Showing posts with label DOH. Show all posts
Showing posts with label DOH. Show all posts
H1N1 influenza death toll doubles in RP
After the Department of Health (DOH) halted its daily update of the H1N1 pandemic in the country, the government agency reported that the August death toll doubled to 28 from July’s mortality of 13. Those who died were part of the 4,548 reported cases of swine flu documented in the country of which 4,369 fully recovered.
Morbidity & Mortality of H1N1, European Center for Disease Control Data
Worldwide, infected, 254,206 as 08/30/09
Worldwide, deaths 3,315 (ECDC)
Southeast Asia, 262
Thailand, 130
Malaysia, 73
the Philippines, 28
Singapore, 17
Indonesia, 10
Vietnam, two
Brunei, 1
Laos, 1
As the pandemic spreads and persists worldwide, the focus is to rush the flu vaccine which is expected to be ready by October. Health authorities predict a surge of the swine influenza during fall and winter seasons needing preventive measures to control its spread. The easily transmissibe virus has the potential of infecting 2 billon people worldwide.
The vaccination makes the public leery over the potential side effects of the vaccination such as Guillain Barre Syndrome which is more fatal than the H1N1 or the usual flu infection. It is unclear if this vaccination being readied will offer enugh efficacy and protection as desired.
Many health workers believe vaccination is important in preventing morbidity and mortality among vulnerable population groups, particularly the young, the elderly. the immunosuppressed, diabetes and dialysis patients, and those suffering from chronic diseases. (Photo Credit: Benedicti Desrus) =0=
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Pres Arroyo slashes price of 5 common drugs
On July 27, 2009, Pres. Gloria M. Arroyo signed Executive Order (EO) 821 to reduce the price of 5 common medicines which manufacturers resisted to put down. The essential drugs include anti-cholesterol drug atorvastatin, anti-hypertensive amiodipine, antibiotic/antibacterial drug azith-romycin, anti-neoplastics/anticancer drugs cytarabine and doxorubicin.
“Last week, pharmaceutical companies acceded to government pressure to cut in half the prices of the 16 other essential medicines which the health department found to be exorbitant.
These are medicines for hypertension, diabetes, common bacterial infections, amoebiasis (a leading cause of diarrhea) and cancers (such as leukemia, the top killer pediatric cancer). But the drug companies refused to give in to the appeal of the Department of Health (DoH) for a 50-percent price cut for the five other medicines on the list."---Inquirer (07/27/09, Pazzibugan, D; Esguerra, CV.)
A welcome respite to the poor and supported by the Department of Health (DOH,) the implementation of Arroyo's drug plan starts on August 15, 2009. However, it remains to be seen if this rule will be followed. High cost of drugs are among the reasons why Filipinos are unable to maintain their medicatons leading to longer patient morbidities and premature deaths.
The maximum retail price (MRP) of drugs has been a source of contention between the manufacturers and the consumers. The Pharmaceutical and Healthcare Association of the Philippines (PHAP), composed of drug companies promised they will support the new price regulation but believes it would have been better if free market---competition dictates the price of the medicines.. (Photo Credit: Techfever) =0=
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Philippines reports first death of swine flu
At a time when the country registered 445 cases of H1N1 flu, the first mortality to the viral infection came to a 49 year old woman who suffered from complications of congestive heart failure following a heart attack.
According to Dr. Yolanda Oliveros, director for the National Center for Disease Prevention and Control, the victim who had pre-existing heart disease developed signs of flu on June 17, 2009. This underscores the higher risk of mortality among those with medical conditions which lower the resistance against flu----those who are immunocompromised or suffer from chronic illnesses like diabetes, heart disease, HIV/AIDS, asthma, cancer and the likes.
Related to the flu pandemic, 8 more schools temporarily closed after some of their students contracted the swine flu. At the rate the infection spreads, Dr. Lyndon Lee Suy testified to the house hearing that it’s possible 25% (about 22 million) of the population can be stricken by the illness. The virus has the potential to transform through genetic changes into a strain of greater virulence and lethality. (Photo Credit: Benedicte Desrus) =0=
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Politics of Health: Give the flu vaccines to those who need them most
The number of H1N1 flu infection ominously jumped from 111 to 147 cases and health authorities reported brisk community transmission in Nueva Ecija----suggesting that more cases are cropping up and the flu is getting harder to control.
As a response, the government said 8,000 Makati City employees will be given free flu shots on Monday to prevent the seasonal flu, not the H1N1 viral infection. The government thinks mass vaccination against the common flu at a cost of P2.8 million will help track down by “elimination” those with swine flu. But health authorities know that giving the vaccine doesn't completely assure seasonal flu will be avoided.
“We have prioritized the immunization against seasonal or common flu of our city workers, especially our frontline and field workers, not only to strengthen their defenses against respiratory diseases, but also to help us in promptly identifying possible cases of A(H1N1),” Makati Mayor Jejomar Binay said.---Philippine Daily Inquirer (06/14/09, Lopez, A.)
Really?
The seasonal flu vaccine is not expected to be effective in preventing the H1N1 flu. At best, the justification that swine flu can be detected by “elimination” is faulty because there are many illnesses which present with flu-like symptoms. If one means to control the viral disease, it’s not by “elimination.” Doctors need the right diagnosis, even if influenzas in general have essentially the same treatment.
To identify H1N1 flu or seasonal flu, a lab test like the one done at the Research Institute of Tropical Medicine (RITM) must be done. This makes one to consider if Mayor Binay’s decision to administer the vaccine is in line with good medical judgment. Why don't politicians like Binay leave the medical decisions to Dr. Francisco Duque III and the Department of Health (DOH?)
Government employees, unless they are in the high risk group, hardly qualify as the priority group to get the vaccines. Though workers may receive them, the government in triaging patients, must give the vaccines to those who need them most as shown below. On the process of production, it will take sometime before the new H1N1 vaccine will be readily available in the market:
2008-09 INFLUENZA PREVENTION & CONTROL RECOMMENDATIONS
Center for Disease Control
Vaccination of all children aged 6 months–18 years should begin before or during the 2008–09 influenza season if feasible, but no later than during the 2009–10 influenza season. Vaccination of all children aged 5–18 years is a new ACIP recommendation.
Children and adolescents at high risk for influenza complications should continue to be a focus of vaccination efforts as providers and programs transition to routinely vaccinating all children and adolescents. Recommendations for these children have not changed. Children and adolescents at higher risk for influenza complication are those:
•aged 6 months–4 years;
•who have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological or metabolic disorders (including diabetes mellitus);
•who are immunosuppressed (including immunosuppression caused by medications or by human immunodeficiency virus);
•who have any condition (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders) that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration;
•who are receiving long-term aspirin therapy who therefore might be at risk for experiencing Reye syndrome after influenza virus infection;
•who are residents of chronic-care facilities; and,
•who will be pregnant during the influenza season.
Note: Children aged <6 months should not receive influenza vaccination. Household and other close contacts (e.g., daycare providers) of children aged <6 months, including older children and adolescents, should be vaccinated.
Annual recommendations for adults have not changed. Annual vaccination against influenza is recommended for any adult who wants to reduce the risk for becoming ill with influenza or of transmitting it to others. Vaccination also is recommended for all adults in the following groups, because these persons are either at high risk for influenza complications, or are close contacts of persons at higher risk:
•persons aged >50 years;
•women who will be pregnant during the influenza season;
•persons who have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological or metabolic disorders (including diabetes mellitus);
•persons who have immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus);
•persons who have any condition (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders) that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration;
•residents of nursing homes and other chronic-care facilities;
•health-care personnel;
•household contacts and caregivers of children aged <5 years and adults aged >50 years, with particular emphasis on vaccinating contacts of children aged <6 months; and,
•household contacts and caregivers of persons with medical conditions that put them at high risk for severe complications from influenza.
Source: Center for Disease Control (Photo Credit: Healthcarewithoutharm/ Southeastasia) =0=
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Mitigation versus containment in the fight against the H1N1 flu
The sudden rise of H1N1 flu cases in the Philippines to 46 had Dr. Francisco Duque III of the Department of Health (DOH) and his team to shift gear in the battle against the viral infection. Early on, containment was the goal to stop the spread of the swine flu at the bud, but the sharp increase of those stricken with the disease, made them to resort to “mitigation”----a lesser goal to reduce the outbreak’s spread and severity.
“As more and more cases were confirmed daily, Duque said health authorities were no longer doing contact tracing since the virus was being transmitted much faster than they could trace and quarantine all contacts of those infected with the virus.
"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,” he said.
“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 mild symptoms can be managed and monitored at home so that only patients at risk of developing complications ‘----PDI (06/08/09, Pazzibugan, D.)
What Dr. Duque says is that the illness is out of the genie box and absolute control is unrealistic. Minimization of the disease’ potential impact is the "better" course of action. Reducing the severity of exposure is now the strategy knowing that the exposed have become more difficult to track.
This comes at a time of the opening of classes. And rainy season is at hand. Dengue, another health hazard carried by mosquitoes is brewing in the air. In greater numbers, more people have become possible swine flu and dengue hemorrhagic fever carriers thus making more infections in the community possible.
To date, the World Health Organization (WHO) identified the Philippines to have the highest number of swine flu cases in Southeast Asia. As of its latest tally on June 8, 2009, WHO listed 73 countries affected by the swine flu with a total of 25,288 confirmed cases and 139 recorded deaths. (Photo Credit: CDC) =0=
UPDATE: June 9, 2009: Follow up update revealed 57 cases of swine flu in the Philippines. Many of the recently infected had been students in Manila and those with history of travel outside the country. Vigilance, personal responsibility, and self-help to prevent the disease are in order to limit the spread of the infection.
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June 3, 2009: Philippine Swine Flu Update
The 22nd case of H1N1 flu in the Philippines was confirmed in a 21 year old foreign student prompting the De La Salle University in Manila to close temporarily on June 4 to 14 as a measure to contain the disease.
As of June 3, 2009, the WHO tally puts the number of swine flu infections to 19, 273 and 117 deaths in 66 countries. About half of the number of cases have been confirmed in the United States. (Photo Credit: Bendicte Desrus)
UPDATE: On June 4, 2009, 6 more positive H1N1 flu sufferers were reported by Dr. Francisco Duque III of DOH, bringing a total of 28 people having contracted the disease. =0=
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H1N1 flu watch: 16 cases reported in RP
As of Saturday, May 30, 2009, the number of new cases of H1N1 flu in the Philippines rose to 16. According to the Department of Health (DOH) Sec. Francisco Duque III, aside from these cases, there are still 29 individuals under observation.
The increase in number of the swine flu infection in the country stresses the need for vigilance and preventive measures to stop the spread of the disease. Although there are suggestions to indefinitely close schools because of the flu, health authorities in Manila believe that the situation doesn’t merit the postponement of the opening of classes.
The World Health Organization (WHO) revealed that so far, there had been 15,510 documented cases of the disease reported in 53 countries. Of those who got sick, at least 99 people died. (Photo Credit: Benedicte Desrus) =0=
UPDATE: June 2, 2009. The number of H1N1 cases in the Philippihes rose from 16 to 21 over the weekend. Filipinos who are preparing for the opening of classes nationwide are advised to take preventive measures to help stop the disease. =0=
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H1N1 flu cases in RP jump to a total of 6
The Department of Health (DOH) announced 4 more Filipinos testing positive for the H1N1 flu bringing the number of cases to a total to 6 of May 27, 2009. Two of the four got their illnesses after attending a wedding in Zambales where the infected Taiwanese woman and her child were present.
A one-year old girl from USA also exhibited signs and symptoms of flu 5 days after her arrival on May 19, 2009. Another is a 13 year old boy who became ill after a trip from Hongkong.
The increase in swine flu cases is a cause of concern knowing that the virus is highly transmissible. With the anticipated opening of classes in the Philippines, the public is advised to take the needed precaution to avoid the disease.
In a tally of the World Health Organization (WHO) as of 06:00 GMT, 27 May 2009, the number of those who contracted the disease has reached 13,398 in 48 countries. It has caused death to 95 people.(Photo Credit: Benedicte Desrus) =0=
RELATED BLOGS: "2nd H1N1 flu case reported in the Philippines" Posted by mesiamd at 5/25/2009; "RP reports its first H1N1 virus infection" Posted by mesiamd at 5/22/2009
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2nd H1N1 flu case reported in the Philippines
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Because of the time lag between the exposure to influenza and the moment manifestations of the infection arise, it’s only now that the 50-year old Filipina who arrived as a balikbayan from USA is confirmed as the second case of swine flu infection in the country. The first case is a 10 year-old child who also came home from a trip abroad. She is reported to have fully recovered from the illness.
The Research Institute for Tropical Medicine (RITM) announces the woman tested positive for the H1N1 virus though it appears that she has been recovering since she experienced having cough and fever, one day after her arrival from USA.
“Since monitoring started on May 1, the DOH has placed 105 individuals under observation, with 88 already being found negative and 15 have pending laboratory test results.”---Malaya (05/23/09, Naval, G)
Though there is no reason to panic, the viral infection that has affected close to 12,000 individuals in 43 countries is a source of concern. The new strain of viral infection has the capacity to kill and is still under study. Nobody knows how the virus with a propensity to mutate and assume more virulence will behave when it spreads in different countries as the seasons change.
Preventive measures such as frequent handwashing, covering one’s nose and mouth when sneezing and coughing, avoiding hand contact with people as advised by the Department of Health are in place.
The World Health Organization urges nations to push for pandemic preparedness and advices pro-active fight against the disease while only a few individuals have been stricken ill of the disease.(Photo Credit: CDC)=0=
RELATED BLOG: "RP reports its first H1N1 virus infection " Posted by mesiamd at 5/22/2009
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Because of the time lag between the exposure to influenza and the moment manifestations of the infection arise, it’s only now that the 50-year old Filipina who arrived as a balikbayan from USA is confirmed as the second case of swine flu infection in the country. The first case is a 10 year-old child who also came home from a trip abroad. She is reported to have fully recovered from the illness.
The Research Institute for Tropical Medicine (RITM) announces the woman tested positive for the H1N1 virus though it appears that she has been recovering since she experienced having cough and fever, one day after her arrival from USA.
“Since monitoring started on May 1, the DOH has placed 105 individuals under observation, with 88 already being found negative and 15 have pending laboratory test results.”---Malaya (05/23/09, Naval, G)
Though there is no reason to panic, the viral infection that has affected close to 12,000 individuals in 43 countries is a source of concern. The new strain of viral infection has the capacity to kill and is still under study. Nobody knows how the virus with a propensity to mutate and assume more virulence will behave when it spreads in different countries as the seasons change.
Preventive measures such as frequent handwashing, covering one’s nose and mouth when sneezing and coughing, avoiding hand contact with people as advised by the Department of Health are in place.
The World Health Organization urges nations to push for pandemic preparedness and advices pro-active fight against the disease while only a few individuals have been stricken ill of the disease.(Photo Credit: CDC)=0=
RELATED BLOG: "RP reports its first H1N1 virus infection " Posted by mesiamd at 5/22/2009
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RP reports its first H1N1 virus infection
Based on the tally of the World Health Organization (WHO,) the swine flu spreading throughout the world has reached 11,168 and 86 deaths as of May 22, 2009. This coincides with the first case confirmed in the Philippines which joins at least 38 countries having the disease.
The Department of Health (DOH,) reported that the swine flu-positive 11 year-old girl identified by the laboratory of the Research Institute for Tropical Medicine(RITM) arrived on May 18, 2009 from USA and Canada where many swine infections have been reported. She is presently quarantined in an effort to contain the virus from infecting the general population.
“The government will conduct contact tracing to identify and diagnose individuals who might have come into contact with the infected girl. Health authorities will also check the plane boarded by the girl for traces of the disease.”--- GMA TV News.com (05/21/09 Balagtas-See, A)
Advising the public to be calm and be mindful of the preventive measures advised by health authorities, the DOH reminds the public of the need for vigilance. Filipinos must not be complacent as the virus easily mutates; it has the potential to cause significant morbidity and mortality which can affect the nation's economy. Pharmaceuticals are still on the process of making a the H1N1 flu vaccine, but it will take a few months before it will be available. =0=
World Health Organization (WHO) Tally of H1N1 Flu Infection
As of 06:00 GMT, 22 May 2009
Laboratory-confirmed cases of new influenza A(H1N1) as officially reported to WHO by States Parties to the International Health Regulations (2005)
Country----Cumulative total-----Newly confirmed since the last reporting period-
--------------Cases---Deaths----Cases-----Deaths
Argentina------1------0-----------0---------0
Australia-------7------0-----------4---------0
Austria---------1------0-----------0---------0
Belgium--------5------0-----------0---------0
Brazil-----------8------0-----------0---------0
Canada--------719----1-----------0---------0
Chile-----------24-----0-----------19--------0
China-----------11-----0-----------3---------0
Colombia-------12-----0-----------0---------0
Costa Rica-----20-----0-----------0---------0
Cuba-------------4------0-----------0---------0
Denmark---------1------0-----------0---------0
Ecuador---------8------0-----------7---------0
El Salvador-----6------0-----------0---------0
Finland----------2------0-----------0---------0
France----------16-----0-----------0---------0
Germany--------14-----0-----------0---------0
Greece----------1------0-----------0---------0
Guatemala------4------0-----------0---------0
India-------------1------0-----------0---------0
Ireland----------1------0-----------0---------0
Israel------------7------0-----------0---------0
Italy-------------10-----0-----------0---------0
Japan-----------294---0-----------35--------0
Korea-----------3------0-----------0---------0
Malaysia--------2------0-----------0---------0
Mexico----------3892---75---------0---------0
Netherlands-----3------0-----------0---------0
New Zealand-----9------0-----------0---------0
Norway-----------3------0-----------0---------0
Panama----------73-----0-----------4---------0
Peru--------------5------0-----------2---------0
Philippines------1------0-----------1---------0
Poland-----------2------0-----------0---------0
Portugal---------1------0-----------0---------0
Spain------------113----0-----------2---------0
Sweden----------3------0-----------0---------0
Switzerland------1------0-----------0---------0
Thailand---------2------0-----------0---------0
Turkey-----------2------0-----------0---------0
United Kingdom--112----0---------3---------0
USA--------------5764---9-----------54--------1
Grand Total----11168---86--------134-------1
Cumulative and new figures are subject to revision
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Manny Pacquiao: a disappointing role model?
The praises Manny Pacquiao got in beating Ricky Hatton during a boxing match in Las Vegas, Nevada had been extraordinary. He was truly deserving of such admiration from his adoring fans. Yet, in a rare read, I came across the editorial of Malaya----which was bold in criticizing the sports hero for not heeding the advice of health authorities in Manila and the World Health Organization (WHO.) The humble entertaining boxer from General Santos City was stubborn. He couldn't be dissuaded from postponing his return so that the health protocol to keep the disease out of the country could be enforced. Billions of dollars had been spent the world over in order to prevent the disease from spreading any further.
“Manny Pacquiao was a disappointment as a role model when he turned a deaf ear to the appeal of health officials to undergo self-quarantine for at least five days before returning to Manila. There were two options presented to him. First, to postpone his return home for at least five days. Second, to closet himself for the same length of time if it was impossible for him to postpone his homecoming.”---- Malaya (05/10/09)
Manny’s slobbering VIP treatment is common in the Philippines. Almost no one in the country can speak against the boxing legend “who can’t go wrong”--- not even Pres. Gloria M. Arroyo and the politicians. The way some people trivialize health risks and disregard medical advice is rather worrisome. I hope nothing horrible comes along because Manny prevailed over the wisdom of Department of Health (DOH). (Photo Credit: Newkleus00)=0=
RELATED BLOGS: "May 8, 2009: H1N1 flu update" Posted by mesiamd at 5/09/2009; " Filipinos take risk in allowing Pacquiao to go home early" Posted by mesiamd at 5/08/2009
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May 8, 2009: H1N1 flu update
As of May 8, 2009, Guatemala is the latest country to report having to deal with H1N1 flu. The country which shares the southern border with Mexico is added among 25 countries which according to the World Health Organization (WHO) have laboratory confirmed the swine flu infection. The Center for Disease Control (CDC,) disclosed that the United States has the H1N1 influenza in 43 states.The countries with the number of confirmed swine flu cases are: Austria (1), Brazil (4), Canada (214), China, Hong Kong Special Administrative Region (1), Colombia (1), Costa Rica (1), Denmark (1), El Salvador (2), France (12), Germany (11), Guatemala (1), Ireland (1), Israel (7), Italy (6), Mexico (1,204), Netherlands (3), New Zealand (5), Poland (1), Portugal (1), Republic of Korea (3), Spain (88), Sweden (1), Switzerland (1) and the United Kingdom (34). United States of America (1,639).
In the Philippines, the Department of Health (DOH) and the government caved in to boxer Manny (Pacman) Pacquiao's decision to go home ignoring the quarantine recommendation of WHO. This is also true with the 50 congressmen who came to the United States to watch the Pacquiao-Hatton match.
The early return of the Pacman and the 50 congressmen plus their respective entourages makes it hard for DOH to abide with its quarantine program, risking the health of Filipinos. There are at least 13 people in the Philippines who have been cleared after undergoing proper observation by DOH for possible swine flu infection. =0= (Photo Credit: CDC)
More Swine Flu Cases
Additional confirmed H1N1 flu cases have recently been disclosed in Japan (3), Australia (1), and Panama (1)
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Filipinos take risk in allowing Pacquiao to go home early
"Better safe than sorry."
"A pound of prevention is greater than an ounce of cure."
This is in essence what the Department and Health (DOH) and World Health Organization (WHO) are telling the country when they advice Manny Pacquiao to postpone his triumphal return to Manila after his boxing victory in Las Vegas, Nevada.
But it appears, some people can’t be dissuaded until something horrible happens. If the Philippines need the proactive control against the H1N1 virus, it must be at this stage when no confirmed case has reached the country. But there are government leaders who don't believe so. The logistics of tackling a potential epidemic is hard and as a nation, Filipinos must cooperate.
I believe the risk of Pacquiao and the 50 congressmen who watched the boxing match in United States is small, but it’s there. There are more than 30 states affected by the swine flu. No one can quantify the exact chance that those who traveled in these places will bring the virus into the country. And no one is sure how the country will cope if the disease takes root among the people
Viruses are very tricky and we must respect them as they are. Health authorities are still on the process of learning about H1N1 flu which has the potential to cause widespread illness, overtax the ability of the health care workers to respond, dampen business, and cause economic hardship.
It’s the duty of the Department of Health (DOH) and the World Health Organization (WHO) to inform Filipinos of the dangers of the swine infection. But it is the Filipino citizens' responsibility to take the needed precautions. This is not the time to joke around. The threat of the swine infection must be treated as a health issue and not as a political matter.
Being a pathologist, I believe keeping Pacquiao, his entourage, and the 50 congressmen out of the country for just a few more days and allow the viral incubation period to elapse is the best. Health and government authorities must not compromise. They have the power to impose mandatory isolation on these possible carriers to safeguard the health the population. So far, DOH looks after at least 3 people in the country who may harbor the disease.
In the excitement of having Manny come home, Filipinos must understand. Erring on the side of caution has strong merits. Diseases don’t discriminate whether someone is a hot-shot victorious boxer or an influential rich congressman who can afford a ringside ticket in Las Vegas. Contagion is something that everyone must take seriously. (Photo Credit: Lalechededios) =0=
RELATED BLOGS: "Wasteful RP Congress holiday after 50 representatives watched the Pacquiao-Hatton boxing match" Posted by mesiamd at 5/06/2009; "Quarantine of 3 possible Swine flu sufferers in Cebu" Posted by mesiamd at 5/06/2009; "May 2, 2009: Update of swine influenza; Hongkong reports its first case" Posted by mesiamd at 5/02/2009; “The march of the pig virus “ Posted by mesiamd at 4/28/2009; “Mexico’s new swine-avian-human flu worries health experts of global pandemic “ Posted by mesiamd at 4/25/2009
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Quarantine of 3 possible Swine flu sufferers in Cebu
It’s a waiting game for three individuals who were quarantined in Cebu on suspicion that they harbor the H1N1 flu virus. A Filipino who was detected to be running fever by thermal scan at Cebu Airpot was isolated together with his wife after they arrived from their trip which brought them to Ireland, Hongkong then to Cebu via Cathay Pacific Fight.
They were sequestered in quarantine rooms at the Vicente Sotto Memorial Medical Center pending the results of their laboratory tests crucial in determining if they have the pig flu. With them was an Englishwoman who voluntarily came to the hospital on May 4, 2009 to complain of cough and colds after visiting Mexico and Hongkong, places where the swine virus had been reported.
Renan Cimafranca, the head of the Regional Epidemiology Surveillance Unit said that the public will be notified of the laboratory tests sent to the DOH’s Research Institute of Tropical Medicine (RITM )in Alabang on the three individuals as soon as they are available. Although the swine influenza seems to behave like the seasonal flu, caution and vigilance are advised because the behavior of the new flu strain isn’t completely known.
Since no swine flu has so far been detected in the Philippines, the Department of Education (DePEd) has no plan to interrupt the schedule of opening of classes in June. Health authorities in Cebu are confident of their readiness to tackle the H1N1 virus infection after learning from their experience in controlling Severe Acure Repiratory Syndrome (SARS) in 2002-2003. (Photo Credit: AP/ Gregory Bull) =0=
50 Congressmen and the harm they do for watching Pacquiao in Nevada when the swine epidemic rages
It’s as if House Speaker Prospero C. Nograles and the 50 representatives of the Philippine Congress are kids. As excited as immature people, they couldn’t be dissuaded from missing the Pacquaio-Hatton fight in Las Vegas, Nevada in spite of the seriousness of the swine flu epidemic.
Perhaps they want to show they have “personal money” to spend abroad unlike the cash-strapped regular Filipinos. The congressmen are determined to risk their health and that of the nation just to satisfy a fancy to be where the action is. Surprisingly, only few Filipinos air their disappointment versus the wasteful travel to Las Vegas.
Manila Archbishop Gaudencio Cardinal Rosales was right in expressing his frustration of having leaders in congress spend big money to travel with no apparent benefit to the Filipinos. As the cardinal said, the presence of congressmen close to the boxing ring will not change the outcome of the match.
The Department of Health (DOH) is trying to safeguard the country of the deadly influenza infection and the congressmen are uncooperative. They show again the lack of responsibility that many people associate with politicians. Seeing the congressmen huddled in the sports crowd that potentially harbors the pig virus is despicable. The P90 miliion the DOH has prepared to spend in case influenza reaches the Philippines is hardly enough for the country’s preparedness.
“Rosales believes that during this time of global economic crisis, it was a “waste of money” to spend on a boxing match, even if it is one of the most anticipated sport events of the year.”----Philstar (05//02/09, Edheminada, P)
Little can be said about these short-sighted congressmen who are insensitive to the needs of their constituents. At the very least, they don’t even know how to set a good example. For insisting on their travel, they need to be quarantined for at least 10 days ----to watch for signs of the H1N1 flu infection---an unnecessary move if they heed to forgo with non-essential trips abroad. (Photo Credit: Sheltercrow)=0=
RELATED BLOG: "Philippine Congress attendance drops to 100 out of 263 as Pacquiao-Hatton match draws near" Posted by mesiamd at 5/01/2009
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The Ebola-Reston virus scare in the Philippines
Ebola Hemorrhagic Fever
There was panic and alarm when Ebola virus first emerged as a fatal bleeding disease in Congo (Zaire) in 1978. Similar outbreaks in neighboring countries in Africa occured. Transmitted mainly by body fluids, the acute infection (aka Ebola hemorrhagic fever, EHF) of the Filoviridae family of RNA viruses presented like a typical viral infection--- fever, headache, joint and muscle pain, sore throat, and weakness after an incubation of 2 to 21 days. Some manifested with a skin rash, conjunctival injection, diarrhea, vomiting, stomach pain, internal and external bleeding.
There were those who survived and spontaneously recovered, but many with severe infections showed signs of hemorrhage, fluid loss, shock, and eventual death. EHF is feared because it is highly transmissible and carries a high mortality rate.
Reported cases of EHF have been zoonotic infections (animal borne.) A potential agent of bioterrorism, Ebola can present as a nosocomial infection, a disease contracted in hospitals and medical facilities during an outbreak. The exact origin, location, and natural habitat (known as the "natural reservoir") of Ebola virus aren't fully known. This makes containment of the infection difficult.
The first 4 of the 5 subtypes of Ebola is known to cause disease in humans: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast and Ebola-Bundibugyo. The virulence and lethality of these viral strains are suggested by World Health Organizations's (WHO) containment recommendations below. EHF has no known vaccine nor specific cure.
WHO's containment of Ebola
•Suspected cases should be isolated from other patients and strict barrier nursing techniques implemented.
•Tracing and following up people who may have been exposed to Ebola through close contact with patients are essential.
•All hospital staff should be briefed on the nature of the disease and its transmission routes. Particular emphasis should be placed on ensuring that invasive procedures such as the placing of intravenous lines and the handling of blood, secretions, catheters and suction devices are carried out under strict barrier nursing conditions (biohazard.) Hospital staff should have individual gowns, gloves, masks and goggles. Non-disposable protective equipment must not be reused unless they have been properly disinfected.
•Infection may also spread through contact with the soiled clothing or bed linens from a patient with Ebola. Disinfection is therefore required before handling these items.
•Communities affected by Ebola should make efforts to ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures, including burial of the deceased. People who have died from Ebola should be promptly and safely buried. --- World Health Organization (WHO)
WHO's therapy and treatment of Ebola
• Severe cases require intensive supportive care, as patients are frequently dehydrated and in need of intravenous fluids or oral rehydration with solutions containing electrolytes.
• No specific treatment or vaccine is yet available for Ebola haemorrhagic fever. Several potential vaccines are being tested but it could be several years before any is available. A new drug therapy has shown some promise in laboratory studies and is currently being evaluated. But this too will take several years.
• Experimental studies using hyper-immune sera on animals have shown no protection against the disease. ---World Health Organization (WHO)
Ebola Reston virus in the Philippines
"In 1989, Reston, an Ebola virus subtype, was isolated in quarantined laboratory cynomolgus monkeys (Macacca fascicularis) in Reston, Virginia, USA. From 1989 to 1996, several outbreaks caused by the Ebola Reston subtype occurred in monkeys imported from the Philippines to the USA (Reston in Virginia, Alice in Texas and Pennsylvania) and to Italy. Investigations traced the source of all Ebola Reston outbreaks to one export facility near Manila in the Philippines, but the mode of contamination of this facility was not determined. Several monkeys died, and at least four people were infected, although none of them suffered clinical illness."---World Health Organization (WHO)
The Ebola-Reston (ERV,) the fifth subtype of the virus was first found in Philippine monkeys. It has caused disease in primates, but not in humans. Mainly because this that local health authorities seem to be “in control” over the simmering Ebola outbreak that has infected pigs in Pandi, Bulacan.
To make sure the ERV doesn't spread to the general population, the Philippine government in coordination with the World Health Organization (WHO) is on the process of slaughtering 6,000 infected pigs. So far no person has been reported to have fallen ill of the disease, but there are 6 farm workers and butchers who turned positive for Ebola antibodies. This is surely a cause of concern.
In spite the Department of Health's (DOH) effort to contain the disease, nobody knows the extent ERV has spread in the country at this time. It is unclear which other animal species harbor the disease agent and need isolation or killing. Philippine health authorities can only speak of what they know---that a number of pigs and some individuals were proven to be positive for antibodies--- which means they encountered the virus without suffering signs of illness.
With the potential to mutate and acquire virulence, Ebola-Reston can be transmitted to susceptible hosts and become infective to more animals and humans. Though ERV doesn’t cause disease in healthy individuals, it’s unclear what happens if the virus infects people with weak immunity or those sick of debilitating illnesses. That’s why to avoid epidemics, isolation or euthanasia of infected animals (like in the Avian Flu infection) are high in the list of priorities.
Awareness of the disease is enhanced through step-up public health education. Cleanliness is important. There is heightened watch over the sale of “double-dead” meat that may carry the disease agent. As a precaution, testing for ERV is expanded and export of porcine meat to other countries has been halted.
The strategies to combat ERV is complex and tedious. Despite DOH’s monitoring and vigilance, medical workers have to deal with the challenges of a serious health threat whose outcome is just starting to unravel. The danger of Ebola doesn't only rest on the Philippines, but on the entire world as well. It's a global effort that this disease is nipped on the bud. (Photo Credit: [][][][][]/ www.bio.davidson.edu /KeeAun)=0=
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Medicine & Religion: Is confession a potent balm against major diseases in RP?
Dr. Francisco Duque III, the secretary of the Department of Health (DOH) reportedly said a staggering 80% of Filipinos are suffering from non-communicable diseases (NCDs) “due to unhealthy lifestyle.” The doctor goes on to say that to combat cardiovascular illnesses, cancers, and diabetes, people have to go to church and make regular “confession.” I find his religious recommendation oddly misleading. It needs clarification.
“Among those considered as NCDs are cardiovascular diseases, cancer, and diabetes. Duque said the three are now among the major health problems in the country. Duque said one way to address this problem is for the people to go on regular confession." I suggest that they go to church to pray and confess their sins because its one way of managing”----GMANewTV.net (02/16/09)
It isn’t unusual to blame stress as a cause of sickness. Though stress goes with almost all diseases, its role is often indirect, sometimes obscure, in many organic diseases. As far as science is concerned, most illnesses have underlying pathogenetic bases whose roles are generally far-reaching than the effects of stress.
Heart diseases are related to high fat diet, sedentary lifestyle, and smoking. Diabetes mellitus may have an autoimmune basis but can come with risk factors like obesity, lack of exercise, and genetics. Certain cancers are triggered by stepwise mutations (alterations in the DNA) that generate clones of abnormal cells that invade, metastasize, and eventually kill the body. In all these, stress plays a role, albeit less strongly than what is suggested by Dr. Duque.
The act of confession (reconciliation) taught by certain religions is not shared by all believers. Confessing sins to a priest by the Catholics has markedly dwindled in recent years. Dr. Duque may encounter criticism and opposition in recommending the holy sacrament to prevent non-communicable diseases. There are non-faith based treatments in medicine which are more predictable and efficacious.
Stress is part of the normal challenges of daily living. Not all people who go through significant emotionally disruptive situations get ill in the process. Sick and healthy individuals, suffer from harrowing conditions in varying degrees. As such the roles of stress in every illness are hard to quantify; their effects on the body aren’t uniformly the same.
I believe emotion plus the working of the mind, and the entire body equilibrium are influenced by stress more than it affects specific organs of the body. It is probably the reason why religion, spirituality, a belief in the supernatural, exercise, meditation, and relaxation regimens have some roles to play in disease management. The mechanisms behind their healing properties aren't fully understood.
Yet, medical science offers credible explanations in disease causation and treatment. Illnesses can be attributed to causes like direct physical injuries, infections, cancers, immunologic conditions, hormonal swings, metabolic derangements, nutritional deficiencies, hereditary disorders, chemical, drug and radiation exposures, poisonings, among others.
Stress is only one among the long list. Therefore, “confession” as Dr. Duque suggested may help in being healthy, preventing sickness, and going through an illness and subsequent recuperation. But surely, we need to account for greater ways to fight diseases more than what have been recommended by the standard and complementary approaches of medicine. This is important in the holistic way of maintaining the health of the nation.(Photo Credits: denislpaul; sacerdotal) =0=
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Nepalese MD’s to train and render service in Bicol Medical Center
As a result of the drop in the number of medical school graduates and the exodus of local doctors to foreign countries, the Bicol Medical Center (BMC) in Naga City has resorted to bringing in 40 doctors from Nepal. From the remote country close to Mount Everest, Nepalese foreign medical graduates will be in the city to train and render service.
"The Bicol Medical Center (BMC) in Concepcion Peque̱a, Naga City is a 500-bed government tertiary hospital under the direct supervision of Department of Health Center for Health Development РBicol, Legazpi City. It is a non-profit institution and one of the 13 medical centers under the National Government." http://doh.gov.ph/bmc (Photo Credit: bmc)
The presence of imported healers in Naga is expected to beef up the medical personnel of the government hospital which has suffered the lack of MDs for the last 5 years. There have been fewer applicants to fill in the 28 doctor-vacancies in BMC. Therefore, the coming of the international physicians appears to be a boon to the hospital service in the city. But is it?
Without inciting any nativist sentiment against the foreign professionals, I think it is justified to ask if the Nepalese doctors’ schooling is comparable to those of the local physicians. The adherence to standard medical training (i.e. in the tradition of Western allopathic medicine) is important before they are allowed to handle patients. Their medical background must be adequate to meet the peculiar health needs of the community. To ascertain competency and avoid compromising the health of patients, they must be tested for basic communication and clinical skills.
Though the Department of Health (DOH) approves of these foreign doctors, does the government have guidelines that define the scope of medical duties and accountability? Are the professional regulations in place to protect the doctors, their patients and the hospitals where they work? Will the presence of these trainee-MDs not interfere with the training and oversight of local doctors, nurses, and other paramedical professionals? Are there enough senior MDs to supervise and teach them? Are they not in violation with the rules of the Professional Regulations Commission (PRC) which regulates physician licensure and practice? Has there been discussions on the effects of foreign doctors on the healthcare of the nation? Their presence may distract the government from pursuing the programs which will make local doctors stay and serve the community instead of going abroad.
In a blog I posted on August 27, 2008, I wrote:
According to Philippine Medical Association (PMA) president Reynaldo Santos, M.D. the arrival of these foreign medical trainees attests to the high quality of education in the country. But this is doubted in the wake of a sharp decline of the number of hospitals, a marked rise in patient load for doctors and nurses, a low passing rate of Filipinos in the United States Medical Licensure Examination (USMLE,) an over-crowding of patients and trainees, lack of budget, equipment upgrade, and medical facilities in many hospitals.
I hope Bicol Medical Center has ironed out the important issues cited above. Otherwise, sending in the Nepalese doctors will solve some of the current healthcare problems of Naga City, but it can also spawn fresh and bigger challenges that haven’t been given enough attention and consideration.=0=
RELATED BLOG: "RP’s 40% drop in med school enrollment & the foreign doctors" Posted by mesiamd at 8/27/2008
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DOH’s plan to spend P90 million for random drug testing
The Department of Health (DOH) plans to spend P90 million on random drug testing for high school and college students. Supposedly, the money is earmarked to develop manpower and laboratory resources for the test which is expected to give teeth to the fight against drugs in the country.
On the basis of trying to find out the prevalence of drug abuse the Commission of Higher Education (CHED,) DOH and its secretary Dr. Francisco Duque believe the testing is justified. They chorused it is needed in setting up strategies in controlling the problem as Pres. Gloria M. Arroyo steps up her campaign against illegal drugs.
According to Inquirer (01/29/09 Pazzibugan, D,) the test will be done in the next 7 to 9 months on 87,000 students from 8,750 high schools and 2,000 colleges nationwide. Based on past random drug testing, about 0.8% of 8,670 high school students and 0.5% of 7,499 college students tested positive for drugs. Notably, those who tested positive (majority use marijuana) aren’t a lot compared to many Filipinos who are sick and in need of urgent medical attention.
Does it mean that the government is willing to spend P1,034.48 for every student in order to track down about 696 students, the 0.8% who are expected to be positive in the test? If they find out who are positive, do the authorities have additional money to “treat & rehabilitate” them? Will the money for drug testing be better used for other serious health problems that involve a larger number of people who may need more medical attention----i.e. tuberculosis, malaria, dengue? Or can funds be used to improve the facilities of schools?
Why is testing being planned for the teachers and not for other professionals? Why doesn’t the government directly run after the drug dealers? How come only the students and teachers are being singled out to undergo the test? Why can’t they not include the regular workers, unemployed, drivers, military personnel etc.? What are the safeguards that medical information culled from the testing will be handled confidentially and not be used or abused for other purpose? Isn’t privacy violated and civil liberties invaded when this testing is done?
The above questions may help in deciding if the controversial drug testing plan is worthwhile to pursue. At this time of economic crisis, wise spending can go a long way in helping the neediest. If a law on drug testing is to be applied fairly, it must cover the entire population and not single out a particular group. Organizations like the Alliance of Concerned Teachers (ACT) and the National Union of Students of the Philippines (NUSP) have valid reasons to oppose the rationale and legality of this plan. (Photo Credit: Mooosh; Suntoksabwan; Latin Snake) =0=
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Campaign against firecrackers and fireworks
A counter-move against the merry tradition of bidding a noisy ending of the year, young students in Manila staged rallies against firecrackers. In a gathering spearheaded by EcoWaste foundation, environment-conscious students in Malate, brought attention to the dangers and polluting effects of firecrackers during the holiday.
In Negros Occidental and Cadiz City, an estimated P300,000 and P100,000 worth of illegal pyrotechnic devices respectively were confiscated by authorities. Similar operations where conducted in various cities all over the country as the new year draws near.
Although the Department of Health (DOH) has made headway in discouraging the use of firecrackers with the use of explicit anti-firecracker ads, hospitals in the country are in “Code White Alert” in anticipation for more people who might need medical attention. More than a hundred injuries have been reported including at least three directly inflicted by gunfire.
The argument against the firecrackers and indiscriminate gunfire at this time is easy to understand, but annually, Filipinos needed to be reminded of the risks and perils. Students and concerned Filipinos standing against firecrackers are helpful in getting this message across. (Photo Credit: Malaya/ Philip Duquiatan) =0=
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