They come seeking medical attention. People who are trapped by the closure of the Inter American Highway between Vigui and Tole and are turning to the Health Center of Los Ruices seeking medical attention. According to Axel Ponce, physician in charge of this center, the most common cases they are treating are for dehydration, gastroenteritis and blood pressure problems. They have also received people with chronic illnesses who have run out of their medicines. Tourists, truck drivers and children are the ones that have sought medical attention.

The Ministry of Education has announced that because some newspapers have not been distributed in the area of Chiriqui, Veraguas and Bocas del Toro, teachers can check the lists of those selected from the Second Nomination Contest 2012 on the website of the Ministry of Education: www.meduca.gob.pa, so as to not affect the start of the school year. (Dia a Dia)

   

The low wages paid by the government have prompted nurses to migrate to private hospitals and clinics. The warning was made by the president of the National Nurses Association (ANEP), Annette Crayg, who admitted there is discontent among the majority of these professionals, not just for the workplace, but also for stability. The ANEP has a membership of approximately 5,000 nurses who work for the Ministry of Health, the Social Security Fund, and private hospitals. The Director of the Children's Hospital Alberto Bissot recently complained that he faces a shortfall of 100 nurses and that with the 2012 budget he can only afford to hire two.

SUPPLY VERSUS DEMAND - The Ministry of Health, according Crayg, pays a nursing technician $475 per month, newly graduated nurses receive $745 per month, and specialized nurses receive $800 per month. She said the private sector pays newly graduated nurses $800 per month to start, and nurses with experience and specialists receive as much as $1,800 per month.

Italy and the U.S. - "Now there are few nurses in other countries," said Crayg, because in the 90's many moved to the United States and Italy, countries where wages are from $2,500 to $5,000 per month. Currently, "many of them are returning to Panama in search of better jobs," she said. According to statistics, the University of Panama (UP) graduates an average of about 140 new nurses every year. (Siglo)

   

Five women with PIP breast implants went yesterday to the Ministry of Health (MoH) and met with the Director General of Health Eduardo Lucas Mora and General Secretary Félix Bonilla, to present their problems with the Poly Implant Prothese (PIP). One of them, a 51 year old woman, has broken implants in both breasts. According to the Director General, they will be meeting with the rest of those who have been affected during the course of the week, and with the Association of Surgeons possibly on Wednesday. (Prensa)

Editor's Comment: The implants involved are called Poly Implant Prosthese (PIP) and were made by a French company of the same name. They were pre-filled with a silicone-based gel (the majority of women having breast implants now have silicone implants). However, the marketing, distribution and use of the PIP implants was suspended in March 2010 after regulators found that the manufacturers were using silicone intended for industrial use, and not medical-grade silicone fillers. It is reported that the company used a cheap type of silicone gel intended for making mattresses. They had been manufactured since 2001. As a result, in March 2010 the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) advised doctors to stop using the implants. The agency then examined evidence on any possible toxic effects of the implants involved, and found that there was no evidence the unapproved filling could cause health problems. Later that year it issued advice to surgeons on how to manage women who already had PIP implants. Here in Panama health authorities are just starting to figure out what's going on, and what they should be doing about it.   

After six months of investigations, the Institute of Legal Medicine and Forensic Sciences (Imelcf) confirmed to the Third Superior Prosecutor that some of the deaths that occurred in the Social Security Fund (CSS) hospital were caused by the antibiotic resistant Klebsiella Pneumoniae Carbapenemases (KPC) bacteria. The prosecutor Sofanor Espinosa said he had already received confirmation from the IMELCF that some of the deaths were caused by the KPC bacteria, but other patients who were similarly affected with the bacteria died of other causes. At the same time he predicted that given the complexity of the case, it will eventually be necessary to request an extension from the Judicial Branch to complete the investigations. On the other hand he said he is waiting for the Supreme Court to decide whether or not to combine all of the complaints made against the Director of the Social Security Fund, Guillermo Sáez-Llorens, into one case. (Prensa)

Editor's Comment: The outbreak of the Klebsiella Pneumoniae Carbapenemases (KPC) bacteria in Panama was made much worse thanks to the efforts of the administrators of the Social Security Fund in Panama to cover it up and to keep the existence of the outbreak out of the press. Once the news broke, and only after the news broke, did they finally start to deal with the situation in a coherent and logical manner. They got outside advice and assistance from international and foreign agencies. They got additional funding to pay for the drastic steps necessary to control the bacteria. The controlled access to the infected areas by the public, and limited visitation. None of these things were done until after the press got the story. Therefore, more people died than should have died, because of the mishandling of the case. Simply look at the cold statistics and death rates. KPC was much more "lethal" in Panama than in other countries.   

A patient in the Nelson Collado hospital in Chitre is in critical condition after presenting symptoms of hantavirus. The man came from Llano Largo in Veraguas with symptoms that had not yet been confirmed as hantavirus. At this moment he remains in serious condition and is being watched closely by doctors. (Dia a Dia)

Editor's Comment: You might want to take a moment to brush up on Hantavirus. This is an issue that comes back around every year, especially during the dry season. Small rodents such as mice carry the hantavirus but it does not make them sick. Humans are exposed to the hantavirus, typically when sweeping out areas where there are mice droppings or urine, the dust becomes airborne, and it's inhaled, making the person sick. In Panama people clear out areas of their homes in the interior and they rent them out, especially during carnival. Anyway, be aware, learn, avoid contact. It's out there.

   

International media on Monday echoed the information provided by the Social Security Fund (CSS) that Panama has issued a health alert in response to the emergence in the region of another resistant bacteria resistant: the New Delhi metallo-beta-lactamase 1, known to have caused deaths in India, Pakistan, United Kingdom, Japan, Australia, Canada, USA and Guatemala. Among the sanitary activities being taken in Panama include epidemiological surveillance and research as well as the steadily increasing participation of laboratories in the system for early detection of outbreaks in hospitals and nursing homes.

The Telesur Network reported: "Panama Under A Health Alert Due To Deadly Antibiotic-Resistant Bacteria." Prensa Latina, Havana, Cuba, reported: "Alert in Panama Over Multiresistant Bacteria." The Radio of the South Reported: "Panama: Government Declared Health Alert For Deadly Bacteria Resistant to Antibiotics." Emol.com published: "Health Authorities of Panama Enacted Alert Over Deadly Bacteria."

The Director of Medical Services of the CSS, Javier Diaz, said on Monday that Panama, a transit country, is stepping up surveillance in the hospital network. In the CSS other multiresistant bacteria have been detected such as the Klebsiella pneumoniae KPC and Blea +, which together have claimed 103 lives, and that require continued vigilance. In August 2010, the World Health Organization (WHO) reported on the emergency response to a mechanism of resistance in Enterobacteriaceae, linked to increased morbidity and hospital mortality in India, Pakistan and England.

Public hospitals had already been subjected to intensive disinfection to control outbreaks of the bacterium Klebsiella pneumoniae carbapenem (KPC), which this year alone killed 101 patients and is associated with nosocomial infections, according to a press release from CSS. The Ministry of Health of Panama said in a statement that the warning measures were ordered after the appearance of a case of infection with NDM in Guatemala on 22 November, which seeks to prevent a possible spread in Latin America. (Estrella)   

One of the rooms of neonatology at the Hospital of the Social Security Fund is infected with a new nosocomial bacteria that has been confirmed by health authorities of Panama. So far, 32 people have tested positive for the bacterium Klebsiella Blea +, said Health Minister Franklin Vergara. Statistics show that 29 infants have been colonized (carriers), 13 have been infected (got sick) and two have died as a result of this new strain of the antibiotic resistant bacteria. (Telemetro)

Editor's Comment: The public hospitals in Panama are basically cesspools. All hospitals have these types of antibiotic resistant bacteria from time to time, however in Panama with the recent outbreak of the KPC bacteria, mortality rates were about twice of what happens in other countries. The bug is the same, but in Panama the public healthcare system sucks - mismanaged and underfunded. You know, like most public health care systems around the world. It might be cheaper, but you get what you pay for. In this case, you die.   

A 41-year-old from Bocas del Toro, who had been tested positive for hantavirus, died yesterday at the Rafael Hernandez Hospital in the province of Chiriqui. The victim identifiable by the initials JML had been transferred from Bocas del Toro to the hospital in Chiriqui on 21 November 2011. However, medical officials stated that more specialized tests will be performed to confirm the diagnosis of hantavirus. (Critica)

Editor's Comment: From the US National Library of Medicine - "Hantavirus is a life-threatning disease spread to humans by rodents that has symptoms similar to influenza. Hantavirus is carried by rodents, especially deer mice. The virus is found in their urine and feces, but it does not make the animal sick. It is believed that humans can get sick with this virus if they come in contact with contaminated dust from mice nests or droppings. You may come in contact with such dust when cleaning homes, sheds, or other enclosed areas that have been empty for a long time. Hantavirus does not spread between humans. Rodents carrying the hantavirus have been found in many U.S. national parks. Campers and hikers may be more likely to catch the disease than most people. This is because they pitch tents on the forest floor and lay their sleeping bags down in musty cabins. However, only a couple of cases have been directly linked to camping or hiking. Most people who are exposed to the virus have come in contact with rodent droppings in their own homes."   

In the Manuel Amador Guerrero Hospital in the province of Colón, a 46 year old patient has been declared as the first case of Klebsiella pneumoniae carbapenems (KPC), so health officials are taking safety and prevention precautions at the hospital. Jaime Jaspen, the Director of the Social Security Fund in Colon, said the patient was hospitalized from 7 to 12 November 2011, due to diabetes and hypertension, and he underwent emergency surgery for an abdominal condition. The patient was in Intensive Care , but was transferred to the Santo Tomas hospital on 12 November, when, after conducting tests, he was diagnosed as a carrier of the bacteria KPC. The man, who had both of his legs amputated due to the diabetes and also has affected part of the intestines, comes from the area of Sardinilla, in the district of Salamanca. According to the medical associations, 171 people have been killed by the bacteria, but the CSS said that number is 72 as of two weeks ago, and the public prosecutor says there have been 71 deaths. (Siglo)

Editor's Comment: Actually, not too long ago the prosecutor said his number is at least 99 deaths and they have conducted more than 50 exhumations, and they are waiting for the results of testing. Personally I tend to believe the higher numbers rather than the lower numbers provided by the CSS, because they have been trying to spin control this KPC situation with lies and bullshit since it started. Their credibility is zero. And now the KPC bacteria is in Colon. Great...   

#Panama - Every time the prosecutor Sofanor Espinoza - who is responsible for investigating the deaths caused by the antibiotic resistant Klebsiella Pneumoniae Carbapenemases (KPC) bacteria in Panama in order to determine how many people have died thus far - the accounts are filled with terror. Nearly 100 patients have died in public hospitals due to the effects of the KPC bacteria in the past 11 months. According to Espinoza they have exhumed 58 bodies but the exact number of deaths caused by the bacteria is still unknown because tests are still being conducted on the cadavers. Espinosa said he has not cited the officials from the Social Security Office to testify yet, the institution where the first cases of infection with the bacteria occurred. The relatives of the victims of the bacteria are asking the authorities to expedite the investigation. Also, they blame the Director of the Social Security Fund, Guillermo Sáez Llorens, for the deaths of their relatives. (Estrella)

Family members of KPC victims filing complaints with the Public Ministry.