http://kyivweekly.com.ua/pulse/society/2010/10/18/171624.html
Scientists say that the swine flu virus in Ukraine had a lethal mutation
PHОТО: PHL
Autumn is upon us and the next swine flu epidemic is not far behind. Ukraine?s citizens have begun preparing for the flu in every possible way
The state enterprise Ukrvaktsyna has filed a lawsuit with the Federal Court of Portland (Oregon, U.S.) against the American company Olden Group accusing it of engaging in financial fraud schemes connected with the supply of vaccines to Ukraine.
Minister of Healthcare Zinoviy Mytnyk already informed Ukrainian citizens that there will be no free vaccination against flu this year.
Citizens have already stockpiled Tamiflu medicines procured in Ukraine last year in massive quantities. After all, whatever is said about the artificially inflated panic over the flu, it gave people quite the scare. The entire country anxiously looked at one another over flu masks. According to official data of the healthcare authorities, the last year?s flu killed 1,126 people, who died a horrible death from asphyxiation caused by pulmonary edema. This flu had not been in Ukraine since the Civil War.
Sticky death
Unfortunately, last year?s epidemic, which officially lasted from October 29, 2009 to March 21, 2010 almost exactly coincided with the presidential campaign and the elections, and was used as one of the main campaigning tools. It is no surprise than that not only medical chiefs but also ordinary doctors, were confused by the diagnoses that nation?s leaders made for Ukrainians suffering from the flu. Doctors? heads were spinning even without authoritative advice: what happened with the ailing by all medical canons should not have happened. Moreover, the mortality rate in Ukraine from the disease was 10 times higher than in neighboring countries while the symptoms were the same.
Unfortunately, the reason for this was discovered only after the patients died. Doctors took samples of lung tissues and experts of the World Health Organization established the genetic code of the Ukrainian variety of the swine flu H1N1. Our virus had a mutation (the scientific name of D225G), which made the Ukrainian flu far deadlier than the same disease in other countries.
The distinctive feature of the swine flu was that it was not limited to the upper air passages but strived to get through to the lungs where it causes viral pneumonia. It began when a virus is attached to the cell surface of the lung.
A mutation of D225G is causes the virus to adheres tightly to the surface of the lungs very strongly. Treating a viral pneumonia with antibiotics is useless. The pulmonary edema must be prevented at any cost up to connecting the patient to an artificial breathing apparatus to support the body until it will be able to fight the infection.
Esprit de corps
The decryption code of the Ukrainian strain of the flu is now included into the global database, which shows that such a mutation has never existed before. Something similar was with the case of the infamous "Spanish flu".
In 1918, the "Spanish flu" killed millions of people as there were no antibiotics or modern treatment methods to prevent this at the time. And the fact that people who were treated in a hospital last season were dying by thousands was unheard of. Even the number of people that died during the major avian flu pandemic (H5N1) six years ago was lower. Then, the avian flu killed 227 people, which triggered major uproar all over the planet. Last winter more than a thousand Ukrainians died from this flu and it looked like nobody even noticed.
It is pointless to speak of the lack of response on the part of the country?s leadership. Everything is crystal clear. But why even officials of the World Health Organization, which unites all the data on influenza, did not sound off the alarm bells is not understood. They must?ve been too busy trying to justify themselves claiming that they did not take money from pharmaceutical companies to promote drugs against the flu.
Be that as it may, an analysis by WHO experts revealing a mutation of the Ukrainian virus rehabilitated the image of Ukrainian doctors even though the latter did not need any excuses. They know better than anyone that they were doing everything possible to fight the virus within their understanding of the situation.
As for domestic flu experts, contrary to the obvious fact of mutation, they somehow still try to defend the honor of their uniform, saying that when they examined the virus it was "normal", adding that they had no device to determine the mutation. Do you understand? There could not have been a mutation because they had no means of detecting it (see comment).
No money!
In any case, this is a thing of the past. The epidemic is over and it is not likely the situation will repeat. The chances of the epidemic to return from the viewpoint of epidemiology are indeed slim to none. Ukraine this year will again be hit by the same swine flu, but it is not likely to be of the same scale as this time the Ukrainians will have immunity against the strain. If there is an epidemic, it will be of some different strain. The question is what strain?
Seeing has a time machine has yet to be invented, nobody can find out the answer to this question. However, apparatuses have been invented that give a virtually instant response to doctors as to what mutation they may be up against. Such an apparatus called a sequencer helped WHO experts to discover the mutation in the Ukrainian influenza virus. They were asked personally by the former president of Ukraine Viktor Yushchenko to conduct testing using this device (probably after our flu experts reported that everything is going well: the virus is common and Ukrainians are dying in a normal mode. In Ukraine, such testing could not be conducted due to the lack of equipment and shortage of trained personnel to operate them.
The device is expensive worth approximately US $1 mn. In addition, supplies for it cost around US $40,000. The device is used not only to detect a mutant influenza. It has no equals in treating cancer these days. So, it will not be a waste of money after all. Te problem is there is not sufficient money in the national budget for the purchase of sequencers for all regional medical centers and personnel training.
Many will likely be shocked to hear, however, that not a single penny is required from the budget. Throughout the world most express-diagnostics labs (for detecting all diseases, not only the flu) are privately owned. This is a highly profitable business and all private labs pull in enough revenues from the services they render.
All that is needed is a change in the system: don?t treat the nation, treat patients. If that be the case this will probably a bona fide preparation for the next influenza pandemic or any other infection for that matter. But this approach is not scientific, rather political.
COMMENTARY
Arkadiy Frolov
Epidemiologist, former Director of the Ukrainian Center for Influenza
This year Ukraine is bracing for three influenza strains ? two Type A "Brisben (H1N1 and H3N2) and one type B ?Brisben".
A (H3N2) has already been in Ukraine, while A (H1N1) is the swine flu. The WHO has already moved them into the category of seasonal because the pandemic has passed into the sixth and final stage. And the third type ? type B, the probability of a breakout of which in Ukraine is quite low. Despite this, it is also included as a component in the process of developing anti-flu vaccines.
As for reports the WHO and allegations that Ukraine was not gripped by a pure swine flu, rather its mutation, those who received such results have the right to interpret them differently. But the first cases in the study I participated in focused on the classical swine flu virus. However, it would not hurt Ukraine?s ministry of healthcare to purchase a sequencer in order to determine the type and subtype of any given virus. For example, I know that previously circulating viruses mutated and even lost their sensitivity to rimantadine. This must be monitored in order to heal an infected person and understand what exactly we are fighting.
Scientists say that the swine flu virus in Ukraine had a lethal mutation
PHОТО: PHL
Autumn is upon us and the next swine flu epidemic is not far behind. Ukraine?s citizens have begun preparing for the flu in every possible way
The state enterprise Ukrvaktsyna has filed a lawsuit with the Federal Court of Portland (Oregon, U.S.) against the American company Olden Group accusing it of engaging in financial fraud schemes connected with the supply of vaccines to Ukraine.
Minister of Healthcare Zinoviy Mytnyk already informed Ukrainian citizens that there will be no free vaccination against flu this year.
Citizens have already stockpiled Tamiflu medicines procured in Ukraine last year in massive quantities. After all, whatever is said about the artificially inflated panic over the flu, it gave people quite the scare. The entire country anxiously looked at one another over flu masks. According to official data of the healthcare authorities, the last year?s flu killed 1,126 people, who died a horrible death from asphyxiation caused by pulmonary edema. This flu had not been in Ukraine since the Civil War.
Sticky death
Unfortunately, last year?s epidemic, which officially lasted from October 29, 2009 to March 21, 2010 almost exactly coincided with the presidential campaign and the elections, and was used as one of the main campaigning tools. It is no surprise than that not only medical chiefs but also ordinary doctors, were confused by the diagnoses that nation?s leaders made for Ukrainians suffering from the flu. Doctors? heads were spinning even without authoritative advice: what happened with the ailing by all medical canons should not have happened. Moreover, the mortality rate in Ukraine from the disease was 10 times higher than in neighboring countries while the symptoms were the same.
Unfortunately, the reason for this was discovered only after the patients died. Doctors took samples of lung tissues and experts of the World Health Organization established the genetic code of the Ukrainian variety of the swine flu H1N1. Our virus had a mutation (the scientific name of D225G), which made the Ukrainian flu far deadlier than the same disease in other countries.
The distinctive feature of the swine flu was that it was not limited to the upper air passages but strived to get through to the lungs where it causes viral pneumonia. It began when a virus is attached to the cell surface of the lung.
A mutation of D225G is causes the virus to adheres tightly to the surface of the lungs very strongly. Treating a viral pneumonia with antibiotics is useless. The pulmonary edema must be prevented at any cost up to connecting the patient to an artificial breathing apparatus to support the body until it will be able to fight the infection.
Esprit de corps
The decryption code of the Ukrainian strain of the flu is now included into the global database, which shows that such a mutation has never existed before. Something similar was with the case of the infamous "Spanish flu".
In 1918, the "Spanish flu" killed millions of people as there were no antibiotics or modern treatment methods to prevent this at the time. And the fact that people who were treated in a hospital last season were dying by thousands was unheard of. Even the number of people that died during the major avian flu pandemic (H5N1) six years ago was lower. Then, the avian flu killed 227 people, which triggered major uproar all over the planet. Last winter more than a thousand Ukrainians died from this flu and it looked like nobody even noticed.
It is pointless to speak of the lack of response on the part of the country?s leadership. Everything is crystal clear. But why even officials of the World Health Organization, which unites all the data on influenza, did not sound off the alarm bells is not understood. They must?ve been too busy trying to justify themselves claiming that they did not take money from pharmaceutical companies to promote drugs against the flu.
Be that as it may, an analysis by WHO experts revealing a mutation of the Ukrainian virus rehabilitated the image of Ukrainian doctors even though the latter did not need any excuses. They know better than anyone that they were doing everything possible to fight the virus within their understanding of the situation.
As for domestic flu experts, contrary to the obvious fact of mutation, they somehow still try to defend the honor of their uniform, saying that when they examined the virus it was "normal", adding that they had no device to determine the mutation. Do you understand? There could not have been a mutation because they had no means of detecting it (see comment).
No money!
In any case, this is a thing of the past. The epidemic is over and it is not likely the situation will repeat. The chances of the epidemic to return from the viewpoint of epidemiology are indeed slim to none. Ukraine this year will again be hit by the same swine flu, but it is not likely to be of the same scale as this time the Ukrainians will have immunity against the strain. If there is an epidemic, it will be of some different strain. The question is what strain?
Seeing has a time machine has yet to be invented, nobody can find out the answer to this question. However, apparatuses have been invented that give a virtually instant response to doctors as to what mutation they may be up against. Such an apparatus called a sequencer helped WHO experts to discover the mutation in the Ukrainian influenza virus. They were asked personally by the former president of Ukraine Viktor Yushchenko to conduct testing using this device (probably after our flu experts reported that everything is going well: the virus is common and Ukrainians are dying in a normal mode. In Ukraine, such testing could not be conducted due to the lack of equipment and shortage of trained personnel to operate them.
The device is expensive worth approximately US $1 mn. In addition, supplies for it cost around US $40,000. The device is used not only to detect a mutant influenza. It has no equals in treating cancer these days. So, it will not be a waste of money after all. Te problem is there is not sufficient money in the national budget for the purchase of sequencers for all regional medical centers and personnel training.
Many will likely be shocked to hear, however, that not a single penny is required from the budget. Throughout the world most express-diagnostics labs (for detecting all diseases, not only the flu) are privately owned. This is a highly profitable business and all private labs pull in enough revenues from the services they render.
All that is needed is a change in the system: don?t treat the nation, treat patients. If that be the case this will probably a bona fide preparation for the next influenza pandemic or any other infection for that matter. But this approach is not scientific, rather political.
COMMENTARY
Arkadiy Frolov
Epidemiologist, former Director of the Ukrainian Center for Influenza
This year Ukraine is bracing for three influenza strains ? two Type A "Brisben (H1N1 and H3N2) and one type B ?Brisben".
A (H3N2) has already been in Ukraine, while A (H1N1) is the swine flu. The WHO has already moved them into the category of seasonal because the pandemic has passed into the sixth and final stage. And the third type ? type B, the probability of a breakout of which in Ukraine is quite low. Despite this, it is also included as a component in the process of developing anti-flu vaccines.
As for reports the WHO and allegations that Ukraine was not gripped by a pure swine flu, rather its mutation, those who received such results have the right to interpret them differently. But the first cases in the study I participated in focused on the classical swine flu virus. However, it would not hurt Ukraine?s ministry of healthcare to purchase a sequencer in order to determine the type and subtype of any given virus. For example, I know that previously circulating viruses mutated and even lost their sensitivity to rimantadine. This must be monitored in order to heal an infected person and understand what exactly we are fighting.
