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Swine Flu Spreads in Bulacan and Jaen, Nueva Ecija

Written By David D'Angelo on Tuesday, June 16, 2009 | 6/16/2009

MALOLOS CITY, Philippines – A day after the Department of Health (DOH) reported the country’s first community-level outbreak of Influenza A(H1N1) in a village in Jaen town, Nueva Ecija, classes at a public high school in Bulacan were suspended after eight students tested positive for the virus.

Health officials said they could not yet determine the source of the virus but clarified that it was not yet a community outbreak, even if 49 others have shown symptoms of the viral infection.

The reported flu cases at the Doña Candelaria Meneses Duque Memorial High School in Barangay Bambang, Bulacan and other parts of the country raised the total to 193, according to the DOH.

Dr. Joycelyn Gomez, provincial public health officer and Bulacan’s spokesperson on A(H1N1), told The STAR that at least 16 students of the high school underwent throat swabbing as early as June 11.

“There is nothing to fear yet because all the cases are mild. Nobody has been hospitalized and the students are recuperating in their respective homes,” Gomez said, allaying residents’ fears.

She said they have to check the level of transmission before declaring a community outbreak.

The Research Institute for Tropical Medicine (RITM) on Sunday afternoon found the Filipino-Japanese student at St. Mary’s Academy in Hagonoy town negative for the virus.

This means that the contact tracing initiated by health officials in Hagonoy town will be discontinued.

Classes at the two schools were suspended last Thursday after two students who returned from a vacation in the United States and Japan showed symptoms of A(H1N1). Classes will resume on June 22 after the 10-day quarantine period.

As this developed, the request for a declaration of a state of calamity in Jaen, Nueva Ecija remains pending at the Sangguniang Bayan.

Jaen Mayor Santiago Austria on Sunday requested the town council to declare a state of calamity after 26 more students in a public high school in Barangay Landakin showed symptoms of A(H1N1) flu, a day after the DOH declared a community outbreak in Barangay Hilera.

Sources said that 19 more residents were subjected to throat swabbing yesterday and surveillance was extended to Pakul, Ulaning Putik, and Landakin, while a command post was set up right inside the Hilera Elementary School.

Education Secretary Jesli Lapus said that it is useless to suspend classes in Jaen because the disease had already spread in the community.

He said the next strategy should be mitigation, and advised residents of the affected area to stay home and avail of self-medication.



Tracing the source

Health Secretary Francisco Duque III, however, said that the infection in Nueva Ecija and Bulacan remains mild.

He directed health officials in Central Luzon to initiate an information campaign to explain to people that there is nothing to fear and prevent possible social distancing.

DOH Undersecretary Mario Villaverde said that the first confirmed case at the Doña Candelaria School was detected last June 8 but they could not determine the source of the virus.

The DOH is puzzled about where the virus in Barangay Hilera came from since the area is remote and hardly visited by outsiders.

“We cannot yet establish the index case in Hilera. This is still a big question mark on our part. But there are many possibilities and one of them is that there was a medical mission group from Manila (that went there) in the week before the first case was reported there,” he said.

It turned out that the mission group came from a school that already reported confirmed cases of the virus.

Villaverde had refused to identify this school but there were five schools that have had infected students – De La Salle University-Taft, which re-opened classes yesterday; FEU-East Asia College, DLSU-St. Benilde College, St. Andrews School in Parañaque and Ateneo Grade School.

The DOH is also looking into the possibility that “a family in Hilera had received visitors from Manila or they went to Manila to visit.”

Villaverde clarified that the DOH would be shifting from containment to mitigation strategy by area. “We are selective in our action preparedness plan. We’ll be implementing an area-based response system.”

Duque, on the other hand, said the government is reviewing its response systems and contingency plans against the virus as the number of cases rose dramatically since it was first reported on May 21.

“We are now shifting from containment to mitigation,” Duque said. “We are reviewing our existing policies and in particular the response level system which our schools have adopted since the opening of classes in June 1.”

Also to be included in the review is the response system for government and private offices.

He however said that the government is still in containment mode in the Visayas and Mindanao where there are no reported cases.



Senators push for aggressive campaign

At the Senate, Sen. Loren Legarda recommended the temporary closure of schools and restriction of movements in areas affected by the virus.

Citing a paper on “Flu Pandemic Mitigation” by the US Homeland Security, Legarda suggested that health authorities should follow the lessons from past pandemics, which include the closing of schools and restriction of large public gatherings.

Legarda urged the DOH to follow the paper’s recommendation that “during prior pandemics, use of masks, closing of schools, and restrictions on large public gatherings and meetings were recommended to prevent community spread.”

The paper explained that “pandemic measures that made good sense at earlier phases – such as isolation of patients, contact tracing and voluntary quarantine of contacts – would cease to be effective or feasible.”

“A two-pronged strategy, that of containment and mitigation, is preferable to just implementing either one,” Legarda said.

Earlier, Sen. Edgardo Angara also pushed the need for DOH to spearhead a more aggressive campaign on how to prevent the spread of the virus in schools.

Angara also batted for the delay in school openings to prevent an outbreak.

Sen. Pia Cayetano, for her part, said the Nueva Ecija outbreak should prompt the government to strengthen the public health system to enable local communities to cope with the influenza scare and other public health emergencies.

Cayetano said the incident only proves how crucial it is for government to prioritize programs that would reinforce the capability of local communities to defend themselves and take care of their constituents in times of health emergencies.

She noted that far-flung barangays lack basic facilities for health care, as well as medical personnel like doctors, nurses and adequately trained community health workers.

Sen. Richard Gordon pushed for the need to improve the public health care system in a bid to strengthen the country’s defense against diseases.

Gordon, chairman of the Philippine National Red Cross (PNRC), pointed out that it is also important to strengthen the health care systems in public schools nationwide to ensure the safety of students and to improve their health and welfare.



Jaen off-limits to soldiers

Meanwhile, Armed Forces of the Philippines chief Gen. Victor Ibrado has instructed soldiers to take steps to prevent the spread of the potentially deadly virus.

Lt. Col. Romeo Brawner, AFP spokesman, said troops were ordered to observe proper hygiene and as much as possible avoid close contact as a precautionary measure.

“Soldiers who feel the symptoms of the virus are also encouraged to place themselves on self-quarantine,” he said.

Brawner also said that military hospitals were instructed to prepare for the virus by stockpiling medicine and to ensure that the facilities are properly sanitized.

“Military doctors and health services personnel were also placed on standby to augment civilian health authorities in case their help would be needed,” he said.

Brawner said that soldiers assigned at the 7th Infantry Division in Nueva Ecija and other nearby camps were advised to avoid going to Jaen town.

The spokesman said the AFP is also ready to augment the police in maintaining peace and order in case of untoward incidents that might arise if a pandemic occurs.

“Of course our measure also is that in case this pandemic would evolve or erupt into widespread chaos, our troops are ready to assist the Philippine National Police in maintaining peace and order in the country,” he said.

Brawner said violent incidents could happen in a pandemic, like what happened in some countries.

– With Sheila Crisostomo, Dennis Carcamo, Ric Sapnu, Jun Elias, Evelyn Macairan, Paolo Romero, Christina Mendez, James Mananghaya



Source: http://www.philstar.com/Article.aspx?articleId=478094&publicationSubCategoryId=63

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