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Though there is some respite in the swine flu scenario that dominated the city for last two weeks, it would be too early to breathe easy, say medical practitioners.

One of the main reasons, they believe, could be because the number of people diagnosed with the infection probably presents just a fraction of those who may be carrying the infection but remain undiagnosed.

"You could say the ones detected are just the tip of the iceberg. There are a huge number of cases that are not reported simply because we have stopped doing the swab tests, except in the case of critical cases. Thus many of the cases of swine flu are now with family doctors, who of course, refer them to the screening centres, but finally the patients end up taking Tamiflu without being tested for the virus and thus do not become part of the official statistics," said Dr Dilip Sarda, president, Indian Medical Association (IMA), Pune chapter.

Agreeing that just about 10 per cent of the infected cases may have been reported, Dr Pandurang Pawar, medical superintendent of Sassoon Hospital said while there may be many more suspected and confirmed cases that do not make it to Naidu or Aundh Chest Hospital, it's not a case for alarm as long as the precautions being taken are continued. "Ninety per cent of the cases need just home medication," said Pawar.

Dr Pallavi Bhargava, infectious diseases specialist at Deenanath Mangeshkar Hospital, said the number of those having tested positive may be way below the number that are actually infected. "In the US those who tested H1N1 positive were around 50,000 and the estimate ran to one million — about 20 times over. The same could definitely hold true for Pune at least," said Bhargava. She said given this estimation, the mortality has been fairly low, which is a good sign and proves that the disease is fairly well curable.

"Despite big numbers, the transmission seems to have reduced. There is a thing called herd immunity. That combined with the city closures we've had and the masks being worn by people may well go a long way in containing the spread," said Bhargava.

According to Sarda, such a virus occurs thrice in a century and this is its third attack. "The virus peaks at about three weeks which was the situation last week and then declines in about three months. So though it is at a low now it could spurt in the coming months," he said.

General practitioner Dr Tushar Choudhary feels that it's a logical conclusion that for every one case detected, there are many that go undiagnosed due to lack of testing facilities and medical infrastructure.

"But the good part is that this is a self-limiting disease, so as long as the cautious approach continues things should stay under control," said Choudhary.
Sunanda Mehta