By William Ysaguirre
A woman, 29, died of atypical pneumonia caused by the H1N1 influenza virus at the Karl Heusner Memorial Hospital last Monday, January 6, Dr. Marvin Manzanero announced at a press conference in the K.H.M.H. conference room on Wednesday, January 15.
Dr. Franz Murray, the National coordinator for Tuberculosis at the Ministry of Health, explained that in such cases where such a young person, who is otherwise healthy, dies, the ministry automatically begins an investigation.
He said health personnel’s standard operating procedure in such a death is to trace the victim’s contacts, to determine how she got infected and who else might be sick and in danger.
Their investigations so far revealed no other immediate family member was sick, and the deceased had not travelled abroad; she contracted the disease in Belize!
Manzanero said of the first 26 sick patients who had been swabbed and their samples sent away for testing, 19 tested negative.
There were five positive results, of which two others from the Western region had tested positive for H1N1, but they were able to walk when they were released from the hospital.
As part of Belize’s participation in CARICOM and the Caribbean Single Market Economy, Belize helps fund the Caribbean Regional Public Health Agency (CARPHA) in Trinidad, where the samples were sent for laboratory testing.
Thirteen more samples have been sent, and results usually take three to five days.
Dr. Michael Pitts of the K.H.M.H. explained that H1N1 virus can now be considered endemic to Belize, and with the tourism industry bringing so many visitors, Belizeans should not consider themselves isolated from what is happening in other countries.
The virus itself is evolving and mutating into different strains, with different levels of virulence, and as it’s the height of the tourism season, with four, sometimes five, cruise ships in harbor, the virus will find its way to Belize.
He said the best way to fight the disease is to heighten public awareness about the disease, to recognize the symptoms and for people to know what to do.
People over 65 years of age are the most vulnerable.
Manzanero added that others at risk are those with asthma, a cardiac condition, or experiencing a renal failure. Anyone with a high fever of 103, a heart rate of 148 should seek immediate treatment; it could be H1N1.
Pitts said in most cases of the flu, the symptoms improve after three days. The health authorities do have flu vaccinations on hand, last year they had administered 9,000 doses. Vaccination is recommended for those in essential services who area dealing with large numbers of the public: health workers, the Police, the BDF, children eight months to three years of age, anyone over 65 and diabetics.
He assured the media that the KHMH immediately begins treatment of anyone who comes in with serious flu symptoms, even before they know if it is H1N1.
A swab is taken from the patient and sent to CARPHA for analysis to determine the genotype of the virus, which may confirm that it is indeed H1N1.
The medication, Tamiflu, is effective against H1N1, but is available only on prescription. Dr Gerardo De Cosio of the Pan-American Health Organization explained that because Tamiflu is the only medication which has proven effective against H1N1, it must be used judiciously and not dispensed indiscriminately. Otherwise the virus could build up resistance to the drug, and then doctors will be left with no drug to treat a serious H1N1 outbreak. When the sample is analyzed, it may not be H1N1, it may also be Adeno-virus, meta-pneumonia virus or a para-influenza virus, which has been reported by the World Health Organization in other parts of the world. Until they know otherwise, the doctors will treat the patient with the same protocols as if it were H1N1.
Dr. Murray added that on average, only 22.5 percent or about one in five of those patients tested will come back positive for any virus, and only when the sample was taken in the first three days of the illness. After three days, the body’s immune defense system has kicked in, the symptoms are beginning to alleviate, and the test will normally come back negative.
Pitts cautioned his audience that anyone who comes down with the flu and develops chest pains, stops eating, is vomiting and feels listless and confused, should immediately see a doctor, especially if they have a high fever and if the symptoms persist or worsen after three days.
Patients with H1N1 will develop a high fever, and this could progress to kidney failure and advance to pneumonia.
His advice to anyone with a cold or flu: avoid public places and contact with others who will then become infected and spread the virus even further.
Parents should keep sick children at home rather than send them to school where they will infect their classmates.
Employers should also consider giving a sick worker time off, so he doesn’t infect everyone else in the workplace.
He also recommended coughing into your elbow rather than the reflex of covering your face with your hand; as hands contact is the fastest way of passing on the disease.
For those in the tourism sector, front line personnel meeting hundreds of visitors should avoid touching their face or nose with their hands, and wash their hands as often as possible, and use hand sanitizers at other times.
A warm smile can show hospitality as easily as handshake, but without contact, as anyone could be infected, even if they don’t look sick.