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AH1N1 – Pressing Need to Re-strategize and Prevent secondary bacterial pneumonia PDF Print
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Thursday, 20 August 2009 12:10

By Dr Ng Swee Choon, Committee member of the Medical Affairs Committee, Federation of Private Medical Practitioners’ Associations Malaysia

 

A H1N1 is a very infectious disease. It spreads by droplet spread and so it is easily transmitted. The DG of Health calls it a high attack rate. For a country of 27 million, struggling with this crisis since April 2009, and with national and international transportation being so widely used, for such an infectious disease, 4,200 reported cases so far is a severe under-reporting.

There has been much alarm over the rising number of cases and fatality rate and rightly so, because this ithe A(H1N1) is an very infectious disease. While alarm and widespread panic is not necessary, there exists the pressing need to restrategize and implement mechanisms and Standard Operating Procedures (SOP) for the prevention of secondary bacterial pneumonia

There are probably 20x that number of cases out there that are not reported. Because of this issue of under-reporting, many countries have stopped trying to report the number of new cases.

Unfortunately, 67 have died in Malaysia. But if you were to be objective, 67 deaths, out of possible 70-80,000 cases, give a death rate of 0.08%. Still a bit higher than the usual seasonal flu death rate of 0.04%, but surely not any where near panic proportions.

A closer look at the deaths revealed that 80% were A H1N1 associated, or were incidentally found to have contacted the virus, the virus by no means causing the death.

We can call this A H1N1 associated death or death with incidental A H1N1 infection. So, if the certification of death is proper, it may be that only 15 deaths were actually due to A H1N1, giving a fatality rate of 0.02%.

The flu itself is usually a mild disease in the majority of cases. From all available clinical epidemiological evidence, the bulk of patients dying in flu pandemics are from secondary bacterial pneumonias.

This has been shown to be the case in all flu epidemics and pandemics.

This is why we need to consolidate measures that are already in place. This should include a national level SOP whereby all affected patients with secondary bacterial pneumonias would be immediately triage for intensive tertiary level care.

There is no cause for panic but we should all be vigilant, because there is a very infectious disease in our midst.

Good personal hygiene is crucial, now and at all times, even after this crisis. If you are not well, as always, seek medical advice. There is certainly no need to panic and there is no national emergency here.

There is already too much misinformation and misperception of the situation out in the lay media without having to distract the public with the hype about national emergency.

Comments (9)Add Comment
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written by Ken Liew, August 20, 2009 13:05:12
And TV advertise that people should go to the Merdeka celebration?? which doubt that The Virus will spread even worst.

So, for health reason, Government should cancel the Merdeka celebration, AND use the FUND for a better use, like BUY mask for the school. We have seen the mask are rocketing price, telling pharmacy not to sell them with higher price, BUT what about the supplier?? The whole world are lack of MASK, cos H1N1 is spreading globally.

Government With the MOST money, are not doing their BEST. by just washing hands, wearing mask(which market are lack of) and you tend to fine normal people of not wearing mask... Nice JOB, you are just TOO GOOD at Robbing the people.
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written by raven1958, August 20, 2009 13:44:17
Shouldnt the government be rather safe then sorry...these deaths whether associated or otherwise could have been avoided or reduced if the MOH was on a sound footing..

On a sound footing they were not because they had spent so much of their time dabbling in bomoh medicine, harassing and running down private clinics while dengue and H1N1 deaths were shooting thru the roof...

Health strategies start with a well informed Minister..In this case the Minister is poorly informed...he ends up listening to "advice" from the DG of Health who is primarily responsible for this mess....

But for keeping this DG...Liow and Najib are ultimately responsible...and they will pay heavily in all the coming elections...The people are not dumb.
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written by asguard, August 20, 2009 14:14:48
Which you prefer have risk for the merdeka celebration or getting H1NI flu?
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written by Ocassey, August 20, 2009 14:28:09
Normally an employer would only employ a worker who is qualified to do the job, to ensure that no jeopardy occurs within the company. A mechanic may be very experienced through years of work but the mechanical engineer is the one who oversees over all his mechanics daily schedules and targets. So when we have a non medical ordinary "orang" to hold the post of Health Minister , do you think he is able to hold the fort? Do we see that he is as blind as a bat in health matters as well as not being able to take the lead to direct his director general to direct to the right continjencies to be taken instead of wading in a pool of quick sand? He gives us an impression that he is powerless as a component nominated candidate to the post of H. Minister. He cannot be Tuan, right?
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written by Michael Pg, August 20, 2009 15:26:51
Malaysia boleh mah with so high infection rate.

DPM declare million ringgit to give face mask and thermometer to schools, til now ZERO, talk only,
School HM also quiet and did not inform the teacher althought the HM was informed by pupil parent his children was infected.
Hospital, quarantine the infected people in a open space jus a few bed away.
Airport night flight back, no body to take temperature. but when LTLai show whow so many nurse in airport in the news check temperature.

this is DPM and LTLai talk only and should be resign 67times for those 67 record death.
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written by LILIN, August 20, 2009 16:05:59
http://wfol.tv/index.php?optio...&Itemid=26

A video that tells the story behind H1N1 n the role played by Obama, Rumsfield etc...watch it before the Admin here deletes the link..smilies/smiley.gif
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written by Nunudada, August 20, 2009 18:22:51
Most have probably died of MRSA.Our hospitals are turning into one way streets.
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written by Ben, August 20, 2009 19:47:26
While the good doctor is trying to articulate calm and vigilance, can he help by giving good advice how we can break this chain of infection which is not showing any signs of abating. The gomen has not been able to arrest this trend and it is spreading like wildfire. If no sign of a plausible strategy is implemented, paranoia will set in. For example, a check with my children school shows students staying away due to the rumour that some students are being treated for the disease.
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written by clarity, August 21, 2009 00:18:50
Little wonder that the public is becoming panicky. Just not enough is done to contain the spread of the virus. A god example is we have to wait until this severe situation in order to start ordering face masks. That's how prepared we are. The Minister of Health is probably too busy playing politics.
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