Monday, August 17, 2009

The Tamiflu for one of my children. Each of the following packaging has 10 capsule of 75mg Tamiflu.

15th August 2009, Saturday – This morning we received a call from the health authority saying that my No.1 is confirmed to have Influenza A H1N1. Even though this is already late to know that she has H1N1, she has taken the Tamiflu since Wednesday (12th August 2009). Therefore, she needs to take 3 more doses of Tamiflu in order to complete her treatment i.e on Monday morning.

My No.1 had a fever on last Sunday. We gave her Paracetamol syrup to reduce her fever. My wife took her to the clinic the next day…and she was prescribed with Paracetamol syrup. She was getting better until the next day (Tuesday).

However, on that Tuesday, my No.2 was starting to have a fever and mild asthma. We gave him Paracetamol syrup to reduce his body temperature (as well the blue inhaler for his asthma).

On Wednesday, my No.1’s body temperature rise again. My No.2’s body temperature is in more favourable condition. We brought them to the flu clinic. They were give a Tamiflu medications. I think it is due to that they are the probable cases of H1n1. In addition, the doctor took their swab sample…And we have to wait until today for the result.

About the Tamiflu….According to the patient information leaflet for Oseltamivir that was given to us by the flu clinic, Tamiflu is an antiviral drug. It attacks the influenza virus and stops it from spreading inside your body. The Tamiflu is given because the patients are considered to be high risk group based on their medical conditions.

The patients are required to start taking Tamiflu immediately. They have to take one capsule of Tamiflu two times a day i.e one capsule in the morning and one more capsule in the afternoon. And…the patients must finish the Tamiflu capsules that have been given even though they feel better.

There are some adjustment in dosage for the children. In the case of my two children, the dosage is 45mg twice daily. Each capsule has 75mg. As there are no syrup forms of this medicine, you have to open the 75mg capsule and mix it with 7.5ml of water. This gives a solution of Tamiflu 10mg per ml. For the 45mg dosage, we give them 4.5ml of the solution twice per day.

It is very hard for us to give the medicine to my No.2 because he refuses to take any medicine…so we have to find some “necessary” ways to make him take it….My No.1 is okay. She is very cooperative, but the problems is she is very selective over the “menu”…Actually, both of them do.

The patients may take Tamiflu with food or without food. But the leftlef says the most common side effects with Tamiflu are nausea and vomiting. There are usually mild to moderate. They usually happen in the first two days of treatment. Taking Tamiflu with food may reduce the chance of these side effects i.e nausea and vomiting. So far, my No.1 and No.2 does not show this side effects.

Tamiflu is made in Switzerland by F.Hoffman-La- Roche Ltd, Basel.

Some of the instructions.
The prescriptions...
Each capsule of Tamiflu has 75 mg of oseltamivir. NOTE: Do not store above 25 degree Celsius.
Side view of the packaging.
Back view.

Tamiflu is presented as hard capsule with a light yellow opaque cap and grey opaque body.

The Tamiflu...

After my wife received a call about my No.1 ‘s H1N1 confirmation this morning, she also received a call from the Department of Schools, Ministry of Education to gather information either to close her class or not. I think it is unnecessary to do so because my No.1 has not going to school since last Sunday…And my No.2 has not going to school since Tuesday. While he was going to school on Monday, he did not show any H1N1 symptoms yet. My only questions are where and when she has contracted with the H1N1 virus and if there are any of her friends are also get H1n1.

This afternoon we went to the flu clinic again for review. We were shown the laboratory result. It is confirmed that my No.1 has positive result while my No.2 has negative result. I have no idea why my No.2 only has the normal fever (with running nose and then cough) eventhough they watch TV together, play together, and sleep near to each other. I guess he has the flu vaccination meanwhile my No.1 does not have the vaccination…but the vaccination is NOT for Influenza H1N1.

Both of them are still on medical leave until 18th August i.e one week from last Wednesday. The doctor gives us the option either to stop or to continue Tamiflu medication for my No.2 as he has H1n1 negative. I decide to finish his dose…just for prevention. So, he must complete his medication until this coming Monday morning, just like his sister.

At present (at the time of writing), both of them are at “recovery mode”…they are just having cough and a little running nose.

There is no quarantine order to the others who live in my house. This is due to Brunei has moved to the Protect and Treat Phase from the Containment Phase. Both my children are “advised” not to go out in the “public”….no schools, no family gathering, and no shopping malls.

But if this was happen during the beginning of the outbreak in Brunei, all people in the house or in contact with them will be quarantined either at Tutong Hospital (Duli Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital) or at home. The quarantine will be for a number of days depending what is your infection status. Please read my ex-colleague’s story about her experience being in quarantine order. Please click here: Under Quarantine...

At the time of writing (15th August 2009, Saturday night), the cummulative counts of confirmed H1n1 cases is 950 cases with 1 H1N1 related death. The counts are based on the information that are available at Ministry of Health (MOH) website. Please take note that you have to calculate yourself in order to know the cummulative numbers…or you have to wait their latest updates over the Radio Television Brunei (RTB) news or at the newspaper.

And… the figure does reflect the actual numbers of H1n1 cases. The actual numbers may be more (I think the actual numbers should be more than 1000 cases already). This is due to Brunei is now at Protect and Treat Phase. During this phase, not all people who has the symptoms are tested for H1N1. Please visit their website for further details: www.moh.gov.bn

Eventough you are not tested for H1N1 and not confirmed to have H1n1, please follow MOH’s advices if you are having H1n1’s symptoms.

p/s: My “armies” still win the war again the flu virus….I hope they do not lose any battle even though I have not “install any anti-virus” (special support team) to help them….Doing some physical activities, eat healthy, control stress and have enough sleep will help them.

Stay home if you have flu symptoms. Visit www.cdc.gov/h1n1 for more information.

16th August 2009, Sunday – About 6.00pm today, I went to a flu clinic in Ong Sum Ping to accompany my wife to see a doctor. She got headache, cough, and dizziness…but no fever. She is given 4 days medical leave until this coming Thursday.

From our visit to the flu clinic, I can further understand that only high risk groups ( or selected people) are tested for H1N1 during this Protect and Treat Phase. And, only high risk groups are given Tamiflu medication (may be due to its price and the normal people can get better without the Tamiflu).

There is no more quarantine order by the authority for those who are sick and their contacts. It is true there were quarantine order during its early outbreak in Brunei Darussalam i.e during the Containment Phase. But, for those who are sick, they have a social responsibility to follow the Ministry of Health’s advice for this Protect and Treat Phase period. You may have H1N1 or you may not have H1N1… you have a probable case of H1N1…not confirmed unless tested.

However, those who are not sick can go to work eventhough there is someone who is sick (probable H1N1 or confirmed H1N1) in their home. You just monitor your health status…and need to see a doctor if you have H1N1 symptoms. Then, you may be prescribed with normal medicine and a medical leave.

Note: Brunei Darussalam has moved from Containment Phase to Protect and Treat Phase on 25th July 2009.

p/s: Should a teacher who is still healthy go to school or not, if he/she is (continously) in contact with the sick people (probable H1N1 or confirmed H1N1)?

Note: This article is written based on my experience and understanding of the situation as well as from the information that I have read. THIS IS NOT A MEDICAL ADVICE. If you have a medical situation, please see your medical professsionals for advice and treatment. Thank you.

(Photos: Abdul Rashid Haji Tahir. Taken on 12th August 2009, Wednesday)

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