Those with regular flu more likely to have H1N1 now: S'pore paper

Borneo Bulletin, 22 July 2009

By Azlan Othman



If you have the flu bug, the chances of it being the H1N1 virus is now higher than it was a few weeks ago, according to Singapore's Health Ministry.

As of Monday, the ministry recorded 64 cases of H1N1 flu, with five patients in intensive care, the Straits Times reported Tuesday.

Brunei recorded some good news on Monday when the sultanate did not report any new cases - the first time since the nation was hit by the flu exactly a month ago. Meanwhile, those undergoing treatment stood at 28 cases on July 20.

While Brunei health officials expect to get back to Bulletin on the matter, the latest Singapore Health Ministry data shows that 53 per cent of patients with flu-like symptoms - cough, fever or a runny nose - have been infected with H1N1. This shows an increase from a month ago, when only 13 per cent tested positive for the new virus.

This number will continue to grow as the H1N1 strain replaces other influenza strains and becomes the dominant one this season, Singapore's Health Minister Khaw Boon Wan said in parliament on Monday.

American city health officials had earlier said the number of people with flu-like symptoms at hospital emergency rooms had declined rapidly since reaching a peak on May 25, while those hospitalised for H1N1 hit a peak on May 27 there.

The phenomenon is taking place as the community acquires "herd immunity," which refers to a slowdown in the rate of increase as more people become exposed to the virus.

The overall risk of death is similar to the normal seasonal flu, but risk groups differ, said the minister. For the normal flu, those older than 65 and younger than two years are at highest risk. But for H1N1, young adults who have medical problems, low immunity, are extremely obese or are pregnant are at higher risk. Focussing on these, full recovery will be one of three priorities, he added.

H1N1 precautionary measures

RIPAS has designated an elevator

specifically for H1N1 patients.

- LYNA MOHAMAD

Borneo Bulletin, 21 July 2009

By Lyna Mohamad


With the current rate of spread of the Influenza A or H1N1 virus, government and private buildings are taking precautionary measures in helping to control and hopefully reduce the spread of this infectious disease particularly at hospitals and health centres.

RIPAS hospital for instance has allocated a public elevator in its lobby area leading to the various wards within the hospital. A lift has been designated specifically for patients diagnosed with H1N1.

Notices have been pasted on the lift as well as wooden stands with the warning "This lift is dedicated for H1N1 only". The main central area that usually acts as a waiting area for queuing patients has been converted into a H1N1 screening area.

H1N1 questions answered

Borneo Bulletin, 20 July 2009



Q1: What will happen to the people who are resistant to Tamiflu?

A: Instead of a person being resistant to Tamiflu, it is more likely that the person cannot tolerate the side effects of the medication.
The Influenza virus, including H1N1 can be resistant to Tamiflu and this has been reported to occur already but only in small number.
This is very likely to increase with time and increasing use of the medications, especially when used widely and inappropriately (this problem also apply to antibiotics).
This is already occurring in Japan and America where resistant type seasonal Influenza is increasing.
So far, despite being infected with Tamiflu resistant H1N1, these patients had recovered and no death had yet been reported.
However, it uncertain how people with significant chronic conditions such as kidney failure or chronic chest problem will fare but it is likely, they will fare less well.

Q2: How easy is it to catch the virus (Influenza A H1N1)?

A: Based on current knowledge, Influenza A H1N1 is behaving like the normal Influenza A or B that cause seasonal flu (the type of 'selesma' that we all get).
With regard to this particular strain, it is considered infectious, meaning it can be easily caught.
Spread of virus that cause flu like illness including Influenza A H1N1 is through contacts with contaminated droplets or secretion that is produced through sneezing, coughing and kissing, among others.
This is why it is important to practice good hygiene such as covering nose and mouth when coughing and sneezing, regular hand washing and keeping environment clean.

Q3: When is the onset of symptoms and how long do they last?

A: For person affected by the Influenza A H1N1 and who are experiencing symptoms, these usually occur within a few days of catching the virus.
In most cases, the symptoms subside within the fifth day.
Symptoms lasting longer than this may suggest additional bacterial infection where patient may start coughing up green phlegm.
The symptoms experienced are exactly the same as the type of selesma that everyone experienced before.
You should see a doctor if this happens or if your symptoms seem to get worst.
Based on experience with normal Influenza A/B, treatment with Tamiflu usually shortened the illness by one to two days only.

Q4: Are we prepared for the second wave?

A: During a pandemic, there are usually multiple waves. This period usually range from four to six months due to seasonal changes in the northern and southern hemispheres.
If the second wave is caused by the same virus that caused the initial wave, then we will certainly be more prepared due to the experiences gained from managing the first wave.
However, if there are mutations of the virus, then we may not be as prepared.
Virus mutations may lead to differences in the course of illness and responses to treatment, that is, it could be milder or it could be more severe.
Despite this, lessons learnt from the first wave will certainly make us more prepared.
If vaccines become available, then measures can be taken to lessen the impact of the second or subsequent waves as vaccine can provide some protection against the particular virus.

Q5: Is it true that the flu is only harmful if you have a compromised immune system?

A: Generally, anyone with compromised immune system will be more susceptible to any infections, be it due virus, bacteria or fungus.
People with immune compromised system usually have other additional medical conditions that make them less fit to handle any infections.
The reason why Influenza A H1N1 or any virus that causes influenza illness is more dangerous to a person with chronic conditions like lung disorders is because their lung is already damaged.
However, it is also important to remember that even a previously fit and healthy person can have bad outcomes as a result of viral infections.

Q6: Is it safe to visit houses of people being quarantined as suspected cases?

A: Being quarantined means that the patient should not mixed with other people during the quarantine period.
This reduces the risk of spreading the infection to other people.
They should not invite people over and they should also not go out. Doing so would mean breaking quarantine and can be penalised under the quarantine act.
Therefore, it is not advisable to visit a suspected person under quarantine until the quarantine order is lifted or results confirm that the person does not have the infection.

Q7 & 8: Is it true that the virus stays in you forever even though you are cured? Is it true that if you have already contracted the disease, you will be immune to the second wave if it happens?

A: Usually if you're infected by a virus the body produces antibodies to fight the virus. In most cases, the sufferer manages to fight off and clear the body of that virus but the antibodies remain.
This means that if that person is exposed to the virus again, the body recognises it and is able to prevent the body from being re-infected (immunity).
It is important to remember that there are many different viruses out there such as chickenpox, the common cold viruses, the herpes simplex virus which causes cold sores.
Therefore, if you do develop immunity to one type of virus, it doesn't mean you will be immune to all other viruses.
The 'second wave' (and even third wave) of this virus has been predicted to occur by virus experts all over the world including those at the World Health Organisation.
What this means is that after this current first wave settles down there is the possibility that it will emerge again, possibly in a more aggressive form. It is also possible that be it would be a milder form.
The likelihood is that if you have already developed immunity to the milder form in the first wave then you will probably be immune to infection in the second wave.
It is very clear however that we are still learning more about this virus and none of the international experts can be certain how it will behave in the future.

Q9: Will it affect home pets?

A: It is unlikely to affect your home pets because this is now a human virus. This is because all animals, including humans, have different immune (body defence) systems.
Therefore, it actually takes a major change in shape (mutation) for any virus to change its attack mechanisms from one animal to another. This is still a possibility but has not been reported so far.
Q10: Can somebody be a carrier of the virus, without getting sick himself?

A: Most flu sufferers know it! They have high fever, body aches, cough and sneezing and cannot get out of bed.
However, it is occasionally possible to be affected very mildly.
Our experience here in Brunei with confirmed cases has been that most sufferers do feel unwell for a few days but we have also come across people who haven't even known that they have the infection.
These people could be considered carriers and could possibly pass on the infection without knowing it.
We do know that like the normal selesma, symptoms experienced range from very mild to very severe. In fact a large proportion of people affected only have mild symptoms.


(The questions are provided by the general public and the responses are provided by designated clinicians (doctors) involved in the management of the H1N1 outbreak. These clinicians are part of the RIPAS H1N1 Committee, Ministry of Health.)

Ministry clarifies H1N1 measures in afternoon religious schools

Borneo Bulletin, 19 July 2009

By James Kon


Following the revelation of religious schools being late to start Influenza A(H1N1) screening as published in the Borneo Bulletin on July 17, the Ministry of Religious Affairs has responded to the article which illustrates parents' dissatisfaction with the delayed start in screening for their children - who are attending the afternoon religious school session - due to lack of thermometers and masks.

In the press statement released by the Ministry of Religious Affairs yesterday, the ministry stated that the absence of thermometers and face masks for religious schools that hold afternoon sessions is based on the consideration that temperature screening for students is already being carried out in the morning. The ministry added that the morning screening is adequate, and that there is no further need for students to undergo such screening in the afternoon.

As an effort to combat the spread of Influenza A(H1N1) among the student population in schools nationwide, the Ministry of Health has taken calculated steps by providing thermometers and face masks to all schools under the Ministry of Education, as well as Arabic schools, the Sultan Haji Hassanal Bolkiah Tahfiz Institute and religious schools that hold morning academic sessions only, that operate under the Ministry of Religious Affairs.

The handing over of the thermometers and masks took place in a ceremony held on June 25, at the Paduka Seri Begawan Sultan Science College at Jln Muara. Officiating at the ceremony were the Permanent Secretary at the Ministry of Education, Permanent Secretary at the Ministry of Health and the Acting Permanent Secretary at the Ministry of Religious Affairs.

The distribution of thermometers is aimed at keeping check on the temperature of students, especially students who are studying in the morning session, while the masks were meant for distribution to students who have temperatures of more than 37.8 degrees Celsius or who are suffering from cough, flu and fever, the Ministry of Religious Affairs stated in the press release.

Students who have flu-like symptoms are also being separated and sent home to get treatment in hospital or health clinic. Students who are found ill are not allowed to come to school.
Principals of religious schools that hold only morning sessions have already been briefed on the guidelines for the use of thermometers and face masks in schools by the Department of Islamic Education on June 27. Principals of the "afternoon-only" religious schools attended a similar briefing on June 30 at the Sultan Haji Hassanal Bolkiah Tahfiz Institute.

Although the afternoon religious schools were not supplied with thermometers and masks, the Department of Islamic Education instructed principals to take precautionary measures and other initiatives, such as purchasing thermometers by means of the school's fund, organising cleaning campaigns, conducting Sunat Hajat prayers and reciting the "Doa Tolak Bala."

In addition, the Department has also provided liquid soap and masks to be used by all the schools under the Department's watch.

Travel trade hurt by H1N1

Borneo Bulletin, 18 July 2009

By Azlan Othman


The ongoing global pandemic of Influenza A (H1N1) has had an adverse effect on local tourism too. Local travel agencies faced a fall in inbound and outbound tourists recording a dip of up to 20 per cent.

Yet travel agencies still lure local travellers to go on holiday abroad with packages offered but with one advice. That is to take precautionary measures against the H1N1.

This was revealed by Mr Foo of the Century Travel Centre who is also the Secretary of the Brunei Association of Travel Agencies.
"Business has already been affected since the flu was first detected in Mexico and spread worldwide. There are not many inbound bookings made for the festive celebrations," he said.

Meanwhile Ms Jennifer from the Continental Tours said the H1N1 definitely affected the outbound and inbound travels. The walk-in customers are lesser nowadays. Locals will travel if they really need to like attending their children's graduation overseas or to undergo medical treatment in places like Singapore, but hardly on for recreation.

"We used to have bigger groups from China and South Korea coming to Brunei for the festive celebration in the past years. But not this year though we still have tours to sell," she added.

A sales staff at Pan Bright Travel Service said many cancellations have been made for tickets issued for regional and international travel especially government personnel attending meetings. Up to 80 per cent cancellations have been reported. But there were those who still travel west, mainly to UK, which is currently having summer sales.

During the last school holiday in June, many bookings were made for leisure travels but cancelled due to the H1N1.

It was learnt that a Travel Fair expected to be held in August, was postponed due to H1N1. It would probably be held later on. But due to the H1N1, some travel agents opt not to take part in such fairs foreseeing gloomy days and bumpy road ahead.

The Ministry of Health through its directive urged people to postpone non-essential travel and limit overseas trips for meetings and conferences while the government ministries and departments issued a circular on July 7 on self-imposed quarantine for officers and staff attending meetings and conferences abroad.

Indeed, it was trying times as the World Tourism Organisation had anticipated the world tourist traffic to drop by eight per cent this year. The tourist traffic in Asia and South Pacific is expected to go down by six per cent.

Trendy way to face H1N1 hazard

Borneo Bulletin - 17 July 2009

By Ben Ng & Amie PDH Ishak

Photos: Azrol Azmi & Syafiq Affendy

Youth wearing a facemask showing his favourite footbal team logo.

Wearing masks of various colours to match their outfits

With all the different types of facemasks available, it seems some youths have started wearing trendy masks as fashion statements regardless of the mask's effectiveness.

Teens sporting masks with printings of cartoons can be seen with some wearing coloured masks that match their outfits. Some teens proudly display their favourite football team logos on their masks, reports say, which brings up an even more important question: how effective are the masks against Influenza A (H1N1) anyway?

According to the US Centre for Disease Control and Prevention (CDC), facemasks help stop droplets from being spread by the person wearing them, while also keeping splashes or sprays from reaching the mouth and nose of the person wearing the facemask.
"They are, however, not designed to protect you against breathing in very small particles," the CDC says, "and facemasks should be used once and then thrown away in the trash".

Neither a facemask nor a respirator will give complete protection from the flu, which is why it is important to wash your hands often, to cover your coughs and sneezes with a handkerchief or your arm, and to avoid crowds and gatherings during a pandemic.
At present, evidence suggests that the main route of human-to-human transmission of the new Influenza A (H1N1) virus is via respiratory droplets, which are expelled by speaking, sneezing or coughing.

Complicating things further, the World Health Organisation (WHO) said on its website that using a mask incorrectly however, may actually increase the risk of transmission, rather than reduce it.

"If masks are to be used, this measure should be combined with other general measures to help prevent the human-to-human transmission of influenza, training on the correct use of masks and consideration of cultural and personal values," the WHO said on its site.

According to the website, any person who is in close contact (approximately one metre) with someone who has influenza-like symptoms (fever, sneezing, coughing, running nose, chills, muscle ache etc) is at risk of being exposed to potentially infective respiratory droplets.

In health-care settings, studies evaluating measures to reduce the spread of respiratory viruses suggest that the use of masks could reduce the transmission of influenza.

"In the community, however, the benefits of wearing masks have not been established, especially in open areas, as opposed to enclosed spaces while in close contact with a person with influenza-like symptoms," the WHO stated.

Meanwhile, a spokesperson from the Health Ministry said, "any precaution you take, counts", while also urging the community to wear masks while visiting hospitals.

Brunei in queue to get H1N1 vaccine

Borneo Bulletin report - 16 July 2009

By Azlan Othman

As health officials in the World Health Organisation (WHO) called Influenza A (H1N1) pandemic 'unstoppable' and added that all countries would need to have access to vaccines, a Brunei health official responded by saying that the nation is also in the queue to get the vaccine along with other countries.

"Order has been made. We have no control on (the arrival of the) vaccine, but it will come. The current anti-viral Tamiflu has cured 182 local patients so far," the health official told the Bulletin. The other anti-viral drug is Relenza.

The Minister of Health, Pehin Orang Kaya Indera Pahlawan Dato Seri Setia Hj Suyoi, last Saturday said, "As for vaccination against H1N1, we are still waiting for it (vaccine) to be produced, which will come in August or September. We hope we will get our share of it (vaccine). We don't know how much will be distributed, but we are in line to get the vaccine. When other countries get it, we will also get it."

The Ministry of Health in a recent statement said that those who have been confirmed with Influenza A (H1N1) would be treated as soon as possible and their close contacts will also be given treatment to prevent the infection from spreading.

Although the vaccine to prevent H1N1 infection is still not available, the current anti-virals have been proven effective to treat and prevent the infection, especially if the treatment is given early. The Ministry of Health said it will ensure sufficient supply of medications for the infection is available.

Meanwhile, AFP reported that with the global death toll from H1N1 now reaching at least 429, WHO's director of vaccine research Marie-Paul Kieny said that the vaccine should be available as early as September.

A handful of pharmaceutical companies are racing to develop a vaccine against H1N1, which the WHO says has infected more than 94,500 people worldwide.

But WHO chief Margaret Chan said Wednesday a swine flu vaccine would not be readily available for months, undermining national plans for rapid immunisation against the accelerating pandemic.

The comments by her came as Australia and Japan reported a surge in cases, and Argentina dramatically upped its death toll from 94 to 137 in just three days.

"There's no vaccine. One should be available soon, in August. But having a vaccine available is not the same as having a vaccine that has proven safe," Chan told Britain's Guardian newspaper.

"Clinical trial data will not be available for another two to three months," she added, contradicting health officials in Britain and elsewhere who said the first stocks would start arriving in August.
___________________________________

MoH stops publishing new H1N1 cases


Borneo Bulletin - 15 July 2009
By Achong Tanjong


Based on new measures taken by the World Health Organisation (WHO), the Ministry of Health yesterday said it will also standardise these measures by no longer publishing the number of new cases in Brunei Darussalam in its media releases, as previously been practised.

The WHO has informed countries that reporting of individual laboratory-confirmed cases of Influenza A (H1N1) is no longer essential as a monitoring tool.

Thus the body no longer requires countries to submit the report and will no longer publish updates on the number of confirmed cases for all countries in their website.

The Ministry of Health will, however, continue to undertake measures to control the outbreak of Influenza A, as outlined in the Influenza Pandemic Preparedness Plan such as continuing the surveillance of influenza like illness in health centres, limit the number of visitors visiting patients in the hospitals, encourage social distancing that is advising the public to isolate themselves and to reduce social interactions if they have the symptoms of influenza, promote personal hygiene and the surroundings to prevent the spread of influenza.

Patients who have a mild form of the infection and are not at risk of developing severe complications are often allowed to be treated at home.

A large proportion of close contacts who, in general, do not have symptoms of the disease, will also be allowed to undergo home quarantine, if home circumstances are deemed suitable for quarantine purposes.

The suitability for home treatment for patients and home quarantine for close contacts are assessed by the relevant departments, according to the current guidelines.

The Ministry of Health will, from time to time, provide updates on changes in the control measures undertaken.

For further information on Influenza A (H1N1) situation in Brunei Darussalam, the public can visit the Ministry of Health's website: www.moh.gov.bn. The public can also contact Healthline 145 during office hours or 8220991 outside working hours for general enquiries on Influenza A (H1N1).

_______________________________

Total H1N1 cases reach 300 mark

Borneo Bulletin - 14 July 2009


The total number of confirmed Influenza A (H1N1) cases in the country yesterday reached the 300 mark after a further 20 cases were reported by the Ministry of Health.

The ministry, meanwhile, continues to carry out control measures against the outbreak.

Based on the Influenza Pandemic Preparedness Plan, Brunei is currently in Phase 6b, which means that the influenza pandemic is currently on going worldwide.

Brunei is affected with the presence of confirmed cases in the country. As such, the Ministry of Health will continue to monitor and carry out activities for the particular phase as outlined in the plan.

This includes the continued surveillance of influenza like illnesses at health centres and to treat confirmed cases and their close contacts.

Close contacts of confirmed cases will also be tracked and with cooperation from the relevant agencies, they will be placed under quarantine.

Up until yesterday, 182 confirmed cases had recovered and 1,156 close contacts had completed their quarantine, allowing them to resume normal activities.

The Ministry of Health has also limited the number of visitors visiting patients at hospitals.

Also in the Influenza Pandemic Preparedness Plan are steps to encourage social distancing by advising the public to isolate themselves and to reduce social interactions - especially if they have the symptoms of the influenza.

Another crucial step is to promote good personal hygiene and clean surroundings to further prevent the spread of the influenza.
The Ministry of Health reminds the public that Influenza H1N1 enquiries can be directed to the Healthline at 145 during office hours or 822 0991 and 718 0991 outside office hours.

Number of new infections shows declining trend

Borneo Bulettin 13 July 2009
H1N1 UPDATE

By Lyna Mohamad



The Ministry of Health (MoH) yesterday said that 56 close contacts of Influenza A (H1N1) patients have completed their quarantine period, while 22 H1N1 patients have completed their treatment or allowed to return home from the hospital as of 4pm yesterday.

The ministry also confirmed nine new cases of H1N1. The number of infections has been dropping steadily since the first case was reported last month.

The MoH again reminded members of the public to practise good personal hygiene to prevent the spread of the virus by always washing their hands using soap and water and drying them using disposable towels or hand dryer.

The public are also advised to use disposable tissues containing alcohol or hand sanitizer should there be no hand washing facilities, to cover their nose and mouth with tissue when sneezing or coughing and dispose of the tissue into the rubbish bin.

They are also advised to avoid getting close with people who have signs of influenza and avoid visiting crowded places. The ministry said that even though the Influenza A infections have only been mild, it could lead to serious situations for pregnant mothers and patients with chronic diseases.
In this regard, cooperation from the public, particularly those visiting patients at the hospital, is very much appreciated to help prevent the infection from spreading to the patients and comply with the visiting regulations at government hospitals.

General enquiries on Influenza A (H1N1) can be made by contacting 145 during office hours or 8220991 after office hours.

16 new H1N1 cases emerge

Borneo Bulletin Sunday 12 July 2009

By Azlan Othman


The Ministry of Health yesterday reported that 99 close contacts of Influenza A H1N1 cases have completed their quarantine. Nine confirmed cases of Influenza A H1N1 have completed their treatment or have been discharged from the hospital.

For the 120 cases that were still undergoing treatment, 85 per cent were continuing treatment at their homes. 16 new cases of Influenza A H1N1 have been confirmed and the source of infection is still being investigated.
The Ministry of Health continues to remind the public to practice good personal hygiene in order to control the spread of the disease through frequent hand washing using soap and water and drying hands using disposable napkins or electrical hand dryer, use of disposable tissue paper containing alcohol or antimicrobial gel in the absence of a hand washing facility.

The ministry also advised the public to cover nose and mouth with tissue paper when coughing or sneezing and immediately throw the tissue paper away in the rubbish bin, avoid being with people who have symptoms of influenza and avoid going to crowded places.

The Ministry of Health also continues to remind the public that although Influenza A H1N1 infection has generally been reported as mild, it can cause serious complications to pregnant mothers and patients with underlying chronic diseases.

Cooperation from the public, especially those visiting patients in the hospitals, is therefore sought to prevent the spread of the infection to the patients that they are visiting. The public is reminded to adhere to visiting regulations at all hospitals.

For general enquiries on Influenza A H1N1, the public can contact the 'Healthline 145' during office hours or 8220991 outside working hours.

H1N1 here to stay says MoH as 33 new cases reported

Borneo Bulletin 9 July 2009

By Azlan Othman

New cases of influenza A (H1N1) are expected to be found in the country for some time in view of the current situation and the high infectivity rate of the virus, the Ministry of Health said.

As of 4pm yesterday, the ministry confirmed 33 new cases bringing the total to 207.

Investigations on the 10 cases reported Tuesday have found that five cases had history of travel while five others were local cases or cases where the infection occurred in the country.

Preliminary analysis by the ministry has showed that approximately 40 per cent of the cases started to show symptoms of the disease within three days of infection and more than 80 per cent showed two or more symptoms.

The ministry also said that members of the public with symptoms of H1N1 who have sought medical attention and undergone virological testing for H1N1 have been advised not to leave their homes and must isolate themselves from other family members and friends until the results of the virological tests have been obtained. They are urged to wear suitable masks to prevent the spread of infection.

Those who have been confirmed with H1N1 would be given treatment as soon as possible and their close contacts would also be given treatment to prevent being infected.

Though the vaccine to prevent H1N1 infection is still not available, the current anti-viral drugs have been proven effective to treat and prevent the infection, especially if the treatment is given early. The ministry said it would continue to ensure that sufficient supply of medications for the infection was available.

For general queries on H1N1, the public can contact the HealthLine 145 during office hours or 8220991 after working hours.

Hi-tech battle against flu

(Borneo Bulletin 8 July 2009)

By Azlan Othman

The fight against influenza A (H1N1) has gone hi-tech as the Ministry of Health has begun sending advisories through b.mobile's short message service (sms) since yesterday reminding the public to wash their hands frequently and to avoid crowded places if the person is not well and suffering from cold.

The messages to b.mobile users were sent as the ministry confirmed another 10 new influenza A (H1N1) cases as of 4pm yesterday bringing the tally to 174 cases. Seventy-six patients have been discharged from hospital or have completed their treatment.

Investigations are still ongoing on all the new cases. Also, 387 close contacts have completed their quarantine period. Meanwhile, 88 more cases are still undergoing treatment at the hospital or at home.

The Ministry of Health also said that from the total of 164 cases confirmed until yesterday, 66 cases or 40 per cent were children aged from five to 18 years. The ministry together with the Ministry of Education said it would continue to cooperate in monitoring the health of schoolchildren, particularly in preventing the spread of H1N1 infection.

Measures currently in place include temperature screening for schoolchildren and staff prior to entering classes, the formulation of guidelines for isolation and transporting of children with influenza symptoms to the nearest health centres and the formulation of guidelines for contact tracing and class closure in the event a case of H1N1 is confirmed in the school.

The ministry continues to remind the public, especially parents and guardians, to continuously monitor the health of their children and, if possible, check their body temperatures and health condition before sending them to school.

For children with symptoms of H1N1, their parents and guardians are advised not to send their children to school, to immediately seek medical attention, not to send them to extracurricular activities, extra classes or tuition classes, to keep them isolated from other family members and friends, not to bring them to public places including shopping malls and recreational parks and not to take them along to family gatherings and functions.

For general inquiries on H1N1, the public can contact Healthline 145 during office hours or 8220991 after working hours.

22 new cases recorded

(Borneo Bulletin 7 July 2009)

By Azim Ghani

Schools throughout the country reopened yesterday

for a new term. Photo shows a student's temperature

being checked by a teacher. - JAMES KON

The Ministry of Health has said that as of yesterday a total of 313 close contacts of Influenza A (H1N1) have completed their quarantine period and 67 confirmed cases have completed their treatment for the disease.

As of 4pm yesterday, the Ministry of Health has confirmed 22 new cases of the virus bringing the total in the country to 164 cases.
Of the 18 cases reported on Sunday, four cases have travel history to neighbouring countries whereas three are local cases, whilst investigations are still in progress on the remaining 11 cases.

With the start of the new school term yesterday, the Ministry of Health has reminded the public, especially parents and guardians, to constantly monitor the health of their children and, if possible, check their body temperatures and health condition before sending them to school.

For children with symptoms of Influenza H1N1, parents and guardians are advised not to send them to school and to immediately seek medical attention.

They are advised not to send their children to extracurricular activities, extra classes or tuition classes and also keep their children isolated from other family members and friends and not bring them to public places including shopping malls and recreational parks, family gatherings or functions.

As Influenza A (H1N1) is highly infectious and can affect everyday activities for those who are infected, the ministry also reminded the public to maintain good personal hygiene with frequent hand washing using soap and water and drying hands using disposable napkins or electrical hand dryer or use disposable tissue paper containing alcohol or antimicrobal gel in the absence of a hand washing facility.

The ministry also advised people to cover their nose and mouth with tissue paper when they cough or sneeze and dispose them of in the rubbish bin and avoid contact with people who have symptoms of the virus and crowded places.

For further inquiries and information, the public can contact Healthline 145 during office hours and 8220991 after working hours.

56 recover, 249 complete quarantine

Borneo Bulletin Report 6 July 2009

By Achong Tanjong

The Ministry of Health yesterday announced that 249 people who have close contact with Influenza A (H1N1) cases have already completed their quarantine period, while 56 confirmed cases have completed treatment for the infection.

Meanwhile, as of 4pm on Sunday, the Ministry of Health confirmed 18 new cases of Influenza A (H1N1), bringing the total in the country to 142 cases. Of the 23 cases reported yesterday, 10 cases have travel history to neighbouring countries, nine are local cases, whilst investigations are still on-going for the remaining four cases.

The Ministry of Health continued to remind members of the public who are showing symptoms of Influenza A (H1N1) such as fever, runny nose, cough, sore throat, difficulty in breathing, joint pains, headache, dizziness, diarrhoea or vomiting, to immediately seek medical attention, wear an appropriate mask to prevent the spread of the infection to other people, keep themselves isolated from other family members and friends until they have recovered, refrain from going to public places including shopping malls, recreational parks, schools, and refrain from attending family gatherings and function as well as visiting patients at the hospital.

As Influenza A (H1N1) is highly infectious and can affect daily activities for those who are infected, the Ministry of Health also reminds the public to maintain good personal hygiene by frequently washing their hands using soap and water and drying hands using disposable napkins or electrical hand dryer, use of disposable tissue paper containing alcohol or antimicrobial gel in the absence of a hand washing facility, covering nose and mouth with tissue paper when coughing or sneezing and immediately throwing the tissue paper away in the rubbish bin. It is also advisable to avoid being with people who have symptoms of influenza and refraining from going to crowded places.

For further enquiries and information, public can contact Healthline 145 during office hours and 8220991 outside working hours.

H1N1 risky for those with chronic illness, kids under-12

By Azlan Othman

(Borneo Bulletin 5 July 2009)

The Ministry of Health has confirmed 23 more new cases of influenza A, H1N1 as of four in the afternoon, yesterday, bringing the total to 124 cases.
Of the total cases, 50 patients have completed their treatment whilst 186 close contacts have also completed their quarantine.

Further investigations were made on the latest cases.

The ministry continues to remind the public that although H1N1 is usually mild, it can become severe for patients with chronic diseases of the lungs, heart, kidneys and liver. Patients who also happen to suffer from neurological diseases, immuno-suppression and diabetes mellitus are also at more risk than others.

Thus the public is also reminded to step-up their vigilance as H1N1 is highly infectious and would result in causing illness among a large number of people and disrupt their daily activities.

There is also the possibility of genetic mutation occurring to the H1N1 virus, which could turn it to a more serious strain. There is still no available vaccine to prevent the infection.

With the rapid increase in cases being reported, the ministry emphasises the importance for the public to adhere to the visiting regulations at all government hospitals and to only visit during the stipulated visiting times as well as limiting yourselves to two visitors per patient and not to bring children below the age of 12 years on visiting trips.

People who have just returned from affected countries are also advised to avoid really public places in the first seven days of their return.

Similar advice has also been given to those showing symptoms of influenza.

For further inquiries and information, the public can call the 'Health-Line' at 145 during office hours and 8220991during after-hours.

H1N1 cases reach 101

By Azlan Othman

(Borneo Bulletin report on 4 July 2009)

The Ministry of Health has confirmed eight more new cases of Influenza A(H1N1) yesterday, bringing the total in the country to 101 cases. Of these cases, 29 patients have recovered and discharged from Pg Muda Mahkota Pg Muda Hj Al-Muhtadee Billah hospital in Tutong.

In the category of cases in different age groups, 57.4% of the reported cases were made up of people aged 20 and below, 37.6% between 20 to 40 years and 5% involved those aged 40 years and above.

In view of the increasing number of reported cases, the Ministry emphasises the importance for the public to adhere to the visiting regulations at all government hospitals such as during the stipulated visiting hours, limiting two visitors for every patient and not bringing children aged 12 years and below to visit patients.

Those who have just returned from overseas or showing symptoms of H1N1, are advised not to visit patients in hospital.

The Ministry of Health continued to advise members of the public who have returned from affected countries within the past seven days, and having symptoms to seek immediate medical attention.

It is also advisable to reduce social activities and crowded places such as community gatherings, shopping centres, markets, stalls, restaurants, cinemas, swimming pools and the like.

The public can help prevent the spread of respiratory infections by maintaining good personal hygiene such as washing hands regularly with soap and water and drying them using disposable tissue or the like, using alcohol-based disposable hand wipes or gel sanitizers if there are no-hand washing facilities. The public were also advised to cover nose and mouth when one sneezes or coughs and to discard used tissues in the dustbin, to avoid people who have influenza like symptoms and to avoid going to crowded places.

For further inquiries and information, the public were advised to call the Healthline at 145 during office hours and 8220991 after hours.

12-year-old girl is first fatality

By Azaraimy HH

(Borneo Bulletin report 3 July 2009)

Precaution by wearing face-masks amid the increasing

number of confirmed cases in Brunei. - JAMES KON

A twelve-year-old girl died yesterday being the first fatality in Brunei involving Influenza A H1N1 virus. The victim said to be a hepatitis and pneumonia patient, failed to survive the H1N1 infection as her body defence system proved too weak to counter the killer disease.

By press time yesterday, the country had recorded 27 new cases bringing the total to 93. According to the Ministry of Health number of cases is likely to increase, but urged the public not to be alarmed.

Meanwhile, the Ministry of Health has disallowed children of 12 years and below from hospital visits.

The Ministry also requested for public places such as cinemas to provide hand sanitizers for their customers. It also advised cinemas to put up banners reminding people on precautions to help control the spread of H1N1.

During a press conference yesterday the Minister of Health, Pehin Orang Kaya Indera Pahlawan Dato Seri Setia Hj Suyoi Hj Osman revealed the sad fate of a 12-year-old patient saying that the 12-year-old was a patient of multiple sicknesses, including auto-immune hepatitis, end-stage liver failure and pneumonia.

Pehin Suyoi said, the child had been in a critical state since June 26. Lab tests yesterday morning confirmed the child was also infected with the H1N1 virus.

The Ministry is now carrying out investigation on how the child was infected with the highly contagious H1N1 virus, he said.

According to Pehin Dato Seri Setia Hj Suyoi, out of the total cases, 58.4 per cent involved those below 20 years old, 36.4 per cent involved between 21 and 40 years of age and 5.2 per cent involved above 41 years old.

To date, 21 H1N1 patients have been cleared of the virus and discharged from the quarantine at Hospital Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah, Tutong.

The Minister added that epidemiological tests so far pointed that 56 per cent of the cases involving recent travelling history from abroad including United Kingdom, Kuala Lumpur, Kota Kinabalu, Johor, Lawas, Bintulu, Miri, Labuan, Singapore, Phillipine and Laos.

While, 25.8 per cent of the cases was infected through contacts and 18.2 per cent are still under investigation. The health minister said it is likely that 18.2% was infected through community transmission but that theory has not been confirmed yet.

The Minister reminded the public the importance of following the hospital rules in the height of H1N1 pandemic.

The Ministry of Health urged visitors to only pay a visit to relatives or friends during office hours, allowing only two visitor per patient and to not bring children of 12 years old and below to visit hospital.

And those who are sick and possess the symptoms of H1N1 were also reminded not to visit the hospital. And once again, the Minister urged those who have just returned from travelling abroad to stay home and away from any form and size of public congregation for at least a week.

Those who have just returned were asked to abandon visits to public places, shopping places, night and flea markets, restaurants, cinema and swimming pool etc.

The Ministry reiterated again that the public can help to lessen the risk of H1N1 from spreading by washing their hands with water and soap and drying them with towel or hand dryer, using disposable tissue that contains alcohol or hand sanitizers if there is no hand-washing facility.

The public should also cover their mouth while sneezing or coughing and dispose used tissue into the dustbins, stay away from people who have symptoms of influenza and stay away from crowded places.

Don't panic urges Health Minister

By Azlan Othman

(Borneo Bulletin report on 2 July 2009)

The Minister of Health

"We don't have to live in fear and there is no need to panic. It's not necessary." That was the message relayed by the Minister of Health in a press briefing as the country recorded 24 new Influenza A (H1N1) cases yesterday, the highest surge since the nation was hit by the flu more than a week ago, thus bringing the tally to 66.

Pehin Orang Kaya Indera Pahlawan Dato Seri Setia Hj Suyoi also said that the pandemic is here to stay.

"According to its cycle, it can remain for two years. But within that period, there could be a lot of changes as well.

"We hope that there will be a vaccine for H1N1 soon. At the moment, we have to be very careful as such a vaccine is not yet available. It might remain mild, and patients would recover from it and the public should not be afraid," the minister added.

Epidemiological studies indicate that as of July 1, 2009 at 3pm, the flu has affected 49 Bruneians and 11 foreign nationals, with Brunei-Muara recording 41 cases, Belait 16, Temburong four, Tutong three and transit one.

As of July 1, 2009, those with travel history constituted to 30 cases, out of which nine were patients who returned from UK, Kuala Lumpur (eight), Kota Kinabalu (six), Johore (one), Lawas (one), Singapore (one), Philippines (one) and Laos (one).

The Ministry also said, 24 cases were transmitted via contacts, while another 12 are still under investigation.

It also informed that there is a possibility of community transmission involving a 15-year-old girl who neither has a travel history nor contact with other cases

He also said the ministry is reviewing the possibility of renewing the management protocol. Among these would be strengthening treatment at homes for mild cases and the suitability of home treatment to ensure that there are no close contact with those who have chronic diseases or pregnant women.

Pehin Dato Hj Suyoi also said there is a possibility to turn Pg Muda Mahkota Pg Muda Hj Al-Muhtadee Billah hospital in Tutong into a full isolation centre for H1N1.

This is a control measure, as H1N1 patients should be treated separately.
As an initial stage to ascertain the continuity of the service at the hospital, steps such as relocating outpatient services to Tutong Health Office and relocating physicians, dermatology, midwifery and pediatric services will also be made to Tutong Health Office effective July 4, 2009.

Specialised OMF, ENT and ophthalmology services will also be moved to bungalow B and C of the Tutong hospital beginning July 4.

The Ministry sources stated that the H1N1 cases here are mild. However, we should step up our precautions as the disease is easily transmitted and causes many illnesses, thus affecting daily activities. There is also a possibility of mutation of such virus to become more dangerous and that there is no vaccine to prevent such H1N1 yet.

Due to the surge in the reported cases, the ministry urged the public to step up precautions and not to be complacent. For those who have just returned from the affected countries in the past seven days and developed the symptoms, they should see a doctor at health centres and hospitals immediately.

The public were also advised to reduce social activities and avoid crowded places within seven days such as community gatherings, shopping centres, markets, stalls, restaurants, cinemas, swimming pools and the like.

The public should also practise good personal hygiene such as to wash their hands thoroughly and often with soap and water, cover nose and mouth with a piece of tissue paper when coughing or sneezing.

Anti-H1N1 strategies

By Lyna Mohamad

(Borneo Bulletin report on 1 July 2009)

Deputy Sultan speaks at the meeting. - LYNA MOHAMED

His Royal Highness Pengiran Muda Haji Al-Muhtadee Billah, the Crown Prince and Deputy Sultan yesterday reiterated that the current Pandemic Influenza Plan needs to be increased and strengthened by taking into account the rising number of cases and incidents occurring globally due to the effect of the Influenza A Virus (H1N1).

HRH yesterday consented to attend the Special Meeting to discuss plans and preparations in tackling the current outbreak of the H1N1, held at the Department of Fire and Rescue's multipurpose hall.

In his opening address, HRH noted that in declaring the concern level from phase five to phase six, WHO faced several challenges in tracing the spread of the virus in various countries.

"What is obvious is that the human-to-human infection level has proliferated rapidly and its potential to further spread is a very serious threat to the safety of our citizens too," HRH stated.
The world now faces the pandemic with WHO reporting a total of 61,688 infected cases and 265 fatalities in 112 countries.

Infections in some of the affected areas including neighbouring countries in Asia are in a cluster while spreading it domestically too amongst the country's residents.

His Royal Highness said what was previously the nation's worry has now become a reality where the sultanate is not exempted from the threat of the virus.

Although the numbers of confirmed infected cases do not involve unwanted effects, the number of victims suffering from the virus will increase and this is a reality that we need to address and be prepared to tackle.

To date, efforts by the related agencies particularly the Health Ministry, are guided by the measures suggested by WHO, in ensuring close monitoring, thorough inspection and sharing of information as well as concerted action with other related agencies.

HRH also noted that the latest step of extending the school term holidays is a monitoring and preventive measure which is reasonable and proactive. Such efforts are definitely required from all government agencies in establishing effective action coordination and implementation of organised control and preventive measures.

The government and private sectors need to prepare their respective action plans and at the same time take preventive measures.

There is also a need to always be ready to face the worst case scenario considering that there are no stronger preventive measures such as vaccine that have been proven effective.
HRH highlighted that questions need to be raised and given serious thought to ascertain about our readiness in facing the surprising and more than predicted increases number of infections. What plans are envisaged should the virus become more severe, having the potential to cause fatality. And do we have enough logistics and human resources capacity to conduct a wide quarantine situation.

The role of the public is no less of importance in shouldering the responsibilities together in preventing the virus from spreading more seriously in the country, HRH said while stressing that the success of all efforts made by His Majesty's government will not be achievable without the involvement and cooperation from every level of the community.

Main agencies need to merge to establish a media centre that is always ready to disseminate the latest update on the situation of the virus, adding that the dissemination of clear, accurate and direct information is the most effective way to ensure the public will take serious note on advice given by the Health Ministry and relevant agencies.

Research and screening procedures are also needed to ensure that the public are not doubtful towards the treatment and medical steps that need to be taken as well as the optimal use of ICT services such as the use of SMS, internet and media.

Such steps, the Crown Prince added can ensure that citizens and residents will be more aware and ready to practise preventive measures in maintaining personal hygiene, lessen the risk of exposure from infections and obeying the quarantine orders to those involved.

Meanwhile in the closing sabda, HRH said that the sharing of information and experience from involved parties and of importance at international level such as WHO must always be made as the main platform from various aspects and actions towards the stabilisation of a more comprehensive and updated action plan.

In the nation's current situation of the virus threat, measurement and re-evaluation of the communication effectiveness amongst agency and public members particularly on preventive measures, is critical.

HRH called on relevant parties to think of methods on how such effectiveness can be achieved in ensuring the steps are directed towards the control and prevention of the virus can be implemented more effectively.

Amongst the efforts that is appropriate to be taken is the stressing of self-isolation for those infected and its closest contacts besides practising responsible attitude and unselfishness to curb the more critical spread of the infection.

HRH further urged all government agencies to be always ready to face the situation that is threatening their respective working scope should the possibility of its officers and staff get infected with the disease. Every agency should prepare a business continuity plan that could secure the implementation of respective activities, HRH added.

It's 32 cases of H1N1 now

By M K Anwar

(Bor neo Bulletin 30 June 2009)

Three cases of Influenza A H1N1 were confirmed yesterday by the Ministry of Health, which has now raised the number of confirmed cases up to 32 cases.

In a statement yesterday, the 30th case was from a 51-year-old female who developed symptoms on June 26 and sought treatment the following day at the Suri Seri Begawan Hospital in Kuala Belait.

The 31st case was a 25-year-old female who developed symptoms on June 28. She sought treatment on the same day at the Department of Accident and Emergency, RIPAS Hospital.

Meanwhile, the 32nd case was a nine-year-old boy who is a close contact of case 30.

All three are undergoing treatment at the Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital in Tutong and are recovering well.

No other information was given as to how they could have possibly got infected with the virus.

The Ministry of Health have also confirmed that four previous cases of Influenza H1N1 have recovered and subsequently discharged from the Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital.

All together, 14 patients have recovered and have been discharged.

Further to their statement yesterday, the Ministry of Health disclosed that out of the 32 confirmed cases, a total of 216 close contacts have been required to be quarantined for seven days.

These contacts did not have symptoms but due to the exposure to the cases, as preventive treatment they have been isolated and given Tamiflu. A majority of these contacts are quarantined in their own respective homes.
The school term which was supposed to resume yesterday have been delayed by another week to next Monday as further precautionary steps to prevent any spread of the virus. Schools meanwhile have been given the instructions to monitor and check the temperature of students coming back to school next week.

In their advisory, the Ministry of Health reminded those who have recently returned from countries like Australia, United States of America, Indonesia, Philippines, Canada, Malaysia, Singapore, Thailand and United Kingdom within the past seven days to seek immediate medical attention if they develop symptoms.

Those with fever, were also advised to avoid crowded places such as community gatherings, shopping centres, markets, stalls, restaurants, cinemas and swimming pools.

Those wishing to enquire or obtain more information about the Influenza A H1N1 can contact the Healthline 145 during office hours or 8220991 (after office hours).

H1N1 tally reaches 29

By James Kon

(Borneo Bulletin report on 29 June 2009)

Four new confirmed cases of Influenza A (H1N1) in Brunei Darussalam surfaced yesterday, bringing the total of cases in the country to 29.

The Ministry of Health in a press statement yesterday revealed the 26th and 27th cases are sisters who were passengers on flight BI098 that arrived in Brunei Darussalam on June 24 from London via Dubai.

The18-year-old and 17-year-old siblings developed symptoms on June 26, 2009 and sought treatment the following day.

The 27th case is a 38-year-old female and the 29th case is a three year old girl. Both had contact with the 24th case that is a 35-year-old man on flight BI089 that arrived in Brunei Darussalam on June 24, 2009 from UK via Dubai.

Meanwhile, five confirmed cases of influenza A (H1N1) previously reported have recovered and discharged from Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital, Tutong which brings the total of patients fully recovered from the disease and have been discharged to 10.
The Ministry of Health also disclosed that a total of 209 close contacts of the 29 confirmed cases need to be quarantined for seven days.

These contacts have not shown any sign of the symptoms. However due to their exposure to the confirmed cases, they are required to be isolated and given Tamiflu as preventive treatment. The majority of these contacts are quarantined in their own respective homes.

The Ministry of Health once again would like to advise members of the public who have just returned from overseas to voluntarily reduce their activities and social interaction for as long as seven days.

For further inquiries and information, the public can contact 145 during office hours or 8220991 during and after office hours.

-------------------------------------------

Border hoppers return with H1N1
By Azlan Othman

(Borneo Bulletin report 28 June 2009)

Border hoppers arriving from Sabah are among the latest A (H1N1) patients, with five more influenza cases reported.

Two had just arrived from Kota Kinabalu in Sabah by car, another two from London via Dubai and another one was in contact with a previous case. The Ministry of Health said yesterday that to date, a total of 25 cases have been recorded.

The 21st case involved a 28-year-old lady who arrived on June 23 from Kota Kinabalu, with her family by car. Prior to this, the patient arrived from Dubai on June 22.

The 22nd case involved a 13-year-old girl who also just arrived from Kota Kinabalu with her family by car, arriving on June 22. The patient developed the symptoms on June 25 and underwent treatment on the same day.

The 23rd case was a 22-year-old man while the 24th case was a 35-year-old man, both of whom were passengers arriving from London via Dubai on June 24.

The 25th case was a 12 year-old girl who was in contact with the 19th case. The patient developed the symptoms on June 26 and confirmed to have the influenza A on the same day.

For the time being, no patients have been released from quarantine and all were still undergoing treatment and in good condition.

The Ministry of Health reiterated the need for the public who have just arrived from overseas to reduce their activities and social interaction voluntarily for seven days. They were also urged to monitor their health and to seek treatment immediately, should they develop the symptoms of the disease. Another measure is to practise good self-hygiene at all time.

The ministry's figure indicated that those aged between 16 to 20 contributed to the highest figure with seven cases, followed by 11 to 15-year-olds with six cases.

The ministry recently stated in a press statement that in the anticipation of the start of the new school term, students who have returned from abroad after June 23 may apply and are advised to apply for an extended holiday to stay at home as precaution against probable spread.

The Bulletin hotline also received calls from the public yesterday expressing concern over the rise in influenza A cases. This is especially so as school is slated to reopen on Monday.

A mother of three identified only as 'Lin' said it's better to be safe than sorry and lauded the move for self-quarantine for those who have visited the affected countries. "The symptoms of H1N1 might only appear days after they've arrived from abroad and once it reaches the school students, it will be a problem," she added.
The Sunday Bulletin understands that several schools in the country held a meeting yesterday morning to discuss the procedures to be implemented like temperature checks on every student before they enter the school.

Meanwhile yesterday afternoon, informed sources told the Bulletin that the school term may be extended for another week. Several teachers that were asked also confirmed that they have received instruction on the holiday extension that will apply for students. Teachers however have been asked to return to work this Monday.

The Ministry of Education when contacted said an announcement will be made but did not elaborate further about the one-week school holiday extension.

--------------------------------------------------
H1N1 cases tally rises to 20

By M K Anwar

(Weekend report on June 27 2009)

Two more new cases of the Influenza A H1N1 was confirmed yesterday bringing the tally to 20 cases in the country.

The Ministry of Health updating on the new cases stated that the 19th case detected involves a 47-year-old male, a permanent resident who went to Kuala Lumpur on June 19, 2009 and returned to the country on June 22, 2009 via Miri on the AK5186 flight. On June 25, 2009, the patient sought medical attention and lab tests confirmed him positive the next day.
The 20th case meanwhile is an 18-year-old female who went to Kota Kinabalu, Sabah Malaysia by car on June 23, 2009 and returned on June 25, 2009. She developed the symptoms on the day she returned and sought medical attention.

Lab test confirmed the next day that she was positive with the Influenza A H1N1.

The two patients are reported to be in good condition and still undergoing treatment.

So far, of the 20 confirmed cases, 12 had a history of overseas travel while the remaining eight were infected from close contacts with other cases.
Four previously confirmed cases have now recovered and discharged from the Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital in Tutong. Prior to being discharged, they have undergone further tests to ensure that they were well and free of the Influenza A H1N1 infection.

Meanwhile, parents are breathing a sigh of relief following further precautionary measures by the Ministry of Health to distribute face-masks and thermometers to schools nationwide. They also applaud the decision of the Ministry of Education to give leeway to students wishing to apply for extended holiday especially for those who had just returned from overseas.
The new school term recommences on Monday, June 29, and many parents expressed concern about the contagious disease. The measure to check students' temperature before entering the school compound was welcomed by most of the parents.

Norhayati, a 28-year-old banker and has two children going to school agrees that checking the students' temperature before they come in contact with other students can help minimise the spread of the disease.

Salehuddin, a teacher in a private school told the Weekend Bulletin that it's not only students who are checked; but even those wishing to enter the school compound must have their temperatures checked.

"Even the teachers will have to go through a temperature check before they enter the school", he added.

The Ministry of Health continues to advise the public who have returned from overseas trips to voluntarily reduce social activities and interactions for seven days.

Members of the public are also advised to monitor their health and seek immediate medical attention if they develop symptoms. The MOH further reminds the public that good personal hygiene should be practised at all times.

Health Ministry distributes masks, thermometers to schools nationwide

By Azaraimy HH

(Borneo Bulletin report 26 June 2009)

Permanent Secretary at the Ministry of Education and the Acting

Permanent Secretary at the Ministry of Religious Affairs

inspecting masks to be distributed to schools.

Students who have returned from abroad after June 23, may apply and are advised to apply for an extended holiday to stay home as precaution against the probable spread of the fast-infecting swine flu virus to other students.

The Ministry of Health previously urged those who have just returned home from abroad to stay away from any social congregation for a week to make sure they are free from the highly contagious swine flu virus and the public were told to step up their own personal hygiene initiative while abroad.

Yesterday, with the new school term opening on Monday, to further gear up schools in the fight against the imminent phase-6 global pandemic, the Ministry of Health has distributed some 1,000 thermometers and 10,000 masks to schools.

With the equipment, schools were asked to check temperatures of students before entering school compound or before starting of class as a temporary measure effective June 29. They were told not to miss out any single student.

The alert level is 40 degree Celsius, where the affected students will be immediately relieved and masks will be immediately given.

Schools will reopen on June 29, and out of the concern on the H1N1 virus, officials from the Ministry of Education along with health officials told schools to allow students to apply for extended holiday for a week.

"Please allow your students to stay at home for a week from the date of their arrival after June 23," Acting Director of Schools, Awg Ibrahim bin Hj Abd Rahman said yesterday during the briefing and distribution of thermometers and masks to schools nationwide at Maktab Sains Paduka Seri Begawan.

During a briefing, which was attended by school principals and representatives, Dr Linda Lei from the Ministry of Health said that those infected with the H1N1 virus usually show symptoms within a week of being infected. It is a good measure to follow, where students who came from abroad must stay a week at home or so.

The briefing was held to raise teachers' understanding on the infectious disease and how it spreads. The masks and infra-red based thermometers were handed out to principals and schools representatives by Dato Paduka Hj Abd Salam bin Abd Momin, the Permanent Secretary at the Ministry of Education and Awg Hj Ismail bin Hj Abd Manap, Acting Permanent Secretary at the Ministry of Religious Affairs.

The thermometers are for use by teachers to check the temperature of students before entering the school compound or before the classes start.

If any student has any symptoms such as coughing, running nose or fever, teachers will be required to fasten the mask to the student and parents will be notified to bring their children for an immediate medical check-up. Teachers were also told to advise parents not to send their children to school if their children have the symptoms such as coughing and fever. The swine flu symptoms are similar to the symptoms of the influenza virus most are familiar with. The good news is that most people who become infected will do fine and will not have any long-term complications.

Those whose immune system is compromised, older or pregnant women may be at higher risk of complications or serious respiratory illness.

The most common swine flu symptoms are cough, nasal congestion, nausea/vomiting, diarrhoea, body aches, joint pains, fevers, sore throat, headaches, fatigue, decreased energy and rarely death in more severe cases, especially from pneumonia.

The World Health Organisation elevated the worldwide pandemic alert to phase 5, on April 29 when WHO considers a pandemic is imminent. On June 11, WHO said the pandemic has reached phase 6, indicating the flu has spread worldwide.

As of June 24, 2009, 11 cases have been detected in the Sultanate.

Acting Director of Schools, Awg Ibrahim bin Hj Abd Rahman, stressed that schools should put emphasis on cleanliness, ask students to sanitise their hands before entering class and step up personal hygiene.

Close contact main cause of H1N1 rise

By James Kon

(Borneo Bulletin report on June 26, 2009 Friday)

As the total number of Influenza A H1N1 cases reaches 18 with seven new cases being recorded yesterday, the Ministry of Health reiterated its call to the public to take every precaution that it had given earlier to prevent the spread of this disease.

The number of cases rose to 18 within a matter of one week, the first case being reported last Saturday. It was also revealed that the new cases have contracted the illness from being in close contact with previous cases.
According to a press statement from the Ministry, five out of seven new cases contracted the contagious disease from close contact with the earlier cases.

The 12th case of H1N1 in the country is a six-year-old boy who arrived in the country on June 22, after travelling to Kuala Lumpur, Malaysia.
The 13th case is a 14-year-old girl who has had close contact with the eighth case who is a 23-year-old woman.She developed the symptoms on June 18, after travelling to Kuala Lumpur, Malaysia.

While 14th case is a 23-year-old man who has had close contact with the first victim of H1N1 in Brunei Darussalam.

The 15th case is a 20-year-old foreign man who has stopped over in Brunei Darussalam from London on board BI098 on June 24, 2009 en route to Kuala Lumpur Malaysia. The patient developed symptoms of H1N1 after arriving in Brunei International Airport.

As a precautionary measure, passengers who sat in the same row and three rows in front and behind are currently being identified and contacted.
The 16th case of H1N1 is a 19-year-old girl who has had close contact with the fourth case.

The 17th and 18th cases are siblings who had close contact with the third case. The 17th case is an 11-year-old boy while the 18th case is a 14-year-old girl. All the confirmed cases are currently being treated and are in good condition.

From a total of 18th, 10 cases contracted the Influenza A Virus (H1N1) while in foreign countries. The remaining eight cases have had close contact with the 10 cases.

In the meantime, the first victim of H1N1 in Brunei Darussalam has been discharged from Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital, Tutong after full recovery.

Before being discharged, tests were carried out to make sure that the patient was in good health and free from H1N1.

The Ministry of Health once again would like to advise members of the public who have just returned from overseas to voluntarily reduce their activities and social interaction for at least seven days.

The just returned travellers are also advised to monitor their health and to get treatment immediately if symptoms of the disease surfaced.

In addition, precautionary measures need to be taken by practising good personal hygiene every time.

Meanwhile, in anticipation of the start of the new school term, students who have returned from abroad after June 23 may apply and are advised to apply for an extended holiday to stay home as precaution against probable spread of the Influenza A (H1N1).

Acting Director of Schools, Awg Ibrahim bin Hj Abd Rahman urged school principals to allow this yesterday during the briefing and distribution of thermometers and masks to schools nationwide.

The Ministry of Health have distributed some 10,000 masks and 1,000 thermometers to public and private schools across the country.