KARACHI: Hospitals across Karachi are reporting a sharp rise in patients with flu-like symptoms, prompting renewed concern about seasonal influenza and the circulation of the H1N1 strain as the city moves towards winter.
Aga Khan University Hospital (AKUH) has recorded 400 influenza cases so far this year, according to Professor Dr Syed Faisal Mahmood, an infectious diseases specialist at the institution. He said H1N1 influenza was affecting people in Karachi and warned that cases could increase further towards the end of the year.
The increase is also evident at the city’s major public hospitals. Jinnah Postgraduate Medical Centre (JPMC) is receiving around 70 to 80 patients with flu-like symptoms daily, up from approximately 30 to 40 a day, while Dr Ruth Pfau Civil Hospital Karachi is reporting around 30 to 40 such patients daily, compared with eight to 10 previously.
The figures indicate a growing burden on hospital services, but they do not establish the total number of influenza infections across Karachi. Nor do they mean that every patient presenting with fever, cough or a runny nose has laboratory-confirmed H1N1.
H1N1 remains a concern as influenza activity rises
Professor Dr Syed Faisal Mahmood said the H1N1 strain affecting people in Karachi was the same influenza A subtype associated with the 2009 swine flu pandemic. The virus has continued to circulate and evolve since then.
Influenza viruses undergo ongoing genetic changes, which is one reason seasonal influenza vaccines are reviewed and updated regularly. However, the emergence of a new variant should not automatically be interpreted as evidence of a more dangerous virus or a new pandemic.
Dr Mahmood cautioned that influenza activity could increase further by the end of the year. His warning comes as hospitals report more patients with respiratory symptoms, although the available figures do not establish that Karachi is experiencing an influenza epidemic or that all the reported illnesses are caused by H1N1.
Testing practices also affect the picture. Dr Mahmood said not every patient with flu-like symptoms undergoes an influenza test; testing is generally more likely in patients who are seriously ill. As a result, the number of confirmed cases recorded by a hospital may not reflect the full number of people experiencing influenza-like illness in the community.
JPMC sees up to 80 patients with flu-like symptoms daily
At Jinnah Postgraduate Medical Centre, the increase has been particularly noticeable over the past week.
Dr Irfan Siddiqui, head of JPMC’s emergency department told, the hospital had been receiving patients with flu-like symptoms for more than a month, but their daily numbers had recently doubled from around 30–40 to 70–80.
He linked the rise to the seasonal transition towards winter, particularly falling night-time temperatures. He also noted that people often initially seek care at neighbourhood clinics and may visit a hospital emergency department only when their condition becomes more serious. Consequently, hospital figures may capture only part of the wider burden of illness in the city.
According to Dr Siddiqui, many of the patients currently presenting at JPMC are between 18 and 32 years old. He also reported that some patients were experiencing more severe illness and taking longer than usual to recover.
The increase in patient numbers is therefore a reason for vigilance, particularly for people who are more vulnerable to complications, rather than proof that every case is caused by a single influenza strain.
Civil Hospital reports a similar increase
Dr Ruth Pfau Civil Hospital Karachi has also recorded a substantial rise in patients presenting with flu-like symptoms.
Civil Hospital's Additional MS and Head of Emergency Dr Imran Sarwar Sheikh said the number of patients had increased considerably. He said influenza daily cases had risen from around eight to 10 to approximately 30–40.
He said patients from different age groups were affected, with younger adults accounting for a considerable proportion of those seeking care. He also noted that several members of the same family were sometimes arriving with similar symptoms.
The hospital was also seeing suspected influenza cases, with some patients referred to Dow Hospital for further assessment. Suspected cases and patients with flu-like symptoms should, however, be distinguished from infections confirmed through laboratory testing.
The rise at both public hospitals suggests that the increase is not confined to one facility. Nevertheless, the available figures are hospital-based counts rather than a city-wide surveillance total.
What symptoms should Karachi residents watch for?
Influenza commonly causes a sudden onset of fever, cough, a runny or blocked nose, sore throat, headache, muscle aches and marked tiredness. Symptoms can overlap with those of other respiratory infections, so they cannot reliably identify H1N1 on their own.
Most people recover without developing serious complications. However, influenza can cause severe illness, particularly among young children, older adults, pregnant women, people with chronic medical conditions and those whose immune systems are weakened.
Possible complications include pneumonia and worsening of existing medical conditions. Severe respiratory illness requires prompt medical assessment, especially if a person develops difficulty breathing, chest pain, confusion, dehydration or symptoms that improve and then return or become worse.
People with severe symptoms or a higher risk of complications should seek medical advice rather than relying solely on home remedies or assuming that the illness is an ordinary seasonal cold.
Vaccination remains a key preventive measure
Professor Dr Syed Faisal Mahmood stressed that influenza vaccination is an important way to reduce the risk of infection and serious complications. He particularly urged older adults, children and people with weakened immune systems to discuss vaccination with a qualified healthcare professional.
The World Health Organization recommends annual influenza vaccination, especially for groups at higher risk of severe disease. The vaccine’s composition is reviewed as influenza viruses evolve, and vaccination can reduce the likelihood of severe illness even when it does not prevent every infection.
Other precautions can help limit transmission. Health experts advise residents to wash their hands regularly, cover their mouth and nose when coughing or sneezing, avoid close contact with people who are ill and stay home when experiencing symptoms, where possible. Wearing a well-fitting mask in crowded or poorly ventilated spaces—and when caring for someone who is sick—can provide an additional layer of protection.
Adequate rest and fluids can help people manage symptoms and maintain hydration. Soups, broths and water-rich fruits may form part of a balanced diet, but they do not prevent or cure influenza. Anyone with worsening symptoms or a higher risk of complications should seek appropriate medical care.
DRAP warns against a falsified influenza vaccine batch
Amid calls for vaccination, a separate public-health alert issued by the Drug Regulatory Authority of Pakistan (DRAP) on October 27 warrants attention.
DRAP warned that a falsified batch of Vaxigrip Tetra quadrivalent influenza vaccine, identified as batch Y4B34, had been found in the market. The authority said the batch, purportedly manufactured by Sanofi Winthrop Industrie of France, had never been imported or distributed in Pakistan.
The alert warned of potential safety and quality risks and directed regulatory field teams and provincial drug-control departments to conduct surveillance and confiscate the falsified product. DRAP also advised healthcare professionals to check relevant supply chains and urged consumers not to use the specified batch.
The warning concerns this particular falsified batch; it is not a declaration that all influenza vaccines are unsafe. People seeking vaccination should obtain it through licensed pharmacies or authorised healthcare providers and ask a qualified pharmacist or clinician if they have concerns about a product’s authenticity.
Why the rise deserves attention
The latest reports from AKUH, JPMC and Civil Hospital Karachi point to increased pressure from influenza and other flu-like illnesses as the weather shifts towards winter. However, the 400 influenza cases reported by AKUH, the daily patient counts at public hospitals and the suspected cases referred for further assessment measure different things and should not be combined into a single city-wide case total.
For residents, the practical message is to take respiratory symptoms seriously, reduce the risk of passing infections to others and seek timely medical advice when symptoms are severe or the patient is vulnerable. For older adults, children, people with weakened immunity and those with chronic health conditions, discussing annual influenza vaccination with a healthcare professional is particularly important.
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