By Kanina Foss
Swine flu cases will probably spike when schools reopen next week. Health officials will monitor schools, but are still advising that mild cases should be treated no differently from seasonal flu.
Only patients with serious symptoms - such as high fever, persistent vomiting, pain in the chest, or shortness of breath - should seek medical assistance. These are symptoms that people would seek medical assistance for anyway, says National Institute for Communicable Diseases (NICD) deputy director Lucille Blumberg.
The number of confirmed swine flu cases in South Africa is 75. Once this number reaches 100, the NICD will stop counting. It will focus instead on severe cases and those at high risk because of compromised immune systems, such as HIV-positive people. The institute will also monitor schools.
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| 'It's something we need to monitor very carefully' |
Counting cases was resource intensive, said the NICD on Monday, and served no more purpose than counting cases of seasonal flu. The overwhelming majority of cases worldwide had been mild, and had required no special treatment.
The World Health Organisation (WHO) has said the spread of the H1N1 virus is inevitable, and the NICD is expecting many more South Africans will be infected. It is unsure how the country's high HIV prevalence will affect the severity of infections.
"It's something we need to monitor very carefully," said Blumberg.
The highest number of confirmed cases are in Gauteng (39), followed by the Eastern Cape (nine), and Western Cape (five).
But the number of actual cases could be much greater. In the US, the country with the highest number of infections, health officials have stopped diagnosing mild cases and estimate a million infections.
In Africa, the total number of confirmed cases stands at 193, with no deaths. However, the first patient diagnosed in Botswana contracted the virus inside the country. The recent outbreak at the University of Johannesburg originated with a Zimbabwean student, despite Zimbabwe's not confirming an infection. This would suggest that a number of cases in Africa were going undiagnosed, said the chief director of communicable diseases for the Health Department, Frew Benson.
The WHO stopped counting infections last week when the global total stood at 94 512, and the number of deaths was 429 (a fatality rate of 0,4 percent). By comparison, seasonal flu has a fatality rate of 0,2 percent to 0,4 percent, and kills between 250 000 and 5007nbsp;000 people annually.
The H1N1 virus introduced itself into the human population in March. Its main source was pigs, but it now also has human and bird virus components. It has spread more rapidly than past pandemics, owing to an increase in air travel.
Health officials were not surprised by the pandemic. "Pandemics of flu come on a regular basis, two or three times a century," said NICD director Professor Barry Schoub. Until now, the focus has been on avian flu, but this virus has not resulted in any sustained human-to-human transmission.
History also tells us that there is a risk of a second wave of infections which could result in a higher number of deaths. The 1918 Spanish flu had a deadly second wave which killed 50 million people.
But modern-day medical treatments such as antibiotics, antivirals and intensive care, as well as improved diagnostic capabilities, make it unlikely that a second wave would be as catastrophic as in 1918.
Schoub also said the NICD hoped to have a vaccine in the event of a second wave.
- This article was originally published on page 3 of The Star on July 14, 2009
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