At a time when health authorities throughout the country have been dealing with surging new cases of Covid-19 infection, cases of H1N1 virus, also known as swine flu virus infection, have been reported from many places.

Public health experts warned that the H1N1 virus, which is not less severe than the coronavirus, could cause a twindemic in the country.

“Even the health workers are unaware of the spread of the H1N1 virus,” said Dr Prabhat Adhikari, an infectious disease and critical care expert. “As the focus of all authorities concerned is on Covid-19, the H1N1 virus could cause epidemic in the country.”

According to the World Health Organisation’s Global Influenza Surveillance, at least 57 cases of H1N1 infection have been reported since June 6. Similarly, infection of 55 cases of AH3 virus also known as Hong Kong flu have been also reported in the same period.

Public health experts say the rise in the number of influenza cases is concerning at a time when the country is dealing with the fourth wave of the coronavirus pandemic. They have warned that chances of misdiagnosis and negligence could be high during this time, which could lead to delayed treatment and even deaths.

“Many people including some senior bureaucrats and leaders died of H1N1 virus infection in the past in our country,” said Dr Sher Bahadur Pun, chief of Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital.

“What concerns me is influenza cases have not been reported so much after the start of the coronavirus pandemic and this time cases are surging along with Covid-19 cases.”

Doctors say most of the symptoms of the H1N1 virus and Omicron variant of coronavirus overlap with each other, which can lead to misdiagnosis and cause confusions. In both infections (Omicron and influenza), patients suffer from fever, cough, shortness of breath, fatigue, sore throat, runny or stuffy nose, headache, vomiting and diarrhoea, and others.

“Both viruses cause respiratory disease and if not treated on time, both cause severity and deaths,” said Adhikari, an infectious disease and critical care expert. “Most people have been immunised with Covid-19 vaccine but we generally do not take the flu vaccine.”

Doctors say people can also be infected with Covid-19 and influenza at the same time.

On Tuesday, two died and 1,090 people tested positive for Covid—560 in 2,958 polymerase chain reaction tests and 530 in 3,342 antigen tests.

Of 6,300 total tests (both PCR and antigen) carried out in the last 24 hours 1,090 tested positive, meaning the cause of infection in over 5,00o people are unknown.

“What was the reason for the infection in other people,” said Pun, chief of the Clinical Research Unit at Sukraraj Hospital. “Some of them could probably have been infected with the H1N1 virus.”

Doctors generally do not recommend additional tests if one tested negative for the coronavirus.

When a person tests negative for Covid-19, he/she returns home believing that they are safe. But doctors say one should not forget that influenza virus (H1N1) is also highly contagious, which could cause pneumonia and if left untreated, even deaths.

In the past, hospitals in Nepal reported that people have been infected with both Covid-19 and influenza at the same time.

“Authorities concerned should step up surveillance measures and carry out influenza tests, if a patient having Covid-like symptoms tests negative for Covid,” said Adhikari, the infectious disease expert.