All hot and bothered about A(H1N1)

ON TUESDAY afternoon, in a private hospital in Bangkok, I took a pop quiz that I knew I would ace. Nevertheless, I had hoped not to flunk it as I feared I would be quarantined.

“Do you have fever?” the receptionist asked when I told her in a hoarse voice that I wanted to see the doctor.

“Yes,” I said.

“Do you have sore throat?” she said.

“Yes.”

“Runny nose?”

Before I could say “no” my wife, who was also seeing the doctor because she was feeling unwell and suspected our eight-month baby was sick too, said “yes”.

“Did you just come from another country?”

“Yes,” I said, as I had just returned from Malaysia and Singapore.

The receptionist wrote something in Thai on an official-looking paper. And I told myself, now we’ve become suspected A (H1N1) cases.

True enough, a polite Thai nurse led us to a special counter – a desk manned by two nurses wearing face masks. A nurse checked our weight and temperature. Interestingly, she did not pay any medical attention to my baby.

If I had fever I would be dispatched to the emergency room to undergo an 8,000 baht (about RM800) test for A (H1N1). And if I tested positive, I would be quarantined.

My wife and I did not have fever so we were allowed to consult our regular doctor. I was diagnosed with throat infection, my wife with common cold. My baby was given the all clear.

False alarm. I’m free of A (H1N1) which I suspected I had contracted.

My suspicion was justified in view of the alarming spike in reported A (H1N1) cases in Thailand the past week. On Sunday, there were 44 reported infections, bringing the total number of A (H1N1) cases to 150. On Monday the number was 201.

And the figures kept on rising – 310 cases on Tuesday, 405 on Wednesday, 518 on Thursday and 589 yesterday.

On Thursday, curious to know why there was an average of 100 confirmed cases a day in Thailand, I sought out Dr Kumnuan Ungchusak, senior expert in preventive medicine in Thailand’s public health ministry.

The country’s first 20 patients were imported cases of A (H1N1), according to Dr Kumnuan. But Thailand could not contain its spread locally and was now facing an outbreak.

For example, two weeks ago 10 students aged 10 from a Bangkok school were absent in one day. One of them tested positive for A (H1N1). Subsequently, about 100 students from the same school tested positive.

“We really don’t know the starting point (of the cases in that particular school). And we detected the problem a little bit late because those infected were not only in one particular class but spread across many,” said Dr Kumnuan.

He added that a school was a conducive place for flu to spread because of the crowded conditions and because students shared common equipment such as computers and telephones.

“Our hypothesis is someone (a student, a parent or a teacher) arriving from a foreign country could have passed through a thermal scan (in the airport) undetected, having mild symptoms. And this person spread it to a student in this particular school.”

Dr Kumnuan said the Thai media’s coverage of A (H1N1) focused on the rising numbers. “Their reports have alarmed the public. But (the increase) is not the key message,” he said.

The key message is that A (H1N1) is similar to the seasonal flu (Thailand has 900,000 cases annually, where 30,000 patients are hospitalised, and 300 die).

Like the seasonal influenza, a patient with A (H1N1) has a 0.4% probability of fatality. Meaning, out of 1,000 infected patients, four (usually five years old and below, 65 years old and above and those with underlying health problems) might die.

“But people are panicking, as they have this image (coming from Mexico) that A (H1N1) is very dangerous,” he added.

There had been no deaths so far in Thailand. As of Wednesday, 393 of the 405 cases recovered.

I asked Dr Kumnuan why he (like most Bangkokians) did not wear a face mask.

“I had observed you, and if you had a runny nose, and you were sneezing and coughing, I would certainly be careful.”

During the 30-minute interview, I tried my best not to cough.

(Published in The Star on June 20, 2009)