Pregnant woman dies of swine flu in Cambodia

PHNOM PENH, Cambodia – Cambodia's health minister says a pregnant woman died from swine flu, the country's third reported fatality from the illness.

Health Minister Mam Bunheng says the 25-year-old woman, who was nine months pregnant, went to a Phnom Penh hospital several days ago with flu-like symptoms and tested positive for swine flu.

He said doctors performed a cesarean section and the baby was born healthy, but the woman died Tuesday.

Cambodia's second swine-flu related death, a 47-year-old man, occurred Monday at the same hospital, the minister said.

The World Health Organization reports more than 340,000 confirmed cases of H1N1 worldwide, and more than 4,100 deaths. Many countries have stopped counting individual cases.

Source: AP

There is a first TypeA/H1N1- Death Case in Cambodia

A Cambodian Woman, Mrs.Eng Heng, 41 years, had died in Calmetre Hospital on Sunday, 27 September, 2009 in the afternoon. This is the first death case of Type A/H1N1 in Cambodia. The Preminister, Samdach Hun Sen has called today to all Cambodian people to pay high attention to this virus.

TYPE A(H1N1) -Vaccine proves to be safe for human trial

GPO to launch FluMist tomorrow; victims on the rise

The Government Pharmaceuti-cal Organisation will next month start undertaking human trials on the live-attenuated vaccine against the type-A (H1N1) virus now that laboratories in the Netherlands and Russia have confirmed the virus-seed vaccine proved to be safe on animals, GPO's board chairperson Dr Wichai Chotewiwat said yesterday.Meanwhile, he added, that tomorrow the GPO would be coming up with the first few doses of FluMist, a nasal spray live-attenuated vaccine. The Public Health Ministry announced last week that the number of swine-flu victims had risen to 81 after 16 more patients succumbed to the virus. The ministry said it is suspected more than 500,000 people have been infected, and that the death toll was closer to 100 people.In a bid to tackle the outbreak, the Public Health Ministry and Mahidol University's ethics committees have, in principle, given the university's Faculty of Tropical Medicine the green light to research the vaccine.Citing a recent e-mail from laboratories in the Netherlands and Russia, Wichai said so far the virus-seed vaccine had been tested for safety and toxicity on mice and ferrets, and that a human trial would be launched in Thailand next month."The e-mails say that the virus-seed vaccine proved to be safe on animals and that there were no toxins or mutation," he said.The GPO will also be incubating the virus to make sure it is free from contamination before it is tested on some 400 volunteers from September 4. So far, about 100 people have volunteered for the trial, he said.In a bid to ensure safety of the volunteers, Wichai said the ministry's Ethical Committee would also set up a data and safety monitoring board. The World Health Organisation's regional office, based in India, will send a representative to help the ministry set up this board, while WHO staff members will work along with Thai researchers to monitor the safety and efficacy of the vaccine. The panel, which is still closely studying details of the project, has until today to decide on whether or not to allow the vaccine to be tested on humans.A recent report from the Ramathi- bhodi Hospital says that samples collected from a patient, who has already recovered, show that the type-A (H1N1) virus is resistant to the oseltamirvir antiviral drug.However, the ministry's advisory committee, chaired by leading virologist Prasert Thongcharoen, insisted that the evidence was not enough to confirm the virus is resistant to the drug, because the study was only done on the change to the virus gene's genetic position. He added that research had not been done on enough samples to confirm the virus was resistant."More samples need to be tested before we can confirm the virus is resistant," he said.However, Public Health Minister Witthaya Kaewparadai said just to be safe, he would reserve up to 100,000 courses of the second drug zanamivir.

Source: The Nation

TYPE A (H1N1)-Decline in new cases, deaths

Minister cites rising awareness about the virus

Public Health Minister Witthaya Kaewparadai said yesterday that the number of infections and deaths caused by the typeA (H1N1) virus has dropped over the past week, mostly because people were more aware of the disease and were not panicking.A source from the ministry said yesterday that so far 10,045 people have been infected and 81 have succumbed to the virus. However, he said the ministry's deputy permanent secretary Dr Paijit Warachit will announce the official numbers at a press conference today.Last week, the ministry said 65 had died since the disease broke out in May, and 8,879 people had been infected. He said the number of cases this week had dropped because not only were people not panicking, they were also seeking treatment immediately. He also complimented health care volunteers, especially those in Ubon Ratchathani province, for keeping an eye out for infections.Meanwhile, Witthaya said his ministry was still vigilant because even people with no underlying diseases had succumbed to the disease.Deputy director of the Maharat Nakhon Ratchasima Hospital, Dr Veerasak Kaitpadungkul, said an 11yearold boy had died from the virus yesterday, bringing the total of fatalities in the province to four. The boy was admitted at hospital on August 1 with high fever and troubled breathing. Apparently, he had had a high fever for more than 15 days before he was taken in for treatment, and tested positive to the virus.Meanwhile, Nakhon Ratchasima public health office chief, Dr Chuwit Likhityingwara, said the hospital also admitted two pregnant women with flulike symptoms, and one tested positive to the virus.One of the women, a 16-year-old who was sixmonths pregnant, had a miscarriage and died from severe pneumonia. She did not test positive to the virus.The second woman, an 18yearold who is also sixmonths pregnant, is in critical condition. She has been transferred to the Ramathibhodi hospital and is being treated with the antiviral zanamivir. Her unborn baby is in normal condition. Chiang Mai public health office deputy chief, Surasing Visaruthrat, said more than 10 healthcare workers had already contracted infections either at work or at home, but all had made a full recovery.Meanwhile, Witthaya said few clinics nationwide had agreed to dispense the antiviral drug oseltamivir because they did not want to shoulder the burden. He said he would extend the deadline for clinics to join the programme to August 17.Director of the Government Pharmaceutical Organisation (GPO), Dr Vitthit Attavejchakul, said his agency will come up with the first dose of the liveattenuated vaccine, even though it has still not undergone animal or human trial.The vaccine was supposed to be tested on humans this month after the National Ethic Committee had given the study its green light.

Source: The Nation

TYPE A (H1N1)-Flu's fatalities reaches 81 Wednesday

Thailand on Wednesday announced an additional 16 fatalities of new strain of influenza, bringing the country's death toll to 81, Deputy Permanent Secretary for Public Health Dr Paijit Warachit said.
The figure was lower than the previous week's toll of 21, which the Public Health Ministry attributed to the public's more awareness of the virus.

"People have a better understanding of the flu and better access to the anti-viral drug Tamiflu," a statement from the ministry said.

Nine men and seven women were killed by influenza between July 26 and August 2, 12 of whom had underlying illnesses when they became infected, it said.

Source: The Nation

TYPE A (H1N1) -Banquets great site for infections

Chinese banquets are prone to spread the type-A (H1N1) influenza among patrons, as most event halls hosting them are poorly ventilated, while serving spoons are not regularly used and eating utensils not properly cleaned or sanitised, the Public Health Ministry warned yesterday.
The ministry's permanent secretary Prat Bunyawongwiroj said such banquets or similar events with large gatherings were still regarded as high risk for spreading the disease.
Prat earlier visited a hospital in Ayutthaya province where five pregnant women with the influenza had been admitted for treatment. He said three had recovered and discharged. The other two were still being treated, but were no longer on life-support systems and could breathe on their own.
Prat did not comment on speculation that the hospital had hidden details about the admission of the five pregnant patients.
One woman, 36, gave birth prematurely to a baby boy, who was also infected with the disease. The other woman, 39, also gave birth but there was no sign of the baby being infected.
A 50-year-old inmate in the provincial prison has been diagnosed with the flu and is being treated at hospital. Her case has prompted concern among local corrections authorities that an outbreak could develop among inmates. There are five prisons in the province.

Source: The Nation

Only 31 of 181 clinics agree to accept tablets

So far only 31 of the 181 clinics registered for experimental use of oseltamivir have agreed to accept the tablets, for fear that ordinary patients will turn away after learning that they will be treated along with those carrying the novel flu.

Only after the Wednesday deadline will it be known how many private clinics in total will decide to join the government scheme in which all confirmed cases are automatically prescribed with oseltamivir, Dr Somyos Deerassamee, directorgeneral of the Health Service Support Department, said yesterday.Six hospitals run by the Bangkok Metropolitan Administration, more than 100 community clinics and several hundred BMArun public health centres would be ready to provide free oseltamivir tablets and other treatment to people without case confirmation needed, he said.Prime Minister Abhisit Vejjajiva said in his weekly address that the flu situation in Bangkok was under control but the virus may still be spreading upcountry. He dismissed criticism that Thailand was the hardest hit by the 2009 influenza, saying the government was following a World Health Organisation guideline to not regularly report on the fatality rate of the disease.The Public Health Ministry is now requiring all private clinics to ensure that all patients unconditionally wear protective masks while awaiting treatment, and to examine people with suspected flu in a separate area, besides the mandatory use of handwashing gel and protective masks.Dr Itthiphorn Khanajaroen, deputy secretarygeneral of the Medical Council, expressed worry over possible confusion among the public on what conditions would get them free oseltamivir. "It's important to make people aware that not everyone who visits a clinic will be automatically given the tablets," he said.Incorrect dosage for children was also highly possible, because it had to be measured precisely by using a drugdiluting device. "Oseltamivir tablets cannot be cut and given to children in smaller doses like other medicine pills," he said. "There is a great risk of giving a stronger dose to young children who visit clinics without the diluting devices," he added.Deputy Public Health Minister Manit Nopamornbodi said a ministry analysis of fatal cases revealed that those patients without the risk factors of chronic disease, pregnancy or young age, had seen a doctor too late, beyond the twoday incubation period. "People with risk factors including the elderly, those with chronic diabetes, asthma, kidney and heart disease, made up 60 per cent of all fatalities," he said.More than 987,000 public health volunteers now pay house calls three times a week in provinces outside Bangkok to educate people about preventive measures against the 2009 influenza and to hand out information. Starting last Friday, more than two million house visits have been made under this project, Manit said.

Source: The Nation

Govt to distribute free flu medicine through clinics

The government will provide the antiviral drug oselamivir to patients with influenza-like symptoms free of charge at private clinics around the country.

Meanwhile, foreign firms, embassies and international organisations will be allowed to stockpile oseltamivir for their emergency use against the pandemic of type-A (H1N1) flu.
The handout of free medicine is aimed at preventing more fatalities of people infected by the virus, which has already killed 71 people as of yesterday. Seven people are in intensive care units.
Over 800,000 tablets of oselamivir will be handed out to medical clinics by mid-August, Public Health Minister Witthaya Kaewparadai said yesterday.
"These clinics should not charge patients for oseltamivir as the government will foot the bill," he said.
Having concluded that some healthy persons died from the flu because they were not treated with the drug or were given it too late, the government is now encouraging doctors and clinics to dispense the medicine as soon as patients show serious flu symptoms.
Clinics that get the state-sponsored drug are also required to collect detailed information about their patients and use a referral system so that patients can be transferred to appropriate hospitals.
Initially, each clinic will get 50 tablets of oselamivir.
Medical Registration Division's director Dr Tara Chinakarn said only 8,700 of 17,000 clinics nationwide and 2,000 clinics in Bangkok are competent to dispense the antiviral drug to patients with flu-like symptoms.
Regarding the move to allow foreign organisations to bring in anti-flu drugs, the Public Health Ministry said local units of the World Health Organisation and the International Red Cross and Red Crescent, for example, are not required to register with the Food and Drug Administration (FDA) to import medicines at this time.
The FDA said each foreign organisation may import antiviral drugs for 20-30 per cent of their local employees. The drugs can be stored at a hospital and will be prescribed only by doctors.
In a related development, a 16-year-old girl who is two-months pregnant suffered a miscarriage after being infected with the type-A (H1N1) virus.
The Health Ministry is now drafting guidelines for physicians to provide special care for pregnant women who are admitted to hospital.
Dr Tawee Chotepitayasunon, head of the Public Health Ministry's influenza team, said the guidelines would be released next week.
However, he advised pregnant women to seek medical help immediately after developing flu-like symptoms, which include fever above 38.5 Celsius.
The Department of Mental Health said public panic over swine flu had lessened.
"We found that people in Bangkok had a better understanding than those living upcountry. That's a good sign in terms of communication [about the disease]," department director Dr Chatree Banchuen said.

The NAtion

TYPE A(H1N1) - All flu patients must seek attention within two days

The Public Health Ministry yesterday advised people, even people with no underlying conditions, to seek medical help within two days of developing flu-like symptoms.

Meanwhile, a 57-year-old physician at Chiang Mai University's Faculty of Medicine succumbed to the flu, becoming the first victim in the healthcare industry, provincial health chief Dr Wattana Kanjanakamonsaid.
Wattana suspected that the unnamed doctor might have caught the infection from a patient.
Meanwhile, the ministry reported that a total of 24 people with no underlying diseases had died of the type-A (H1N1) influenza so far. The other 41 fatalities involved patients with chronic health problems. As of yesterday, the number of confirmed flu cases were 8,877.
Most of the deaths were caused by patients waiting six or more days before seeking medical attention, which meant that they did not respond well to the antiviral oselatmivir, said Dr Paijit Warachit, the health ministry's deputy permanent secretary.
People with no chronic diseases should wait no more than two days before seeking medical treatment, while those with chronic disease should head to the nearest hospital as soon as they develop flu-like symptoms, he warned.
Patients with severe flu symptoms need to consume oseltamivir within 48 to 72 hours after being infected in order to cut down the chances of developing severe pneumonia, which can be fatal, he said.
Ramathibodhi Hospital's Dr Sayomporn Sirinavin said the antiviral showed best results if taken within 48 hours. However, he said, it was not necessary to dispense the antiviral to patients with mild symptoms because they could develop a resistance to the drug.
Next month, the Government Pharmaceutical Organisation (GPO) will start producing 20 million tablets of the antiviral to help fight the outbreak, and decided last week to increase its stock of oseltamivir from 15 million to 55 million doses.
GPO director Dr Vithit Attavijjakul said it would take no more than 24 hours to deliver the drug in urban areas and 48 hours for rural areas. GPO is also reserving 50,000 oseltamivir tablets for its regional offices in Chiang Mai, Udon Thani and Hat Yai to distribute to 18 provinces.
GPO has also reserved 50,000 courses of the zanamivir, imported from Australia, for patients resistant to oseltamivir. The World Health Organisation reported that type-A (H1N1) cases resistant to oseltamivir have been found in Canada, Denmark, Japan and Hong Kong. So far, nobody has shown resistance to the antiviral in Thailand.

Source: The Nation

TYPE-A (H1N1) -Bt450 billion more to help fight virus

Ministry to spend Bt180m on buying respirators for hospitals nationwide

The Cabinet yesterday approved Bt450 million to help with the Public Health Ministry's fight against the type-A (H1N1) influenza outbreak now that the number of cases and deaths have surged rapidly over the past few weeks.
The ministry's deputy permanent secretary Dr Siriporn Kanjana said Bt180 million would be spent on purchasing 180 respirators, which will be distributed to hospitals nationwide. The ministry will also spend Bt9 million on 20,000 courses of the drug zanamivir for patients resistant to oseltamivir.Two weeks ago, the Cabinet approved a Bt850-million budget to buy vaccines and oseltamivir tablets. Of this, Bt600 million was earmarked for two million doses of the vaccine and the rest for the tablets.Siriporn, who pushed for the funds at the Cabinet meeting yesterday, said Bt50 million of the budget would be used to disseminate information to the public and to pay medical workers.To date, the type-A (H1N1) virus has infected about 8,600 people, killing 66 of them. At last report, 22 patients have died over the past seven days. The Public Health Ministry will be issuing an official update at its weekly press conference today.Meanwhile, Prime Minister Abhisit Vejjajiva yesterday asked the Public Health Ministry to provide him with a report about the outbreak and why fatalities were rising. A health expert from the ministry explained to the Cabinet that about 80 to 90 per cent of the fatalities were as a result of delayed treatment.Siriporn also raised concern about the fact that the number of seasonal flu cases had also risen drastically over the month when compared to the same period last year. The number of patients admitted to hospitals with flu-like symptom has doubled from 2,000 cases in last July to 4,000 this July.She added that the number of patients with flu-like symptoms has risen in regional areas while the number in Bangkok was stable and expected to drop.In a move to reduce the death toll, the ministry will today have clinics nationwide prescribe the oseltamivir antiviral to patients with serious flu symptoms, Public Health Minister Witthaya Kaewparadai said.Witthaya said he would meet provincial public health chiefs across the country to give them updates about the outbreak, and will give them guidelines on handling infections apart from sending the antiviral drug to clinics that wish to join the programme. Deputy Public Health Minister Manit Noppamornbhodi said 800,000 tablets of oseltamivir would be sent to 16,000 clinics nationwide, which averages out to 50 tablets per clinic, which should be adequate.Under the programme, which can be joined on a voluntary basis, clinics will be given oseltamivir provided they follow a set of criteria: prescribing the antiviral; continuously collecting information about the patient; and developing a referral system so patients can be transferred to hospital. Clinics also have to follow up on patients' symptoms after they consume the antiviral drug. In addition, each medical facility needs to be disinfected to prevent spread of the disease.Each physician will be required to attend training and must pass the assessment. Moreover, they must follow the ministry's guidelines when approaching patients.Manit said the pilot project has been up and running in Ratchaburi for a week now because it reported the second-highest number of fatalities after Bangkok. He said about 150 clinics in Ratchaburi had been given 50 oseltamivir tablets but every prescription of the drug will have to be reported to the ministry.Meanwhile, the National Health Security Office (NHSO) will invite healthcare providers, hospitals and clinics to inform them about the ministry's criteria in prescribing the antiviral. A 24-year-old woman, who contracted type-A (H1N1) influenza during her pregnancy, is still under close medical supervision at Chulalongkorn University. She was about seven months pregnant when the baby had to be delivered via Caesarean section. Her five-day-old baby is now getting healthier but is still kept in an incubator. The mother, meanwhile, is in a serious condition. "She has serious lung infections," the hospital director Dr Adisorn Patradul said. "She has become more dependant on the respirator".

Source: The Nation

Death toll up 50% to 66 in a week

The death toll from type-A (H1N1) influenza rose to 66 yesterday, after the virus claimed 22 more lives during the seven days since the last report.
The Public Health Ministry will issue the official update at its weekly press conference tomorrow.The ministry announced last Wednesday that fatalities had hit 44 since the disease broke out in the country in May. Infections now number 6,776.Deputy Public Health Minister Manit Nopa-mornbodi said about 30 per cent of the fatalities could be blamed on delayed treatment. Some victims had wanted to stay home or sought medication at a nearby clinic rather than going to a hospital to undergo treatment, he said. This was why the virus had spread to their lungs so rapidly.Manit said he had ordered the ministry to investigate drug distribution to hospitals operating under its responsibility across the country.All hospitals must stock an adequate supply of medicine and distribute antiviral drugs thoroughly.He also asked the National Health Security Office to invite private hospital and clinics to discuss medical services that follow the ministry's standards.To date, more than 2.8 million tablets of oseltamivir out of the 6.23 million available have been delivered to hospitals around the country.The Government Pharmaceutical Organisation will produce 40 million more antiviral tablets to build up inventories.Alarmed at the surge in infections and fatalities, the Public Health Ministry has decided to allow private clinics nationwide - and not just hospitals - to prescribe the oseltamivir directly to patients with flu-like symptoms on a trial basis.The pilot project has been under way in Ratchaburi for a week, since the province reported the second-highest number of fatalities in the country with seven. Bangkok has the highest number. The results from this project will be used as a guideline for clinics nationwide.The ministry's advisory committee on a strategy for public health and medicine, chaired by leading virologist Prasert Thongcharoen, also met with health experts to discuss the distribution of antiviral drugs to clinics, which would help patients with flu-like symptoms access the medicine faster.
6% OF CLINICS TO GET DRUGA health expert, who wanted to be unnamed, said the committee would draw up the ministry's specific criteria for clinics to prescribe the antiviral drug for flu treatment.The source said those clinics volunteering for the project would be asked to register with the ministry. Physicians at the clinics must be trained by the ministry in antiviral prescription. They will be required to send reports about the amount of antivirals in stock and the amount prescribed.There is no need for every clinic in the province to store the antiviral drug. Only 6 per cent of all clinics in a province will be required to carry the medicine for type-A (H1N1) flu treatment.However, there is no regulation to ban clinics from keeping a supply of oseltamivir, the source added.

Source: The Nation

Baby may be the first to be born with type-A (H1N1)

An infant girl delivered prematurely at Ratchaburi hospital was born infected with type-A (H1N1) influenza - possibly the country's first mother to child transmission of the infection, medical authorities revealed yesterday.
"This is the country's first case study," said Dr Adisorn Phattaradul, director of Chulalongkorn hospital which admitted the 24-year-old mother from Ratchaburi province on Saturday.After the baby was born prematurely last Tuesday her mother developed a severe form of type-A (H1N1) influenza before being transferred to Chulalongkorn - the country's leading medical school - to receive special care.She is now in a critical condition with severe pneumonia. Doctors say the virus has spread to her lungs and she is on a respirator in the intensive care unit. They have given her the antiviral drug oseltamivir and sleeping pills to help her recovery.Meanwhile, her newborn daughter is in a baby incubator and has also been given antiviral drugs. Doctors say her lungs are now normal but they are worried the virus might affect her brain. Dr Lelanee Paitoonpong, an infectious disease specialist of Chulalongkorn University said: "Mother to child transmission of type-A (H1N1)flu in this case was only an assumption."She said to reduce the risk of getting a severe form of flu-like illness, pregnant women should avoid close contact with people with symptoms and keep clear of public spaces.They should also wear face masks to prevent infection, she added.To date, Thailand has 6,776 reported cases of type-A (H1N1) influenza which has killed 44 victims nationwide.Prime Minister Abhisit Vejjajiva has assured the public adequate stockpiles of antiviral drugs and vaccine are on hand.He said the Public Health Ministry is now improving its methods to help patients with flu-like symptoms to access treatment faster.Deputy Public Health Minister, Manit Nopamornbodi said the ministry will today send 980,000 health care volunteers to screen patients for severe forms of type-A (H1N1) symptoms in villages and communities to reduce cases of infection and death.

The NAtion

FLU EPIDEMIC - Too many details causing panic: Ammar

Govt just telling the truth, minister says

Prominent economist and social critic Ammar Siamwalla urged the government yesterday to stop creating panic over the new flu pandemic, and said its efforts to curb with the outbreak were unclear.
"Personally, I think Thailand has disseminated too much information about the new flu virus and caused panic among people, which is unbalanced," he said.
Ammar gave a speech entitled "Economic development on a biological base" at the Ministry of Natural Resources and Environment's Biodiversity-Based Economy Development Office.
The move comes after a jump in the number of infections and deaths, which the Health Ministry announced on Wednesday. Thailand has had 6,776 confirmed cases of the new flu, with 44 fatalities.
But Ammar thought the Health Ministry's latest report scared people.
While reports on about the spread of the virus did not affect the economy and only slightly reduced the number of tourists, he feared serious outcomes in the future if people panicked too much.
Instead of reporting the number of people who caught the bug and increasing number of deaths, the government should focus on what people knew and understood about the disease.
"The government should inform the public that this new flu virus is easy to spread but it is not dangerous if people receive the appropriate medication immediately," he said.
He advised the government to focus on prevention and provide information to people, especially those in crowded places such as schools, or public space with airconditioners.
Public Health Minister Witthaya Kaewparadai said he conceded some failings in moves to tackle with the pandemic, including the provision of medication to patients with severe flulike symptoms.
Witthaya, who was stuck in a blockade of people during a visit to Angthong, Ayutthaya and Chai Nat, he said the ministry had not concealed any information over the influenza pandemic and condemned people for trying to distort information and politicise the issue.
"These were real figures that we reported to the public. There was no reason for us to lie to people because if we do not tell the truth to people hospitals would be pushed to breaking point," he said.
Asked if the ministry had pondered panic concern caused by the surge in infections and deaths, he said Thais knew more about the virus now, and that people all over the world did not have immunity against it, so they were equally at risk and needed to avoided getting the flu.
He urged medical workers to provide drugs faster to patients with severe flulike symptom to reduce the number of deaths.
"Most patients die because of delayed treatment," he said. "They go to hospital too late after developing a severe flulike illness."
All provinces must reserve a sufficient stockpile of the antiviral drug oseltamivir and provide it immediately to patients with severe flulike symptoms.
"Patients who have flulike symptom for two days must be given oseltamivir immediately when admitted hospital," he stressed.
Pregnant women with flulike symptoms also must be given special care.
Clinics and drug stores should not let patients who have high fever and develop severe flulike symptoms to take a fever reducer by themselves for week. They should be advised to go to hospital instead.
The Health Ministry was trying to control the spread of disease in areas where there have been a high number of infections or deaths, he said.

The Nation

FLU PANDEMIC - 440,000 people said to have had the bug

The number of people in Thailand who have caught the new flu virus is getting close to half a million, the Public Health Ministry announced yesterday.

Dr Kamnuan Ungchusak, spokesperson for the Disease Control Department, said the ministry estimated the "real" number of people who had caught the typeA (H1N1) flu strain in the three months since the outbreak hit the country in early May was about 440,000. This was based on a ratio of about 10 deaths per 100,000 people infected with the new virus. Thailand has had 44 deaths attributed to the new flu. That meant about 440,000 people had had the virus. Kamnuan spoke at the first weekly press conference at the ministry yesterday, when it announced there had been 20 more deaths over the past week.The number of cases confirmed by laboratory tests is 6,776. At present, only 35 patients were in hospital. But seven were in a critical condition. Previously, Professor Prasert Thongcharoen, a leading virologist and chairman of the ministry's advisory committee on strategy for public health and medicine, had predicted the number of patients would jump because the virus was spreading more easily among people, especially in urban areas. Its spread through rural areas was also seen as rising, but over a period of months, not weeks. Prof Prasert said most did not have immunity against the new flu virus and the H1N1 pandemic was spreading faster among humans than the seasonal flu virus. Disease Control Department spokesperson Dr Suppamit Chunsutiwat estimated that between 6 to 30 million people would get the new flu virus with about 600 to 1,200 people likeฌly to die because most people do not have immunity. To reduce the mortality rate, Kamnuan said the ministry would try to control the spread of the virus by asking people with flulike symptoms to stay at home and avoid public places. Dr Somchai Chakrabhand, directorgeneral of the Disease Control Department, said his agency had sent 1.2 million antiviral oseltamivir tablets to rural hospitals nationwide in bid to boost the stockpile of essential medication in case of a surge in patients with severe symptoms. The department had earlier sent one million tablets of oseltamivir to rural hospitals. Dr Paijit Warachit, deputy permanent secretary of the health ministry, said medical schools nationwide had been asked to boost the number of higherlevel graduates available to treat patients. He said this measure would be effective in four weeks. Meanwhile, Chulalongkorn University virologist Dr Yong Pooworawan said he has studied the genetic code of the new A(H1N1) flu strain, collected from patients over the past three months. He found there were only slight changes in two proteins on the surface of the virus: hemagglutinin (H) and neuraminidase (N). This meant the virus was not mutating yet. Thailand may use a lot of oseltamivir to treat patients with new flu virus, but he said the lab results showed the virus was not showing resistance to the antiviral drug.

Source: The Nation

TYPE A (H1N1) VIRUS - Ministry urged to get ready for patient influx

Flu infections will increase drastically next month; flu jabs encouraged; Flu patients can't watch Liverpool

The Public Health Ministry yesterday was urged to prepare sufficient medical resources - including intensive care units, respirators and health experts - to handle the peak period of the type-A (H1N1) outbreak expected next month. Professor Prasert Thongcharoen, a leading virologist and chairman of the ministry's advisory committee on strategy for public health and medicine, said the ministry has learnt that number of patients would rise drastically in the next two to eight weeks as the virus is spreading more easily among people, especially in urban areas. Patients in rural areas would also increase over the next two to four months.The elderly and those with underlying diseases should receive the seasonal flu jab to protect them, he said.Patients with the 2009 flu virus will be crowding hospitals seeking medication over the next few months, especially those suffering from severe flu symptoms and those with critical conditions that could lead to death. "During the past three months we learnt that some patients infected with the new flu virus had died because they had gone to see a doctor too late and also suffered from underlying diseases. Patients in critical condition also had pneumonia," he said. According to the ministry's statement released last Wednesday, the new strain has claimed 24 lives in Thailand over the past three months and infected more than 4,469. Most patients made a full recovery within two or three days and most fatalities were among people who had put off treatment until it was too late.Prime Minister Abhisit Vejjajiva expressed great concern over the flu pandemic after the ministry's health experts reported the situation to the Cabinet at Government House. He looked worried upon hearing that the ministry will today issue its first weekly report on total morbidity and mortality from type-A (H1N1).He said he was afraid that people would panic after being informed about the increasing number of new flu cases.According to the epidemiological principal, the health experts' presentation to the Cabinet showed that the number of patients with type-A (H1N1) virus would more than double from 20,000 cases per week to 50,000 cases per week. This was based on the ratio of one death per 10,000 people infected with the new flu virus. "The most important thing we have to do is cut this cycle before it reaches its peak period," said a health expert, who wished to remain unnamed.Dr Somchai Chakrabhand, director-general of the Disease Control Department, said his agency has sent 1.2 million tablets of the antiviral oseltamivir to rural hospitals nationwide in bid to reverse the surge in patients with severe symptoms.Dr Supamit Chunsuttiwat, the department's spokesman, said patients with mild symptoms should stay home for seven weeks and wear a face mask. Those who have high fever and find it difficult to breathe for more than two days should report to hospital immediately.
Flu patients can't watch LiverpoolFootball lovers wanting to watch the Liverpool-Thailand friendly match will have to pass through thermal scanners to prove that they are free of type-A (H1N1) influenza. Chief of the Disease Control Department, Dr Somchai Chakrapan, said yesterday the Public Health Ministry would set up three scanners at the entrance of the Rajamangala National Stadium where the match will be held today. "We want to scan audience members to make sure they don't infect anyone else," he said. Those who have a fever will not be allowed in and their tickets would be refunded, he added. In addition, the ministry will also distribute face masks, though visitors are advised to bring their own.An informed source said PM Abhishit Vejjajiva agreed with the installation of thermal scanners and distribution of face masks, and has instructed Public Health Minister Witthaya Kaewparadai to work with match organisers to come up with more intensive measures. Asked if such moves would affect Thailand's image, Tourism and Sports Minister Chumpol Silapa-archa said tourists might be scared away if they believed there was a new outbreak in the country. In addition, the government has been informed that no other country was using thermal scanners because they are not effective in detecting people infected with the virus.

Source: The Nation

TYPE A (H1N1) - Virus attacks lungs

The type-A (H1N1) virus directly attacks the lung, developing severe symptoms that can lead to death, the Public Health Ministry said yesterday. "We found that most patients with severe influenza symptoms also had pneumonia," said Dr Rewat Wisarutwej, director-general of the Medical Service Department. The finding was revealed by health experts meeting to examine the characteristics of the virus and its severity when infecting humans, based on patient's medical records, laboratory tests, and x-ray results."The virus has been found in the bottom of the lungs," Rewat said, adding that most patients developed the symptoms after contracting the virus from other infected patients. The Public Health Ministry will reveal details from its first autopsy on a swine-flu patient today. Rewat has urged patients with mild flu symptoms to not do any exercise, as heavy breathing would help the virus attack the lungs.According to the Public Health Ministry, the new strain of flu has claimed 24 lives in Thailand and infected more than 4,469. Most patients make a full recovery within two or three days - and most fatalities were among people who had gone to hospital too late.However, Public Health Minister Witthaya Kaewparadai said the number of patients admitted to Bangkok hospitals with the virus had dropped as people were no longer panicking."The situation will normalise as people understand and follow ministry's recommendations that anyone with mild flu symptoms should stay home - or see the doctor when their condition worsens - helping reduce the spread of the disease," he said. Rajavithi Hospital's director, Dr Varunee Jinarat, reported that the number of patients seeking treatment for flu had dropped from 500 cases a day to 150; and admissions were down to four or five a day. Total patients seeking hospital treatment for flu symptoms over the past three months was over 7,000. However, Varunee remained concerned about the spread of the disease in public spaces and in hospitals, infecting people with underlying diseases. She said the hospital urged all admitted patients to wear face masks, but some were reluctant to do so. "Even though the number of patients with flu-like symptoms has decreased, we are not confident [in controlling the situation] as many infected people still don't wear masks," she said. Rewat said the number of suspected flu patients had also dropped at the Nopparat and Bangkok Children's hospitals. "I think patient admissions will drop by 50 per cent if we send out clear messages," he said.Witthaya said the Health Ministry had distributed 4 million name-card-sized manuals with information about self-care for people with flu-like symptoms. It has also distributed 60,000 clinical practice guidelines for medical workers on the appropriate approach to treating flu patients.

Source: The Nation

Type-A (H1N1) virus zeroes in on lungs

The type-A (H1N1) influenza virus directly attacks the human lung, developing severe symptoms that can lead to death, the Public Health Ministry said Monday. " We found that most patients with severe type-A (H1N1) influenza symptoms also suffered severe pneumonia," said the director-general of the Medical Service Department, Dr Rewat Wisarutwej. The finding was revealed by health experts meeting at the department to examine the character of the new influenza virus and its severity when infecting humans - based on patient's medical records, laboratory tests, and x-ray results." The virus has been found deep in the bottom of the lungs," Rawat said, adding that most patients developed the symptoms after contracting the virus in large amounts from other infected patients. The Public Health Ministry will reveal details from its first autopsy on a swine flu patient this Wednesday.
The Nation

Increase in flu patients force delays in surgery

Medical services for patients with diseases who need to undergo surgery at the country's top hospitals are being interrupted by the increasing number of patients with flulike illness seeking medical treatment.
Dean of Mahidol University's Faculty of Medicine Siriraj Hospital, clinical professor Dr Teerawat Kulthanan said hospitals were postponing for up to two weeks general operations for patients who could delay treatment.
According to the Public Health Ministry, the new strain of typeA(H1N1) flu has already claimed 24 lives in Thailand and infected more than 4,469 cases.
Teerawat said because of the outbreak, the hospital had to reserve some intensive care units for patients with the influenza - which could delay some patients with other illnesses. However, he said, this should not affect general operations as doctors would diagnose and continue to provide close care for patients.
Siriraj Hospital's deputy director, Dr Sanan Wisuthisakchai said 3,000 patients with flulike symptoms had been admitted during the five day holiday period early this month.
But now the number of patients with the symptoms had decreased drastically to 300 cases per day. Only 60 of these cases tested positive to the TypeA (H1N1) of influenza,while the rest had seasonal flu.
The number of patients with flu symptoms admitted to Chulalongkorn Hospital, one of the country's top medical schools, also increased drastically, prompting the hospital to rearrange its medical services for patients.
Chulalongkorn Hospital's director, Dr Adisorn Phattaradul said at least 100 patients with flu symptoms had applied each day for admission as inpatients and outpatients.
In the first three months of the flu outbreak, only two cases per day attended the hospital; but now at least 20 patients were seeking medication each day. Of this number, two or three were found suffering from severe flu symptoms.
The hospital has isolated flu victims from other patients and services for outpatients would be available at Chakkraphong Building.
If the pandemic is prolonged throughout the year, Adisorn worries tmedical workers will be overtaxed providing treatment as many are now are tired and some have been infected with the new flu virus from outside sources.
Meanwhile, the increasing of number of patients with flulike symptoms has also affected medical services at Ramathibhodi Hospital.
Dr Surasak LeelaUdomlipi, the hospital's director, said on average it receives 300 to 400 flu patients with flulike symptoms per day. Half have the new flu virus but only 2 3 per cent were admitted for observation. Most make a full recovery and go home within two days.