Preparedness for Pandemic Influenza – With the constant change of weather many people have been getting sick with the flu, so Ambergris Today decided to contact Dr. Javier Zuniga for friendly advice and we learned more than we expected. Dr. Zuniga explained to us that the Government of Belize along with the Pan American Health Organization (PAHO) held a two week training workshop to help detect and respond to outbreaks of Severe Acute Respiratory Infections (SARI), with emphasis on Human Influenza.
Seasonal Influenza (or flu) refers to the commonly circulating viruses that cause yearly epidemics at specific times of the year, mainly in the coldest months in countries with marked seasons. In countries with tropical climate, the patterns of circulation are not clearly defined.
The incubation period of the virus varies from 1 to 4 days, with an average of 2 days. The disease is characterized by fever, headache, runny nose, sore throat, and cough. The cough tends to be intense and long-lasting. This virus is effectively transmitted from person to person through various mechanisms such as direct contact, though droplets that in general disperses up to 1 meter, by fomites and more rarely aerosols.
The World Health Organization (WHO) advises that vaccines should be administered before the annual peak.
* The influenza vaccine provides approximately 70% to 90% protection against clinical disease in healthy adults.
* Among older persons, vaccination against influenza can reduce the number of hospitalizations between 25% to 39% and reduce mortality between 39% to 75% during influenza season.
Take Yearly Vaccines to Stay Healthy
Since 2004, PAHO has recommended annual vaccination for people over 60 years of age, the chronically ill, health professionals, pregnant women and children between 6 and 23 months old.
Another advantage of more widespread use of the seasonal vaccine is that it will help increase the production capacity to respond to a pandemic. In principle, the same technology that is available would be used to produce against a pandemic strain.
Dr. Zuniga stated that the WHO Global Influenza Preparedness Plan, established 6 phases of increasing risks to public health caused by the appearance of a new subtype of the influenza virus that could represent a pandemic threat. And in April 2008, WHO observed that the world is in phase 3 of pandemic risk (Human infection with a new subtype but without transmission from person to person).
“What we are currently doing is running a Sentinel Surveillance of Influenza-Like Illness (ILI) and of Severe Acute Respiratory Infections (SARI),” commented Dr. Zuniga. “Sentinel surveillance of ILI is carried out in outpatients while the monitoring of SARI takes place in hospitalized patients. The objective of this surveillance is to provide data for determination of the epidiological characteristics of the influenza, to guide the policies on the prevention and control of the disease.”
He continued by explaining that Influenza-Like Illness (ILI) has symptoms such as sudden appearance of fever higher than 38° C, cough or sore throat and runny nose which can be treated with proper medication, and then there is the Severe Acute Respiratory Infections (SARI) which is when one has a fever higher than 38°C, cough or sore throat, difficulty breathing and need for hospitalization (categorized as pneumonia) which can cause death.
The only way of knowing with certainty the cause of ILI or SARI is by means of laboratory diagnosis. Laboratory diagnosis of influenza is important for prevention, surveillance, containment and formulating compatible vaccines. In order to carry out these tests the doctor will have to collect samples within 72 hours of onset symptoms to perform tests in an indirect immunoflourescence.
Dr. Zuniga highly recommends for everybody to get their flu shots, especially children and the elderly. The Poly clinic is currently providing Flu vaccines for children from 6 months to 23 months old and for those older than 65-years.
* In the last century three major pandemics have been documented: The first occurred in 1918 (influenza A/ H1N1) and was responsible for the death of approximately 40 – 50 million people throughout the world, mainly affecting the young.
* The second was in 1957 (influenza A/H2N2) casing approximately 2 million deaths,
* The third in 1968 (influenza A/H3N2) causing approximately 1 million deaths.
* Currently, influenza virus A/H5N1 has infected birds in more than 50 countries on three continents. This H5N1 strain has not demonstrated the ability to easily infect humans, but the possibility still exists that it could mutate to become a pandemic strain. Cases in humans caused by this strain have shown high case-fatality of about 60%. While it is not possible to predict whether the next influenza pandemic will be caused by influenza H5N1, the emergence of an avian influenza strain capable of infecting humans highlights the importance of surveillance systems that are sensitive enough to detect such viruses as they emerge.
