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Influenza – this contagious respiratory disease caused by a virus – is common to almost all countries, with most annual outbreaks occurring only once a year in winter.
This is not the case in Thailand: as in other tropical countries, flu strikes twice a year – from January to March, and again during the rainy season from June to August. Experts estimate the likely severity of this outbreak of the rainy season on the basis of reported cases from January to March. This year, about 40,000 cases of influenza and three deaths were attributable to the virus.
"The numbers show that the epidemic will probably be worse than last year," said Professor Tawee Chotpitayasunondh, president of the Thai Pediatric Infectious Diseases Society.
For most people, it can be difficult to differentiate between colds and flu. Most stay at home and take over-the-counter medications until they feel well. But how do you know when you should see a doctor?
According to Dr. Tawee, the best is to observe the symptoms and, if you have a high fever for two consecutive days, it's time to see a doctor. Initially, the flu may look like a cold with fever over 38 degrees Celsius, sore muscles, chills and sweats, headaches, coughing and sore throat.
High fever means that your body temperature is above 38 degrees with peaks once a day. Dr. Tawee adds that the length of the peak depends on your own defense mechanism.
According to the World Health Organization, about one billion people are infected with the flu each year. About 3 to 5 million patients have to be hospitalized and 500,000 people die of complications. As the flu virus lives longer in cold weather, epidemics occur during the cold season.
"In addition to the cold weather factor, in Thailand, the peak is also in the rainy season. This is because schools have reopened after the long summer break and children, who are a high-risk group, tend to spread the virus, "says Dr. Tawee.
For most people, the flu is a benign disease that goes away on its own. But sometimes the flu and its complications can be deadly. People most at risk for flu-like complications include young children, the elderly, pregnant women, asthmatics, heart disease, kidney disease and diabetes, as well as people with chronic illnesses.
The mortality rate in Thailand is one in 10,000 and is deteriorating to reach a population of 1,000 when a pandemic strikes, as was the case in 2009.
Unlike bacteria that can be cured by antibiotics, there is no medicine to kill a virus. A virus initiates infection by attaching itself to its specific receptor on the surface of a susceptible host cell. This means that drugs that block the virus are not able to attach the receptor.
"The flu virus is different from other viral diseases because it is highly transmissible, preventable and treatable. We have a vaccine and the drug, oseltamivir phosphate, reduces the symptoms and helps patients improve one or two days faster than if they had not taken it, "says Dr. Tawee.
In Thailand, oseltamivir, used for more than ten years, is only available in hospitals to prevent overuse. Physicians establish the diagnosis with symptoms and confirmatory laboratory tests before prescribing the drug, which must be taken twice daily for five consecutive days.
A new drug called Baloxavir is available and has just been approved by the Food and Drug Administration. Thailand is the third country to have approved the drug and the first to have approved the use by patients belonging to high-risk groups.
Instead of taking five consecutive days like oseltamivir, patients take only one tablet per dose. It is expected that it costs 1000 Bt per tablet.
There are three types of flu – A, B and C – and each has a variety of subtypes. Of these, type A, which includes subtypes H1N1 and H5N1, and type B (Victoria and Yamagata) are responsible for annual influenza outbreaks. Type C, although it can lead to the flu, is usually harmless. But influenza viruses constantly mutate and new strains appear regularly. For more than 50 years, the World Health Organization has worked with scientists and policy makers around the world to develop a unified approach to the manufacturing, testing and regulatory oversight of influenza vaccine development, as well as than their effective use and distribution.
The WHO updates the prevalence of the epidemic for the coming year, identifying the type or subtype of the virus causing the outbreak, and then sends the information to the pharmaceutical company for the production of the vaccine.
The vaccine production process takes six months. In some years, the vaccine is less effective, either because the virus has undergone a radical change during the period, or the forecasts are incorrect. "That's why you need to be vaccinated every year," says Dr. Tawee.
In Thailand, the new annual vaccine will be available this month. The type of virus on which it is based will be the same as that produced for countries in the southern hemisphere, where the epidemic coincides with the rainy season in Thailand. Dr. Tawee advises getting it right out, saying, "It's better to keep the vaccine in our body than in the refrigerator."
http://www.nationmultimedia.com/detail/lifestyle/30366932
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