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http://www.milenio.com/node/425315
Spanish to English translation
The epidemic of A-H1N1 still "not resolved"
Despite the low case count, we must remain vigilant, experts agree, recalling that the infection must be reported zero infections in 20 consecutive days to consider the outbreak broke.
Mon, 19/04/2010 - 05:38
The health alert popularized the use of masks among the population. Photo: Marco A. Vargas Guadalajara .-
This Friday marks one year that the federal Health Secretariat (SSA) declared a health alert to the emergence of a new influenza virus in Mexico, which caused a worldwide epidemic resulting in thousands of sick and dead (17.700 deaths in the world) and has left only 4.278 Jalisco infections and 95 deaths to date, according to official data. Twelve months away, the agency reports quoted the lowest level of infection in the country during this period, although they have not broken the infectious outbreak.
"This can not be declared solved as we do not have no cases, having complied with ideally three times the maximum incubation period of the disease, which would be approximately 20 days, to be declared free of infection, at least from the standpoint epidemic" , referred H?ctor Ra?l P?rez G?mez, director of the Civil Hospital of Guadalajara (HCG).
The incubation period of influenza (acute respiratory infection caused by a virus) is usually one to three days, but can be up to seven days.
While this does not happen "we must be alert to risks of mutations in the A-H1N1 virus, especially after heavy usage of antivirals such as oseltamivir last year, as well as the possible generation of drug resistance, said P?rez G?mez , a specialist in infectious diseases.
The low transmission of cases (in the last month in Jalisco have been recorded from one to two infections per week) has opened the debate on whether Mexico should continue or terminate a health alert this decree. Asked by this newspaper, experts and representatives of the health sector divide Jalisco.
The health secretary in the state, Alfonso Petersen Farah, has spoken for not lifting the health alert: "It is time. I personally believe that the conduct has had the flu, and particularly the lessons that has left us, where the two shoots that somehow were considered, which were in hot weather do not let us be sure to raise the alert. "
Jaime Agustin Gonzalez Alvarez, general director of public agency HCG, said "will merely be a matter of protocol," as already made serious and formal studies in this regard. "In three weeks we will have the results. I think it would be nice to lift the alert, but remain vigilant. "
The epidemiologist and coordinator of the Centre for Health at the University of Guadalajara (University of Guadalajara), Marco Antonio Castillo Moran, agreed that health alert can be lifted but strict surveillance should continue: "The Influenza A-H1N1 remains a risk especially for susceptible groups. "
All agreed that once broken the outbreak, influenza A-H1N1 enter into an endemic period (expected number of cases at a time and place), which is added the antigen A-H1N1 influenza vaccine applied annually in the winter. And in the future what follows is the epidemiological surveillance and molecular surveillance of the virus, to determine which strain of virus is circulating. Gomez Perez added: "If something is sure is that influenza viruses are not eradicated from the world, like the smallpox virus and other pathogens. That will not happen. "
Learning
With regard to education that leaves the appearance of influenza A-H1N1 infectious diseases H?ctor P?rez G?mez said: "The first learning is how we have organized our surveillance system to a threat like this" and get organized "to with the efficient management of resources give the best care to an epidemic, for their immediate containment and of course to provide the best treatment to those already affected by it. "
He admitted that before this flu epidemic, the epidemiological surveillance system in Mexico was involved "in an activity of habit" (Jalisco are that not a single reported case of seasonal influenza in 2008, for example, and in 2009, parallel to Seasonal influenza epidemics are over 1,200 confirmed cases of seasonal).
"I think we had lost a little fear of an epidemic of influenza. Yes, at the end of each decade were saying 'here comes the wolf' but as in the past three decades has not had a threat, we were very confident in that system, "said Perez Gomez. After the epidemic, "my impression is that the surveillance system was strengthened in Mexico."
The doctor emphasized the generation of electronic tools that should be the benchmark for the future: surveillance network from the hospital unit, to immediately known nationally, the case warrants it.
The specialists believe
"The two sprouts that somehow considered, it was precisely in hot weather, since we can still have the utmost security and peace of mind to lift the warning, but I think there is reason to be calm, observant of the situation , inviting people to continue to participate, not to let your guard down but conscious that it is very unlikely that we might have a health status such as that envisioned just a year ago "
Alfonso
Petersen Farah
Jalisco Secretary of Health
"It was a phenomenon which has required special efforts. We have designed clinical measures of attention and all our staff trained in clinical diagnosis ... We are working on an alert condition to the specificity with which the phenomenon has behaved. In the health sector would have expected about 50 thousand cases between October [2009] and March [2010] and the figure was much lower, only at the Institute recorded in this period a little more than 4,800 infections "
"Ultimately people manage to find some positive attitudes. Despite the mixed messages which in principle were in Jalisco and that preventive measures were questioned, they have an effect to cushion the impact of the epidemic. Later we learned that the fatality was not as high and in a third phase was gaining consciousness, a process of involvement that created a new culture of health, who came to impact hygiene "
Marco Antonio Castillo Mor?n
Coordinator
Centre for Health UdeG
Carranco Benito Ortiz
Delegate Jalisco Social Security (IMSS)
"We are talking April a year ago. It was a disease that had a pattern very similar to the 1918 epidemic and the measures taken, which themselves were strict, that it was very rude, I described them as successful, because in some way helped us, first raise awareness, the better through afraid ... Now we believe it is a disease that is here to stay, it will be like the seasonal flu and we believe will have a cyclical "
Jaime Agustin Gonzalez Alvarez
Director General Hospital OPD
Civil Guadalajara
Maricarmen Rello
Spanish to English translation
The epidemic of A-H1N1 still "not resolved"
Despite the low case count, we must remain vigilant, experts agree, recalling that the infection must be reported zero infections in 20 consecutive days to consider the outbreak broke.
Mon, 19/04/2010 - 05:38
The health alert popularized the use of masks among the population. Photo: Marco A. Vargas Guadalajara .-
This Friday marks one year that the federal Health Secretariat (SSA) declared a health alert to the emergence of a new influenza virus in Mexico, which caused a worldwide epidemic resulting in thousands of sick and dead (17.700 deaths in the world) and has left only 4.278 Jalisco infections and 95 deaths to date, according to official data. Twelve months away, the agency reports quoted the lowest level of infection in the country during this period, although they have not broken the infectious outbreak.
"This can not be declared solved as we do not have no cases, having complied with ideally three times the maximum incubation period of the disease, which would be approximately 20 days, to be declared free of infection, at least from the standpoint epidemic" , referred H?ctor Ra?l P?rez G?mez, director of the Civil Hospital of Guadalajara (HCG).
The incubation period of influenza (acute respiratory infection caused by a virus) is usually one to three days, but can be up to seven days.
While this does not happen "we must be alert to risks of mutations in the A-H1N1 virus, especially after heavy usage of antivirals such as oseltamivir last year, as well as the possible generation of drug resistance, said P?rez G?mez , a specialist in infectious diseases.
The low transmission of cases (in the last month in Jalisco have been recorded from one to two infections per week) has opened the debate on whether Mexico should continue or terminate a health alert this decree. Asked by this newspaper, experts and representatives of the health sector divide Jalisco.
The health secretary in the state, Alfonso Petersen Farah, has spoken for not lifting the health alert: "It is time. I personally believe that the conduct has had the flu, and particularly the lessons that has left us, where the two shoots that somehow were considered, which were in hot weather do not let us be sure to raise the alert. "
Jaime Agustin Gonzalez Alvarez, general director of public agency HCG, said "will merely be a matter of protocol," as already made serious and formal studies in this regard. "In three weeks we will have the results. I think it would be nice to lift the alert, but remain vigilant. "
The epidemiologist and coordinator of the Centre for Health at the University of Guadalajara (University of Guadalajara), Marco Antonio Castillo Moran, agreed that health alert can be lifted but strict surveillance should continue: "The Influenza A-H1N1 remains a risk especially for susceptible groups. "
All agreed that once broken the outbreak, influenza A-H1N1 enter into an endemic period (expected number of cases at a time and place), which is added the antigen A-H1N1 influenza vaccine applied annually in the winter. And in the future what follows is the epidemiological surveillance and molecular surveillance of the virus, to determine which strain of virus is circulating. Gomez Perez added: "If something is sure is that influenza viruses are not eradicated from the world, like the smallpox virus and other pathogens. That will not happen. "
Learning
With regard to education that leaves the appearance of influenza A-H1N1 infectious diseases H?ctor P?rez G?mez said: "The first learning is how we have organized our surveillance system to a threat like this" and get organized "to with the efficient management of resources give the best care to an epidemic, for their immediate containment and of course to provide the best treatment to those already affected by it. "
He admitted that before this flu epidemic, the epidemiological surveillance system in Mexico was involved "in an activity of habit" (Jalisco are that not a single reported case of seasonal influenza in 2008, for example, and in 2009, parallel to Seasonal influenza epidemics are over 1,200 confirmed cases of seasonal).
"I think we had lost a little fear of an epidemic of influenza. Yes, at the end of each decade were saying 'here comes the wolf' but as in the past three decades has not had a threat, we were very confident in that system, "said Perez Gomez. After the epidemic, "my impression is that the surveillance system was strengthened in Mexico."
The doctor emphasized the generation of electronic tools that should be the benchmark for the future: surveillance network from the hospital unit, to immediately known nationally, the case warrants it.
The specialists believe
"The two sprouts that somehow considered, it was precisely in hot weather, since we can still have the utmost security and peace of mind to lift the warning, but I think there is reason to be calm, observant of the situation , inviting people to continue to participate, not to let your guard down but conscious that it is very unlikely that we might have a health status such as that envisioned just a year ago "
Alfonso
Petersen Farah
Jalisco Secretary of Health
"It was a phenomenon which has required special efforts. We have designed clinical measures of attention and all our staff trained in clinical diagnosis ... We are working on an alert condition to the specificity with which the phenomenon has behaved. In the health sector would have expected about 50 thousand cases between October [2009] and March [2010] and the figure was much lower, only at the Institute recorded in this period a little more than 4,800 infections "
"Ultimately people manage to find some positive attitudes. Despite the mixed messages which in principle were in Jalisco and that preventive measures were questioned, they have an effect to cushion the impact of the epidemic. Later we learned that the fatality was not as high and in a third phase was gaining consciousness, a process of involvement that created a new culture of health, who came to impact hygiene "
Marco Antonio Castillo Mor?n
Coordinator
Centre for Health UdeG
Carranco Benito Ortiz
Delegate Jalisco Social Security (IMSS)
"We are talking April a year ago. It was a disease that had a pattern very similar to the 1918 epidemic and the measures taken, which themselves were strict, that it was very rude, I described them as successful, because in some way helped us, first raise awareness, the better through afraid ... Now we believe it is a disease that is here to stay, it will be like the seasonal flu and we believe will have a cyclical "
Jaime Agustin Gonzalez Alvarez
Director General Hospital OPD
Civil Guadalajara
Maricarmen Rello