Coping With H1N1 Influenza (Feature)

WITH no hope in sight of a cure for the deadly Acquired Immune Deficiency Syndrome (AIDS), the world woke up somewhere in April this year to hear of another pandemic, H1N1 influenza initially refereed to as swine flu.
This is after two pandemics; sars and the avian influenza (bird flu) which in recent times shook the medical world to the position of red alert and saw researchers falling over each other to find a solution.
According to a report issued by the World Health Organisation (WHO) on Wednesday, August 19, 2009, the number of confirmed H1N1 flu deaths since its emergence in April has reached 1,799, a jump from 1,462 deaths since the organisation’s last update.
The WHO report also noted that Ghana, Tuvalu and Zambia became the latest countries to confirm H1N1 cases for the first time, bringing the total number of countries with H1N1 to over 170 worldwide.

H1N1 cases in Ghana
So now whether we like it no not, our country Ghana has been added to the global statistics and as usual the rest of Africa and even parts of the world are closely watching how we handle the situation. This is because we have a history of doing good in such matters. An example is the way and manner in which we faced the avian influenza and pushed it out of our way. Remember, we were commended by the United States Agency for International Development (USAID). So far we have not recorded any deaths but seven people have so far tested positive to the disease.
Reports from the Ghana Health Service (GHS) said while the first two patients had been treated and discharged, the latest patients, made up of three people in a family of four, were quarantined in their home and receiving treatment from health professionals.
In an interview with the Daily Graphic on Thursday August 20, 2009, the Director-General of the GHS, Dr Elias K. Sory, noted that there was the need for intensive education on the issue.
The first time the nation was hit with reality was on August 6, 2009 when it recorded its first case of H1N1 in the Greater Accra Region.
Another suspected case, which at the time was under investigation at the Effia Nkwanta Hospital in the Western Region, later turned out to be negative.
The Accra patient, who was a young woman and said to have been infected by a brother who came from the United Kingdom with the virus, went to a health facility with mild symptoms of influenza but further checks detected the presence of the virus.
While the official figure stood at seven by August 22, 2009, some Ghanaians believe that it could be higher due to the fact that we live in a country where hospital attendance is considered a preserve of the rich. Many people treat themselves at home and if they die, in many cases, autopsies are not performed to know the cause of death. Another point is that even if one goes to hospital, one is not properly diagnosed to determine what is actually wrong.

Where are tests for H1N1 carried out?
In the midst of this confusion and uncertainties, the Noguchi Memorial Institute for Medical Research (NMIMR) situated near the University of Ghana, Legon came out to say that it was well equipped to test for the presence or otherwise of the H1N1 virus.
The institute informed the nation through an interview with the Daily Graphic that its equipment was of international standard accepted by the WHO, as well as other international organisations.
In the said interview in Accra, the Director of the institute, Professor Alex Nyarko, said it was the same equipment procured about two to three years ago which was used during the outbreak of avian influenza (bird flu).
Prof. Nyarko said the NMIMR was the country’s central laboratory where samples from other laboratories were sent for confirmation of suspected cases.

H1N1 infection and poor countries
A US Global Health Policy report posted on the Internet on August 19, 2009 indicated that the total number of deaths from H1N1 in Latin America rose above 1,300 — more than 70 per cent of the world's fatalities.
The report continued that "With vaccines against swine flu still more than a month away from being available, and wealthy countries snapping up all available pre-orders from the big drug companies, Latin American nations are looking at ignoring patents to produce their own.”
The question is what happens to those of us in Africa who could not produce our vaccines? There is hope all the same, because there are reports to indicate that WHO is working closely with manufacturers to expedite the development of a safe and effective vaccine. Our hope is based on the fact that if WHO gets involved, those of us in the developing world could be assured of getting help from that world body.
Now in the absence of vaccines to protect the world from the H1N1 virus at the moment, what do we do as individuals, communities and a nation to protect ourselves from death?
Fortunately for us in Ghana, we have not as yet recorded any fatality and it is also on record that all the cases we have so far recorded occurred because of contacts they had with relations who returned from abroad. To some of us this means that locally, we are not at risk but the Director-General of the GHS, Dr Sory, holds a different view. To him, there is the possibility of people getting it from others within if we ignore the safety measures and take things for granted. Since there is the presence of the virus in the country, there could be more cases in the near future and so called for intensive education on the issue. At this point, Dr Sory is relying so much on the local media and other opinion leaders to spread the news of personal hygiene.
What is this new influenza?
Reports from the WHO indicate that the new influenza, H1N1 virus (swine flu), has never before circulated among humans. It said the virus is not related to any previous or current human seasonal influenza viruses.
The report explained that the virus is spread from person to person and transmitted as easily as the normal seasonal flu. It could be passed to other people by exposure to infected droplets expelled by coughing or sneezing which could be inhaled, or which could contaminate hands or surfaces.
To prevent spread, people who are ill should cover their mouth and nose when coughing or sneezing, stay home when they are unwell, clean their hands regularly, and keep some distance from healthy people, as much as possible.
The place of origin of the virus, according to the WHO, is unknown.
Signs of influenza H1N1 are similar to that of common cold and they include fever, cough, headache, muscle and joint pain, sore throat and runny nose, and sometimes vomiting and diarrhoea. Health experts say one thing that stands out during infection of the new flu is the intense nature of the fever which is associated with it. One cannot miss it.
Why so much interest in the disease?
Globally, people are asking why the world is so much worried about this flu when hundreds of thousands die every year from other seasonal flu?
This is because the H1N1 is a new virus and one to which most people have no or little immunity and, therefore, the virus could cause more infections than are seen with seasonal flu. The new influenza appears to be as contagious as seasonal influenza, and is spreading fast particularly among young people, mostly people from ages 10 to 45.
The severity of the disease, according to health experts, ranges from very mild symptoms to severe illnesses that can result in death if not treated early. The majority of people who contract the virus experience the milder disease and recover without anti-viral treatment or medical care. Of the more serious cases, more than half of hospitalised people had underlying health conditions or weak immune systems.
The fact that one could not determine whether his or her illness could degenerate to something serious, it is important for people to seek medical care if they experience shortness of breath or difficulty in breathing, or if a fever continues more than three days.
For parents with young children who fall sick with such symptoms, it is important they seek medical care if a child has fast or difficulty breathing, continuing fever, convulsions or seizures.
In the absence of health facilities, people could reduce the risk through supportive care at home which include resting, drinking plenty of fluids and using a pain reliever for aches.
What to do to prevent spread of H1N1
Some of the actions one could take to help prevent swine flu from spreading are for them to cover their noses and mouths with tissue when coughing or sneezing and they are to throw away used tissues.
There is the need for people to wash their hands often with soap and water, especially after coughing or sneezing.
One important measure is the need for people to avoid touching their eyes, nose or mouth and try to avoid close contact with sick people.
If one suffers from any of the symptoms of influenza, it is recommended that such a person should stay home from work or school and limit contact with others to prevent its spread.
How to protect oneself from getting the flu
Information provided by the Ministry of Health (MoH) in Accra showed that regular washing of hand with soap is strongly recommended; hand rubbing with alcohol is also advised where available; people should keep a distance of at least one metre from an infected person to avoid coming into contact with the influenza droplet.
In addition, if contact with a sick person or with potentially infected person or objects occurs, those involved must not touch their eyes, nose or mouth with unwashed hands.
In same vein, people are advised to refrain from handshaking, kissing or hugging during outbreak and those taking care of sick persons should use face mask in accordance with guidelines provided by health authorities.
In all these, it is also advisable for people to be physically active, drink a lot of fluids, especially water, eat well, reduce stress and have enough sleep.
Unlike the bird flu which Ghana was able to protect its citizens from being infected, the same cannot be said of the swine flu which seems to be stronger. It is with us and so far, seven of our brethren are infected and what the rest of us can do is to heed professional advice and fight it. We are capable but not without intensive education.

Intensive Education
The education is important and to some of us, the earlier we intensify it, the better. This is because we live in a society where many of the things we do make us prone to disease.
Ghanaians like shaking one another’s hands, hugging one other, especially “long time no see friends”, and showing our affection to the sick by touching them.
Now we are being told to stay away from many of these things, and to be able to prevent the spread of the deadly H1N1 influenza, let us go by the advice given by health workers and save ourselves from preventable deaths.