June 20, 2009 — 392 H1N1 Confirmed Cases in the Phils — DOH Should Now Tell Us About H1N1, Cytokine Storms & the 1918 Spanish Influenza Pandemic

21 June 2009

As of June 20, 2009, there are now 392 confirmed H1N1 cases in the Philippines.  This is the report by Mariz Umali of Saksi courtesy of GMANews.tv:

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This is Update No. 46 from the DOH website:

Update No. 46- Duque: 70% of All Reported A (H1N1) Cases have Already Fully Recovered as 13 Moe Patient Were Sent Home Today

20 June 2009

Health Secretary Francisco T. Duque III today reported that 13 more fully recovered A (H1N1) patients were already sent home, thus bringing the total count of fully recovered cases to 275.  This figure constitutes 70% of the total confirmed cases reported since May 1.

Duque also disclosed that there are 48 more confirmed A (H1N1) cases recorded today, all mild in nature. These new additional cases bring the total number of (mild) confirmed cases to 392.

The new 48 mild confirmed cases involved 20 males and 28 females. The age range of cases is 1-53 years old, with 17 as median age.

Duque noted that 45 of the cases are Filipinos, while the remaining 3 are foreigners. He added that 12 of the new cases have a history of travel to a country affected with the novel virus.

Duque noted that all of these new patients are responding positively to their treatments. 

Duque reminded the public that the simplest ways to avoid contracting the flu are to wash hands thoroughly and to cover mouth and nose when you cough and sneeze, respectively.

Meanwhile, as of June 19, the World Health Organization reported 44,287 cases with 180 deaths from 90 reporting countries. Lao, Netherlands Antilles Sint Maarten, Oman, Papua New Guinea, South Africa andSuriname are the new countries reporting with A (H1N1) cases.

We have seen Secretary Duque of the DOH going the rounds assuring everybody that there is no need to be concerned about H1N1 because all we've had here in the Philippines are mild cases. We should all be thankful for that.   

However, I believe now is the time for Secretary Duque and our officials at the Department of Health to start talking more in public about the possible dangers that lie ahead based on historical precedents and what the entire nation can do to prepare for any future eventuality.

For example, the public's attention should be called to the existence of cytokine storms and their reported role in the grievously devastating toll in the number of deaths during the 1918 Spanish influenza global pandemic. 

Cytokine storms are not science fiction. They have happened in the past and one of the most authoritative pieces of literature on the subject is this article, written by Michael T. Osterholm, Ph. D., entitled Preparing for the Next Pandemic.  It appeared in the May 5, 2005 issue of the New England Journal of Medicine.

Dr. Osterholm is the director of the  Center for Infectious Disease Research and Policy, the associate directory of the National Center for Food Protection and Defense, and a professor of public health at the University of Minnesota, Minneapolis.

Although the article by Dr. Osterholm discusses cytokine storms in relation to H5N1 or the avian flu, the general principle remains the same when applied to the current H1N1 flu virus.

At the end of his article, Dr. Osterholm posed the question, "Is there anything we can do to avoid this course [meaning, the potentially large number of casualties in the event of the next global pandemic]?

And this is his answer:

The answer is a qualified yes that depends on how everyone, from world leaders to local elected officials, decides to respond. We need bold and timely leadership at the highest levels of the governments in the developed world; these governments must recognize the economic, security, and health threats posed by the next influenza pandemic and invest accordingly. The resources needed must be considered in the light of the eventual costs of failing to invest in such an effort. The loss of human life even in a mild pandemic will be devastating, and the cost of a world economy in shambles for several years can only be imagined.  

I guess few people have credentials similar to Dr. Osterholm's. Prudence dictates that we should at least spend a few moments to read and investigate further what he has to say.