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Flu epidemic approaches

THE FIRST big epidemic of seasonal flu broke out recently in Ukraine, Slovakia’s eastern neighbour, leading to a surge in media reports about the epidemiological situation and advice on prevention techniques. Despite large numbers of flu cases just across the border from Slovakia, some of them confirmed as being the novel H1N1 virus, experts say there is nothing to worry about as the numbers affected remain within seasonal norms.

THE FIRST big epidemic of seasonal flu broke out recently in Ukraine, Slovakia’s eastern neighbour, leading to a surge in media reports about the epidemiological situation and advice on prevention techniques. Despite large numbers of flu cases just across the border from Slovakia, some of them confirmed as being the novel H1N1 virus, experts say there is nothing to worry about as the numbers affected remain within seasonal norms.

As of November 5, the Ukrainian Ministry of Health had reported more than 630,000 cases of influenza-like illness in Ukraine, with hundreds requiring intensive care. Ninety-one people were reported to have died from acute respiratory illness up to November 5.

Regions in western Ukraine neighbouring Poland and Slovakia continue to show the highest rates of acute respiratory illness and influenza-like illness.

“Laboratory testing in Ukraine has confirmed pandemic H1N1 influenza virus in samples taken from patients in two of the most affected regions,” the World Health Organisation (WHO) stated in its November 3 report. “As the pandemic virus has rapidly become the dominant influenza strain worldwide, it can be assumed that most cases of influenza in Ukraine are caused by the H1N1 virus.”

In response to the epidemic, Slovakia has sent 200,000 face masks to Ukraine to help prevent the spread of the virus. Custom officers at border crossings with Ukraine have also been ordered to wear face masks and gloves.

However, Slovaks have shown little fear of the flu and have kept travelling to Ukraine, mainly to do their customary cheap shopping in towns and villages on the border. In response, the Interior Ministry temporarily closed the Veľké Slemence–Mali Selmenci and Ubľa–Malyj Bereznyj border crossings to cyclists and pedestrians.

While seasonal flu as well as pandemic flu continued to affect Ukraine, the situation in Slovakia remained calm as The Slovak Spectator went to press on November 5. Slovakia’s Chief Hygienist Ivan Rovný said that the epidemiological situation in Slovakia was relatively favourable and was in line with the usual situation during the flu season, the TASR newswire reported, adding that the flu season in Slovakia is only starting and a slight increase in infections is expected in December.

Meanwhile, one case of the H1N1 infection was confirmed in a school-boy in Bratislava.

According to physician Peter Lipták the epidemic in Ukraine is not exceptional in comparison with previous years, as some 14,000 people die annually in connection with flu in the country. Globally, flu-related conditions typically claim the lives of 500,000 people each year, 1,500 of them in Slovakia.

“That shows that [seasonal] flu is indeed a serious illness,” Lipták told The Slovak Spectator.
According to Darina Sedláková, head of the WHO Country Office in Slovakia, the epidemic in Ukraine is part of the pandemic announced by the WHO in June 2009 when a level-6 pandemic alert was declared.

“It was only a question of time, or season, for it to break out more intensively than it did in the northern hemisphere before now,” Sedláková told The Slovak Spectator, adding that seasonal flu is normal at this time of year, but this year it is complicated by the occurrence of the pandemic H1N1 virus.

“The fact that the occurrence of pandemic flu in Ukraine is higher could play a role, particularly if people from the two countries are in intensive contact, but the border closure basically won’t prevent the infection from spreading to Slovakia,” she said.

The WHO recommendations for protection against the infection are the same for seasonal and pandemic flu: maximum hygiene, avoiding mass events and contact with people who are already sick, following physicians’ advice for curing the illness, and vaccination, which is an effective method of primary prevention, i.e. not getting the diseases and/or mitigating the impact of infection on health.

Despite the effectiveness of the flu vaccine, only about 10 to 12 percent of Slovaks seek vaccination against the seasonal flu annually, too low a number according to experts, and one which is not expected to increase despite the reports from Ukraine and other parts of the world which appear regularly in the Slovak tabloid media.

“Slovaks are ignorant, nothing can cause them fear,” Peter Lipták told The Slovak Spectator. “A resistance to the information that people can die of flu has been developed, so nobody is worried about it anymore.”

According to him, people often give as their reason for not getting a vaccination the belief that it will cause them illness.

“But the vaccination doesn’t contain any living causal agent of the illness, only information particles from different viruses which can cause flu,” Lipták said. “By providing them to the body in advance, we allow it to prepare antibodies in advance.”

The vaccine for this year’s seasonal flu is fully covered for every Slovak citizen from their health insurance and, according to the Center for Disease Control and Prevention (CDC) in the USA, it also can provide a high level of protection from the pandemic H1N1 virus, Lipták said.

Some protection against pandemic flu is thus provided by vaccination against seasonal flu. In addition, all people over 65 years of age already have antibodies against H1N1 in their body, because they lived through a pandemic that occurred 65 years ago which, according to experts, was very similar to the current novel flu virus, Lipták said.

Slovakia also has a well-functioning surveillance system and if that is used properly to detect new cases of influenza, which are subsequently isolated and treated, it could prevent the uncontrolled spread of the virus, Sedláková said. Simultaneously, it is important to inform the population in a timely and correct manner about the situation to avoid panic, to activate the country’s Preparedness Plan for the pandemic of influenza in due time and to share and exchange information with relevant international partners.

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