– Guyana remains on high alert
Guyana remains on high alert for new swine flu cases, according to Health Minister Dr Leslie Ramsammy, who revealed that the illness appears to be accompanied by conjunctivitis.
With some 29 specimens already tested and only two positive cases confirmed he said that the impact of H1N1 here has been moderate so far.
Speaking with Stabroek News on Thursday last at his Brickdam office hours before his ministry was destroyed by fire he said that persons with the H1N1 flu do not have different symptoms from those suffering from the common flu. However, he noted that experiences in other countries have pointed to the swine flu being accompanied by conjunctivitis.
The normal flu is not accompanied by conjunctivitis (red eyes), Ramsammy noted, but he cautioned that the presence of conjunctivitis is not a necessary confirmation of H1N1.
“We only had two confirmed cases, but the experience in other countries point to a high percentage of persons who flu seems to be accompanied by conjunctivitis… therefore if someone has flu and they seem to have conjunctivitis it is very suspicious,” he said.
The minister pointed out that if someone is suffering from both illnesses then a specimen should certainly be taken and sent overseas for testing.
In addition to the presence of conjunctivitis, he said that people with the H1N1 flu virus also seem to experience some diarrhoea and vomiting which the ministry has since added to the index of suspicion.
Ramsammy said too that if the flu persists for some time, running past a week persons should take note and see a doctor because swine flu patients are usually sick for many days. He added that the regular flu only lasts for a few days.
“If you have fever for more than a week it is something that you should check out with the doctors, but it is not wise to wait for a whole week before you see a doctor,” he stated.
He stressed that H1N1 has similar symptoms as the normal flu such as body aches, fatigue, loss of appetite, cough, runny nose, sore throat and fever.
The Health Minister said that currently medical professionals across the globe are accumulating evidence from people and trying to see if there are certain things that are peculiar with H1N1, but noted that so far they have not found anything peculiar.
However, he said scientists studying the flu virus have now discovered that unlike other viruses H1N1 seem to have the ability to move from the lungs to other areas of the body which he referred to as a troublesome indicator. This, he said, might explain the diarrhoea and vomiting.
Further, he said that H1N1 appears to have a greater impact on people with other illnesses.
“If you’re diabetic or asthmatic it seems to worsen the symptoms and that is why people with other illnesses contracting the flu these days should check it out and not stay home and hope to get better,” he said.
Confirmed cases
Speaking on the two confirmed cases here Ramsammy said that in one instance, a man who works overseas visited his family here and passed the virus onto his 14-year-old. He would not say what the sex of the child was.
He stated that the father came from a country neighbouring Guyana and while he also declined to name the country, he said that the man did not come through the airport.
The man spent a few days with his family and subsequently returned to work. Ramsammy said that he came ill with fever and also had a cough, but that he did not appear ill enough to see a doctor. Other persons in his family took ill after he left and while they recovered in a few days, the 14-year-old had to go to the hospital.
Ramsammy said the child is asthmatic, adding that this could have been the reason why the flu virus attacked.
With respect to the other case, he said it was a middle-aged woman. He said that the ministry is still not certain who her contact was because “she had many contacts with foreign people”. But he stated that again none of her contacts felt sick enough to go to the hospital. He stated that the woman is diabetic and insulin dependent.
Of the persons suffering with H1N1 in countries globally, Ramsammy said that the vast majority of cases seem to behave like regular flu. He noted that some persons treat it as a regular flu without going to see a doctor and it goes away. But he emphasized that some people have become seriously ill after contracting the swine flu virus.
“Most of the people with swine flu have not gone to the doctor, they treat them as any other flu and they were fine,” the minister said.
In terms of the surveillance systems here, he said that there are two currently in place; Influenza Like Illnesses (ILI) and Severe Acute Respiratory Infection (SARI). He said that persons in the health system are obligated to report to the ministry on a daily basis every case they have seen in either category, adding that for any case that meets a certain criteria on the index of suspicion a specimen is required to be sent for testing.
“We have had to train people to take the specimens,” he added.
Additionally, he said that if the ministry locates a confirmed case officers are required to track down the family and test everyone including their contacts.
Treatment
Ramsammy said the two persons who contacted the H1N1 flu here had been treated with Tamiflu. He said that the ministry has some 30,000 units of Tamiflu in stock and outside of that he was made aware of a recent purchase in the private sector.
“I have been told that the private sector have purchased Tamiflu and have been using it, I am not sure how much has been utilized in the country but I know that at least 10,000 doses of Tamiflu were procured by the private sector from the New GPC,” the minister said.
Pharmacies are now selling Tamiflu, but Ramsammy stressed that it is a prescription drug and not an over-the-counter drug. He said that no pharmacists should be selling the medication to persons who have not seen a doctor and received a prescription.
Ramsammy emphasized that Tamiflu cannot be dispensed as any other flu medicine since there are risks of resistance being developed in the event of widespread, unsupervised use.
He said that a doctor with a patient who has flu and who is not responding to normal medication can go ahead and use Tamiflu provided that that person meets the criteria on the index of suspicion. He noted that doctors can start treating without waiting for confirmation.
To date the health ministry has dispensed some 23,000 doses of regular Influenza A vaccines. Ramsammy said the vaccines had nothing to do with H1N1, adding that they cannot prevent persons from contracting swine flu.
Some 25,000 doses of the Influenza A vaccines were purchased and according to him, the targets of the vaccines are children and elderly people. He said the vaccines are meant to reduce the severity of H1N1 on persons falling into either category if they contract the virus.
So far, he said, the ministry has sent 39 specimens overseas for testing and received results for 29. The two confirmed cases were among the results that came back.
Further, the minister said that Guyana has an active airport programme and that travellers are being screened. He said persons and the airlines are asked to fill out health declarations forms, adding that the ministry expects people to be honest.
He said they have received occasional reports and have followed up by interviewing persons who come in. He added that people largely been cooperative.
Currently, he said, health officials at the airport are not being intrusive as before since they are hoping that people are honest enough to say whether they are ill when they arrive.
