DOH: Low-level flu outbreak in Metro Manila

by Sheila Crisostomo
Accessed June 24, 2009

MANILA, Philippines - Health Secretary Francisco Duque III confirmed yesterday there is now a “low-level community outbreak” of Influenza A(H1N1) virus in Metro Manila, even as 28 individuals were added to the list of cases in the country, raising the total to 473.

Duque said those affected by the low-level outbreak are mostly areas in Quezon City, Parañaque City and Manila.

But he clarified that there is no “huge clustering of cases” in any community in the metropolis.

He maintained that a majority of the schools with confirmed cases were situated in these cities.

“You can put it this way: where are the schools where you already have school community transmission beyond second level? But it is still a very limited number (of cases), therefore it’s just a low-level transmission,” he said.

As of June 19, the Department of Health (DOH) had recorded a total of 81 cases in Quezon City, 44 cases in Manila, 21 in Parañaque and 15 in Makati City.

Three more schools have reported confirmed cases of the contagion, raising the total to 22. These are the Holy Spirit in Cubao and in Fairview, both in Quezon City, St. Mary’s College in Caloocan City and St. Paul’s College in Makati.

Among the schools that suspended classes due to several cases were Assumption College in Makati City; Maria Montessori School of Quezon City along Visayas Avenue, Lagro High School in Quezon City; Colegio de Santa Rosa in Makati; Claret School of Quezon City.

Classes were also suspended at the Manila Central University (MCU) in Caloocan City.

The suspension at MCU occurred when an employee was found infected with the virus.

The University of Santo Tomas suspended more colleges after a case was confirmed at one of the engineering colleges in the Roque Ruano building.

Classes were suspended until June 29 for all engineering students at the Ruano building.

Classes were already suspended last Monday for students of the College of Nursing, College of Medicine and College of Rehabilitation Science that hold classes at the St. Martin de Porres.

As of Tuesday night, the number of students found positive of A(H1N1) at the University of the Philippines has rose from four to seven.

UP Diliman Vice Chancellor Betsy Enriquez, however, said there will be no suspension of classes.

In the Cordillera region, cases have risen to 47, six of which have already been confirmed positive while 15 others are still awaiting results.

Authorities temporarily suspended classes in Sta. Rosa, Laguna after 11 people, mostly elementary and high school students, were found positive for the virus.

But town mayor Arlene Arcillas said there is no outbreak in her area of responsibility and that all the patients were responding positively to treatment.

“But numbers wise, the situation is not yet alarming. What may be alarming is if you are given statements that schools are affected. But if you are looking at the total number of public and private schools, you have anywhere around 40,000 while the number of affected schools is only 22. That’s a minuscule percent of total number of schools,” he said.

Community outbreak pertains to the fourth level of transmission of A(H1N1). This is declared when health authorities can no longer trace those who could have contracted the virus from the index case, the second-generation case and the third-generation case, respectively.

According to DOH Undersecretary Mario Villaverde, contract tracing is done “only if you know the index case.”

“But in some cases, it’s very difficult to do it if you see third generation cases. So the best thing to do is to shift to mitigation so you just look for those who are ill,” he said.

The DOH is now finalizing its guidelines for the shift of its anti-A(H1N1) strategy from containment to mitigation where the DOH would no longer do contact tracing.

Instead, management and treatment will be provided to the infected individuals, particularly those who have underlying conditions like diabetes, hypertension, asthma and chronic obstructive pulmonary disorders and those who are pregnant, immuno-compromised, above 60 and below five years old.

Villaverde said that community-level transmission is declared “by school or by community” just like what has been done in barangay Hilera in Jaen, Nueva Ecija in the past weeks.

Duque said the new cases involved “16 males and 12 females and their ages ranged from seven months to 49 years old.

“All of these cases are Filipinos with no history of travel to any affected country. All contacts in the household and in workplace of these particular patients are being monitored and are now in quarantine,” he said.

Of the 473 cases, a total of 400 or 85 percent have already fully recovered.

DOH links up with Smart

In an effort to strengthen its fight against the virus, DOH yesterday tied up with Smart Communications Inc.

Under the project, Smart has assigned Hotline 155 on its Smart and Talk N’ Text-powered mobile phones where subscribers could access information about the virus. This line will be available from Monday to Friday from 8 a.m. to 5 p.m.

Ramon Isberto, head of Smart’s Public Affairs Group, said subscribers could get information by simply dialing 155. Each call will be charged P6.50 per minute.

Isberto said that although the hotline has been designed to address inquiries on the virus, “it is envisioned as an information channel on other pressing outbreaks or diseases as determined by the DOH.”

“Smart has been deploying its mobile technology and communications solutions in aid of government agencies involved in emergency preparedness and disaster response.

“This time, it’s even more vital considering that we are talking about a global outbreak and the effects can already be seen nationwide,” he said.

Duque said the project would give a big boost to the awareness campaign of the DOH against the pandemic.

“We have given them all relevant information on the novel virus that they will need because they would be manning the hotline. However, when tougher questions come up, they will be referring the callers to the DOH-Health Emergency Management Service Operations Center,” he added.

No drastic measures yet

Meanwhile, Malacañang said it is not yet contemplating on implementing drastic measures earlier prepared to contain the spread of A(H1N1) in the country.

Deputy presidential spokesman Gary Olivar added that President Arroyo will also have to do some “social distancing” and limit physical contact —such as shaking hands —with other people to comply with World Health Organization (WHO) protocols, as well as to prevent her from getting the virus from infected persons.

Mrs. Arroyo is currently on a state visit in Brazil after visiting Japan, among the many countries in the world where there are cases of infections.

The WHO and the DOH have recommended “social distancing” and quarantining for persons coming from such countries.

The President is expected to arrive in the country during the weekend.

Olivar said Mrs. Arroyo and her party are fully aware of the health procedures they would have to undertake.

“We are confident they’d (presidential party) be properly looked after when they come back here,” Olivar told a news briefing.

“Obviously there would be a proper advice to be given at that time based on the assessment on where they been and the various risks involved,” he added.

Dr. Asuncion Anden, head of the National Center for Health Promotion of the DOH, said Mrs. Arroyo and members of her delegation would have to go through the health screening at the airport.

When asked what steps the President must take upon her arrival, Anden said: “She should have to observe herself for any respiratory conditions, signs and symptoms. I’m sure the President will be adequately briefed on this.”

“I think the President will behave responsibly in cognizance of responsibilities to public health issues on one hand and also to her office and to those she serves,” Olivar said.

Anden suggested that it would be prudent for Mrs. Arroyo to wash or sanitize her hands as often as possible during public engagements to prevent from being infected by others with the deadly virus.

Olivar said such hand sanitizing would not be taken as an affront during these times.

He said the country’s situation is different from Mexico where the government earlier temporarily shut down its operations to stop the spread of the virus.

He pointed out that the fatalities in Mexico due to the virus numbers by the hundreds while Philippines only had one death that was accompanied by the victim’s other serious health conditions.

“If we compare the situation (between Mexico and the Philippines), I think the difference is very, very big,” he said. Anden said Secretary Duque has already been designated the lead crisis manager of the situation and at present, all measures he has been implementing are working.

“We have to take our cue from the DOH,” Olivar said. “They continue to stay on top of the situation and if they have not recommended an action as drastic as emergency powers or anything like that, that has to be because in their professional assessment as public health professionals, that drastic action is not needed at this time.”

Anden stressed the need for government and private offices to undertake measures to prevent the spread of the virus like sanitation procedures. – Artemio Dumlao, Ed Amoroso, Dennis Carcamo, Paolo Romero, Katherine Adraneda

Originally posted on: http://www.philstar.com/Article.aspx?articleId=480478