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Mexico: Conducting research on A/H1N1

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  • Mexico: Conducting research on A/H1N1

    Source: http://www.vanguardia.com.mx/diario/..._a_h1n1/364485

    Mexican doctors to get x-ray A H1N1

    Conducting research on the origin, development and consequences of influenza
    By: Special
    16-June-2009

    Study on the human influenza

    This paper is a bibliographic research done by Drs Luis C?rdova Alvel?is, Julio Cruz Robles, Ana Delia Realm Irene Josefina Vazquez and Salazar Valdes, students of the Masters in Multidisciplinary Research in Health Sciences, Faculty of Medicine, University of Coahuila.

    On June 12 the World Health Organization decided to raise the alert level of influenza A H1N1 Phase 6. Less than two months of the emergence of the first cases in our country, the condition takes the form of a pandemic.

    Its origins

    In mid-February 2009 in San Diego, California, a child with asthma aged 10 became the first case of H1N1 influenza in swine origin, documented by the Center for Disease Control (CDC) in Atlanta.

    In late March and early April were made in Mexico and outbreaks of respiratory disease on April 12 identified an outbreak of disease flu-like symptoms in a small community in the state of Veracruz. On April 17 a case of atypical pneumonia in the state of Oaxaca forced the authorities to implement measures for greater surveillance.

    On April 23 were reported to the Pan American Health Organization (PAHO), several cases of infections by influenza virus A H1N1, confirmed by laboratory tests and analysis of the gene sequence revealed that it was the same virus that child had been reported in California.

    However, the origin of this "new virus" goes back to 1918, when the pandemic emerges known as "Spanish Flu" which caused 50 million deaths.


    Baptizing the epidemic

    The identification of the virus showed that it was a mixture of viruses that cause flu in pigs, so at first it was called "swine flu". In some countries, calling attention to the emergence of Mexico outbreak and because our country had the most cases, the media christened it as "Mexican Influenza."

    The virological analysis showed that the two major groups of viruses that cause influenza (A and B), the epidemic became known in April 2009 corresponded to the A, the disease affects humans and the virus has two glycoproteins (proteins linked to sugars), one of which produces agglutination of red blood cells (haemagglutination) and the other is involved with an enzyme, neuraminidase.

    Based on this, the correct name of the disease is human influenza A H1N1.

    Viruses are not cells, are exclusively made of genetic material DNA (deoxyribonucleic acid) or RNA (ribonucleic acid), can not live if it does not enter a cell, in so doing exchanged their genetic material with which a cell infected.

    The influenza virus A H1N1 genetic material from three species: the pig, poultry and humans. This indicates that at some point the virus infected pigs and the birds, to finally be able to infect human cells.


    The epidemic day by day

    The data used by scientists to know the progress of the epidemic are provided by the World Health Organization (WHO), which updates its site daily and available at the following address: http://www.who .int / csr / disease / swineflu / en / index.html At the time of writing this letter (yesterday), the epidemic has spread to 76 countries on five continents, 35 thousand have been 928 confirmed cases and 163 deaths have been attributed to the disease. The country with the highest number of reported cases is United States, with 17 thousand 855, followed by Mexico, with 6 thousand 241, and thirdly Canada, with 2 thousand 978.

    Countries that increased growth of the epidemic have occurred since the last report of June 12 are United States, United Kingdom, Australia and China. To our fortune in Mexico are not reported even a single new case in this period. Below are some of the major questions about the H1N1 virus.


    Why not all cases respond to antivirals?

    At the beginning of the epidemic, all cases responded to two new antiviral drugs: oseltamivir and zanamivir.

    Have recently reported cases of resistance to these drugs, due to the high capacity of mutation of these viruses in combination with host genetic material.



    Why is child mortality in countries like Canada and United States?

    The answer is controversial, there are several factors that may influence mortality. Accessibility to medical services, quality of care patients receive and the speed with which antiviral treatment is started are some factors that explain the lower or higher mortality.

    In developed countries the phenomenon is self-existent in our country is a common practice in cases of influenza diagnosis slows. Recall that antivirals are indicated for use in the first 48 hours of the symptoms started.


    Furthermore, the rapid reporting of confirmed cases is very different in developed and developing countries. In our country, the first cases of the epidemic had to be sent to Canada and United States for confirmation.


    Will we have a vaccine available in the short term?

    The virus responsible for the current pandemic mutates rapidly, this explains why it will not be feasible to have an effective vaccine in the short term. International agencies are already working to provide the pharmaceutical industry the biological material needed to produce a vaccine, however, because the effectiveness of the vaccine varies from person to person depending on age and overall health status of each, when available will serve to assess whether mass vaccination against these new strains of influenza A. Finally, bad news: The vaccine does not give away to poor countries, they will have to pay and that no doubt greatly influenced the spread of evil.


    How the infection is confirmed by this new virus?

    The CDC has developed a test in real time for the reaction of the reverse transcriptase polymerase chain, which is the safest method to characterize the virus.

    This method is not available in all countries, some are using inaccurate methods that generate errors in diagnosis.



    Already passed or the worst is yet to come?

    Experts want to answer this question. On June 11, Margaret Chan, director general of WHO, ordered the move from 5-6 level, which is the highest stage of alert for a pandemic, thus giving way to the first pandemic of the century. So far the virus mainly affects young people and their mortality is relatively low (2%), however, Chan warned that given the poverty of large parts of the world, we must prepare to see a growth of evil.

    Addition made it clear that countries that have stopped the epidemic must be prepared for a second wave of disease whose severity is not yet predictable. It is possible to happen in October this year when we will have the vaccine, but are there medical resources to cope? If the economic consequences of this first phase were devastating, what will happen in few months?

    Something if it is true, is the first time that scientists have been able to observe an epidemic in "real time" and what we learn from it is incalculable.

    sc
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