Ukraine 2013
As I fly back into Ukraine after a few days in London I am struck by masked passengers at the check in for the Kiev flight and have already been warned of the “huge epidemic”. As a health care professional it is difficult and yet important to obtain an objective picture and to give sound advice.
I previously wrote of the real time statistics that the Ministry of Health collected from all rayons and oblasts and as I look at the recent figures and watch the first snow in Kiev I see there is a huge disparity between cases in west Ukraine – particularly Ivano-Frankivsk, Lviv and Ternopil ,and those in Kiev and the east of Ukraine. Discussing these with the Ministry it appears that the figures from the west, reflecting an epidemic, include nearly everybody who has seen a doctor with a temperature and symptoms of viral illness, whilst those from Kiev ( less than one hundred) for example include just those with severe signs of viral infection and who are hospitalised.
It has also been reported that in west Ukraine there have been 71 deaths associated with viral infection (38 associated with A/H1N1 flu -”swine flu”) . Most deaths have occurred in those failing to seek medical attention within the first 5 days of the illness. On testing initial samples with internationally accepted procedures about 35% are caused by A/H1N1 flu. Perspective has to be maintained and it is important to remember that normal seasonal influenza will cause about 35,000 deaths each year in the USA and just over 4,000 in the UK. In serious epidemics these figures can increase upto tenfold, where 90% deaths are in those over 65. Whilst there are no accurate historical figures to hand for Ukraine we could expect some 3,000 deaths in Ukraine in a normal year. The Ministry of Health has responded by closing schools, advising citizens to practice social isolation and to wear masks. A World Health Organisation expert has arrived in Ukraine to advise the Ministry of Health and an initial report has been compiled.
Ukraine is considering a law to introduce a compulsory vaccination record for all citizens and to exclude from school children who fail to have the card. A recent poll has shown many citizens to be against such moves being concerned that many parents would simply purchase such a card or more worryingly be persuaded to use cheap and possibly toxic vaccines. There is always a balance in public health between human rights and personal freedom and the necessity to stop serious diseases. Some American States and other democracies use vaccination cards for school entry, whilst others believe in public education and choice on informed information is the correct political stance.
Preventative measures are both national and personal. At the national level school closure helps to slow the spread of epidemics and isolates many young children and their younger brothers and sisters from contact with the virus. The wearing of face masks is controversial as the influenza particle size is smaller than the holes in the conventional masks even if they were well sealed around the face. Good diet, adequate sleep and decreasing alcohol all help to boost immunity. Social exclusion of those who are ill or at risk is important as is regular hand washing after blowing noses and the safe disposal of tissues in sealed bins
https://kyiv.amcenters.com/news/a-h1n1-flu-in-ukraine-update-ii/