Email

Print

Last week Monday, Shahera Bodden, a 29 year old mother, died at the KHMH – at the time her cause of death was listed as pneumonia.  But yesterday she was confirmed as Belize's first h1n1 fatality.  It's a tragedy unto itself, the loss of such a young life…but it's also a worrying medical event, because Shahera was young and robust, but now she is a victim of what seems to be a particularly strong strain of h1n1.  Her death raises all kinds of public and personal health questions – and today at a press conference we asked ministry of health officials what you need to know about her shocking death, and your health concerns:

Jules Vasquez Reporting

Dr. Marvin Manzanero - Director, Epidemiology Unit
"Of the 5 cases reported only one came back positive for h1n1, which is the patient that died last week Monday. The other 2 cases are from western region, hj1n1 positive, but these are ambulatory patients that recovered and they have no further complications."

The patient that died is Shahera Bodden - a 29 year old mother of a 12 year old.  She is the first h1n1 casualty in Belize and what worries authorities is that she had no other illnesses:

Dr. Michael Pitts - Director of Health Services
"But when we see a 29 year old dying like that we investigate it completely. We have not been able to confirm any underlying cause. So now we look and re-think and we say well if somebody like that has influenza what is it that the system can do to mitigate to try and prevent deaths."

But could the public healthcare system have done more?  On December 28th, she visited the KHMH for flu-like sympthoms, and she was released.  By the time she was re-admitted on January second, it was too late.

Dr. Marvin Manzanero
"But when she came on the second, the first note at A and E said she is severely ill - that she has a heart rate of 148, fever of 103, and a respiratory rate of 28."

Dr. Michael Pitts
"It so happened that this person came in severely, severely ill - I think she had bilateral pneumonia."

Dr. Marvin Manzanero
"She was admitted on the 2nd and she started, and she was started on Tamiflu - which is perhaps the relationship you will find - one day after.  She was intubated 24 hours after being admitted. She was in the intensive care from the third to the sixth when she passed away."

So, while h1n1 has long been identified in Belize, the fact that it caused the death of an otherwise healthy young woman, suggests that this could be a new strain - which has been seen recently in other parts of the world:

Dr. Francis Murray - Focal Point Communicable Diseases, Ministry of Health
"The deaths in these young individuals in other countries has been rapid, and individuals have gone from mild symptoms to severe symptoms within days. We might be getting different strains and we might be getting a strain that has mutated and has changed its virulence and pathogenicity all over again. And hence we would be able to say, you know what, our strain is much more lethal, much more, would be producing a higher mortality rate to what we might get in country."

Dr. Michael Pitts
"At this point I can't say it's a new subtype.  At this point, all I can say out of the severe cases that we had, one of them was h1n1 - and that person a 29 year old female died.  When a young person die without pre-morbid conditions dies, it's very unusual."

And very worrying, for those of us - who have the common flu.  Here's what to look out for in what will be marked as a very sudden onset flu:

Dr. Francis Murray
"And we usually see individuals who have high temperatures of over 101 degrees Fahrenheit. Also the person may have severe chest pains, muscle and ache pain that may mean that the person will want to stay lying down. The person may not want to eat. The person may be vomiting."

Now these are also symptoms of the common flu, but here's when you should go to the hospital:

Dr. Michael Pitts
"What we're saying to the public, if you have flu like illness and after 3 days you're not improving, please make it a point to go to your doctor wherever you are."

For the time being though, health authorities are not advising the extreme type of measures that were advocated in 2009, when h1n1 first appeared

Dr. Michael Pitts
"But at that point, we were just 2 weeks into what appeared to be a new and highly virulent disease with case fatality. So, there were certain types of responses. Right now, we have moved on, and we've said that that h1n1 began acting like seasonal influenza. Today, only one person that we have known of that has died and had h1n1in their profile. I don't think that we're there, but we are watching the information, and I will update if there is anything new that we learned."

So what's next?  Well, health authorities are very closely watching a 14 year old boy who is in the KHMH intensive care unit and is presenting symptoms consistent with acute h1n1.  We are told he is exhibiting kidney failure and has been placed in an induced coma.  So that case is touch and go, and another very worrying one.

Plus there's another case of a man from Paraiso village in Corozal who has died at a hospital in Chetumal – and doctors there are saying it could be h1n1 but we stress in that case, no cause of death ahs been confirmed.

13 samples have been taken from other cases and are being sent to the regional testing center in Trinidad.  These will take 3 to 5 days to return because to get to Trinidad, the tests have to go from Belize to Miami, Miami to Panama, Panama to Venezuela, and, finally, from there to Trinidad.

Tamiflu is available in country for all forms of influenza but it is on a prescription basis only.  Flu Vaccinations are offered to public and health care workers, the elderly, pregnant mothers and infants . Nine thousand flu vaccines were administered last year.

Again, to go over the signals for h1n1, the key thing to be on the lookout for in H1N1 vs the common flu is that in H1N1 fever is abrupt and usually above 102 degrees. H1N1 also presents with more frequent chills, intense headache and muscle ache, moderate to intense general weakness and dry, continuous cough. If any of these are present from the onset, do consult your doctor.