June 8, 2009 — H1N1 Confirmed Cases in the Philippines Now at 46, DOH Still Not Admitting there is "Community Level Outbreak" — Nasa Denial Pa Rin!

8 June 2009

The DOH announced thirteen (13) new cases of H1N1 infections bringing the total of confirmed H1N1 cases in the Philippines to forty-six (46).

Four (4) of the 13 new cases are students of De La Salle University (DLSU) while 1 is a student of East Asia University.

For the first time, the DOH admitted indirectly the inadequacies of its brand of what I've repeatedly characterized here as secretive contact tracing.  This is how the DOH dealt with the issue of contact tracing in its report:  

With the mitigation strategy, Duque said that government will also veer away from contact tracing and instead focus on controlling the disease as is being done for other emerging and reemerging diseases in the country. “H1N1 will now become part of our Influenza-like Illness (ILI) surveillance activity and one of our notifiable diseases.  It offers little benefit to do extensive tracing of this virus when it is clear that the disease can be passed on to others at a rate faster than it will ever be  humanly possible to find the contacts,” Duque said.

The DOH does not need to veer away from contact tracing;  it just needs to tell the public more about what it really needs to know about H1N1. 

Secretary Duque can do that by disclosing to the public the details of airline flights as soon as it is confirmed that any flight have brought in confirmed H1N1 cases in the country. 

If Secretary Duque goes on TV and announces these flight numbers to the public (or posts the information in the DOH website, www.doh.gov.ph), the information will become known much faster than the disease can be passed by affected passengers on that flight to others.

For all of the criticisms that have been hurled against the Chinese government who learned lots of lessons in battling SARS in 2003, it is clear that they approach H1N1 with a much more serious concern for their people, rather than for anything else.  And few will probably dispute the fact that the Chinese know just as much as anybody else about containing H1N1.  Their tactics may be overkill but it cannot be said that they are taking chances about the spread of H1N1.  

Right now, no less than Mayor Ray Nagin of New Orleans is under quarantine in Shanghai, China.  Please see my post, China Quarantines New Orleans Mayor Ray Nagin for H1N1 After Sitting Beside An H1N1-Infected Suspect On Flight to Shanghai.  

Here is the  full text of DOH Update No. 35 straight from the DOH website:

Update No. 35 - Duque Readies DOH for Shift Toward Mitigation

June 08, 2009

Health Secretary Francisco T. Duque III today reported that the total number of cases of Influenza A (H1N1) in the country has now reached 46 after confirming 13 more cases over the weekend.

“We have reached 46 and although it’s a big number we are fortunate that all of these are just mild cases which are consistent with most of the cases of A (H1N1) we are seeing in other affected countries,” Duque said.

The 13 new confirmed cases include 8 Filipinos and 5 foreigners. Five are females and 8 are males with age range of 12-63 years old. Four of the cases are students of the De La Salle University, while one is the first confirmed case from the East Asia University. Eight of the 13 new cases have history of travel to the US, Japan and Canada.

“All are responding well to treatment. Contact tracing is still on-going,” Duque said. 

Duque announced that with the more complete profile of the A(H1N1) virus seen in local cases, which is mostly mild in nature, the DOH is set to shift its control strategy from containment to mitigation.

“This means that we only do early detection and aggressive treatment of cases as they come especially for those with high-risk preexisting conditions.  Those manifesting with mild symptoms can be managed and monitored at home so that only patients at risk who develop complications will have to be hospitalized,” Duque explained.

With the mitigation strategy, Duque said that government will also veer away from contact tracing and instead focus on controlling the disease as is being done for other emerging and reemerging diseases in the country. “H1N1 will now become part of our Influenza-like Illness (ILI) surveillance activity and one of our notifiable diseases.  It offers little benefit to do extensive tracing of this virus when it is clear that the disease can be passed on to others at a rate faster than it will ever be  humanly possible to find the contacts,” Duque said.

Duque cited the efforts of other affected countries such as the US and Mexico where the number of cases have been increasing so fast.  These countries have managed to curb down the case fatality rate due to A (H1N1) through early diagnosis and antiviral treatment as well as targeted and appropriate management of patients at risk for developing flu complications.

Duque added that with the more complete mild picture of the virus observed among positive cases in La Salle and East Asia University, there may be no need to order school closure in the future even with a confirmed case.

“Sick students can just be asked to stay at home while they have the symptoms, if mild, so that they do not pass on the virus to others.  Of course, they should be closely monitored by their parents and guardians while they are given supportive treatment at home.  School authorities can also contact DOH and report an unusually high number of influenza-like illnesses in their schools so that we can immediately investigate,“ Duque said.

Meanwhile, in light of the A (H1N1) scare which swept over several offices last week,  DOH just recommends isolating a suspected or confirmed case, let them stay home if they are sick.  Duque also advised offices to immediately notify DOH regarding these cases.  

“There is no need to wear masks, quarantine entire rooms or floors and suspend business activities.  All businesses, however, should have a contingency plan to ensure the continuity of their operations,” Duque said.

Duque reiterated that only those who qualify as CUOs including close contacts of confirmed cases are tested and given free treatment and hospitalization in designated DOH referral hospitals.   

At present, DOH includes the following high risk individuals as priority: 1) Those who have flu-like symptoms and have recently travelled from affected countries; 2) Symptomatic individuals who were known close contacts of confirmed cases. As yet there is no community-level outbreak of A (H1N1) as the DOH and local government units are able to contain its spread.

“Again, I emphasize early and appropriate health seeking behavior to the general public as we prepare for the increase in flu cases during the rainy season. For those with only mild symptoms, stay at home, take supportive treatment and vitamins and plenty of bed rest.  If you have preexisting conditions like diabetes, asthma, COPD, heart disease and if you are pregnant or immunocompromised, also those at the extremes of age (i.e. <5>

Since May 1, 2009, the DOH has monitored a total of 541 CUOs.  Of these, 46 are positive A(H1N1) cases, 98 have pending laboratory results, and 397 are negative for A(H1N1) and have been discarded.  There are 91 new Cases Under Observation (CUOs) today.

In their latest report dated June 3, the World Health Organization reported 21,940 cases and 125 deaths from 69 reporting countries.  Countries which are now included in the list of A (H1N1) affected countries are Barbados, Luxembourg and Saudi Arabia.

We have these video reports courtesy of GMANews.tv:

For the latest Philippine news stories and videos, visit GMANews.TV

For the latest Philippine news stories and videos, visit GMANews.TV

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