Swine flu cases now exceed half million
Swine flu cases may now exceed half million
BANGKOK: — Just one week after announcing plans to release weekly pandemic A(H1N1) infection and mortality rates, the Public Health Ministry yesterday abandoned the proposal.
Deputy permanent secretary for public health, Dr Paichit Warachit, said that in the previous week the number of deaths attributed to pandemic A(H1N1), originally termed swine flu, had increased by 21, to 65, while the number of confirmed cases had risen from last weeks figure of 6,776 to 8,877.
However, in a dramatic back-flip to the planned weekly updates, Dr Paichit also announced yesterday that the ministry will no longer make announcements on the number of infected people.
According to Dr Paichit more than 500,000 people could currently be infected with the virus and it is unrealistic to continue attempting to report the exact number.
At the same the ministry also advised any person exhibiting flu-like symptoms to seek medical assistance within two days of the onset, irrespective of whether they had underlying symptoms which could exasperate the condition or not.
The instructions came as the first death of a healthcare worker, an unnamed 57-year-old doctor at Chiang Mai University’s Faculty of Medicine, was also announced.
According to the ministry, the majority of people who have so far died from pandemic A(H1N1) resulted from patients delaying seeking medical assistance for six days or more.
Dr Paichit said people with no chronic diseases should wait no more than two days before seeking medical treatment, while those with chronic disease should head to the nearest hospital as soon as they develop symptoms.
He said patients with severe flu symptoms need to take the anti-viral drug oseltamivir within 48 to 72 hours of infection to reduce the chance of developing pneumonia, which can be fatal.
The Government Pharmaceutical Organisation (GPO) is to start manufacturing 20 million tablets of oseltamivir to increase stocks from 15 million to 55 million doses early next month and GPO director Dr Vithit Attavijjakul said it could be delivered to urban areas in less than 24 hours and to rural areas in less than 48 hours.
He said the GPO is also reserving 50,000 oseltamivir tablets for its regional offices in Chiang Mai, Udon Thani and Hat Yai for distribution to 18 provinces.
Free oseltamivir available from today
BANGKOK: — People with pandemic A(H1N1) symptoms will be able to receive government supplied oseltamivir (the generic form of Tamiflu), free of charge at state hospitals and private clinics as of today.
So far 31 private clinics in Bangkok have been certified by the Public Health Ministry (PMH) to prescribe the flu treatment drug, with more clinics in the capital and provinces expected to be authorised this week if they meet ministry requirements.
Dr Somyot Deerasmi, chief of the Department of Health Services Support, said each authorised clinic has received 50 oseltamivir tablets, enough to treat five people with pandemic A(H1N1), originally termed swine flu.
The tablets are being produced by the Government Pharmaceutical Organisation (GPO) at a cost of Bt25 (about $US0.73) each and labelled as GPO-A-Flu.
Dr Somyot said that though the tablets will be supplied free, patients will have to pay for other drugs and medical services provided.
A meeting between health officials and clinic owners yesterday went through the procedures that must be followed when prescribing the tablets.
These include only doctors at clinics being authorised to prescribe the drug, and the compulsory reporting of any patients experiencing side-effects. Any patient that experiences a severe reaction after taking the drug must be immediately hospitalized.
Clinics must ensure that all patients wear protective masks while awaiting treatment, and a separate examination area must be used for people suspected of having the virus.
In addition, hand cleansing gel, wash basins and bins must be available at each clinic, while only clinics with a drug-diluting device will be permitted to prescribe oseltamivir for children.
According to Dr Itthiphorn Khanajaroen, deputy secretarygeneral of the Medical Council, “oseltamivir tablets cannot be cut and given to children in smaller doses like other medicine”.
Meanwhile, Dr Somyot said clinics that provide medical care for pregnancy and other high-risk category patients will not take part in the program to lower the risk of these patients contracting the virus from visiting pandemic A(H1N1) patients.
According to the PMH there are about 2,100 private clinics in Bangkok and 14,900 in rural areas.
The PMH also said that as of last Friday more than two million home visits had been made by 987,000 public health volunteers in provinces outside Bangkok to educate people about preventive measures against the virus.
According to the GPO, the country had enough oseltamivir to treat 10 percent of the population, with a further 60 million planned to be produced.
As of last Wednesday Thailand had recorded 65 deaths due to pandemic A(H1N1) and 8,877 infections.
Pandemic A(H1N1) active inside Bang Kwang Central Prison
BANGKOK: — A British national in Thailand’s infamous Bang Kwang Central Prison has written to the charity Prisoners Abroad asking if it or the British Embassy in Bangkok has plans to pay for the flu treatment drug Tamiflu (also sold under the generic name oseltamivir), for jailed Brits in Thailand.
According to the prisoner, who requested his name not be divulged, as of July 13 two prisoners and one prison guard had died from the pandemic A(H1N1) virus, originally termed swine flu, with at least one other guard at that time “seriously ill” in hospital.
The author says he believes the Thai Department of Corrections has issued instructions that face masks are to be worn by all staff and prisoners, “though non-Thai prisoners have to pay Bt100 (about $US3) for each mask”.
The author said he was “aware that all medication for foreign prisoners must be sourced and paid for by their respective embassies” and he “wondered if the British Embassy in Thailand has a contigency plan in place?”.
The email goes on to say, “the conditions inside Thai prisons are very harsh and the health of a lot of the prisoners incarcerated is not good, with many also suffering with tuberculosis”.
The prisoner says he suspects that prison hospitals “are not equipped to handle the influx that this epidemic could cause” and pleaded for help in securing the anti-flu drug on behalf of all British passport holders currently incarcerated in Thailand.
Over the weekend the Public Health Ministry announced that people with pandemic A(H1N1) symptoms will be able to obtain the locally produced oseltamivir free of charge at state and private clinics as of today, while disclosing the cost of manufacturing the drug was Bt25 (about $US0.73) each.
The Government has not made any public announcement whether the free treatment will be extended to foreigners who fall ill in Thailand from pandemic A(H1N1), or whether the anti-viral drug will be supplied to prisoners in its jails.
Thailand is reported to currently have enough oseltamivir to treat 10 percent of the population, with a further 60 million tablets being produced.
As of last Wednesday Thailand had recorded 65 deaths due to pandemic A(H1N1) and 8,877 infections.
A(H1N1) virus detected in second Thai prison
AYUTTHAYA: — Officials at Phra Nakhon Si Ayutthaya Central Prison yesterday announced that a 50-year-old prisoner with flu-like symptoms had tested positive for the pandemic A(H1N1) virus after being sent to Phra Nakhon Si Ayutthaya Hospital on August 1.
Laboratory tests returned yesterday showed the man, who is also afflicted with diabetes, chronic kidney disease, as well as congenital diseases, had had the infectious virus when he was removed from the prison population last Saturday.
The positive test result is reported to have resulted in an outbreak scare among other prisoners he was locked up with, with many anxious of the virus spreading through the prison community.
Call for red, yellow and green A(H1N1) zones
BANGKOK: — Thailand could soon be divided into red, yellow and green zones indicating the level of pandemic A(H1N1) infections in each region if a suggestion by former public health minister Sudarat Keyuraphan is acted on.
The call for the three color zones to indicate levels of infection came as Sudarat continued to receive treatment for the virus, originally termed swine flu, at Bamrungrad Hospital in Bangkok.
Sudarat said that despite taking preventative measures she still became infected with the virus, and said the Public Health Ministry (PHM) had not taken sufficient preventive measures, especially in areas outside Bangkok.
She said the country should be divided into red, yellow and green zones – for highly affected, less affected, and not affected – so that people would be able to better protect themselves from the virus.
The call for the color coding coincided with an announcement by the PHM that the rate of pandemic A(H1N1) infection in the provinces appears to be increasing.
Dr Paijit Warachit, deputy permanent secretary for public health, said farm workers and others outside the capital were among the groups health officials were most concerned about.
Thailand yesterday reported an additional 16 fatalities from pandemic A(H1N1), raising the number killed to 81, and while the PHM has stopped announcing the number of confirmed cases, a source inside the ministry said so far 10,045 people have been infected.
According to Government Pharmaceutical Organisation managing director Dr Witit Artavatkun, an estimated 30,000 people each day are going to hospitals nationwide seeking treatment.
He said production of the first batch of locally produced pandemic A(H1N1) flu vaccine at the Nakhon Pathom pilot plant will be completed by August 16, with clinical trials on humans scheduled to commence next month.
‘Rampant unprotected sex, drug abuse at Thai jails’
Experts at an international conference in Bali have voiced concern about the spread of HIV/Aids in Thai prisons and say many inmates admit to having unprotected sex or sharing needles with other addicts.
Dr Sutayut Osornprasop, a human development specialist at the World Bank’s office in Thailand, said sex and drug abuse is rampant in prisons despite strict bans imposed by relevant authorities.
“Top officials at the Justice Ministry won’t admit that such things happen, but in reality they do,” Sutayut said.
He said he received the information while conducting a survey alongside diseasecontrol officials over the past month or two.
“Some inmates revealed that they offered sexual favours in exchange for cigarettes or chocolate,” Sutayut said.
He was speaking at the ninth International Congress on Aids in Asia and the Pacific, which ended yesterday.
He said campaigns against Aids should extend to prisons.
“Inmates should be educated about Aids and how to guard themselves against the disease. They should have access to condoms and lubricant. Blood tests should also be provided to those who want to see if they have contracted the disease,” he said.
Sutayut said fresh needles should be available for older inmates with a drug habit.
“Younger inmates usually take methamphetamines, so they don’t need a needle, but the older inmates have different habits,” he said.
Medecins Sans Frontieres – the acclaimed medical group also known as ‘Doctors Without Borders’ – started a pilot project in three jails in and around Bangkok to provide cheap antiretroviral drugs to prisoners with HIV or Aids, and train and educate health workers, guards and prisoners about the disease.
The project was undertaken at Bang Kwang, Minburi and Pathum Thani prisons from 2003 but ended late last year.
Minburi jail director Kongkrit Pornkongtwatch said at the time he was sad the MSF project had ended and feared HIV infections would continue at the jail. “It has made a lot of improvements, as we can’t even afford a fulltime doctor here. If prisoners get infected, there is no way to protect other inmates.
“Staff in other jails need to be trained too. It’s important that prisoners be released with training and counselling [about the disease]. This is a good model for other prisons, but that is a policy decision for the Department of Corrections.”
But it is not known if the department considered the curriculum developed by MSF on treatment for prisoners with HIV with a view to replicating the project at other jails.
Former senator Jon Ungpakorn said inmates with good behaviour should be allowed conjugal visits, because this would reduce the risk of Aids.
“Since it’s normal for humans to have sex, it would be better to let inmates have sex with their spouses,” Jon advised.
He said protection should be give to sex workers, migrant workers, homosexuals, drug addicts, plus homeless and stateless people.
“These people have been marginalised and thus have limited defence against Aids. If we help them, there will be fewer Aids cases in society overall,” Jon said.