Patients on the mend as cases reach 39

The first person confirmed to be suffering from swine flu in Malta will be returning to work today, a week after being diagnosed.

His friend, who caught the H1N1 virus at about the same time, has also been given the clearance and is expected to be back at work tomorrow. In the meantime, the number of people confirmed to have fallen ill with this form of flu in Malta and Gozo has risen to 39, as the virus continues to spread around the world, causing the first pandemic since 1968.

The health authorities yesterday reported 15 new cases of the virus, which was first confirmed in Malta last week in a 26-year-old man who returned from Spain with his rugby team mates.

That patient said yesterday he never felt very ill and might even have left the house earlier had he not been suffering from the pandemic virus and so asked to stay in voluntary quarantine to stem the spread of the flu.

"I think people are making a big fuss. It was not worse than a bout of the seasonal flu," he said.

In fact, most of those who fell ill with the H1N1 virus have had moderate symptoms and have responded well to treatment with antivirals. Only two people - an 18-month-old British boy and a 19-year-old Londoner - have been admitted to hospital. The infant was discharged a few days later and the teenager is still under observation.

The 15 newly-confirmed cases - five of which were diagnosed late on Monday evening - consists of 11 Gozitans, two Maltese, a 10-year-old Australian boy and a 20-year-old Swiss woman who lives in Malta.

The youngest is an eight-year-old girl and the oldest a 44-year-old woman, both from Għasri, which reinforces the belief that older people have some form of resistance to the virus causing the pandemic.

Of the new cases, only one, the Australian boy, has been confirmed as travel-related, while the two Maltese were yesterday being traced in a bid to establish the mode of infection.

The authorities said all those who had contracted the pandemic influenza were recovering well.

EU health ministers meeting in Sweden yesterday discussed the steps being taken to contain and mitigate the spread of infection. They called for continued information sharing and for the quality and safety of the potential vaccines to be evaluated prior to embarking on full-scale vaccination campaigns. At the meeting, Social Policy Minister John Dalli explained how the outbreak in Malta was being managed and called for central authorisation of the vaccines and for central guidance on identification of risk groups as more evidence became available.

In a video message, WHO director general Margaret Chan stressed the importance of non-pharmaceutical methods to control the spread.

Although the virus was still moderate and not causing severe infection, Dr Chan alerted ministers to the need to remain vigilant and be prepared to take the necessary action in the coming weeks and months.

Swab testing

A room in the basement of Mater Dei Hospital was buzzing with activity yesterday morning as swabs from patients suspected to be suffering from H1N1 poured in.

They were being fast-tracked to a laboratory on the second floor of the hospital, to be tested for the H1N1 virus.

Christopher Barbara, the chairman of the Pathology Department, explained that swabs were taken from the back of a patient's throat, after inserting a special cotton bud through the nose.

The swab is dipped in an orange liquid, which keeps the virus viable for testing.

As soon as the test tubes arrive at the virology lab, a five-hour testing process kicks off, during which the samples undergo a molecular biology test, called polymerase chain reaction, which analyses the sequence of the virus' coding to check whether it matches the characteristic of the pandemic-causing virus.

Two batches of tests are being carried out for the time being, one in the morning and a second in the afternoon.

Since patients are being treated with antivirals, which need to be taken within 48 hours of the onset of symptoms, timeliness of testing is imperative. Dr Barbara said that because the testing process was lengthy, some countries, like the UK, had decided to stop swabbing patients and instead treat all those showing symptoms with antivirals. But this brought with it the risk of resistance to antivirals. Three of the nearly 100,000 cases reported around the world have been resistant to the commonly-used antiviral Tamiflu but have responded to another medication, Relenza.