxiety ridden persons flocking to the A.P. Government General and Chest Hospital was on witness on Tuesday as the swine flu scare continued to keep the city in its grip. While the number of those coming for screening kept swelling, worried relatives of those already admitted stayed put in the hospital campus waiting for results of the screening.

Today, two more persons including one who had travelled to the city from Pune had tested positive for A (H1N1) influenza prompting authorities to decide on widening the screening network. Steps were being initiated for what has been descried as ‘passive screening’ at the bus and railway stations for passengers arriving from other places to the city.
Allegations

“My sister had fever and was admitted here yesterday but they neither started any treatment nor took blood samples,” said Sanket R. Jadhav, who rushed from Nasik. Accompanied by his mother, he paced around nervously and complained bitterly, “They have not even given basic treatment for her high fever”.

Kamaraju was also sore at the way the status on his 13-year-old daughter admitted on Friday night was not yet known. “They took samples but results have not come. The poor child is quarantined and it is as if she is serving prison sentence,” he bemoaned. The State Coordinator for swine flu, K. Subhakar however denied that the patients were not being taken care of at the hospital and that enough facilities were made for a quick check. “Indeed some reports were delayed at the National Institute of Communicable Diseases (NICD) and even we are eagerly waiting for them,” he said.

Since a positive case was reported among those who travelled from Pune, the authorities took a decision on ‘passive screening’ at the bus and railway stations. The Institute of Preventive Medicine (IPM) would also be ready to handle the screening of samples in a week’s time and the authorities are looking at roping in the services of private laboratories .

So far, 76 positive cases were reported in the city and Dr. Subhakar added that 73 were treated and sent home while the other three were undergoing treatment at the hospital.
YSR convenes meeting

Meanwhile, Chief Minister Y.S. Rajasekhara Reddyconvened a high level meeting on Wednesday to dicuss about steps to prevent the spread of the virus.

‘Tamiflu can have bad side-effects on children’

Consumers in India will soon be able to buy anti-flu drug oseltamivir (marketed as Tamiflu by Swiss company Roche) from retail stores, with the
government planning to lift the ban on retail sales. However, researchers at Oxford University have questioned the safety of the drug for children. They found in a study that it caused vomiting, dehydration and other complications in about 5% of cases among children aged between one and 12 years.

While the drug provided a small benefit by shortening the duration of illness in children with seasonal influenza and reducing household transmission, it was found to have little effect on asthma flare-ups, says the study published in British Medical Journal.

Researchers have clearly said that the harmful effects of Tamiflu and Relenza — another commonly used anti-viral drug — far outweigh their benefits and the results found for seasonal flu would apply for H1N1 too. The way out, they say, is to limit Tamiflu use, especially in children, to serious cases.

Indian doctors say this is the latest in a long series of questions raised about the H1N1 ‘‘wonder drug’’. Earlier, another study had reported that Tamiflu caused nausea and nightmares in children.

Said AIIMS professor of medicine Dr Randeep Guleria: ‘‘There have been other reports. In Japan, it was found to cause neuro-psychiatric manifestations like suicidal tendencies in patients. The drug’s literature, I believe, mentions this. That’s why we have been constantly warning against indiscriminate use.”


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'Allow pvt hospitals to diagnose, treat swine flu'

To control the spread of swine flu in the country, which have result in six deaths, industry chamber Assocham today asked Health Minister Ghulam Nabi Azad to permit reputed private hospitals and accredited charitable institutions to diagnose and treat suspected such patients.

The chamber said the government hospitals are over congested to tackle current outbreak of the disease.

"Established and credible laboratories in private sector including charitable centres are well equipped to diagnose and offer treatment for swine flu," Assocham President Sajjan Jindal said in a release.

Jindal said, since authorised health institutions in the government sector are limited in number to check blood samples of suspected and afflicted swine flu patients, credible health institutions in private sector be allowed to detect the flu and treat it.


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Swine flu helpline numbers and hospitals

WHO declared the start of the Influenza A(H1N1) pandemic on June 11, 2009. Over 1,000 people across the world have succumbed to the disease including a 14-year-old girl in India.

Here is the list of helpline numbers in India:

All India toll free H1N1 helpline: 1075 or 1800-11-4377

Delhi: Ram Manohar Lohia Hospital: 011-24525211, 23404328, 23365525

Deen Dayal Hospital: 011-2512 5259

Chennai: Communicable Diseases Hospital - 044-25912686.

Coimbatore Medical College Hospital - 09442012555

Kolkata: Infectious Diseases Hospital: 09433392182/ 09434009077

Hyderabad: AP Chest Diseases Hospital: 040-23814939

Mumbai: Kasturba Hospital: 022-23083901, 23083902, 23083903, 23083904

Pune: Dr Naidu Infectious Disease Hospital - 09923130909

Bangalore: Rajiv Gandhi Institute of Chest Diseases - 91-80-26632634

Lakeside Hospital - 80-5360823

Pune doc, Chennai boy die; swine flu toll 6

The H1N1 panic is spreading as fast as the virus across the country with two deaths being reported early on Monday morning. In Pune, an Ayurvedic doctor, who was brought to Sassoon hospital in Pune after reporting of symptoms, died of swine flu-related complications. A four-year-old boy from Chennai also died while being treated for other complications.



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Pune doctor dies of swine flu, toll rises to 5

A 35-year-old ayurvedic doctor died here on Monday morning becoming the fifth fatality of the deadly swine flu in the country.
Dr Babasaheb Mane is the third person to lose his life due to the H1N1 virus in Pune. Mane, who was admitted to the Sasoon Hospital here, died this morning due to swine flu, a senior health official said.

Mane was ailing for sometime and there was blood in his cough for the last couple of days, officials said.

Pune reported India's first swine flu death on August 3 with 14-year-old Reeda Sheikh succumbing to the disease.

On Saturday, 53-year-old Fahmida Panwala from Mumbai and 42-year-old teacher Sanjay Tukaram Kokre from Pune had died of swine flu. On Saturday, A 43-year-old NRI had died in Ahmedabad.

Ahmedabad man dies of swine flu, toll rises to 4

A 43-year-old man died of swine flu early morning on Sunday at the city civil hospital here, a senior official said Confirming the first swine flu death in Gujarat, state health secretary Ravi Saxena said Praveen Patel, an NRI, died of swine flu at city civil hospital at around 1:30am.

"He was admitted to the hospital in critical condition yesterday morning. His left lung was badly damaged," Saxena said.

Patel, who had returned from Atlanta on July 31, was admitted to a private hospital for pneumonia and common flu on Friday.

"He was referred to the civil hospital after doctors treating him realised that it was not common flu," Saxena said, adding where he was confirmed having swine flu.

Patel's wife has also been confirmed suffering from swine flu and is being treated at the civil hospital, he said. So far, 10 people have been tested positive for H1N1 virus in the state, he added.

The country has now seen four deaths from swine flu with the number of infected cases rising to 782.

On Saturday, 53-year-old Fahmida Panwala from Mumbai and 42-year-old teacher Sanjay Tukaram Kokre from Pune had died of swine flu. Earlier on August 3, 14-year-old schoolgirl Reeda Shaikh also from Pune, had died due to the H1N1 virus.

Doc, chemist with H1N1 battle for life

As swine flu
cases across the country rose, an ayurvedic doctor and a chemist infected with the H1N1 virus were battling for
their lives on Friday in Pune, the city from which the first flu fatality was reported. Both the doctor and the chemist are on the ventilator.

Across India, 96 new cases were confirmed taking the total number of flu patients to 171. Alarmed by the spurt, the Union health ministry on Friday decided to allow private hospitals and labs with bio-safety level-II to conduct swab tests but only if these had isolation wards where positive cases could be quarantined. These private facilities are also required to have a real-time PCR, the gold-standard test to detect H1N1. Health authorities also directed fliers in high-risk groups, such as senior citizens, pregnant women and heart patients, to wear masks at all times during the journey.

On Friday, Mumbai also reported its first flu-positive case - a school student. While school authorities denied the student had swine flu, health officials confirmed the case. The school will be shut from Monday.

In Pune, the 36-year-old doctor, who had been suffering from an upper respiratory tract infection (URTI) for a week, went to the Naidu government hospital to get his throat swabs taken. According to the doctor's brother, authorities at Naidu hospital did not take his throat swab following which he went to a private hospital. When he started complaining of breathlessness on Wednesday, the hospital, suspecting it to be a case of swine flu, sent his swab for testing to the NIV on Thursday. The report, which was received early on Friday, showed that he was H1N1 positive.

The 35-year-old chemist from Hadapsar, who tested positive for the flu and was admitted to the Sassoon hospital on Thursday night, was said to be showing signs of improvement. He was brought to the hospital in a critical condition, medical superintendent Pandurang Pawar said.

A six-year-old girl, who also tested positive for swine flu at a private hospital, was shifted to Sassoon hospital later in the evening. Her condition was stable, said Dr Pawar.

Ten people with whom the chemist came in contact over the past few days have been quarantined and under observation. Most of them are the chemist's relatives. Eight of them have been quarantined at home while two are at Sassoon hospital.

The hospital has just two ventilators and has requisitioned for six more. Dr Pawar said he had enough Tamiflu tablets but has still asked for 5,000 more.

10,000 masks sold in 15 days

After the first swine flu death in Pune, several people in the city are panicking and are thronging city hospitals for enquiries. People with the slightest hint of cough and cold are anxious to get themselves tested for the H1N1 flu virus. Interestingly, the list starts from younger age group who are more concerned about contracting the deadly virus. Adding to this are mails that are frightening people with bizzare statistics of swine flu cases across the world. Says Dr. J. K. Reddy, pediatrician at Child Trust Hospital, “I get nearly five persons a day who enquire about swine flu. As there was a change in climate, many kids suffer from fever and cold. Concerned parents approach me wanting to know more about this disease and how it could affect their kids. As the symptoms for this virus are a common fever or cold, they are more worried.”
The demand for face masks have also increased. Dilip Ranka, manager at Chennai Surgical and Pharma Generics says, “There is an increase for swine flu masks. There are two types of masks — one of a cheaper quality available for just Rs 1.50 and the other at Rs 70. In 15 days, we have sold about 10,000 masks.”
Doctors are also advising the HR managers of various companies about what they should do when they come across such symptoms among employees. Says Dr. Vijay Raghavan, consultant medicine, LifeLine Hospitals, “I’m getting around four to five enquiries per day and many are from the IT sector. Surprisingly the age group is from 18 to 35 years. As the awareness is high, the fear factor is increasing and people with slight cold and fever are on the lookout for doctor’s advice.”
Says Divya Bhargavi, an IT professional, “One of my friends had a sore throat, running nose — almost all the symptoms of swine flu. But fortunately, her temperature came down and she was all right within a week. Adding to our worry are the various e-mails about the flu, even though we look at the lighter side of it. These have figures of people who died in USA, UK, Australia, and finally it reads, ‘It’s India’s turn to lose. Be cautious’.”
Dr. Gunasekaran, deputy director, department of Virology, King Institute of Preventive Medicine says, “People themselves assume that it could be swine flu and come to us. There is a lot of panic after the death of a young girl from Pune. Unless the director of Public Health permits, we are not allowed to proceed further.”

SWINE FLU MYTH BUSTER

* Eating pork could give you the disease : No, it does not. The virus spreads person-to-person by contact and close proximity.

* A running nose : Not necessary as it may be just a regular flu. Nevertheless if you have other swine flu symptoms such as high fever, vomiting etc., get a check-up done

* No cure : With proper medications and care, H1N1 virus can be cured.

* Safer with mask : May not be always helpful. It is better to sneeze into a tissue and bin them. Wash your hands regularly.

w H1N1 virus, the only threat today : There are more people dying of diarrhoea everyday compared to swine flu!

Now, outbreak of panic over swine flu

Women cradling babies, schoolchildren tagging along with parents, college-going teens, senior citizens and even pregnant women - more than
a thousand people thronged Pune's government-run Naidu Hospital on Wednesday as panic deepened two days after the country's first fatality from swine flu was reported from the city.

Men, women and children with the slightest hint of cough and cold, anxious to get tested for the flu virus, began gathering from early morning and doctors and hospital staff soon found themselves swamped by a jostling crowd.

What made things worse was private general physicians, who normally are the first point of consultation, turning back patients who came to them with cold and fever symptoms, telling them to get checked at Naidu Hospital.

Pune municipal commissioner Mahesh Zagade said 20 patients suspected of having the virus were admitted to the hospital on Wednesday. Nine positive cases were reported as more people reported for testing, following the death of 14-year-old Rida Shaikh. The city planned 15 more screening centres for the H1N1 flu from Thursday. The civic administration also decided to increase the number of doctors at the hospital to clear the rush.

As the crowd at the hospital grew larger, tempers rose. Around 11am, a scuffle broke out between members in the crowd and the hospital staff following confusion regarding entry into the medical officer's cabin. However, policemen deputed at the hospital brought the situation under control.

No sooner than he came to the hospital for an inspection, municipal commissioner Zagade was surrounded by concerned parents. Parents of students from St Anne's School, where Rida Shaikh studied, demanded that their children be tested first.

``One doctor can handle 40-45 cases in a day. With more and more people pouring in here, we need more experts to deal with the situation,'' Zagade said.

On Wednesday, as many as 100 throat swab samples were sent for testing to the National Institute of Virology (NIV).

The institute usually receives an average of 40 samples every day. In view of the large number of samples, the NIV has doubled its workforce and machinery.

Taking note of complaints that private practitioners were directing patients to Naidu Hospital with minor ailments, district collector Chandrakant Dalvi warned that it would be considered a ``serious offence'' if any doctor avoided his duty of initially screening flu patients.

However, Dilip Sarda, president of the Pune unit of the Indian Medical Association, told TOI that the developments following Rida's death had created a panic in the medical fraternity. ``Doctors are reluctant to check patients suffering from cold and fever as they fear action may be taken against them if any of the patients test positive for H1N1 later. However, the IMA is appealing to the doctors not to refuse patients,'' he said.

With more than 70 confirmed cases of H1N1 flu coming from various city schools so far, the Pune Municipal Corporation

(PMC) held an emergency meeting of school representatives on Wednesday and instructed principals and headmasters of all private and municipal schools to raise awareness about the flu among students and their parents and submit a report about the steps taken to the civic body on August 7.

Meanwhile, worried parents at Naidu Hospital, many of whom waited for over two hours, seemed far from satisfied with the doctors.

``All the doctor did was counsel us. He refused to do the swab test even though my son has been suffering from fever, diahorrea and vomiting since the last six days. The doctor says unless they are sure that he has come in contact with an infected person, they will not do the test. But since my son goes to school, it is difficult to say whether he has come in contact with a positive case,'' said an angry father.

Another parent, also unhappy with the testing, said, ``In the past few days, we have been to the railway station, banks and other public places. How can we possibly know whether anybody there was infected or not?”

Defending their stand of not testing every person who showed symptoms, Narendra Thakur, medical officer at the Naidu hospital, said, ``The government has set criteria for us to conduct the tests. The swab test will be done only if a person has been abroad recently or has come in contact with a positive case. We have to work according to the guidelines of the government. Due to panic, even those suffering from ordinary flu are coming to us and we cannot test everyone.''

The Pimpri Chinchwad Municipal Corporation (PCMC) also held a meeting of school representatives on Wednesday. PCMC medical officer R R Iyer told TOI that the civic body has appointed 42 medical officers to keep a watch on schools in the municipal limits. The relatives of two H1N1-positive cases in the PCMC limits have been quarantined at home.

Aundh civil hospital, which is the other centre for treating and admitting H1N1 cases, took in 17 new suspected cases on Wednesday. The hospital has seen 18 positive cases so far. Of these, 15 have recovered.

In Satara district, the Krantisinh Nana Patil hospital opened a special screening cell on Wednesday. Twenty-five positive cases have been detected in the district over the past two weeks. The hospital presently has six confirmed and two suspected cases. Seventeen patients have recovered.

Two students of Rida's school test positive for A(H1N1) flu

Two girl students of a school from where the country's first A(H1N1) flu death was recorded tested positive for the deadly virus on Wednesday night, as hundreds of anxious people including children thronged a referral hospital to take tests leading to panic and chaos.

A Class Ten student from St. Anne's school tested positive for the deadly A(H1N1)virus as per the information provided by her father, according to Nirmala Chandy, Vice Principal of the school.

14-year-old Rida Sheikh, a Class 9 student, succumbed to the disease on Monday triggering a wave of panic in the city.

Rida, who had flu symptoms on July 21, attended school briefly after taking treatment from a general practitioner before she was admitted again on July 27 at Jehangir hospital.

Civic Medical Officer R R Pardeshi said a fourth-standard girl from the same school was also admitted to the Naidu civic hospital, a referral centre for A(H1N1) Flu, in the morning on Wednesday with symptoms of the disease.

Throat swabs of the girl were sent to Pune-based National Institute of Virology(NIV) which tested positive for the virus, he said.

Ms. Chandy said the school will be closed for eight days from Wednesday.

Doctors and authorities tried to calm frantic parents with children wearing face masks for protection rushing to Naidu hospital to take H1N1 influenza tests. Police had to be called in to control the crowd.

There were complaints galore by people referred to the Naidu hospital for the tests that they were not being attended properly but hospital authorities sought to downplay it saying the "whole burden" was on them and that people even without any symptoms were being referred.

Swine flu death: Victim's family to sue hospital for negligence

The family of the 14-year-old girl who died of swine flu on Monday due to "delayed treatment" has threatened civil and criminal action against the private hospital where she was admitted.

Fourteen-year-old Rida Shaikh died at the Jehangir Hospital in Pune. She was suffering from the influenza A (H1N1) virus infection for a fortnight. Her upset family on Tuesday said that they would sue the hospital for negligence and give all the money to charity.

"We will take civil and criminal action against the hospital. The family will also sue the hospital for damages and get a huge sum of money. We are not interested in the money. The money will be given to charity," Asif Lampwala, the family lawyer said at a press conference here.

An upset and emotional Sajid Shaikh, Rida's father, said: "If they (the private hospital) had sent Rida's samples to the NIV earlier, probably my daughter would have been alive today."

Her aunt, Ayesha Shaikh, added: "We didn't know then, but now we know that Ruby Hall, where Rida's samples were sent for tests initially, was not authorised (to test for swine flu)."

"Initially the hospital said she was suffering from pneumonia, then they said she was suffering from some respiratory disorder. When her lungs got affected they told us that there was nothing to worry because her other organs were not affected.

"When we realised what the truth was, it was too late," she added.

Rida had consulted a general practitioner on July 21 when she first reported flu-like symptoms - sore throat, runny nose and headache. When her condition improved, she joined school on July 23.

According to a health ministry statement, she again developed fever on July 25, and consulted another private practitioner. Her fever continued and she was admitted to the Jehangir Hospital on July 27.

Her condition worsened and she was shifted to the ICU and put on the ventilator on July 29. Her sample was sent to the National Institute of Virology only on July 31 and found to be positive for swine flu. She was put on Oseltamivir or Tamiflu on July 30. Her condition, however, deteriorated and she died on Monday, the first death in the country because of H1N1 virus.

On Monday, union health secretary Naresh Dayal said in New Delhi that the girl was given anti-flu medicine at a very late stage.

"It appears she was treated late. If she had been treated earlier, she could have been saved," Dayal said