Philippines - Second Korean case of Zika linked to trip to Philippines

The number of Koreans visiting the Philippines might significantly decrease following a second confirmed Zika case in a man who is believed to have been infected there.

According to the Korea Centers for Disease Control and Prevention (KCDC), Wednesday, the man, 20, who tested positive for the virus, visited Boracay, a small resort island in the Philippines, and Kalibo, between April 10 and 14. He said he was bitten by a mosquito there on April 13.

Boracay is one of the most frequently visited tourist destinations for Koreans, especially newlyweds, with more than 100,000 traveling there annually.

So far, worries about the mosquito-borne virus have remained minimal here, because the outbreak is mainly concentrated in Central and South America. Korea's first confirmed patient last month was infected with the virus after travelling to Brazil, a country which is not a popular tourist destination for Koreans. But the situation is different for the Philippines.

Expectant mothers and soon-to-be-married couples are discussing in Internet communities about whether to cancel trips to the Philippines, because the virus is linked with birth defects.

"I decided to cancel my plans to travel to the Philippines. I am pregnant so my baby's heath is most important," a woman posted on one such site.

"Traveling is always fun and romantic, but I would never risk my baby's health for anything," another woman wrote.

According to Hana Tour, the nation's largest travel agency, the company is bracing for a possible spike in cancellations in the upcoming summer holiday season.

"Although there has been no significant number of cancellations yet, we are preparing for a possible decrease of travelers to the Philippines this summer," an official from the agency said.

"If the KCDC issues a travel advisory for virus-affected regions, then we would consider exempting cancellation fees for pregnant women," he added.

Meanwhile, the second patient, who had been hospitalized at the Seoul National University Hospital, was released Thursday, according to the KCDC.

"The man is healthy, and all his symptoms including rash and fever have subsided. We decided to release him as he is not likely to infect others," an official said.

The KCDC is running a test on the man's older brother, who accompanied him during the trip. The brother said he was not bitten by a mosquito, nor is he showing symptoms.

The mosquito-borne virus is almost never life threatening but poses serious health concerns for pregnant women, because it is linked with microcephaly, a birth defect in which babies are born with abnormally small heads and underdeveloped brains.

The KCDC recommends pregnant women delay their travel to 45 countries on its watch list, mostly in countries in Central and South America, and Oceania.

By Lee Kyung-min

koreatimes

Philippines - Philippines dengue vaccine update: 200,000 kids vaccinated, 362 adverse events, details on child death

In an update on the first of its kind immunization program with the newly approved dengue vaccine, Dengvaxia, Philippines health officials (DOH) provided the following update Monday.

The Dengue School-Based Immunization program that commenced on Apr. 4 continues on and at the three week mark, a total of 204, 397 (73%) pupils were vaccinated out of 279,393 pupils with parents’ consent.

As of April 24, 2016 a total of 362 cases of Adverse Event Following Immunization (AEFI) from the three regions where the Dengue School Based Immunization Program were received. The top five common reactions were fever, headache, dizziness, vomiting, and rash. The DOH established a strict monitoring and surveillance system for adverse events and side effects following immunization.

There has been a lot of coverage on the fatality of an 11-year-old boy who was vaccinated on Mar. 31.  The DOH offered the following details and explanation of the case:

The patient is claimed to have been diagnosed to have congenital heart disease during his childhood. No maintenance medication was taken since his transfer to his current guardians.  During immunization of dengue vaccine, the patient was screened and assessed by the RHU physician at the school. When asked the guardian (uncle) denied history of fever, illness, and maintenance medication during assessment.

On April 3, 2016 patient developed diarrhea and fever, he was seen and examined the next day at the Bagac Community Medicare Hospital and was diagnosed to have amoebiasis. Patient was sent home with medications. On April 9, the patient was seen and admitted at the Isaac Catalina Medical Center after experiencing difficulty of breathing, fever, and cough. He was initially diagnosed with pneumonia, severe; congenital heart disease in Congestive Heart Failure, and electrolyte imbalance. April 10, the patient was referred and transferred to Bataan General Hospital. April 11, patient had a cardiac arrest and was eventually pronounced dead. The immediate cause of death was pulmonary edema with the following underlying causes: congenital heart disease, Acute Gastroenteritis with moderate dehydration.

The case was presented to the National Adverse Event Following Immunization Committee (NAEFIC) last April 21, 2016 to assess the findings. Their conclusion is consistent with the hospital findings. The dengue vaccination is coincidental. According to NAEFIC, congenital heart disease is not an exclusion criterion for vaccination.

The Philippines reported more than 200,000 dengue cases last year and nearly 600 deaths. As of April 9, 2016, a total of 33, 658 suspected dengue cases were reported nationwide. The Philippines has the highest incidence of dengue and ranks number 1 in the Western Pacific Region from 2013 to 2015.

outbreaknewstoday

Philippines - Groups demand cheaper pneumonia vaccine for Filipino kids

WASHINGTON, D.C. — A number of advocacy organizations are  calling on the Filipino American community to support a global effort to save Filipino children from pneumonia, the leading cause of child mortality in the Philippines.

According to the World Health Organization (WHO), the Philippines is one of 15 countries that together account for 75 percent of childhood pneumonia cases worldwide. In children aged under five years, pneumonia is the leading cause of mortality.

The National Federation of Filipino American Associations (NaFFAA) is supporting the petition drive spearheaded by NextDayBetter and Doctors Without Borders that is directed at two pharmaceutical companies –  Pfizer and GlaxoSmithKline (GSK) – the only two producers of the life-saving pneumonia vaccine.

“We need Pfizer and GSK to lower the pneumonia vaccine price in the Philippines, from $45 to $5 per child,” says Ryan Letada of NextDayBetter, a storytelling platform for creative diaspora communities, which uses digital media and global speaker events to generate action and make an impact. “Many lives have been saved by this vaccine, but pneumonia still kills nearly 1 million children every year. The problem is urgent.”

NaFFAA’s Director of Health, Dr. Rommel Rivera of Philadelphia, Pennsylvania, says the situation is alarming and affirms NaFFAA’s endorsement of this initiative.

“We must take a stand as a community and use our influence to put pressure on these giant companies to make the vaccine affordable not only for children in the Philippines but for all children all over the world,” Rivera said. “The petition campaign ends next Tuesday so we’re calling on everyone to tell their family, friends and co-workers to sign now. It is critical that we make our voices heard.”

The link to the petition is www.nextdaybetter.com/afairshot​. The goal is to collect 300,000 signatures by April 26. The petitions will be delivered to the offices of Pfizer and GSK the following day.

Rivera, who is President of the Philippine Medical Society of Greater Philadelphia (PMSGP), posted the online link to the petition a week ago, which was in turn shared by NaFFAA members nationwide.

Among those responding is Dr. Nanette Bernabe Quion of Arlington, Virginia, a pediatrician who is trained in public health. “This vaccine will save millions of lives,” she wrote in a Facebook post. “This vaccine has been proven to be safe and efficacious. The expensive cost of drug development should not be borne by poor and developing countries. It is very unfortunate that the Philippine DOH has not included the pneumococcal vaccine in its Expanded Program of immunization when it is a proven and cost effective vaccine. We should have spent on this vaccine, which has a better safety profile, instead of the haphazard implementation of the dengue vaccine.”

In explaining NDB’s collaboration with Doctors Without Borders, Letada says that they “recognize that the Filipino diaspora is a source of world-class healthcare professionals (nurses, doctors, physical therapy) and public health community organizers. Without Filipino healthcare professionals, the global healthcare system would implode — that’s how influential and critical we are as a community.

“Doctors Without Borders and NextDayBetter believe that the Filipino diaspora belong on the decision making table when it comes to public health issues that plague our community. This campaign is about ensuring that our community’s voice is heard.”

globalnation.inquirer.

Philippines - Davao Oriental declared malaria, filariasis free

Health officials in Davao Oriental in the southern Philippines has declared the province free of the mosquito borne parasitic diseases, malaria and filariasis.

During the ceremonial declaration and awarding on April 20 at the Provincial Capitol, DOH Undersecretary for Technical Services, Dr. Vicente Belisario, Jr., lauded Davao Oriental’s feat for eliminating two major public health diseases.

“This is a major feat because you have eliminated filariasis and malaria which are public health problems that are greatly associated with poverty,” he said.

Provincial Health Officer I, Dr. Joy Sanico, said that the elimination of these public health diseases involves considerable amount of time and effort. She listed several strategies in eliminating these diseases which include among others: early detection and prompt treatment, case surveillance,

capability-building among municipal health workers, and increasing public awareness through extensive information, education, and communication campaign, among many others. In the case of filariasis, the Public Health Office has been giving prophylaxis treatment to susceptible and predisposed groups particularly in far-flung areas.

In order to efficiently implement sustainable set of measures to ensure that filariasis and malaria will continually be eliminated as a public health problem here in the province, the DOH has turned over to the Provincial Government a total of P 2 million cash grant for filariasis and malaria control which will further boost the province’s disease-control programs.

Malaria, from the Italian for “bad air”, is caused by a parasite called Plasmodium, which is transmitted via the bites of infected Anopheles mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells.

Elephantiasis of leg due to filariasis/CDC

In 2013 an estimated 198 million cases of malaria occurred worldwide and 500,000 people died, mostly children in the African Region.

Symptoms of malaria include fever, headache, and vomiting, and usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.

There are three different filarial species (nematode parasites) that can cause lymphatic filariasis in humans. Most of the infections worldwide are caused by Wuchereria bancrofti. In Asia, the disease can also be caused by Brugia malayi and Brugia timori.

Lymphatic filariasis affects over 120 million people in 73 countries throughout the tropics and sub-tropics of Asia, Africa, the Western Pacific, and parts of the Caribbean and South America.

A wide range of mosquitoes can transmit the parasite, depending on the geographic area. In Africa, the most common vector is Anopheles and in the Americas, it is Culex quinquefasciatus. Aedes and Mansonia can transmit the infection in the Pacific and in Asia.

The painful and profoundly disfiguring visible manifestations of the disease, lymphoedema, elephantiasis and scrotal swelling occur later in life and lead to permanent disability. These patients are not only physically disabled, but suffer mental, social and financial losses contributing to stigma and poverty.

By Robert Herriman

outbreaknewstoday

Philippines - Philippine Cancer Healthcare Spends Less Than Southeast Asian Counterparts

With the shift in healthcare priorities in the sustainable development goals, non-communicable diseases such as cancer are becoming a global priority and urgent action against cancer in Southeast Asia in particular is recommended.

A new study has shown that the disease has become an overwhelming burden on society and healthcare systems in Southeast Asian regions.

The study, Asean Costs in Oncology (ACTION), conducted by the George Institute for Global Health showed that a cancer diagnosis in Southeast Asia is disastrous within only 12 months for 75 percent of new patients.

Just a year after diagnosis 29 percent of the participants of the study died while 48 percent experienced financial catastrophe. Additionally, almost half or 44 percent of those who survived experienced economic hardship as a consequence of the cancer, with the majority using their life savings for cancer care.

Socioeconomically disadvantaged patients with advanced cancer stages were common and particularly vulnerable to adverse economic outcomes and poor survival.

In the Philippines, cancer is the second leading cause of death following cardiovascular disease. In particular, women in the country are negatively affected by cancer with incidences of breast, cervix and ovarian cancer almost doubling in recent years.

But despite the increase in cancer incidence in the country, public healthcare spend to help treat and combat the disease has remained low compared to its Southeast Asian neighbors.

In 2015, research was conducted to benchmark Philippine healthcare spend and government support towards cancer care as compared to Vietnam, which has a similar gross domestic product (GDP) to the Philippines, and to Thailand, an aspirational country with double the GDP of the Philippines.

In the Philippines, overall healthcare spend for cancer is comparable with that of Vietnam and Thailand at 4.4 percent of GDP in 2013.

Of that total spend, only 32 percent is contributed by public sector reimbursement or assistance, 12 percent by private sector assistance (insurance and others) and the rest of the 57 percent is paid out of pocket by cancer patients.

In Vietnam, 42 percent is covered by the public sector, 9 percent by the private sector and 49 percent is out of pocket – 8 percent lower than in the Philippines. In Thailand, 80 percent of cancer healthcare spend is provided by the public sector, 9 percent by the private sector and only 11 percent is out of pocket expense for patients.

Additionally, the Philippines has a very low percentage of access to innovative cancer treatments compared to Thailand and Vietnam.

In the Philippine Costs in Oncology Study (PESO Study), a significant percentage of cancer patients either suffer financial ruin or die within a year of diagnosis due to lack of funds, support and access to medication. Financial difficulties prevented access to treatment, hindered medical intervention and prevented patients from being able to afford medicines.

These statistics may not have been as bad if patients had better support and access to treatments and medications. Funding agencies such as the Philippine Charity Sweepstakes Office (PCSO) can help cancer patients fund treatments and medication and for many, PCSO was the only reason they were able to fight the dreaded disease.

Steps need to be taken to address and prevent cancer, such as accessible and affordable screening programs to catch cancer earlier, providing a better safety net for cancer patients who are wage earners, a significant increase in reimbursements for cancers, support for cancer patient funding agencies such as PCSO and cancer post-hospitalization benefits.

malaya.com.ph

Philippines - WHO Subnational Initiative: Accelerating Convergence Efforts Through Systems Strengthening for Maternal and Newborn Health (AcCESS for MNH) in Davao, Philippines

The Accelerating Convergence Efforts Through Systems Strengthening for Maternal and Newborn Health (AcCESS for MNH), a project of the World Health Organization Sub National Initiative (WHO SNI) in partnership with the Department of Health Regional Office XI (DOH RO XI), shared its insights and experiences in addressing maternal and newborn health challenges in Davao Region in a forum entitled “Stories from the Field: Walang Nanay at Sanggol ang Mamamatay dahil sa Panganganak” (No mother and newborn shall die from childbirth-related causes) in Davao City.

The forum was an avenue for project partners to take stock of what was done so far, and re-evaluate what works and what doesn’t. It was an opportunity to share early wins, insights, and experiences in implementing activities and strategies on maternal and newborn health. Various stakeholders such as barangay officials, community leaders, barangay health workers, midwives, and other health service providers committed to continuously work together to improve maternal and neonatal health in Davao Region.

AcCESS for MNH is a three-year project launched in 2015 with funding support from the Korean International Cooperation Agency (KOICA). It is part of WHO’s Sub National Initiative to model a systematic and evidence-based approach in improving implementation of the country’s Universal Health Care at community level, capitalizing on WHO’s core function as a global leader in public health. AcCESS for MNH seeks to provide catalytic technical and advisory support to DOH RO XI and partner local government units (LGUs) to accelerate convergence of efforts for the health and survival of mothers and newborns, especially among the most disadvantaged populations. It aims to strengthen health systems and governance, establish a functional network of services, and improve utilization of quality maternal and newborn services in the neediest communities in the region, towards the overarching goal of reducing maternal and neonatal deaths in Davao Region. It is being implemented in ten LGUs in the four provinces of Davao as follows: Malita, Sta. Maria, and Don Marcelino in Davao Occidental; Maco, Mabini, and Pantukan in Compostela Valley; Tagum City and New Corella in Davao del Norte; and Manay and Caraga in Davao Oriental.

The forum, held last February 9, was attended by DOH Assistant Secretary Dr. Nestor Santiago, KOICA Deputy Director Heesoo Hong and Health Specialist Dr Michelle Apostol, DOH RO XI Regional Director Dr. Abdullah B. Dumama Jr. and Assistant RD Dr. Annabelle Yumang, WHO Philippines Technical Officers led by Dr Benjamin Lane and Ms Lucille Angela Nievera, other DOH officials, municipal mayors, Provincial Health Officers, DOH Representatives, and community health service providers.

WHO

Philippines - Hurdles cleared but disillusionment, homesickness prompt Filipino health workers to exit Japan

MANILA – A number Filipino nurses and caregivers who seized the opportunity to train in Japan to work there have ended up returning to the Philippines, including some who passed the tough licensing exam.

“The journey to becoming a nurse in Japan was indeed a mission impossible. . . . We were very tired physically, mentally and emotionally while studying to pass the board exam and working at the same time. All of us were pushed to study even on our rest day,” a Filipino nurse who quit only a year after his deployment in 2011 said recently.

The 33-year-old nurse, who requested anonymity so he could freely express his views, is among more than 1,200 Filipino nurses and caregivers who were accepted by Japan starting in 2009 under the Japan-Philippines Economic Partnership Agreement.

Under the program, nurses and caregivers from the Philippines first learn the Japanese language and culture, undergo training in Japanese health facilities, and then take the Japanese licensing exam in their respective profession.

Candidates who pass are granted a working visa, allowing them to both work and help graying Japan address its growing shortage of health workers at the same time.

A fresh batch of 60 nurses and 275 caregivers is about to complete a six-month Japanese language and culture course in the Philippines before deployment to Japan in June.

“Learning the language alone is already difficult, and it’s all the more grueling trying to pass the exam,” the Filipino nurse, who has already migrated to another country after returning from Japan, said in an email message.

He complained also of a change in the payment terms in his contract when he started working in the Japanese hospital.

To encourage candidates to complete the program, he said they should be allowed to shadow their Japanese counterparts as they perform their jobs, instead of getting assigned tasks usually performed by orderlies or janitors.

“If I could turn back the clock, I would have not chosen to sacrifice my career as a public nurse back home and my family life,” the Filipino nurse said.

Filipino caregivers Aira Ignacio and Bernadette Villanueva, speaking in a separate interview, also attested to the difficulty of working and studying at the same time when they entered the program in 2011.

“There are times when you really wanna give up, because not all things in Japan are good,” Ignacio, 30, said. “There were times during my first year there that I asked myself if that is really the job that I wanted, because I’m not really used to taking care of old people, and doing it alone.”

Ignacio, who is a licensing d nurse in the Philippines, was assigned to a facility in Okinawa, while Villanueva, 29, went to a facility in Hamamatsu, Shizuoka Prefecture.

But unlike the other nurse, Ignacio and Villanueva endured the challenges of their three-year training program and passed the licensing exam for caregivers in 2015.

Both said that while their respective facilities supported them in their studies while they worked, they also had to study in their free time just to make sure they passed the exam.

But passing the exam did not lead to a significant increase in pay, contrary to their initial expectations.

For this reason, coupled with personal ones — recurring back pain and wanting to be reunited with her family (Ignacio), and marriage plans (Villanueva), the two decided to return to the Philippines last year.

Equipped with Japanese skills, the two now have relatively high-paying jobs in Manila as interpreters in hospitals for Japanese patients who cannot speak English.

The two agree that their present circumstances are much better than if they had continued working in Japan as licensed caregivers, because aside from the good pay, they are also living with or close to their respective families. Being able to continue speaking Japanese and working in the medical field are additional benefits.

But amid their difficulties in Japan, Ignacio and Villanueva said there were plenty of positive things they will never forget, foremost of which is the sense of achievement of overcoming the physical, mental and emotional challenges as affirmed by their successful shot at the licensing exam.

“Living in Japan is not like being in heaven. There’s loneliness, homesickness. But when I felt the desire to go home before, I just thought right away of the reason why I went there,” Villanueva said.

“We advise them to have lots of patience, because you really have to study and work at the same time,” Ignacio added.

The two admit to being open to the possibility of returning if the right offer comes, noting also how they miss the clean environment, the politeness of the Japanese, and the efficiency of the public transport system, among other aspects.

According to official data, just over 160 of the nearly 200 Filipino nurses and caregivers who passed the Japanese licensing exam from 2010 up to 2015 are working in Japan.

For this year, 56 Filipino caregivers and nurses passed, but there are no data immediately available as to how many of them are employed in Japan.

The Japan International Corporation for Welfare Services, which directly handles the program on the part of Japan, said the most common reasons cited by those who passed the exam but decided not to work in Japan are personal and family issues, particularly the desire to just be close to and take care of their parents.

By Ronron Calunsod

japantimes