letter from MMA Sarawak Branch Chairman to GPs
1) Over 90% of confirmed flu cases in Malaysia are now due to H1N1.
2) SGH is only sending sample for confirmatory testing for those will serious complications such as pneumonia to avoid overloading the system. It is taking 3 days for the result.
3) The death rate in Malaysia is now 0.8%. (Death/confirmed cases. Actual mortality is probably lower as many mild cases are not tested.)
4) Tamiflu is effective treatment but treatment need to be started within 48 hrs of symptom onset. It is difficult to obtain original Tamiflu from Roche. Generic Tamiflu ( Flu halt) is available from Ranbaxy but it cost about RM 150/ course. (more expensive than original!)
5) For practical purpose, if a patient demand Flu testing, you can take a throat swab and send to lab to test for Influenza. If +ve, > 90% chance of it being H1N1. But the test is only 70-75% sensitive.
6) please advise isolation and give at least 3 days sick leave. ( ideally 7 days from onset of symptoms.)
7) From the experience of Australia and New Zealand, those that require ventilation are ventilated for 2-3 weeks. If we don't try to slow down the spread, we might run out of ventilator!
Soon Su Yang
Chairman, MMA Sarawak