O. Golubovska: “People die from the flu, when in the country there are no specific drugs”

О. Голубовская: «Люди погибают от гриппа, когда в стране отсутствуют специфические препараты»

Ukraine was gripped by an epidemic of influenza. Morbidity exceeded the epidemic threshold, said the Ministry of health. From 3 to 9 December with flu and ORVI was ill for 203 335 people, of whom about 70 are children under 17 years, there are already two fatalities. School is closed on quarantine. What you need to be prepared during the epidemic of influenza and how to protect themselves, the correspondent of ГолосUA told infectious disease physician Olga Golubovska.

– Olga, why deal with the flu, like measles, is impossible?

– Undoubtedly, to eliminate the flu as we laminirovanie measles, impossible. The objective of the health system is the readiness. In order to readiness, it is necessary to analyze previous seasons and to adapt to predicted the possible situation of the health system in the country. Because we are a country with a limited resource, so our commitment to this event is somewhat different than the willingness, for example, in the United States of America. In addition, a very important feature is that our people are very great distrust of the health system. Very low confidence in doctors. People prefer to rely only on themselves.

– Self-medicating is dangerous…

– Of course. If we talk about the flu, there are specific drugs for its treatment that the physician prescribes. These drugs are most effective in the first 48 hours of influenza virus infection. Therefore, the task of the physician to work with groups at risk, to understand the problem. Probably every family physician your range of patients. The doctor must understand what patients he is dealing, to predict in these patients or that the course of influenza disease severity, who may be a severe predictability. The physician should explain to the patient that he had, example, prognostically, if he is sick, will be a severe flu, so he needs to do something, so-and-so. In General, the task of primary health care, from my point of view, is prevention. The most important thing. Any disease is better to prevent than to deal with him. And then to follow the doctor’s recommendations is a personal matter for each person. He is responsible for their health. But above all, people must be properly informed.

– This year we are threatened by a very dangerous flu “Singapore”…

Yes. We always fear the flu strain H1N1 is the most dangerous virus. The disease proceeds rapidly, very quickly kills young people. This deadly strain. For three days the flu H1N1 can cause irreversible changes in the lungs. Last year in the United States of America from strain “Singapore” we expect this year we, in Ukraine, killing 80 thousand people. As far as he is aggressive this year, we can not say. I repeat that in the US in 2017 was a very unusual situation, and the flu there acquired an unusually severe course. In General, influenza is an unpredictable disease. All of his studying, he is second – in study after immunodeficiency virus. The flu constantly surprises. Talk about predictions for influenza – a thankless task. In Ukraine the peak of incidence may be to the end of December, but it could be later. Last flu season we had quite calm, was dominated by influenza B. But H1N1 is the most dangerous of the flu, which causes severe lesions especially in risk groups – people with diabetes, people with overweight, people with chronic heart disease, pregnant women. The flu, or 5 days passes, or irreversible changes in the lungs (from 3 to 5-6 days), and death.

– The flu shot can prevent the dangerous consequences of influenza?

– It is believed that Yes. Since 2009 the situation has changed fundamentally. In 2009, a new pandemic strain is the fourth pandemic since 1918. Every 20-30 years we have a new strain of influenza. If there is a brand new strain, it is called a pandemic because it causes a pandemic, but a pandemic is when the disease spans the globe this strain.

We got the H1N1 strain, which differs from all other circulating influenza viruses. All strains of H1N1 can cause primary lung, not doing what the other strains. Immediately follows primary infection of lungs. H1N1 causes primary viral pneumonia, which cause the so-called acute respiratory distress syndrome in adults, the major cause of death.

– Antibiotics are powerless here?

– Antibiotics are absolutely powerless. Here we are dealing with by this syndrome. If we talk about vaccination, it may not prevent the disease, people can get sick, but the disease it flows more easily. What is the feature of the last flu season, why is the US not so lucky? Because not included in the vaccine strains H1N1. This happens once in 5-6 years. The vaccine was just the strain H3N2 – the strain was one, and have been circulating quite different. I say again, that the flu is absolutely a kind of disease, it is unpredictable. When such a situation has arisen and it became clear that was not included in this vaccine strain, the center for control and prevention of disease United States have updated recommendations for this year. These recommendations are very useful for clinicians. So it should work with the state institutions, and not to tell that we have bad doctors and incorrect population.

The quarantine helps prevent the massive spread of the flu?

– Yes, this disunity. Isolation plays a huge role. Every infectious disease has its peaks, it can occur in waves, but when there is a large increase in incidence, the separation just slows down this process, but to stop completely can not. When we in 2009, there was a situation with severe flu originated pandemic H1N1, then it all started at the end of October, early. By the way, all new strains so themselves and lead. Then at the government level a decision was taken to quarantine for 3 weeks. It was the right decision, because people cease to travel, communicate, none of this mass. Then there was panic, people were afraid. And in 2015, when there was again H1N1, and we have in a short period killed as many as 400 young people completely socially adapted – aged 25 to 49 years. People died from potentially preventable diseases. And oseltamivir (antiviral drug – Ed.) in the country there is Tamiflu. For me, as a Clinician, it is better to let the planes are imported such drugs, let the state regulate than when they are in the country, and people are dying. In 2015, we have this oseltamivir is not delivered due to some kind of re-registration. I do not rule out that some people died then because of lack of preparation.

– What you need to be ready during the epidemic of flu?

– Most importantly, the flu is ready, must be ready all the clinics. Need to stock up on medicines for specific treatment of flu. Again let me remind you that 3 days can be irreversible changes in the lungs. These medications must be in the pharmacy network. Responsibility of patients is that time to seek medical help. In the first 48 hours it is necessary to take certain medicines which are effective during this time.

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