Published Date: 2009-10-16 18:00:06
Subject: PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (70): Nepal
Archive Number: 20091016.3563

INFLUENZA PANDEMIC (H1N1) 2009 (70): NEPAL
******************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 15 Oct 2009
Source: Republica [edited]
<http://www.myrepublica.com/portal/index.php?action=news_details&news_id=10815>


Swine flu appears among masses
------------------------------
Influenza pandemic (H1N1) 2009 virus infection -- otherwise known as swine
flu -- has now appeared among the masses, the Health Ministry said at a
press conference Thursday [15 Oct 2009]. "While the previous confirmed 36
cases had travel or contact history, we have now found the virus in persons
who have no history of travel and have not come into contact with a
confirmed patient," deputy coordinator of the Avian Influenza Control
Project Dr Jitendra Man Shrestha said.

Dr Shrestha said that random tests done on 46 common flu patients at Patan,
Bir, Teaching, and Kanti hospitals in the Valley showed that 3 of them had
the [pandemic 2009] virus. The trio had no travel or contact history with
swine flu. Similarly 2 more in the Valley, including a foreigner, have been
confirmed infected by the virus. Likewise, 3 out of 6 patients currently
being treated for viral fever in Chitwan have also tested positive.

A strange viral fever [one of several reported recently in ProMED-mail],
that has affected hundreds in Chitwan since August [2009], has also claimed
3 lives. "We will try to trace the relatives of the 3 deceased and find out
if they had shown symptoms of swine flu [pandemic (H1N1) 2009 virus
infection]," director of the Epidemiology and Disease Control Division Dr
Garib Das Thakur said. Dr Thakur also said that additional samples will be
brought from Chitwan on Friday [16 Oct 2009].

Speaking at the press conference, health secretary Dr Sudha Sharma said
that the strategy of the government now has to be changed. "We will now
focus on treatment and tracing of patients instead of scanning them at
border checkpoints and the airport," Sharma said. The health officials
mobilized there will now be used in treatment.

Director general of the World Health Organization (WHO) Dr Margaret Chan on
7 Sep 2009 during her Nepal visit for a regional WHO conference advised the
Nepal government to stop screening passengers for the virus saying it is
very hard to detect the virus and most infected persons don't even show the
symptoms. Instead use the manpower for other diseases, she had said.

The ministry has urged people to follow the preventive measures it had
previously advised. It has also advised patients with basic flu symptoms
not to panic and to seek medical consultation only if they have difficulty
in breathing and sore throat, or if they also have difficulty in drinking
and are pregnant.

The Ministry said that a stock of Tamiflu [oseltamivir] sufficient for
treatment of 36 000 patients is available in Kathmandu while major
hospitals outside the Valley also have enough Tamiflu to treat 200 patients
each. "Only the high risk groups like pregnant women, children, patients
with other health conditions like respiratory disease, immunosuppression
and diabetes will be given Tamiflu," Dr Shrestha said.

Secretary Dr Sharma said that the government will now discuss with private
hospitals how they can help in controlling the disease. Dr Sharma also
stated that WHO has agreed to provide vaccines for medics involved in the
treatment process in the 1st stage in what is a major boost for health
officials who may themselves have inherent fears about the disease.

Preventive measures advised by the health ministry:
-- cover mouth and nose with handkerchiefs while coughing or sneezing
-- reuse the materials used in covering mouth and nose only after properly
washing and cleaning them
-- wash hands properly with soap after coughing or sneezing
-- refrain from taking hands unnecessarily to mouth, nose and eyes
-- refrain from shaking hands as greetings and do namaste instead [Namaste
is a traditional Indian greeting or gesture of respect, made by bringing
the palms together before the face or chest and bowing - Mod.CP.]
-- don't travel or visit crowded places unnecessarily

Symptoms:
-- fever, which is usually high, but unlike seasonal flu, may sometimes be
absent
-- cough, runny nose or stuffy nose, sore throat, body aches, headache, chills
-- fatigue or tiredness
-- diarrhea and vomiting, sometimes, but more commonly seen than with
seasonal flu
-- difficulty in respiration and pneumonia in serious cases

High risk groups:
-- pregnant women
-- people with chronic medical problems, such as chronic lung disease, like
asthma, cardiovascular disease, diabetes, or immunosuppression
-- children and adults with obesity

[byline: Prem Dhakal]

--
communicated by:
ProMed-mail rapporteur Mary Marshall

[An interesting account of the appearance of the influenza pandemic (H1N1)
2009 virus in Nepal, in contrast to several recent unresolved outbreaks of
disease in Nepal: such as Undiagnosed deaths - Nepal: (DP) RFI
20090318.1093, and Undiagnosed deaths - Nepal: (Sindhupalchowk) RFI
20080727.2299.

The interactive HealthMap/ProMED map of Nepal can be accessed at
<http://healthmap.org/r/007i>. - Mod.CP]

See Also

Influenza pandemic (H1N1) 2009 (69): case management 20091013.353
Influenza pandemic (H1N1) 2009 (68): Viet Nam, virus clearance 20091011.3519
Influenza pandemic (H1N1) 2009 (67): vaccine delivery 20091011.3515
Influenza pandemic (H1N1) 2009 (66): case counts 20091010.3510
Influenza pandemic (H1N1) 2009 (65): update 20091009.3495
Influenza pandemic (H1N1) 2009 (64): Canada, vaccination update 20091005.3457
Influenza pandemic (H1N1) 2009 (63): USA military vaccine 20091002.3437
Influenza pandemic (H1N1) 2009 (62): Taiwan hosp cases 20091001.3421
Influenza pandemic (H1N1) 2009 (61): FLAARDS 20091001.3419
Influenza pandemic (H1N1) 2009 (60): bacterial coinfection 20090930.3410
Influenza pandemic (H1N1) 2009 (50): oseltamivir-resistance 20090917.3260
Influenza pandemic (H1N1) 2009 (40): global update 20090906.3138
Influenza pandemic (H1N1) 2009 (30): assumptions 20090813.2879
Influenza pandemic (H1N1) 2009 (20): Peru, 33 percent asymptomatic
20090730.2668
Influenza pandemic (H1N1) 2009 (10): vaccine 20090720.2577
Influenza pandemic (H1N1) 2009 - Viet Nam: patient data 20090708.2450

..................cp/ejp/sh



*##########################################################*
************************************************************
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Become a ProMED-mail Premium Subscriber at
<http://www.isid.org/ProMEDMail_Premium.shtml>
************************************************************
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: promed@promedmail.org

(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.

############################################################
############################################################