WHO team arrives to assist with Ukraine flu probe
Lisa Schnirring Staff Writer
Nov 3, 2009 (CIDRAP News) – The World Health Organization (WHO) said its team arrived in the Ukraine last night and met with the country’s health ministry today to discuss a dramatic spike in flulike illnesses and deaths, particularly in the western part of the country.
The Ukrainian health ministry has recorded more than 250,000 flulike illnesses, of which 235 patients needed treatment in intensive care units, the WHO said in a statement today. As of yesterday, 70 deaths had been reported.
The high level of illnesses activity and severe cases, combined with reports of hemorrhagic pneumonia cases, have raised some speculation that the virus might be behaving differently in the Ukraine, but further testing is just getting under way.
Laboratory testing at labs in the Ukraine have confirmed the pandemic H1N1 virus in samples taken from patients in two regions, the WHO said, adding that because the pandemic virus has become dominant throughout the world, most of the Ukrainian respiratory illnesses are probably caused by the novel H1N1 strain.
Though the highest illness rates have been seen in the western part of the country, illness activity is increasing rapidly in Kiev, the WHO reported.
The WHO’s field investigation team will start in the Lviv region, where the number of cases of severe respiratory illness has been especially high. Virologists from the WHO have started working with Ukrainian scientists at the National Influenza Centre and the Central Sanitary and Epidemiological Station, both in Kiev.
Ukraine’s health ministry has sent viral samples to the WHO collaborating center in London, where laboratory experts will conduct confirmatory tests and further characterize the virus.
The outbreak raises several questions and may provide clues about how the virus will circulate in the Northern Hemisphere during the winter months, particularly in areas such as Eastern Europe that have healthcare challenges.
The WHO commended Ukrainian officials for their transparent reporting and open sharing of viral samples. It also said border closures and international travel restrictions are not warranted.
Lawmakers in the Ukraine today approved legislation freeing up $1 billion UAH (about $131 million) in reserve funds for flu response actions, according to a report from UNIAN, the country’s independent news agency.
The country’s head sanitary inspector today, in a television interview, denied that the country was experiencing an outbreak of pandemic flu and said only 14 cases had been confirmed, including three deaths, according to another UNIAN report today.
Meanwhile, two of Ukraine’s top leaders, who are opponents in a January presidential election, scrambled to respond to the flu outbreak, UNIAN reported. President Victor Yuschenko instructed the military to prepare portable military hospitals, and Prime Minister Yulia Tymoshenko promised to provide all of the country’s residents with masks to reduce their flu exposure.
An official from the Ukraine’s flu and respiratory disease center, Oleksandr Hrynevych, today projected that pandemic H1N1 vaccination could begin in a month or two after regulators approve two vaccines that are undergoing testing, according to a report from the National Radio Company of Ukraine (NRCU). He said the vaccine supply will come from the WHO and from individual country donations.
A warden message posted on the US State Department’s Ukrainian embassy Web site said US officials are aware of the outbreak and are monitoring the situation. Though the country has imposed several social-distancing measures, such as a 3-week school closure, Ukrainian officials have told the State Department that no general quarantine is in effect.
The US embassy said that, because of legal restrictions and lack of resources, it is not able to provide private citizens with pandemic supplies, medication, medical treatment, or medical advice.
http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/nov0309ukraine.html
Hat Tip to Cascadians on TB2 & PFI Poster BeWell
04.11.2009 19:00
Press office of President Victor Yushchenko
President’s address to the Ukrainian people on the occasion of flu epidemic in Ukraine
http://www.president.gov.ua/en/news/15609.html
Dear fellow citizens!
I address you in performance of my constitutional duty under the Article 106 of the Basic Law of the state.
The reason is the emergency epidemic situation in the country.
Infections of viral origin, including the A/H1N1 flu, are rapidly spreading across Ukraine.
The emergency is evident in the scale of the epidemic: the speed and the geography of its spreading, rapid progress of the illness and the exceptional number of deaths.
People are dying. The epidemic is killing doctors. This is absolutely unprecedented and inconceivable in the XXI century.
All the limits have been exceeded - even those under the Constitution that determine my actions as the President.
Therefore I am motivated by the most important: the security of your life and your health.
Therefore I give clear and frank assessment of the situation. And you should know that.
We have special risk factors that aggravate the epidemic in Ukraine.
The conclusions of the National Security and Defense Council of Ukraine, my numerous consultations with national and international experts show that.
First. Unlike similar epidemics in other countries, three pathogens of viral infections came to Ukraine at the same time: two of them are seasonal flu and the third is the A/H1N1.
According to virologists, such a combination of infections due to mutation may produce a new, even more aggressive virus.
That’s why I have addressed the United Nations with the request to conduct a virologic examination in Ukraine and to establish the appropriate laboratory in order to take timely preventive measures.
Second. The A/H1N1 virus is easily mutating. It has travelled across half of the globe before coming to Ukraine.
This means that the virus has become particularly pathogenic.
This means that medical aid must be urgently reinforced by emergency, critical care treatment.
The third risk factor. It is generally known that the only way to prevent any infection is vaccination.
Due to unprofessional and highly disorganized vaccination against measles and rubella in Ukraine the practice of vaccination is compromised in essence.
According to the estimates of the Minister of Health approximately 58% of citizens are vaccinated today in Ukraine with the effective level being 90% and higher.
People have stopped getting vaccinated against extremely dangerous infections: tuberculosis, diphtheria, etc.
This led to high risk of A/H1N1 infection spread, when the virus came to Ukraine and made impossible preventive vaccination against both strains of seasonal flu.
All this made general epidemic situation in Ukraine even more complicated.
As the President I ask you, dear fellow citizens, to reconsider your attitude to vaccination and do it if necessary, but only, I emphasize it - only after consultation with the doctor.
At the same time I instruct the Government and the Ministry of Health to immediately start preventive and promotional work in areas where there is no epidemic, targeting primarily the special risk groups.
I demand the Government to immediately cancel the existing order of registration of medical supplies, including vaccines.
Studying this issue by the National Security and Defense Council shown that this procedure has allowed various dealers to bring to Ukraine dubious medicines, which are not recognized by the WHO or other national institutions.
Under my direction the Security Service is investigating the issue.
The fourth factor. In reality it is the Reactor 4.
I mean the epidemic, rapid spread of viral infections in the west of the country. The Government, the leadership of the Parliament and the opposition were all aware of that already in early October.
The first and the most effective preventive measure is avoiding large gatherings of people.
Ignoring this principle, hundreds of thousands of people from different regions were brought to Kyiv; from both the areas struck by the epidemic, and those where there was no evidence of this epidemic.
This greatly increased the risk of infection.
I emphasize: it was a well-known thing. And it was ignored by the Chairman of the Parliament, by the opposition leader and, first of all, by the Prime Minister. And Chief Sanitary Inspector, together with his subordinates in the regions, including those in the city of Kiev ignored their professional duty.
This directly reminds of the May Day demonstration in Kiev, held shortly after the accident at Chernobyl NPP.
This is a display of criminal irresponsibility of politicians and complete indifference towards the people.
Let me cite one example. On October 20 the epidemic of flu was declared in Ternopil with schools and kindergartens closed for quarantine. “From October 21 secondary and primary schools are closed due to the growing rate of flu and ARD sickness”. This was the order of local authorities.
As of October 20 the rate of ARD in Ternopil was 172.9 cases per 10 thousand people with epidemiological threshold for the city being 160 patients per 10 thousand people. In other words - all services of the country responsible for monitoring the figure were informed and knew about the situation.
However, not a single Sanitary Inspector has banned either the movement of people, nor their gathering, including those in Kiev on October 24, when people have gathered at the central square.
I would like to remind you, my dear, that on October 24, 2009 10 deaths were known to have occurred in Ternopil region itself and 6 deaths were reported in Lviv region. And in 7 days after the abovementioned gathering Kyiv turned out in the situation, when the rate of sickness demanded the announcement of flu epidemic. This is the behavior of the great politicians. The neglect of elementary means of prevention of a disease in any country in the world, by any society. Because they must conduct a show, they have concerts, because they were paid for and 130 million have already been spent.
In that, dear Ukrainians, I see not only moral but also criminal liability.
I have addressed the Prosecutor General of Ukraine with the request to institute criminal charges of negligence committed by first of all the Chief Sanitary Inspector, Kyiv City Sanitarian and the officials, who, despite having daily information on the epidemic situation in the country, neglected it in pursuit of political dividends and ambition.
Now, the only principle of organizing preventive measures at the national scale should be as follows:
We treat the West and defend East, Center, North and South of Ukraine amain.
I now rely solely on the professionalism of our doctors. Today they are the true heroes of our nation.
I once again demand the Government to comply with the order the National Security and Defense Council to resolve the issue of wages for our doctors in this difficult period for the country.
The fifth factor.
Dear fellow citizens, the key threat that is aggravating the situation is chaos in the system of healthcare and protection of lives of people.
Today we must recognize that Ukraine does not have a single healthcare system. Prevention of any infection, including through vaccination, the localization and overcoming the consequences of epidemics is the responsibility of the State Sanitary-Epidemiological Service of Ukraine.
The Service is headed by the Chief Sanitary Inspector. He is appointed by the Prime Minister.
The current Constitution after alterations in 2004 makes the Government solely responsible for conducting state healthcare policy.
The practice of using the power, as evident today, is a failure.
To the executive power, which is not subordinate to the President, I have suggested the holistic healthcare reforms plan and a set of instructions and recommendations that would help create the optimal model of the system for years to come. My remarks were presented as the groundless interference in Government’s work and as the unfounded criticism.
Back in April of 2009 I addressed the Government with the request to establish a special interdepartmental commission on fighting the spread of flu viruses, to finance the establishment of Flu Center and to take all measures to protect the country against flu. That included providing adequate availability of medicines, facemasks and all other necessaries.
Partial implementation of the instructions has its consequences.
They were not ignoring me – they were ignoring the people, the citizens. It is clear why. Because Ukraine still has unfair system of healthcare - one is for the power, the other is for the people.
We must change the system. We must change the entire system of government in Ukraine.
But now, in this moment there is no time for waiting or remonstrance.
National Security and Defense Council should become the center of decision-making.
Failure to comply with its orders will immediately result in application to the law enforcement authorities.
I remind all the responsible persons and draw attention to all of my orders, made in Lviv four days ago. In three days the deadline for compliance with these orders expires.
With my decree I put Minister of Health and Chief Sanitary Inspector of Ukraine into the Council for National Security and Defense.
I am conscious of my responsibility.
I express deep condolences to the families and relatives of those who have died.
I express my deep appreciation to doctors, who are saving our people risking their own lives. I am moved by this sacrifice. Such a commitment means that the epidemic will be stopped.
I appeal to all of you, dear fellow citizens, to show solidarity, mutual support, and strictly adhere to all the safety regulations regarding protection of your health and lives.
For not a single moment you will be left alone by the state.
Thank you for your attention.