DOH on A(H1N1): You Ain't Seen Nothing Yet

Health Secretary Francisco Duque III said Friday the Philippines has yet to see the worse of the A(H1N1) virus outbreak and warned people to brace for the worst.

"It will get worse before it gets any better," Duque said in a press conference facilitated by the Department of Health-Center for Health Development Northern Mindanao (DOH-CMD NM) Media Health Advocates at the Office of Misamis Oriental Governor Oscar Moreno. "We cannot afford to be complacent, so better to err on the side of caution."

Duque said so far, the AH1N1 has been a stable virus and has not mutated into something more dangerous, although new cases indicate that its clinical manifestations have now been noted to appear in 1-7 days from the time of infection, compared to 7-10 days after exposure as previously thought.

"We still don´t know very much about the virus and how it will behave under various circumstances," Duque said.

The World Health Organization (WHO) reported 94,512 laboratory confirmed cases of influenza A/H1N1 infection from 135 countries as on 6th July 2009 with 429 deaths. There have been no further updates.

The WHO said that as the AH1N1 pandemic progresses, the data needed for risk assessment also changes and its further spread is considered inevitable. It said that the increasing numbers of cases in many countries with sustained community transmission is making it extremely difficult to confirm them through laboratory testing.

Because the DOH is set to abide by the newly recommended reporting system of WHO for A (H1N1), it is now reviewing and adjusting its surveillance systems to fit the monitoring of the AH1N1 virus in its regular surveillance of Influenza-like illnesses (ILI) in the country.

Duque said as of the July 31, 2009, the Philippines already recorded over 3,000 cases of the AH1N1 influenza virus with six deaths recorded.

However, he said this translates to a case fatality rate of only 0.003% per 100,000 cases which is lower compared to the seasonal variety of flu.

"Last year, we recorded 379,000 cases of seasonal flu with some 270 fatalities," Duque said. This translates to a higher case fatality rate of 3-4% per 100,000 cases."

Like seasonal flu, Duque said AH1N1 is rarely fatal to most people who can tolerate its mild clinical manifestations without any medication, except for those with pre-existing conditions such as uncontrolled diabetes, frank cardiovascular disease, chronic obstructive pulmonary disease, chronic liver and kidney disease who are highly vulnerable to complications arising from contracting AH1N1.

Patients who are organ transplant recipients, immuno-compromised and suffering from other infections like HIV/AIDs and TB; pregnant women; the very young and elderly are more at risk of developing serious cases of A (H1N1), he added.

Meantime, Duque said the Regional Institute of Tropical Medicine (RITM) charged with verifying AH1N1 cases from swab tests has now considerably reduced its time to process from a week to as low as three days.

Real-Time Polymerase chain reaction (RTPCR) facilities to confirm AH1N1 swab samples are now operational at Cebu City´s Vicente Sotto Memorial Medical Center and would be available at the Davao Medical Center in Davao City in one week´s time, he added.

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