H1N1: A real life public health drill

With the hype over this global pandemic intensifying, there appears to be an argument as to what this illness should be called. As the world waits intently for a vaccine to be developed, the only method of containment is isolation. With expected rise in the number of cases, it will surely become more costly and labour intensive to maintain a reasonable tab on the cases and their respective contacts. What then can we expect in the coming months?

The origins of this strain of influenza A (H1N1) is still relatively unknown although it closely resembles those found among pigs. It is clearly a mutated strain. Fortunately, the virulence of this virus is low as compared to their cousins, the bird flu or the SARS virus. Most confirmed cases are usually well and might have recovered even without the aid of Tamiflu. Why then are we concentrating our healthcare resources on a ‘mild’ virus?

My belief is that previous deadly encounters with firstly the SARS virus and then the bird flu, has made Asian countries extremely sensitive to such viral outbreaks. The consequences of inaction is no longer acceptable to the general public. Therefore, Governments have taken a cautious approach lest they be accused of being lackadaisical. I prefer to belief that this ‘real life drill’ could be paramount in our future responses to more deadly air borne viruses.

The virus is bound to spread further and the numbers of confirmed cases is expected to rise. Our actions of containment appears only to delay the inevitable. It is hoped that with increasing infections, the global community will develop a herd immunity towards this virus. Until and unless, a vaccine becomes readily available, our strategies only appear to be surmountable barriers for the virus.

Our only prayer is that this virus will not mutate into a more deadly virulent strain that could then inflict high number of casualties.

1st Case of A(H1N1) in Malaysia

First confirmed case detected in Malaysia. Student from US.

H1N1 closes in on Malaysia

With the first confirmed case in Thailand, the flu virus is edging closer to our shores. It appears inevitable with the current momentum of spread.

A(H1N1) Flu : Potential Pandemic

A H1N1 variant of the influenza virus which started from Mexico, and now suspected of spreading to the United States, has potential for human to human transmission. Although the mortality is reportedly only 1-3%, dozens have died in Mexico.

Our Health Minster has directed screenings and checks at our entry points especially those from Mexico. How or whether it has truly been enforced is left to be confirmed. Mock preparations by hospitals from previous H5N1 scare might come in useful. Hospitals must strengthen their protocols and all doctors, nurses and paramedics must be well versed in wearing the Personal Protective Equipment.

Useful resource
CDC
WHO

TB on the rise in KL

From a recent news report indicating an alarming rise of tuberculosis and HFMD infections in an affluent area of Malaysia.

What is worrying is the actual incidence rate of MultiDrug Resistant TB infections in Malaysia. MDR TB is a problem in surrounding countries in South East Asia and has not yet been a major problem in Malaysia.

Tuberculosis has always been thought to affect lower socio-economic groups. Thus much blame has been put on migrant workers. The new style of living in high rise buildings could also have a role in this air borne infection where families are now living in closer proximity to each other.

It is however still of paramount importance to beef up the health screening of migrant workers and identifying illegal immigrants which is thought to be in the region of a few hundred thousands in Malaysia. Citizens of Malaysia will have play an important role here. Solely relying on the police and the immigration authorities may not be sufficient if we are to plug the holes in our borders.

At the same time, doctors should be thorough when examining immigrants during their compulsory health screenings. Being pressured to pass off an unhealthy individual should not occur and is tantamount to medical negligence.

Strengthening our DOTS program is important to ensure completion of treatment and thus reduce the likelihood of MDR TB. Complacency in this aspect will be catastrophic.

Ultimately, TB is a treatable condition. What is more ideal would be a more effective drug requiring a much shorter course of treatment. Many new compounds are currently being tested and still remains far from reaching clinical practice. There is a Tuberculosis Antimicrobial Acquisition and Coordinating Facility (TAACF) which accepts new compounds for testing against TB.

Perhaps a Nobel Prize is in store for the discoverer of a new more potent anti-TB drug which will revolutionise TB treatment and save millions of lives.

AIDS Vaccine Fails

Merck reported recently that they are halting their trial on an AIDS vaccine after it failed to prevent HIV infection.

Read their News Report here.