Nine-month-old baby found to have the A (H1N1) virus

Josianne Spiteri

Jul 12th 2009, 02:20

Tamiflu has to be administered at the onset of symptoms or else the virus would have allready replicated and they wont work.Health dept said only cases vulnerable or that worsen will be given Tamiflu. So if someone worsens after the first 2 days with what will they cure him? Tamiflu wont be an option anymore as it wont work.
This is some interesting info : http://pandemicinformationnews.blogspot.com/2009/07/swine-flu-virus-unpredictable.html

D Fenech

Jul 11th 2009, 13:18

Only the vulnerable being tested means that these statistics are the tip of the ice berg.
Many Maltese are adopting a flippant ,fatalistic attitude which we are all going to regret very soon.

M Bonello

Jul 11th 2009, 10:57

To add on to Andrew Camilleri, the reason for GPs to give Augmentin to such patients with sore throat is if they think there are elements of Bacterial Pharyngitis/Tonsillitis by Streptococcus.

This is given because as a complications of Strep Throat, Rheumatic Fever may develop due to an Immune Mediated Process. That is why GPs would treat such infections quickly with Antibiotics.

What perplexes me is the need for Augmentin, which is a Penicillinase Resistant Antibiotic, when the patient could actually be treated with simple oral Penicillin V. Strep Throat is usually treated quite effectively with Penicillin V, and all over the world, including UK and US it is still first line.

However in Malta if your GP gives you a simple Penicillin product (sometimes not even stocked in pharmacy) not Augmentin, the GP is tought to be a Bad Doctor. The funny thing is that if the Sore throat is Caused by EBV (a virus) amoxicillin (compound of augmentin) will make the rash worse!!!!!

Also when prescribed, I was called by pharmacists in Malta that they do not stock Simple Penicillin V.

Andrew Camilleri

Jul 11th 2009, 00:24

@Ludwig: Thanks. As to different treatments/prescriptions it may often be that different treatments are available for a specific condition, and doctors are often biased towards one treatment in favour over another due to their interpretation of current literature. Secondly, treatment may not be needed at all, but the patient insists treatment is needed (calling the doctor a bad doctor if no treatment is given) and hence the doctor caves in and prescribes something, be it needed or not. Since this is not actually treatment, what is given will naturally vary. Thirdly, some doctors may be more up to date on certain treatment modalities then others.

I must have misunderstood your comment, so I apologise!

Ludwig Flask

Jul 10th 2009, 19:42

@ Andrew Camilleri: No offence caused, we're both open minded mature bloggers. I agree with you - we have to speak with facts, but prove me wrong on this one: go to 3 doctors with the same symptom, and compare what they prescribe you, they won't be the same! When I have highlighted your comments “Stopping the misuse, abuse...”, this was a compliment to your reply – you were right. Study hard, learn as much as you can, and be the best whatever medical specialization you'll go for!

Andrew Camilleri

Jul 10th 2009, 18:54

@C Weitze: Of course I appreciate that fact - you're perfectly right. But I am in an argument here, so it has nothing to do with patient-doctor relations and the appropriate etiquette thereof. Were Ludwig a future patient of mine I'd treat him with as much respect as any other. On the other hand, I made a point which was rubbished by a person who I do not know - I do not think I reacted inappropriately by stating that what he said is rubbish, because it was just that. @Ludwig: Sorry for any offence caused, but again, get your facts right before commenting.

Ludwig Flask

Jul 10th 2009, 18:13

@ C. Weitze: Appreciated.

C. Weitze

Jul 10th 2009, 14:42

@ Andrew Camilleri: Thank you for explaining the obvious.

It is very unfortunate, that some doctors are still giving in to the pressure of their patients when it comes to the prescribtion of antibiotics. Once somebody told me that it is by far easier to write a prescribtion than to convince and explain to a patient, that antibiotics cannot treat a viral illness.

However, I can assure you that your future patients would greatly appreciate somebody, who explains facts and details in a gentle and polite way , rather than using phrases like "utter rubbish".

You must understand one very important thing:

These patients might not have studied medicine. However they have a lot of know-how in the professional field they themselves are or have been working in. They are the people you might have to turn to for help one day. They could be a plumber, an electrician, a lawyer or a teacher....just to name a few.
They are all humans with a functional brain and feelings they certainly deserve a respectful explanation and treatment.

M Gauci

Jul 10th 2009, 14:28

@Andrew Camilleri - holy words but don't wind yourself up. These people will never understand that misuse of anitbiotics is making their immune system weaker and the bacteria resistant. What I can surely say for myself is that since living away from Malta for 3 years (in a very crowded place with poor air quality overall) I've only used antiobiotics once for a really bad chest infection, u Malta kulhadd jibla' l-hin kollu.. even for a simple sore throat. I'm no pharmacologist but the mind boggles! I'm glad we have professors like yours in our University and wish you the best of luck in your career.

Andrew Camilleri

Jul 10th 2009, 08:57

@Ludwig Flask: I know what I'm talking about, I'm a med student. This is the advice of our antibiotics professor, a microbiologist. I suggest you study some microbiology and pharmacology, since it will become patently obvious towards the very beginning that what you are saying is complete dross. The professor himself states that antibiotics are misused by doctors who cave in to patient pressure, since patients like yourself always expect to be given treatment even if none is actually needed - otherwise the doctors is a 'bad doctor li ma jaf xejn' of course.

Ludwig Flask

Jul 10th 2009, 08:49

@Andrew Camilleri: "Stopping the misuse, abuse and overuse of antibiotics will save us a lot of unnecessary trouble, so inform yourself well before using these compounds." Thanks for the advice. MDs take note before administering!

Stephanie Zammit

Jul 10th 2009, 07:34

The ONLY way to confirm if a symptomatic patient is infected with AH1N1, is to have the patient swabbed. If a symptomatic patient presents himself/herself to a GP in the current circumstances, why is co-amoxiclav being prescribed instead of instructing the patient to remain at home for 7 days?
When having a prescription done for an antibiotic with no advice to stay at home, the patient is put under the false impression that since Tamiflu was not prescribed, it is not possible that he/she is infected and a GP knows if patient is/is not infected after a conventional medical visit.

Public should be educated that if NO SWAB IS TAKEN, PRESENCE OF SWINE FLU CANNOT BE EXCLUDED.

edward bartolo

Jul 10th 2009, 07:22

The dark side of the whole issue is, that according to the WHO, the virus can mutate into a far deadlier virus. Also, the more people get it, the greater the chance of this happening.

Let us all be responsible and present the facts as they are: the virus can mutate at any time, and we have no guarantee that this will not happen. On the other hand, nobody can forecast that the virus will become deadlier. The only fact that is known is, that the less contact it gets with people, the lesser the chance of a deadly mutation occuring.

So, let us be responsible to educate the people. "Brainwashing" will not help in the long term.

Andrew Camilleri

Jul 10th 2009, 00:41

@Ludwig Flask: What utter rubbish. Augmentin is co-amoxiclav, an antibiotic (i.e antibacterial); if anything, it would be taken to prevent superinfection by bacteria of the viral illness, but can in absolutely no way treat a viral illness such as influenza. Treatment for influenza is the preserve of oseltamavir (Tamiflu), zanamavir (Relenza) and amantadine.

Stopping the misuse, abuse and overuse of antibiotics will save us a lot of unnecessary trouble, so inform yourself well before using these compounds.

C. Weitze

Jul 9th 2009, 22:44

@ David Zarb: regarding "The worse has yet still to come - wait until this virus will start killing people massively"

Every year we are bombarded with viruses. Every year people die of viruses - those, who are weak and those who have a low immune system.

Every year I mentally freak out about the ignorance and selfishness of people, who instead of staying at home to cure their illness, pop in a couple of Panadols and go to work or out for their personal entertainment, whatever that might be.

Every year parents pump up their kids with paracetamol and send them to school ...because the mid year exams are around the corner, because both parents are working and the child should not stay at home alone or because the first symtoms are (still) mild. Just have a look at the school attendance records in early spring to realise what I am talking about.

The most important rule to apply with any virus - apart from keeping up a high standard of hygiene - is: STAY AT HOME - STAY AWAY FROM OTHER PEOPLE!

Oh yes, and regarding your alcohol wipes: there is a big difference between "anti-viral" and "anti-bacterial"!

Gianfranco Spiteri

Jul 9th 2009, 21:53

Tamiflu may be given to pregnant women and children below one year of age in the current pandemic situation: http://www.emea.europa.eu/humandocs/PDFs/EPAR/tamiflu/32609509en.pdf

O'Connor

Jul 9th 2009, 21:26

Could ??? some person tell me the difference between vulnerable persons / groups and what are the "underlying problems" that always seem to be the reason why people are passing away from the epidemic, Can we know what an underlying problem are to help us prepare
Can we replace the free energy saving light bulbs "for the moment" with lingettes antiseptiques or lotion to kill cross contamination.Lets prepare to be the first country to be clear as we were the last country in Europe to receive swine flue .

Who shall be last shall be first.

Thomas Armatys

Jul 9th 2009, 21:24

@ David Zarb: I agree - let's be responsible: stop spreading panic! "Deadly pandemic"? The mortality currently stands at less than 0.5%, which is not more than the "normal" seasonal influenza. Hardly "deadly".

jschembri

Jul 9th 2009, 20:41

U jghidulek issifirx ghax tlaqqat l-iswine flu...nahseb iktar riskjuz tmur Ghawdex...

D. Galea

Jul 9th 2009, 20:39

What treatment is this baby being given? I read that tamiflu cannot be administered to children under 1 year old and pregnant women.

David Zarb

Jul 9th 2009, 20:23

Dear All,

Let's do something, let's feel responsible first and foremost towards ourselves, secondly towards our relative and our Maltese & Gozitans siblings. We have an alarming high H1N1 rate in Malta. No joke, we're speaking about over 50 cases. Compared to other nations, ours is very very high, considering the population ratio. Let's do our utmost: cleaning our hands with disinfectant regularly, sneezing politely, regular cleansing, using alcohol wipes and alcohol solutions, NO drinking from common bottles, it's common sense!!

I'm sorry to say that yesterday I was driving through Floriana (I didn't attend the MTV) and saw tens if not hundreds of irresponsible people sharing bottles, with friends/girlfriends riding on top of their shoulders mixing sweat, some vomitting etc.. When are we going to feel our sense of responsibility? Hellooo, the swine flu is here, and is hitting us badly. The worst has yet still to come! when the virus adapts to the antiviral agents and will start killing people massively!! This is a deadly pandemic, it doesn't mean that if till now we didn't experience any high toll deaths, the virus is mild, NOTHING AT ALL, the worst has yet still to come!! PLEASE ACT RESPONSIBLY!

B.Sacco

Jul 9th 2009, 20:16

Jekk kull min ghandu l-influwenza jinghata t-tamiflu u ma tkunx H1N1 mbghad wara taqbdek veru nahseb it-tamiflu mbghad jaghmlu inqas effett meta tohodhom it-tieni darba!

Ludwig Flask

Jul 9th 2009, 19:59

Very recently, cases of influenza and sore throat were treated with Augmentin - now first signs of flu symptoms will immediately be prescribed Tamiflu. Well done to all 'those' who took H1N1 for granted! May 'those' be given 2x as much we will be gettin or already have been given!

michael galea

Jul 9th 2009, 18:29

From the latest news seems like Gozo Is being hit more badly than Malta......