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A(H1N1) : Health Ministry ready to face mitigation stage
by Karen Arukesamy

http://www.thesundaily.com/article.cfm?id=35475

PETALING JAYA (July 7, 2009) : In the wake of the fast-spreading A(H1N1) virus which has raised global concerns, the question now is how various sectors can respond to the pandemic in order to migitate its effects.

According to reports, influenza pandemics have occurred every 20 to 30 years around the world; in 1918 the Spanish Flu pandemic known as H1N1 caused some 40 to 50 million deaths globally, in 1957 the Asian Flu/H2N2 caused about a million deaths, and the Hongkong Flu/H3N2 of 1968 recorded a similar casualty.

“The influenza virus can keep changing and after a certain period it will develop into a new virus. Due to this, in 1995 the World Health Organisation (WHO) called on all the countries to develop a pandemic preparedness plan,” said the Health Ministry’s Disease Control Division director Datuk Dr Hasan Abd Rahman.

Malaysia came up with the National Influenza Pandemic Preparedness Plan (NIPPP) in 2005 and implemented it the following year.

Hasan explained that the pandemic can be tacked in various ways, such as
» medical intervention – antiviral drugs, vaccine, medical care and treatment;

» non-medical intervention – personal hygiene, quarantine, social distancing, risk communication and travel restriction; and

» for service sectors like security, food water supply, power supply, transportation, telecommunication, other essential services to have business continuity plans to protect their staff.“The new strain is a mix of human, avian and swine genes and is transmitted from human to human; and everyone is at risk due to absence of immunity,” he said.

He said the current containment phase approach in the country is effective; nevertheless the Health Ministry is ready to face the mitigation stage if the need arises.

“The transition from containment to mitigation phase is when there is clear evidence of beginning of widespread community transmission where there are a number of unlinked cases with no known epidemiological link to any known case,” Hasan said.

“It is a shared responsibility and we should not wait for the pandemic to impact everyone before we act,” he said.

About 80% of Malaysia’s cases are imported but this may change if there is an outbreak in the country, Hasan said.

“The aim now is to delay the spread of the virus in the community because if there is an outbreak and about 10% of the population is affected, there will not be adequate medical services to treat everyone,” he said.

Malaysia has not officially imposed travel restrictions to or from infected countries although WHO has declared that the pandemic is in phase six.

“In the mitigation stage the aim will be to reduce morbidity and mortality, to slow the spread of disease although it cannot be controlled completely and to minimise disruption to essential services,” Hasan said.

During this stage, there will still be disease surveillance conducted to identify the area of the outbreak, look out for clustering whether in particular communities, schools or groups.

“We would then establish the extent of spread to see whether the outbreak has only affected one street or others as well, or in a school whether only one classroom is affected or several others as well,” Hasan explained.

He said there will be constant monitoring of the changes in the natural history of the disease including severity as the virus can mutate and become more virulent.

“The medical laboratories will conduct random sampling for confirmation instead of testing case by case which is what we are doing currently,” he said