– According to Rospotrebnadzor, more than 70 regions of Russia are already experiencing cases of swine flu. What is its danger compared to other strains?
Influenza is a heterogeneous infection.
Different strains cause different variants of the disease, but if we talk about the currently actively circulating H1N1 / 09 swine flu, then its peculiarity is that it can affect both at-risk age groups – that is, young children and the elderly. healthy and capable adults. A separate problem is pregnant women, where swine flu can cause very serious lesions, up to wilting of pregnancy and death in the women themselves.
Classic risk groups for influenza are people suffering from certain types of chronic pathology, including hypertension, stroke survivors, cancer and patients with autoimmune lesions, congenital or acquired immunodeficiency. Problems of an allergic nature, for example, with bronchial asthma. Almost every chronic illness is activated or worsened by the flu, which can cause delayed death when the patient dies a few months after the illness.
The second problem is that the flu virus itself, after an acute primary infection, causes the so-called post-flu anergy – a weakening of the forces.
First, it concerns general well-being – people stay sane for a long time, their general working capacity is impaired, such that people are forced to change their jobs, especially if they are associated with physical or high-level intellectual labor. Second, the flu opens the door to bacterial infection. This pair, influenza and pneumococcus, often accompanies each other. And in people in the second or third week, when the condition seems to have returned to normal, purulent complications often occur. If we talk about children – purulent otitis media, pneumonia is not uncommon. Older people may have sinusitis. It is also worth mentioning also young or middle-aged active people who, with early activation, often suffer from complications from the heart and kidneys after having a flu infection, which can significantly affect their overall health later on. acquisition of a kind of chronic pathology.
– What percentage of the population usually manages to catch the flu during the winter months? Is there an increasing trend in this share this year?
– It is difficult to give exact figures on the number of infections. Case detection depends on population coverage tested, species characteristics, and other factors, so estimates do not always correspond to reality. We can only talk about trends and there is indeed an upward trend in incidence.
There is the concept of immune debt, namely the delay of meeting routine, circulating pathogens. Quarantine measures have caused us to see an increase in cases of acute respiratory viral infections, bacterial respiratory tract infections, whooping cough and meningitis in the last epidemic season. And the situation is even more complicated, including this year’s flu infection.
It arrived in Russia en masse, literally within a week or two, and this is not very typical of the current circulating flu strain called swine flu. The spread of infection is a multifactorial process, dependent on both quarantine measures and non-specific prophylaxis, but there is a direct correlation with the extent of immunoprophylaxis, that is, vaccination.
“The debate about the need for a flu vaccine flares up every year – they say that strains mutate so quickly and there are so many variants circulating that vaccines cannot protect against them. To what extent are such statements true?
– The professional community certainly agrees on this, and we are talking not only of Russia, but also of other countries where circulating strain variants have been traced for more than a hundred years: the predictions of which strains will circulate in the epidemic are quite accurate throughout the season, and vaccination can reduce morbidity and the number of complications.
Of course, the accuracy varies from year to year, but the strains circulating in Russia this year – H1N1 / 09 and the influenza B variant – fully correspond to the estimate and strain composition of the vaccines used in the country. Therefore, vaccination is possible and necessary.
The recommendations are the same in all countries. In the northern and southern hemispheres, winters are opposite in time, and based on how common a particular species is in one part of the world, you can calculate what to expect elsewhere. It is carried out by the Influenza Research Institute – mainly in Russia – on the basis of year-round monitoring. AA Smorodintseva — Around February, WHO gives vaccine manufacturers a direct recommendation on strains for the next epidemiological season.
– As for the vaccines themselves, not everything is clear either. Whole virion, split vaccine, subunit, virosomal – which is better?
– Today, in Russia, the so-called inactivated vaccines of three variants are most widely used: split (or split vaccines) containing virus fragments, the subunit containing only the surface antigens of the virus, and the subunit adjuvanted, where a substance that enhances the immune response is added to the antigens. The latter belongs to the new generation of vaccines, but in fact it has been used in our country for more than 20 years. All of them have been registered and have demonstrated their effectiveness in large-scale studies. It is also now developing several options for universal – eg recombinant – vaccines.
— Some subunit vaccines are criticized for their low antigen content. How many do you need for a vaccine to be effective?
— Critics should delve further into vaccine production, because one of the main limiting factors of the vaccine platforms I mentioned earlier is the problems in producing the large number of antigens used in these vaccines. In connection with this, many countries, for example Western Europe – and not to mention the so-called third world countries – do not have free vaccines on their national calendars and are forced to purchase vaccines. because their production is quite a complex thing.
WHO guidelines assume that the universal dosage is 15 micrograms for each of the strains. However, if the manufacturer can create a vaccine that maintains immunogenicity while reducing this volume, this tactic is advantageous as it allows the vaccine to be produced faster and be more accessible to the general population. Therefore, a very important element, I repeat, is the introduction of immunoadjuvants.
They are not applied only in our country. For example, adjuvant MF59 is used in US vaccines, and in this case the results of large-scale studies of immunoadjuvant vaccines being conducted in very large cohorts of the population break criticism. Meta-analyses cover more than one hundred thousand people.
The composition of vaccines must meet safety requirements, tested at all stages – pre-clinical, clinical and post-registration. Both performance parameters are evaluated. Efficiency is divided into immunological and epidemiological. In the first case, the parameters of humoral, that is, antibody immunity of those vaccinated, as well as in Russia and the CIS countries – cellular immunity are evaluated. In the second, they compare cohorts of people, some vaccinated and some unvaccinated, and assess how they get sick and sometimes, possibly die, in the future.
And if the vaccine has not demonstrated its effectiveness, it will not be put into production. The manufacturer will not discredit himself. In addition, this is still a market and the purchase of certain drugs depends on whether they are competitive.
– Why is it not recommended to carry the flu on your feet?
– First of all, the vascular-heart-brain connection plays a role in determining what general condition a person will have. The flu actually causes an immune storm, followed by a period of decline. Therefore, even a slight increase in activity can cause complications. Many consider intellectual activity to be a meaningless burden compared to physical – for example, if we compare the work of a programmer or artist with the work of a loader.
But the fact is that the brain is the largest consumer of nutrients and is extremely dependent on the work of the vascular system, which can suffer from microthrombosis during the flu – something similar is observed in the complications of COVID-19. And indeed, the flu creates conditions in which the routine burden becomes unbearable.
This is noted by the patients themselves – their performance decreases for a long time. The advanced prognosis, not only for the coming months but also for the years to come, largely depends on the rehabilitation period after an acute infection. Many people suffering from infections that are not very healthy in terms of rehabilitation can get a variety of ailments, including the vascular system. For example, they may develop hypertension that they did not have before.
– Is there a risk of the current situation regarding infections getting out of control and making vaccination mandatory?
– If you open the sanitary rules, in the subsection “Influenza Prevention” you will find categories of citizens with certain health, age and professional employment on the territory of the Russian Federation, who since 2005-2006 have been subject to mandatory influenza vaccination. clearly stated, which is reflected in the national immunization schedule.
So there is no change here in terms of unpredictability and an impact on the population, especially since the flu is literally the king of respiratory infections.
There are proven preventative drugs, there are populations that need to be vaccinated. But in Russia, anyone can voluntarily refuse to be vaccinated against COVID-19, flu or other infections. However, in addition to the recommendations of the Ministry of Health and Rospotrebnadzor, there are internal orders for employees of medical, housing and social, educational and some other institutions – and such employees must necessarily be vaccinated. Without this they will not be allowed to work.
Source: Gazeta
Barbara Dickson is a seasoned writer for “Social Bites”. She keeps readers informed on the latest news and trends, providing in-depth coverage and analysis on a variety of topics.