India confirms first case of swine flu as WHO prepares to declare H1N1 a pandemic

India speeds up preventive efforts even as H1N1 Influenza A spreads rapidly through Asia-Pacific.

The health ministry of India has swung into another round of  action to safeguard the country against a possible outbreak of  swine flu in the country as the first case of swine flu infection got confirmed in the country.

India’s National Institute of Communicable Diseases (NICD)  on Saturday confirmed its first case of H1N1 virus in a 23-year-old man who arrived in Hyderabad from the US.

The IT student whose samples confirmed positive for H1N1 virus has been put in isolation, following the H1N1 infection got confirmed the National Institute of Virology(NIV), Pune.  His co-passengers were also being tracked.

According to the Health Ministry officials, all the passengers who travelled in the connecting flight from Dubai to Hyderabad have been identified and they were being contacted through Integrated Disease Surveillance Project.

“Their health status would be monitored. These passengers are also being advised to remain under quarantine for a period of seven days,” the health ministry officials stated.

The H1N1 virus has made its way though the Asia-Pacific, infectcting 121 on Sunday.

According to the latest confirmed cases of flu in the Asia-Pacific region, Japan 97, New Zealand 9, China 6 (3 cases in Hong Kong), South Korea 3, Malaysia 2, Thailand 2, Australia 1 and India 1.

Meanwhile, the World Health Organization is preparing to declare flu as a pandemic at its annual meeting beginning Monday, at Geneva. 

India has set its stockpile of the antiviral oseltamivir target to 10 million doses from about three million currently, as it joins a host of Asian nations in stepping up surveillance to check the spread of the H1N1 flu in the region.

The National Pharmaceutical Pricing Authority (NPPA) has already asked drug makers in India to give periodic report pertaining to the stock of the common anti-flu drug situations.

The leading oseltamivir producers including Cipla, Ranbaxy, Roche, Hetero, Strides and Natco have been asked to give details on the stocks of the drug everyday by 4.30 p.m. to NPPA.

NPPA’s latest step is to ensure the oseltamivir selling prices are not moving up in the retail market in case of an emergency, besides keeping a close vigil on the availability of uninterrupted supply of drug in an outbreak like situation.

Last week, the health ministry had issued an advisory prohibiting retail sale of anti-flu drugs oseltamivir following reports that Tamiflu was being sold at exorbitant prices in the retail market is not permitted in India.

Further, the government wants restrict the supply of anti-flu drug only through hospitals and public health centres attached to it as a measure to check the indiscriminate use of the drug which could result in the virus developing resistance to the only available drugs like oseltamivir.

So, the objective behind stockpiling of the drugs is to distribute them free of cost through the public health network in case of need for confirmed cases.

Almost all the oseltamivir makers have expressed their interest to supply the drug at government’s stockpile when given orders for the production. However, the government has not yet contacted any oseltamivir makers other than the Hyderabad-based Hetero Drugs for the purpose.

Hetero has already been agreed to supply some 10 lakh doses of generic oseltamivir to the government.

Hetero Drugs, the only Oseltamivir supplier in India licensed by Roche, could ramp up production to reach monthly capacity of about 80 million doses of Fluvir within weeks, Managing Director Srinivas Reddy said.

“We have told them we are keeping 1 million doses ready for them, which we can supply in 4 to 5 days,” said Reddy, referring to the Indian government.

Strides Arcolab, generic drug producer based in Bangalore, have commenced production and the commercial supplies of capsules for oseltamivir. Strides aims at producing over 2 million doses per month of swine flu capsules by June.

“This is a pandemic where we have to play a role in the public health domain and it would impact our revenue but we are in a stockpiling situation, it’s very difficult to say what the direct impact on the revenues would be,” said Aloka Sengupta, President-Business Development at Strides Arcolab.

Cipla Ltd said the company had the capability to supply 1.5 million doses of oseltamivir in four to six weeks. Cipla, which recently got its generic oseltamivir included in WHO’s prequalification list, sell its generic version of Tamiflu at about $1 a capsule for export markets, slightly more than Hetero’s 10 doses for about $6.0.

“We have received some enquiries from Mexico, Israel, New Zealand and Latin America, but nothing has been finalised in terms of exports,” Amar Lulla, joint managing director of Indian drug maker said.

Ramesh Adige, president of Ranbaxy Laboratories, the third supplier in India, said his company was also prepared to begin supplying a generic version of the drug if needed.

According to U.S. Centers for Disease Control and Prevention, World Health Organization and government officials, swine flu infection has risen to over 8000 people worldwide.

A total of 76 deaths occurred due to H1N1 infection so far. Out of this 68 in Mexico, six in US, one in Canada and one in Costa Rica. WHO says 40 countries have reported more than 8,480 confirmed cases, mostly in US and Mexico. 46 US states plus District of Columbia have combined 4,714 confirmed and probable cases. Most probable cases are eventually confirmed.

Japan’s swine flu cases soared to more than 120, health officials said, prompting the government to order the closure of schools and the cancellation of community events.

While confirmed its first two cases of swine flu in two women who arrived from the Dominican Republic.

Global health experts are planning to examine swine flu’s spread in Spain, Britain and Japan.