Duque confirms first A(H1N1) RP case
By Dona Pazzibugan, Anna Valmero
Philippine Daily Inquirer, INQUIRER.net
First Posted 01:38:00 05/22/2009


MANILA, Philippines—Take the health warnings seriously—it’s here.

Health Secretary Dr. Francisco Duque III Thursday night confirmed the first case of Influenza A(H1N1) infection in the country—in a 10-year-old Filipino girl who arrived from the United States with her parents on May 18.

“The DoH confirms today the first case of AH1N1 in the Philippines. She is a female traveler who arrived in the country on May 18 from the United States, whose throat specimen tested positive based on results from the Research Institute for Tropical Medicine (RITM),” Duque said.

Duque, who is in Geneva, Switzerland, attending a World Health Organization (WHO) meeting, held a video conference with reporters at the WHO regional office in Manila to break the news Thursday night.

“I talked with the president and from the tone of her voice she was very concerned. In fact, she gave me the go signal to conduct this press conference,” Duque added.

Dr. Eric Tayag of the Department of Health’s National Epidemiology Center said the girl, who was not identified, had also been to Canada.

The girl, he said, developed a fever, cough and sore throat on May 19, the day after arriving, and was brought to the RITM in Muntinlupa City where the diagnosis was confirmed Thursday.

Despite the index case, Duque said: “There is no community outbreak in the country, measures are being done to prevent transmission, including quarantine of immediate household of the first case. The first case is something we have been preparing for as a result of public and private sectors’ effective surveillance system.”

Health Undersecretary Mario Villaverde said the test results came Thursday afternoon from RITM and the patient was immediately given antiviral Oseltamivir.

The first case no longer had fever and cough but still has sore throat, said Villaverde.

Tayag said specimens from the index case will be sent to a WHO collaborating center in Melbourne as routine procedure for all specimens that will test positive for the novel AH1N1.

“The child developed the symptoms a day after arrival, so this is also a call for vigilance on the part of the public that people in the country and incoming travelers from abroad, especially from infected areas, submit themselves to quarantine screening and continuous monitoring of health, especially body temperature for 10 days, and to report to the DoH any flu-like symptoms,” said Villaverde.

Villaverde reiterated that the public should observe proper hygiene, strengthen resistance and do social distancing—avoid going to crowded areas if the need is not urgent.

Since there is only a single confirmed case, Villaverde said, there is no need to postpone the opening of schools in June.

Up till then the country had been flu-free despite the disease afflicting citizens of nearby countries like Malaysia, South Korea, Taiwan, Hong Kong and Japan.

In Geneva, a month after the world was alerted to a potential influenza pandemic, doubts fostered by the mild symptoms of the new swine flu virus have prompted the WHO to think twice about sounding the maximum alarm despite the spread of infection in 41 countries.

The WHO on Thursday raised its tally of swine flu cases around the world to 11,034 and 85 deaths. Most of the 791 new cases have been reported in Canada, Mexico and the United States.

Mexico confirmed three more deaths linked to the A(H1N1) virus, while the United States confirmed two additional deaths since Wednesday’s tally.


‘Imminent pandemic’

At least 38 other countries in the Americas, Asia and Europe have reported cases since the outbreak in Mexico, but the world remains at flu alert level five, signaling an “imminent pandemic.”

WHO Director General Margaret Chan is hesitant about declaring a fully fledged pandemic by moving to Phase 6, even though travelers have carried the virus to other continents.

The maximum alert level would indicate sustained community transmission in a second region outside the Americas.

On Thursday, Japanese Prime Minister Taro Aso reiterated his appeal for calm as the number of swine flu infections in his country soared to 292, including the first two cases in Tokyo, the world’s largest urban area.

Antoine Flahaut, an epidemiologist and head of the School of Public Health (EHESP), said that the technical elements were in place to move into the pandemic phase.

“But the WHO senses that recommendations which go with that are not adapted to the situation,” Flahaut explained, pointing to air travel restrictions or advice to wear surgical masks.

“Invoking phase six would be disproportionate with the current situation,” he added.

The doubts have grown because of the relatively mild symptoms of swine flu, which experts acknowledge is no worse than seasonal influenza for now.

Many of the deaths have occurred among those who were suffering from other ailments, a common pattern for ordinary strains of flu.

When the WHO’s annual assembly opened on Monday, British Health Secretary Alan Johnson voiced doubts about phase six that had been growing behind the scenes after countries rushed to contain new cases of swine flu.


More time needed

“I think you, as you and others have said, need more time, we need more time to study this,” Johnson told Chan, prompting nods of approval from other health officials afterward, including China, Japan and New Zealand.

“She (Chan) has taken that on board,” WHO spokesperson Thomas Abraham said late Thursday, underlining that most of the cases in Japan were largely confined to students or their close entourage.

Chan acknowledged earlier this week that the WHO’s pandemic response plan, introduced three years ago, was largely designed around the more deadly and virulent, but less transmissible, H5N1 bird flu virus.

“This scale was based on geographical distribution, but the public belief is that pandemic means seriousness,” said Sylvie Briand, acting director of the WHO’s Global Influenza Program.

But the WHO is also looking ahead at the potential progress of the new virus, and fears of its impact in poor countries, where millions of people are already weakened by chronic illness.

“Whatever the member states might say, we are in phase five,” Abraham pointed out.


Similar to 20th century

In studies released by the New England Journal of Medicine, scientists pointed out the similarities between the new A(H1N1) virus and ones behind pandemics that marked the 20th century.

Those pandemics in 1918-1919—which killed an estimated 50 million people—in 1957-1963 and 1968-1970 started off as mild but went through waves that became more lethal at their peak, often the second season, and had different impacts in different regions.

The viruses also affected young people—a feature underlined by the WHO in the current outbreak—and were highly transmissible, according to researchers from the US National Institutes of Health and George Washington University. Reports from Agence France-Presse and Associated Press

It was just a matter of time for the virus to arrive. In these age of globalization, even infectious diseases are global.

Ingat na lang tayo and always take care of our health. Prevention is always better than the cure. Exercise, eat healthy food and supplement with Fern C, just like me. :armywink:

1st Pinoy A(H1N1) victim had contact with 17 people - DOH
MARK D. MERUEÑAS, GMANews.tv
05/22/2009 | 12:03 PM


MANILA, Philippines – The first ever Filipino victim of the dreaded Influenza A(H1N1) is doing well, but health authorities have said they would observe the 17 people the patient had close contact with.

The patient – a 10-year-old girl who arrived last May 18 after traveling to United States and Canada – is being quarantined in a facility the Department of Health (DOH) wouldn't disclose in the mean time.

In press conference in Manila on Friday, Health Undersecretary Mario Villaverde said among the 17 people the young girl had been in close contact with were members of her family.

The girl's mother was among the first people in the household to undergo testing. The result was negative.

“Negative siya, that's the good news. And since negative ang mother and we hope that since the mother is the closest in contact sana wala nang ibang na-infect," Villaverde said.

After arriving home from the airport, the girl came in close contact with the people in the household. The next day, she developed a fever.

After confirming that the girl carried the deadly novel virus, the DOH conducted contact tracing and eventually found out who were in danger of possibly contracting the disease – that had already downed more than 11,000 people globally.

Doctors required the mother has already taken medicine and undergone a prophylaxis, as she was the one watching her daughter while in quarantine.

"We are conducting a thorough assessment today of all the household contacts. Ginagawa na namin ang lahat ng dapat magawa [We are doing what are needed to be done]," Villaverde assured.

The Health official stressed that despite the global outbreak and the virus reaching the Philippines, the DOH sees no reason why a travel ban should be ordered. - GMANews.TV

Just proves that thermal scanners at the airports are not much of a deterrent. People can have the virus already without manifesting symptoms when they arrive from abroad.

Best defense is to strengthen further our immune systems by living a healthy lifestyle.

17 passengers monitored for flu

Philstar.com - Saturday, May 23


http://ph.news.yahoo.com/star/20090522/tph...lu-541dfb4.html


The Department of Health is tracking down 17 passengers of the plane that carried the 10-year-old girl who tested positive for Influenza A(H1N1) – the first confirmed case in the Philippines.

Taiwan health officials, meanwhile, said yesterday one of their three confirmed cases of A(H1N1) involved a woman returning from the Philippines.

Dr. Mavic Vasquez of the DOH’s Bureau of Quarantine said they have determined the identities of the 17 passengers – all Filipinos – based on the manifest obtained from the airline company.

“We are lucky that the patient was (seated) way back in the plane near the wall. There were 17 possible persons with six-hour exposure (to the patient) and (situated) within six feet,” she said at a press briefing.

Vasquez said the 17 passengers are advised to undergo self-quarantine for up to 10 days, the period during which infected individuals manifest symptoms.

Health Secretary Francisco Duque III on Thursday announced that a 10-year-old Filipino girl from the United States was the first confirmed case of A(H1N1) in the Philippines.

The girl had also traveled to Canada where there are also confirmed cases of A(H1N1).

She arrived in the Philippines with her mother on May 18 and complained of fever, cough and sore throat the following day. The patient was brought to an undisclosed hospital.

The swab throat samples taken from the girl were examined and confirmed at the DOH’s Research Institute for Tropical Medicine (RITM) Thursday afternoon.

DOH Undersecretary Mario Villaverde noted that throat specimens were also taken from the mother but these tested negative for A(H1N1).

Villaverde added the girl’s father and her other housemates have been notified of the situation and are now undergoing self-quarantine at home.

“It’s a good thing that the patient stayed mostly inside their house after arriving, probably because of the time zone difference, and she developed fever the following day. Her contacts are thus limited,” he said.

“The patient is now recovering well. She no longer has fever and cough but still has sore throat,” he said.

But the DOH will send a team of experts to the patient’s house to conduct a “more thorough assessment of the household contacts” who have already been given prophylactics, an antibiotic.

The doctors, nurses and other health personnel attending to the patient have also been given antibiotics and instructed to put on protective gear like face masks to prevent them from contracting the virus.

It was not clear yet how the girl contracted the virus.

“She traveled to many cities in the US but because there is already an established community level transmission in the US, even if we identify the cities, it becomes immaterial because it is almost in the entire US,” Villaverde added.

Taiwan’s Centers for Disease Control, meanwhile, said a 30-year-old woman who had been traveling in Manila from May 16 to 20 with three relatives tested positive for A(H1N1) influenza.

“She was feeling unwell while in Manila. She went to a clinic on Thursday after she developed a fever. Her daughter was also screened after she too was running a fever,” said CDC spokesman Shih Wen-yi.

Test results for the five-year-old girl were scheduled Friday.

DoH: H1N1 community outbreak in Ecija village
By Tonette Orejas
Central Luzon Desk
First Posted 17:06:00 06/14/2009


CITY OF SAN FERNANDO, Philippines -- The Department of Health (DoH) on Sunday declared a community-level outbreak of the Influenza A(H1N1) virus in a farming village in Nueva Ecija province, as the 92 contacts of 11 children who tested positive for the virus there, exhibited flu symptoms.

Health Secretary Francisco Duque III approved the declaration after a two-week surveillance on Hilera village in Jaen town, said Doctor Rio Magpantay, DoH Central Luzon director

"There is an outbreak," Magpantay told the Philippine Daily Inquirer (parent company of INQUIRER.net) in a text message.

A DoH team found "epidemiological link" among the 11 confirmed cases and their contacts, Magpantay said, adding, "There's local transmission."

On Sunday, the DoH announced that the country had 147 confirmed cases of the A(H1N1) flu with no fatality.

So far, Hilera is the first community that has been placed on an outbreak status.

The 11 confirmed cases -- 10 students of the Hilera Elementary School (HES) and a 4-year-old child -- were among the 103 people stricken with influenza-like illnesses between May 29 and June 12 in the village.

Magpantay said that meant that 6.3 percent of the village's population of 1,622 have been affected, he said.

The 11 positive cases belonged to the first batch of 15 children who underwent testing for the A(H1N1) flu. They have been recovering well with home-based treatment, Magpantay said. Four of the 15 people in that batch tested negative for the virus.

Magpantay said no one among those sick had traveled abroad. The DoH said a source of exposure to the virus could be a team of doctors and nurses who held a medical mission in the HES in May.

Results of throat swabbing on the second batch of 19 people have yet to be released.

"We are managing it well through early detection and aggressive treatment. Symptoms are mild. Our concern now is how to take care of high risk groups -- the very young and the elderly," Magpantay said.

He said he did not recommend making Hilera off-limits to outsiders or prohibiting residents from leaving the village.

"Those are not necessary. The symptoms are mild, and we're very thankful to God. We have enhanced our mitigation efforts. The positive ones are confined at home and receiving their supplies of Tamiflu. The rest are provided antibiotics and Vitamin C," he said. "It should be business as usual."

But classes at the HES would remain suspended to prevent the further transmission of the virus, he said.

It is in that school that the DoH has set up its command post for residents volunteering to undergo checkup for symptoms of the A(H1N1) flu.

Aside from the 30 health personnel ent to the area, the DoH on Saturday started mobilizing barangay (village) health workers to do home visits in neighboring villages of Kalabasa, Pitak, Pakul and Lambakin to identify the people there with flu symptoms.

With the outbreak status, Jaen Mayor Santiago Austria said the local government would continue to support DoH measures in Hilera and four other villages.

On Friday night, Magpantay said DoH personnel took throat swabs from 20 residents in Pakul and Lambakin to test them for the virus. Pakul has 39 people with influenza-like illness while Lambakin monitored 52 between May 27 and June 12.

The attack rates in Pakul and Lambakin are three percent and 2.4 percent, respectively. Their ages range from six months to 68 years old, but most of them are between 6 and 15 years old.