Flu Epidemic Kills 19

At least 19 people have died from flu in the last week, according to Iran’s deputy health minister.

Speaking to reporters, Ali Reza Raeesi said the flu victims all had “underlying illnesses including respiratory, heart disease, and cancer.” All 19 had been hospitalized before they died. 

Dr. Saeed Safarnejad, an internal medicine specialist based in Tehran, said: "The flu has been raging for a month. I don't know how accurate the statistics are but, in my opinion, the number [of deaths] should be higher. The data for small towns may be incomplete and samples from the pharynx of some deceased people have not been sent for testing, and so their death from flu may not have been confirmed.”

According to Safarnejad, this year’s flu virus is more aggressive and is spreading faster than in previous years. "The samples tested are mostly H1N1 influenza, whereas H3N2 was more prevalent last year. Both are classified as class A [viruses], but the virus seems to be more invasive this year ... this is the reason for the rapid outbreak.”

Influenza symptoms include muscle pain, fever of 38 degrees Celsius [100.4 Farenheit] or higher, weakness, numbness, a dry cough and sometimes a sore throat – all of which are similar symptoms of a normal cold. Specialists usually diagnose influenza by examining the patient's pharynx and sending a sample off to a laboratory to detect the presence of the virus and determine its type.

Many Iranian hospitals are not equipped to carry out laboratory assessments for influenza. “Some university hospitals that do not have a separate infectious center and have to send samples to a university lab to get the results. Sometimes when the patient visits the university, the laboratory is closed and the result may be delayed and the sample may come after two days. If the treatment is not started immediately, the patient may die.”

Safarnejad said that in hospitals that have infectious wards, the sample is examined in the hospital laboratory. In private hospital laboratories, samples are examined either in the hospital laboratory itself or with the help of other laboratories, but the cost of testing in private hospitals is higher.

Shortage of Medicine

He says in many cases of in-house treatment for high-risk groups and critically ill patients, treatment begins before the flu test results arrive. "People with chronic and underlying diseases such as hypertension and diabetes, pregnant women and women who have given birth in the last two weeks, children aged between six months to five years old, people over the age of 50, people who have any immune-deficient disease, or who are undergoing chemotherapy, people who have recently had an organ transplant or received a blood transfusion all fall into the high-risk group.”

The doctor said there was a shortage of medicines in hospitals earlier this year when doctors started to diagnose flu cases. "Almost a month ago, the flu epidemic spread. In early November, an epidemic was reported. At first the medication was not available; we did not have oseltamivir [an anti-viral medication also known as Tamiflu]. To begin the treatment, the [relevant] deputy at the university centers, who usually provided the medicine to the hospitals, said that the diagnosis had to be absolutely positive to give us the medicine, but sometimes if we waited for the results to come, the patient would die. Therefore, we had to begin the treatment based on clinical diagnosis. But after about two weeks the problem was resolved and we got back to normal.”

A Telegram channel that publishes medical news quoted Gholamhossein Mehralian, the director of Iran’s Food and Drug Administration, and his confirmation of Dr. Safarnejad’s assessment. "Unfortunately, the domestic manufacturer of the flu medication suddenly announced in autumn that despite the availability of raw materials, it was unable to produce the medication. So we encountered an unexpected situation because it is difficult to supply medication in the autumn. We managed to provide the flu medication from foreign sources and emergency centers.”

A Flu Virus From Another Country? 

Safarnejad says the flu has claimed lives from the medical community as well. "A cardiac surgeon and professor at Tehran University, who was about 42 two years old, unfortunately died from the flu." He did not name the doctor, but the funeral announcement on Telegram named him as Dr. Alireza Safavizadeh, and confirmed he was a cardiac surgeon and that he had died after contracting the flu.

"It seems that he had paid a visit to a person who had gone on a pilgrimage trip to a neighboring country and became infected,” Safarnejad said.

On the subject of the current strain of the virus possibly coming from outside the country, he said: "We have unverified expert reports showing that most of the infected people have been in contact with people who have traveled to pilgrimage destinations in neighboring countries.” He added: “In general, the virus is more likely to spread in public spaces with a high volume of people.”

He urged people at high risk of contracting the virus to get a vaccination and also appealed to the medical community to offer the vaccine to vulnerable people. "As far as I know, the flu vaccine is available in the country and there is no problem in this respect. I don't know why the high-risk groups do not take the doctors’ vaccination recommendations seriously. Public health education and proper information can very much help to curb the spread of the virus."