# 3619
Proving that political realities sometimes trump existing policy, India today has decided to begin treating all suspect swine flu cases with antivirals based on clinical observations, and not waiting for a positive test.
Over the past week, India has recorded at least 17 deaths from the virus, including that of a doctor. Schools and cinemas are closed in Pune and now in Mumbai, and people are clearly concerned.
While the WHO today reiterated their advice that healthy people with mild flu symptoms need not be given the antiviral, and that Tamiflu should be reserved for those with severe symptoms or for those at higher risk of complications, some countries are finding that easier said than done.
This report from the Times of India.
Now, all suspect cases to be given Tamiflu
Sanjeev Shivadekar, TNN 13 August 2009, 01:39am IST
MUMBAI: Major changes are on the cards in the treatment protocol for swine flu following a high-level meeting between chief secretary, Johny Joseph, and a central delegation led by additional director general (health), S Shivlal.
Now, patients suspected of having swine flu will start getting doses of Tamiflu even before their swab samples are collected. TOI was the first to report this in its edition dated August 11.
It was also proposed that Tamiflu should be made available over the counter with private chemists on prescription from a registered medical practitioner. "It was decided that instead of waiting for the confirmation test, Tamiflu treatment should be started on the basis of clinical examination of the patient,'' Joseph said.
At present, the medicine is prescribed by government doctors and is available at government hospitals, Joseph said. He added that the situation was under control with the medical and paramedical staff tackling the situation on top priority. "Our efforts will be to ensure that the disease does not spread further,'' he said.
Meanwhile, additional chief secretary (health), Sharwaree Gokhale, said so far, the practice was to give Tamiflu tablets only after collecting swab samples. "After a discussion with the Union government, the state has decided to change the treatment strategy,'' Gokhale said.
Incidentally, Gokhale on Monday had said the government did not believe in giving Tamiflu without confirming the presence of H1N1 virus. On Wednesday, she clarified that there was "no golden rule'' in the medical profession.
Gokhale, however, maintained that having Tamiflu without confirmation of the disease might lead to the virus developing resistance to the drug. "But the government cannot wait for patients to die. Decisions and strategies change as the situation demands,'' she said. The decision to change the treatment procedure was taken following the death of a doctor in Nashik early on Wednesday.
