On 16th of July in Genoa, it has been declared that risk management should be reconsidered in light of the foregoing knowledge about H1N1 virus.

The increase of pandemic spread seems inevitable considering the increase of number of cases in effected countries and the cases which are seen in new countries.

This hypothesis depends totally on experiences. The international spread of 2009 influenza pandemia features a unique speed. The new H1N1 virus has reached a level in less than 6 weeks, whereas the other influenza viruses reached the same level in 6 months. Moreover, the increase of number of cases in most countries is still not understood. Because in most countries the laboratory tests for diagnosing and verifying are not sufficient yet. In addition, the patients who are exposed to the pandemic virus hasn’t suffered from serious complications, so they recovered without the need to be hospitalized or any intervention. Thus, it is believed that there are many patients who haven’t been diagnosed. In determining the number of patients all over the world, the patients having serious complications and taking medication or who died are still being considered. All these declarations makes us think that the spread of the infection may be more rapid than we assume. The increase in number of cases is really alarming, although it is summer time on northern hemisphere and the schools in most countries are closed.

The increased number of cases on southern hemisphere also shows that the the number of cases on northern hemisphere would also increase rapidly after September, when autumn and winter come.

All the health organisations fear that the number of cases would increase and moreover serious cases and even deaths would increase. The declaration on the 8th of July is very thought provoking, which implies that there would be resistance to oseltamivir (called tamiflu in the market) which is used in the therapy of the infection. Three patients have been reported for the resistance to oseltamivir and there isn’t any close contact history between these three patients. The virus is resistant to oseltamivir but sensitive to zanamivir.

As it is reported by the global influenza surveilance network, there are about 1000 H1N1 viruses which are reported as resistant to antiviral medicine. All other viruses appear to be sensitive to oseltamivir and zanamivir. WHO and other health organisations strictly follow the medicine resistance of iinfluenza viruses.

WHO keeps on announcing the number of cases from all countries in a table which are verified. Probably hte best thing to do is to examine all the cases even if they are not serious and try to obtain more certain numbers of cases. To follow the virologic properties of the virus such as drug resistnace is also very essential for the diagnosis and therapy. Thus, WHO demands from all the countries to fill a form taht will enable detailed follow-up of patients. Cases from all over the world are reported to WHO by filling these forms up and so they can be watched closely.

The situation in Turkey:

As declared by the Ministry of Health, the number of pandemic (H1N1) cases in our country has reached 110 with the ones detected between 14th to 16th of July. 27 of these cases are native. 18 cases are still being followed ambulatory and 4 are hospitalized and their overall situations are well. The people who had contact with them are also determined and followed. All other cases have healed.

Most of the cases have a story of foreign travel. But there are also cases who don’t have such a travel story. How the individuals without a foreign travel story encountered the virus is still unclear. It is possible that those individuals may have contacted people carrying H1N1 virus who have traveled abroad but have minor or no symptoms. However, considering that the virus is a new species composed of three viruses that have united and that the structurel changes occur so fast in the virus, it may be thought that animals may carry the virus. That the number of cases are very high in summer, it is probable that the infection will become serious.

There are questions how the virus is caught and this is a serious epidemic. The precautions that should be taken are continuously being reminded by the Ministry of Health and by all institutions, which take the health of the public serious. Washing the hands properly, using disposable handkerchiefs while coughing or sneezing are simple precautions which all of us can take in order to preserve our health.