MANILA, Philippines—Despite the expected surge of swine flu cases in the northern hemisphere with the onset of winter, the Department of Health (DoH) sees no need to reinstate measures to prevent the spread of Influenza A(H1N1) and declare a health emergency at this time because the novel virus is already in the Philippines with generally mild symptoms.

The DoH has confirmed 5,212 cases as of Oct. 17, of which 30 people, mostly those with underlying medical condition, have died, resulting in a case fatality ratio (CFR) of 0.6 percent. The DoH began tracking swine flu cases in May.

Globally, 414,945 people were infected with the flu virus of whom 4,999 died as of Oct. 18, for a CFR of 1.2 percent, according to the World Health Organization (WHO).

“We are not going back to containment measures because we already have cases in the Philippines. As of the moment, there is no need to do that,” Health Secretary Francisco Duque III told reporters at the DoH headquarters in Manila Monday.

Quarantine procedures

Duque said the existing quarantine procedures at entry ports, including the thermal scan that checks arriving passengers for fever, were enough in the meantime.

“It’s probably not necessary [to take steps] beyond what our quarantine personnel are doing. Of course, we still have the thermal scans. They’re going to stay. We’re not going to reduce our efforts in terms of these important quarantine measures,” the health secretary said.

“But again, it doesn’t make sense to be in a state of hyper-alertness because the virus is already in the communities and we have documented that 99 percent (of patients) recover and there’s a less than 1 percent CFR. And so the important thing is that systems are in place,” he added.

Pandemic alert

When the WHO raised a pandemic alert over the swine flu virus in May, the DoH instituted large-scale testing, contract tracing and administration of the anti-flu medicine Oseltamivir not only for confirmed cases but also for people who have come into contact with them.

After a few months, however, the DoH lifted the strict measures and, in line with the WHO recommendation, said the monitoring of the virus would be part of the regular influenza surveillance system.

“We follow the recommendation of the WHO,” Duque said.

Over the weekend, US President Barack Obama declared the swine flu outbreak in the United States a national emergency, giving his health chief the power to let hospitals move emergency rooms offsite to speed up treatment and protect non-infected patients.

Forty-six of the 50 US states now report widespread flu activity—an unusually early surge that ordinarily takes place in January or February at the peak of a normal flu season, according to US health authorities.

Preemptive measure

Duque interpreted Obama’s declaration as a preemptive measure. “It doesn’t reflect an unusual surge in H1N1 cases. [It was] meant to capacitate the US health system to respond to the possibility of a sudden surge in cases,” he said.

He said that in some parts of the United States, in the southern and eastern parts, the virus was observed to be waning.

“But we can’t question the wisdom of the US leadership in declaring a national emergency,” he said.

Duque acknowledged that infected people from countries experiencing winter would travel to warmer countries like the Philippines.

“Yes, it’s possible they’re going to bring it in here, but we don’t have to be extra careful. Our quarantine procedure will continue. Those with fever will be put aside,” he said.

Second wave

The DoH, nevertheless, is on the lookout for a possible “second wave” of the spread of the virus.

A second wave, according to Duque, could either mean that the same virus strain has infected a bigger part of the population, or that the strain has mutated into a deadlier form.

The DoH said countries should accelerate swine flu vaccination and actively monitor influenza-like illnesses that turn serious or fatal.

Random testing of suspected swine flu cases will continue to track any mutation of the virus. “If we see more people in emergency rooms, more serious symptoms, these are the things we are in lookout for,” Duque said.

Hospitals have been advised to prepare to handle a possible increase in swine flu patients.

To head off the further spread of the flu, the public is advised to practice good respiratory hygiene like covering one’s nose and mouth when sneezing, and properly washing hands.

“What is important is that hospitals are ready, not for all persons with influenza-like illness but the high-risk cases,” he added.

Foot baths at NAIA

The Manila International Airport Authority (MIAA) on Monday assured the public that “usual and standard” implementation of thermal scanning and foot baths was still being observed at all Ninoy Aquino International Airport (NAIA) terminals amid the declaration of a national emergency in the United States.

The MIAA-Medical Division, headed by Dr. Augusto Rillo, and the Bureau of Human Quarantine are still manning round-the-clock thermal scanner stations at the arrival areas, MIAA general manager Alfonso Cusi said in a statement.

Duque said H1N1 vaccines would not be available in the country until January at the latest.

“It’s not as quick as we wanted it to be, or as the multinational drug companies had projected it to be. It’s much slower than expected for various reasons,” he said.

The DoH has placed an order with the WHO for P100 million worth of vaccines which the department said would be given to high-risk groups, namely frontline health workers, the elderly and the very young, the pregnant and those with preexisting illnesses. With a report from Jerome Aning