SWINE FLU

[Grim]

Just in case you haven't heard, we already have a case in the country.

Duque confirms first A(H1N1) RP case

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