Back in July 2009, the Ministry of Health in Belize reported that there had been 23 laboratory-confirmed cases of swine flu, caused by the H1N1 strain of the influenza “A” virus in Belize—a virus which medical experts now reveal had caused deaths way back in 1918, around the time of World War I, and again in the 1960s, as confirmed by Dr. Federico Gerardo de Cosio, WHO Representative in Belize.

Belize and the rest of the world panicked when reports surfaced four years ago that the virus was spreading again and causing multiple fatalities.

Director of Health Services Michael Pitts said at a press conference held in Belize City today that in 2010 and 2011, the country saw mild cases of H1N1 – never severe ones – and since October 2013, they have been seeing increased cases of H1N1 flu in the region. Today, however, he reported that they have confirmed Belize’s first death due to the swine flu.

Currently, medical authorities are treating a 14-year-old who arrived at the hospital with severe respiratory illness, and has been manifesting that condition over the last 36 hours.

The Ministry of Health has also announced that of five severe flu cases sent for testing at the Caribbean Public Health Agency (CARPHA), one was confirmed to be of the H1N1 strain. Sadly, that one case ended fatally on Monday, January 6, for Shahera Bodden, a 29-year-old mother of Belize City, despite being treated at the Karl Heusner Memorial Hospital (KHMH) since she was admitted on January 2. Hospital authorities declined to release the name of the deceased due to confidentiality concerns, but said that checks into her medical background didn’t reveal that she had any underlying illness that would have compromised her immunity.

The patient had first sought treatment in December, and was treated on a second visit on December 28 and released. However, she did not heal and returned on January 2, with a heart rate of 148, a fever of 103, and a respiratory rate of 28 – alarming signs which led to her hospitalization. She was treated with Tamiflu, but died in the Intensive Care Unit on January 6.

DHS Pitts also said that there was one person who had reportedly died in the private section of the hospital of flu-like symptoms. That patient, he said, had been advised to take antibiotics, but did not do so, and returned to the medics in a worse condition.

They also confirmed that investigations are ongoing into a report that another Belizean had died in neighboring Mexico from the flu or a flu-like illness.

Meanwhile, two other patients from the Cayo District who had also contracted H1N1 were treated and have since recovered from the flu, medical authorities said.

Dr. Marvin Manzanero, who heads the Epidemiology Unit in the Ministry of Health, said at today’s press conference that out of 26 samples sent to Belize’s Central Medical Lab, no virus was found on the initial swab for 19 cases. There were three H1N1-positive cases and 1 death—that of Shahera Bodden.

The other H1N1 cases were managed in ambulatory fashion – treated and released with full recovery, he said. There are a further 13 samples pending results, and those should be available within the next few days.

Dr. Francis Murray, National TB Coordinator and the Focal Point for Communicable Diseases in the Ministry of Health, said that last year (2013), there were 517 suspected cases of H1N1 in Belize.

He said that in Belize, there have been different viruses circulating, and some might also have become ill due to an adenovirus (a DNA virus said to cause respiratory illness), the meta-pneumonia virus, or bacteria which cause respiratory illness, a combination of which can affect patients along with the flu viruses named—what DHS Pitts calls the “alphabet soup of viruses…”

Pitts said that while there are deaths from time to time due to the flu, every time they see a death of this nature, they investigate it thoroughly.

Murray notes that data gathered between 2009 and September 2013, since H1N1 has been a concern in Belize, indicate that rhinoviruses have accounted for 26% of the viral respiratory illnesses reported, while 23% have been due to H1N1.

Pitts said that they had thought it would be people over the age of 65 or under the age of 5 who would have been at the greatest risk, or people with underlying medical conditions—but that has not been so.

He said that they have been offering influenza vaccinations to healthcare workers, police, Belize Defence Force soldiers, elderly people over the age of 65 and children between 8 months and 3 years, as well as pregnant women and diabetics. He said that last year, they issued 9,000 doses of vaccine, which covers three subtypes of the flu virus: two type “A” viruses and one in the “B” virus subtype.

Currently, they have on hand 10,000 doses of Tamiflu in the country, which won’t expire until March, but which will be issued on a prescription basis only.

DHS Pitts advises anyone with flu-like illness to report to a doctor if their symptoms don’t begin to improve within three days, so that potentially severe cases can be treated early.

The DHS also recommends social distancing of persons with the flu, where possible, but for those who must interact with others, he recommends proper cough etiquette – coughing in the sleeve and not in the hands. He also recommends the regular use of hand sanitizers.

Back in 2009, the Ministry of Health had said that H1N1 transmission would become widespread in Belize. Whereas the Ministry’s 2009 swine flu report indicated that the cases had predominantly been located in the Corozal District, with a few cases in the Orange Walk, Belize, and Cayo Districts; today, the health officials indicated that the swine flu cases have not been clustered in any one location but exist across Belize, and they went on to describe its current status as “endemic.”

Whereas respiratory illnesses rank within the top 10 causes of morbidity in Belize, it is not among the leading causes of death, since the majority of patients do recover.

More tips from the Ministry of Health:

1. Washing your hands frequently with soap and clean water.

2. Coughing and sneezing into your sleeve and not your hands.

3. Keeping your hands away from your face.

4. Keeping common surface areas (such as door knobs, counters) clean and disinfected.

5. If ill, limit contact with others as much as possible to keep from spreading infection.

6. If symptoms are persisting or become more severe, visit your nearest health facility.