DEVIL NOT AS BLACK AS HE IS PAINTED

The А/Н1N1 virus reached Azerbaijan in July, when the first two cases were registered. Two more were recorded in October and the rest in November. Therefore, as this edition went to print, the number infected by А/Н1N1 in Azerbaijan was 14, most of whom have recently come to Azerbaijan or have been infected by newcomers, while one is a UK citizen. The condition of all patients is considered to be satisfactory, say medics.

The anxiety surrounding so-called swine flu climaxed when people began wearing protective masks and the Health Ministry issued a statement recommending parents not to send their kids to school without masks. The global panic over А/Н1N1 has done its job, and done it very convincingly. Whereas, earlier, infections and deaths from a familiar virus would have gone largely unnoticed (А/Н1N1 is effectively the same virus as one registered in 1947, which has undergone slight mutation), today every case is given special attention, not only by medical institutions but also by the media. One can't help recalling the notorious bird flu which, as a matter of fact, is a close relation of H1N1-H5N1, though not close enough to be communicated from person to person. But what if we analyze the whole issue carefully? The panic over the spread of swine flu, which, according to Gennaiy Onishchenko, head sanitary doctor of the Russian Federation, does not even exist, is playing into the hands of the pharmaceutical companies. They have registered unprecedented increases in sales of masks and anti-flu medicines, most of which should not even be taken in this case. But who will bother to look into this situation? 

Affected by the universal desire "not to go down with the flu", people are rushing to pharmacies to buy medicines and masks. In fact, prices of the latter have soared from 10 gapiks to 3 manats in Baku. The criminal resourcefulness of the sellers, who are even making money from people's fear, is truly amazing. What is there to say? This, however, is a triviality compared to the global anxiety over A/H1N1, if indeed it was created artificially with the aim of enriching not only pharmaceutical companies but also countries developing as yet untried vaccines against this so-called swine flu. European countries, Russia, the governments of all countries and international humanitarian organizations are allocating huge resources and funds to combat the virus. Isn't this a timely and clearly profitable solution to the global economic downturn? Against this background, the question may be asked: what is A/H1N1? Is it a deadly pandemic or a PR campaign by pharmaceutical companies? Or perhaps it is global panic? The last seems more likely if we consider that, according to the WHO, ordinary seasonal flu claims the lives of 250,000-500,000 people around the world, while three to five million people are infected every year. Many are gradually beginning to understand that so-called swine flu is a carefully thought-through pandemic of regular seasonal flu which may kill those with weak immunity. Thus, wouldn't it be better to simply find out what the virus represents and then decide whether it is worth fearing? 

What is flu? 

The best known flu pandemic was called "Spanish flu". It occurred in a wave-like fashion between 1918 and 1920. In the first 25 weeks it killed more than 25 million people throughout the world. According to not very precise calculations (accurate records were not kept in most countries at the time), over 1 billion people were affected by the virus, while the mortality rate of registered cases was between three and seven per cent. And although the percentage does not seem very high, the disease was dangerous because of its spread. In 1933, the virus was officially discovered and described, and since then mankind has known how it works and why it could be so dangerous. 

First of all, flu can be of three types - A, B and C. It is virus A that leads to pandemic, B is encountered less often and causes "only" epidemics, while C is even more rare and does not threaten a pandemic at all. 

Yes, man would have become immune to flu if the virus didn't always change and adapt to new conditions. Thus, the 1933 flu virus was called Н0N1, but it 1947 it changed into H1N1. As a result, immunity to the 1933 virus proved useless in 1947, not only because it was too old but because the disease had changed. The Asian flu of 1957 was labelled H2N2 but, in 1968, it transformed into H3N2. It was said at the time that the deadly "Spanish flu" was H1N1 and this was subsequently verified: in 1997 the AFIP research centre (USA) obtained a sample of the "Spanish" virus of 1918 from the corpse of an indigenous Alaskan buried in deep-frozen soil 80 years before. It proved to be the H1N1 strain. In fact, the latest major outbreak of H1N1 was registered in New Jersey, USA, in 1976. The logical question is how and where the changes in the virus take place. 

And this is when dumb animals, namely pigs, come to our "rescue". Back in the early 20th century, many researchers made the following observation: almost every flu epidemic is accompanied by an epizootic of similar diseases in animals. We can recall bird flu, which was always changing and becoming less dangerous for man but always contained a small proportion of bird gene material. Then a crucial meeting took place - the virus of an ordinary swine flu (since swine can be affected by human viruses) and the human flu virus H1N1, with a memory of bird flu, met in one organism, in one cell. Gene material was exchanged and a new sub-type of H1N1 came into being. 

This flu has dominated headlines in the last few days. As of 9 November, a total of 6,000 people have died, while over half a million people have been infected. The epidemic has affected 199 countries and territories, says a report circulated by the World Health Organization. As of 1 November, at least 6,071 people had succumbed to the disease. 

Is the threat deadly?

The biggest problem of the virus strain is that human beings have not yet developed immunity to it. Of course, they will, gradually, the virus will transform and everything will start anew - this is what history tells us. But there is an important caveat: when communicated from person to person, the virus often weakens. All other speculation about its deadliness or its particular nature is nothing but widespread hysteria. At the same time, there is a sad aspect behind the hysteria - the group at risk, due to low immunity, includes vulnerable people - children, the elderly and those suffering from chronic illnesses. For them the progress of the disease may be more serious and fatalities are possible. An adult is likely to experience A/H1N1 like normal flu - fever, body pain, headache etc. 

Unfortunately, the situation in which residents of FSU countries have found themselves is very similar to that of the Mexicans who were the first to bear the brunt of the new virus: poor nutrition, a disregard for sports, world leaders in smoking. Immunity is first to be affected by these factors. It is hardly a secret that lack of attention to basic rules of hygiene and health, both one's own and the family, is commonplace. The widespread attitudes, "the danger will not affect me" or "let's see who gets the upper hand" are a lot worse than not washing hands before a meal. At least people have started wearing masks.   

What is there to know? 

There is no A/H1N1 epidemic in Azerbaijan, says Elmira Aliyeva, head of the Department for Special Infectious Diseases and Epidemiology under the Ministry of Health. 

"There is no special need to wear masks everywhere and at all times, as long as one adheres to such basic rules as the frequent washing of hands and consulting a doctor in case of a high fever. In order to prevent ordinary flu infection, however, the likelihood of which increases dramatically in autumn and spring, medical masks are recommended," the specialist stressed.

It is worth mentioning that everything has been done to avert the spread of A/H1N1 in Azerbaijan. Medical controls at nursery and secondary schools have been tightened. Emergency response plans have been drawn up by Azerbaijan Airlines for application on aircraft. Officials from the medical and sanitary department, specialists of the sanitary and quarantine section of the State Customs Committee and other relevant bodies are carrying out comprehensive sanitary and quarantine work at the Heydar Aliyev international airport. Six Japanese thermovisors have been purchased by the airport to detect A/H1N1 symptoms in inbound passengers. Control measures have been put in place for people entering the country to produce medical clearance statements. Similar measures have been carried out by the Azerbaijan Railways CJSC, by customs bodies, the armed forces, border checkpoints and the Baku underground.

Deputy Health Minister Abbas Valibayov has said that the results of tests on viruses obtained from patients in Mexico and the US have revealed that the virus is sensitive to a number of medicines. There is a sufficient supply of such medicines in Azerbaijan. Today, the rate of acute respiratory diseases in Azerbaijan is at an average level, more than five times below the epidemiological threshold. 

"Since the А/H1N1 virus was registered, the Health Ministry has been taking measures to combat the disease. It has published brochures describing methods of protection against the virus. In fact, an electronic version of the brochure is being broadcast by local TV channels. Medical institutions have been put on a high status of alert, a supply of certain medicines, disinfectants, PPE etc. has been established. A laboratory fitted with state-of-the-art equipment has been established for virus detection and diagnosis. Laboratory personnel are people trained in the world's leading reference laboratories. Negative-pressure wards meeting international requirements have been set up at the Scientific Research Institute of Lung Diseases to treat severe and virulent cases of the flu, including pandemic flu. A system of epidemiological flu monitoring has been put in place. Material from suspected sufferers is sent for laboratory analysis. In other words, everything has been undertaken to ensure diagnosis and treatment of flu."

Vaccines can be different

Abbas Valibayov has an equivocal attitude to the А/H1N1 vaccination which is due to arrive in Azerbaijan in late November or early December. "The WHO has sent us the vaccines, but the point is that all infections occur in different categories - those manageable by preventive measures and unmanageable ones. The first category covers such diseases as polio, diphtheria, measles, rubella, stupor etc. In other words, vaccination gives general protection against the said diseases. Thanks to it, many countries, including Azerbaijan, have already practically eliminated these diseases. Unfortunately, flu belongs to the second category. Despite Herculean efforts, a vaccine guaranteeing full protection against the virus has not yet been developed anywhere in the world. As for the new vaccines against А/H1N1, they are very little known and it is premature to talk of their effectiveness. They have to prove their effectiveness in practice. And that takes time. We believe that even if the effectiveness of the vaccine proves to be low, it is not worth rejecting it. At the same time, vaccination should be conducted on a case-by-case basis. First of all, it should be carried out among the personnel of in-patient and out-patient clinics and infection hospitals of big cities, then among the employees of customs and border checkpoints, international flight crews, diplomats and schoolchildren aged 14-18. In fact, the WHO intends to supply vaccines in the numbers required specifically for these categories of the population. Vaccination will be conducted on a voluntary basis," he said.

However, even before vaccination has begun, many think that it is absolutely pointless. People are discussing on various Internet forums how these untried vaccines may affect general health in the future. It is said that the vaccines can lead to sterility and many other problems which will manifest themselves later. 

At the same time, according to Araz Manuchehri-Lalei, associate professor in the Psychiatrics Department of the Azerbaijan Medical University, such speculation usually accompanies any epidemic and can only be described as being misleading. He is also convinced that the anxiety and panic over swine flu is a product of the media. "The media rush over swine flu resembles a historical situation which occurred in America in the early 20th century. An emotion-filled reading by an American radio presenter of a play about an invasion from Mars was taken by many to be fact. Similarly, the attention media are paying to flu today is causing panic and making people rush to pharmacies looking for medicines and masks."

On 12 November, as part of a campaign against the artificial increase of prices for anti-flu remedies, the state anti-monopoly service under the Ministry of Economic Development, jointly with specialists from the Health Ministry, conducted inspections into the creation of artificial shortages and increases in prices for masks and respirators. Appropriate measures have been taken regarding places where violations were discovered.