Words of Wisdom ...or so it seems...


Sunday, 22 November 2009

Latest on H1N1

*****Latest update Second wave hit Thailand....Malaysia...get ready folks for a second wave...

This morning, I attended the lecture given by Dr Christopher KC Lee,the former Head of Infectious Diseases Department in Hospital Kuala Lumpur, now heading the Medical Department in Sungai Buluh, one of THE man in handling the pandemic H1N1 that is hitting us today.

He had recently attended the World Response Conference on Global Outbreak of H1N1 and had shared with us, the latest updates on this matter.

I will present to you, in a very brief manner and as lay man as possible, to avoid decreasing your pre-existing short attention span, on factual matters. My job had taught me that humans are most likely to achieve full attention span when their attention are on matters like porn and politics. Oops...that's redundant, but you get what I mean right?

So here's the deal. The outbreak of such H1 viruses is not a new phenomenon to the human species. One of the earliest known outbreak was back in 1918, (America) , 1957 (Asian Flu in China), 1968 in Hong Kong. All have the same pattern - they have what we call a "second wave", which kills more than the first. 1918 saw a different strain, meaning the virus had mutated into something more potent. However, in the 1957 and the 1968, the culprit remained non mutated. Needless to say, we are expecting a second wave of 2009 H1N1, but this may range between 6 months to 2 years, with reference to the earlier flu outbreak.

I won't go into boring details of how the health side are expected to handle the out break. What I can say in conclusion is, I will not advice any doctors, or anyone to have any wedding plans involving doctors, just yet, just in case.

The H1N1 vaccine is already in Malaysia, but not yet accessible to public, nor anyone who is not as important as those who we call the VIPs (no, I don't mean "very important pricks"...although.....), of course you will not get this published anywhere. However, hopefully, if everything goes well, the vaccine will be accessible to the front liners then the public sometime by January 2010. But don't you worry, it'll definitely be before December 21st 2012.

And by March 2010, the seasonal influenza jabs will include the strain of H1N1. Currently, I do hope that you will not fall into that "cash rush" by some irresponsible clinics that insists the current Influenza Vaccination have protective properties against H1N1.

A note in regards to the anti viral medications. There are two types of anti viral tablets; oseltamivir (better known as Tamiflu) and zanamivir. The latter is not to be taken by those who have problems of bronchospasm, such as asthmatic patients and COPD (chronic obstructive Pulmonary disease, or smokers' asthma). The age group of less than three years old, will not benefit from antiviral tablets, unfortunately. Furthermore, people traveling to pandemic areas are not advice to take these tablets as prophylactic measures. This causes emergence of resistant strain of virus. The same applies to those who have already contracted H1N1, they should not take the tamiflu as prophylactic measures against re-infection.

So here's what you can do, to avoid contracting, or transmitting the disease:

1. Know your personal hygene.

Basically, shut your trap when you sneeze, cough etc. This is one thing I hate. People should have freedom of speech, but not in a form of sneezing and coughing. I really don't understand parents who love to tell their children to "salam doctor" when they damn well know that their kids use their hands to wipe their gooey nasal discharges. This is one occasion when I would love to tell them to F*** with courtesy. Parents who are unable to tell a simple thing like, "close your mouth when you sneeze or cough" should not be allowed to breed. Funny thing is, they have no problems telling their kids to shut their mouth up when they are being inquisitive yet have problems telling their kids to shut up and behave in public places, not to mention shut their traps when they cough and sneeze.
This is a YES....
And this man should learn something from the kid up there.....
Wash your hands frequently.

2. The simple common sense of staying away from crowds during an out break, blah blah blah..please don't let me repeat this.

3. Know how to perform self assessment/home assessment.

a. Respiratory difficulties : shortness of breath (SOB, not son of a bitch yaa), rapid breathing or purple or blue discoloration of lips. Tell your teenage kids to lay off Goth for a while and stay away from those black lipsticks.

b. Coughing out blood or blood streaked sputum

c. Persistent chest pain. But I do hope you don't rush your teenage girl to casualty because you cannot differentiate between chest pain from complication of H1N1, and the eruption of adolescent breasts, save yourselves the embarrassment. But if you really are in doubt, do not hesitate to seek doctor's opinions. Bomoh's opinion will only resort to blaming everything on the poor's bad enough that we're wearing their pants...let's just give them a break shall we?

d. Persistent diarrhoea and / or vomiting, with or without the history of ingesting food from the local mamak store.

e. Fever persisting beyond 2 days or recurring after 2 days.

f. Abnormal behaviour, confusion, less responsive, convulsion. Having said that, please do not drag some of the people sitting in parliament to casualty - those are not exactly the abnormal behaviour, confusion nor less responsive type I meant.

g. Dizziness when standing and / or reduced urine production. Dizziness in the presence of George Clooney and Brad Pitt, does not count.

Those who have the symptoms above need to be seen by the doctor in the hospital, otherwise, home quarantine is all that is needed, even if you're tested positive for H1N1. Another thing about testing is that "there is not much point in testing for H1N1, unless one needs to be hospitalized", as treatment is emphasized, based on clinical evaluation.

5. Be careful when you have what we call "co-morbidities" or "risk factors". They are:

a. Chronic respiratory conditions such as asthma, COPD, and Obstructive Sleep Apnoea (OSA). The latter pertains to obese people. It's the heights of self torture really, that you get so fat, you stop yourself from breathing. So, in short, try not to smoke your way to smokers' asthma and to not stay fat (unless of course you have a medical excuse to be fat)
b. Pregnant women, especially in their second and third trimester

c. Obesity.

d. Other possible predisposing conditions such as chronic cardiac disease (but not simple hypertension, so don't tension tension), and chronic illnesses including diabetes mellitus, renal failure, haemoglobinopathies, immunosuppression (including cancer, HIV/AIDS, chemotherapy, long term steroids). For those who cannot comprehend some of the terminology, then don't worry, it simply means you don't have it.

e. Adults above or the age of 65years, especially those with chronic disease.

People with co morbidities with symptoms need to be seen by doctors in order to start antivirals.

Here's a brief note by Dr Christopher Lee for further reading and I leave you with a video showing Dr Lee giving an update on H1N1 on NST. Stay safe folks.

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