By Dr. Gyan Pathak
H1N1, also known as swine flu, has been rising sharply across several states in India with the National Capital Territory Delhi is worst hit. It has been reported that as on September, the cases in Delhi have crossed 4000 according to some reports, though it is not officially confirmed, that has been rising sharply for the last seven days. The other states having largest burden of the disease are Tamil Nadu (1,558), Uttar Pradesh (551), Maharashtra (427, but only through July 31), Rajasthan (163) and Punjab (93 as of August 23).
Karnataka should be kept separate from this ranking. Its widely quoted figure of 4,212 is sometimes described in headlines as an H1N1 tally, but the underlying IHIP data cited by the Karnataka health department describe laboratory-confirmed influenza cases, including H1N1.
Kerala reported 2,088 influenza infections in August and 94 influenza-associated deaths during 2026 by August 26.
Nevertheless, there is a serious data-transparency and comparability problem. NCDC’s Seasonal Influenza portal, although updated on 11 August 2026, still lists its downloadable consolidated state/UT series only for 2018–2025, not 2026. States meanwhile publish data on different schedules and under different definitions: H1N1 alone, Influenza A, H1N1 plus H3N2, total laboratory-confirmed influenza, ILI/SARI, or individual hospital notifications.
Though the Union Ministry of Health has been claiming that the emerging situation is being monitored and action has been taken accordingly, but the reality is India lacks an up-to-date publicly accessible national state-wise list of cases and what is happening to the patients. Union Health Minister J. P. Nadda’s August 21 review covered national ILI/SARI trends, laboratory surveillance, testing and hospital preparedness, with particular attention to Delhi.
The Centre’s position remains that this is a seasonal H1N1 increase, not evidence of a new pandemic strain. On August 25, ICMR said genomic surveillance identified the circulating virus as A/Missouri/11/2025 (H1N1) pdm09-like, in clade 6B.1A.5a2a/subclade D.3.1.1, and that the genetic changes were consistent with normal antigenic drift rather than emergence of a new dangerous strain. Surveillance is being conducted through 73 DHR-ICMR Virus Research and Diagnostic Laboratories.
Nevertheless, the repots in the media suggest a substantial H1N1 resurgence, even though the Union government says that there is no evidence of a new or unusually virulent influenza strain. NCDC seasonal-influenza page currently provides state/UT-wise historical data through 2025, while 2026 figures are being released through state surveillance systems and individual health departments.
The increase in H1N1 cases is also reported from Uttar Pradesh where authorities have raised alert levels, particularly because of increasing fever and influenza-like illness in part of the state. Cases are also reported on September 1 from Lucknow bringing the cities confirmed cases has reached 17. Jharkhand has also reported a number of new H1N1 cases.
NCDC, ICMR and the Ministry of Health are maintaining epidemiological, virological and genomic surveillance. The laboratory network is being used to detect changes in circulating influenza viruses.
Union government has asked states to ensure hospitals are prepared for an increase in severe respiratory illness. Delhi, for example, has instructed hospitals to maintain dedicated isolation capacity as cases rise.
The Ministry has recommended respiratory hygiene, handwashing, avoiding close contact when symptomatic and seeking medical advice when symptoms become severe or worsen. It specifically has warned against taking antivirals or antibiotics without medical advice.
The seasonal influenza vaccine provides protection against the H1N1 component of seasonal influenza. Doctors are particularly emphasising annual vaccination for people at higher risk of complications.
With the rise of cases, there is rising public concern, which is justified. However, we need not panic. H1N1 can be more serious in older adults, young children, pregnant women and people with underlying medical conditions. Most otherwise healthy people recover with supportive care, but influenza can occasionally progress to pneumonia, respiratory failure and other complications. We just need to be alert and carful.
The present situation looks like a seasonal influenza surge, not a repeat of the 2009 pandemic, experts say.
The government’s most important task now is therefore a stronger surveillance, adequate testing and treatment capacity, protection of high-risk groups, vaccination where appropriate, and rapid detection of any change in the virus or severity of disease.
Secretary, Department of Health Research (DHR) and Director General, ICMR, Dr. Rajiv Bahl has said that the current influenza situation is being continuously monitored and that there is no cause for panic or alarm. The influenza viruses currently circulating in the country are consistent with the seasonal pattern observed in recent years.
He said that seasonal influenza, including Influenza A (H1N1), is predominantly a mild and self-limiting respiratory illness in otherwise healthy individuals. Common symptoms include: Fever, Cough, Sore throat, Headache, Body ache, Fatigue and weakness. In most people, symptoms improve with supportive care and adequate rest and hydration. The presence of H1N1 does not, by itself, mean that a person will develop severe disease or require hospitalisation.
Union Ministry has issued advisories, which include covering the mouth and nose while coughing or sneezing; washing hands frequently with soap and water or use an appropriate hand sanitiser; staying at home when unwell and avoid close contact with others; maintaining adequate hydration and take sufficient rest; consuming a healthy and balanced diet; seeking medical advice if symptoms are severe, persistent or worsening; and following medical advice regarding testing or treatment. (IPA Service)
