MANILA, Philippines – The Department of Health (DOH) reported yesterday the country’s first death from Influenza A(H1N1), a 49-year-old mother who was known to have other pre-existing illnesses.
The latest total count of infected cases nationwide soared to 445 after 17 more were recorded yesterday. The good news, however, is that out of the total cases, 374 have fully recovered.
Health Secretary Francisco Duque III said that based on the autopsy report, the viral infection was not the primary cause of the death, but rather “congestive heart failure secondary to acute myocardial infarction aggravated by severe pneumonia – either bacterial, viral or both.”
“This one is a very interesting case. It embodies several high-risk and pre-disposing factors that accelerated the death (of the patient). It is in line with what we have been saying for several weeks, that complicated cases will be encountered,” Duque noted at a press conference.
Aside from congestive heart disease, the patient was found to have tuberculosis, enlarged liver, kidney and spleen, tumor in the uterus and tyromegaly or goiter.
The patient was not even in the DOH’s records of suspected and confirmed A(H1N1) cases and had no history of travel to countries that have the virus.
According to Duque, the patient came home from work with a cough last June 17 and developed fever, cold and chills the following day so she did not report for work.
On June 19, the patient was no longer able to take her breakfast and suddenly experienced difficulty in breathing. She died even before the doctor called by her family arrived.
The next day, the brother notified Duque about the incident and throat swab samples were collected from the patient.
The specimens tested positive for A(H1N1).
“Given the available information, we cannot conclude that the death is due to A(H1N1). But in other countries which have reported A(H1N1) deaths, a majority have pre-existing medical conditions. We condole with the family of the patient as we mourn her untimely death,” Duque, who was a friend of the patient’s brother, said.
He assured the public that the patient no longer poses a threat to those who might attend her wake because the virus dies when the host-body perishes.
The DOH had advised the household contacts of the patients to observe self-quarantine while it is checking with others who could have come in close contact with her.
Duque said the husband had manifested symptoms ahead of the patient but he tested negative for the virus when examined. The patient’s son, mother, sister and brother have not developed flu-like symptoms.
With this development, the health secretary said that the DOH will be “more aggressive in targeting segments of patients with high vulnerability to fatal flu complications and who should be the ones to receive the most care and attention by healthcare professionals.”
Malacañang immediately stepped into the picture and urged the public not to panic.
Deputy presidential spokeswoman Lorelei Fajardo said the victim was considered a “high-risk” case and health authorities still consider her infection as mild.
“I think our DOH officials are on the right track by giving more attention to the high-risk patients,” Fajardo said.
“There’s nothing to be alarmed about. Again we just need to be prepared and that’s what we’re doing right now,” she added.
Although the health department is doing its best to prevent the virus from spreading, one of its officials estimated that around 22.5 million Filipinos may be afflicted with it, considering the way it has been spreading.
Dr. Lyndon Lee Suy, head of the agency’s Emerging and Re-Emerging Infectious Disease Program, told the panel of South Cotabato Rep. Arthur Pingoy that the virus could affect 25 percent of the population estimated to be at least 90 million.
“When you talk about projection, with the 25 percent attack rate, we can say that we are expecting 25 percent of the population to be affected with influenza A(H1N1),” he told Parañaque Rep. Roilo Golez.
Suy, however, did not specify any time frame for the spread of the disease.
Dr. Vito Roque, head of the surveillance unit of the DOH National Epidemiological Center, acknowledged that the current trend of the virus is steadily increasing, as evidenced by the day-to-day monitoring of cases.
Muntinlupa City Rep. Ruffy Biazon said the first casualty of A(H1N1) virus should be thoroughly studied by the health department to determine if a new strain had indeed claimed the life of the victim.
“The first A(H1N1) death in the country should be fully investigated by the DOH in order to determine if it was caused by a new strain of the virus or if the victim simply had a weaker physical condition,” he said.
“The first few hundred cases were considered mild. But this death might be the start of the stronger cases, hence the DOH should take extra effort in containing the virus,” added Biazon.
During the initial stage of the briefing, Golez showed disappointment over the absence of Duque and warned the representatives of DOH about its logistical capability.
“I know that Secretary Duque is busy, but this is a very important matter. I am going to ask the policies and budgetary concerns of the agency.”
But Suy defended his boss’ absence. “The secretary is currently attending an emergency meeting regarding H1N1.”
Still wreaking havoc
But while the bureaucracy is neck-deep in its efforts to control the spread of the virus, several other cases have been recorded all over the country, prompting schools to suspend classes.
In Metro Manila, St. Scholastica’s College in Manila and St. Paul College-Makati had suspended classes for 10 days starting yesterday due to A(H1N1). Classes for pre-school, elementary and high school students will resume at both schools on July 1 when school facilities have already been subjected to disinfection.
Reedley International School in Libis, Quezon City and Rosary Hills International School in Kaybiga in Caloocan City also suspended classes yesterday.
Dr. Teresita Domalanta, of the Department of Education National Capital Region, said classes were also suspended in La Salle Greenhills, San Juan; Don Bosco Technical Institute, the St. Bernadette School and the Southridge-PAREF School in Mandaluyong City.
Adamson University-Manila suspended classes at all levels but only for five days with one confirmed case of A(H1N1). Classes will resume on June 25.
The University of Santo Tomas in España, Manila had suspended classes for a number of courses housed in its St. Martin de Porres Building.
Among the UST colleges that had suspended their classes for 10 days are the Colleges of Nursing, Medicine and Rehabilitation Sciences.
University of Cebu in Mandaue City had three confirmed cases that resulted in some 600 nautical course students being quarantined.
Two cases were reported at Karangalan Elementary School in Cainta, Rizal while 11 persons, including nine students, were reportedly infected in Sta. Rosa, Laguna, leading to the suspension of classes in at least six schools.
Six of the infected students were from Sta. Rosa Central School and three from Canossa Academy School.
Nazareno said the patients are now being treated and are responding well to medication.
Classes were also suspended at the Sacred Heart College in Tacloban City after a Grade IV pupil was monitored with the viral infection.
City health officer Dr. Jaime Opinion reported that it is monitoring 163 individuals who were exposed to persons confirmed with the virus.
Two of the three cases in Eastern Visayas are residents of Tacloban. The other, a 44-year-old seaman, is from Catbalogan, Samar.
The three are now confined at the Eastern Visayas Regional Medical Center, the hospital designated by the DOH for treatment of persons infected with the virus.
However, not everything is lost in the fight against A(H1N1).
Dr. Rio Magpantay, DOH director in Central Luzon, yesterday said that the panic triggered by the outbreak has already died down after 53 out of 55 cases in San Fernando, Pampanga have recovered.
“I think the panic dissipated after people found out that those stricken with A(H1N1) fully recovered within three to four days,” Magpantay told The STAR.
He said swab samples were taken over the weekend from 32 students of schools in Camiling, Tarlac and another 30 people in Bulacan, Hagonoy and Guiguinto in Bulacan after they manifested flu-like symptoms.
Results on the swab laboratory tests were still being awaited as of yesterday.
He said of the total 55 confirmed cases so far in Central Luzon, 27 were in Guiguinto and Bulacan in Bulacan, 26 in Jaen, Licab, Lupao and Cabanatuan City in Nueva Ecija, and one each in Angeles City and Floridablanca in Pampanga.
The only two victims still recovering from the virus are from Bulacan, while the rest fully recovered in three to four days.
Magpantay said that the DOH is now less preoccupied with tracing the contacts of the cases and has zeroed in on containing the spread of existing cases.
“We have enough supply of Tamiflu and all our patients took the medication for their recovery,” he said.
He said the panic that initially ensued from the emergence of the new flu ailment has died down, attributing this to media reports that stressed the mild nature of A(H1N1) in the country.
“Reports that the victims readily recovered in three to four days has somehow taken away the worry of people,” he added. – With reports from Dennis Carcamo, Ding Cervantes, Miriam Desacada, Arnell Ozaeta, Delon Porcalla, Dino Balabo, Paolo Romero, Rainier Allan Ronda - By Sheila Crisostomo (Philstar News Service, www.philstar.com)