AS of last Friday the country had recorded four deaths related to the presence in the country of the Influenza A/H1N1, popularly known as swine flu. These deaths involved three men and one woman, with the Ministry of Health saying it was monitoring at least one other suspected case.

That the four deaths came so close upon one another in the space of a little more than a week may tend to trigger alarm in the population more than may be necessary in these circumstances.

While this is understandable, it is wise, however, for citizens to remain calm and importantly, to follow all the procedures and the protocols established by the authorities as the best means for warding off disaster.

In speaking about the four deaths, all of which occurred at the San Fernando General Hospital, the Executive Medical Director of the South West Regional Health Authority, Dr Albert Persaud, said there were some commonalities.

All four cases came from the same general area in the country. But more importantly, they were cases of ’morbid obesity’’. They were significantly overweight. This, Dr Persaud said, confirms what is contained in the international literature, that people who are excessively overweight suffer more severely from the virus.

But the four cases confirmed up to Friday do not include the death of advertising agency executive Astra Da Costa, who died Thursday evening from cardiac arrest, but who was said to have been confirmed as having contracted the swine flu influenza. She died at the Port of Spain General Hospital.

Up to this point, the authorities in Trinidad and Tobago have recorded 158 ’laboratory confirmed’’ cases. This compares with 153,697 cases recorded in the 35 countries in the Americas region with a recorded death toll of 3,406, in 25 of those countries.

From all the advice we have had and continue to receive on the best ways of containing the spread of this virus, personal responsibility in adhering to the best practices of hygiene are undoubtedly the most effective.

The Ministry of Health has again pointed to the list of precautions and protocols that citizens should follow in these circumstances.

Persons attending mass gatherings and high risk activities should follow all the recommended guidelines.

High risk individuals include pregnant women and children under five years old, persons with chronic medical conditions including asthma and other lung conditions, sickle cell anaemia, heart disease, diabetes, HIV/AIDS and other ailments affecting the immune system.

Cautionary steps include washing your hands with soap and water or with an alcohol-based sanitiser. Cough or sneeze into the elbows or into a tissue and not into your hands. Dispose of the tissue properly.

Avoid persons who have respiratory illness, and if you have flu like illness stay home and limit contact with others as much as possible. Delay travel plans and seek immediate medical attention.

Some of the recognisable symptoms in children include fast breathing, not drinking sufficient liquids, severe irritability, coughing with fever or rash. Those in adults include dizziness, confusion, severe persistent vomiting, pain or pressure in the chest or abdomen, difficulty breathing or shortness of breath.