‘Swine flu’ victim hits health officials

The slow and confusing response of health authorities literally put in a dilemma a 33-year old pregnant woman, who is the first confirmed case of the Influenza A(H1N1) in the province.

Meanwhile, health officials are now closely monitoring a second possible case in one of the coastal towns but assured that the person suspected to be afflicted of the virus has submitted to self-quarantine procedures.

The woman arrived in Bohol from California last May 23 but developed fever after she went swimming. She decided to seek medical treatment at a city hospital taking extra care as she is in her second month of pregnancy.

However, the balikbayan criticized the "lousy" response of health workers to her case.

She was admitted to a private hospital on May 25 but the Department of Health (DOH) regional office took respiratory swab samples from her only three days later (May 28).

The hospital management immediately informed the Provincial Health Office and the City health office on the day the balibayan-patient was admitted at the hospital.

The woman was discharged from the hospital at noontime of June 1 after the regional DOH representative authorized him to check out from the hospital even if she was not given the findings on whether she got inflicted with the virus. The patient recuperated from the fever when the DOH-7 representative, identified as Reinan Cimafranca issued her the clearance to checkout from the hospital on June 1 even if there was no result yet on the swab lab test.

The confirmation came eight days after the swab sample was taken by a team from the DOH regional office.

"Their response was so delayed and I had to wait several days for the confirmatory results," she said.

Although the fatality rate of this particular influenza virus is below one percent of recorded cases, the victim felt her life and that of her unborn child were unnecessarily put in danger.

What fueled her distress even more was the announcement of Provincial Health Officer Dr. Reymoses Cabagnot over the airlanes last Friday that health authorities have been trying to locate her to prevent the spread of the virus.

In an interview with the Chronicle, the woman said she did not expect she had A(H1N1) until she received the information from Renan Cimafranca of DOH-7 last Thursday.

This was confirmed by Cimafranca in a separate interview by the Chronicle that he received the laboratory results from the Research Institute for Tropical Medicine (RITM) on Thursday morning which showed that the pregnant woman tested positive of A(H1N1).

Cimafranca said he took a second swab sample from the victim on the same day as it is the standard procedure for confirmed cases in order to re-check if the victim is still positive of the virus. He added that the result of the second test will come out two to three days.

The lack of coordination between the regional health team and the provincial health office was noted when Cabagnot announced that the victim's whereabouts was still unknown even as the regional team was already in contact with her.

Even Vice Gov. Julius Caesar Herrera (presently the acting governor), called out for an emergency meeting with provincial health officers, the Bohol Provincial Police Office and municipal mayors to locate the balikbayan.

The victim said that at the onset of a fever, she went out for swimming and thought she just developed a fever out of being exhausted from the summer heat at the beach.

The release of the patient without being declared as H1N1-free became the subject of complaints by the public who were monitoring over dyRD the first confirmed Influenza A(H1N1) case in the province.

CASE NO. 2?

Reports are verified on another suspected case of A(H1N1) who is reportedly residing in one of the eastern coastal towns.

Dr. Cabagnot disclosed that swab samples have been taken from the suspected case but the laboratory findings from RITM is still pending.

The provincial health officer declined to disclose more information about the patient who has exhibited flu-like symptoms but assured it is under control.

DOH APOLOGY

In a press conference last Friday, regional health officials apologized for "the inconvenience we have caused" to the 2-month pregnant suspected to have the virus.

The DOH pointed to the problem with shipping out the swab samples to the RITM in Muntinlupa City and the numerous samples that its laboratory had to test. After samples test positive, the laboratory technicians have still to re-run tests for verification.

Health authorities said they are taking the case "with caution" in order not to compromise pregnancy.

According to Cimafranca, contact tracing of all those who had contact with the pregnant woman is still ongoing and they are given medication.

CONDITION IMPROVING

Cimafranca disclosed that since the woman was admitted last May 25, her condition is constantly improving.

"There is no problem right now and we are in constant communication with her and her family to monitor their condition," Cimafranca assured.

He said they could not give an antiviral medication to the woman since she is in the first trimester of pregnancy.

Cimafranca said it is not necessary to confine her to a hospital. Aside from her improving condition, her residence is ideal for containment of the virus.

In fact, Cimafranca added, the balikbayan agreed for self-quarantine in her home and she is also limiting her visitors.

The DOH is coordinating with the Tagbilaran City Health Office and Dauis Rural Health Unit for the "thorough monitoring" of the woman's contacts since her arrival here last May 23.

"But based on our tracing so far, nobody has exhibited symptoms of flu or developed influenza-like illness," he said.

VOLUNTARY TESTING

Vice Gov. Herrera urged all those who may have come into contact with the woman to voluntarily submit to medical tests.

Asked regarding another suspected case of A(H1N1) in the province, Herrera assured that the person has already submitted to self-quarantine measures.

The acting governor advised Boholanos to take precautions such as frequent hand-washing saying the Influenza A(H1N1) virus could spread easily.

DENGUE MORE DANGEROUS

In trying to allay public fears over the Influenza A(H1N1) virus, Dr. Cabagnot said the public must also be equally vigilant against dengue fever which is more deadly.

Cabagnot said dengue is more fatal and that cases continue to be recorded in the province since January this year.

Although cases are lower than the preceding year, dengue prevention remains a top priority of health officials.

WHAT TO DO

As the Department of Health (DoH) already appropriately handled Bohol's index AH1N1 case, the provincial health officer turned to strengthening public awareness to allay fears and unnecessary panic among the Boholanos who are afraid that they might also catch the infection.

Cabagnot clarified that AH1N1 is spread through droplet infection. He said this calls for the covering of the nose and mouth when coughing and sneezing, frequent washing of the hands, taking a bath once or even twice daily and general personal hygiene.

He also strongly urges for the meantime social distancing - less beso-beso (cheek-to-cheek kisses or smacks), handshakes and bear hugs with relatives and friends coming in from countries with confirmed AH1N1 cases.

He likewise suggests to persons developing flu-like symptoms with diarrhea, especially those who made contacts with relatives and friends from AH1N1 positive countries to submit to medical check ups.

He said the swine flu virus is less fearsome or dreadful than rabies, dengue or pneumonia. Mortality of AH1N1 remains at 0.8 or less than one for every 1,000 population affected.

Just like any other opportunistic disease however AH1N1 is fatal to a person with lowered immune system and those with lesser resistance like the elderly and the very young children.

He asks for the full cooperation of the mayors, local officials and municipal health officers for the widest dissemination of the suggested steps to take to avoid the infection.

"I will also suggest to Gov. Erico Aumentado the issuance of an executive order adopting the national technical guidelines, standards and other interactions for reference in the Pandemic Response to Influenza A(H1N1) that Sec. Duque has released, with modifications to make them more suited to the Bohol situation," he said.

Asked if he will suggest that the Tigum Bol-anon Tibuok Kalibutan (TBTK) or the global conference of Boholanos in July ought to be postponed because of the virus threat, Herrera said the task force and the Sandugo festival organizers are in a better position to decide and announce the decision thereafter.