The 2009 flu pandemic was a global outbreak of a new strain of influenza A virus subtype H1N1, first identified in April 2009, termed Pandemic H1N1/09 virus by the World Health Organization (WHO)[1] and colloquially called swine flu. The outbreak was first observed in Mexico,[2][3] and quickly spread globally. On the 11th of June 2009, the WHO declared the outbreak to be a pandemic.[4][5] The overwhelming majority of patients experience mild symptoms,[4] but some persons are at higher risk of suffering more serious effects; such as those with asthma, diabetes,[6][7] obesity, heart disease, or those who are pregnant or have a weakened immune system.[8] In the rare severe cases, around 3–5 days after symptoms manifest, the sufferer's condition declines quickly, often to the point respiratory failure.[9] Although Ukraine was not (very) affected at first there was on outbreak of the virus in Western Ukraine in early November 2009 that led to the closing of public buildings and cancellation of meetings for three weeks.[10]

As of December 2009 more than two million people had fallen ill since Ukraine's flu epidemic began[11] and about 500 of those people died of flu or flu-like illnesses and its complications (pneumonia) of the 46 million people then living in Ukraine.[12] Ukraine was one of the countries most affected (8th) by swine flu in Europe.[13]

According to Ukrainian Justice Minister Mykola Onischuk the epidemiological situation during October–December 2009 didn't change the overall death rate in Ukraine.[14]

Ukraine has two laboratories capable of identifying influenza strains.[15]

Timeline

First cases

An ambulance in Kyiv

The virus reached Ukraine on 5 June 2009 when the first case of the virus was officially confirmed in Ukraine. The patient concerned, a 24-year-old Ukrainian citizen, had arrived from New York City via Paris at Kyiv's Boryspil Airport on May 29, 2009.[16] Before that imports of pork and live pigs from all affected countries had been banned. The ban applied to all shipments after April 21, 2009.[17]

A second swine flu case (in Ukraine) was confirmed on September 29, 2009.[18]

Flu epidemic

October 2009

On October 27, 2009, an outbreak of influenza-like illness and the deaths of seven people from its complications were reported in Ternopil region.[19][20] Schools and universities in Ternopil were closed.[19]

Radio Netherlands Worldwide mentioned (on November 4) that rumors had spread about a plane said to have been flown over the capital of Ukraine, Kyiv, releasing powder containing a mutated variety of the A (H1N1) virus.[21]

On 30 October 2009, Ukrainian Ministry of Health confirmed 11 new cases of swine flu and the first death from it. An epidemic was declared and nine out of 25 regions of Ukraine were put under quarantine,[10][22] on November 5, 2009 Kirovohrad became the 10th.[23] Due to the outbreak public meetings, including cinema,[24] were forbidden nationwide and all educational institutions were closed for three weeks (subject to extension if necessary).[25][26] Conscription into the Ukrainian army was also suspended,[27] and the Professional Football League of Ukraine postponed football matches in the Ukrainian First League and Second League.[28]

November 2009

A large shipment of Tamiflu was delivered from Switzerland to Ukraine on November 1, 2009 for distribution among hospitals for free.[29]

On November 2, 2009, at Ukraine's request, the WHO sent a team of nine experts to determine if the same strain of swine flu was responsible for the 70 recent deaths from acute respiratory illness in the country.[30][31]

According to the Ukrainian Health Ministry, by November 2, 2009, the number of people who had died of influenza and respiratory diseases had reached 60, the number of people suffering from the flu was 200,000[29] and about 22 patients had tested positive for swine flu.[32] On November 5, 2009 the Ministry said the death toll of patients with flu-related and acute respiratory illnesses had jumped to 95. 15 of 31 patient samples sent to London for laboratory analysis tested positive for the H1N1 virus.[33]

By November 6, 2009 twenty-eight cases of swine flu had been confirmed in Ukraine. Thirteen of these cases were in people who had died by that point.[34] The Ukrainian health ministry estimated that Ukraine required 12.5 million doses of a vaccine against swine flu.[35] Four days later, on November 10, 2009 the number of confirmed cases had risen to 67. However, only one more person had died. 1,031,587 people in Ukraine had contracted flu or a flu-like illness by then and of them 52,742 where hospitalized at the time of the report.[36] Since there had been 174 additional deaths from acute respiratory viral infections [37] and other patients had recovered, though this number is less than the total hospitalizations related to flu and flu-like illnesses.

At this point, a policy was implemented that stated that if at least one person had been diagnosed with swine flu in any region of Ukraine, then everyone in that region diagnosed with the flu would receive swine flu treatment.[36]

On November 17, 2009, the WHO issued a statement that there were no significant differences between the pandemic H1N1 strain and the Ukrainian strains tested.[38]

Starting on November 18, 2009, the Ukrainian ministry of health stopped publishing separate statistics on cases of A/H1N1 influenza.[39] Regional commissions were given the power to cancel quarantines of higher educational establishments on November 20.[40]

On November 23 educational institutions opened again in regions below the epidemic threshold for flu and respiratory infections;[41] for instance on November 25, 2009, all educational institutions and kindergartens in Kyiv resumed work.[42]

December 2009

As of December 2, 2009, 445 people had died of flu and flu-like illnesses with a total of 116,982 people hospitalized since the start of the epidemic (October 29, 2009). Of those hospitalized, 93,213 people had at the time been discharged from hospitals. On December 2 the epidemic threshold was still exceeded in the Zakarpattia and Khmelnytsky regions.[43]

By December 7, 2009, more than two million people had fallen ill since Ukraine's flu epidemic began, with 88 patients in intensive care at the time.[11] At the time about 46 million people lived in Ukraine.[12]

By December 8, 2009, 468 people had died of flu and flu-like illnesses and its complications (pneumonia) in Ukraine with a total of 128,851 people that had been hospitalized since the start of the epidemic (October 29) and 102,510 people discharged from hospitals. On December 8 the epidemic threshold was still exceeded in Vinnytsia, Dnipropetrovsk, Kirovohrad, Luhansk and Sumy regions.[44]

In December 2009, Ukrainian and World Health Organization officials warned of a second and third wave of the flu epidemic starting in late December 2009 and early 2010.[45] On December 23, the WHO said that H1N1 was resurgent in Ukraine, as well as in Serbia and Turkey, with increasing influenza-like illness and acute respiratory illness.

As of December 28, 652 people had died since the epidemic started in late October. At the time 258 people were in intensive care with dozens on ventilators. More than 200,000 people have been hospitalized.[46] Late December 2009 saw high influenza activity in the Eastern Ukrainian provinces Donetsk Oblast and Luhansk Oblast.[47]

The spread of acute respiratory infections in Ukraine passed over a second peak in late December 2009, with case counts almost three times those from the same time in the prior year.[48]

January 2010

On January 8 the WHO said that intense A/H1N1 virus activity continued in Ukraine, as well as in several other eastern Europe countries.[49] On January 23, Ukrainian health officials reported that they expected a second surge of flu and respiratory infections to strike early in February 2010.[50]

The number of those who had died of flu and flu-like illnesses in Ukraine increased to 940 people on January 12, 2010, with the epidemic threshold exceeded in Dnipropetrovsk, Luhansk, Poltava, Sumy regions and Crimea; according to the Ukrainian Health Ministry.[51] This number increased to 1,019 people on January 21, 2010 with the epidemic threshold exceeded in the Dnipropetrovsk, Luhansk, Poltava and Sumy regions.[52]

Epidemiology

According to Chief State Sanitary Doctor Oleksandr Bilovol, the mass refusal by Ukrainians to be vaccinated (after several persons allegedly died after vaccinations in 2008[53] and 2009[54]) was partly the cause for the epidemic.[26]

According to Ukrainian doctors the Government of Ukraine had provided no public information and taken no precautionary measures to prevent the pandemic.[21][55][56] In November, the WHO praised the Ukrainian government for the measures it took to prevent the spread of the flu epidemic in Ukraine.[57] According to a poll carried out by the Institute of Social and Political Psychology of the Academy of Pedagogical Sciences of Ukraine in November 2009 Ukrainian citizens had mainly negative feelings about measures being taken by the government to fight the flu epidemic. According to the poll, 49.8% of respondents made a negative assessment of the activities of the Cabinet of Ministers (37.4% a positive one), 44.8% the Health Ministry (28.1% positive), 57.4% the president and his secretariat (18.8% positive), and 50.4% the Verkhovna Rada (parliament of Ukraine) (18.6% positive).[58]

Ukrainian analysts have suggested that politicians, mainly Ukrainian President Viktor Yushchenko and Prime Minister Yulia Tymoshenko, have tried to use the pandemic to score political points with the January 2010 presidential election in mind.[59] This was denied by Prime Minister Tymoshenko.[60][61] According to a poll by Research & Branding Group the majority of Ukrainians thought that the epidemic of flu would not affect the presidential elections.[62] According to a November 2009 poll by FOM-Ukraine 33.3% of Ukrainians think that the public panic about the flu epidemic helped Prime Minister Tymoshenko the most, while 28.7% said it was a boost for all politicians (other individual politicians where polled at <10%). Asked what caused the panic, 45.6% pointed to the media and 20.3% to government representatives.[63]

According to the Ukrainian Health Ministry the average daily number of fatalities caused by flu in 2009 was lower than in 2008, when it was 18.[64]

During the pandemic Ukrainians started to eat onions and garlic (in Lviv, the price of garlic had skyrocketed in November 2009[21]), took vitamins, spent more time at home or drank alcoholic beverages in order to protect themselves from flu and flu-like illnesses.[65] There is no evidence, however, that drinking alcoholic beverages can prevent respiratory illnesses.

By mid-December 2009 the Verkhovna Rada (Ukraine's parliament) had allocated over 600 million hryvnya to fight the flu epidemic in Ukraine.[66]

Comparisons within Europe

On 13 November 2009, the WHO announced that, based on data collected from 43 European countries, Ukraine had the 8th highest infection rate of A/H1N1 in Europe (following Norway, Sweden, Bulgaria, Moldova, Iceland, Ireland and Russia). Furthermore, Belarus, Kazakhstan, Poland, various regions of Russia, Northern Ireland, Turkey, Finland, and Ukraine had a high sickness rate of А/Н1N1 flu.[13][67]

According to Jukka Pukkila, head of a WHO international mission to Ukraine, "there is no difference concerning the rate of A/H1N1 flu infection in Ukraine compared to other countries".[68] WHO tests of the H1N1 pandemic virus samples taken from Ukrainian patients haven't exposed any signs of mutation.[69]

A total of 22 countries had given assistance to Ukraine in fighting its flu epidemic by November 2009.[70]

See also

References

  1. ↑ "Transcript of virtual press conference with Dr Keiji Fukuda, Assistant Director-General ad Interim for Health Security and Environment, World Health Organization" (PDF). World Health Organization. 7 July 2009.
  2. ↑ Mcneil, Donald G. (April 27, 2009). "Flu Outbreak Raises a Set of Questions". The New York Times. Retrieved 2009-10-24.
  3. ↑ Maria Zampaglione (April 29, 2009). "Press Release: A/H1N1 influenza like human illness in Mexico and the USA: OIE statement". World Organisation for Animal Health. Archived from the original on 30 April 2009. Retrieved April 29, 2009.
  4. 1 2 Chan, Dr. Margaret (2009-06-11). "World now at the start of 2009 influenza pandemic". World Health Organization. Archived from the original on 22 October 2009. Retrieved 2009-10-25.
  5. ↑ "UK National Institute for Medical Research WHO World Influenza Centre: Emergence and spread of a new influenza A (H1N1) virus, 12 June 09". Archived from the original on 2009-09-26. Retrieved 2009-09-02.
  6. ↑ "Diabetes and the Flu". U.S. Department of Health & Human Services. Archived from the original on 25 October 2009. Retrieved 2009-10-25.
  7. ↑ National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation (14 October 2009). "CDC's Diabetes Program - News & Information - H1N1 Flu". CDC.gov. CDC. Archived from the original on 23 October 2009. Retrieved 25 October 2009.
  8. ↑ Hartocollis, Anemona (2009-05-27). "'Underlying conditions' may add to flu worries". The New York Times. Archived from the original on August 7, 2009. Retrieved 2009-09-26.
  9. ↑ "Clinical features of severe cases of pandemic influenza". Geneva, Switzerland: World Health Organization. 2009-10-16. Archived from the original on 25 October 2009. Retrieved 2009-10-25.
  10. 1 2 "Quarantine ordered". KyivPost. 2009-10-30. Archived from the original on 1 November 2009. Retrieved 2009-10-31.
  11. 1 2 Sick list tops two million in Ukraine, Kyiv Post (December 7, 2009)
  12. 1 2 "Ukrainian population down to 46 million in September". Kyiv Post. 2009. Retrieved 2009-11-13.
  13. 1 2 WHO: A/H1N1 infection rate in Ukraine not the highest in Europe, Kyiv Post (November 19, 2009)
  14. ↑ Influenza hasn't raised death rate in Ukraine, says Justice Minister, Kyiv Post (December 28, 2009)
  15. ↑ Flu strain testing lab opens in Volyn, Kyiv Post (December 31, 2009)
  16. ↑ First case of A (H1N1) virus officially confirmed in Ukraine, says Health Ministry Archived 2009-11-11 at the Wayback Machine, Interfax-Ukraine (June 5, 2009)
  17. ↑ The world response to flu crisis, BBC News, 2009-04-28. Retrieved on 2009-04-30.
  18. ↑ Second А (H1N1) swine flu case confirmed in Ukraine Kyiv Post (September 29, 2009)
  19. 1 2 "Seven die of unknown flu virus in Ukraine's Ternopol region". ITAR-TASS. 2009-10-27. Archived from the original on 16 November 2009. Retrieved 2009-10-27.
  20. ↑ "Seven people died of ILI complications in Ternopil region" (in Russian). Inter TV-channel. 2009-10-27. Archived from the original on 29 October 2009. Retrieved 2009-10-27.
  21. 1 2 3 Ukraine gripped by the A (H1N1) flu virus Archived 2009-11-07 at the Wayback Machine by Willemien Groot, Radio Netherlands Worldwide 2009-11-04
  22. ↑ В Украине началась эпидемия "свиного" гриппа. Стране грозит карантин Podrobnosti.ua (September 30, 2009)
  23. ↑ Kirovohrad region became next to impose quarantine, Kyiv Post (November 5, 2009)
  24. ↑ Flu epidemic causes panic in Ukraine Archived 2009-11-05 at the Wayback Machine, Euranet (October 30, 2009)
  25. ↑ Ukraine shuts schools, halts campaigning over H1N1, Reuters (October 30, 2009)
  26. 1 2 Chief doctor: mass refusal by citizens to be vaccinated partly to blame for A (H1N1) epidemic, Kyiv Post (November 1, 2009)
  27. ↑ Draft into Ukrainian army suspended due to flu epidemic Archived 2009-11-03 at the Wayback Machine, Interfax-Ukraine (October 31, 2009)
  28. ↑ "Епідемія переносів [оновлюється] (Epidemic causes postponements (renewed))" (in Ukrainian). PFL. 2009-10-30. Archived from the original on 2009-11-13. Retrieved 2009-10-31.
  29. 1 2 Ukrainian Hospitals To Distribute Tamiflu For Free, Radio Free Europe/Radio Liberty (November 2, 2009)
  30. ↑ Choursina, Kateryna; Pavliva, Halia (2009-11-02). "Ukraine Mystery Outbreak Sparks WHO Concern as Disease Spreads". Bloomberg.com. Bloomberg. Retrieved 2009-11-04.
  31. ↑ Pandemic (H1N1) 2009, Ukraine - update 1, World Health Organization, November 3, 2009.
  32. ↑ Ukraine Mystery Outbreak Sparks WHO Concern as Disease Spreads, Bloomberg L.P. (November 2, 2009)
  33. ↑ Update: more death, illness, Kyiv Post (November 5, 2009)
  34. ↑ Twenty-eight swine flu cases confirmed in Ukraine, 13 die of swine flu, says emergencies ministry Archived 2009-11-08 at the Wayback Machine, Interfax-Ukraine (November 6, 2009)
  35. ↑ Health ministry estimates Ukraine needs 12.5 million doses of vaccine against A (H1N1), Kyiv Post (November 6, 2009)
  36. 1 2 Government: Ukraine records 67 swine flu cases, 14 of them fatal, Kyiv Post (November 10, 2009)
  37. ↑ Health Ministry confirms 174 deaths, acute respiratory viral infections, Kyiv Post (November 10, 2009)
  38. ↑ "Pandemic (H1N1) 2009, Ukraine - update 2". World Health Organization. 2009-11-17. Archived from the original on 19 November 2009. Retrieved 2009-11-18.
  39. ↑ Health Ministry: Flu, respiratory diseases claim 344 lives in Ukraine, Kyiv Post (November 18, 2009)
  40. ↑ Ukrainians still running high risk of contracting flu, respiratory infections, says first-vice premier Archived 2013-04-18 at archive.today, Interfax-Ukraine (November 20, 2009)
  41. ↑ Education institutions in regions with low rate of flu cases to resume working on Nov. 23, Kyiv Post (November 21, 2009)
  42. ↑ Quarantine ends in educational institutions of Kyiv on Nov. 25, Kyiv Post (November 21, 2009)
  43. ↑ Flu, pneumonia kill 445 people in Ukraine, Kyiv Post (December 2, 2009)
  44. ↑ Five people die of flu, pneumonia in past 24 hours in Ukraine, Kyiv Post (December 8, 2009)
  45. ↑ Flu-related illness persists in five Ukrainian oblasts, Kyiv Post (December 8, 2009)
  46. ↑ 17 more deaths attributed to flu-like illness, Kyiv Post (December 29, 2009)
  47. ↑ Health Ministry confirms 633 deaths by influenza and ARVI, Kyiv Post (December 28, 2009)
  48. ↑ EuroFlu: Ukraine to see second outbreak of flu, Kyiv Post (January 4, 2010)
  49. ↑ Pandemic (H1N1) 2009 activity continues despite declining clinical trends Archived 2010-01-07 at the Wayback Machine, World Health Organization (January 5, 2010)
  50. ↑ Ukraine health officials expect new flu surge for runoff, Kyiv Post (January 23, 2010)
  51. ↑ Death toll from flu, respiratory infections in Ukraine rises to 940, Kyiv Post (January 13, 2010)
  52. ↑ Health Ministry: Death toll from flu, respiratory infections in Ukraine rises to 1,019, Kyiv Post (January 22, 2010)
  53. ↑ Teenager’s death spurs vaccination questions, fears, Kyiv Post (October 29, 2008)
  54. ↑ Vaccinations against flu proving to be hard sell, Kyiv Post (November 12, 2009)
  55. ↑ Pandemic politics, Kyiv Post (November 5, 2009)
  56. ↑ Fragile Care Worsened Swine Flu in Ukraine, The New York Times (November 14, 2009)
  57. ↑ WHO praises Ukrainian government for work on prevention of flu epidemic, Kyiv Post (November 24, 2009)
  58. ↑ Poll: Ukrainians dissatisfied with government's measures on fighting flu epidemic, Kyiv Post (December 7, 2009)
  59. ↑ Panic in Ukraine over swine flu, BBC News (November 3, 2009)
  60. ↑ Flu Archived 2009-11-30 at the Wayback Machine, Personal Blog of Yulia Tymoshenko (November 12, 2009)
  61. ↑ BYT: Regions Party, president using health of Ukrainians as weapon in struggle against Tymoshenko, Kyiv Post (November 26, 2009)
  62. ↑ Poll: epidemic of flu not to affect elections, Kyiv Post (December 1, 2009)
  63. ↑ Poll: Over 30% of Ukrainians say panic over flu epidemic helped Tymoshenko Archived 2012-09-05 at archive.today, Interfax-Ukraine (December 7, 2009)
  64. ↑ Health Ministry: Flu, respiratory infections kill 315 people in Ukraine, Kyiv Post (November 16, 2009)
  65. ↑ Poll: Ukrainians eat onion, garlic, drink alcoholic beverages to protect themselves from flu, Kyiv Post (December 1, 2009)
  66. ↑ Ukrainian parliament allocates over UAH 600 m to fight flu Archived 2012-09-04 at archive.today, Interfax-Ukraine (December 15, 2009)
  67. ↑ "EuroFlu Weekly Electronic Bulletin 13.11.2009". Archived from the original on December 27, 2012.
  68. ↑ Health Ministry sees no need to publish information about confirmed cases of A/H1N1 flu, Kyiv Post (November 16, 2009)
  69. ↑ World Health Organization: Initial tests show no mutation in H1N1 virus samples from Ukraine, Kyiv Post (November 17, 2009)
  70. ↑ Twenty-two countries ready to assist Ukraine in fighting flu epidemic, Kyiv Post (November 17, 2009)
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