La nueva gripe A H1 N1 o swine flu, se constituye como la primera pandemia del siglo XXI: La OMS eleva la alerta de la gripe A al nivel 6.

Como ya hemos comprobado que esta nueva gripe es leve podemos hacer alguna broma y anunciar a bombo y platillo: Señoras y Señores “Tenemos el dudoso honor de anunciar la primera pandemia del siglo XXI”.

 

Hace tiempo esperábamos que la OMS declarara la fase 6 de pandemia porque se habían cumplido las condiciones para hacerlo, es decir, que la propagación del virus afectara a más de una región de la OMS y que exista transmisión de persona a persona sin contacto con los focos primarios de la enfermedad ( México y EEUU) y que aparezcan brotes comunitarios en, al menos, otro país de otra región de la OMS.

 

Esto es lo que tiene el utilizar en la clasificación únicamente criterios geográficos; como ya dijimos en un post anterior esperamos que la OMS haga una revisión de las fases de pandemia e incluya otros criterios (como ya reclaman muchos expertos) entre los que se incluya la gravedad de la enfermedad.

 

La directora de la Organización Mundial de la Salud (OMS), Margaret Chan, ha anunciado el aumento del nivel de alerta. “El virus se transmite fácilmente entre personas y entre países. Por eso he decidido elevar el nivel de alerta”, dijo Chan.

 

Hay que dejar claro que el aumento de la fase de alerta responde a cuestiones de extensión del virus y de su facilidad de transmisión, no porque haya empeorado el diagnóstico, ni haya aumentado la mortalidad.

La directora de la OMS Margaret Chan nos recuerda que: “Pandemia quiere decir una enfermedad que se propaga rápidamente” y añadía que la decisión refleja la propagación geográfica del virus, pero no es un indicativo de la gravedad de la gripe A o H1N1, más conocida como gripe porcina y precisó que la evaluación global de la OMS es que la pandemia es moderada. “Queremos que se entienda muy bien que si declaramos la fase 6 de pandemia, eso significa que el virus se extiende y que hay contagios estables en comunidades en países de distintas regiones”, ha señalado Fukuda, quien ha aclarado que “eso no significa que el virus se haya hecho más grave, que la enfermedad sea más severa o que haya aumentado la tasa de mortalidad”.

Estas son las declaraciones de la Directora de la OMS Margaret Chan:

World now at the start of 2009 influenza pandemic

Dr Margaret Chan Director-General of the World Health Organization

Ladies and gentlemen,

In late April, WHO announced the emergence of a novel influenza A virus.

This particular H1N1 strain has not circulated previously in humans. The virus is entirely new.

The virus is contagious, spreading easily from one person to another, and from one country to another. As of today, nearly 30,000 confirmed cases have been reported in 74 countries.

This is only part of the picture. With few exceptions, countries with large numbers of cases are those with good surveillance and testing procedures in place.

Spread in several countries can no longer be traced to clearly-defined chains of human-to-human transmission. Further spread is considered inevitable.

I have conferred with leading influenza experts, virologists, and public health officials. In line with procedures set out in the International Health Regulations, I have sought guidance and advice from an Emergency Committee established for this purpose.

On the basis of available evidence, and these expert assessments of the evidence, the scientific criteria for an influenza pandemic have been met.

I have therefore decided to raise the level of influenza pandemic alert from phase 5 to phase 6.

The world is now at the start of the 2009 influenza pandemic.

We are in the earliest days of the pandemic. The virus is spreading under a close and careful watch.

No previous pandemic has been detected so early or watched so closely, in real-time, right at the very beginning. The world can now reap the benefits of investments, over the last five years, in pandemic preparedness.

We have a head start. This places us in a strong position. But it also creates a demand for advice and reassurance in the midst of limited data and considerable scientific uncertainty.

Thanks to close monitoring, thorough investigations, and frank reporting from countries, we have some early snapshots depicting spread of the virus and the range of illness it can cause.

We know, too, that this early, patchy picture can change very quickly. The virus writes the rules and this one, like all influenza viruses, can change the rules, without rhyme or reason, at any time.

Globally, we have good reason to believe that this pandemic, at least in its early days, will be of moderate severity. As we know from experience, severity can vary, depending on many factors, from one country to another.

On present evidence, the overwhelming majority of patients experience mild symptoms and make a rapid and full recovery, often in the absence of any form of medical treatment.

Worldwide, the number of deaths is small. Each and every one of these deaths is tragic, and we have to brace ourselves to see more. However, we do not expect to see a sudden and dramatic jump in the number of severe or fatal infections.

We know that the novel H1N1 virus preferentially infects younger people. In nearly all areas with large and sustained outbreaks, the majority of cases have occurred in people under the age of 25 years.

In some of these countries, around 2% of cases have developed severe illness, often with very rapid progression to life-threatening pneumonia.

Most cases of severe and fatal infections have been in adults between the ages of 30 and 50 years.

This pattern is significantly different from that seen during epidemics of seasonal influenza, when most deaths occur in frail elderly people.

Many, though not all, severe cases have occurred in people with underlying chronic conditions. Based on limited, preliminary data, conditions most frequently seen include respiratory diseases, notably asthma, cardiovascular disease, diabetes, autoimmune disorders, and obesity.

At the same time, it is important to note that around one third to half of the severe and fatal infections are occurring in previously healthy young and middle-aged people.

Without question, pregnant women are at increased risk of complications. This heightened risk takes on added importance for a virus, like this one, that preferentially infects younger age groups.

Finally, and perhaps of greatest concern, we do not know how this virus will behave under conditions typically found in the developing world. To date, the vast majority of cases have been detected and investigated in comparatively well-off countries.

Let me underscore two of many reasons for this concern. First, more than 99% of maternal deaths, which are a marker of poor quality care during pregnancy and childbirth, occurs in the developing world.

Second, around 85% of the burden of chronic diseases is concentrated in low- and middle-income countries.

Although the pandemic appears to have moderate severity in comparatively well-off countries, it is prudent to anticipate a bleaker picture as the virus spreads to areas with limited resources, poor health care, and a high prevalence of underlying medical problems.

Ladies and gentlemen,

A characteristic feature of pandemics is their rapid spread to all parts of the world. In the previous century, this spread has typically taken around 6 to 9 months, even during times when most international travel was by ship or rail.

Countries should prepare to see cases, or the further spread of cases, in the near future. Countries where outbreaks appear to have peaked should prepare for a second wave of infection.

Guidance on specific protective and precautionary measures has been sent to ministries of health in all countries. Countries with no or only a few cases should remain vigilant.

Countries with widespread transmission should focus on the appropriate management of patients. The testing and investigation of patients should be limited, as such measures are resource intensive and can very quickly strain capacities.

WHO has been in close dialogue with influenza vaccine manufacturers. I understand that production of vaccines for seasonal influenza will be completed soon, and that full capacity will be available to ensure the largest possible supply of pandemic vaccine in the months to come.

Pending the availability of vaccines, several non-pharmaceutical interventions can confer some protection.

WHO continues to recommend no restrictions on travel and no border closures.

Influenza pandemics, whether moderate or severe, are remarkable events because of the almost universal susceptibility of the world’s population to infection.

We are all in this together, and we will all get through this, together.

Thank you.

El diario el País refiere: Los últimos datos son que en el mundo hay confirmados casi 28.000 casos (este número incluye todos los diagnósticos desde que a finales de abril se detectó al enfermedad, por lo que la mayoría están ya fuera de peligro, aunque también se registran los 141 fallecidos). Esta cifra es sólo la de los enfermos más graves o los que han ido a un servicio médico donde se han molestado en hacerle los análisis correspondientes. Por eso lo más seguro es que, en verdad, la cifra de infectados, incluidos los que han pasado una enfermedad tan leve que no han ido al médico o los que se han infectado pero ni se han enterado, sea muy superior. En EE UU los Centros de Control de Enfermedades (el organismo científico de referencia) calcula que por cada diagnóstico hay otros 3.000 afectados que quedan sin registrar. Esta proporción es conservadora (es un país puntero donde las alertas saltaron desde el principio), por lo que aventurar que ya ha habido 90 millones de infectados no parece una exageración.

Ésta es la primera pandemia de gripe que se declara en 40 años. La anterior empezó en Hong Kong en 1967, y se saldó con medio millón de muertos.

 

Este quiere ser un post breve anunciando que hemos alcanzado la fase 6, más adelante ahondaremos en este tema.

 

Consuelo Ibáñez Martí

Médico salubrista

Otros post sobre gripe pandémica

 

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Comentarios

te olvidas de la casi epidemia de 1976 que se origino en el fuerte DIX de Nueva Jersey con el soldado David Lewis que murio la noche de la marcha, y que luego le siguieron mas de 500 soldados con influenza porcina, y de la terrible propaganda que se hizo con la vacuna a base de huevo, que ocasionó mas muertes que la gripe misma. Aparentemente el medico que estudio el virus, guardó muestras del mismo para analizarlas y encontrar cura. Parece ser que se le escapo a mexico 33 años despues.

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