EMILIO DE BENITO - Madrid - 09/08/2010
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Two weeks ago the Center for Epidemiological Surveillance of the Health Institute Carlos III does not detect a single case of so-called influenza A (officially, California-AnH1N1). All registered correspond to a virus variant that is always present, although traditionally not given importance: influenza B. In Catalonia even more time since there were reports of new influenza: Public Health Agency of Barcelona is not found since April. Nothing to do with the situation the same period a year ago, when, unusually for a summer flu cases were numerous, and the H1N1 gained prominence. For example, in week 32 of last year, the viral detection rate was 41.17 cases per 100,000 population, the vast majority of H1N1 virus. This year, however, the rate is almost zero (five interceptions by the sentinel in two weeks).
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This disappearance of the northern hemisphere influenza A also corresponds to what is happening in the south. The latest report from the World Health Organization (WHO) last Saturday, noted that currently experiencing a season of active influenza transmission in southern Asia and South and Central America. This is normal as in equatorial areas the virus is less subject to seasonal factors (there is less change in temperature) and is spread in a more constant throughout the year. In the south, which is going through the winter, nor is having a severe flu season, with the exception of South Africa. In the rest of the continents (Australasia and South America) the disease is still very little aggressive. But-and here comes the new-is not mainly caused by the influenza virus H1N1, but two: one of type B and one A (H3N2).
However, authorities do not consider finished the new flu. This limited impact is that, as the Secretary of State, Ministry of Health, José Martínez Olmos, makes it impossible to advance what will happen next winter. "We do not like to speculate, but what is happening in the southern hemisphere [where winter is now] can not say that the flu has disappeared altogether." Course, precisely because of the "low level" of the flu this summer (winter in the south) "can not do surveys," said Martínez Olmos.
What I dare say the secretary of state is "not in the south flu is becoming more serious." And, of course, if anyone has doubts, he hastens to reassure influenza B and H3N2: "They are viruses that appear every year, do not pose a special risk." (In fact, it is normal that every year, without any media noise, there are at least three active flu virus).
The diagnosis is widespread. Both WHO and the EU agencies and the Agency for Food and Drug Administration (FDA for its acronym in English) hope that next winter the flu virus is one of those moving to the north. Therefore it is included in vaccines to be supplied, along with A (H3N2) and B-Brisbane. This composition should not frighten or surprise. It is similar in the normal flu vaccines for all years, which often combine three viruses, two type A and one type B, determined in February according to samples taken in Southeast Asia.
But the composition of the vaccine this year creates a collateral issue: as AnH1N1 include not going to need six million doses against the virus that are left over from last winter, which cost 7.2 euros each, indicates Martínez Olmos. "The communities have and they will have to decide what to do with them," says Secretary of State. Most likely, destroyed.
But Olmos does not believe that his purchase was overstated. "In the end we modify the contracts with the labs and ask nine million doses, the same as other years, and also this. What happens is that there was much suspicion and were not made," he says. So he insists that "it performed well in terms of forecasts," and the Spanish situation compares favorably with other countries that "redefined their contracts" and "vaccine called for a greater percentage of the population."
Just one of the first actions of the rotating EU presidency, which this semester is for Belgium, was to organize a ministerial conference to address the issue of influenza A. "There is widespread concern about how to act in the future to alert potential," says Olmos. "The conclusion is that they responded quickly and well", although there were "difficulties in securing vaccines all at an affordable price," he says.
The solution that the EU has agreed that it wants to set for Spain: centralize purchasing. When the Minister of Health, Trinidad Jimenez, made the announcement of this measure after the Inter-Territorial Council (the meeting between the Ministry and the autonomous board) in March this year, said that flu vaccines would be the first attempt to the establishment of a central purchasing. But Martinez Olmos admits that this will happen "next year." "When we wanted to get to work this year, some communities had already published their contests. What we are going to do is talk to the labs so that they behave as if a joint purchase decision, especially with prices," he said.
Is another open question, as agreed by European representatives: How to transmit information to an alert. What happened to the flu vaccine last winter was a pity, "said Martínez Olmos. Immunization was "as safe as that of every year." But this was not the message that it sparked.
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