Lok Sabha Question No. 4125 (UNSTARRED), answered on 2023-03-24
Subject: Rising Cases of Influenza Subtype A H3N2
Ministry: HEALTH AND FAMILY WELFARE
Asked by: DNV Senthilkumar. S., C.N. Annadurai, Manickam Tagore B, Manjulata Mandal, Ganesan Selvam, Dhanush M Kumar

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 4125 TO BE ANSWERED ON 24.03.2023

## RISING CASES OF INFLUENZA SUBTYPE A H3N2

## 4125.  DR. DNV SENTHILKUMAR S.:

SHRI C.N. ANNADURAI:

SHRI MANICKAM TAGORE B.:

SHRIMATI MANJULATA MANDAL:

SHRI SELVAM G.:

SHRI DHANUSH M. KUMAR:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether cases of cough and fever linked to Influenza subtype A H3N2 have been reported in various parts of the country and if so, the details of number of such cases reported and those treated, State/UT-wise;
- (b) whether the Government has reviewed the preparedness of the States and adequacy of availability of drugs to deal with the disease and if so, the details of financial and technical assistance including drugs provided to States for treatment of this disease;
- (c) wether it is a fact that people are taking antibiotics to treat Infection caused by H3N2 and if so, the details thereof;
- (d) whether  Indian  Medical  Association  (IMA)  has  issued  note  of  caution  against misuse of antibiotics and if so, the details thereof and the outcome of the advisory;
- (e) the steps taken/proposed to be taken by Government for proper management and creation of health infrastructure for early detection and treatment of this disease;
- (f) whether Indian Council for Medical Research (ICMR) has indicated that the virus appeare to lead to more hospitalization than other influenza subtypes;
- (g) whether many patients who have been hospitalized with severe acute respiratory infections have tested positive for Influenza A H3N2 virus, if so, the details thereof; and
- (h) whether the Government has taken any precautionary steps in light of the warnings by ICMR and if so, the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) to (h):

As  per  information  provided  by  States/UTs,  total  1161  cases  of  H3N2  have  been reported  from  1 st January  2023  to  20 th March  2023.  State/UTs-  wise  details  is  at Annexure.

Union Health Ministry monitors the situation and has taken several steps to support states for management of influenza cases including H3N2 which includes:

-  Union Ministry of Health & Family Welfare has issued an Advisory requested all states/UTs to take necessary steps including:
- o Closely follow the trend of Influenza-like illness/Severe Acute Respiratory Infections (ILI/SARI) in respective areas, monitor the proportion of SARI cases among all ILI& SARI cases and refer sufficient number of samples for testing for Influenza, SARS-CoV-2 etc.
- o Raise community awareness regarding adherence to respiratory and hand hygiene  (like  covering  one's  mouth  and  nose  with  a  tissue/elbow  when coughing or sneezing, avoiding spitting in public places, preferably use of mask in crowded environments, frequent hand wash etc.), promoting early reporting of symptoms, and limiting contact, if suffering from respiratory illness.
- o Widely disseminate technical guidelines for Seasonal Influenza (https://main.mohfw.gov.in/basicpage/technical-guidelines), COVID-19 (https://mohfw.gov.in)  etc.  which  have  also  been  made  available  on  the website of this Ministry
- o Implement  'Operational  Guidelines  for  Revised  Surveillance  Strategy  in Context  of  COVID-19'  which  provides  for  integrated  surveillance  of respiratory pathogens  presenting as cases of ILI/SARI  available at: https://www.mohfw.gov.in/pdf/OperationalGuidelinesforRevisedSurveilla nceStrategyincontextofCOVID-19.pdf.
- o Take stock of hospital preparedness including drugs, medical equipment, capacity  building  of  human  resource  on  existing  guidelines  as  well  as vaccination coverage against COVID-19 and Influenza.

To  ensure  adequate  infrastructure  at  district  level,  Government  of  India  provides financial assistance to all States/UTs under National Health Mission for strengthening public health care systems including setting up new health facilities and infrastructure upgradation under various schemes.

As  part  of  ILI/SARI  surveillance  conducted  by  ICMR,  50%  of  the  total  hospitals admitted  cases  due  to  respiratory  infection  are  due  to  H3N2  Influenza  in  last  two months and most of these cases presented with symptoms of cough and fever.

H3N2 is a viral respiratory infection and antibiotics have no role in treatment of a viral infection. However, sometimes in respiratory infections a bacterial infection may cooccur along with a viral infection and therefore physicians may prescribe an antibiotic to take care of secondary bacterial infections.

## Annexure

|   S. No. | States/UTs          |   Cases |
|----------|---------------------|---------|
|        1 | Andaman &Nicobar    |       0 |
|        2 | Andhra Pradesh      |      12 |
|        3 | Arunachal Pradesh   |       0 |
|        4 | Assam               |       1 |
|        5 | Bihar               |       1 |
|        6 | Chandigarh          |       2 |
|        7 | Chhattisgarh        |       1 |
|        8 | Dadra &Nagar Haveli |       0 |
|        9 | Daman &Diu          |       0 |
|       10 | Delhi               |     370 |
|       11 | Goa                 |       1 |
|       12 | Gujarat             |       9 |
|       13 | Haryana             |      10 |
|       14 | Himachal Pradesh    |       0 |
|       15 | Jammu               |       0 |
|       16 | Kashmir             |       4 |
|       17 | Jharkhand           |       0 |
|       18 | Karnataka           |     134 |
|       19 | Kerala              |      49 |
|       20 | Ladakh              |       0 |
|       21 | Lakshadweep         |       0 |
|       22 | Madhya Pradesh      |       1 |
|       23 | Maharashtra         |     184 |
|       24 | Manipur             |       0 |
|       25 | Meghalaya           |       0 |
|       26 | Mizoram             |       0 |
|       27 | Nagaland            |       0 |
|       28 | Odisha              |      28 |
|       29 | Puducherry          |      99 |
|       30 | Punjab              |      25 |
|       31 | Rajasthan           |     180 |
|       32 | Sikkim              |       0 |
|       33 | Tamil Nadu          |       0 |
|       34 | Telangana           |       0 |
|       35 | Tripura             |       4 |
|       36 | Uttarakhand         |       7 |
|       37 | Uttar Pradesh       |      19 |
|       38 | West Bengal         |      20 |