Public health officials say as many as 1,600 people could have been infected with the H1N1 swine flu virus in the Cayman Islands since it reached our shores in late May.
While the number of confirmed cases stands at 60, officials speaking at a press conference Monday agreed the real figure was sure to be higher.
With the majority of cases remaining ‘mild’ and not requiring hospitalisation, they said most people would not know if they had H1N1 swine flu or regular seasonal flu.
‘I would project there have been about 2,000 flu cases in this time,’ said Dr. Kiran Kumar, medical officer of health, referring to surveillance figures. ‘Eighty per cent of them I expect to be H1N1.’
Mr. Kumar’s assessment of the real number of H1N1 cases comes after the announcement late last week that a 31-year-old man had become the first swine flu related death in these Islands.
While the dead man’s name has not been officially released, he has been identified locally as 31-year-old Armando Carlos Julian, a resident at Caribbean Haven, a government substance abuse treatment facility.
Health officials have said the deceased man had ‘underlying medical conditions’, but have not said what those conditions were, sighting patient confidentiality restrictions.
But Mr. Julian’s sister, Nicole Hydes, on Monday told the Caymanian Compass that she wasn’t aware of her brother having any underlying medical conditions.
‘He was a healthy young man,’ said Nicole Hydes.
She also dismissed rumours that her brother had AIDS.
‘I can dismiss that. I have his records in my file,’ she said. He has no AIDS,’ she said.
Ms Hydes said she would give the HSA the benefit of the doubt for sighting ‘underlying medical conditions’ until the results of a post mortem exam become available in three to four weeks.
Officials stressed Monday that most cases of the virus continue to be mild and only 12 people have been hospitalised locally with the virus.
A screening test done on Mr. Julian initially showed a negative result for H1N1, but later tests at the Caribbean Epidemiology Centre in Trinidad turned out positive.
Health Services Authority Medical Director Dr. Greg Hoeksema said the screening test has returned a ‘false negative’ in about 25 to 30 per cent of cases.
He explained that the screening test was developed some years ago to test for flu viruses generally and that the Cayman Islands does not have the capability at this point to test specifically for H1N1 swine flu.
‘Particularly in the Cayman Islands where we know there is widespread community transmission of this virus, the clinicians have to rely on the clinical presentation … and we should never rely on a single test result,’ Mr. Hoeksema said.
‘Testing is not for diagnostic purposes; testing is not for treatment purposes,’ added Mr. Kumar. ‘When thousands of cases are occurring … just like when you cook your rice; you don’t test each grain; once a few grains are cooked then the rice is cooked.’
Mr. Kumar said United Kingdom officials last week confirmed that Cayman Islands residents will receive the same access to a future H1N1 flu vaccine as citizens of the United Kingdom.
But that doesn’t mean everyone will be able to instantly access the vaccine when it becomes available – tipped for sometime in the fall. Mr. Kumar said priority will likely be given to high risk groups first.
Mr. Hoeksema stressed that a flu response team continues to meet weekly to review and modify how the Cayman Islands deals with H1N1 flu as the situation changes.
‘Every day we are learning more about this virus and we are going to know an awful lot more in a month from now than we know today. We sure as heck know a lot more today than we knew a month or two ago.’
Minister of Health Mark Scotland urged people to call the 24-hour Cayman Islands flu hotline on 926-2812 if they are unsure about the information they hear about H1N1 swine flu.
‘The most important message … is for the public to remain vigilant; to ensure your personal hygiene; to ensure that if you have flu symptoms that you either stay at home in home isolation … or know when to go to a doctor or hospital,’ Mr. Scotland said.
Of 60 confirmed cases in Cayman, roughly half have been in people aged 5 – 19, although older residents have been hospitalised with the virus. 47 per cent of cases have been in George Town and almost all of the rest have been in West Bay and Bodden Town. There have been two confirmed cases in East End and none in North Side or the Sister Islands.
Mr. Hoeksema explained that people that have had H1N1 flu should be immune from contracting the virus again, although they will not be completely protected if the flu strain mutates into something else. ‘Even in that situation you should have some protection,’ he said.
‘Particularly in the Cayman Islands where we know there is widespread community transmission of this virus, the clinicians have to rely on the clinical presentation … and we should never rely on a single test result.’
Dr. Greg Hoeksema
Health Services Authority medical director