The cold facts: 

The cold facts: 

Context:

• Ever since the influenza virus known as H1N1 ushered in India on 2009 pandemic, outbreaks have been an annual occurrence.
• But India’s surveillance systems are poor and underestimate the influenza burden substantially.

How accurate are these official figures in India?

• The problem with these official figures is that they only capture H1N1 numbers, a practice that has been adopted in response to the severity of the 2009 pandemic.
• But influenza was present in India even before 2009 in the form of H3N2 and Influenza B virus types
• Out of these, H3N2 is capable of causing outbreaks as big as H1N1, and yet India does not track H3N2 cases as extensively as it does H1N1.
• A surveillance project for acute febrile illnesses, anchored at the Manipal Centre for Virus Research in Karnataka, has found that influenza accounts for nearly 20% of fevers across rural areas in 10 Indian States fevers that are often undiagnosed and classified as mystery-fevers.
• All this indicates that India’s surveillance systems are significantly poor.

What are the consequences of these inaccurate figures?

• As of 2015, India submits a woefully small number of H1N1 genetic sequences to global open-access databases for a country of its size and population.
• Sequencing is important because it can detect mutations in genetic material that help the virus evade human immune systems, making it more deadly.
• Because India does not sequence a large enough sample of viral genomes, it would be missing mutations that could explain changes in the lethality of the virus.