AMELIA NIETO, PILAR AND RAFAEL PEREZ-FERNANDEZ MUÑOZ BREÑA 14/09/2010
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In a few months winter will come again and with it their seasonal diseases among which are those caused by influenza viruses. And this year, as echoes of last season, will raise questions about the H1N1 pandemic, the management and follow-up has raised questions and even distrust among some sectors of the population.
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Why this mistrust?, Largely because the high expectations created around the pandemic was taking for granted that the H1N1 virus would cause a serious health problem and that has not happened and has generated a kind of disappointment. It is as if we were actually complaining that the new H1N1 virus siso not as aggressive as the 1918 H1N1 virus and has "killed little", rather than congratulate his "kindness." And yet, looking back to remember that the "new H1N1 virus" is a completely new virus, which combines components avian, human and swine, so that, based on knowledge available at the time of their appearance, their behavior and future developments were unpredictable, and of course we had no vaccine could protect us against him.
In this scenario, it should be noted that the manufacture of vaccines, needs several months for the large amount of virus is to grow and inactivate and capacities in the pharmaceutical industry are limited. So, before we have sufficient data about the pathogenicity of the virus to humans, had to take decisions on the number of doses required and the appropriateness of using "adjuvants". These compounds are used in a routine manner in different vaccines in order to increase efficiency and allow use of lower doses of virus. As a scenario was raised global vaccination against new viruses, which meant a massive growth level of the virus, the use of adjuvants was approved.
Therefore the question arises of whether international health authorities, represented by WHO, as well as national, were working properly. Remember that the virus appeared in April 2009 in Mexico and had to take decisions in both the manufacture of vaccines and the antiviral stockpiling, in a very short period of time did not allow scientists to analyze the possible evolution a virus that had never failed to amaze. There have also heard other voices wondering why they would have required health authorities if the aggressiveness of the virus had been higher and we had had no vaccines and antivirals to protect the population.
There is no doubt that the production of vaccines and antivirals at large scales leads to increased profits for multinational pharmaceutical companies, but, really, does anyone have waived increase the benefit of having known that the new virus was indeed very aggressive? . It is true that it was not, but it certainly could have been, and no one would have forgiven the health authorities is a lack of foresight in a scenario that could have reached global dimensions of tragedy.
In the next shot for the season approaches have included the H1N1 virus H1N1 pandemic instead of the previous season. And this has been because despite its lack of aggressiveness the pandemic virus will spread throughout the world, shifted almost entirely to seasonal, caused severe illness and even killed many young and healthy people and caused three times more deaths than usual in children. Therefore, in this time of calm, we must evaluate and reflect on the events experienced, as if in the future was raised a similar situation should be back to take new decisions facing another new virus that will generate new scenarios and approaches. But hopefully we will have the experience of this pandemic of the XXI century with broader and deeper knowledge about the behavior of influenza viruses that have been acquired as a result of it. And at that time will wait for all of us responsible and effective collaboration.
Amelia Nieto, Pilar Perez-Brena and Rafael Fernández Muñoz are members of the board of the Spanish Society of Virology
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