Ukraine mystery outbreak sparks WHO concern

The World Health Organization sent a team of experts to Ukraine on Nov. 2 to investigate an outbreak of respiratory disease that’s sickened a quarter of a million people and left pharmacies without masks or flu remedies.

A group of epidemiologists, physicians, laboratory technicians and communications advisers were scheduled to arrive that night in Kiev, Gregory Hartl, a WHO spokesman in Geneva, told on Nov. 2.

Ukraine faces an outbreak of flu-like illness that’s killed at least 67 people and infected 255,000, according to the country’s first deputy health minister Vasyl Lazoryshynets. About 22 patients tested positive for swine flu, Lazoryshynets said. It’s “difficult to tell” whether the pandemic H1N1 virus is responsible for all the cases, according to Hartl.

“There are a lot of unknowns,” he said. The crew of experts will collect samples from patients and send them to the WHO’s influenza collaborating center in London for diagnosis. The WHO may have more information on Nov. 4, Hartl said.

Ukraine’s government has closed schools and banned public events. In four of Kiev’s 10 districts, a majority of drugstores posted handwritten signs in their windows that read “no masks.” A central information line for the city’s drugstores said Nov. 1 that most stores had run out of protective masks or flu and cold remedies such as acetaminophen, and new supplies were expected later in the week.

According to the WHO, international experience of the H1N1 2009 pandemic to date, especially from the Southern Hemisphere, has shown that poor clinical outcomes are associated with delays in seeking health care and limited access to supportive care. In addition, this virus has also shown its ability to cause rapidly progressive overwhelming lung disease, which is very difficult to treat.

Public health measures recommended by the Ministry of Health of the Ukraine across the entire country include: social distancing (school closures and cancellation of mass gatherings); enhancement of surveillance activities; increased respiratory hygiene; and continuation of the vaccination campaign against seasonal influenza targeting at risk groups.

The government of the Ukraine has activated coordination mechanisms to respond to the rapidly evolving situation, including the harmonization of response plans across all administrative levels, the WHO said.

About 15,000 people are being treated at hospitals across Ukraine, Lazoryshynets said at a press conference Nov. 2 in Kiev.

Ukraine has asked the United States, the European Union, NATO and neighbors for anti-flu drugs. Poland and Slovakia sent protective masks and Roche Holding AG’s drug Tamiflu to Ukraine after President Viktor Yushchenko said the country couldn’t fight an outbreak of pandemic influenza alone, according to a statement from the government.

H1N1, a new flu strain that’s evolved in pigs, humans and birds, has sickened at least 440,000 people and killed more than 5,700 since it was discovered in Mexico and the U.S. in April, the WHO said last week

“It’s a bit like Mexico in the beginning,” said John Oxford, professor of virology at Queen Mary’s School of Medicine and Dentistry in London, adding that Ukrainian authorities may not have the scientific resources they need to observe the outbreak closely.

“One’s first reaction is that not due to any fault of their own, they’re getting into a bit of a flap.”

It’s unlikely that the virus has mutated and become more deadly, according to Oxford. “It doesn’t fit with the experience of other countries at the moment, so why should the Ukraine be different,” he said.

An analysis of early data on the outbreak suggests severe cases and deaths in Ukraine occurred among adults aged between the ages of 20 and 50, according to the Geneva-based WHO.

The U.K. Health Protection Agency estimated on Oct. 29 that about 521,000 of the country’s 61 million residents have gotten the virus since the pandemic began, and 137 of them have died. That’s a death rate of 0.03 percent, similar to the one Ukraine’s numbers indicate.

Across the Black Sea, Bulgaria also said it was hit by a flu epidemic, closed schools and banned gatherings, the Sofia News Agency reported, citing Angel Kunchev, head of the health ministry’s department of control of communicable diseases.