As of date, The DOH (Department of Health) have not found any Filipino resident or any visitor to the Philippines to be influenza A (H1N1)-positive. From the among the 49 cases that had been reported by government and private hospitals to have undergone clinical observation in their facilities and whose laboratory results have been processed by the Research Institute for Tropical Medicine, NONE have tested positive for the influenza A (H1N1) virus. Thus, all these 49 cases have been declared definitely "not A (H1N1)" cases and have been discharged.
From May 1, 2009 until today, 49 total cases under observation or CUOs at various government and private hospital facilities had been reported to the RITM for laboratory confirmation. This is an increase of 3 from yesterday’s total of 46 CUOs. All laboratory results are in and, we reiterate that all are negative and all CUOs had been discharged clear of the new influenza virus. This indicates that it is highly probable that the influenza A (H1N1) virus or its carrier has, so far, not been able to penetrate our public health cordon.
However, on the global front, WHO (World Health Organization) reports that every day more countries are finding laboratory-confirmed cases of influenza A (H1N1). It has been found in North and South American, European and Asian countries, and in Australia and New Zealand as well. There are now 5,728 cases and 61 deaths reported and confirmed by the WHO from 33 countries. This is the reason why we continue to be vigilant and to institute measures to tighten our defenses at the various ports of entry at Luzon, Visayas and Mindanao.
Systematically and without causing undue alarm and panic, The National Quarantine Officers, in coordination with airline and shipping authorities, have patiently required travelers coming from influenza-affected countries to be screened for signs and symptoms of the virus. However, because of the variable onset of signs and symptoms of the new influenza, DOH cannot presume to have a completely foolproof screening system.
Thus today, DOH are issuing an "Interim Guideline for Public Gatherings in Response to the Influenza A (H1N1) Threat." This Guideline will apply to all persons who have commitments or have choices to make with regards attending, gracing or hosting public gatherings. The Guideline is patterned after the recommendations of the Centers for Disease Control and Prevention (CDC) in Atlanta, USA, though, it is tailor-fit to the risks we have locally at present. This means that as the disease pattern and risks change and as information is updated, the DOH may have to issue newer guides to the public for the prevention and containment of influenza A (H1N1).
This Guideline is focused on precautionary measures all of us should employ when organizing or when attending public gatherings where we are likely to be exposed to probable positive cases of influenza A (H1N1) virus—we would like to emphasize here that these precautionary measures are applicable now while we have yet no evidence of any positive case of influenza A (H1N1) infection among our incoming travelers nor of community transmission.
The guideline refers to public gathering as defined by CDC:
"an assembly or grouping of many people in one place…and can include commencement exercises, church services, sporting events, concerts, social and cultural celebrations, weddings, conferences and other similar activities attended by relatively large groups of people." The common denominator of all these is any situation in which crowding is likely to occur. While we advocate for social distancing as the principal measure to protect one’s self while among or when coming from a community with known positive cases, we are recommending this set of precautionary measures for public gatherings in general, while we have YET no public health indication to ban public gatherings as in some parts of Mexico.
The principles used for this Guideline has been applied to our People’s Hero, Manny Pacquiao … is now being applied to American Idol, David Cook and American Idol runner-up, David Archuleta, and will be therefore be applied to other public gatherings of such nature.
In brief, DOH are recommending that event organizers and event hosts to: (1) provide information to guests, participants or audience about what to do in case they have flu-like illness, (2) make available adequate hand washing facilities with disinfectant soap or sanitizers and (3) suggest other options for participation such as video-conferencing, wider open spaces, etc.
All persons, especially those in public places, are recommended to practice healthful respiratory- or lung-clearing practices and regular hand washing. Those who have known health problems that make them susceptible to infections are advised to keep away from crowds. Health care workers who are tasked to handle emergencies in public gatherings are advised to have personal protective N95 masks ready for persons who may develop the signs and symptoms of influenza A (H1N1).
The DOH would like to thank the press and media practitioners and the general public for their interest and understanding of the public health situation. I also thank especially those who have cooperated with us in this daunting and necessary work of preventing the entry of influenza A (H1N1) to the country…those who have been working 24 hours in our ports of entry and referral hospitals and those who have allowed to be subjected to hospital-based or home quarantine.
Today May 15, the Department of Health reported five new cases under observation. Four were negative for influenza A (H1N1), while the laboratory result for one case is still pending. The total number of cases that the DOH monitored since May 1 to May 14 is now 54. Forty-five of these cases were reported from the National Capital Region, six from Region VII, and one case each for Regions IV-A, V and X.
The reported cases had history of travel to the following countries with confirmed influenza A (H1N1) cases: Australia, Canada, China (Mainland), Germany, Hong Kong, Ireland, Italy, Japan, Korea, Mexico, Netherlands, Spain, Switzerland, United Kingdom and the United States of America.
As of May 14, the World Health Organization has reported no new countries with confirmed cases of A (H1N1). The total number of confirmed influenza A (H1N1) cases reported in 33 countries is now 6,497. This is a 13% increase compared to the number reported in the previous day (5,728). The most number of new confirmed cases (387/769) was from Mexico. No new deaths were reported; the total number of deaths is still 61.
While the Philippines is still free from Influenza A (H1N1), the DOH reiterates that they will continue to intensify its surveillance in ports, airports and the community so that cases of influenza A (H1N1) are detected early and appropriate control measures implemented immediately.
Interim Guidelines No. 4
On Public Gatherings in Response to Influenza A (H1N1) Virus Threat
Given the current information on the status of influenza A (H1N1) in the country, the Department of Health (DOH) issues the following interim guidelines on "Public Gatherings in Response to Influenza A (H1N1) Virus Threat" for the guidance of event organizers, local officials, health care providers and the general public.
Public Gathering refers to a congregation or grouping of several people in an area or activity. Examples of a gathering are social and cultural celebrations like fiestas, conferences, concerts, sports event, and other comparable activities, both indoor and outdoor, where crowding of people may occur.
Public gatherings are usually festive and personal contact like handshaking, hugging and kissing likely occur, thereby increasing the risk for spread of Influenza A (H1N1) virus.
For All Persons Attending a Public Gathering:
Practice proper cough manners and cover mouth and nose when coughing or sneezing and wash hands after doing so
- Maintain personal hygiene, especially regular hand washing with soap and water or sanitizer
- At the first signs and symptoms of flu-like illness, defer from attending a public gathering and seek medical consultation
- Persons who are at high risk of complications from Influenza A (H1N1) infection should avoid exposure to this virus by reconsidering attendance to public gatherings. Persons at high risk are:
- Persons with certain chronic medical conditions and the immuno-compromised
- Children less than 5 years and persons 60 or older
- Pregnant women
For Event Organizers or Hosts:
- Determine the time required to achieve the purpose of the public gathering and avoid extending the period of time that people are gathered as crowds
- Provide alternative options and venues for participation. In general, open spaces are preferable over indoor venues.
- Make adequately available at the event the following basic facilities and services:
- Hand washing facilities with soap and running water or hand sanitizers
- Garbage bins for proper disposal of tissues, disposable cups and other items
- On-site medical assessment team that is adequately equipped to screen persons developing flu-like illness
- Ensure that frequently touched objects and surfaces had been adequately disinfected, e.g. door knobs, tabletops, chairs, toilets, etc.
- Deliver key educational messages about measures attendees can take to help reduce the spread of the Influenza A (H1N1) virus infection
For the Local Officials, Health Officers and other officials with jurisdiction over the Public Gathering:
- Reinforce guidelines on public gatherings for event organizers and hosts by issuing corresponding memorandum or ordinances
- Provide key educational messages to event organizers and the public on the prevention and control of influenza A (H1N1) virus, such as: local situation with regards influenza A (H1N1), health alerts and advisories derived from newspapers and official websites, etc.
- Complement the preparations made by event organizers in the provision of adequate facilities and services for the public gathering
- Plan for the provision of on-site medical assistance for possible medical emergencies
- Report any incidence of flu-like illness manifesting or found in community or area where public gatherings are planned
In the event that a suspected case of Influenza A (H1N1) virus infection is reported in the scheduled public gathering, the DOH is authorized to investigate, make recommendations and assist the community to contain the infection, as specified in Republic Act No. 9271, Quarantine Act of 2004, "An Act Strengthening the Regulatory Capacity of the Department of Health in Quarantine and International Health Surveillance":
Section 1.4.b provides for the "apprehension, detention or surveillance for the purpose of preventing the introduction, transmission or spread of such public health emergencies of international concern as may be specified in Department Orders by the Secretary of Health upon the recommendation of the international health surveillance."
Implementing Rules and Regulations of "Quarantine Act of 2004", pursuant to RA 9271 further specifies under Section 53.2:
In the event of an outbreak of public health emergency of international concern in a community, the Director of the Bureau shall recommend to the Secretary of Health the following measures:
- "apprehension, detention / isolation or surveillance of suspect / cases;
- place under active or passive surveillance, individuals who have been exposed to the infection considered as dangerous contact; and
- declare an area or community "under quarantine" where the public health emergency occurs."