Schweinegrippe (Influenza) A H1N1 in der Ukraine- die Fakten laut WHO

On 28 October 2009, the Ministry of Health of Ukraine informed WHO, through its Country Office in Ukraine, about an unusually high level of activity of acute respiratory illness in the western part of the country, associated with an increased number of hospital admissions and fatalities.

On 30 October 2009, the Ministry of Health of Ukraine announced the confirmation of pandemic (H1N1) 2009 virus infection by RT-PCR in eleven out of 30 samples obtained from patients presenting with acute respiratory illness in two of the most affected regions. Tests were performed in two laboratories in Kyiv, including the National Influenza Centre. Confirmatory tests will be performed at one of the WHO Collaborating Centres for Influenza.

The situation is quickly changing with increasingly high levels of acute respiratory illness (ARI)/Influenza-like-illness (ILI) activity being observed in Ternopil, Lviv, Ivano-Frankivsk, and Chernivtsi regions. The higher levels of transmission in these regions corresponds to an increased number of hospital admissions and fatalities associated with severe manifestations of acute respiratory illness.

As of 30 October 2009, over 2,300 individuals have been admitted to hospital, including over 1,100 children. One hundred and thirty one (131) cases have required intensive care, including 32 children. As of 31 October 2009, a total of 38 fatalities associated with severe manifestations of ARI have been registered. Preliminary epidemiological data analysis indicates that severe cases and deaths primarily occur among previously healthy young adults aged 20 – 50 years. Fatal and severe cases are reported to have sought medical attention 5 to 7 days after onset of symptoms.

International experience of the (H1N1) 2009 pandemic to date, especially from the Southern Hemisphere, has shown that poor clinical outcomes are associated with delays in seeking health care and limited access to supportive care. In addition, this virus has also shown its ability to cause rapidly progressive overwhelming lung disease which is very difficult to treat.

Public health measures recommended by the Ministry of Health of Ukraine across the entire country include: social distancing (school closures and cancellation of mass gatherings); enhancement of surveillance activities; increased respiratory hygiene; and continuation of the vaccination campaign against seasonal influenza targeting at risk groups.

The Government of the Ukraine has activated coordination mechanisms to respond to the rapidly evolving situation, including the harmonization of response plans across all administrative levels.

In response to the request from the Minister of Health of Ukraine, WHO is deploying a multi-disciplinary team of experts to assist national authorities in mitigating the impact of the pandemic. The team comprises of the following expertise: health emergencies coordination, case management, epidemiology, laboratory diagnostics, logistics, and media/risk communications.

As per WHO's communication in May 2009, there is no rationale for travel restrictions because such measures will not prevent the spread of the disease.

Travellers can protect themselves and others by following simple recommendations aimed at preventing the spread of infection such as attention to respiratory hygiene. Individuals who are ill should delay travel plans and returning travellers who fall ill should seek appropriate medical care. These recommendations are prudent measures which can limit the spread of many communicable diseases and not only the pandemic (H1N1) 2009 virus.



3 November 2009 -- According to the Ministry of Health of Ukraine, the country has now recorded more than 250 000 cases of influenza-like illness, with 235 patients requiring intensive care. As of 2 November, 70 deaths from acute respiratory illness have been reported.

Regions in western Ukraine continue to show the highest rates of acute respiratory illness/influenza-like illness. The level of activity in the Kyiv area is also increasing rapidly.

Laboratory testing in Ukraine has confirmed pandemic H1N1 influenza virus in samples taken from patients in two of the most affected regions. As the pandemic virus has rapidly become the dominant influenza strain worldwide, it can be assumed that most cases of influenza in Ukraine are caused by the H1N1 virus.

As elsewhere, WHO strongly recommends early treatment with the antiviral drugs, oseltamivir or zanamivir, for patients who meet treatment criteria, even in the absence of a positive laboratory test confirming H1N1 infection.

At the request of the government, a multi-disciplinary team of nine experts has been deployed by WHO and arrived in Kyiv yesterday evening. Discussions with the Minister of Health were held this morning to brief the team.

Team members will now begin field investigations to characterize the clinical and epidemiological features of the outbreak. Work will initially begin in Lviv region, where reported numbers of cases showing severe manifestations of acute respiratory illness have been especially high. Two virologists on the team have started working at the National Influenza Centre and the laboratories of the Central Sanitary and Epidemiological Station in Kyiv to provide diagnostic support.

Samples sent by the Ministry of Health were received today by the WHO Collaborating Centre for Reference and Research on Influenza, Mill Hill in London, UK. The laboratory will conduct confirmatory tests and further characterize the virus.

Many questions remain to be answered. The outbreak in Ukraine may be indicative of how the virus can behave in the northern hemisphere during the winter season, particularly in health care settings typically found in Eastern Europe.

Given the potential significance of this outbreak as an early warning signal, WHO commends the government of Ukraine for its transparent reporting and open sharing of samples.

WHO continues to recommend no closing of borders and no restrictions on international travel, including to Ukraine. Experience shows that such measures will not stop further spread of the virus.

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