By Vestnik Kavkaza
The influenza and ARVI growth began in Russia. “Please annoy people with masks on your face in shops, metro, driving your car,” the chief state doctor of Russia, Gennady Onishchenko, told his fellow countryfolk. “First of all, women’s eyes look more mysterious; secondly, you are protected from influenza and recruit supporters of healthy life.” He urged not to fear people in masks: “I respect such people. It means a high cultural level.”
Yevgenia Selkova, deputy director of the Gobrichevsky Institute of Epidemiology and Microbiology under Rospotrebnadzor
Our history has seen several very severe influenza pandemics. The last pandemic was caused by the H1N1 flu. It began in 2009. Now we are experiencing the consequences of this pandemic. Plus, every year we experience growth of disease incidence of ARVI and flu between pandemics. Regarding the last pandemic, the World Health Organization announced the end of the pandemic on August 10, 2010. The memorandum said that the H1N1 virus began circulation as a seasonal kind of influenza, the circulation would go on during several years. Some mass media and colleagues posed the question: what is next? We would like to focus on this.
You all and the scientific society know the peculiarities of the influenza virus which has a unique feature – it changes and gains new characteristics and strikes humanity again and again causing severe diseases. On August 16, 2012, the WHO published information that 225 cases of influenza were registered in the USA among children under 18. The cases were caused by a resurgence of flu. And it has new features. The basic influenza was H3N2, but it had elements of pandemic influenza. This means a new virus has appeared. Fortunately, no difficult cases were registered. However, considering this peculiarity of influenza, the WHO is warning that the epidemic situation might worsen. It means that we should work on training our bodies and prepare for the sensation of the infection. For example, some results of influenza in 2011-2012. The previous epidemic season began in March 2012. This is official information of Rospotrebnadzor and it is available on their website. The epidemic season was of low effectiveness. You can see unified data on the picture which was gathered by the Center of monitoring of influenza and other respiratory viruses circulation. The viruses of influenza H3, H1N1 prevailed. This confirms the WHO’s information that the former pandemic influenza which turned into a seasonal kind of virus prevailed. Other respiratory viruses were intensive during the season along with this kind of influenza.
What are social consequences of influenza in general and the last influenza pandemic? When an epidemic of influenza begins, the hospitalization rate grows from 0.2% to 0.6% of the sick. The average time spent being ill is growing too. Of course, this damages the state economy. The USA estimated that its GDP is damaged by 0.72%. I think our state has a similar situation. The mortality rate of seasonal influenza is growing: usually it is about 0.1%-0.2%, but in a pandemic season the mortality rate grows up to 1.2%. And these are big figures. What are the results of the analysis of influenza’s consequences? Unfortunately, in the pandemic period of 2009-2010 the biggest disease rate was registered among school children. 25%-30% of sick young people died, even though they had never been ill before. This information is from the WHO and around the world, but it corresponds to our data.
Why is influenza dangerous? First of all, as I have already said, it causes social losses. It is also dangerous to every person by its possible complications. Relatively, influenza complications can be divided into three periods. Previously there was a view among people that the most difficult form of influenza lasts from 7 to 10 days. Unfortunately, much work by many scientists confirms that influenza complications can be divided into three periods. During the first week, convulsions and fever can be observed. I believe many of you have seen this, especially among children. Also, it can cause high temperatures and initial viral pneumonia. Earlier, many years ago, epidemiologists and infectologists argued with specialists who deal with respiratory diseases that initial viral pneumonia was impossible. But today there is no doubt that initial viral pneumonia undergoes difficulties and sometimes causes death. Over the following two weeks, types of otitis, recurrent bacterial pneumonia, encephalitis and cerebral infection can be observed, especially among people with CDV and bronchovascular diseases. After three weeks complications caused by influenza seem to be separate from it, but they are really caused by it. These are myocarditis, pericarditis, myositis.
Irina Lytkina, the head of the department for epidemiological control of the Rospotrebnadzor Office in Moscow
Influenza is a disease which can cause heavy complications and even death. They say that every case of influenza takes a year of the life of a person. It is thought that Napoleon lost Waterloo because he caught influenza. Influenza is not only a medical, but generally a biological problem. Influenza is always changing. Every year new kinds of viruses appear, which can lead to development of epidemic and even the pandemic which took place in Russia two years ago. This is also a big social problem, as almost 67% of sick lists registered in Moscow are of influenza and ARVI. Of course it is a serious economic problem as financial losses which are connected with the disease cannot be compared with any other infection. Even though influenza doesn’t threaten health of an adult today, it weakens human immunity and gives a green light to various complications. Moscow is a huge city with its own peculiarities, high density of population, huge migration processes, and developed transport infrastructure. Every day million people come to us and million people leave the city. Every person can bring any respiratory infection to us.
During recent years the level of influenza infection is similar in Russia and in Moscow, and it is lower than at the beginning of the century. It is a result of the huge preventive work against influenza, firs of all, vaccinial preventive measures. Last year the economy of the city lost 29 billion rubles because of influenza.
Cases among children are most frequent. It is understandable as children are active, mobile part of our society. They interact with each other in kindergartens and schools, exchange infections and bring them home infecting members of their families. Influenza is most dangerous for babies because their immunity is not developed and they face the infection for the first time, they have no protection against it, except for those who are vaccinated. They might get heavy complications. That is why they have to be vaccinated first and foremost. Last year 103 viruses of influenza were registered in Moscow. 70% of them were based on the virus of H3N2. This kind of influenza replaced the pandemic virus of influenza which was circulating in previous years.
Preventive measures against respiratory infections and influenza in Moscow can be divided into several directions. Of course, the leading role is given to vaccination. People always ask when the best time for vaccination is. Considering the location of our country, the best time for development of immunity – 2-4 weeks are needed for this – is before an epidemic growth, i.e. early autumn – September, October, and even November as weather in our city provides us with a perfect opportunity for vaccination.
