BY GERARD NAVAL

A TOTAL of 123 new cases of influenza A(H1N1) were reported yesterday, bringing the total to 727.

The new cases are all still mild and there is still no cause for alarm, the health department said.

The Philippines continues to rank high in the global tally of H1N1 cases from some 90 reporting countries.

Countries with higher cases are the United States (21,449), Mexico where the virus was found in April (7,847), Canada (6,457), Chile (4,315), the United Kingdom (2,905), Australia (2,857), Argentina (1,213), China (906), Japan (893), and Thailand (774).

The Philippines has had its first fatality, but health officials would not link this directly to the new virus.

As the number of cases tripled in less than 10 days after breaching the 200-mark on June 16, health officials advised high-risk individuals to seek medical attention immediately after showing flu symptoms.

"They should not wait for their symptoms to worsen because they are prone to many infections other than the novel virus such as our seasonal flu strains," said Health Secretary Francisco Duque.

Belonging to the high-risk group are those with diabetes, cardiovascular diseases, asthma, COPD (chronic obstructive pulmonary disease), chronic liver and kidney diseases, tuberculosis and people suffering from HIV/AIDS infections.

Others in the category are organ transplant recipients, pregnant women and the very young and the elderly.

The first fatality, an employee of the House of Representatives, had pre-existing medical conditions. Health officials have said the woman died from "congestive heart failure secondary to acute myocardial infarction aggravated by severe pneumonia."

Duque said those who do not belong to the high-risk group should only practice home quarantine.

"Most can fight off this novel virus even without medication or hospitalization. If you have mild flu-like symptoms but you do not have any pre-existing medical condition, then there is no reason to be alarmed. Just stay home and take plenty of fluids, vitamins and bed rest," Duque said.

And to highlight the rapid recovery rate from the illness, Duque said there are already 536 patients that have already been discharged after fully recovering.

The number represents 74 percent of the total sum of reported confirmed mild cases since May 21, said Duque.

The health department in consultation with the education department issued a revised guideline on the suspension of classes.

At least 45 schools nationwide have suspended their classes because of the new flu.

Based on the new guidelines, a school which has suspended classes for 10 days need not impose another suspension if there is a new H1N1 case.

In cases of new infections, all schools have to do is send the infected students, faculty, or non-teaching staff home for self-quarantine and let them recover.

Based on the old guidelines issued before the opening of classes early this month, a school that reports its first H1N1 infection can suspend classes for 10 days to prevent the spread of the virus.

Duque said a second suspension is not needed because the "likelihood that transmission has occurred prior to the occurrence of symptoms and laboratory testing is high."

"The emphasis of infection management should be shifted to individual patient care. As such, only confirmed cases or students, faculty members or non-teaching staff manifesting flu-like illness shall be sent for home quarantine or be referred to a health facility," he explained.

Dr. Juan Lopez of the Department of Health’s National Epidemiology Center said the number of cases continue to increase because of greater public awareness.

Lopez said the rich folks were first infected by the virus because they had the capacity to travel to countries with H1N1 cases. He said the rich travelers then infected members of their households, and the virus then spread to "rich" schools.

Dr. Joy Althea Pabellon of the NEC’s Applied Public Health Division said based on the experience of other countries, every infected person spreads the disease to two to three others.

There are eight confirmed cases in the Western Visayas region, with a one-year-old Japanese boy and female student added to the list.

The boy, whose father is Japanese and mother a Filipina, arrived in Talisay City, Negros Occidental from Japan on June 11, manifested influenza-like illness on June 13, and was admitted to a private hospital in Bacolod City on June 16.

The boy has recovered and is believed to have returned to Japan.

The Research Institute for Tropical Medicine also confirmed that a female student from Roxas City enrolled at the Assumption High School in Iloilo City was positive for the virus.

Of the eight confirmed H1N1 cases in Western Visayas, Negros Occidental has five, Capiz two, and Iloilo one.

Sen. Joker Arroyo said the health officials and the media are practically advertising H1N1, thus projecting the country to the world as the most vulnerable to the novel disease.

"We have this tendency to self-flagellation," he said, noting Duque has been conducting press conferences twice a day since the outbreak of swine flu in the country.

"Para bang… we advertise how many have been infected instead of stressing what we do to manage or control. As it matters now, we’ve now more infected persons than Mexico where it started. Why? Because we keep on advertising it," Arroyo said.

At the House, Duque was criticized for not telling the House leaders of the confirmed case before it was made public.

On Monday, health officials briefed the panel on the virus but did not reveal that the 49-year-old casualty was a House employee despite the inquiries of Rep. Roilo Golez (Ind., Parañaque).

Rep. Arthur Pingoy (NPC, South Cotabato), chair of the House committee on health and a physician, said an early coordination with the House leadership would have enabled them to conduct preemptive measures to avert a "contagion."

Two other House employees have been found positive for the virus.

Pingoy said he could have immediately mobilized his committee and the House medical services to conduct contact tracing and other measures that would ensure the immediate containment of the viral disease.

Pingoy also wants Duque to explain before his panel why the DOH kept them in the dark.

"The DOH gravely endangered the health of our employees by keeping us in the dark. I think that the House should conduct an inquiry," he said.

Pingoy said Duque’s explanation that the DOH kept it secret because it was part of DOH protocol and to prevent panic was "very ironic."

"On the contrary, this is against protocol because the DOH could have reported this to the leadership which could have exercised discrete health procedures," he said.

Golez said that unlike schools and universities, the House of Representatives "is an institution with implications on national security."

"Apart from the fact that we have at least 4,000 employees who are potential victims of this virus, the House of Representatives is also host to government dignitaries and officials of foreign governments who come to us almost every day. This action of the DOH also endangered the health of the members of the media and resource persons who attend our hearings," he said.