Memo: Standard Operating Procedure on Suspected Cases of the Novel Influenza A (H1N1) Virus

To: ALL CONCERNED

As per latest guidelines issued by the UP Manila Task Force on Preparedness for the Novel Influenza A (H1N1) virus, please be reminded that if you observe symptoms of the said flu, you are strongly recommended to stay at home. Please be extra cautious and observant of yourselves when you notice the following symptoms:

 Fever
 Headache
 Fatigue
 Lack of appetite
 Runny nose
 Sore throat
 Cough
 Vomiting or nausea
 Diarrhea

In addition, please contact Task Force Hotline 0919-7470570.

For students, absences from classes due to self-quarantine are excused.

Thank you very much.

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

UPLB steps up info drive on A (H1N1)

Written by SC Seminiano

The College of Agriculture (CA) and the College of Veterinary Medicine (CVM) conducted a public forum for UPLB constituents on the much-feared Influenza A (H1N1) virus that has spread to thousands of people in many countries around the world. The forum was held on May 6 at the Training Hall of the Agricultural Systems Cluster, CA, in response to the UPLB community's growing concern on the health issue. Forum participants included University constituents and representatives of local government units.

The Animal and Dairy Sciences Cluster (ASDC) through Dr. Cesar C. Sevilla initiated the event with Dr. Hope G. Rovira, Dr. Loinda R. Baldrias, and Dr. Mildred A. Padilla of the CVM as resource persons. Dr. Ma. Victoria M. Turalba, UHS director, also answered some questions during the open forum.

Dr. Rovira, Dr. Baldrias, and Dr. Padilla presented a backgrounder on the dreaded disease which is now threatening to gather pace worldwide. According to them, pigs can be infected by both human and avian influenza viruses in addition to swine influenza virus.

The recent A (H1N1) outbreak was first detected in April 2009 in the United States with Mexico having the highest number of persons infected. As of May 5, there have been 1,085 confirmed cases and 26 deaths reported. The virus is now at alert level 5 and has so far spread to 22 countries. Majority of the cases are of young adult women from 25 to 44 years old. The World Health Organization is distributing antiviral drugs to 70 nations.

A (H1N1) is transmitted from person to person via the respiratory route, through aerosol droplets produced through sneezing, coughing, and talking; and contact with contaminated surfaces and objects.

The Philippine government has already conducted proactive strategies to fight A (H1NI) through strict airport and seaport surveillance, use of footbaths, thermal scanning of disembarking passengers, establishment of hot lines, and acquisition of a million doses of Oseltamivir (Tamiflu).

Dr. Rovira and Dr. Baldrias said that the signs and symptoms of A (H1N1) infection are fever, cough, sore throat, body aches, headache, chills, fatigue, diarrhea, and vomiting. Its incubation period is from 2 to 7 days. At risk are young children, pregnant women, and chronically ill patients with pulmonary, heart, metabolic, and cancer diseases.

For diagnosis, clinical signs and a history of contact with sick persons are important information. Prevention can be done by avoiding close contact with sick people, practicing proper hygiene by covering the mouth and nose with tissue paper when coughing and sneezing, avoiding touching one's eyes, nose or mouth, and washing hands often; and maintaining a strong immune system by getting plenty of rest, being physically fit, drinking plenty of fluids, and eating nutritious food. Those who think they have symptoms of A (H1N1) are advised to consult a doctor and to stay home for self quarantine.

Dr. Virginia R. Cardenas, vice chancellor for community affairs, congratulated the organizers for conducting a very timely forum. At the institutional level, the resource persons suggested the implementation of a massive information campaign through posters and other communication materials. The public is also advised not to panic and to help contain the contagious disease by being honest if they get sick, and to wear masks. Dr. Turalba warned of a potential shortage of respiratory facilities not only in UHS but in the Los Baños and neighboring communities if more persons get ill.

Alex dela Peña, municipal agricultural officer of Nagcarlan, Laguna, also expressed concern on how unfounded fears about A (H1N1) have led to a slowdown of and losses in the swine industry. Dr. Artemio M. Salazar, CSC-IPB deputy director, also said that the corn, being a major component of feed products, will experience a slowdown as well. Dr. Sevilla said that the misnomer "swine" flu must be corrected because of its negative impact on the swine industry. He also signified the willingness of UPLB experts to talk about the issue in other localities. (SC Seminiano)

Originally posted at UPLB Insider News

'Class suspensions won't prevent spread of A(H1N1)' - Duque

Moving the opening of classes will not guarantee a school's safety from the influenza A(H1N1) virus, Health Secretary Francisco Duque said Saturday.

"Hindi natin masasabi iyon. Walang kasiguruhan sa virus na ito. Ang banta na iyan, andyan na iyan at hindi basta-bastang mawawala. Ang pasya ng mga school ng iurong ang opening [ng klase] ay malabo ang batayan (We cannot say that. There's no assurance with this virus. The virus' threat will not go away. The schools' decision to move the opening of classes has no clear basis)," Duque told radio dzMM's Para Sa Iyo Bayan program.

The health secretary reiterated that schools should use the government's new school suspension alert system for the new influenza virus instead.

The De La Salle University (DLSU) in Manila is currently implementing a 10-day suspension of classes after three of its students tested positive for influenza A(H1N1).

The schools that have suspended the opening of classes from June 8 were the University of Santo Tomas, University of the Philippines-Manila, Far Eastern University, University of Asia and the Pacific and St. Paul University-Manila.

Duque said that while the schools' suspension of opening of classes is within the authority given to them by the Commission on Higher Education, there are better ways to prevent the spread of the dreaded influenza virus in campuses.

He said the practice proper hygiene among students and school officials is still the best protection against the virus.

DLSU cases

Duque on Friday announced that four more people have been infected with A(H1N1) in the Philippines, bringing the total number of confirmed cases in the country to 33.

One of the new cases is a 17-year-old DLSU student, who may have been infected by the two Japanese students.

The student does not have a history of travel to countries with confirmed cases of A(H1N1). He manifested symptoms on June 2 and consulted a doctor on June 3 in response to the health advisory of DLSU officials.

“The three DLSU cases are responding well to their treatments and do not even have fever anymore, including the latest case. Contact tracing though is still in progress,” Duque said.

The first case in DLSU, a 21-year-old female student, arrived in the Philippines on May 12. She reported flu-like symptoms on May 29 and was tested on May 31. Her positive result was reported June 3.

The DLSU campus along Taft Avenue in Manila is closed for 10 days, or from June 4 until June 14, to avoid the virus from spreading to other students.

Duque said the health department is currently tracing 120 students who had contact with the three DLSU patients.

Originally posted at ABS-CBNNews.com

Opening of classes postponed, freshman orientation canceled

Opening of classes in UP Manila on June 8 has been postponed to June 15, and large group events--including the University Freshman Orientation set on June 9--are canceled.

This is amidst two confirmed A (H1N1) cases at De La Salle University Manila and suspension of classes among nearby schools and colleges. There is no confirmed case of A (H1N1) infection yet in UP Manila.

The College Freshman Orientation--set at 2 pm on the same day-- is also canceled.

More information shall be provided as frequently as possible. Please inform your classmates accordingly, including freshmen. You may also ask them to monitor this website or Faura Online (As I checked the UP Manila and UP Websites, there are as of this moment--06 1137H June 2009--no announcements regarding postponement of classes).

If you have any question, post them here or send an email to info.casupm@gmail.com

Discuss

Related Information:
What is Influenze (DoH Website)
Daily A Influenza Update (DoH)
Influenza A (H1N1) Information (WHO)
FAQs (DoH)