Influenza A (H1N1) Information

Hi Everybody, Influenza A (H1N1) flu cases has started in April and the number of cases has been rising until now. It has started from Mexico and spread to the US. From then on, it has spread across 89 countries until now. According to WHO, as at 6th July 2009, there are over 94,512 cases of H1N1 reported all over the world with 429 deaths. ¹ Overall, only 0.45% of the reported A (H1N1) cases reported result in death. The number might be more because more cases were reported after this WHO update. It might be more than 100,000 Influenza A (H1N1) cases now. In comparison with the seasonal influenza, it is actually less than the number of deaths caused by the seasonal influenza. Initially Malaysia only had 7 cases and thought that it may remain there but suddenly it has now increased to 772 with 85% recovery rate over 2 months.² There were also more local transmissions than imported ones with 34 local and 28 imported. Other countries in South East Asia such as Thailand, Jakarta and the Phillippines also reported more cases now in the past few weeks. WHO has been monitoring the H1N1 situation in the past few months. In the start, WHO declared a low level of pandemic around April. Then WHO raised the H1N1 level from Phase 5 to Phase 6 (Level 6) on. It means that Influenza H1N1 was Pandemic. It was the highest alert that WHO can declare. ⁹ A lot of countries were infected then and continued spreading. Airports around the world uses the thermal scanner to detect if passengers show fever and other H1N1 symptoms. For passengers coming to Malaysia, they need to fill in a form to declare their health, This will enable easier follow up with the passengers if they show symptoms in the future. I also noticed that a majority of air passengers do not wear masks. Only a small percentage, I think about 5-10% wear masks. What is Influenza A (H1N1) ? It is a new Influenza A virus that has never before circulated between humans. It is not related to current seasonal or previous influenza viruses. There are also no cases of this strain being reported through exposure to pigs and other animals. It also has an unknown location of origin.³ Personally, I think that the definition above from WHO is more accurate than other sources. Here are some others as well: Definition from The Star Online: It is a respiratory disease of pigs caused by Type A strains of the influenza virus. It has a high flu outbreaks in pigs and low death rates. There are 4 main sub types of the virus but the most recent isolated cases are found in pigs.⁴ It is also most commonly known as Swine Flu. Signs & Symptoms^3,4,5

• Fever
• Cough
• Headache
• Sore throat
• Muscle / joint pains
• May have diarrohea and vomitting
• Lack of apetite
• Lethargic / fatigue
• Chills

Proper precautions need to be taken to curb the spread of the Influenza A virus. Prevention

• Cover our eyes and nose with tissue or handkerchief when we cough or sneeze^3,4
• Washing hands with soap or anti-bacterial soap such as Protex, Lifebuoy and Dettol and water^3,4
• Wear masks at airports or at the right situations. Incorrect use may increase the chances of spreading. According to WHO, you don't have to wear a mask if you are not sick. However, it is good to ensure proper precautions are taken to prevent H1N1 from spreading³
• Have good health habits such as having enough sleep, eating nutritious food and keeping physically active³
• Avoid touching eyes, nose or mouth^3,4
• Avoid crowded places³
• Avoid contact with people who are ill or sick^3,4

Vaccinations Tamiflu (osteltamivir)⁵ Relenza (zanamivir)⁵ However, it is reported in several cases that Tamiflu is not effective. Some of the viruses are resistant to Tamiflu. A vaccination that fully effective vaccine has not been developed yet. It is still under research by pharmaceutical companies. Also, the vaccine for H1N1 will take at least 4-6 months to develop. The vaccine therefore is excepted to be ready around year end by November and December.^7,8 Influenza A (H1N1) is a milder form of influenza as compared to the seasonal influenza. The seasonal influenza resulted in more deaths. However, we still need to take proper precautions to ensure we are not infected with H1N1. I am continuing to pray that the Influenza H1N1 situation will improve and in the future, the Influenza H1N1 pandemic will end. References: ¹ Pandemic H1N1 2009 - update 58, WHO (World Health Organisation), http://www.who.int/csr/don/2009_07_06/en/index.html ² More local H1N1 cases, The Star Online, 14th July 2009, http://www.thestar.com.my/news/story.asp?file=/2009/7/14/nation/4314690&sec=nation ³ What is the new influenza A (H1N1)?, WHO, http://www.who.int/csr/disease/swineflu/frequently_asked_questions/about_disease/en/index.html ⁴ Influenza A (H1N1) FAQ, The Star Online, http://thestar.com.my/news/story.asp?file=/2009/4/28/nation/20090428132524&sec=nation ⁵ 2009 Flu Pandemic, Wikipedia, http://en.wikipedia.org/wiki/2009_flu_pandemic ⁶ WHO | What Can I Do?, http://www.who.int/csr/disease/swineflu/frequently_asked_questions/what/en/index.html ⁷ WHO sees little Tamiflu-resistant H1N1 flu spread, http://thestar.com.my/news/story.asp?file=/2009/7/8/worldupdates/2009-07-07t224352z_01_nootr_rtrmdnc_0_india-408745-2&sec=worldupdates ⁸ WHO: H1N1 Vaccine Will Take 4 to 6 Months to Make, http://www.medscape.com/viewarticle/702258 ⁹ WHO declares swine flu pandemic, The Star Online, http://thestar.com.my/news/story.asp?file=/2009/6/11/ah1n1flu/20090611163547&sec=ah1n1flu