The New And The Seasonal Influenza May Arrive At The Same Time

Since the school year has begun, the H1N1 virus called swine influenza has been spreading faster in Hungary as well. Teaching is suspended in several educational insitutions and there are more and more infected employees at the larger companies and manufacturers. The exact number of infected persons is not known, but it is a fact that in Hungary one person has fallen victim to the swine flu so far. He was chronicly ill and died of the complications of the influenza.

“The pandemic influenza virus is continuously spreading all over the country, according to the estimate based on the reports of physicians participating in the monitoring service, between 7 and 13 September, 2009, three times as many sick people (approx. 4,100 persons) contacted their doctor with influenza-like symptoms than in the course of the previous week. Compared to the previous week the number of respiratory epidemics reported to the National Public Health and Medical Officer Service (ÁNTSZ) has also significantly increased, and there have been four community epidemics among them in the case of which the role of the pandemic virus has been proven. Virological examination has been carried out in 158 cases and 30 percent of the patients have turned out to be A/H1N1v positive. These two facts indicate that the continuous spreading of the influenza A/H1N1v virus has already begun among the population in our country as well. This explains the unusual rise in the trend of influenza-like diseases, which is not typical in September" – says the website of the National Epidemiological Centre, under the title „Information on the appearance of new influenza virus-related diseases in Hungary".

A new decree in preparation for an epidemic

Lt.Col. Dr. Katalin Meglécz, the chief epidemiologist of the Hungarian Defence Forces told honvedelem.hu that obviously, the defence forces have also prepared for treating the illnesses caused by the new influenza virus and for prevention as well. At the moment a decree of the defence minister stipulates what to do in case the epidemic appears in the barracks as well. For the National Public Health and Medical Officer Service is not a competent authority as regards the corps and organizations of the Hungarian Defence Forces, the Ministry of Defence and its (background) institutions, thus the tasks resulting from the epidemic have to be ‘adapted’ to the employees of the HDF and the MoD, in compliance with the regulations of the chief medical officer. The aforementioned instruction serves this purpose, but soon it will be replaced by a measure of the chief of the cabinet. The latter will come into effect shortly – we were told by Dr. Meglécz.

The epidemiological specialist added: the Hungarian Defence Forces have prepared for the appearance of the virus, the medical services of the corps and the MoD National Medical Centre know what they have to do. The HDF Dr. Radó György Military Medical Centre and the Medical Services – as per the national and international regulations – have prepared for the protection of the MoD. They have done so in line with the activities of the National Pandemics Prevention Committee, the Office of the Chief Medical Officer, and the National Public Health and Medical Officer Service. Moreover, the pandemic plan of the defence portfolio was updated last year, being the first complete sectoral plan, and it has also been incorporated into the disaster management plan of the defence sector.

Since the declaration of the pandemic, that is the epidemic widespread over the world, the epidemiological specialists of the defence portfolio have been monitoring the changes in the epidemiologic situation at home and worldwide. They have reported the epidemiologic events, the planned and approved measures to the military command, the medical and health care services, as well as the personnel on a regular basis. In addition to that, the portfolio is also represented in the national bodies governing and supervising the protection against the influenza pandemic – told us Lt.Col. Katalin Meglécz.

They monitor the spread of the virus

Starting from week 27, the military medical officers and epidemiological specialists of the HDF Sanitary and Epidemiological Service have confirmed the operation of the influenza monitoring and reporting service. They help the work of the ÁNTSZ by processing the incoming data. They keep providing in-service and preparatory trainings for the medical services, and check the epidemiological plans of corps and institutions. In case the disease is diagnosed somewhere, which must be reported, they conduct an on-site epidemiological examination, ordain the necessary measures in a military medical official measure, and check compliance. In the course of terminating the process of the epidemic they will provide operative assistance to the medical services of the corps, not only in the country but in the foreign missions as well – emphasized the chief epidemiologist of the Hungarian Defence Forces, who also told us that the National Medical Centre provides medical care for the active personnel of the armed forces, bodies, and the law enforcement organs, who require hospital treatment, in line with the pandemic plan of the institute. The medical services of the military organizations are updating their pandemic plans and preparing for the reception of patients.

According to the plans, those who have influenza-like symptoms and live outside the barracks will be isolated in their homes for seven days, starting from the appearance of the symptoms. Naturally, this is only possible if the symptoms of the disease appear at home and the troops in question see their GP. If the symptoms appear on those who live in the barracks, isolation must take place within the barracks, in the designated facilities.

In the opinion of Dr. Meglécz it is extremely important that people do everything to prevent the disease. Therefore they will tell every barracks and military organization to pay special attention to the observance of hygienic regulations. Among these the most important ones are frequent hand wash with warm water and soap, the use of tissue when coughing or sneezing, and the avoidance of crowded places.

They expect less contagion

And even though the report issued by the World Health Organization (WHO) says that it is mostly the age group under 24 that falls ill with the new influenza virus, Dr. Katalin Meglécz hopes that there will be less contagion as regards the military personnel, due to the good physical condition of the troops. For they play sports regularly, therefore they are probably more resistant to contagion than the average citizen.

At the moment the military medical professionals expect that the disease will have a mild course in the future too. In other words, those who fall ill with the virus of the new influenza, will recover in 3 or 4 days. Naturally, similarly to every influenza-related disease, there may be complications in case of the new type H1N1 contagion as well. Based on data to date, in 15 percent of the cases some kind of a complication sets in, mostly pneumonia. In two percent of these cases hospital treatment is also necessary. These complications afflict the age group between 40 and 60 in the first place.

It may also be a problem – as Lt.Col. Dr. Katalin Meglécz told honvedelem.hu – that in two weeks’ time, starting from week 40, the influenza season in terms of epidemiology will begin, meaning that two strains may ’attack’ the population at the same time. And even though the seasonal influenza endangers infants and the elderly in the first place, due to the two epidemics the health care system will probably be overloaded.

The military medical professionals are prepared for the seasonal influenza epidemic as well. Soon they will receive the vaccinations that are effective against this year’s strain, which will be distributed among the troops in the order that has become usual in recent years.

About the vaccine against the new type H1N1 virus Dr. Meglécz said that the serum will enter circulation in late September or the first days of October. As a result of the negotiations with the Ministry of Health, from the vaccine made in the first phase of production all the amount that is required by the HDF will be available for the troops. The serum will be provided free of charge for the entire personnel of the Hungarian Defence Forces – since the military is one of the so-called critical infrastructures – and inoculation will be organized by the HDF Dr. Radó György Military Medical Centre. The vaccination will provide full protection against the new type of influenza, and this protection will develop within two weeks at the most.

About the new type of influenza

As it is known at the end of April 2009 the United States Epidemiologic and Disease Prevention Center announced the spread of a potential pandemic influenza in the American continent. The pathogen that causes the pandemic was identified as a new virus strain consisting of the genetic material of the human influenza A (H1N1), the avian, and the swine influenza viruses. Having monitored the pandemic process, the WHO have raised the pandemic alert to phase 4, and soon to phase 5. Since the epidemiologic specialists are facing a new strain of virus that has been unknown until now, and the epidemiological features of pandemics are different in the initial phase of the pandemic, the objective was to collect the typical features that may lay the groundwork for protection. As a result of data collection they have managed to establish that the disease is spreading among young adults for the most part, while it is mainly age groups 0–4 and 5–24 that need hospital treatment, and it is mostly the chronicly ill who fall victim to the influenza. It has also been found that the age group above 60, that is the most endangered by seasonal influenza, has a certain level of immunity against the disease.

As a consequence to the spread of the epidemic over several continents, on 11 June the WHO raised the pandemic alert to the highest phase, that is phase 6. From that day, in line with international recommendations, instead of slowing down the spread of the pandemic, the health care resources must focus on monitoring its development and providing good quality medical care for the sick.

The latest data to appear in the press seem to be contradictory. However, a point they all share is that there are more than 2,800 deaths all over the world which are attributed to the new influenza. So far 73 people have died of the complications in Canada, nearly 500 in the United States, and 900 in Brazil.