Friday, October 23, 2009


I have always had an interest since they started to include us ( FPMPAM ) in the advisory committee on this "swine flu " pandemic that swept us in May 2009 ( about 1 month after the Mexican case reports ). Well we have seen that the initial wave seemed to have quietened down. There are still sporadic cases reported but the fatality in Malaysia has remained at 77 ( no new deaths since september 2009 ). The ICU admissions also seemed to have reduced. Thank God for our good fortune.
At the moment, the cases in the southern hemisphere ( now they are in autumn going to summer ) seem to have lessened. The reports from New Zealand suggest that there are still sporadic cases and no deaths. As for the northern hemisphere, the USA has reported more cases of ILI ( influenza like illness ) and also fatality. The CDC estimates that they expect that about half of the US population will be infected at some point or other, with about 1.5 million hospitalisation, and about 30,000-90,000 deaths, working out to a fatality rate of 0.06% ( not as high as the death rate of SARS or bird flu or the dreaded Spanish flu ). So far, they have noted that the ILI seem to infect the younger age group ( 5-15 years ) and most of the deaths are also in the younger age group. A significant number still involved those with co-morbidities. There is also an increase rate of secondary pneumonias. It appears that the A H1N1 now seem to predispose the lower respiratory tract to secondary bacterial infections, like pneumococus, and streptococcus. The US has began to vaccinate their school children, and front liners and found that they do not have enough vaccines, since some of the promised vaccines, are still undergoing testing, suggesting that they may not be as safe as initially touted. It is never a good idea to rush out a poorly tested vaccines.
In the northern hemisphere, as it Europe, there are most reported cases of ILI, almost like the US situation but with less deaths. The UK and France have began to ask their front-liners to be vaccinated. I understand that the front-liners have a choice and some are finding it difficult to choose. There is no increase deaths as compared to a severe seasonal flu.
In summary, after 6 months from the initial Mexico report, the A H1N1 is still very much amongst us and seem to be very active in the northern hemisphere, winter countries. So far there seem to be no sign of any severe mutation, except that the A H1n1 virus now seem to predispose the lower respiratory tract to secondary bacterial infections causing some of the severe pneumonia. The vaccines are being rushed out and some are obviously not ready for widespread use. It looks like personal vigilance and personal hygiene remains the best way to try and prevent infection and contain the infection. Things at the moment, are not as bad as we had feared. But the A H1N1 is still very much alive and kicking.
But always remember, this virus is ever changing and nothing is firm and clear at the moment. we will have to keep monitoring and keeping all of you informed.
Please take care.

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