The Department of Health (DOH) has reported a 16 per cent increase of the dengue cases in the country from the period of January to July 2012. According to the National Epidemiology Center latest dengue surveillance report,   the 51, 597 dengue cases recorded from January to July 2012 already surpassed the number of dengue cases recorded last year for the same time period which is 44, 315. Moreover, the number of deaths from this mosquito-borne virus also increased from 293 last year to 328 cases for the same period. These statistical data indicates the urgency to develop more preventive and curative measures that shall hopefully reduce, if not totally eliminate, the number of dengue-infected cases in the country. The Department of Science and Technology (DOST), through its sub-agencies, are developing measures for dengue elimination and surveillance ranging from the use of the Information and Communication Technology (ICT) field for real-time reporting of dengue cases to the formulation of new medicinal drugs from herbal plants locally found in the country. One of these plants is the tawa-tawa plant.   

The tawa-tawa plant (Euphorbia hirta l.)  has been traditionally used in the Philippines as an adjunct treatment for dengue. To further study the  properties of this indigenous plant specifically its anti-viral and anti-inflammatory properties and its ability to increase blood platelet count, the Philippine Council for Health Research and Development (PCHRD-DOST)  is currently supporting evidence-based studies on  the  said  medicinal  plant. 

The eHealth Philippines, through its online conference, intends to review the available studies about the medicinal properties of tawa-tawa and to further generate key insights on the use of this plant as a cure for dengue and other illnesses. We hope to contribute to the ongoing  discussions  on  the medicinal value of the tawa-tawa plant and  provide  additional  information  on  Dengue  as  an  environmentally-related  and  preventable  disease.

Reference:

Alave, K. (2012). Dengue Cases in the Philippines up by 16 %. Retrieved from http://newsinfo.inquirer.net/237507/dengue-cases-in-philippines-up-by-16.

Marchadesch, B. (2012). Local Tawa-Tawa herbs may cure tuberculosis, dengue. Retrieved from http://www.gmanetwork.com/news/story/254965/scitech/science/local-tawa-tawa-herbs-may-cure-tuberculosis-dengue.

Agron, E. (2012). Tawa-tawa contains active ingredients that may help dengue hemorrhagic fever (DHF) patients – study. Retrieved from http://www.pchrd.dost.gov.ph/index.php/2012-05-23-07-46-36/2012-05-24-00-01-32/5296-tawa-tawa-contains-active-ingredients-that-may-help-dengue-hemorrhagic-fever-dhf-patients-study.

The Philippine Council for Health Research and Development, Department of Science and Technology (PCHRD, DOST) in partnership with the Institute of Philippine Culture, Ateneo de Manila University (IPC, ADMU) is currently redeveloping PCHRD’s eHealth portal program with special focus on the PCHRD’s Drug Discovery and Development Program (DDDP). The eHealth Philippines (Philippine Electronic Health Information Village) was designed to be an internet-linked community where health specialist and generalist and other health enthusiasts can interact with each other on specific health issues and at the same time have access to the specialty database, journal articles, advisories, and directory type information. The eHealth portal was launched to the public in 1998 and redesigned in 2003, but was deactivated in 2008 due to management and sustainability issues. Now, it is currently being redeveloped and reactivated.

“What We Should Know About the New SARS-like Virus?” 11 October 2012 http://ehealth.ph

One of the objectives of the 2012 eHealth redevelopment project is the conduct of two online conferences on current and emerging health issues. These online conferences intend to strengthen the community-building aspect of PCHRD’s eHealth initiative by providing health experts and enthusiasts an enabling virtual environment where they can converge and discuss specific health-related issues without the constraints of time and space. The first eHealth online conference was held last 13-14 September 2012 with the topic entitled, “Virgin Coconut Oil (VCO): Kasalukuyang Kaalaman at Kaugnay na mga Programa”. Last 13 October 2012, another eHealth online conference entitled, “What We Should Know about the New SARS-like Virus?”, was conducted.

This new coronavirus (NCV) online conference intends to provide timely and relevant information about NCV. Five resource speakers were able to share their expertise regarding the new coronavirus (NCV) and experiences as well with the 2003 SARS outbreak. They are the following:

1) Dr. Maurizio Barbeschi, Department of Epidemic and Pandemic Alert Response, World Health Organization, Geneva (WHO, Geneva);

2) Dr. Tamano Matsui, World Health Organization-Western Pacific Region (WHO WPRO);

3) Dr. Jose Ramoncito Navarro, former officer, Field Epidemiology Training Program (FETP);

4) Dr. Faith Gaerlan, Medical Action Group (MAG); and

5) Professor Leo Quintilla, University of the Philippines Visayas (UPV). Dr.Troy Gepte of Ateneo Graduate School of Business Health Unit was the moderator of the conference.

A total of eleven participants (including project team members), mainly Filipino health professionals and social scientists, were able to join the discussion. The conference yielded significant insights regarding the new coronavirus. The discussion tackled the basic technical information about NCV and the sociocultural and political aspects of dealing with a health crisis. Essentially, the 2003 SARS outbreak experiences were referenced as the starting point for the NCV discussion. Updates about NCV were provided by Dr. Jose Ramoncito Navarro, Dr. Maurizio Barbeschi, and Dr. Tamano Matsui.

The discussion on the updates included the issue of NVC transmissibility, WHO investigations in Qatar and Saudi Arabia regarding the two laboratory confirmed NCV cases, the difference between NCV and SARS virus (properties and clinical manifestations), and the Hajj pilgrim travel and health advisories. One sub-topic that figured prominently amongst participants is the “Readiness for Health Emergencies”. A series of insights were shared regarding the country’s preparedness on the possibility of having another outbreak.

Specifically, the following issues were brought up:

1) creating an efficient crisis management team during a health crisis;

2) the functionality of the Barangay Health Emergency Response Teams (BHERTs) that were formed during the 2003 Philippine SARS outbreak;

3) optimizing the IT field in responding to health emergencies;

4) the emphasis on learning from the past and the need to utilize the data and inputs to "form an integrated response plan and preparedness plan to address another such problem in the future"; and

5) considerations about mitigating the effect of such public health emergencies (e.g. H1N1) particularly concerns on the health of health workers and the continuity of health care by having a sufficient manpower complement to take care of sick patients.

From these insights, multi-sectoral cooperation is crucial in addressing the various issues confronting the country’s capacity of dealing with an outbreak. Observations regarding the responsible reporting of updates on NCV and efficient ways of disseminating the right information to the general public were also discussed. The challenge is to have a set of clear and concrete guidelines that will be promptly implemented and more so, strictly followed by the media people and other stakeholders to avoid news sensationalism and public anxiety. Also, risk communication training for health managers is needed. Effectively communicating this information to the general public most especially at the local levels is crucial for public awareness. Dealing with a health crisis involves not only the perspectives of the health experts but also, of the social scientists. The clinical management of individuals and communities possibly infected by a coronavirus must be complemented with social and psychological supports. Social stigmatization sets in once someone is detected to be a possible carrier of the coronavirus because of the perceived risks of an infectious disease. A holistic perspective is therefore crucial to effectively deal with an outbreak.

The eHealth Philippines portal, through this NCV online conference, aimed of providing the public the necessary information about NCV. The country’s readiness for another health crisis, based on the conference, entails multi-perspective approach and sectoral convergence.

The eHealth portal is an online platform for this kind of health endeavour. References: Conference proper, see this site: http://ehealth.ph/index.php/forum/coronavirus-what-we-should-know-about-the-new-sars-like-virus.

Detailed summaries by Dr.Troy Gepte, see this site: http://ehealth.ph/index.php/forum/coronavirus-what-we-should-know-about-the-new-sars-like-virus/125-summaries-of-the-online-conference

Institute of Philippine Culture. (2012). IPC Hosted Online Forum on Novel Coronavirus. Retrieved from http://www.ipc-ateneo.org/node/110.

A total of 92 cases, mostly suspect SARS cases that were eventually diagnosed to have other infections or underlying conditions, were admitted in RITM, San Lazaro Hospital or the regional hospitals in the provinces. 14 probable cases were reported in the Philippines. Two of these were confirmed and had died (a daughter and her father in Pangasinan). Six of these were either relatives of these two fatal cases or health workers that had been inadvertently infected. Four were imported cases from SARS affected areas – Hong Kong, Singapore and Taiwan. In addition, two cases were attributed by the World Health Organization to the Philippines.  A British couple who had probably gotten infected in Hong Kong were seen and treated as cases of ordinary pneumonia during their stay in the Philippines (last week of February) before the WHO issued a worldwide health emergency (March 12) and before the first travel advisory was issued (March 15). This couple had been diagnosed retrospectively by blood tests by health officials in the United Kingdom sometime in May. With the results of studies and the development of an effective diagnostic test, the world has benefitted from the appearance of SARS as the first global health threat of the new millennium. As countries have been alerted, the WHO and the rest of the United Nations have woken up to an urgent need to change policies and health systems for disease surveillance and reporting and encourage the international mobilization of health officials during public health emergencies. With the newly discovered SARS-like virus isolated in the United Kingdom, health authorities all over the world are now coordinating with WHO about the risk for potential spread of this disease. Register to the eHealth website and subscribe to the online conference: "Coronavirus: What We Should Know About the New SARS-like Virus?" and join the discussion.

"In order to ensure an appropriate and effective identification and investigation of patients who may be infected with the virus, without overburdening health care systems with unnecessary testing, a revised interim case definition has been issued by WHO (see related links to right of this page). It should be noted that this case definition was developed based on data from two confirmed cases and as such some degree of clinical judgment is required where individual cases are concerned." Please see link below for the updated Interim case definition as of 29 September 2012 of Global Alert Response, World Health Organization

Recently, the World Health Organization has detected a new strain of corona virus which is likened to the SARS virus. WHO already issued clinical guidelines to its 194 member states regarding this virus (Reuters 2012). One particular concern of WHO is the upcoming haj pilgrimage when millions of Muslims go to Mecca to perform this religious duty (Ibid). Given the fact that the coronavirus is first detected in two Muslim nationals in Saudi Arabia and United Kingdom, there is then the potential risk for the virus to escalate abruptly during the Islamic pilgrimage.

According to experts, the virus is a new respiratory illness similar to the SARS virus which had proliferated globally in 2003 and consequently killed hundreds of people (BBC 2012). Deputy presidential spokesperson Ms. Abigail Valte stated in an inquirer report that the Bureau of Quarantine of the Department of Health (DOH) has already been alerted to possible carriers of the virus that may entry the country especially those coming from the Middle East where the virus was first detected (Ubac 2012).

The eHealth Philippines, through its online conference, intends to provide an informative and socially relevant discussion on the coronavirus. The online conference shall tackle the implications, appropriate and timely responses on, and the social aspects of the virus outbreak. The basic information about the virus for public dissemination (i.e. What is the coronavirus? How is it similar to SARS? Is it contagious? What are its symptoms?) shall be discussed and further elaborated. In escalating the discussion to tackle its sociopolitical angle, the following issues shall be discussed: a) appropriateness and cultural relevance of government’s responses (especially that of concerning the haj pilgrimage of Muslims to Mecca. What will be the measures of the government to protect our fellow Muslim brother/sisters from infecting the disease in case they travel to Mecca? Will the government issue a ban or impose a limitation to the number of Muslims that will be allowed to go to Mecca?); b) social exclusion and/or ostracism of people or groups of people that may possibly be infected(people that possibly be infected may suffer not only from the symptoms of the virus itself, but more so, from social ostracisms. There’s a big chance that once a person is deemed to be infected and therefore quarantined, the social treatment of his/her immediate milieu towards him/her will change); c)the readiness of the government in times of such outbreak (Do we have enough facilities, health experts, and tools in case someone has been infected? Even if there’s enough, the distribution across regions and rural and urban areas may be asymmetrical); d) the State’s police power (What are the scope and limitations of the State’s police power when applied to coronavirus outbreak? How do they protect the common good without infringing an individual’s rights?); e)SARS 2003 context vs Coronavirus 2012 context (Do the measures taken by the national government and its local units during the SARS outbreak still applicable with the current situation of the country? What did we learn from our experience during the 2003 SARS outbreak? In case there were loopholes back then, do you think we have already addressed these loopholes and therefore we are more prepared now?)

The abovementioned questions and issues shall hopefully be tackled in the online conference.

http://ehealth.ph/index.php/forum/coronavirus-what-we-should-know-about-the-new-sars-like-virus

References (Coronavirus):

Reuters. (26 September 2012). WHO issues Guidance on SARS-like Virus, Gears Up for Haj.Retrieved 2 October 2012 from http://ibnlive.in.com/news/who-issues-guidance-on-sarslike-virus-gears-up-for-haj/295431-17.html.

BBC.  (24 September 2012). How Threatening is the New Coronavirus?.Retrieved 2 October 2012 from http://www.bbc.co.uk/news/health-19699677.

Ubec, M. (2 October 2012). Warning Out on Newest SARS Strain Called ‘Coronavirus’.Retrieved 2 October 2012 from http://globalnation.inquirer.net/byline/michael-ubac.

Image taken from:
http://en.wikipedia.org/wiki/File:Coronaviruses_004_lores.jpg#file