All public schools in the Maldives have been closed to prevent the spread of the H1N1 swine flu virus after the number of cases reached 51 and a fatality was identified.
Less than 12 hours after insisting that the situation does not warrant closing schools, health officials told the press late on Monday night that the number of confirmed H1N1 cases has increased from 27 in the morning to 51 after more samples were tested.
Samples from 251 influenza patients have been tested as of Monday.
Upon reviewing the 51 confirmed cases, the authorities found that a sample from a 27-year-old man who died on March 4 had also tested positive.
“Additionally, there are 70 samples in the testing process today. Looking at our rate, when 51 out of 251 cases tested positive for H1N1 it means about 20 percent. So we believe we will find more cases in these 70 samples,” Dr Abdulla Niyaf said at last night’s press conference.
The national health alert has been raised to level three based on the “rapid increase of cases” nationwide since February, the discovery of severe disease among high-risk patient groups, and the death of one flu patient.
The education ministry decided to close schools for the rest of the week based on the advice of the Health Protection Agency. Schools were due to close next week for the half-term holiday.
As most of the cases have been detected in the capital, the HPA also advised against non-essential travel between Malé and the atolls during the holidays.
Since the 2009 pandemic when it was a new strain, the H1N1 swine flu virus has been circulating as a normal seasonal influenza every year.
According to the HPA, the virus is now “similar to any other influenza and not any more severe or dangerous,” but children under five years of age, the elderly, pregnant women, and those with chronic conditions such as lung or heart diseases are at risk of developing life-threatening complications such as pneumonia.
Dr Niyaf, chief medical officer at the ADK hospital, said a pregnant woman who tested positive for H1N1 is presently in critical condition.
Samples from another pregnant woman and a child are also being tested, he added.
The 27-year-old man meanwhile died while undergoing treatment at the Indira Gandhi Memorial Hospital. He was placed on a ventilator and treated with the anti-viral medicine Tamiflu but died of acute respiratory distress syndrome, a serious illness with a high mortality rate.
A sample saved from the deceased tested positive for the H1N1 virus on Monday. Niyaf said hospitals have been taking samples from patients with respiratory illness since the beginning of the year.
The only testing facility in the country is the national laboratory at IGMH.
Samples have to be sent to Malé from the atolls and efforts are underway to supply anti-viral medicine to island health centres and atoll hospitals, Niyaf said.
Information is also being provided to doctors and health workers through teleconferencing, he added.
According to the HPA, discussions are ongoing about vaccinating high-risk age groups. Niyaf said the Maldives has a “limited stock” of the influenza vaccine.
Dr Niyasha Ibrahim noted that the vaccine is brought into the Maldives every six months and given to Hajj and Umra pilgrims. The vaccine has “a very short shelf life” as the influenza virus mutates, she explained.
She also stressed that doctors treat patients with severe flu symptoms with the anti-viral medicine without waiting for test results. Patients with less severe symptoms are not given Tamiflu.
As the flu spreads through airborne droplets, Niyaf stressed the importance of washing hands regularly and covering the mouth and nose when sneezing and coughing.
Niyaf also advised flu patients to stay home. The virus can spread one day before symptoms appear and up to seven days after that.
Symptoms of influenza include fever, cough, sore throat, runny or stuffy nose, muscle or body ache, headaches and fatigue.
If the symptoms are not severe, the doctors advised undergoing treatment at home and resting instead of going to flu clinics.
The swine flu scare comes amidst a seasonal spike in respiratory infections and influenza. Last week, the health ministry cautioned that the contagious common cold and viral fever have been rapidly spreading across the Maldives.
About 3,000 cases of flu from the atolls and 2,000 cases from Malé have been reported in a week, according to the HPA, compared to about 4,000 cases a week nationwide in previous years.
The number of people visiting the 24-hour flu clinic set up at IGMH has increased substantially in the past two days and the main hospital in the capital is jam-packed.
A flu clinic has also been set up at the Hulhumalé hospital and the ADK hospital has temporarily barred visiting at its intensive care unit, high dependency unit, and neonatal intensive care unit.
The IGMH has also cut short visiting hours from 5:00pm to 7:00pm and temporarily closed its children’s play area. As of Sunday, children under 12 are also not allowed to visit patients at the hospital.
The Maldives National University and the Islamic University of Maldives have meanwhile cancelled regular classes for the rest of the week and the Football Association of Maldives has suspended all ongoing competitions, including the Malé League, the inter-school football tournament, and the Minivan Championship.
Inter-school badminton and handball tournaments have also been postponed.
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