H1N1 UPDATE IN JB & SINGAPORE

The situation now is almost similar to the SARS period, but the panic level has not reach there yet because of there are no deaths reported yet. You work in the office, a colleague coughs and another sneezes, everyone will joke that it might be the H1N1 virus. Jokes aside, we are concerned and lost at the same time about how this H1N1 virus will develop from here. It is the season of flu and cough and everyone is trying their best to avoid getting sick. A colleague of mine who sneezed a few times last Monday quickly ran to the clinic to get some medication.

I was going to the Johor Bahru CIQ (Customs, Immigration and Quarantine) building as usual yesterday morning when I saw all the police masked. I thought to myself, oh no, there must be a super outbreak that has caused such an alarmed reaction. However, no one else is wearing the mask. Of course, before this, the only people who are masked are those monitoring the infrared cameras and those taking your temperature live at the scene. I only realized the reason when I read the news later. Johor Bahru had just reported its first ever H1N1 victim, a 19-year-old female student returning home from Melbourne.

That just shows one thing about the Malaysian police force. You know what it is, I don't have to say it clearly out loud. Singapore has up to now 220 cases but their police force is not wearing any masks. Apart from highlighting the police force in Malaysia, I want to share about the findings from the clinical data of the first 50 H1N1 patients in Singapore in this post. Read the findings in the news report attached. The summary is most of the victims do not show the symptoms that are required to determine whether you get the H1N1 virus. That is a serious problem for all of us here. It seems like they are still unsure about this virus fully.

Female student first H1N1 victim in Johor

JOHOR BARU, June 24 — A 19-year-old female student was confirmed the first influenza A (H1N1) victim in Johor after returning from Melbourne, Australia, two days ago.

State Women, Family, Community and Health Committee chairman Dr Robia Kosai said today the student landed at Changi Airport, Singapore, on board flight SQ0238 and had fever and flu upon reaching her home in Johor Baru.

"The student was home on vacation after six months in Melbourne. She is now being monitored at the Sultanah Aminah Hospital,” she told reporters.

Dr Robia said the student's family, including the father, mother, 16-year-old brother and 17-year-old sister were under home quarantine for a week.

The taxi driver, 36, who sent the student home was also under home quarantine.

Dr Robia said the student's grandmother died of old age this morning and Health Department staff would help the family with the funeral arrangements to ensure that they were not exposed to others.

She said Health Department staff would also be sent to the schools of the student's siblings — Sekolah Menengah Datuk Jaafar and Sekolah Menengah Infant Jesus Convent — because the two attended school yesterday.

"We will check the two schools to prevent any spread of the virus," she added. — Bernama

TTSH releases clinical data of first 50 H1N1 patients in Singapore
By Satish Cheney, Channel NewsAsia | Posted: 24 June 2009 1923 hrs

SINGAPORE: The World Health Organisation uses a temperature benchmark of 37.8 degrees Celsius as one of the factors to determine if someone is a suspect H1N1 case, but experts at the Tan Tock Seng Hospital warn that doctors should not overlook those with low fever as well.

92 per cent of H1N1 patients in Singapore had respiratory infections, but 46 per cent had mild fever of less than 37.8 degrees Celsius when they sought medical treatment.

This is according to Tan Tock Seng Hospital, which released its clinical findings on the first 50 H1N1 patients on Wednesday.

Professor Leo Yee Sin, clinical department head at Tan Tock Seng Hospital, said: "We do come across many patients where the fever may not be very high. It's important to be able to add several symptoms together that would include fever and respiratory symptoms that would include running nose, cough, sore throat and other clinical symptoms like headache and muscle ache."

The professor continued to say that it is possible for general practioners to miss out on diagnosing some of their patients as having the H1N1 virus because their symptoms could be very mild.

There is also the possibility that some patients may not show any symptoms at all.

According to the hospital, about 20 per cent of the first 50 H1N1 cases who are on Tamiflu were still infectious on the fifth day of treatment.

Those who started Tamiflu earlier (for example, on the second day instead of the third day of infection) have a shorter infection period.

Currently, there are about 70 confirmed H1N1 patients hospitalised at the Communicable Disease Centre.

One of the bigger concerns for medical authorities now involves the higher risk group – people with asthma, very young children, the elderly and anyone with major underlying medical problems.

The high risk group also includes those with chronic lung disease, heart disease, liver disease, renal disease, immuno-compromised patients such as those on chemotherapy, radiotherapy or patients who are required to be on long-term steroids and pregnant women.

Professor Leo said: "How the disease is going to behave in the high risk population is yet to be seen and to be determined in the local situation.

"However, we know from overseas data and understanding of seasonal influenza, that high risk groups tend to have a higher frequency of complications and they may have adverse outcomes and we may not be surprised that there may be deaths among the risky individuals."

The hospital said high risk patients may need more medical attention while on antiviral medication.

Another concern is the mutation of the H1N1 virus as it mixes with other types of flu viruses. Professor Leo said this is something the authorities are keeping track of.

The hospital said it will be doing more clinical research to help authorities understand the nature of the disease better. It has urged the public to remain vigilant and not to be complacent.

Professor Leo said Singaporeans must change their mindsets about donning face masks when they are sick and that they should adopt a life-long approach to improve their personal hygiene to ward off flu viruses.

- CNA/yb