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added: 7 11th 2009 15:59, author: CT24
Martina Havl?čkov? The Czech Republic has registered 400 cases of swine flu. Country and apparently on the verge of the first wave of an influenza pandemic. In the next few days, the weather in addition to the emergence of respiratory diseases entirely ideal. And beside all report came from the south of Bohemia, where one breeding mallard ducks found bird flu. Alarming situation in Ukraine, where the number of sick swine flu has exceeded half a million people. The first victim reported swine flu and Slovakia.
Interview guest at CT 24 of 6 November was head of the National Reference Laboratory for Influenza from the State Health Institute Martina Havl?čkov?. Franti?ek Lutonsk? moderated.
vlo?eno: 7. 11. 2009 15:59, autor: ČT24
Let's start with news from South Bohemia - bird flu. It makes a connection with the swine flu, seasonal flu?
I think that this is no causal connection, no seasonal flu or with swine flu. It is a low pathogenic subtype H5N3 strain, which is found in the continuous monitoring systems. So for the current epidemic situation, it basically does not alarming message.
When reminded, as we now bird flu erupted, it can be compared with the pig?
Too impossible because avian strain is highly pathogenic for the first and second (outbreaks are still in the active phase in Egypt) bears signs of bird pathogen that is exceptionally, if certain conditions are met, especially a large infectious dose can pass to humans. And we know from statistics that the infection is very serious.
Avian H5N1 strain that infected people are also among the people never even in a small community did not disclose. This is another very significant and important difference from the current pandemic strain, which has far lower pathogenicity and easy to spread. Indicates the H1N1, a new H1N1, Mexican flu, swine flu, the terminology is different.
How do you highlight the workplace?
Say a pig, even though this is obviously not accurate. Swine influenza is the animal infection, which is precisely determined and the difference between these strains is very sharp. However, when we want, we all know what we are talking, saying the 2009 Pandemic in the routine a little cumbersome. (H1N1 Pandemic 2009, the official designation of the strain, which declared the World Health Organization (WHO) in the spring, when the strain appeared.)
The title indicates that we have long pandemic?
At the moment we have a pandemic, WHO declared the sixth grade. In Europe the situation has long been relatively calm since the summer in the northern hemisphere for the spread of influenza virus extremely unfavorable.
After the first outbreak occurred and the first cases and then the epidemic in Mexico, passed a few weeks and the virus was transferred to Europe. It just shows how well our distance from sděln?mi infections protect a relative, because in today's travel from pole to pole transfer infection actually very easy and very quickly.
In Europe, because they were more cases imported. And even though it was such a minor outbreaks around the imported cases, had it except the UK elsewhere in Europe throughout the summer rather the character of introduced infection, which is consistently monitored. The number of patients, we did not know if it was not so careful monitoring.
So at this moment the 400 current cases in the Czech Republic, experts assesses how We are still in this qualification?
We're totally in it, increase virological, laboratory-confirmed cases in the past two weeks is quite immense. Also increases morbidity, as regards the cases of acute respiratory infections and flu-like infection, but it's not rocket onset. When tonight fellow epidemiologists evaluated, the increase is about 15%, which is nothing drastic. But if you'll be linked with laboratory findings that are clearly inflate two weeks, we can talk about the spread in the Czech Republic begins.
Slovak Republic are the first victim of swine flu. Then we also have with us. Since you said that an increase of 15% is any reason to panic?
I think that there is no reason to panic because the information simply must be seen in context. Although the increased morbidity, but increased relatively slightly. 15%'s not something dramatic increase. A present value of illness is deeply podepidemick?.
Of course we are in a situation where patients are increasing. Early November is a pretty unusual here. It's because it is spreading a new virus, which still does not tame seasonal nature of classical strain that occurs in some, to some extent, predictable regime.
I have to imagine, so that at the moment experts monitor, monitor, where the virus occurs everywhere. Vir Meanwhile uncontrollably flies, it can not be any way to define, it is not clear whether mutates, it is not clear what should be done with it come seasonal flu and stuff?
Influenza virus, which has the character of a pandemic virus may have spread during the first wave of the epidemiological characteristics rather that defy our view of the seasonal flu, which traditionally comes in the northern hemisphere from about mid-December onwards.
Now we have a summer amplitude, but rather shows that the monitoring in Europe in the Czech Republic is very careful. Partially to actively seek cases, be fully reported, and patients themselves, especially travelers. Thus, we tap into a number of cases and small outbreaks, and began to apply a consistent epidemiological measures, which is at the very beginning right.
Now the virus has also spread in the population and improve the conditions for its spread (cools, it changes the humidity). At the same time in front of almost free path, because the general perception, so it will pick up the intensity.
And what we can not predict is what a large percentage of the quantity will be overtaken by the intensity, which we used the average epidemic. Meanwhile, we say that it presents itself as a major influenza epidemic.
As the number of affected people or in intensity of the disease?
This and that. Of course, certainly significantly more infected people than among the epidemic, the epidemic during the period in Bohemia ill about 8 to 10% of people. This time we expect a higher number, but it is rather difficult to speculate. It can be 20%, 25%, 30% simply do not know.
It can also be interpreted as the better side. So that two thirds of the population simply infected. It's not that he would simply gradually infected all can.
Third is quite crazy number ...
It's high. Pathogenicity of the strain, however, is rather low and quite comparable to seasonal influenza. But of course we must be prepared for the various complications that will become heaps of patients. That means in a short time a large number of patients and proportionately higher number of complications and death - in fact, what brings seasonal flu.
If I understand this correctly, the worst option at this moment is that the virus hits the third of the population in the Czech Republic? Or it may also be a variant that should hit 0.5% of people, but it will mutate and be much worse?
Antigenic change in influenza virus can not never be ruled out. It can not be ruled out of seasonal influenza. This is a virus that is genetically unstable, has a large animal reservoir, infecting different species. Type A is found in a wide range of variants and generic crossing barriers of this virus is quite common thing. So the possibility is always there and it can not significantly affect.
Of course you can influence things that we can to some extent hold. Perhaps in some operations, the health workers consistently vaccinated against seasonal flu, so there could zavl?ct the current strain of influenza.
Otherwise, the virus, which is almost a natural ohniskovost and zoonotic (transmitted from animals to humans), which is clearly influenza virus, the population is indelible. With this, we just learn to deal and treat it rationally, but in principle we can not get rid of the problem.
This is way easier said, but when we look at the headlines, let the TV, turn on the radio, look at internet message should be from the Ukraine, where we hear speculation about some other flu virus, how are we to take?
In Ukraine we have a report by WHO. Ukraine is a pandemic wave hit really massive. More or less it illustrates that, without it the character of the heavy strain of the pathogen, which in itself causes a very difficult courses to death, increased in patients quanta.
So when we have the seasonal flu to be 100 patients, two of them will have a complicated course. For the same amount of time for the pandemic flu, we must count on the six patients. Then we just multiply in the large numbers. So the burden of a pandemic wave in health care and other systems is that the quantum handle problems that are otherwise normal wings quite well manageable.
It may not be even given the fact that the virus is highly pathogenic. So far we have no indications that this pandemic strain in a substantive change. On the contrary, is quite genetically stable.
Why are the risk group for Swine flu more young people?
It can not exactly answer. Anyway, we believe that it is also quite characteristic of the pandemic virus that can affect younger age groups. Each time it has a bit different form. Like the Spanish flu, mortality was high among the young. Immune response of the young organism was exaggerated, that subsequently turned against their carriers.
For the older population is likely to play a role that they are people with long immunological experience. And despite the fact that the virus is really a lot different than just what they could during his life experience, there are still only an identical moments. So, while sick, but a milder form of infection. Anyway, it's age group, where he is currently the smallest impact.
When he will return to the coincidence in time between seasonal flu and pig. It will be the seasonal flu and a pig, each going after his line? Or is there any chance that the two viruses together and hit a lot more people?
I think that it will not look like overlapping of the two disasters. Maybe if I took a category of patients who have influenza type A, some part of them will have a new pandemic strain, but some of the earlier subtypes. If you keep the old line of H1N1, is the question. Rather, the displacement of emerging strain. Subtype H3N2 and type B certainly persist, then the situation is very likely to return to zajet?ch track, where the epidemic on the conscience of each one of these vyvolavatelů.
When the World Health Organization said yesterday that the pandemic virus has become the dominant influenza virus in the world, what does it actually mean? A revolution in the virus?
Does not mean no revolution. In essence, this means that among the representatives, who can cause flu in humans (type B from type A subtype H3N2, H1N1 and its older version and now a new emerging variant pandemic) is always one of the viruses predominate. And at this moment is the prevailing pandemic.
But we do not know for how long?
We know that the first wave roll over about a few weeks. They would then be followed by several weeks of dormancy. And then, as history taught us, usually comes the second wave of yet. If boards quickly or less quickly, or will be longer and slower, I would not dare to judge.
I also noted several cases where the swine flu antiviral gone to cure. It is still probably unique thing?
The question is, when the antiviral deployed. Indeed, the fact must be given quickly, within the first two days of the beginning of the disease, a condition which is not always possible to meet. And while a patient is indeed manifest, launching the disease, may affect antiviral only a limited extent. So the base is set to specifically indicated for proven disease and especially now.
But probably does not reveal the practitioner?
When will the surgery patient with influenza in a given situation is no longer necessary for searching for whether it's new or other flu. If the patient will have symptoms that would go some way indicated that it had to be hospitalized, the hospital treatment and symptomatic therapy is sent for home treatment. So neither will be necessary to search for the virus.
It should be noted that when a health system that impact patients endure and, indeed, serve, as it should, it will have a focus on serious cases, the hospitalized patients, the patients where the primary infection or complicated to be given their předchorob? reason to worry about this.
It is possible to pig flu přechodit normally, as it does a lot of people?
It makes a lot of people with normal flu and it's exactly the same mistake as with any other flu. When you take an analgesic, antipyretic, and even a bit more, so a few hours, of course, I feel better. But this is very shortsighted, because, first, further spread of infection and could get himself hurt.
As at this moment we do wrong? Are moving flu, or vice versa, according to your great panic, which should cause the media?
I do not think it did something fundamentally wrong. People always crossed the flu. It's a bit of educating. Just completed his mind that at all costs must somehow address their health difficulty, to her, if possible, not quickly. Just occasionally ill, that's life.
In humans it is also rooted in general that the flu is like cold, they are treated, or treat it, it's always seven days. Influenza is while the overall infection which may have a really tough course, involving the authorities, with respiratory tract which have nothing to do. It can attack the heart, nervous system, kidneys or skeletal muscle. It can have very serious enormous progress. Such situations are not many, I do not want to sound kind of dramatic, but they are.
Influenza is actually between respiratory viruses rather exclusive. So take it with some respect, understanding. I do not want to demonize.
http://www.ct24.cz/textove-prepisy/o...na-havlickova/
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added: 7 11th 2009 15:59, author: CT24
Martina Havl?čkov? The Czech Republic has registered 400 cases of swine flu. Country and apparently on the verge of the first wave of an influenza pandemic. In the next few days, the weather in addition to the emergence of respiratory diseases entirely ideal. And beside all report came from the south of Bohemia, where one breeding mallard ducks found bird flu. Alarming situation in Ukraine, where the number of sick swine flu has exceeded half a million people. The first victim reported swine flu and Slovakia.
Interview guest at CT 24 of 6 November was head of the National Reference Laboratory for Influenza from the State Health Institute Martina Havl?čkov?. Franti?ek Lutonsk? moderated.
vlo?eno: 7. 11. 2009 15:59, autor: ČT24
Let's start with news from South Bohemia - bird flu. It makes a connection with the swine flu, seasonal flu? I think that this is no causal connection, no seasonal flu or with swine flu. It is a low pathogenic subtype H5N3 strain, which is found in the continuous monitoring systems. So for the current epidemic situation, it basically does not alarming message.
When reminded, as we now bird flu erupted, it can be compared with the pig?
Too impossible because avian strain is highly pathogenic for the first and second (outbreaks are still in the active phase in Egypt) bears signs of bird pathogen that is exceptionally, if certain conditions are met, especially a large infectious dose can pass to humans. And we know from statistics that the infection is very serious.
Avian H5N1 strain that infected people are also among the people never even in a small community did not disclose. This is another very significant and important difference from the current pandemic strain, which has far lower pathogenicity and easy to spread. Indicates the H1N1, a new H1N1, Mexican flu, swine flu, the terminology is different.
How do you highlight the workplace?
Say a pig, even though this is obviously not accurate. Swine influenza is the animal infection, which is precisely determined and the difference between these strains is very sharp. However, when we want, we all know what we are talking, saying the 2009 Pandemic in the routine a little cumbersome. (H1N1 Pandemic 2009, the official designation of the strain, which declared the World Health Organization (WHO) in the spring, when the strain appeared.)
The title indicates that we have long pandemic?
At the moment we have a pandemic, WHO declared the sixth grade. In Europe the situation has long been relatively calm since the summer in the northern hemisphere for the spread of influenza virus extremely unfavorable.
After the first outbreak occurred and the first cases and then the epidemic in Mexico, passed a few weeks and the virus was transferred to Europe. It just shows how well our distance from sděln?mi infections protect a relative, because in today's travel from pole to pole transfer infection actually very easy and very quickly.
In Europe, because they were more cases imported. And even though it was such a minor outbreaks around the imported cases, had it except the UK elsewhere in Europe throughout the summer rather the character of introduced infection, which is consistently monitored. The number of patients, we did not know if it was not so careful monitoring.
So at this moment the 400 current cases in the Czech Republic, experts assesses how We are still in this qualification?
We're totally in it, increase virological, laboratory-confirmed cases in the past two weeks is quite immense. Also increases morbidity, as regards the cases of acute respiratory infections and flu-like infection, but it's not rocket onset. When tonight fellow epidemiologists evaluated, the increase is about 15%, which is nothing drastic. But if you'll be linked with laboratory findings that are clearly inflate two weeks, we can talk about the spread in the Czech Republic begins.
Slovak Republic are the first victim of swine flu. Then we also have with us. Since you said that an increase of 15% is any reason to panic?
I think that there is no reason to panic because the information simply must be seen in context. Although the increased morbidity, but increased relatively slightly. 15%'s not something dramatic increase. A present value of illness is deeply podepidemick?.
Of course we are in a situation where patients are increasing. Early November is a pretty unusual here. It's because it is spreading a new virus, which still does not tame seasonal nature of classical strain that occurs in some, to some extent, predictable regime.
I have to imagine, so that at the moment experts monitor, monitor, where the virus occurs everywhere. Vir Meanwhile uncontrollably flies, it can not be any way to define, it is not clear whether mutates, it is not clear what should be done with it come seasonal flu and stuff?
Influenza virus, which has the character of a pandemic virus may have spread during the first wave of the epidemiological characteristics rather that defy our view of the seasonal flu, which traditionally comes in the northern hemisphere from about mid-December onwards.
Now we have a summer amplitude, but rather shows that the monitoring in Europe in the Czech Republic is very careful. Partially to actively seek cases, be fully reported, and patients themselves, especially travelers. Thus, we tap into a number of cases and small outbreaks, and began to apply a consistent epidemiological measures, which is at the very beginning right.
Now the virus has also spread in the population and improve the conditions for its spread (cools, it changes the humidity). At the same time in front of almost free path, because the general perception, so it will pick up the intensity.
And what we can not predict is what a large percentage of the quantity will be overtaken by the intensity, which we used the average epidemic. Meanwhile, we say that it presents itself as a major influenza epidemic.
As the number of affected people or in intensity of the disease?
This and that. Of course, certainly significantly more infected people than among the epidemic, the epidemic during the period in Bohemia ill about 8 to 10% of people. This time we expect a higher number, but it is rather difficult to speculate. It can be 20%, 25%, 30% simply do not know.
It can also be interpreted as the better side. So that two thirds of the population simply infected. It's not that he would simply gradually infected all can.
Third is quite crazy number ...
It's high. Pathogenicity of the strain, however, is rather low and quite comparable to seasonal influenza. But of course we must be prepared for the various complications that will become heaps of patients. That means in a short time a large number of patients and proportionately higher number of complications and death - in fact, what brings seasonal flu.
If I understand this correctly, the worst option at this moment is that the virus hits the third of the population in the Czech Republic? Or it may also be a variant that should hit 0.5% of people, but it will mutate and be much worse?
Antigenic change in influenza virus can not never be ruled out. It can not be ruled out of seasonal influenza. This is a virus that is genetically unstable, has a large animal reservoir, infecting different species. Type A is found in a wide range of variants and generic crossing barriers of this virus is quite common thing. So the possibility is always there and it can not significantly affect.
Of course you can influence things that we can to some extent hold. Perhaps in some operations, the health workers consistently vaccinated against seasonal flu, so there could zavl?ct the current strain of influenza.
Otherwise, the virus, which is almost a natural ohniskovost and zoonotic (transmitted from animals to humans), which is clearly influenza virus, the population is indelible. With this, we just learn to deal and treat it rationally, but in principle we can not get rid of the problem.
This is way easier said, but when we look at the headlines, let the TV, turn on the radio, look at internet message should be from the Ukraine, where we hear speculation about some other flu virus, how are we to take?
In Ukraine we have a report by WHO. Ukraine is a pandemic wave hit really massive. More or less it illustrates that, without it the character of the heavy strain of the pathogen, which in itself causes a very difficult courses to death, increased in patients quanta.
So when we have the seasonal flu to be 100 patients, two of them will have a complicated course. For the same amount of time for the pandemic flu, we must count on the six patients. Then we just multiply in the large numbers. So the burden of a pandemic wave in health care and other systems is that the quantum handle problems that are otherwise normal wings quite well manageable.
It may not be even given the fact that the virus is highly pathogenic. So far we have no indications that this pandemic strain in a substantive change. On the contrary, is quite genetically stable.
Why are the risk group for Swine flu more young people?
It can not exactly answer. Anyway, we believe that it is also quite characteristic of the pandemic virus that can affect younger age groups. Each time it has a bit different form. Like the Spanish flu, mortality was high among the young. Immune response of the young organism was exaggerated, that subsequently turned against their carriers.
For the older population is likely to play a role that they are people with long immunological experience. And despite the fact that the virus is really a lot different than just what they could during his life experience, there are still only an identical moments. So, while sick, but a milder form of infection. Anyway, it's age group, where he is currently the smallest impact.
When he will return to the coincidence in time between seasonal flu and pig. It will be the seasonal flu and a pig, each going after his line? Or is there any chance that the two viruses together and hit a lot more people?
I think that it will not look like overlapping of the two disasters. Maybe if I took a category of patients who have influenza type A, some part of them will have a new pandemic strain, but some of the earlier subtypes. If you keep the old line of H1N1, is the question. Rather, the displacement of emerging strain. Subtype H3N2 and type B certainly persist, then the situation is very likely to return to zajet?ch track, where the epidemic on the conscience of each one of these vyvolavatelů.
When the World Health Organization said yesterday that the pandemic virus has become the dominant influenza virus in the world, what does it actually mean? A revolution in the virus?
Does not mean no revolution. In essence, this means that among the representatives, who can cause flu in humans (type B from type A subtype H3N2, H1N1 and its older version and now a new emerging variant pandemic) is always one of the viruses predominate. And at this moment is the prevailing pandemic.
But we do not know for how long?
We know that the first wave roll over about a few weeks. They would then be followed by several weeks of dormancy. And then, as history taught us, usually comes the second wave of yet. If boards quickly or less quickly, or will be longer and slower, I would not dare to judge.
I also noted several cases where the swine flu antiviral gone to cure. It is still probably unique thing?
The question is, when the antiviral deployed. Indeed, the fact must be given quickly, within the first two days of the beginning of the disease, a condition which is not always possible to meet. And while a patient is indeed manifest, launching the disease, may affect antiviral only a limited extent. So the base is set to specifically indicated for proven disease and especially now.
But probably does not reveal the practitioner?
When will the surgery patient with influenza in a given situation is no longer necessary for searching for whether it's new or other flu. If the patient will have symptoms that would go some way indicated that it had to be hospitalized, the hospital treatment and symptomatic therapy is sent for home treatment. So neither will be necessary to search for the virus.
It should be noted that when a health system that impact patients endure and, indeed, serve, as it should, it will have a focus on serious cases, the hospitalized patients, the patients where the primary infection or complicated to be given their předchorob? reason to worry about this.
It is possible to pig flu přechodit normally, as it does a lot of people?
It makes a lot of people with normal flu and it's exactly the same mistake as with any other flu. When you take an analgesic, antipyretic, and even a bit more, so a few hours, of course, I feel better. But this is very shortsighted, because, first, further spread of infection and could get himself hurt.
As at this moment we do wrong? Are moving flu, or vice versa, according to your great panic, which should cause the media?
I do not think it did something fundamentally wrong. People always crossed the flu. It's a bit of educating. Just completed his mind that at all costs must somehow address their health difficulty, to her, if possible, not quickly. Just occasionally ill, that's life.
In humans it is also rooted in general that the flu is like cold, they are treated, or treat it, it's always seven days. Influenza is while the overall infection which may have a really tough course, involving the authorities, with respiratory tract which have nothing to do. It can attack the heart, nervous system, kidneys or skeletal muscle. It can have very serious enormous progress. Such situations are not many, I do not want to sound kind of dramatic, but they are.
Influenza is actually between respiratory viruses rather exclusive. So take it with some respect, understanding. I do not want to demonize.
http://www.ct24.cz/textove-prepisy/o...na-havlickova/</TD></TR><TR><TD class=submitcell>
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