H1n1 Update

On June 19, as the cases of Influenza A(H1N1) surged past 300, the health department made public the statistics they have so far on the H1N1 cases in the Philippines. Roughly one-third came from abroad, many of them Filipinos who went for a vacation in the US despite the DOH warning to put off unnecessary travel. Most of the recorded cases so far are in Metro Manila — and many of them were in Quezon City. All cases have so far been mild. Notes on June 19 2009 press conference: Dr. remy olveda, ritm director Francisco duque III, secret Dr. Mario villaverde, doh usec Dr. juan lopez, doh nec epidemiologist Duque: also invited ritm director to respond to allegations that came out in pdi front page… written by ms. Orendain…such an unfair and unfriendly negative light…some patients expect that ritm is a five star hotel. It is not a hotel where every time you call for someone there’s always somebody…you’re in isolation in a quarantine room There have been 15 more fully recovered cases that we have sent home…262…344 total count of positive cases…all mild in nature, those under treatment and those sent home. Although it is true that for now the novel virus seems to be causing only mild illness, still should not be complacent. Continue to be vigilant…monitor for changes in trends and patterns. Would also like to state the 344 confirmed cases are from metro manila, our ncr, with 234 cases, roughly equivalent to 60%, central Luzon, 30% roughly and calibrator, with 31 cases, 9% of total cases. In ncr most cases came from quezon city, 81 or 34%, manila, 34 cases 18% Paranaque…makati, 15 cases…age range from 1-76 years old, with 18 as median age. Most of cases belong to 15-24 years of age group, roughly 171 cases of 50%. Majority males, 187, 54.4% of total cases. 305 cases or 89% of reported confirmed cases are Filipinos. That’s about 60-65% Filipinos. The rest are Japanese, six cases, american, 4 cases, Australia 1, china 1, India 1, iran 1, korea 1…the remaining 22 did not specify nationality. 101 had history yof travel to country that reported confirmed cases. 48 cases of 14% from us, japan, 16 cases or 5%…as of june 17 the who reported… June 7-13…week 23rd…not necessarily the peak, just the highest so far…of course the next slide will show the bar graph…horizontally…ncr pinakamarami, followed by reg3, 45 cases…in ncr, highest quezon city, manila, 44, Paranaque, 21. The last page simply tells us that usa did report most number of cases as of jun 19…followed by japan, china, Australia… Villaverde: right now we are developing a new guidelines in relation to the shift to the mitigation phase. We are simplifying the existing guidelines, revising also the school response level as we have case experience already in relation to 5-6 schools that have suspended their classes and as we have characterized disease in school population among students. We are simplifying guidelines and before end of day the sec may be able to sign it. Issuing by early next week the mitigation response level edited version because we are refining it. Also revising the clinical protocol in the sense that the characterization of this illness, some of the mild cases have recovered even before we have instituted any definitive treatment so we are revising this. Even the original guideline where we provide prophylaxis to close contact. Travel guidelines revising to simplify because of change in global picture. Now pandemic alert six so we will adjust in relation to home quarantine for travelers, 10 day period and so on…over the weekend just review any inconsistencies in draft of new guidelines. Olveda: what we are doing at ritm is more than what people should expect from ritm. We work very hard but despite the work and dedication our people gave…we have one news like this. But

we understand what patient feels when quarantined, really difficult to be quarantined inside isolation room…negative pressure room…to protect workers and also patient…the title was very bad…I know title was adopted from movie…about war crime… Duque: hope public will be a little more generous with their sense of appreciation. We do our best, life isn’t getting any better for all of us, especially for those at the forefront of providing care… Olveda: 70 year old woman who was happy and appreciative…not my mother in law.. Duque: (344…walang dagdag, good news for us) in-update pa ang ibang mga reports. Baka bukas mapalabas na natin…alam ninyo ang proseso na nire-reconcile ang figures, repeat tests for those to be discharged, it’s really taking quite some time before the latest figures are brought out. (cuos) hindi na sinasama…doesn’t really say much… (policy for outbound pinoys) who has not recommended, in fact discouraged outbound screening, use of thermal scans for people leaving the country, also don’t encourage continued or heightened use of screening measures for inbound passengers. From way look at it, most of those who came in, kaunti lang nakuha from thermal scan….most of them were seasonal influenza or other bacterial infectious diseases…time to move towards more measures in sphere of mitigation…not saying go mitigation, drop containment, where containment is apropos, continue with it. Where in certain communities spread cannot be prevented, slowing the infection should be the next… (region 3 nadagdag…last school to report) we don’t have increase in number of confirmed cases, and no. of ili cases has started to go down. (mitigation response…st paul in pasig has one confirmed case in grade school dept…closed today, is that in violation of ten day suspension) villaverde: still implementing the old guideline, the new one will probably come out today or tomorrow once sec signs it, still in final version. We have come to realize that some campuses have different configurations. The mere fact may clustering sila, nakahiwalay….very impractical pag the entire campus will be closed. Same sa setup ng up…have to evaluate and assess on case to case basis, just provided general guideline and assess configuration of schools. There are some schools….block section ang kanilang approach…we really need to take this into consideration and this will come out in new guideline. Duque: private schools….may mga doctor yang mga yan. Should be given opportunity to make their own assessments… (how is reports from brazil they found new strain) refuted if not negated by who and the cdc… there is no such thing. The strain that they refer to is minor modification of the virus. Major amino acid that constitute the virus…now that virus is already here, characterized as, mild… Us cdc rejected claim. We’re second largest contributor to overseas workers… All the more, brings us to the point that we might have to treat it as sub type of ordinary flu virus but continue to monitor its potential for change as it behaves in different communities. (demography of ah1n1 cases) duque: hindi makukuha kasi kailangan kunin income tax return. Villaverde: if you will look at present report, most of those affected…101…had history of travel. A bulk of these 101 nagbakasyon sa US during the summer vacation. You can already gauge the economic profile of this group.. Those affected sa mga school, second generation, most from exclusive schools. Can also gauge the economic profile.

(ofws who get sick in other countries) it’s the dfa because we have our postings in different countries with diplomatic relations. 19 schools. Latest. 19 over 40,000 schools… Villaverde: (possible na mabago sa guidelines) yung mga detalya…based on experience, school response level, based on five to six schools na nakuha na natin ang profile ng cases. Hindi applicable ang ibang…issued these as interim guidelines, first time we have this particular illness we have to gain experience also. Only phils has definitive school response level system. Yun iba pag nagkaroon, kino-close na lang without any…