MANILA (5th Update) -- The Health department declared a “low-level community outbreak” of influenza A (H1N1) in Metro Manila Tuesday, a day after the country reported its first swine flu-related death.

The outbreak was declared in areas where almost 70 percent of the 473 confirmed cases in the Philippines are located, according to the Department of Health (DOH).

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Health Secretary Francisco Duque said the outbreak was declared in Quezon City, Manila, Parañaque, Marikina, Pasig, Mandaluyong, and Caloocan, as well as in the areas of 18 schools where a third level transmission was confirmed.

The health department, however, assured that there is no sustained community outbreak yet as cases are lumped together in small areas, particularly in schools.

Duque explained that a low-level community outbreak represents a third generation transmission of the virus, which means there are now individuals who contracted the virus from an index case.

He also confirmed 28 more infections, bringing the country’s total to 473. The new cases involved 16 males and 12 females with ages ranging from seven months to 49 years old.

Duque, however, noted that all the new cases have no history of travel to any A (H1N1) affected country.

On Monday, health officials confirmed that a woman who works at the House of Representatives in Quezon City died of myocardial infarction but tested positive for A (H1N1), prompting House officials to suspend operations from Tuesday until June 28.

The House was thrown into panic Tuesday when employees learned that the 49-year-old woman who is believed to be the first A (H1N1) fatality in Asia was one of their own.

Speaker Prospero Nograles, who is in an official visit to Australia, was forced to shut down operations at the House for five days to cleanse the building premises.

Nograles said he has already instructed House officials to “maintain close coordination with the DOH in order to mitigate possible effects on other employees and their families.”

Dr. Ramon Ricardo Roque, deputy secretary general for administration, announced in front of the employees who gathered at the North Wing lobby that the victim was an employee of the committee on people’s participation.

DOH officials said the patient died of "congestive heart failure secondary to acute myocardial infarction." Based on the autopsy, her death was "aggravated by severe pneumonia either bacterial, viral or both."

Another positive case

Roque also confirmed to the crowd that another employee has been tested positive of A (H1N1) infection but has already recuperated after going on a self-quarantine.

“We have two positive cases of influenza A (H1N1) virus. The one who died as reported in the media and a male one from the Congressional Planning and Budget Department,” he told employees who were administered anti-flu vaccination.

He said the fatality was from Sta. Rosa, Laguna while the male employee worked at the Congressional Planning and Budget Department (CPBD).

The female victim, Roque said, attended the seminar of the committee affairs department (CAD) last June 15 and 16, went to work the following day June 17, and started feeling ill the next day.

The House official said the woman had also gone to Kalinga province with officemates last June 11 to 14, while the CPBD employee had just come from Malacañang before being tested positive for A (H1N1).

He also said they will undertake all the necessary preventive and mitigation measures with the DOH for the more than 3,000 House employees, especially since President Gloria Macapagal-Arroyo's State of the Nation Address (Sona) is set on July 27.

The Speaker said the House’s medical services staff “will spearhead, in coordination with the DOH, all the necessary precautionary steps needed to eliminate further health hazards.” 

“This includes the necessary contact tracing of possible victims and their families,” he said, noting that all employees will be strictly monitored.

Panic

Health committee chairman Arthur Pingoy admitted that the House was taken aback by the development and made some of the employees panic.

“There’s some sort of panic,” he said. “The House leadership still doesn‘t know what to do with the problem.”

Pingoy said the responsibility to handle the situation was left with the secretariat, the doctors and other officials because “unfortunately, the Speaker [Prospero Nograles] is not around.”

The congressman said the casualty had worked at the third floor of the Ramon Mitra building of the Batasan Pambansa complex -- the same building where health officials briefed the panel on A (H1N1) on Monday.

As soon as the news broke out, employees were asked to vacate the Mitra building, which caused a slight panic.

Pingoy said they only learned that the first casualty was a House employee after the committee hearing, noting that they are now consulting with the DOH to determine if there is really a need to close down the whole Batasang Pambansa or only the concerned building.
 
“Do we have to close schools, institutions or do we have to change strategy in solving the problem?” he asked, noting that the disease can only be contracted by having physical contact with someone infected.

Many lawmakers were already away because the House is in recess until July 27.

However, the suspension shuts down ongoing committee hearings and closes staff offices continuing work during the recess.

3 more students

In a related development, three more students at the University of Cebu Lapu-Lapu and Mandaue (UCLM) campus tested positive for A (H1N1).

Aside from the three students, a two-year-old Japanese boy who just arrived from Japan also tested positive for the virus, bringing the total number of swine flu cases in Central Visayas to 16.

Despite the additional A (H1N1) cases in the UCLM campus, the health department assured the public that all the patients and students in an on-campus dormitory were doing fine.

“All those who are positive were given medication. There is nothing threatening about the situation, as they are all doing fine. The students are cooperative and it is all good, to them it is like they are on vacation,” said DOH Central Visayas Pandemic Influenza Incident Command spokesperson Dr. Cora-Lou Kintanar.

When three nautical students tested positive of the A (H1N1) last week, health and school officials placed all 600 scholars in the same dorm under quarantine for 10 days.

As of Tuesday, a total of 140 persons have been placed under observation in Central Visayas, with 16 tested positive and 20 still waiting for their results. (WV/AP/EPB of Sun.Star Cebu/BOT of Sun.Star Davao/Sunnex)