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Sentinel
09-07-2009, 01:44 PM
I am going to Adelaide. After the 3 mths, i will be going there on & off. The H1N1 & medical is a issue for me too to look after.
Thanks for the feedback, guys.
Take the necessary precautions. Apart from the washing your hands and wearing the face mask bit, just keep your immunity high and thats thru consumption of enough Vitamin C and avoid catching a chill. Adelaide is cold now and for someone from the tropics to go there, the chances of catching a cold is high. Avoid getting a chill coz that will get you a common cold and lowers your immunity... clarification : I am not a doctor, just passing on what my doctor told me when I saw him about my trip to capital city of H1N1 : Melbourne 2 weeks ago....

jimmyay
09-07-2009, 02:22 PM
Take the necessary precautions. Apart from the washing your hands and wearing the face mask bit, just keep your immunity high and thats thru consumption of enough Vitamin C and avoid catching a chill. Adelaide is cold now and for someone from the tropics to go there, the chances of catching a cold is high. Avoid getting a chill coz that will get you a common cold and lowers your immunity... clarification : I am not a doctor, just passing on what my doctor told me when I saw him about my trip to capital city of H1N1 : Melbourne 2 weeks ago....

Hi Sentinel,
I was told the Australian are no longer scared or conscious of the flu. They treat like nothing happened. How true is it by your experience?

Sentinel
09-07-2009, 03:02 PM
Hi Sentinel,
I was told the Australian are no longer scared or conscious of the flu. They treat like nothing happened. How true is it by your experience?
Not true. 28 died as of yesterday and they are not scared? Hey 28 people died - not kangaroos ok. My partners in Melbourne and Sysdney are all very worried, they do not even want to fly to KL to meet me so I had to go down to see them. Come back from Melbourne via Brunei... no quarantine, ha ha!

AllUrban
09-07-2009, 05:36 PM
Not true. 28 died as of yesterday and they are not scared? Hey 28 people died - not kangaroos ok. My partners in Melbourne and Sysdney are all very worried, they do not even want to fly to KL to meet me so I had to go down to see them. Come back from Melbourne via Brunei... no quarantine, ha ha!Not to hijack, but I remember the Minister of Health criticising other nations for not implementing pre-departure screening.

Now that Malaysia has more cases of H1N1 (including local transmission) do we see pre-departure screening in our airports?

I think you already know the answer........

Jimmyjay, if you want to avoid flu just do your best to wash your hands regularly and avoid touching surfaces, as Sentinel has advised. Masks will do little to protect you from an airborne virus if you touch a contaminated surface and then touch your face, eyes, mouth or nose.

If you do not carry soap, then buy alcohol-based hand sanitizer gel and use it regularly. The mask is up to you.

Also, the authorities in Australia, the UK and Canada are now focusing on treatment, not prevention. They are stockpiling anti viral medication and anti-influenza medication and developing a new influenza shot which will be available in October.

Hand sanitizer is sold everywhere in Canada and dispensers can now be found in found at public toilets, hospitals and shopping centres and even on public transportation (since 2003 when SARS came to Toronto).

Similar measures may already be in place in Australia.

Lastly, good luck and have a good time. :)

Cheers, m :)

Sentinel
09-07-2009, 05:57 PM
Not to hijack, but I remember the Minister of Health criticising other nations for not implementing pre-departure screening.

Now that Malaysia has more cases of H1N1 (including local transmission) do we see pre-departure screening in our airports?

I think you already know the answer........

If the developed world like US and Canada have done the departure screening, Malaysia would not have contracted that many imported cases which led to the inevitable local transmission.

I am sure if exit screening proposal has been accepted on a consensus worldwide, Malaysia would have carried out, even if it is expensive. The developed nation has no political will to carry it out.

AllUrban
10-07-2009, 02:44 PM
If the developed world like US and Canada have done the departure screening, Malaysia would not have contracted that many imported cases which led to the inevitable local transmission.

I am sure if exit screening proposal has been accepted on a consensus worldwide, Malaysia would have carried out, even if it is expensive. The developed nation has no political will to carry it out.so you are saying that Malaysia should wait for a developed country to take the lead? Yeah, sure, why not. Wait for others and follow them instead of developing integrity and do what's right, on your own.

If the Health Minister believed in pre-departure screening then he should implement it in Malaysia. Otherwise he is just...what is the phrase? Talking caulk?

Cheers, m

Sentinel
10-07-2009, 07:26 PM
so you are saying that Malaysia should wait for a developed country to take the lead? Yeah, sure, why not. Wait for others and follow them instead of developing integrity and do what's right, on your own.

If the Health Minister believed in pre-departure screening then he should implement it in Malaysia. Otherwise he is just...what is the phrase? Talking caulk?

Cheers, m
AllUrban, how can a third world country with a 27 million population take a lead in such a situation? Even if the country had taken a unilateral decision and implemented the exit screening, wouldn't you think it would help? At that stage when the Health Minister proposed the step at the WHO committee meeting, Malaysia had only just a few cases.

Most of the cases in Malaysia, Thailand, Singapore and Brunei were imported cases from countries like US, Canada and some from Australia, mainly from the US and Canada!

It is not a question of the Minister of Health of Malaysia talking kok, do you seriously think a MoH from a Third World whcih contributed just USD35 million a year to WHO, can turn the table and influence the big hypocrites G-8 countries from accepting & implementing a proposal they will find expensive, if not difficult?

I am not a fan of the MoH myself (politically speaking) but from what I hear he works till 10-11pm every night including Saturdays since the influenza A H1N1 broke out in Malaysia. Credit should be given where credit is due.

I am surprised at you for defending the selfish acts by the big countries esp US and Canada for refusing to carry out when it was proposed. It was for good of the rest of the world who are poorer and might not be able to handle if a pandemic was declared (which is now the case). Is US or Canada now going to help pay for those thousands of cases they 'exported' irresponsibly to other countries.

If you degrade Malaysian MoH for talking kok when the proposal was so viable and practicle to defend a pandemic, obviously you too don't put much weight in proposal from a small country like Malaysia. Perhaps it is not a place worth for any of us to be staying neither is any of its population worth listening to because they all talk kok?

I suppose thats the perception and attitude of rich powerful countries and selfish enough not to help the world to contain the spread of the disease.

I also hope that in your case you're not of the same attitude ie here to share your knowledge with us downtrodden Third World citizens instead of here to earn a living?

kwchang
11-07-2009, 01:53 AM
Actually I am quite proud of Malaysia's efforts to screen for A(H1N1) although it is not something cheap. I am also proud to see how the medical staff are so serious about their roles at the airports (in KLIA, at least)

I was in Schipol and Heathrow right in the initial weeks of the world outbreak and I can tell you that I never saw a single nurse or paramedic at both the airports. Schipol and Heathrow are one of the few air-transport hubs in the world. You get thousands of people passing through the international terminals everyday because these are the airports where everyone connects to another place. I can tell you the only people with face masks were a handful of Asians who are probably more afraid than the others who mingle with the huge crowds of passengers.... then I come home and the first thing I see after I get off the ramp from the plane are people standing around tables filling up the medical forms and being herded through a passage so that everyone is checked for fever via the thermal (infra-red?) cameras.

By the way, we are not implementing departure screening - what for? All our 'flu cases are imported. KLIA is not a transit hub. I believe Changi and Suvarnabhumi are more important hubs and I did not see any screening at Suvarnabhumi too. Didn't go to Chnagi so, no comments there.

chin_wan
11-07-2009, 09:16 AM
But how deadly is the H1N1?

According to WHO, only 0.4% who got it died. 94512 people got it and 429 died. See http://www.who.int/csr/don/2009_07_06/en/index.html

In fact, I think the common flu kills more people than H1N1. See ABC News (http://www.abcactionnews.com/news/local/story/Common-flu-far-more-deadly-than-swine-flu-in-U-S/SYwVqQF_3Umy0qY3qhp9zQ.cspx).

Is this all just a media hype?

EricK
11-07-2009, 12:15 PM
But how deadly is the H1N1?

According to WHO, only 0.4% who got it died. 94512 people got it and 429 died. See http://www.who.int/csr/don/2009_07_06/en/index.html

In fact, I think the common flu kills more people than H1N1. See ABC News (http://www.abcactionnews.com/news/local/story/Common-flu-far-more-deadly-than-swine-flu-in-U-S/SYwVqQF_3Umy0qY3qhp9zQ.cspx).

Is this all just a media hype?

precisely.. got all hyped up by the media.. and now people are scared out of proportion to the danger...

Sentinel
11-07-2009, 12:22 PM
precisely.. got all hyped up by the media.. and now people are scared out of proportion to the danger...
Like the "Millenium Bug" in 1999 which made computer buffs billions in the business, maybe?

Well, the good news is that number of cases daily has fallen quite drastically. Only Australia and Thailand is still not under control.

Wonder if by the time the vaccine is launched, there will be any use for it. So much is gonna go down wasted in R&D...

bugbear
11-07-2009, 03:59 PM
Malaysia will go on to the next phase of mitigation in their effort to combat this disease. Brace yourself for there will be newer guideline forbidding mass gathering and function in the future. It is call social distancing. Personal hygiene will be the new byword of the day. School might be force to close down if situation get any worse. By the way, the good news is there will be no more quarantine except in exceptional cases. People will be required to go home with their medication as though it is just a normal flu. I will keep you posted in the event of newer development.

Sentinel
11-07-2009, 11:01 PM
Malaysia will go on to the next phase of mitigation in their effort to combat this disease. Brace yourself for there will be newer guideline forbidding mass gathering and function in the future. It is call social distancing. Personal hygiene will be the new byword of the day. School might be force to close down if situation get any worse. By the way, the good news is there will be no more quarantine except in exceptional cases. People will be required to go home with their medication as though it is just a normal flu. I will keep you posted in the event of newer development.
I thought it is already in place? We are not allowed to gather together with more than 5 of us without a police permit :D coz that is considered as 'illegal assembly?

USJ27Resident
12-07-2009, 03:16 PM
We are not allowed to gather together with more than 5 of us without a police permit :D coz that is considered as 'illegal assembly?

yakah??? so going for dinner... 6 fellas/family members, who happened to wearing BLACK ... could be arrested before the meals arrived??? :eek:

Nick Chia
12-07-2009, 10:15 PM
I heard Singapore have stopped screening as they said it is a common flu and the fatality rate is so low. It may be the west way of selling their drugs for flu. Afterall Aedes mosquitoes that spread Dengi is more fatal.

bugbear
13-07-2009, 01:29 AM
I heard Singapore have stopped screening as they said it is a common flu and the fatality rate is so low. It may be the west way of selling their drugs for flu. Afterall Aedes mosquitoes that spread Dengi is more fatal.
You are quite correct Nick. That is because they have move on into the mitigation phase of pandermic containment plan. We on the other hand are going the same as they are. Always a step behind. But we learn a lot from them when we first started. It is not easy. Our daily cases used to be in the single digit but has since gone over the horizon and we cannot contain them anymore. That is why we have to widen the net to social activities to contain the disease. My stand all these while when dealing with this flu is mitigation but our MOH want to go their own way but that is not wrong entirely. They have their reason which is valid. People who are healthy do not have to fear this flu. It is only those who are sickly and having co-morbidity like heart diseases, Diabetic, HIV or immuno compromised persons need to fear. By getting this flu now we will be immunized automatically against the next wave of attack in the future.

Sentinel
13-07-2009, 01:35 AM
Bugbear, you mentioned the H1N1 flu is dangerous for those with co-morbidity like diabetes, heart diseases etc. I read also those with irregular heartbeat problem also run a high risk. How does the flu inflict these group of people with more impact?

AllUrban
13-07-2009, 11:43 AM
AllUrban, how can a third world country with a 27 million population take a lead in such a situation? Even if the country had taken a unilateral decision and implemented the exit screening, wouldn't you think it would help? At that stage when the Health Minister proposed the step at the WHO committee meeting, Malaysia had only just a few cases.

Most of the cases in Malaysia, Thailand, Singapore and Brunei were imported cases from countries like US, Canada and some from Australia, mainly from the US and Canada!

It is not a question of the Minister of Health of Malaysia talking kok, do you seriously think a MoH from a Third World whcih contributed just USD35 million a year to WHO, can turn the table and influence the big hypocrites G-8 countries from accepting & implementing a proposal they will find expensive, if not difficult?

I am not a fan of the MoH myself (politically speaking) but from what I hear he works till 10-11pm every night including Saturdays since the influenza A H1N1 broke out in Malaysia. Credit should be given where credit is due.

I am surprised at you for defending the selfish acts by the big countries esp US and Canada for refusing to carry out when it was proposed. It was for good of the rest of the world who are poorer and might not be able to handle if a pandemic was declared (which is now the case). Is US or Canada now going to help pay for those thousands of cases they 'exported' irresponsibly to other countries.

If you degrade Malaysian MoH for talking kok when the proposal was so viable and practicle to defend a pandemic, obviously you too don't put much weight in proposal from a small country like Malaysia. Perhaps it is not a place worth for any of us to be staying neither is any of its population worth listening to because they all talk kok?

I suppose thats the perception and attitude of rich powerful countries and selfish enough not to help the world to contain the spread of the disease.

I also hope that in your case you're not of the same attitude ie here to share your knowledge with us downtrodden Third World citizens instead of here to earn a living? Excuse me but I'm not defending any country here. If there is proof that the pre-departure screening was necessary then all countries should have done it.

But more importantly, when the health minister of Malaysia says that pre-departure screening is important ... then clearly there must be proof that it important ... and so it should be carried out in Malaysia without waiting for other countries.

Yes Malaysia can and should take the lead ... they have the resources ... if they can mobilize hundreds of health ministry officers for arrival screening then they can mobilize people for pre-departure screening.

If you talk the talk, you must be able to walk the walk.

As for me, I'm here to gather knowledge and be part of a community and earn a living. Gathering knowledge and being part of a community are two reasons why Im here on this forum...because great forumers like yourself, Sentinel, as well as others like Green Bug (I miss him), Silver Bird, Han2 (where has he gone), USJ27 Resident, PatrickTan, KWChang and many many others, have helped me learn alot about Malaysia and Malaysians and made me feel like Im part of a larger community.

Even if we dont agree 100% of the time..........

Cheers, m

Sentinel
13-07-2009, 01:38 PM
Have some common sense lah, at the early stage Malaysia was not an "exporting country" as far as the H1N1 flu was concerned. Why should it implement something like that when the major "exporting countries" of the flu like US and Canada did not want to do it. Unilateral actions in such cases will not work, it is as simple as that and even the "kok tokking" Minister of Health you referred to isn't that silly not to know.

The truth is these rich countries couldn't be bothered if the rest of the world gets the disease. Afterall, the propective sales of any new antiH1N1 flu vaccine is sure going to be benefitting either the US or Canada.

You may say you're not defending any particular country but your posting insinuated that the proposal for exit screening from a country like Malaysia was "kok tokking" on the part of the Minister and thus implicitly implying the rich countries were right in refusing this.

The exit screening could only work if all countries accept and implement the steps. Just look at how many cases in Malaysia were imported from these 2 countries I mentioned?

Are you saying Malaysia is not putting every effort to screen arrivals? For a third world country, it was doing its best. I was in Australia 3 weeks ago at the peak of the H1N1 flu pandemic, there were hardly any screening. From what I heard from KWChang in his earlier post, there were hardly any in UK airports as well.

Walk the talk? I think Malaysia should be proud for playing such an active and proactive role. It is the rich countries not walking the talk, hoping for a windfall for vaccine sales?

AllUrban
13-07-2009, 02:17 PM
Have some common sense lah, at the early stage Malaysia was not an "exporting country" as far as the H1N1 flu was concerned. Why should it implement something like that when the major "exporting countries" of the flu like US and Canada did not want to do it. Unilateral actions in such cases will not work, it is as simple as that and even the "kok tokking" Minister of Health you referred to isn't that silly not to know.

The truth is these rich countries couldn't be bothered if the rest of the world gets the disease. Afterall, the propective sales of any new antiH1N1 flu vaccine is sure going to be benefitting either the US or Canada.

You may say you're not defending any particular country but your posting insinuated that the proposal for exit screening from a country like Malaysia was "kok tokking" on the part of the Minister and thus implicitly implying the rich countries were right in refusing this.

The exit screening could only work if all countries accept and implement the steps. Just look at how many cases in Malaysia were imported from these 2 countries I mentioned?

Are you saying Malaysia is not putting every effort to screen arrivals? For a third world country, it was doing its best. I was in Australia 3 weeks ago at the peak of the H1N1 flu pandemic, there were hardly any screening. From what I heard from KWChang in his earlier post, there were hardly any in UK airports as well.

Walk the talk? I think Malaysia should be proud for playing such an active and proactive role. It is the rich countries not walking the talk, hoping for a windfall for vaccine sales? Common sense tells me that If I know that it is the right thing to do, then I do it. If necessary I do it unilaterally and set an example for others. If I am not going to do it then I don't talk about it.

Those "exporting countries" that you mentioned were/are not doing exit screening. Yes, they should have been doing exit screening before the disease got to this level. Now they have reasoned that all forms of screening are pointless because they have moved to the "treatment phase."

(Or, if I follow your reasoning of the "truth", they have moved to the "sit-back-and-watch-the-money-roll-in-from-the-vaccine-sales" phase.)

We could also say that if Mexico (not a rich first world country) had been doing exit screening in the first place then the disease would not have got to the US, Canada, Australia and the UK before it got to Malaysia (from the US).

The reality is that Mexico never had the chance to stop some of the first carriers from traveling because they weren't fast enough to respond to the disease. That said, they implemented some heroic measures pretty quickly - like shutting down Mexico City for nearly a week - but they weren't fast enough to prevent the first carriers from traveling.

So Mexico had no warning - but the "exporting countries" had some warning - and Malaysia talked about arrival and pre-departure screening but only implemented the former while criticizing other countries for not implementing the latter.

Mexico may only be a 3rd world country that is not rich in resources - and they got hit hard by the outbreak of the virus - but at least they didn't just tell others to do things and then not do it themselves ...

Cheers, m

Sentinel
13-07-2009, 02:30 PM
You are right, Mexico doesn't have the resources. US and Canada have the resources and they should have supported the proposal.

It was pointless for Malaysia to implement exit screening at that time because it was not an "exporting" country, please understand that first and not run down Malaysia just like that.

I think Malaysia did the right thing in making the proposal and nothing is going to change that whether or not it implemented unilaterally or not.

It is on record the rich countries esp US and Canada which rejected the proposal. These countries are super rich with resources.

kwchang
13-07-2009, 03:25 PM
PEACE guys.
I'd say both have points, altho arguements are from different perspectives.

I am planning to put up some info about A(H1N1) guidelines for the public to follow. Please bear in mind that this is not a trivial matter just yet and I will reveal all (teaser here to keep you on your toes).

We have a general thread on A(H1N1) and I will decide if I post it there (not here) or a new thread specifically on Malaysian Guidelines and Public Information. I did check the MOH website and I am sad to say it is not up to date for the current phase.

bugbear
14-07-2009, 01:25 AM
Ok guys, here is it. I have just came back from the state Influenza A (H1N1) briefing and it is official that as of 10/07/09 we are no more trying to contain this disease and will be moving onto mitigation phase. This the next level in the defence against H1N1.

Background: The H1N1 virus is actually a continuation of the 1918 Spanish flu pandermic virus abeit with newer reassortment with the incorporation of newer swain, human and avian virus components. That is why this virus is a novel influenza (H1N1) and not known as "SWAIN FLU" as our Information Minister Rais Yatim would like you to believe.

As of a few days ago, Malaysia has recorded 710 cases out of which 208 are locally made while 502 are imported cases. However, we are also recording 3rd generation local transmission spread meaning clustering of cases has now occur where epidermiological link cannot be established satisfactory. In other word, all these while we have been guarding our country against this virus by trying to screen them at the ports of entry but we fail to prevent the virus from coming in anyhow.

By going into mitigation phase, we are admitting defeat in prevention method of defence and is moving into reducing the mortality and morbidity of the disease. Now it is not a case of who will get it but when you will get it and when that occur, we will try to make sure that the mortality and morbidity rate is kept down.

For a start, there won't be anymore airport monitoring but the filling up of form will still go on. Secondly, not everybody will be quarantine now. Only those who exhibit symptoms, contact case as well as having complication from the illness will be admitted and be given Tamiflu. The rest of you who are only having mild flu or are not complicated will be given MC and adviced to go home for rest. You will be ask to self quarantine yourself while at the same time self monitor your symptoms. If you get worse, please seek treatment at nearest hospital.

Social distancing will be adviced meaning, do not get too close to others while in a crowded place. Any distant inside of 1 meter is consider a risky distant. Cough etiquette must be observe at all time. Prefarably, those who have flu (either normal flu or H1N1) should wear mask in order not to spread the virus. Please note that we will no longer swab every cases of flu from now on but only those who are admitted. Those in the high risk group should wear mask while the rest of the people should not wear mask. For one, the flimsy mask that you wear does not protect you from getting the virus and secondly you are wasting money and look uncool and silly in public. :rolleyes:

Co-morbidities / Risk factors :

1. Chronic respiratory conditions including asthma, COPD (Chronic Obstructed Pulmonary Disease).

2. Pregnant women esp. in the 2nd and 3rd trimester.

3. Morbid obesity.

4. Predisposing condition such as chronic cardiac disease, chronic illnesses like diabetic, renal failure, haemoglobinopathies, immunosuppression (HIV/AIDS, chemotherapy, long term steroids)

5. Adults more than 65 with chronic illness.

6. Children under 5 esp. those 2 and below.


Complication of H1N1/ Influenza :

1. Respiratory :- Pneumonia, upper respiratory infection, acute bronchitis.

2. Cardiovascular:- Myocarditis and Pericarditis.

3. Muscular:- Myalgia - Rhabdomyositis

4. Neurological:- Encephalitis, Reye's syndrome, Guillain barre syndrome, transverse myelitis

5. Systermic :- Toxic shock syndrome and sudden death.


Patient home assessment tool :-
The following patients home assessement tool is designed to detect moderate or severe flu and can be used to guide patient on the need to seek professional medical attention.

1. Respiratory difficulties - Shortness of breath, rapid breathing or purple or blue lips.

2. Coughing out blood or blood streak sputum

3. Persistent chest pains

4. Persistent diarrhea and / or vomiting

5. fever persisting beyond 3 days

6. Abnormal behaviour, confusion, less responsive, convulsion

7. Dizziness when standing and or reducing urine production.

AllUrban
14-07-2009, 10:42 AM
PEACE guys.
I'd say both have points, altho arguements are from different perspectives.

I am planning to put up some info about A(H1N1) guidelines for the public to follow. Please bear in mind that this is not a trivial matter just yet and I will reveal all (teaser here to keep you on your toes).

We have a general thread on A(H1N1) and I will decide if I post it there (not here) or a new thread specifically on Malaysian Guidelines and Public Information. I did check the MOH website and I am sad to say it is not up to date for the current phase.ya, fair enough.

Hand Sanitizer can be found at most pharmacies now, Dettol has a good brand. I keep a small bottle with me at all times.

Soap and water is great too. Give your hands a real scrubbing and try to avoid touching surfaces directly (like taps, door handles, telephones, etc).

Cheers, m

kwchang
14-07-2009, 11:09 AM
OK, since BugBear had already started the ball rolling, I shall move on my initial proposal to work on MOH's general guidelines for A(H1N1) and further discussions for the local community. I will start a new thread on this .. so watch out for it. Any discussions made here on the same issues will be brought to the new thread.

kwchang
14-07-2009, 03:12 PM
New thread is Important notes for Influenza A(H1N1) (http://www.usj.com.my/bulletin/upload/showthread.php?t=27303)

tesdniMa
14-07-2009, 04:57 PM
Thanks KW for starting the other thread with updated info.

Does it mean that a person is not contagious until symptoms start to show ; eg until he starts sneezing or coughing? am not clear about this becoz a doctor friend did say that one can pass on the virus during the incubation window - possibly by spreading the virus through your warm breath - thats why social distancing is important - but then again close family members will be the ones who will likely be exposed also.

If we catch it now while it is still mild , are we immune to a later more dangerous mutation ?

kwchang
14-07-2009, 05:13 PM
I am not a Doctor but I guess I understand enough of this to give my opinion. But of course, I hope the Docs will add their views and correct me where I am misled...

Does it mean that a person is not contagious until symptoms start to show ; eg until he starts sneezing or coughing? am not clear about this becoz a doctor friend did say that one can pass on the virus during the incubation window - possibly by spreading the virus through your warm breath - thats why social distancing is important - but then again close family members will be the ones who will likely be exposed also.
It is known that Influenza A (H1N1) can come on suddenly. For example, someone was fine yesterday but today he becomes very ill with high fever. It is also known that the patient is INFECTIVE one day before the onset of symptoms. So in my example, if you had been close to your friend yesterday when he was apparently healthy, you could have been infected since one day later he came down with the symptoms. The fact about infectivity is -
1 day prior to onset of symptoms, up to 7 days after the onset


If we catch it now while it is still mild , are we immune to a later more dangerous mutation ?If you get this flu today, you will be immune to the SAME flu virus later. However, if the virus mutates, it may be antigenically different from the current strain and so you may not be sure of your acquired immunity. However, if both of them are antigenically similar, there is a good chance of cross-immunity whereby you are also protected from the slightly new strain. this is the reason for new vaccines for seasonal flu - people need to be vaccinated every year because of the mutations (thus new seasonal strains)

By the way, although the Influenza A (H1N1) vaccine is coming out soon, we may not get the chance to be vaccinated so soon. The first people in line will be the health workers because we need to ensure they are protected and healthy so that they can help the sick later. This is the latest (today's news) recommendation from WHO. Then the hospitals will jab the high risk population first - check MOH's list of co-morbidities in the other thread. After that only the rest of us will be given. I have heard that for most of us, we would probably obtain the vaccine in next year's seasonal flu jab ie the 2010 vaccine which will incorporate the A(H1N1) strain vaccine.

tesdniMa
14-07-2009, 05:28 PM
The fact about infectivity is -
1 day prior to onset of symptoms, up to 7 days after the onset



I have heard that for most of us, we would probably obtain the vaccine in next year's seasonal flu jab ie the 2010 vaccine which will incorporate the A(H1N1) strain vaccine.

Thxs KW.

So - if someone has been in a situation where he could have been exposed its best he is quarantined at least for seven days or until he shows symptoms whereby he will know he has to be quarantined.

My view is no rush to get vaccinated until its been properly tested for any side-effects.

kwchang
14-07-2009, 05:41 PM
...So - if someone has been in a situation where he could have been exposed its best he is quarantined at least for seven days or until he shows symptoms whereby he will know he has to be quarantined..
Self-Quarantine is good if you have the 'flu - be a responsible citizen and don't spread it around because if you infected someone with co-morbidities, he/she may die from the infection. However, please note that we cannot say you have A(H1N1) unless you get your blood tested. Beware of the symptoms -

high fever (38degreesC or more), cough, sore throat
difficulty in breathing - shortness of breadth, rapid breathing, cynosis (lips or extremities turning bluish)

It is also known that some H1N1 positive patients did not have high fever but generally, high fever is an alert. I will put up a list of symptoms MOH looks out for.

bugbear
14-07-2009, 06:00 PM
Hey kwchang, you are doing a very good job already.

Another thing I would like to enclose here is new visitation to hospital guideline.

1. Public are discouraged from visiting the hospital as much as possible if you can help it.

2. Only 2 visitors can visit at any one time.

3. Children 12 and below are not allowed to go to the hospital.

4. Visiting hours are cut down.

Please note, that this is a guideline issued by DG and may not be reflected on the gound as some hospital might not be able to comply fully one reason or the other.

Naka
14-07-2009, 06:43 PM
If you are travelling, maybe it's a good idea to get a prescription from your local Doctor for a course of Tamiflu..... one course is 10 tablets & it costs abt A$51.00 here....take it if you got it.....peace of mind....& of course, you still have to get medical attention.

bugbear
14-07-2009, 09:42 PM
If you are travelling, maybe it's a good idea to get a prescription from your local Doctor for a course of Tamiflu..... one course is 10 tablets & it costs abt A$51.00 here....take it if you got it.....peace of mind....& of course, you still have to get medical attention.
I would not recommend taking tamiflu just for prophylaxis purposes but it is a free world. There is a fear that indicriminately taking Tamiflu can lead to the virus H1N1 being immune to it. When that happen in a year or two then we will be in big trouble. I would not mind getting the flu myself and in the process getting immunized to the disease. :)

kwchang
14-07-2009, 09:46 PM
...maybe it's a good idea to get a prescription from your local Doctor for a course of Tamiflu..... .
I had said it earlier and I should repeat myself again - please do not use Tamiflu like you are taking sweets. At the moment, this is the FINAL cure that can be used to fight the virus infection. The indiscriminate use can bring about resistance. If the resistant strain of A(H1N1) spreads, can you imagine what would happen to all of us who are at risk?

How does resistance come about? I can think of one possibility, for example, if the patient did not take the right dose or did no complete the course, it may be possible that some virus particles survived the initial treatment and then multiply to reproduce a stronger strain which in effect means you would have created a resistant strain. Today, WHO had already confirmed the existance of resistant A(H1N1) strains - Google for it and you will find easily thousands of references on this matter. Such kiasi action is selfish and dangerous. It is very common in HongKong for example. This is actually not entirely the fault of patients but mainly the fault of doctors who prescribe such medication to healthy people.

By the way, I do not think anyone can buy Tamiflu. I bet you the MOH would be stock-piling it for the expected future wave of 'flu A resurgence. Everyone should be glad that our medical service is actually prepared. We have good people there.

bugbear
15-07-2009, 12:22 AM
How does resistance come about? I can think of one possibility, for example, if the patient did not take the right dose or did no complete the course, it may be possible that some virus particles survived the initial treatment and then multiply to reproduce a stronger strain which in effect means you would have created a resistant strain. Today, WHO had already confirmed the existance of resistant A(H1N1) strains - Google for it and you will find easily thousands of references on this matter. Such kiasi action is selfish and dangerous. It is very common in HongKong for example. This is actually not entirely the fault of patients but mainly the fault of doctors who prescribe such medication to healthy people.

By the way, I do not think anyone can buy Tamiflu. I bet you the MOH would be stock-piling it for the expected future wave of 'flu A resurgence. Everyone should be glad that our medical service is actually prepared. We have good people there.
Virus are a very adaptable creature. Remember, this is a similar strain to the 1918 virus but with newer addition. This mean, this virus adapt to the condition that affect it survival. Oseltamivir or Tamiflu is a member of the class of neuraminidase inhibitors -- neuraminidase in the "N" in H1N1 -- and is widely used because it is an oral drug. In other word, Tamiflu acts by inhibiting the formation of the N component in the H1N1.

According to Dr. Jeffrey Boscamp, if oseltamivir resistance becomes widespread in the pandemic flu, it could create difficult treatment choices for physicians.

Resistance to oseltamivir is more frequent in people treated with the drug, according to Daniel Hinthorn, MD, of the University of Kansas Hospital and Medical Center in Kansas City, Kan.

If it shows up in a person who hasn't been exposed to the drug, it could be that it was transmitted from a person who had been given oseltamivir, he said.

The virus might also have undergone a genetic change to become resistant -- the "spontaneous mutation" Dr. Fukuda mentioned.

Or the virus might have recombined with other strains -- something that influenza viruses do frequently -- and derived resistance that way.

About getting Tamiflu in the open market kwchang, it is possible as any pharmacy out there can sell it to any people with a precription. We gotta watch it with the anti-viral drug folks. Now, the government is not even giving out Tamiflu to healthy flu patients anymore.

Naka
15-07-2009, 02:28 PM
I would not recommend taking tamiflu just for prophylaxis purposes but it is a free world. There is a fear that indicriminately taking Tamiflu can lead to the virus H1N1 being immune to it. When that happen in a year or two then we will be in big trouble. I would not mind getting the flu myself and in the process getting immunized to the disease. :)


Agreed but I would not like to get the H1N1 flu when travelling overseas say in some villages where medical facilities are bad.

Even on a cruise ship with 2,000 to 3,000 passengers, you think they stock a lot of Tamiflu?

Remember the folowing cases.

Source (http://www.theage.com.au/execute_search.html?text=cruise+ship+with+swine+fl u&ss=theage.com.au&x=9&y=13)

Naka
15-07-2009, 02:34 PM
QUOTE=kwchang]I had said it earlier and I should repeat myself again - please do not use Tamiflu like you are taking sweets. At the moment, this is the FINAL cure that can be used to fight the virus infection. The indiscriminate use can bring about resistance. If the resistant strain of A(H1N1) spreads, can you imagine what would happen to all of us who are at risk?
How does resistance come about? I can think of one possibility, for example, if the patient did not take the right dose or did no complete the course, it may be possible that some virus particles survived the initial treatment and then multiply to reproduce a stronger strain which in effect means you would have created a resistant strain. Today, WHO had already confirmed the existance of resistant A(H1N1) strains - Google for it and you will find easily thousands of references on this matter. Such kiasi action is selfish and dangerous. It is very common in HongKong for example. This is actually not entirely the fault of patients but mainly the fault of doctors who prescribe such medication to healthy people.



I noticed that you only partially quoted what I wrote.

I said 'if you are travelling....etc' and I am amazed & wondered why.

As for your 'such kiasi action is selfish and dangerous' statement, I have this to say. Yes, all of us have only one life. Who is not 'kiasi'? If you only have one life, you have to be selfish & look after yourself.


By the way, I do not think anyone can buy Tamiflu. I bet you the MOH would be stock-piling it for the expected future wave of 'flu A resurgence. Everyone should be glad that our medical service is actually prepared. We have good people there.[/QUOTE


So much have been said about H1N1, here is a course of Tamiflu which was purchased on 24th May 2009 ( personal details deleted) from a local Pharmacy.

http://forum.ipoh.com.my/gallery/data//500/medium/tamiflu1a.jpg

http://forum.ipoh.com.my/gallery/data//500/medium/tamiflu2a.jpg


I am glad it is still not opened yet.

This drug like all drugs is not to be abused.

bugbear
16-07-2009, 02:36 AM
QUOTE=kwchang]I had said it earlier and I should repeat myself again - please do not use Tamiflu like you are taking sweets. At the moment, this is the FINAL cure that can be used to fight the virus infection. The indiscriminate use can bring about resistance. If the resistant strain of A(H1N1) spreads, can you imagine what would happen to all of us who are at risk?
How does resistance come about? I can think of one possibility, for example, if the patient did not take the right dose or did no complete the course, it may be possible that some virus particles survived the initial treatment and then multiply to reproduce a stronger strain which in effect means you would have created a resistant strain. Today, WHO had already confirmed the existance of resistant A(H1N1) strains - Google for it and you will find easily thousands of references on this matter. Such kiasi action is selfish and dangerous. It is very common in HongKong for example. This is actually not entirely the fault of patients but mainly the fault of doctors who prescribe such medication to healthy people.



I noticed that you only partially quoted what I wrote.

I said 'if you are travelling....etc' and I am amazed & wondered why.

As for your 'such kiasi action is selfish and dangerous' statement, I have this to say. Yes, all of us have only one life. Who is not 'kiasi'? If you only have one life, you have to be selfish & look after yourself.


By the way, I do not think anyone can buy Tamiflu. I bet you the MOH would be stock-piling it for the expected future wave of 'flu A resurgence. Everyone should be glad that our medical service is actually prepared. We have good people there.[/QUOTE


So much have been said about H1N1, here is a course of Tamiflu which was purchased on 24th May 2009 ( personal details deleted) from a local Pharmacy.

http://forum.ipoh.com.my/gallery/data//500/medium/tamiflu1a.jpg

http://forum.ipoh.com.my/gallery/data//500/medium/tamiflu2a.jpg


I am glad it is still not opened yet.

This drug like all drugs is not to be abused.
I notice that this Tamiflu is actually from Australia where it is available freely from their health center. Here in Malaysia it is not as easy as in Australia. So I do not think we can compare with that.

bugbear
16-07-2009, 02:43 AM
Agreed but I would not like to get the H1N1 flu when travelling overseas say in some villages where medical facilities are bad.

Even on a cruise ship with 2,000 to 3,000 passengers, you think they stock a lot of Tamiflu?

Remember the folowing cases.

Source (http://www.theage.com.au/execute_search.html?text=cruise+ship+with+swine+fl u&ss=theage.com.au&x=9&y=13)
Again, I would like to emphasize that taking tamiflu is your choice. That is what happen all around the world. People panic and go on a mass spree of self medication and chemoprophylaxis. I believe this is not a good idea as I have pointed out above, that strain of virus (H1N1) resistant to Tamiflu has been isolated in people not exposed to the drug before. I dread to think when in 2-3 years time when the disease turn for the worse and our Tamiflu just do not work anymore. That to me is the worse case sceanario. :(

Naka
16-07-2009, 05:43 PM
QUOTE:-Again, I would like to emphasize that taking tamiflu is your choice. That is what happen all around the world. People panic and go on a mass spree of self medication and chemoprophylaxis. I believe this is not a good idea as I have pointed out above, that strain of virus (H1N1) resistant to Tamiflu has been isolated in people not exposed to the drug before. I dread to think when in 2-3 years time when the disease turn for the worse and our Tamiflu just do not work anymore. That to me is the worse case sceanario.UNQUOTE



If I am travelling & go to KK for holidys, I'll bring that Tamiflu along cos' you may have to get it from KL in case of emergency or most likely, there is a limited supply of Tamiflu in KK.

We all know that certain strain of virus (H1N1) are resistant to Tamiflu even if the patient is not exposed to Tamiflu & that mutation of the virus is on-going. In the meantime, a 100% sure-cure drug for H1N1 is months away.

If you are a Doctor in Lahad Datu & I come to you for treatment & after consultation, you said to me, " Mister, I have bad news, you got H1N1 but I don't have Tamiflu or similar." You were quick to add, " Don't worry, I'll get it from...."

I say " Doctor, I have Tamiflu. Is that good enough for the time being?"

To me, that is what that pack of Tamiflu is for.


[Off-Tropic----I know for a fact that there is a limited allocation of certain drugs from KL to KK. Some patients would rather fly to KL for treatment/follow-up than KK because they can get 3 month supply of certain drugs in KL as against 1 week supply or none in KK. Certain QE Hospital Doctor need that limited drug to treat his own patients.]

Sentinel
16-07-2009, 09:18 PM
I just saw the 8.00 o'clock news that the Australian Health Minister has forecasted "at worst scenario, Australia will have 6,000 deaths from H1N1". It now is at 22 deaths.

Naka
16-07-2009, 09:48 PM
Mass Swine Flu Vacination:-


The (H1N1) strain of influenza has infected almost 10,000 people and been linked to 19 deaths in Australia.

The Government said it was placing an advance order for 21 million courses of a vaccine that is now under development.

Federal medical officer Jim Bishop, hopes that the government could launch a nationwide immunisation drive by October 2009,warned that the virus was now infecting the population.
...........

source (http://news.theage.com.au/breaking-news-world/australia-braces-for-mass-swine-flu-vaccination-20090714-djyg.html)

kwchang
16-07-2009, 09:52 PM
Just reading the headline is insufficient because there are no statement of the way that figure was derived. Do check out Reuter's report (http://www.reuters.com/article/latestCrisis/idUSSYD537212). Some points to note -

each year a few thousand Australians die from the 'flu
currently A(H1N1) is the main 'flu in Australia
the death rate is not more than the seasonal 'flu


Final conclusion, that headline was just stating the fact of an annual event. It just happen that by statistical inference, they projected a possible outcome.

Unknown to a lot of people, such quantum of deaths is not anything new. We in equatorial Malaysia do not know what 'flu is like in colder temperate areas.

bugbear
17-07-2009, 12:34 PM
QUOTE:-Again, I would like to emphasize that taking tamiflu is your choice. That is what happen all around the world. People panic and go on a mass spree of self medication and chemoprophylaxis. I believe this is not a good idea as I have pointed out above, that strain of virus (H1N1) resistant to Tamiflu has been isolated in people not exposed to the drug before. I dread to think when in 2-3 years time when the disease turn for the worse and our Tamiflu just do not work anymore. That to me is the worse case sceanario.UNQUOTE



If I am travelling & go to KK for holidys, I'll bring that Tamiflu along cos' you may have to get it from KL in case of emergency or most likely, there is a limited supply of Tamiflu in KK.

We all know that certain strain of virus (H1N1) are resistant to Tamiflu even if the patient is not exposed to Tamiflu & that mutation of the virus is on-going. In the meantime, a 100% sure-cure drug for H1N1 is months away.

If you are a Doctor in Lahad Datu & I come to you for treatment & after consultation, you said to me, " Mister, I have bad news, you got H1N1 but I don't have Tamiflu or similar." You were quick to add, " Don't worry, I'll get it from...."

I say " Doctor, I have Tamiflu. Is that good enough for the time being?"

To me, that is what that pack of Tamiflu is for.


[Off-Tropic----I know for a fact that there is a limited allocation of certain drugs from KL to KK. Some patients would rather fly to KL for treatment/follow-up than KK because they can get 3 month supply of certain drugs in KL as against 1 week supply or none in KK. Certain QE Hospital Doctor need that limited drug to treat his own patients.]
Just to keep you in the loop, we no longer give tamiflu for healthy cases anymore. Only those who are in the high risk group will be hospitalised and be given tamiflu. FYI, where I work, we do have tamiflu too. :D

bugbear
17-07-2009, 12:40 PM
I just saw the 8.00 o'clock news that the Australian Health Minister has forecasted "at worst scenario, Australia will have 6,000 deaths from H1N1". It now is at 22 deaths.
I believe the above figure is a worse case scenario and won't be surprise if the figure do hit 6,000. In the US alone about 30,000 people died of normal flu every year.

Naka
17-07-2009, 04:26 PM
Just to keep you in the loop, we no longer give tamiflu for healthy cases anymore. Only those who are in the high risk group will be hospitalised and be given tamiflu. FYI, where I work, we do have tamiflu too. :D

Good to know that too, so we don't have to worry too much when visiting places Silam/Tengah Nipah/Segama. :D

Naka
17-07-2009, 04:28 PM
Just a note to say that for Tamiflu to be effective, it is to be taken within 48 hours of getting H1N1 .

It is not easy to differentiate Normal Flu and H1N1, so it's best to consult a Doctor.

For those with underlying sicknesses, you are likely to need more than a pack of Tamiflu because you are likely to require supporting medical facilities too.

So take care. :D

bugbear
17-07-2009, 08:45 PM
Just a note to say that for Tamiflu to be effective, it is to be taken within 48 hours of getting H1N1 .

It is not easy to differentiate Normal Flu and H1N1, so it's best to consult a Doctor.

For those with underlying sicknesses, you are likely to need more than a pack of Tamiflu because you are likely to require supporting medical facilities too.

So take care. :D
Correct Naka. So as a reminder to all, whenever you have difficulty with breathing and especially if you are in the vulnerable group do drop in to the nearest hospital for assessment. :)

Naka
22-07-2009, 06:56 PM
http://au.news.yahoo.com/a/-/latest/5742695/world-first-h1n1-vaccine-trial-underway/

bugbear
23-07-2009, 11:44 AM
http://au.news.yahoo.com/a/-/latest/5742695/world-first-h1n1-vaccine-trial-underway/
I can't wait for the trial to be underway. The way I look at it, if this vaccine is workable then it is fantastic news.

kuma
30-07-2009, 10:07 PM
Here is a recent update that's kinda freaky :eek:

CDC in the US is saying the flu could hit as much as 40% of population there and predicts several 100 thousand are going to die from it.

And, BTW, they are still referring to is as Swine Flu to hit 40% (http://www.guardian.co.uk/world/feedarticle/8626608) :D

Well...for those who have got accustomed to reading all those H1N1 news over the past few months and in true M'sian fashion beginning to ignore them ....

If this report doesn't freak you out , then? :(

Go READ THIS > BioMeds Reports published today...Who's Afraid Of The Big Bad Flu? (http://biomedreports.com/articles/most-popular/3544-whos-afraid-of-the-big-bad-flu-one-company-is-preparing-for-very-possible-worst-case-scenario.html)

Apparently, world govts are quietly freaking out about this. So it is saying that government scientists researching this pandemic flu are privately discussing amongst themselves about how scared to death they are as they see just how intelligent this virus is.

[Sorry, no time to write a condensed version. It's a very long report and since I cant C&P exerts here, you just have to follow the link and read]

Sentinel
30-07-2009, 10:14 PM
The fact that the Australian Minister of Health pointed out few weeks back they are expecting 6,000 deaths from the flu in a worst case scenario and stocking up on Tamiflu for 2 million people should have rung a bell. I tried to sound some kind of alarm here by posting the news but of all the persons, our moderator KWChang came in and said that in Australia thousands die every year of flu in winter... I can't banana him, can I?

kuma
31-07-2009, 02:48 AM
The fact that the Australian Minister of Health pointed out few weeks back they are expecting 6,000 deaths from the flu in a worst case scenario and stocking up on Tamiflu for 2 million people should have rung a bell. I tried to sound some kind of alarm here by posting the news but of all the persons, our moderator KWChang came in and said that in Australia thousands die every year of flu in winter... I can't banana him, can I?
Quote: I can't banana him, can I? Wow! Banana the Mod? That's a good 1:D

I suppose he is right in a way...stats show about 3000 die in Aust. annually due to pneumonia and influenza....BUT the percentage of that, that is related to influenza per se is believed small compared to pneumonia, which could have been caused as a result of other reasons.

6000 is expected as a result of the H1N1 virus this winter alone. This stat probably would not be including the average 3000...I think.

Anyway, much of these statements are still scare tactics so as to quickly get their budgets for the vaccines and Tamiflu and whatnot, passed through the various houses. This is desperately needed as it will help boost the economy as well.

BUT, that report in BioMed [see earlier post] is another thing altogether. If what these biochemists and govt researchers say is true....then we better be $&*% scared! :eek:

nyem
31-07-2009, 04:46 AM
I'm currently scared... it seems that local hospitals has changed their procedures not to do tests for H1N1 unless you're from the high risk groups (those already with pneumonia, TB, etc with weak immune system; and those already dead with suspected symptoms - probably for statistical purpose).

A relative just came back from one of those colleges closed for suspected infection and she currently had a fever. Can't get her to do the H1N1 test as she's not considered as high risk. The hospital she went to just gave her the normal treatment for fever.

USJ27Resident
01-08-2009, 04:38 AM
I'm currently scared... it seems that local hospitals has changed their procedures not to do tests for H1N1 unless....

A relative just came back from one of those colleges closed for suspected infection and she currently had a fever. Can't get her to do the H1N1 test as she's not considered as high risk. The hospital she went to just gave her the normal treatment for fever.

Bingo... took my wifey to see doctor... the fella takes one look at her and says normal flu.... :confused: like can guess... without swabs/tests...
... next thing u know - pay rm38 and collect 1. Paracetamol 2. Antihistamines [Piriton] .... cud have just gone to the darn pharmacy and got the same darn thing for half the price.... !

So the big question now is.... where the hell do we get tested... and no.2 - who pays for the tests???

tesdniMa
01-08-2009, 08:22 AM
From Singapore MOH site

Influenza Biosurveillance Report
Last updated on 20 July 09

MOH has been monitoring the flu situation in Singapore, to identify the strains of flu virus circulating in our community. The influenza biosurveillance programme carries out routine laboratory tests on random virus samples taken from patients in our clinics and hospitals to determine the circulating strains.

Latest data shows that 53% of samples taken from patients with influenza-like illness (ILI) are Influenza A (H1N1-2009)-positive.

This means that about 1 in 2 patients with ILI have Influenza A (H1N1-2009). As observed in other countries, this proportion will grow as the virus spreads further in the community, and displaces other influenza strains.



Close monitoring is crucial. On the one hand they tell us to seek medical attention early; then when we do so they tell us not serious and wait abt 2-3 days;

Are they adopting this strategy because the system cannot handle too many tests a day?

palmdoc
01-08-2009, 09:13 AM
So the big question now is.... where the hell do we get tested... and no.2 - who pays for the tests???

Hopefully these posts will answer your question on who should get tested:


H1N1 : Who should get tested (I) (http://medicine.com.my/wp/?p=7528)

H1N1: Who should get tested (II) (http://medicine.com.my/wp/?p=7543)

In a nutshell: the majority of patients (over 90%) who will have relatively mild, self-limiting disease, DO NOT need testing and will need only symptomatic treatment (yes, your paracetamol etc.)

The MOH (http://h1n1.moh.gov.my/) has released a Home Assessment Tool as a guide for the public on when they should seek medical attention

http://farm3.static.flickr.com/2608/3770802577_a985c2e8b0.jpg
ILI = Influenza like illness is defined as fever with cough and/or sore throat in the absence of a KNOWN cause other than influenza
Please note "runny nose" per se is NOT Flu
The Wikipedia reference on Influenza (http://en.wikipedia.org/wiki/Influenza) is worth a read.

palmdoc
01-08-2009, 09:32 AM
And in reality I think doctors understand the anxiety patients face and indeed the practical problem is that there are serious resource limitations in this country, especially with regard to testing, but the point is decision to treat would be based on clinical severity and co-morbid factors/risk factors

See Dr. David Quek's blog:

http://myhealth-matters.blogspot.com/2009/07/h1n1-flu-guidelines-is-it-non.html


The dedicated H1N1 website (http://h1n1.moh.gov.my) by the MOH is not sufficiently updated and spot-on contemporary, being at least one to 2 weeks behind, except for the daily numbers and DG update. Unfortunately the website is entirely in Bahasa Malaysia, and this may discourage some people from accessing this site...

And again, how many of our citizens bother to check with these information on a compulsive manner, daily, to keep themselves totally abreast of the most current information?

Realities of the ground however, are proving to be tricky and frustrating. With the high alert mental state among some of our citizens, there has been growing exasperation for some people (including some foreigners, visitors) when trying to seek treatment and confirmation on what appears to be influenza-like illness (ILI).

Directives from the MOH are not entirely clear, and although on paper these may look good. The interpretation of what constitutes serious symptoms always pose a dilemma and a bone of contention with many a presenting patient, who demand to know for sure, to be tested and be confirmed (or dismissed), and treated appropriately, quickly.

There has been crescendoing demands for the Tamiflu antiviral drugs, which are now under strict control and distribution by the MOH. To be fair, this rationing is to prevent indiscriminate use and the possible creation of resistant strains of the H1N1 flu bug.

tesdniMa
01-08-2009, 11:24 AM
Thxs palmdoc.

Its likely that from the home assessment guide the severe symptoms show only after three days.

High fever would be the guide for the 1st three days then?

There would be less anxiety if swab tests were made readily available -- how much of a strain on existing resources would it present? why cannot testing resources be geared up?

I get the impression that minister of health and his kakis are opening their mouths too often with nothing of substance coming out.

palmdoc
01-08-2009, 11:32 AM
Duration of the fever would be more important than "high fever" per se, hence the cut-off of 3 days by the MOH guidelines.
At the moment PCR testing for H1N1 is only available in IMR and in the Universities. IMR from what I understand, can perform about 200 PCR tests a day. These are also not cheap to do.
There are some so-called "rapid tests" for Influenza but these are not accurate enough for H1N1 screening according to Dr. Christopher Lee, so the gold standard is still the PCR test for H1N1
The message is that the majority of people will need only at most out-patient treatment. H1N1 testing is being restricted by the MOH to those referred for admission.

Naka
01-08-2009, 11:34 AM
Given Back? :D :rolleyes:

Swine flu found among pigs in NSW


http://www.thewest.com.au/default.aspx?MenuID=2&ContentID=159655

Naka
02-08-2009, 12:00 PM
Swine flu's potency


http://au.news.yahoo.com/a/-/latest/5769306/swine-flus-potency-revealed-in-report/

bugbear
03-08-2009, 11:01 AM
Duration of the fever would be more important than "high fever" per se, hence the cut-off of 3 days by the MOH guidelines.
At the moment PCR testing for H1N1 is only available in IMR and in the Universities. IMR from what I understand, can perform about 200 PCR tests a day. These are also not cheap to do.
There are some so-called "rapid tests" for Influenza but these are not accurate enough for H1N1 screening according to Dr. Christopher Lee, so the gold standard is still the PCR test for H1N1
The message is that the majority of people will need only at most out-patient treatment. H1N1 testing is being restricted by the MOH to those referred for admission.
In Sabah, we can do rt-PCR test in KK now. No need to send to IMR. I am sure there are many more center through out Malaysia that can do the same. FYI, each test cost about RM1,000.

About Tamiflu, it is only effective within 48 hours of symptoms starting and might not be too effective after that. Tamiflu works by inhibiting the production of neuraminidase which is one of the component of the H1N1 virus. Hence, if taken after the 48 hours it is of no use. It is like bolting the stable door after the horses are gone. It is also not to be taken on prohylatically in the absent of the disease. There is the fear of viral resistance occuring in the future due to injudicious usage. So be wise. :cool:

Naka
03-08-2009, 11:35 AM
Here are more info on Tamiflu

http://i750.photobucket.com/albums/xx148/uc-naka/Tamiflu%20info/tamiflu8a.jpg


http://i750.photobucket.com/albums/xx148/uc-naka/Tamiflu%20info/tamiflu8b.jpg


http://i750.photobucket.com/albums/xx148/uc-naka/Tamiflu%20info/tamiflu8c.jpg


http://i750.photobucket.com/albums/xx148/uc-naka/Tamiflu%20info/tamiflu8d.jpg



http://i750.photobucket.com/albums/xx148/uc-naka/Tamiflu%20info/tamiflu9a.jpg

http://i750.photobucket.com/albums/xx148/uc-naka/Tamiflu%20info/tamiflu9b.jpg

http://i750.photobucket.com/albums/xx148/uc-naka/Tamiflu%20info/tamiflu9c.jpg

Again, this drug like all drugs is not to be abused

palmdoc
03-08-2009, 01:15 PM
7th death reported

http://thestar.com.my/news/story.asp?file=/2009/8/3/nation/20090803111301&sec=nation

bugbear
03-08-2009, 01:48 PM
With the 7th death recorded in Malaysia, we are now faced with the grim reality of what this disease H1N1 can do. Although, the death rate is still remarkably low at 0.6% however among co-morbid patients, it is more like 30-40%. The government is doing its best to mitigate the death rate among the people but unfortunately some people still succumb to this disease. That is the reality guys.

kwchang
03-08-2009, 01:55 PM
Remember one important thing - WASH YOUR HANDS
For those who don't understand the significance of washing your hands, please read my earlier posts (especially #3) in IMPORTANT notes for Influenza A(H1N1) (http://www.usj.com.my/bulletin/upload/showthread.php?t=27303)

bslee
03-08-2009, 01:57 PM
I was told of another unfortunate death just last week and its wasn't public news. 30's male after a holiday from some local island resort. (perhaps coincidental).

bugbear
03-08-2009, 02:02 PM
I was led to believe that our deputy health minister is also one of the victim of H1N1 but that is an unconfirmed report. So it is best that we all be alert to the danger at hand.

Richard Poh
03-08-2009, 02:53 PM
I was told of another unfortunate death just last week and its wasn't public news. 30's male after a holiday from some local island resort. (perhaps coincidental).
Any ideal which island ,resort ?

palmdoc
03-08-2009, 03:52 PM
Remember one important thing - WASH YOUR HANDS
For those who don't understand the significance of washing your hands, please read my earlier posts (especially #3) in IMPORTANT notes for Influenza A(H1N1) (http://www.usj.com.my/bulletin/upload/showthread.php?t=27303)


I think everyone should read and re-read the IMPORTANT notes for Influenza A(H1N1) (http://www.usj.com.my/bulletin/upload/showthread.php?t=27303)
Whether people follow or not is another issue.

kuma
03-08-2009, 07:49 PM
Kit Siangs Warning On H1N1.

Says he....WHO director of communicable diseases, Dr Tee Ah Sian at the recent briefing he gave the National Influenza Pandemic Task Force....laid out a possible scenario for the Pandemic in Malaysia.

Based on a simulation on facts available to WHO...

* up to 5.5 Million M'sians will get H1N1

* 100K to as much as 500K will require hospitalization

* and if taking the global case fatality rate - currently at 0.66%, over 30K will die!

READ MORE HERE (http://blog.limkitsiang.com/2009/08/03/does-tiong-lai-agree-with-who-estimates-that-some-110000-to-500000-people-in-malaysia-would-have-to-seek-hospitalization-in-ah1n1-outbreak-causing-as-many-as-5500-to-28000-deaths-and-what/)

palmdoc
03-08-2009, 09:41 PM
Death toll now 8
The projected death toll is just a projection. No one knows for sure.
The point is it's up to us all and it's everyone's responsiblity to prevent this thing from spreading.
The key point is personal hygiene - cough etiquette, hand washing etc as mentioned in this forum.
Now how many deaths from H1N1 have there been in Japan for instance?

silver_bird
03-08-2009, 11:57 PM
Hospital refuse to check people with suspected virus !!!

http://thestar.com.my/news/story.asp?file=/2009/8/3/focus/4433423&sec=focus

kwchang
04-08-2009, 12:18 AM
Hospital refuse to check people with suspected virus !!!

http://thestar.com.my/news/story.asp?file=/2009/8/3/focus/4433423&sec=focus
No need to get agitated - I believe they will check those most at risk (see the co-morbidities in the "IMPORTANT notes for Influenza A(H1N1)" thread).

The current Ministry directive is to go for cluster cases - hence the request by the hospital for the complainant to get all the people he met to see if they also developed any flu symptoms.

The reason for this is because our labs are unable to handle the overload of PCR tests.

By the way, USA and other developed western countries had already stopped testing much earlier than us when their suspected cases reached the thousands. They too cannot cope.

It is our duty to do self-isolation. If you have the 'flu, please take action to prevent its spread - wear a mask to prevent your droplets from infecting others, especially your family members. Wash your hands because you will spread the virus around by touching objects around the house and your family will pick up the virus from surfaces that you had touched.

If you are not in the co-morbidity group, you will have a mild 'flu (even if it was H1N1) so don't worry.

The fact that you were alarmed is because you hadn't been reading the public announcements (and understanding them) made by the MOH recently. Perhaps the communication of the messages were not effective and perhaps they were not clear - I hope we have made it clearer in this Forum.

Let us know where it is not clear for any one of you and I am sure BugBear, Palmdoc, cskok and other doctors will be glad to clarify.

kuma
04-08-2009, 01:56 AM
The fact that you were alarmed is because [B]you hadn't been reding the public announcements (and undestanding them) made by the MOH recently. Perhaps the communication of the messages were not effective and perhaps they were not clear - I hope we have made it clearer in this Forum.

Let us know where it is not clear for any one of you and I am sure BugBear, Palmdoc, cskok and other doctors will be glad to clarify.

I think a lot of people just don't read the announcements of MOH....for whatever reason.

silver_bird
04-08-2009, 07:14 AM
No need to get agitated
No one is agitated in this forum.
Highlighted text was to prompt that some ppl's misconception of Govt's handling of A(H1N1) virus.

tesdniMa
04-08-2009, 08:00 AM
The onset of the disease began on July 23, and the teacher visited a general practitioner on July 27.

She went to the Sungai Buloh Hospital on July 30, and subsequently to the Tuanku Ja’afar Hospital in Seremban on Sunday after experiencing a shortness of breath. She was admitted to the intensive care unit where she died. Star 04/08 (http://www.thestar.com.my/news/story.asp?file=/2009/8/4/nation/4445732&sec=nation)

Condolences to family and loved ones.

Shouldn't she have been treated as a likely case and been tested. 1 week and she died. Could she have been saved if she had been tested earlier and the early treatment different ?

silver_bird
04-08-2009, 08:29 AM
Health Minister Liow : Anti-viral treatment for high-risk groups

High-risk groups, including children and pregnant women, must be given anti-viral treatment if they go to hospitals with influenza-like symptoms

# These groups must be treated fast although they had yet to be confirmed with the influenza A (H1N1) virus

# Waiting to be tested and waiting for the results could result in a delay in treatment

http://thestar.com.my/news/story.asp?file=/2009/8/4/nation/4448336&sec=nation

The key question : Who is considered "HIGH RISK" when they have yet to be confirm case ?

bugbear
04-08-2009, 02:05 PM
Health Minister Liow : Anti-viral treatment for high-risk groups

High-risk groups, including children and pregnant women, must be given anti-viral treatment if they go to hospitals with influenza-like symptoms

# These groups must be treated fast although they had yet to be confirmed with the influenza A (H1N1) virus

# Waiting to be tested and waiting for the results could result in a delay in treatment

http://thestar.com.my/news/story.asp?file=/2009/8/4/nation/4448336&sec=nation

The key question : Who is considered "HIGH RISK" when they have yet to be confirm case ?
High risk in this case are those with co-morbidity features. Please refer to my earlier reply for this. The latest communique from the DG is for all cases that have ILI (Influenza Like Illness) with co-morbid features to be treated with Tamiflu. This is irregardless of whether they are admitted or not.

However not everyone who comes to the hospital will be swab as implied by someone here. Only those who are admitted will be swab. So please don't expect to be swab every time you go to the hospital. Like what KWChang said earlier, some country just do not bother with it anymore.

I hope people just do not have this high hope of getting swab at the hospital. What we should do is to monitor ourselves and at the slightess hints of complication to go to the hospital. We must do our part to help.

palmdoc
04-08-2009, 02:39 PM
The key question : Who is considered "HIGH RISK" when they have yet to be confirm case ?

from the CDC (http://www.cdc.gov/h1n1flu/recommendations.htm)

High-risk groups: A person who is at high-risk for complications of novel influenza (H1N1) virus infection is defined as the same for seasonal influenza at this time. As more epidemiologic and clinical data become available, these risk groups might be revised.

* Children younger than 5 years old. The risk for severe complications from seasonal influenza is highest among children younger than 2 years old.
* Adults 65 years of age and older.
* Persons with the following conditions:
o Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus);
o Immunosuppression, including that caused by medications or by HIV;
o Pregnant women;
o Persons younger than 19 years of age who are receiving long-term aspirin therapy;
o Residents of nursing homes and other chronic-care facilities

As the pandemic evolves, the guidelines and recommendations will change.
The situation is fluid.
At the moment treatment is recommended for:
1. All hospitalized patients with confirmed, probable or suspected novel influenza (H1N1).
2. Patients who are at higher risk for seasonal influenza complications (see above).

Naka
04-08-2009, 05:21 PM
Pigs set for slaughter after swine flu recovery. :confused: :eek: :eek:

I don't feel like eating pork..



http://www.abc.net.au/news/stories/2009/08/04/2645580.htm

bugbear
05-08-2009, 10:17 AM
Pigs set for slaughter after swine flu recovery. :confused: :eek: :eek:

I don't feel like eating pork..



http://www.abc.net.au/news/stories/2009/08/04/2645580.htm
This piece of news just reinforced my view that pigs are the real victim here. It is no fault of their that some human infected them. In an utopia world like those written by Orson Welles as in Animal Farm, the human will be culled instead for infecting the pigs. That is why I am glad that our government did not go ahead with what the Australian authority is doing. After all the pigs in this case are very much the victim of the mis-nomenclature "swine flu".

kuma
05-08-2009, 03:37 PM
Three New Deaths Today making it 11 so far :eek:

silver_bird
06-08-2009, 08:40 AM
Patients with full-blast A(H1N1) symptoms complain they were refused throat swabs at UMMC (although private doctor recommended it) because :-

# They had not travelled abroad to countries with a high number of influenza A (H1N1) cases

# Did not came in contact with someone infected with H1N1

# Only those admitted or needed admission qualify for throat swabs

UMMC infectious disease head Prof Dr Adeeba Kamarulzaman said : "If you have flu symptoms, you should assume that you have H1N1, so rest at home"

http://thestar.com.my/news/story.asp?file=/2009/8/6/nation/4467518&sec=nation

The Ministry of Health must have more promo and information on A(H1N1) to avoid confusion and unnecessary delay among suspected patients.

Naka
06-08-2009, 08:51 AM
What you need to know about swine flu


http://www.thatslife.com.au/article.asp?ArticleID=2535&Pid=1

VeeJay
06-08-2009, 01:38 PM
Its quiet alarming, since the death toll keeps on increasing by the day, its 14 now.

Please ensure to take precautions, and keep your kids well informed. At least to me, its getting kinda of scary and with the amount of schools/class closure going on, especially in PJ area.

bugbear
06-08-2009, 02:26 PM
Its quiet alarming, since the death toll keeps on increasing by the day, its 14 now.

Please ensure to take precautions, and keep your kids well informed. At least to me, its getting kinda of scary and with the amount of schools/class closure going on, especially in PJ area.
Nothing surprise me too much nowadays especially when it is regarding H1N1. I have warn all forumers since the advent of this disease many times to not take it lightly. To my mind MOH have done a good job limiting the disease thus far but we all know that a pandemic is not always controllable. That is out of the question. What we can do is to limit the damage as much as possible. Pray that you are not one of the numbers. :o

klutch
06-08-2009, 09:46 PM
It has landed in our town OFFICIALLY !

http://sjecho.com.my/?page=article&id=961

:eek: :eek: :eek:

silver_bird
06-08-2009, 11:55 PM
A bank in Kuala Lumpur and six schools closed to prevent the spread of influenza A (H1N1).

http://www.bernama.com/bernama/v5/news_lite.php?id=430889

silver_bird
09-08-2009, 03:10 PM
18 + 8 = 26 Death

http://thestar.com.my/news/story.asp?file=/2009/8/9/nation/20090809134118&sec=nation

cml
09-08-2009, 05:20 PM
I think the issue is not so much how the virus is spreading in the country but rather what is the reponse of those responsible for the containment/prevention of the spread of the virus. No one is saying it is an easy job but the competency of those responsible is seriously questionable. I was in a flight at the earlier stages of the spread of the virus. We were given a form to fill up upon leaving the plane and they expected us to tell them of we had come from a country that had this virus. I am coming from east malaysia to west malaysia. How do we fill up a form like that . Ended up a lot of people just walked away without filling anything cos the walkway was jammed with people trying to fill up the form pressing against the glass windows as there was no where for them to write. If you have kids with you, god help you. After that they gave out forms but there was no one to collect them when we arrived and we just breezed past the entry point. Now they do not even give out any forms. As the situation gets more and more serious, the enforcement becomes more and more lax. They talk about buying the temperture scanners but it is all talk and even if they buy I dont think they have the will or the determination to do it.

We have our health minister announcing an additional deaths at a mca meeting or something like that. I would have thought that they announce more measures to control the spread of the virus. Instead the deaths are like attributed to those who are obese, have asthma and so on. It was like if you are healthy then the likelihood of dying is very little. This is the impression I get from reading those statements by the politicians/health ministry people. It is like they are lying to themselves to assure themselves that it would only affect those who have inherent medical problems. I think this is wrong, very wrong. Our neighbour have announced their latest fatality of one who does not have any medical condition, in other words the person was healthy and yet still died.

I just wish that our MOH/politicians who are responsible will take a more proactive role in congtrolling the spread of the virus.

Sentinel
09-08-2009, 06:37 PM
Something is very wrong... I think the system set up to monitor, report and control the A(H1N1) virus is very weak.

The reason for the death toll from the A(H1N1) virus to jump to this number today is because 6 deaths that occurreed from way back as August 3 were only picked up by MoH today and reported...

If they do not even know there were deaths from August 3, how could preventive measures have been implemented, like additional monitoring and quarantine those around the victim?

I believe the MoH has screwed big time this time. While other countries are seeing improvement, our numbers are increasing hypothetically.

ysgst
09-08-2009, 10:00 PM
From my understanding, if a person were to have ILI (Influenze Like Illness) one has to assume that they have H1N1 as the rate is 95% now (refer to http://myhealth-matters.blogspot.com/search?updated-max=2009-08-05T23%3A36%3A00%2B08%3A00&max-results=7)

But they are saying that all ILI's are to stay home and rest well and HOPE to recover. If it worsens then only proceed to seek medical help, and if the conditions are met, then TAMIFLU will be prescribed.

Is it me or something doesn't sound right here? Tamiflu has to be taken within 48 hours from the onset of symptoms so if one were to wait 3 days, the anti-viral treatment will not be as effective anymore.

If the fear of resistant cases is the reason as claimed, then the US,UK and other developed countries should be the ones to stopp using the drugs for prevention purposes. And we should use the drugs for treatment NOW.

And the resistance is referred to the H1N1 resistant strain (the virus) not the person who takes the drugs (anti-virals).

I am so worried about the death rate going up everyday. Paranoid about going out nowadays.

pepsi
09-08-2009, 10:34 PM
I heard that a lot of people are getting flu. Fever with vomitting and diarrhoea especially children. Going by the info of A (H1N1) symptoms, almost everyone down with flu has it. But only those who are really, really sick with fever above 38 celcius, underlying medical conditions and have breathing difficulties are seriously considered for further examination. Otherwise, they will sent you home with antibiotics, paracetamol and vitamin C.
MC 2 days only and pray that within 2 days we recover fully and do not spread it while working in an aircond office. If condition deteriote go back and see the doctor.

How can it not spread ? Early detection doesn't make any difference. MC only 2 days and when you go see the doctor, the patients in the waiting room don't even wear a mask. So even visiting the doctor or the hospital is risky.
The irony the hospital staff would be wearing masks and they sent patients home if they failed the minimum requirement A(H1n1) list.
What they fail to see is that once it spreads it will get them eventually.

bugbear
10-08-2009, 08:28 AM
I think the issue is not so much how the virus is spreading in the country but rather what is the reponse of those responsible for the containment/prevention of the spread of the virus. No one is saying it is an easy job but the competency of those responsible is seriously questionable. I was in a flight at the earlier stages of the spread of the virus. We were given a form to fill up upon leaving the plane and they expected us to tell them of we had come from a country that had this virus. I am coming from east malaysia to west malaysia. How do we fill up a form like that . Ended up a lot of people just walked away without filling anything cos the walkway was jammed with people trying to fill up the form pressing against the glass windows as there was no where for them to write. If you have kids with you, god help you. After that they gave out forms but there was no one to collect them when we arrived and we just breezed past the entry point. Now they do not even give out any forms. As the situation gets more and more serious, the enforcement becomes more and more lax. They talk about buying the temperture scanners but it is all talk and even if they buy I dont think they have the will or the determination to do it.

We have our health minister announcing an additional deaths at a mca meeting or something like that. I would have thought that they announce more measures to control the spread of the virus. Instead the deaths are like attributed to those who are obese, have asthma and so on. It was like if you are healthy then the likelihood of dying is very little. This is the impression I get from reading those statements by the politicians/health ministry people. It is like they are lying to themselves to assure themselves that it would only affect those who have inherent medical problems. I think this is wrong, very wrong. Our neighbour have announced their latest fatality of one who does not have any medical condition, in other words the person was healthy and yet still died.

I just wish that our MOH/politicians who are responsible will take a more proactive role in controlling the spread of the virus.
I believe the reason you did not see anymore scanner and form being given out is because the MOH has moved from containment phase into the mitigation phase of combating the disease as of July 10.

jan tomaswaki
10-08-2009, 08:45 AM
Something is very wrong... I think the system set up to monitor, report and control the A(H1N1) virus is very weak.

The reason for the death toll from the A(H1N1) virus to jump to this number today is because 6 deaths that occurreed from way back as August 3 were only picked up by MoH today and reported...

If they do not even know there were deaths from August 3, how could preventive measures have been implemented, like additional monitoring and quarantine those around the victim?

I believe the MoH has screwed big time this time. While other countries are seeing improvement, our numbers are increasing hypothetically.
Read in today's SUN pg 4 what a stupid and ridiculos on preventive H1N1.The DR.... ask everybody to stop masturb... to prevent H1N1 but can have normal sex union...?????what is talking about....

bugbear
10-08-2009, 10:41 AM
Read in today's SUN pg 4 what a stupid and ridiculos on preventive H1N1.The DR.... ask everybody to stop masturb... to prevent H1N1 but can have normal sex union...?????what is talking about....
Really ah????? Can post the link here?

zap188
10-08-2009, 11:22 AM
Really ah????? Can post the link here?
http://www.sun2surf.com/article.cfm?id=36681

bugbear
10-08-2009, 05:17 PM
http://www.sun2surf.com/article.cfm?id=36681
Interesting idea but rather unconventional. Any takers? :D

kuma
11-08-2009, 02:14 AM
Doubts are now being cast on administering antiviral drugs to children for swine flu.

Read BBC Report (http://news.bbc.co.uk/2/hi/health/8193012.stm)

Naka
11-08-2009, 08:02 AM
Kids and Tamiflu:-


http://au.news.yahoo.com/a/-/world/5793156/kids-with-flu-hould-not-take-tamiflu/

Naka
11-08-2009, 08:06 AM
Read in today's SUN pg 4 what a stupid and ridiculos on preventive H1N1.The DR.... ask everybody to stop masturb... to prevent H1N1 but can have normal sex union...?????what is talking about....



Most children are not into sex yet....so? :confused:

Sugarfree
11-08-2009, 08:29 AM
Read in today's SUN pg 4 what a stupid and ridiculos on preventive H1N1.The DR.... ask everybody to stop masturb... to prevent H1N1...i'm most puzzled. what is urmm...masturb, huh? :p :D

*kidding*

wsl
11-08-2009, 11:34 AM
My brother in law in Canada said that the government there ordered the H1N1 vaccine for its citizen. Is there such a vaccine? Has our MOH ordered this vaccine?

cml
11-08-2009, 12:01 PM
I'm sure that we have and all the 'big' people have already taken their shots, otherwise they would not dare to go around and talk rubbish and shake hands and shake legs !! These are things that the msm dont report. Asking people to stay at home if they have the symptoms and 'hope' that it does not get any worse. If if does get worse then be prepared to go on a merry go round to get it tested and heaven forbid be able to get the mediction for it!!

ysgst
11-08-2009, 12:06 PM
My brother in law in Canada said that the government there ordered the H1N1 vaccine for its citizen. Is there such a vaccine? Has our MOH ordered this vaccine?

the vaccine is not available to the public yet, under going trials. this is the best bet that we can bet on right now, to pray that we will have our share of the vaccines as soon as it becomes available.

Anyone knows when? Bugbear? Or if our govt has placed any orders? US pre-ordered enough for half of their population and UK's pre-order is suff for their entire population even if it needs 2 shots for suff protection.

bugbear
11-08-2009, 01:00 PM
the vaccine is not available to the public yet, under going trials. this is the best bet that we can bet on right now, to pray that we will have our share of the vaccines as soon as it becomes available.

Anyone knows when? Bugbear? Or if our govt has placed any orders? US pre-ordered enough for half of their population and UK's pre-order is suff for their entire population even if it needs 2 shots for suff protection.
Going by initial report our government has put in an order of 200,000 doses which is peanut as compared to Australia (21 millions), France (94 millions). However, this vaccine is still on trial and will only be available sometime in the next 1-2 months I hope barring any complication that is. I have had patients and public calling my up today as to the government offer of vaccine jab to the public as announced on TV yesterday to which my reply is "uh-uh" :confused:

Being a rather insignificant country, Malaysia was only accorded 200,000 dosages possibly because the bigger nations has cornered the major share in time for their winter season. So, we will have to ration at best the little we have for our front line health care workers as well as high risk group of our population. As for the rest, you will have to take your chance with the H1N1. :cool:

Sentinel
11-08-2009, 01:05 PM
As at today 11.08.2009, the number of deaths resulting from the A(H1N1) virus, as reported by the MoH, stands ar 38, 6 more in the last 24 hours.

Richard Poh
11-08-2009, 02:07 PM
Read from Star paper , 1688 people from 174 country died of HINI related virus. I average it : 1688 divide by 174 = 9.7 poor soul per country. Our country reported 32 poor soul. So does that make us i TOP of the LIST. ?

Sentinel
11-08-2009, 02:13 PM
Read from Star paper , 1688 people from 174 country died of HINI related virus. I average it : 1688 divide by 174 = 9.7 poor soul per country. Our country reported 32 poor soul. So does that make us i TOP of the LIST. ?The official number as of this morning was 38, Richard. We are also No. 1 if you divide 38 by 27 million in terms of "incidence"... Malaysia Boleh!

gtl
11-08-2009, 02:55 PM
IMHO, the country are not prepared to handle H1N1.

Naka
11-08-2009, 03:51 PM
I think the situation in Boleh is not good at all.


H1N1 deaths--11/8/09

Boleh------2253 infected--------38 deaths

http://thestar.com.my/news/story.asp?file=/2009/8/11/nation/20090811122343&sec=nation



Australia ------infected 27,633----95 deaths

http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/updates-16August09.htm

Sukdershan
11-08-2009, 03:52 PM
IMHO, the country are not prepared to handle H1N1.
Read:

http://www.nhsdirect.nhs.uk/

:D

Richard Poh
11-08-2009, 04:05 PM
IMHO, the country are not prepared to handle H1N1.
Again Politician take the main stage . No need to explain anymore . Cheers ...
damn ..forget my liver pill.

VeeJay
11-08-2009, 11:38 PM
some traditional medicine practitioner (including chinese and indian) have been recommending cinnamon intake.

Google would give some detailed results..one of...
http://www.chinadaily.com.cn/china/2009-06/24/content_8317365.htm

bslee
12-08-2009, 12:31 AM
I think this disease is swiftly becoming a pandemic and our gahmen is still so cool about it. I think they should start thinking of emergency or proceedures to minimize the spread. Just the news just now reported the Pahang princess and her 5 children are in hospital. This IS SERIOUS!.. better stay at home and not go out UNLESS VERY NECESSARY...NO TEH TARIK sessions folks!

Sukdershan
12-08-2009, 03:26 AM
I think the situation in Boleh is not good at all.


H1N1 deaths--11/8/09

Boleh------2253 infected--------38 deaths

http://thestar.com.my/news/story.asp?file=/2009/8/11/nation/20090811122343&sec=nation



Australia ------infected 27,633----95 deaths

http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/updates-16August09.htm
On the flip side we will develop herd immunity faster.

cml
12-08-2009, 08:58 AM
I do not think that very much will move unless some 'vip' dies from the virus and then probably some real action can and will take place. That's how our feudalistic thinking bureaucracy works. Correct me if I am wrong and I stand corrected if proven otherwise.

bugbear
12-08-2009, 10:14 AM
I think the situation in Boleh is not good at all.


H1N1 deaths--11/8/09

Boleh------2253 infected--------38 deaths

http://thestar.com.my/news/story.asp?file=/2009/8/11/nation/20090811122343&sec=nation



Australia ------infected 27,633----95 deaths

http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/updates-16August09.htm
The above figure may appear damning but the number of infected cases (2253) is actually under reported. Ever since we moved on to the mitigation phase, we only do swab testing on in patients only and neglected the outpatient. As we all know that is where the real number is. What I do not understand is the newspaper fixation with the daily figure published since the government has already stated that the number of cases is no longer important. What we are picking up are but the tip of the iceberg. My sentiment is that the number 2253 is not accurate. The global death rate for H1N1 is still very much stand at 0.6%. Working on that assumption, our infected cases should actually be around 7000 cases which is much lower than that of Australia.

The other public perception that the MOH is not doing enough to combat this disease is mere perception. What they do not see behind the scene does not mean the MOH is lax in their duty to the nation. ICU beds across the board are maxed up not to mention outpatient and emergency department. In some hospital, the jump of patient arrival doubled or tripled which placed tremendous strain on the public health services. MOH just placed another order of RM21 millions for Tamiflu.

H1N1 is a pandemic which mean that it is a global disease and not just confined to a particular location. It is a fact that the disease is here to stay. What we can do is to mitigate and reduce the mortality and morbidity. Public education of the disease is a must. In this way, we the public can do our part to prevent the spread of this disease. Social distancing of 1 meter is an effective measure of prevention. Cancellation of public event that is of no important is a must. Personal hygiene is of utmost important. Above all, keep a good ventilation of your home. Shut off aircon if possible and open the drape.

I hope with that, we will all survive this pandemic intact and God speed in our healing when we are down with the disease.

VeeJay
12-08-2009, 10:49 AM
Suprisingly death is very low in UK....

Infected :12,470 and Death: 40

Raikonen
12-08-2009, 11:13 AM
Suprisingly death is very low in UK....

Infected :12,470 and Death: 40

Maybe their healthcare is better in terms of response and treatment procedures?

tsd
12-08-2009, 11:15 AM
very scary...

any death today ?

Richard Poh
12-08-2009, 11:19 AM
not scary ..but very very scary .

VeeJay
12-08-2009, 11:33 AM
Maybe their healthcare is better in terms of response and treatment procedures?

They do have initial screening done on the phone... medical hotline!

LMei
12-08-2009, 03:39 PM
Just read this (http://www.nowpublic.com/health/why-not-use-medical-mask-during-h1n1-swine-flu-hype).

A note to add is if you are having the flu then you should wear the mask.

Sentinel
12-08-2009, 03:46 PM
Looks like the virus does not recognise your status...

http://www.thestar.com.my/news/story.asp?file=/2009/8/12/nation/20090812120720&sec=nation

LMei
12-08-2009, 04:33 PM
Yes but your status will get instant treatment. I've read articles of people with symptoms being refused throat swabs cos no fever or in contact with anyone from overseas!

Sentinel
12-08-2009, 08:34 PM
Anyway the death number is up by 6 from 38 to 44...

cetan
12-08-2009, 09:43 PM
Can anyone please report on schools around USJ and Subang Jaya.

I told my kids not to go to school from tomorrow until ................., i don't know.
I am worried.

Naka
13-08-2009, 08:52 AM
Counterfeit Tamiflu.


http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/health-swine_influenza-index.htm

tsd
13-08-2009, 09:08 AM
Looks like this thing is out of control already, I feel the best way now is to boost your own body strength to fight this virus.

I suggest the MOH should step in help to boost immune system of everyone living in the country by giving out free Vit-C or other stuff that can help boost the body resistance against flu. That way less people infected, soon the H1N1 it will go away by itself.

PeterLee
13-08-2009, 09:13 AM
The above figure may appear damning but the number of infected cases (2253) is actually under reported. Ever since we moved on to the mitigation phase, we only do swab testing on in patients only and neglected the outpatient. .

My staff with symptoms of H1N1 went to SJMC and after 2 visits was admitted for 3 days. During post hospitalisation check up, he asked the doctor:Am I suffering from H1N1.
Doctor: Most likely
Patient: Why not you did throat swab on me?
Doctor: You are not in high risk group. don't worry, anyway you are recovering.
That's the scenario at the most expensive hospital in this region.

QuietStorm
13-08-2009, 09:34 AM
I told my kids not to go to school from tomorrow until ................., i don't know.Mine aren't going to school today & tomorrow. Since the school exams are over and this H1N1 thingy is getting to be a real pain, I thought it wouldn't be a bad idea to let them chill at home. One drawback, though. The noise level increases threefold! :p
Doctor: You are not in high risk group.It is easy to be in the non-high risk group. Stay at home! :D

nyem
13-08-2009, 09:47 AM
Looks like for private hospitals: they'll admit you for the slightest of symptoms when chances of recovery is high; they won't do tests for H1N1 immediately as if confirmed they had to send you to public hospitals instead, reducing their chance of collecting more money from you. In a way this help reduce the number of people warded in public hospitals.

Richard Poh
13-08-2009, 10:58 AM
With Private Hosp. now ok by the Gomen . Health care for all will improve for sure .(HINI stuff) .

VeeJay
13-08-2009, 11:29 AM
BTW, the designated hospital to go for H1N1 are

SELANGOR

HOSPITAL TENGKU AMPUAN RAHIMAH KLANG
41200 Klang
No. Telefon : 03-33757000
No. Fax : 03-33749557

HOSPITAL SUNGAI BULOH
47000 Sungai Buloh
No. Telefon : 03-61454333
No. Fax : 03-61454222

W.P. KUALA LUMPUR

HOSPITAL KUALA LUMPUR
No. Telefon : 03-26155555
No. Fax : 03-26911681
http://www.hkl.gov.my

INSTITUT PERUBATAN RESPIRATORI
Jalan Pahang
50586 Kuala Lumpur
No. Telefon : 03-40232966 (IPR)
No. Fax : 03-40218807 (IPR)

PUSAT PERUBATAN UNIVERSITI MALAYA
Lembah Pantai,
59100, Kuala Lumpur.
No. Telefon : 03-79494422
No. Fax: 03-79572253
Email : ummc@ummc.edu.my


Also read on how to identify the flu...
http://malaysianmirror.com/featuresdetail/43-features/8042-what-you-need-to-know-about-influenza-a-h1n1

tsd
13-08-2009, 12:22 PM
another 7 death, hide at home now ?

bugbear
13-08-2009, 12:28 PM
another 7 death, hide at home now ?
Hide in the cave better. :D

waga
13-08-2009, 12:33 PM
its getting scarier.....today announced on staronline...latest news...another 7 death....making it a total 51

http://thestar.com.my/news/story.asp?file=/2009/8/13/nation/20090813114148&sec=nation


make me nervous and difficult or scare to move around in air conditioned joints....Why cant the MoH oso mentioned where d area or at least the district where the death happened?..we can at least be more extra cautious if we know it happened near us...like eg USJ (touchwood)....

mikasa
13-08-2009, 12:34 PM
Hide in the cave better. :D

hi,


:D :D

jz n home better la

bugbear
13-08-2009, 12:39 PM
its getting scarier.....today announced on staronline...latest news...another 7 death....making it a total 51

http://thestar.com.my/news/story.asp?file=/2009/8/13/nation/20090813114148&sec=nation


make me nervous and difficult or scare to move around in air conditioned joints....Why cant the MoH oso mentioned where d area or at least the district where the death happened?..we can at least be more extra cautious if we know it happened near us...like eg USJ (touchwood)....
No lah waga, the disease is all around now. No need to tell you where already. Just look at your back yard, it is there. :D :D :D

Naka
13-08-2009, 03:51 PM
I think it's best to follow official figures & this is as of 13/8/09

Boleh

xxxx infected-----deaths---51


http://www.bernama.com/bernama/v5/newsindex.php?id=432517

Ozzie

28,987 infected------deaths---102

http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/updates-16August09.htm

robertec
13-08-2009, 04:24 PM
Dear all

I am trying to get some literature on the Prevention of the H1N1 Virus to be mailed to all SJ Alert members.

But I can't seem to find any. I visited the
http://h1n1.moh.gov.my but the site seems to be overloaded and can never actually load properly.

I understand that there are some flyers around maybe some of you would like to help me get them.

Thanks

umadavid
13-08-2009, 04:37 PM
Another 6 deaths brings total to 44 deaths

http://thestaronline.tv/default.aspx?vid=3940

robertec
13-08-2009, 04:40 PM
I think the death is now at 51...

At this rate it could easily run into hundreds if not thousands.

We really need to educate the people, fast....

bugbear
13-08-2009, 04:45 PM
Dear all

I am trying to get some literature on the Prevention of the H1N1 Virus to be mailed to all SJ Alert members.

But I can't seem to find any. I visited the
http://h1n1.moh.gov.my but the site seems to be overloaded and can never actually load properly.

I understand that there are some flyers around maybe some of you would like to help me get them.

Thanks
You could also go to the nearest health department in your area for more info.

Naka
13-08-2009, 04:46 PM
Dear all

I am trying to get some literature on the Prevention of the H1N1 Virus to be mailed to all SJ Alert members.

But I can't seem to find any. I visited the
http://h1n1.moh.gov.my but the site seems to be overloaded and can never actually load properly.

I understand that there are some flyers around maybe some of you would like to help me get them.

Thanks


I think if ppl observe some simple preventive measures, it should go a long way to contend this disease.

#3

http://www.usj.com.my/bulletin/upload/showthread.php?t=27303

robertec
13-08-2009, 05:36 PM
You could also go to the nearest health department in your area for more info.

I know, problem is I am presently traveling.

Just frustrates me when so many people just take the "tidak apa attitude" at the Shopping Malls, Airport, Exhibition Halls and gatherings.

Naka
13-08-2009, 06:46 PM
I think this link is very good for those who want to know more H1N1:-


http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/businesscomm

robertec
13-08-2009, 07:48 PM
Thanks for the link.

In any case the http://h1n1.moh.gov.my link suddenly became active.

So I got all my information from there.

Thanks Guys..

Watch out for the posters.

Carolrasiah
13-08-2009, 10:38 PM
Hide in the cave better. :D

yea...........i might do just that...........& have KFC , MD & pizza delivered at my cave door.............armed with DEtol for the delivery guy............... :D :D :D :D :)

fRaNkY
13-08-2009, 10:55 PM
yea...........i might do just that...........& have KFC , MD & pizza delivered at my cave door.............armed with DEtol for the delivery guy............... :D :D :D :D :)

you dont know if people coughed at your food :eek: :eek: .... better bread/butter or biscuit. :D :D

Carolrasiah
13-08-2009, 11:34 PM
you dont know if people coughed at your food :eek: :eek: .... better bread/butter or biscuit. :D :D
yea..........good idea...............will stock up the bread/butter or biscuit stuff....maybe if i suspect ................ :D :D :D :D :rolleyes:

mikasa
14-08-2009, 11:35 AM
yea..........good idea...............will stock up the bread/butter or biscuit stuff....maybe if i suspect ................ :D :D :D :D :rolleyes:

hi,
ur all dun't like this, makam biscuit only. :D : :D ...later got health problem also... :p

robertec
14-08-2009, 03:53 PM
5 more dead today bringing total to 56.

And there are still 27 cases in ICU.

Everyone has to be Alert.

Richard Poh
14-08-2009, 04:29 PM
we are screwd.

waga
14-08-2009, 04:53 PM
Now is even more scarier.....Tamiflu medicine has cases of resistance to d effect of this drug !....Guess we need to practise 1st class personal hygiene...

http://www.straitstimes.com/Breaking%2BNews/Singapore/Story/STIStory_416687.html

understand tat d virus mutate n gets stronger....

Sentinel
14-08-2009, 05:23 PM
And guess what... the MoH Liow Tiong Lai has issued a directive to all doctors... "treat all flu cases as if they are A(H1N1) flu...." aiyoh, scary lah....

tsd
14-08-2009, 05:43 PM
And guess what... the MoH Liow Tiong Lai has issued a directive to all doctors... "treat all flu cases as if they are A(H1N1) flu...." aiyoh, scary lah....

aiyoo... everyone have to buy the tamiflu ah... one doctor visit RM300 ?

they should spend effort helping everyone building a stronger body resistance. Create a cleaner environment so people can stay healthy, even kena H1N1, it wont be that severe.

Sentinel
14-08-2009, 05:52 PM
they should spend effort helping everyone building a stronger body resistance. Create a cleaner environment so people can stay healthy, even kena H1N1, it wont be that severe.How can that happen?

zero04
14-08-2009, 09:01 PM
anyone has the statistic on how many children or babies fatality now?

Naka
14-08-2009, 09:06 PM
anyone has the statistic on how many children or babies fatality now?

You are talking abt Malaysia? I dun think they want you to know....the least the better, no? :confused:

Now there is no record of the total numbers infected in Boleh & also they do not want you to know the Hotspot too :eek:

http://thestar.com.my/news/story.asp?file=/2009/8/14/nation/20090814151504&sec=nation

In Australia, Melbourne was & is known as the Swine Flu capital city for at least 3 months now.

kuma
14-08-2009, 09:57 PM
You are talking abt Malaysia? I dun think they want you to know....the least the better, no? :confused:

Anything new?

tsd
14-08-2009, 10:21 PM
How can that happen?

few years back, few of us kena dangue in the office. Everyone admited into hospital... all of us stayed for about 1 week, all experience bone pain, vommit and etc... with the exception of one guy, who was discharged the next day. We are all hit by the same virus, why does he heal much faster than all of us.

We started to observe him.. and we notice that the food he take is so much different from us. He dont take iced water, he bring his own fruits every day... consumes lots of garlic whenever we eat out together. He told us he also take lots of vitamins and other healthcare products and also exercise regularly.

ksj_cool
15-08-2009, 12:33 PM
Somebody here wrote that he has to spend RM300 on a tamiflu anti viral tablet..for yr info most clinics don't have it! So if you are in the high risk group plz search for a clinck which has ready stock, so that you can get the medication immediately.

Naka
16-08-2009, 03:48 PM
So this is the official figures.

Malaysia----3,857 infected-----62 deaths

http://thestar.com.my/news/story.asp?file=/2009/8/16/nation/20090816115416&sec=nation

Ozzie------29,833 infected----108 deaths

http://www.healthemergency.gov.au/internet/healthemergency/publishing.nsf/Content/updates-16August09.htm

cml
17-08-2009, 11:42 AM
Dont know when all these will come to an end. Really keeping my fingers crossed.

palmdoc
17-08-2009, 11:44 AM
So what's the real H1N1 mortality rate in Malaysia anyway? (http://medicine.com.my/wp/?p=7685)

waga
18-08-2009, 01:22 PM
Indonesia...est population 200 million...oso have hugh amount of tourists...own people oso travel in n out of country...so how come for H1N1 ..only got 4 deaths..up to yesterday...

http://www.straitstimes.com/Breaking%2BNews/SE%2BAsia/Story/STIStory_418187.html

bugbear
18-08-2009, 01:27 PM
Indonesia...est population 200 million...oso have hugh amount of tourists...own people oso travel in n out of country...so how come for H1N1 ..only got 4 deaths..up to yesterday...

http://www.straitstimes.com/Breaking%2BNews/SE%2BAsia/Story/STIStory_418187.html
Most likely under reporting. :p

QuietStorm
18-08-2009, 01:31 PM
Indonesia...est population 200 million...oso have hugh amount of tourists...own people oso travel in n out of country...so how come for H1N1 ..only got 4 deaths..up to yesterday...I know! All that smog killed most of the H1N1 viruses! :p

maxima
19-08-2009, 09:18 AM
Korea just reported that the Korean food Kim Chi has been proven to help resist H1N1 effectively. It is no wonder because Kim Chi contains abundance of vinegar, chili, and enzymes. Raw coconut water which contains enzymes was also reported to be a good herbal prevention of H1N1. Of course, so are raw organic vinegar, raw fruit juice, and enzyme drink.

Good and cheap raw organic vinegar like Bragg's apple cider vinegar (about$18) is available at Giant supermarket. Leave a cup of vinegar on table can also help sterilize the air in a room.

fRaNkY
20-08-2009, 08:26 PM
Just heard that you need RM60,000 to be admitted to SJMC for H1N1 case :(

Naka
20-08-2009, 09:05 PM
Just heard that you need RM60,000 to be admitted to SJMC for H1N1 case :(


Sounds beri beri expensive....are you sure?...must be a very terrok patient with acute underlaying sicknesses. :eek:

gtl
20-08-2009, 09:47 PM
what's happening in Msia, have not been back for 3 weeks, suddenly the whole country is in the H1N1 death grip?

tesdniMa
21-08-2009, 08:09 AM
During the Care Campaign, 85 private clinics in the country will sell a box of 10 FluHalt (Oseltamivir Phosphate) capsules manufactured by Ranbaxy Malaysia at RM80, instead of the usual price of RM180.

Participating clinics can be identified with the sign ‘Klinik Cegah dan Rawat Influenza A(H1N1)’ on the door.

Star (http://thestar.com.my/news/story.asp?file=/2009/8/21/nation/4559812&sec=nation)

Great news reporting - just like road signs here -- lead halfway and then leave you in the dark.

Does anyone have a list of these clinics or any pharmacies where h1n1 anti-virals are available?