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1 month on, flu lessons still being learned
Source: http://www.yomiuri.co.jp/dy/national/20090609TDY03105.htmTakashi Hagihara, Makiko Tatebayashi, Masaru Fujita and Masae Honma / Yomiuri Shimbun Staff Writers
Tuesday marks a month since the first infection of the new strain of influenza, originally dubbed swine flu, was confirmed in Japan.
While the rate of discovery of newly infected people, which has been concentrated in Hyogo and Osaka prefectures, has generally been declining and life in the areas has been getting back to normal, new cases have been reported in the Kanto and Kyushu regions.
The unfolding course of the infections has highlighted the challenges facing medical workers, especially as the virulence of the new strain is not as was originally predicted and shortcomings were found in diagnosis procedures at special facilities when the infection rate was rising.
In Kobe, the spread of the virus has slowed and medical institutions have largely returned to normal.
Hiroshi Fujii, a doctor at Kobe City Hospital Organization Medical Center West Hospital in the city's Nagata Ward, which was one of only three emergency facilities initially set aside in the city for the new flu, said, "At the peak of the infections, patients were also coming from nearby cities.
"There were a lot of children among the patients visiting us, but we only had two pediatricians. We had to mobilize all of our doctors, not just those specializing in internal medicine, around the clock to cope with the large number of patients," he said.
At its peak, the hospital treated 69 patients in a day, while Kobe City Medical Center General Hospital treated 70, both considered within the hospitals' capacities.
However, the General Hospital had to temporarily stop accepting ambulances and postponed treatment on other patients to cope with the suspected new-flu patients.
In the end, the city government obtained cooperation from the municipal association of doctors to allow suspected new-flu patients to be accepted at about 500 locations, including ordinary medical institutions.
But a telephone consultation center that first started taking inquiries about the new flu was stretched to breaking point.
The center in Kobe received 3,640 calls on May 19, the peak date. More than half of the callers said they were experiencing health problems and asked which hospitals would be able to help them.
In Hyogo Prefecture as a whole, more than 10,000 calls a day were placed to consultation centers.
The naming of emergency facilities meant to treat people experiencing a fever added to the confusion.
"There were [also calls] from people with symptoms not caused by flu, such as those suffering heat disorders," Ryoichi Nishimura, head of the Hyogo Prefecture Medical Association, said.
The limits of the system of emergency facilities established to ensure suspected new-flu patients were treated in a small number of facilities were quickly reached in Hyogo and Osaka prefectures, even though the pace of infections was considered moderate at more than 300 patients.
An additional concern was how facilities would cope with a spike in the number of new flu patients in a confined area and there also were cases reported in which waits for test results at emergency facilities delayed necessary treatment for other conditions.
In the case of a 4-year-old child in the Kansai region who developed a fever last month, basic tests were conducted twice because of the possibility that there would not be a positive result if new-flu symptoms had only just developed.
After the tests proved negative for the new flu, the doctor recommended the child be taken to another clinic run by a pediatrician. However, the child developed pneumonia while waiting for the flu test results.
Though the child recovered after being administered antibiotics, a pediatrician who treated the child said, "If the patient had been brought to my clinic at the beginning, it wouldn't have been so serious."
Shumpei Yokota, president of the Japan Pediatric Society and professor of pediatric medicine at Yokohama City University, said: "Most patients taken to pediatricians have already been suffering from a fever. It's confusing for doctors if those suspected of having the new flu are handled separately."
The medical society drafted a proposal on June 1 stating that all medical facilities with pediatricians should assist in treating flu, even if it is not the new strain.
The proposal also stated that patients with mild symptoms should be treated in clinics, while those with severe symptoms such as pneumonia should be treated in hospitals where appropriate equipment is available.
The new strain of flu generally does not cause serious symptoms, and patients can recover without medication.
But Nobuhiko Okabe, head of the Infectious Disease Surveillance Center of the National Institute of Infectious Diseases, warned: "Considering that many patients this time only developed mild symptoms, the authorities should reconsider the conventional responses. We have until the autumn."
(Jun. 9, 2009)
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SN1987A
Source: http://www.yomiuri.co.jp/dy/national/20090609TDY03105.htmTakashi Hagihara, Makiko Tatebayashi, Masaru Fujita and Masae Honma / Yomiuri Shimbun Staff Writers
Tuesday marks a month since the first infection of the new strain of influenza, originally dubbed swine flu, was confirmed in Japan.
While the rate of discovery of newly infected people, which has been concentrated in Hyogo and Osaka prefectures, has generally been declining and life in the areas has been getting back to normal, new cases have been reported in the Kanto and Kyushu regions.
The unfolding course of the infections has highlighted the challenges facing medical workers, especially as the virulence of the new strain is not as was originally predicted and shortcomings were found in diagnosis procedures at special facilities when the infection rate was rising.
In Kobe, the spread of the virus has slowed and medical institutions have largely returned to normal.
Hiroshi Fujii, a doctor at Kobe City Hospital Organization Medical Center West Hospital in the city's Nagata Ward, which was one of only three emergency facilities initially set aside in the city for the new flu, said, "At the peak of the infections, patients were also coming from nearby cities.
"There were a lot of children among the patients visiting us, but we only had two pediatricians. We had to mobilize all of our doctors, not just those specializing in internal medicine, around the clock to cope with the large number of patients," he said.
At its peak, the hospital treated 69 patients in a day, while Kobe City Medical Center General Hospital treated 70, both considered within the hospitals' capacities.
However, the General Hospital had to temporarily stop accepting ambulances and postponed treatment on other patients to cope with the suspected new-flu patients.
In the end, the city government obtained cooperation from the municipal association of doctors to allow suspected new-flu patients to be accepted at about 500 locations, including ordinary medical institutions.
But a telephone consultation center that first started taking inquiries about the new flu was stretched to breaking point.
The center in Kobe received 3,640 calls on May 19, the peak date. More than half of the callers said they were experiencing health problems and asked which hospitals would be able to help them.
In Hyogo Prefecture as a whole, more than 10,000 calls a day were placed to consultation centers.
The naming of emergency facilities meant to treat people experiencing a fever added to the confusion.
"There were [also calls] from people with symptoms not caused by flu, such as those suffering heat disorders," Ryoichi Nishimura, head of the Hyogo Prefecture Medical Association, said.
The limits of the system of emergency facilities established to ensure suspected new-flu patients were treated in a small number of facilities were quickly reached in Hyogo and Osaka prefectures, even though the pace of infections was considered moderate at more than 300 patients.
An additional concern was how facilities would cope with a spike in the number of new flu patients in a confined area and there also were cases reported in which waits for test results at emergency facilities delayed necessary treatment for other conditions.
In the case of a 4-year-old child in the Kansai region who developed a fever last month, basic tests were conducted twice because of the possibility that there would not be a positive result if new-flu symptoms had only just developed.
After the tests proved negative for the new flu, the doctor recommended the child be taken to another clinic run by a pediatrician. However, the child developed pneumonia while waiting for the flu test results.
Though the child recovered after being administered antibiotics, a pediatrician who treated the child said, "If the patient had been brought to my clinic at the beginning, it wouldn't have been so serious."
Shumpei Yokota, president of the Japan Pediatric Society and professor of pediatric medicine at Yokohama City University, said: "Most patients taken to pediatricians have already been suffering from a fever. It's confusing for doctors if those suspected of having the new flu are handled separately."
The medical society drafted a proposal on June 1 stating that all medical facilities with pediatricians should assist in treating flu, even if it is not the new strain.
The proposal also stated that patients with mild symptoms should be treated in clinics, while those with severe symptoms such as pneumonia should be treated in hospitals where appropriate equipment is available.
The new strain of flu generally does not cause serious symptoms, and patients can recover without medication.
But Nobuhiko Okabe, head of the Infectious Disease Surveillance Center of the National Institute of Infectious Diseases, warned: "Considering that many patients this time only developed mild symptoms, the authorities should reconsider the conventional responses. We have until the autumn."
(Jun. 9, 2009)
_________________________________
SN1987A