Azerbaijan, Baku, May 12 / Trend , S. Babayeva/
World Health Organization Azerbaijan Representative Office Head Kamran Karakhanov's spoke in an exclusive interview with Trend .
Trend : Can you please provide main information about new Influenza A/H1N1?
Kamran Karakhanov: Influenza A/H1N1 (referred to as "swine flu" early on) is a new influenza virus causing illness in people. An unusual increase in the number of influenza-like illness (ILI) cases was detected in Mexico starting at the end of March 2009. The new virus was first detected in people in April 2009 in the United States.
The reason why this virus was originally referred to as "swine flu" is because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs. But further study has shown that this new virus is very different from what normally circulates in pigs. It has two genes from flu viruses that normally circulate in pigs and avian genes and human genes.
Outbreaks in humans are now occurring from human-to-human transmission. When infected people cough or sneeze, infected droplets get on their hands, drop onto surfaces, or are dispersed into the air. Another person can breathe in contaminated air, or touch infected hands or surfaces, and be exposed.
Early signs of influenza A(H1N1) are flu-like, including fever, cough, headache, muscle and joint pain, sore throat and runny nose, and sometimes vomiting or diarrhea.
Many infections reported travellers who tend to be younger people. More cases have been mild than severe. Milder cases of illness show seasonal flu symptoms - fever, cough, aches. In severe cases (i.e. Mexico and some US cases), there have been pneumonia and respiratory infections, hospitalizations, and deaths. Males and females infected at about the same rate. Incubation period - 1-5 days. There are no specific measures - vaccine, antivirals for prevention and etc. - to prevent influenza A/H1N1.
Q: How situation in the world is evolving in regard with the Influenza A/H1N1?
Situation in the world is evolving very rapidly. As of 06:00 GMT, 12 May 2009, 30 countries have officially reported 5251 cases of influenza A(H1N1) infection. Mexico has reported 2059 laboratory confirmed human cases of infection, including 56 deaths. The United States has reported 2600 laboratory confirmed human cases, including three deaths. Canada has reported 330 laboratory confirmed human cases, including one death. Costa Rica has reported eight laboratory confirmed human cases, including one death.
The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Brazil (8), China (2, comprising 1 in China, Hong Kong Special Administrative Region, and 1 in mainland China), Colombia (3), Denmark (1), El Salvador (4), France (13), Germany (12), Guatemala (1), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Norway (2), Panama (16), Poland (1), Portugal (1), Republic of Korea (3), Spain (95), Sweden (2), Switzerland (1) and the United Kingdom (55).
On April 29 based on assessment of all available information and following several expert consultations, Dr Margaret Chan, WHO's Director-General raised the current level of influenza pandemic alert from phase 4 to 5. She stated that all countries should immediately activate their pandemic preparedness plans. At this stage, effective and essential measures include heightened surveillance, early detection and treatment of cases, and infection control in all health facilities (Phase 5: The identified virus has caused sustained community level outbreaks in two or more countries in one WHO region).
Q: What is the role of WHO and what WHO is doing at the global level in relation with Influenza A/H1N1?
A: WHO is coordinating the global response to human cases of influenza A(H1N1) and monitoring the corresponding threat of an influenza pandemic. While continuing to monitor the virus, WHO is taking an operational response to outbreaks in collaboration with other UN partners and NGOs.
WHO DG continues to discuss with pharmaceutical companies on how best to future needs of antivirals for developing countries. On diagnostic front, WHO Collaborating Centres and USCDC are dispatching diagnostic kits to all influenza collaborating labs to dispatch to national labs.
WHO HQ's SHOC room (Strategic Health Operation Centre) in Geneva is the centre where WHO's data, information and various task teams are coordinated. Over 100 WHO staff in Geneva are committed to this, working on global tracking, monitoring, vaccine development, antivirals, virology, etc.
WHO has been issuing guidance on a wide range of areas, including travel restrictions, pandemic preparedness, antivirals, use of face masks and pork meat safety.
Q: What about situation in Azerbaijan?
A: According to the official information we are receiving regularly on a daily base from the Ministry of Health no suspected cases are registered in Azerbaijan.
It is worth to mention that country capacity in terms of coordination, rapid response, epidemiological and laboratory surveillance, diagnosis and treatment are at a quite high level at the moment. Experience gained by the country during the outbreak of Avian Influenza in 2006 played a very significant and important role in pandemic preparedness.
On April 28, 2009 the State Commission on Pandemic influenza had a meeting devoted to the situation with the A/H1N1 flu. The meeting was headed by Mr Yagub Eyyubov, Chirman of Commission, the First Deputy Prime-Minister. On the meeting the National Pandemic Preparedness Plan endorsed by the State Commission on August 8, 2008 has been activated. All relevant Ministries and Committees were charged to take necessary measures.
The Ministry of Health identified reference hospitals for admission of cases. National Virology Laboratory started laboratory surveillance, republican Center of Hygiene and Epidemiology is taking care about epidemiological surveillance of all influenza like illnesses. The Ministry of Health is also coordinating the work with medical services of Azerbaijan Airline Company, Azerbaijan Railways Company and Caspian Shipping Company.
Q: What WHO is doing in Azerbaijan about swine flu?
A: WHO Country Office in Azerbaijan is leading Influenza A/H1N1 efforts on behalf of UN Azerbaijan. WHO office in Azerbaijan also leads coordination of UN support to Government efforts as well as speaking as the "One Voice" of the UN Azerbaijan on the influenza epidemic. We are also in close contacts with other international organizations (International Committee Red Cross, United States Agency for International Development and different embassies) to coordinate support to the country if necessary.
We are working closely with the Ministry of Health on strengthening of laboratory and treatment capacity of the country. In addition to the national stock we will shortly provide a country with the specific test kits for laboratory and antivirals for treatment of cases.
All WHO guidelines are under translation into Azerbaijani now and will be submitted to the Ministry of Health by the end of this week.
If situation will require WHO is ready to provide all kinds of needed additional technical support to the country.
I would like also to mention that we have a very good experience of collaborating with the Government during avian influenza outbreak in 2006-2007. During these years with WHO assistance necessary tools for rapid surveillance and adequate response have been developed and approved (WHO recommended AI case definition, epidemiological surveillance card, contacts tracing form, treatment protocols and etc.), Avian Influenza guidelines and action plan has been developed and approved, engineering lay-out for isolation facility for air-borne diseases has been developed. By the way construction of this isolation facility, which is very modern, is almost completed. WHO took active part in development of the National Influenza Pandemic Preparedness Plan. Last year our experts assisted to work out preparedness plan for MoH in case of such epidemics. We organized and facilitated in cooperation with other international organizations a series of trainings for national specialists on infection control, IHR (2005), epidemiology and etc.
WHO is also working with the Ministry of Health on implementation of new Infection Control Guidelines. The project is ongoing. This activity envisages assessing, intervening and evaluating country's preparedness for acute respiratory diseases in the tertiary health care level. The field evaluations will review and update the current Infection Control Policy taking into account the local conditions, also how the national standards would be in the near future. Infection Control for itself is a cross-cutting issue and different areas of the health sector will benefit of the results obtained from this guideline implementation. For the first time in the European region an interim World Health Organization Infection Control guideline will be field evaluated before its implementation. By now more than 300 specialists, including 60 people from 30 districts of Azerbaijan have been trained. National trainers on Infection Control have been prepared.
In order to raise awareness about the scope of the new International Health Regulations (IHR), including obligations of States Parties and WHO, provide a platform for IHR-related multisectoral/interdisciplinary communication and coordination in Azerbaijan, assist Azerbaijan in the IHR-related planning process and initiate the process of structuring an early warning and response system with the contribution of key national stakeholders round table with participation of related governmental agencies has been conducted.
All these work contributes now to the level of preparedness of the country to the current threats.
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