Two Japanese students, ADB exec test positive for A(H1N1)

Three doctors, from left to right: Ninal, Duque, Villaverde.

Two Japanese students have tested positive for the A(H1N1) virus, prompting school authorities to voluntarily suspend classes for 10 days, from June 4 to 14.

Classes at the St. Benilde campus, however, opposite DLSU Taft, were not suspended.

The health department said the two Japanese students were friends and lived in the same dormitory.

Meanwhile, a Filipino executive of the Asian Development Bank (ADB) has also tested positive for the virus, after a trip to the US, Duque III. The ADB, however, is not suspending operations.

Update No. 33

DUQUE REPORTS 7 NEW CASES OF INFLUENZA A (H1N1); REACTS TO POSSIBLE ANNOUNCEMENT OF LEVEL 6 BY WHO / 04 June 2009

Health Secretary Francisco T. Duque III today reported seven more positive cases of Influenza A (H1N1) in the country bringing the total number of confirmed cases to 29.

One of the six new confirmed cases is a 20 year-old male international graduate student of the De La Salle University, who is a contact of the first positive case at DLSU. This student also arrived in the country on May 12. On June 2, he manifested mild respiratory symptoms and consulted a health facility where he was tested for the presence of A (H1N1). RITM confirmed the test this morning and he is now confined in the health facility.

The other six cases are Filipinos who all have a history of travel to the US. Three belong to the same family: two females aged 12 and 16; and an 18-year old male. The other three include a 22 year-old male, a 33 year-old pregnant woman and a 52 year old-female. All of the six show only mild flu-like symptoms and are now being observed and managed in health facilities.

Duque reiterated that the 10-day suspension of classes is applicable only for the students, faculty and staff of DLSU Manila due to the confirmation of at least one A(H1N1) case. He reminded all other schools in the country to be on alert for possible cases of A (H1N1) particularly for students and staff who have a history of travel within the last 10 days in affected countries and who are showing flu-like symptoms.

In reaction to a possible Pandemic Level 6 declaration by the World Health Organization, Duque, Chair of the ASEAN + 3 Health Ministers Meeting on A (H1N1) held in Bangkok, Thailand last month, emphasized that this move should be made in the most careful and prudent approach voicing the joint view of the ASEAN + 3 countries for WHO to also consider the severity of the disease and not just the geographic range of the virus.

“We do not want a disproportionately destructive global scare from a virus that has thus far only shown mild symptoms in most of the cases that we are seeing in affected countries. We do not need at this at a time of great economic crisis and uncertainty. But at the same time, we should not also underestimate the potential of the virus to become more severe in the future,” Duque said.

In the country, Duque stressed that in all of the 29 confirmed cases, patients manifested only with mild symptoms reflecting the general trend and behavior of the virus in other affected countries.

“With further characterization of the virus in our local cases, if we see that A (H1N1) poses no severe threat and is self-limited in most cases, we may be seeing a shift in our control strategy to outpatient and home management of patients showing only mild symptoms. This is already being done in countries like Mexico and the US which already have sustained community transmission,” Duque said.

Meanwhile, as the world braces for the WHO’s possible announcement of Pandemic Level 6, Duque reminded other government agencies as well as the business and private sector to consider implementing their business contingency plans.

In 2006, DOH already convened the heads of major business groups and members of the private sector to help them craft their own business contingency plans during the height of the Avian Flu scare. This Plan will ensure that commercial activities and essential government and non- government services will continue even during a pandemic.

Since May 1, 2009, the DOH has monitored a total of 414 CUOs. Of these, 29 are positive A(H1N1) cases, 47 have pending laboratory results, and 338 are negative for A(H1N1) and have been discarded. There are 13 new Cases Under Observation (CUOs) today.

In their latest report, the World Health Organization reported 1,863 new cases and 2 new deaths. There are now a total of 19,273 cases and 117 deaths from 66 reporting countries. Bulgaria, Egypt, Lebanon and Nicaragua are the newest countries with confirmed A (H1N1) cases.

Notes from the press conference.

WARNING: Some of what was said is different from the press statement the DOH issued. The DOH made some corrections during the press conference, such as the date of arrival of the second Japanese student at the DLSU (they don’t know; the press statement said May 12).
The ADB executive, upon verification, was one of the six new cases of Filipino patients, all of whom came from the US. The total number of cases so far is 29, not 30 as was said during the press conference.

Duque:
Mario villaverde:
Dr. marlow ninal, nec, surveillance chief

Today I am reporting 7 more positive cases in the country bringing total number of confirmed to 29. One of six new confirmed is 20 yr old male international grad student from dlsu in taft manila. Two is a contact of first positive case at dlsu. Also arrived on may 12, june 2 manifested mild respiratory symptoms…ritm confirmed test this morning and now confined in health facility.

Other six cases Filipinos who all have history of travel to us. Three belong to same family. Other 3 include 20 yr old, 33 yr old pregnant woman…all six show only mild flu like symptoms, being managed in health facilities.

Suspension of classes only applicable to dlsu manila.

We should also not underestimate potential of virus to become more severe in future. Nobody knows how this virus will end up…remains to patients to manifest mild symptoms…in the country I stress that in all of 29 confirmed cases patients manifest only mild symptoms. With further characterization of virus in our local cases, if we see that ah1n1 truly poses no severe threat…may be seeing shift in control strategy showing only mild symptoms…whatever developments we observe and in particular in la salle, we will further characterize how this virus will be behaving in an entirely different environment. Once we see commonality of findings…easier for us to shift policy of containment to policy of mitigation.

Meanwhile as world braces for possible announcement of pandemic 6, remind…to consider implementing business contingency plans…2006…convene to help them craft during the height of avian flu scare….will ensure that commercial activities will continue even during a pandemic.

414 cuos, 29 positive for novel virus, 47 pending. 338 negative….13 new cases under observation today.

Case fatality rate of .6%. The bulk of that represents deaths in mexico.

(nationality of dlsu case) duque: this is a Japanese national. The second is also a Japanese national.

(dorm mates, class mates) duque: they’re together.

Ninal: they are friends, also stayed in same dormitory.

Villaverde: same class, same dorm.

(traveled together) not have information. Staying in same dormitory, and classmates.

(other Japanese students in class) ninal: we don’t have list yet, we haven’t identified nationalities.

(mancao…suggest to go in self-quarantine) duque: I think precautionary measures must be followed especially since he’s coming from part of US that reported confirmed cases of novel virus. Baka 10 days so he can be under observation. Right now he is in quarantine…

(attended same four classes as first dlsu case) duque: presumably. Foreign exchange student. We don’t know the course.

(idea how contracted virus) duque: not yet. Second one, date of arrival is may 30. Could be that he might have carried the virus. Unang jap, may 12. No info when he arrived. Onset of symptoms cough…may31st. Consulted jun3. If he arrived much later, there’s the possibility he might have…the first one might have contracted it from him. We will have to find it out. Along that line, somebody else might have traveled recently and got in touch with these 2 foreign students.

(adb exec) duque: we just got that confirmation from adb and we were given go signal to respond to questions on this particular executive of adb. She’s being quarantined, adb has indicated to us they are following the who and doh guidelines in doing contact tracing, identified people with whom this executive had contact from the time she began to develop the symptoms.

(among the cases under observation) duque: hindi pa nasasama. Filipino…kung masasama 30. Pinay na executive…

(when arrived) duque: not have information yet. We’ll probably ascertain dates of information that come to us by tomorrow.

(need to suspend operations) duque: no. here in adb isolated ka, naka-cubicle ka. Adb said they’re not gonna suspend operations.

(expect more cases from dlsu) duque: in general we expect more cases because we’re doing contact tracing and we have continuous international travel. We expect in general cases will continue to increase.

(expect 20% of total classmates to be infected) duque: it’s a…a figure that the nec has considered in terms of…there is no clear basis, also conjecture. We are dealing with a new virus. The 20-30% rate of transmission might have no solid ground or basis.

(how doing) duque: just with cough, no more fever. Both just have cough.

(how long need to observe behavior of virus) duque: we suspended classes in la salle…probably within that timeframe we should be able to see new developments if there are any. We will continue to observe how the virus will behave within that environment and how it’s affecting exposed students to the first Japanese case. If we are able to solidly establish that symptoms continue to mimic those of index cases in first instance and patients exposed to Taiwanese national in second instance…ngayon nagkaroon tayo sa eskwalahan. We’re tracking it down..nine days more since suspension yesterday. While we’re able to observe some deviatoins from the usual mlid symptoms of those affected in prevoius instances, can use as basis to shift policy from containment to mitigation. Simply include ah1n1 as one of those disease regular, notifiable diseases and also integrate in disease prevention and control program, include in ili surveillance system. Just do early dteciton and case management. Just watch it come and go, just treat them…protocol for outpatient management, if syptoms are indicative…then do in patient or hospital management.

Adb…30 kung kasama siya. Ngayon 29 lang tayo.

Zambales: villaverde: as far as the Taiwanese, there are at least two…laboratory nagpa-positve pa so we are not yet discharging this patient. I forgot the case number but I think that’s…anyway contained sya…and we have not detected any further case.

(six Filipinos, where did they travel) duque: all from the US.

Villaverde: yesterday, before they were dismissed from school, all the classes were devoted already to health advice and instructions for students and faculty on what to do during the 10 day period.

(paano nalaman ang adb) duque: patingin, symptoms, nakaramdam…pumasok, di sumunod sa quarantine…

(adb when mmanifest) duque: we don’t have full detail…

Ninal: Two Japanese in health facility. Basta nasa health facility.

(six new cases, kailan dumating) duque: all index cases from USA. Cough, no indication they still have fever. 52 f, 33 m, 18 f…all travel to US. Case 23, may 30 arrived. 24-may29. Case 25-may23. Case 26-wala pa ito. We need more info on case 26. 27-may31. Reported jun3. 28-may31, arrival. Jun3 reported. 29-may31 arrived, reported jun3.

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