Health watch

Not deadly but can cause a huge economic impact :

Novel Influenza

Suharshi Perera

Novel Influenza A(H1N1) virus which has plunged to pandemic state today, has become a threat to the Sri Lanka's health system as its economic impact is very high due to its very high spreading capacity, even though the disease is not deadly, Epidemiologist, Epidemiological Unit of the Health Ministry Dr. Sudath Peiris says.

Influenza virus unlike other viral diseases changes its genetic structure frequently.

For example the measles virus retained the same viral and genetic structure for the past 600 years. Once a person is infected, immunity to measles develops within his body so only once in life measles can attack a person. But humans can be infected by Influenza virus several times in life since the immunity developed to a certain variant of Influenza may not be strong enough for another variant, he said.

What is Novel Influenza?

Novel Influenza A(H1N1) is the newly mutilated Influenza virus. Human beings have not developed resistance towards this new variant of Influenza. Therefore it started spreading across countries.

The virus is an adaptation of human influenza virus, avian influenza virus and swine influenza virus. It is a mix of genetical materials of all these three sources. It first surfaced in Mexico in early April this year and there were no specific tests to identify the virus, leading to comparatively higher death rates than the seasonal influenza. It spread rapidly across the American region and the relatively high mortality created a fear psychosis among people that it was very deadly.

By June, studies correctly identified the disease. It also revealed that the case fatality of this new influenza is not very different from that of the common seasonal influenza. However, because it is a new virus the total population is non immune to the disease.

Thus it can spread fast reporting more cases compared to a seasonal influenza. Majority of those who died in the disease were with an immune deficiency status. Most of them were above 65 years old with underlined chronic lung, heart and kidney diseases.

Swine flu

At the very beginning when the disease was being researched, the genetic structure of the virus had a resemblance to the Swine Influenza virus.

Different variants of the Influenza virus affect different animals like birds and pigs.

However, the studies conducted later revealed that the virus does not transmit from pigs but it is a combination of swine influenza, avian influenza and human influenza calling it the Novel Influenza A(H1N1).

How does A(H1N1) transmitted?

The A(H1N1) virus can be transmitted from respiratory routes. Unlike the diseases transmitted through food and water or sexual routes, it is very difficult to contain air- borne diseases.

The disease can be transmitted via droplets expelled by speaking. Sneezing or coughing.

With global travel, in a few months the disease spread world over becoming pandemic. Health authorities take measures to control the disease entering the country as it is impossible to contain totally.

Another difficulty in containing the disease is that every case is not symptomatic. If 100 persons are infected, the majority does not show symptoms but all 100 are disease carriers. Only 10 percent of the infected shows classical symptoms. Therefore it is impossible to contain it totally.

Symptoms

The main symptoms of the Novel Influenza are similar to any other influenza.

1. Fever (could be high or mild)
2. Cough
3. Headache
4. Body aches
5. Sore throat
6. Runny nose

Precautions

1. Avoid close contact with people who show influenza like symptoms
2. Avoid touching mouth and nose
3. Clean hands thoroughly with soap and water, or cleanse them with an alcohol based hand rub on a regular basis (if touching the mouth and nose or surfaces that are potentially contaminated)
4. Avoid close contact with people who might be ill
5. Reduce the time spent in crowded settings if possible
6. Improve airflow in your living space by opening windows
7. Practice good health habits including adequate sleep, eating nutritious food and keeping physically active

Using a mask

If one is not infected wearing a mask is not needed. But the infected can wear masks to prevent the disease being transmitted to others.

If a person is having close contacts with an infected it is advisable to wear a mask. It should be disposed immediately and properly after contact and cleanse the hands thoroughly.

The correct use of a mask is very essential and the incorrect use increases the chance of spreading infections.

As responsible citizens we can prevent the spread of the disease if we suspect that we are infected. If one show the above symptoms

1. Stay at home and keep away from work, school or crowds
2. Rest and take plenty of fluids
3. Cover nose and moth when coughing and sneezing. If using tissues make sure you dispose of them carefully.
4. If there is no tissue around cover your mouth as much as possible with the crook of the elbow when coughing and sneezing
5. Use a mask when having contacts with others and make sure to do so in the correct way.
6. Inform family and friends and try to avoid contact with other people

Apart from the above measures the infected may contact a health professional before traveling to a health facility to discuss whether a medical examination is necessary. Refrain from taking antiviral without medical advice.

A person should seek medical advice if one experience shortness of breath or difficulty in breathing or if fever continues more than three days.

Novel Influenza could be treated effectively if the infected reach a Government Hospital immediately. Certain antiviral like Tami flu are used to treat the disease. Sri Lanka is also armed with a stock of Novel Influenza antiviral drugs donated by WHO.

However, it is only available with Government Hospital. Those drugs are not made available with the private sector as if used indiscriminately the virus may develop resistance to those antiviral and it will be difficult to treat complicated cases.

Economic impact

The Novel Influenza can create a huge economic impact on Sri Lanka.

As the cost of researched drugs is very high and the entire population is susceptible to the new virus if spreads it will be a massive burden on the country's economy. Unnecessary fear psychosis about the disease may cramp the economic activities of the country.

Unnecessary travel bans will affect the tourism industry and the unnecessary medical attention to the disease may lead to over treating the situation.

Therefore, a proper understanding about the spread of the disease is vital.

We have to act cautiously till the peak of the epidemic passes.

HealthWatch Medical Crossword No. 38

-Prize winners-

The following are the prize winners of the Daily News HealthWatch Medical Crossword Draw No. 38 held Saturday August 15 at WISH Institute auditorium'.

The Health Education Crossword was sponsored by the Wickremarachchi Institute of Sight and Hearing - WISH.

The chief guest at the draw was the Australian Trade Commissions' Business Development Manager in Sri Lanka Shameel Javadh who had come with his wife and daughter for the event, as he was interested in this new health education feature in the media where for the first time the Medical Advisory panel in the Daily News medical page HealthWatch has started using the normal crossword feature for health education with success.

Shameel said that he came for the draw on invitation by the crossword sponsor Mihiri Wickremarachchi, Head of the WISH institute and the HealthWatch Medical Advisory panel, as it gives him an opportunity to speak to the assembled who had won prizes in the last crossword to receive their prizes. He also personally knew Mr. Wickremarachchi.

Recently he had visited some of the IDP camps and offered help to a number of persons there with eye and hearing defects.

Colombo Science Faculty undergraduates R. A. D. Amath and H. Dissanayake who had won second and third prizes in Crossword No. 37 also spoke at this draw and picked consolation prize winners in this draw No. 38.

The prize winners in Draw No. 38

1st prize: Rs. 3,000 - Entry No. 6: S. P. Y. W. Senadheera (Central Bank Staff Officer), Nugegoda.
2nd prize: Rs. 2,000 - Entry No. 26: T. D. P. Jayasuriya (Pensioner), Kotte.
3rd prize: Rs. 1,000 - Entry No. 79: S. Nihar (nurse), Colombo 2.

The first prize winner being picked up by the Australian Trade Commissions Business Development Manager in Sri Lanka Shameel Javadh. Pictures by Sudath Nishantha	Medical Crossword sponsor WISH Institute Head Mihiri Wickremarachchi (left) presenting Glen Fernando (representing the Medical Crossword No. 37 first prize (Rs. 3000) winner P.M. Batholameusz) with the cheque.

Consolation prize winners:

Pair of sunglasses each: 1. Entry No. 15 - Hashini Jayasingarachchi, Colombo 10. 2. Entry No. 83 - Safaz Saleem, Colombo 15. 3. Entry No. 10 - G. K. M. de Soysa, Gampola.

Our congratulations to all the winners, Daily News Editorial, HealthWatch Coordinator and Medical Advisory panel, and the crossword sponsors WISH Institute and its head Mihiri Wickremarachchi.

Medical Crossword No. 38 correct solution

Across: (2) Brain, (4) Paracetamol, (9) Laptop, (10) Male, (12) Nasaid, (15) Soya, (16) Spondylosis, (17) Rest, (18) Fractures, (19) Incontinence.

Down: (1) Air, (5) Arthroplasty, (6) Asprin, (7) Exercise, (8) Rheumatoid, (10) MRI, (11) Virus, (12) Disc (14) Posture.

The grid was drawn by Dr. Kelum Pelpola of the Sri Jayawardenapura Hospital, Kotte.

Living your lifestyle

During the past forty years it has gradually become apparent that many of the prevalent diseases in the world are not due to infectious organisms but to the way people live, that is, their lifestyle. Disease that fall into this category include coronary heart disease, stroke, cancer, high blood pressure, diabetes, tooth decay, and skin cancer.

To these might be added those disorders related directly or indirectly to the fast pace of life and the pressures and emotional conflicts at the workplace, in the home, and in society at large. Among these are peptic ulcers, colitis, eczema, heart irregularities, asthma, depression, neuroses and psychosis.

Modern man, living in the large cities of the world with his advanced technologies, is denied many of the conditions that make for physical well-being. Instead, he is constantly faced with forces that destroy health. There is not need for physical work, so he remains under exercised. He tends to eat too much of food that is nutritionally poor.

He is constantly stimulated and has little opportunity to relax.

He is lost in a sea of humanity, in which self-restraint and self-discipline are often easily overruled. His physical demands are low, while his emotional pressures are high.

As a result, he suffers from diseases of disuse on the one hand and the tension diseases on the other.

Maintaining good health means avoiding all deficiencies and excesses that cause an imbalance, lower resistance, and so contribute to disease and death. In order to keep all your functions at peak performance, you must use them judiciously, rest them adequately, meet their needs fully, and provide them with a harmonious internal and external environment. Here are the main components of a healthful lifestyle:

Exercise is a must, for what you don't use, you lose. It should be appropriate to your needs and you should enjoy it.

Rest and sleep to keep you feeling refreshed and strengthened - renewed for each day's activities.

Nutritious food, eaten at regular times, of maximum quality and minimum quantity.

Water, pure and soft, used generously both internally and externally.

Fresh air, breathed deeply both day and night.

Sunshine: Not too much but enough to provide you with its rich benefits. Enough is enough: recognizing balance and avoiding extremes.

Avoid hindrances: Chemical crutches such as alcohol, tobacco and other drugs that provide an illusion of well-being but are actually very self-defeating.

Mental serenity: In a mind that is consistently challenged with ennobling thoughts, flavoured with a consciousness of doing right.

Emotional composure, unperturbed, under conflict and abuse and pervaded with a spirit of cheerfulness and joy.

Trust in divine power, under girding your weakness and empowering your resolve.

May your lifestyle bring you a long, healthy life and much happiness.

Sent by Dr. Dennis J. Aloysius in our medical advisory panel for use in the healthwatch. Dr. W.A. Ferdinand