Authorities dispel alarm over (A) H1N1 outbreak

The recent death of three patients within a span of 48 hours at ward 69 of the Kandy Hospital forced a temporary closure of the ward, causing much alarm over a possible outbreak of a deadly virus. Hospital authorities suspected the patients had died of Influenza (A) H1N1. Two patients were reported to have succumbed to the virus while the third death was caused by an advanced stage of pneumonia. Taking immediate action, hospital authorities introduced swift measures to contain further spread of the virus within the hospital.

Director of the Kandy Hospital Dr. Saman Ratnayake, speaking to the , said the patients in ward 69 were isolated as an emergency measure. “The ward was not closed, the patients were temporarily isolated until the ward was sterilised,” Dr. Ratnayake clarified, adding that the ward was reopened following its disinfection. Measures have also been implemented to halt the spread of the virus to other wards.   
Questioned about the number of patients diagnosed with the deadly virus, Dr. Ratnayake said at present 4 patients were identified as having been infected with the virus. The three female and one male patients who have tested positive for the virus are being monitored closely by authorities. Dr. Ratnayake who denied the possibility of the virus developing into epidemic levels, assured that the hospital and its staff were well equipped to manage and contain the virus.   
Influenza A (H1N1) virus emerged in 2009, with the World Health Organisation declaring the rapid spread of the disease a global pandemic. According to the WHO it is a new re-assortment that has never before circulated among humans. The disease, previously known as ‘swine flu’, is transmitted mainly through droplets disseminated by unprotected coughs and sneezes. Short-distance airborne transmission of influenza viruses may occur, particularly in crowded and enclosed spaces. Hand contamination and direct inoculation of virus is another possible source of transmission. Manifestations of H1N1 influenza are similar to those of the flu. Patients have symptoms of acute respiratory illness, including fever, cough, sore throat, body aches, headache, fatigue, diarrhea
and vomiting.   
The first death in Sri Lanka caused by H1N1 was reported in 2009. The victim, a 16-year-old boy, also from Kandy, succumbed to the virus while doctors believed that his immune system which had been compromised by other severe illnesses was more likely the cause of death. Since then, there have been a number of positive cases identified across several parts of the island with many fatalities reported. Nevertheless officials insist that the disease has thus far spread only in cluster stage over the past years.   
The  also spoke to the Director General of Health Services Dr. Jayasundara Bandara, who ruled out the possibility of the spread of the H1N1 virus. “We had a three year surveillance programme to monitor the prevalence of the disease. The virus has been highlighted in the public recently, following the unfortunate deaths reported at the Kidney ward of the Kandy hospital. However we have issued a circular in this regard in 2013, detailing how the virus must be tackled at state hospitals,” Dr. Bandara said.   
The Director General of Health Services added that the disease is not a new phenomenon. “We have observed the prevalence of the disease during the cold season, especially from September to February. The disease is known to have adverse effects on pregnant women, children and those who already have low immunity due to other health conditions. In such cases, the virus which is usually self- limiting and presents itself as a flu-like illness, can even develop to pneumonic stages. For a small percentage of patients, this may result in severe outcomes,” Dr. Bandara explained.   
Asked of provisions employed for a possible outbreak of the virus, Dr. Bandara said hospitals had been provided with the necessary staff, knowledge and drugs, to counter such an escalation. Speaking of the situation at the Kandy Hospital, Dr. Bandara said the situation had been brought completely under control. However, he cautioned visitors to the hospital to take necessary precautions against seasonal influenza and added that visitors to the hospital must be controlled.   
Our attempts to contact the Infection Control Unit of the Kandy Hospital on numerous occasions failed. However,  learned that the hospital staff was advised against divulging information pertaining to the disease and the deaths at ward 69 by hospital authorities.   
According to Dr. Samitha Ginige of the Epidemiology Unit, Ministry of Health, there have been no further developments reported in relation to the deaths at the Kandy Hospital. “The condition is under control and there are no further developments. Officials have employed all necessary precautions to contain the disease,” Dr. Ginige said. Asked if there were reports of clusters of the disease from other parts of the island, Dr. Ginige said an unusual number had not been reported thus far. “Throughout the year, there are reports of a few patients having contracted the virus. This is not unusual. We cannot label such numbers as an outbreak because every year there is a slight increase of the number of patients diagnosed with the (A) H1N1 virus from the period between October to January,” Dr Ginige added.   
 Saying that there was no cause for alarm over an outbreak of the infectious agent, Dr. Ginige warned however that people should remain vigilant about symptoms of the virus such as continued flu symptoms and breathlessness. He added that such individuals should maintain good health and avoid crowds where they could be exposed to the risk of contracting the disease. “The Health Ministry and the Epidemiology Unit have implemented all necessary measures in hospitals islandwide to address any possible outbreak of the disease,” Dr. Ginige assured.