Before the world began panicking about coronavirus, India’s swine flu epidemic had worsened.

Number of cases for the communicable respiratory disease caused by a subtype of influenza A virus, called H1N1, doubled in the country in 2019 as compared to a year ago, Ashwini Kumar Choubey, minister of health and family welfare, said in an answer in a Lok Sabha (lower house of parliament) session. In 2018, the country had seen a sharp fall in the number of affected people and deaths had halved, too.

The seasonal infection, which first surfaced in the world in 2009, occurs every year with two peaks—between January and March, and July and September. Already by March 1 this year, over 1,100 people in India have been affected by the communicable respiratory disease caused by a subtype of influenza A virus called H1N1. Twenty-eight have died.

In February, German software giant SAP shut down its India offices for “extensive sanitation” after two employees tested positive for H1N1 at its Bengaluru headquarters. By the start of March, at least 78 cases were reported in Uttar Pradesh, with over 19 policemen testing positive. Nine died. The same month, six supreme court judges were down with the illness.

“During such outbreaks, the situation is regularly reviewed and closely monitored on highest levels in the ministry of health and family welfare including through video-conferencing with senior state government functionaries,” Choubey said in his answer. It is also regularly reviewed by the Joint Monitoring Group under the chairmanship of Director General of Health Service (DGHS), which last held a meeting on Jan. 8.

Much like with the COVID-19 outbreak, the symptoms of H1N1 include fever, sore throat, runny nose, and cough. Precautionary measures are similar, too: wash hands frequently, wear a mask when unwell or in the vicinity of the patient, and practice basic hygiene and cleanliness.