2009 swine flu pandemic in Ukraine

The 2009 flu pandemic is a global outbreak of a new strain of influenza A virus subtype H1N1, first identified in April 2009, termed Pandemic H1N1/09 virus by the World Health Organization (WHO)[1] and colloquially called swine flu. The outbreak was first observed in Mexico,[2][3] and quickly spread globally. On the 11th June 2009, the WHO declared the outbreak to be a pandemic.[4][5] The overwhelming majority of patients experience mild symptoms",[4] but some persons are at higher risk of suffering more serious effects; such as those with asthma, diabetes,[6][7] obesity, heart disease, or those who are pregnant or have a weakened immune system.[8] In the rare severe cases, around 3–5 days after symptoms manifest, the sufferer's condition declines quickly, often to the point respiratory failure.[9] Although Ukraine was not (very) affected at first there was on outbreak of the virus in Western Ukraine early November 2009 which led to the closing of public buildings and meetings for three weeks.[10]

As of December 2009 more than two million people had fallen ill since Ukraine's flu epidemic began[11] and about 500 people of those died of flu and flu-like illnesses and its complications (pneumonia) of the 46 million people living in Ukraine.[12] Ukraine is one of the most affected (8th) by swine flu country's in Europe.[13]

According to Ukrainian Justice Minister Mykola Onischuk the epidemiological situation during October–December 2009 hasn't influenced the death rate in Ukraine.[14]

Ukraine has two laboratories capable of identifying influenza strains.[15]

Timeline

First cases
An ambulance in Kyiv

The virus reached Ukraine on 5 June 2009 when the first case of the virus was officially confirmed in Ukraine. The patient concerned, a 24-year-old Ukrainian citizen, had arrived from New York City via Paris at Kyiv's Boryspil Airport on May 29, 2009.[16] Before that imports of pork and live pigs from all affected countries had been banned. The ban applied to all shipments after April 21, 2009.[17]

A second swine flu case (in Ukraine) was confirmed on September 29, 2009.[18]

October 2009

On October 27, 2009, an outbreak of influenza-like illness and deaths of seven people from its complications have been reported in Ternopil region.[19][20] Schools and universities in Ternopil were closed.[19]

Radio Netherlands Worldwide mentioned (on November 4) rumours about a plane said to have flown over the capital of Ukraine, Kyiv, releasing powder containing a mutated variety of the A (H1N1) virus.[21]

On 30 October 2009, Ukrainian Ministry of Health confirmed 11 new cases of swine flu, and the first death from it. An epidemic was declared and nine out of 25 regions of Ukraine were put under quarantine,[10][22] on November 5, 2009 Kirovohrad became the 10th.[23] Due to the outbreak public meetings, including cinema,[24] were forbidden nationwide and all educational institutions were closed for three weeks (subject to extension if necessary).[25][26] Conscription into the Ukrainian army was also suspended,[27] and the Professional Football League of Ukraine postponed football matches in the Ukrainian First League and Second League.[28]

November 2009

A large shipment of Tamiflu was delivered from Switzerland to Ukraine on November 1, 2009 for distribution among hospitals for free.[29]

On November 2, 2009, at Ukraine's request, the WHO sent a team of nine experts to determine if the same strain of swine flu was responsible for the 70 recent deaths from acute respiratory illness in the country.[30][31]

According to the Ukrainian Health Ministry as of November 2, 2009 the number of people who have died of influenza and respiratory diseases has reached 60, the number of people suffering from the flu is 200,000[29] and about 22 patients tested positive for swine flu.[32] On November 5, 2009 the Ministry said the death toll of patients with flu-related and acute respiratory illnesses had jumped to 95. 15 of 31 patient samples sent to London for laboratory analysis tested positive for the H1N1 virus.[33]

As of November 6, 2009 twenty-eight cases of swine flu have been confirmed in Ukraine. Thirteen of these cases were in people who were dead by this point.[34] The Ukrainian health ministry estimated that Ukraine required 12.5 million doses of vaccine against swine flu.[35] Four days later, on November 10, 2009 the number of confirmed cases had risen to 67. However, only one more person had died. 1,031,587 people in Ukraine had contracted flu or a flu-like illness by then and of them 52,742 where hospitalized at the time of the report.[36] Since there had been 174 deaths from acute respiratory viral infections [37] and other patients had recovered, this number is less than the total hospitalizations related to flu and flu-like illnesses.

At this point it was determined to implement a policy so that if at least one person had been diagnosed with swine flu in any region of Ukraine everyone in that region diagnosed with the flu would receive swine flu treatment.[36]

On November 17, 2009, the WHO issued a statement that there were no significant differences between the pandemic H1N1 strain, and the Ukrainian strains tested.[38]

Starting on November 18, 2009 the Ukrainian ministry of health stopped publishing separate statistics on cases of A/H1N1 influenza.[39] Regional commissions were given the power to cancel quarantines of higher educational establishments on November 20.[40]

On November 23 in the regions where the epidemic threshold for flu and respiratory infections wasn't reached educational institutions opened again;[41] for instance on November 25, 2009 all educational institutions and kindergartens in Kyiv resumed work.[42]

December 2009

As of December 2, 2009 445 people had died of flu and flu-like illnesses with a total of 116,982 people hospitalized since the start of the epidemic (October 29, 2009). Of those hospitalized, 93,213 people had at the time been discharged from hospitals. On December 2 the epidemic threshold was still exceeded in the Zakarpattia and Khmelnytsky regions.[43]

On December 7, 2009 more than two million people had fallen ill since Ukraine's flu epidemic began with 88 patients at the time in intensive care.[11] At the time about 46 million people lived in Ukraine.[12]

On December 8, 2009 468 people have died of flu and flu-like illnesses and its complications (pneumonia) in Ukraine with a total of 128,851 people that had been hospitalized since the start of the epidemic (October 29) and 102,510 people discharged from hospitals. On December 8 the epidemic threshold was still exceeded in Vinnytsia, Dnipropetrovsk, Kirovohrad, Luhansk and Sumy regions.[44]

As of December 2009 Ukrainian and World Health Organization officials have warned of a second and third wave of the flu epidemic starting in late December 2009 and early 2010.[45] As of December 23, WHO says that H1N1 is resurging in Ukraine, as well as in Serbia and Turkey, with increasing influenza like illness and acute respiratory illness.

As of December 28, 652 people have died since the epidemic started in late October. At the time 258 people were in intensive care with dozens on respirators. More than 200,000 people have been hospitalized.[46] Late December 2009 saw a high influenza activity in the Eastern Ukrainian provinces Donetsk Oblast and Luhansk Oblast.[47]

Overall the spread of acute respiratory infections in Ukraine passed over a second peak late December 2009, almost three times up on the same time a year ago.[48]

January 2010

As of January 8 the WHO says that intense A/H1N1 virus activity continues in Ukraine, as well as in several other eastern Europe countries.[49] As of January 23 Ukrainian health officials expect a second surge of flu and respiratory infections to strike early in February 2010.[50]

The number of those who have died of flu and flu-like illnesses in Ukraine had increased to 940 people on January 12, 2010 with the epidemic threshold being exceeded in Dnipropetrovsk, Luhansk, Poltava, Sumy regions and Crimea; according to the Ukrainian Health Ministry.[51] This number increased to 1,019 people on January 21, 2010 with the epidemic threshold being exceeded in the Dnipropetrovsk, Luhansk, Poltava and Sumy regions.[52]

Epidemiology

According to Chief State Sanitary Doctor Oleksandr Bilovol, the mass refusal by Ukrainians to be vaccinated (after several persons allegedly died after vaccinations in 2008[53] and 2009[54]) was partly the cause for the epidemic.[26]

According to Ukrainian doctors the Government of Ukraine had provided no public information and taken no precautionary measures to prevent the pandemic.[21][55][56] In November, the WHO praised the Ukrainian government for the measures it took to prevent the spread of the flu epidemic in Ukraine.[57] According to a poll carried out by the Institute of Social and Political Psychology of the Academy of Pedagogical Sciences of Ukraine in November 2009 Ukrainian citizens had mainly negative feelings about measures being taken by the government to fight the flu epidemic. According to the poll, 49.8% of respondents made a negative assessment of the activities of the Cabinet of Ministers (37.4% a positive one), 44.8% the Health Ministry (28.1% positive), 57.4% the president and his secretariat (18.8% positive), and 50.4% the Verkhovna Rada (parliament of Ukraine) (18.6% positive).[58]

Ukrainian analysts have suggested that politicians, mainly Ukrainian President Viktor Yushchenko and Prime Minister Yulia Tymoshenko, have tried to use the pandemic to score political points with the January 2010 presidential election in mind.[59] This has been denied.[60][61] According to a poll by Research & Branding Group the majority of Ukrainians think that the epidemic of flu will not affect the presidential elections.[62] According to a November 2009 poll by FOM-Ukraine 33.3% of Ukrainians think that the public panic about the flu epidemic helped Prime Minister Tymoshenko the most, while 28.7% said it was a boost for all politicians (other individual politicians where polled at <10%). Asked what caused the panic, 45.6% pointed to the media, and 20.3% to government representatives.[63]

According to the Ukrainian Health Ministry the average daily number of legalities caused by flu in 2009 was lower than in 2008, when it was 18.[64]

During the pandemic Ukrainians started to eat onions and garlic (in Lviv, the price of garlic had skyrocketed in November 2009[21]), took vitamins, spent more time at home, and drank alcoholic beverages in order to protect themselves from flu and flu-like illnesses.[65]

As of mid-December 2009 the Verkhovna Rada (Ukraine's parliament) has allocated over 600 million hryvnya to fight the flu epidemic in Ukraine.[66]

Comparisons within Europe

Based on data collected from 43 European countries, on 13 November 2009 the WHO announced that Ukraine had the 8th highest infection rate of A/H1N1 (following Norway, Sweden, Bulgaria, Moldova, Iceland, Ireland and Russia) in Europe. Furthermore, Belarus, Kazakhstan, Poland, various regions of Russia, Northern Ireland, Turkey, Finland, and Ukraine had a high sickness rate of А/Н1N1 flu.[13][67]

According to Jukka Pukkila, head of a WHO international mission to Ukraine, "there is no difference concerning the rate of A/H1N1 flu infection in Ukraine compared to other countries".[68] WHO tests of the H1N1 pandemic virus samples taken from Ukrainian patients haven't exposed any signs of mutation.[69]

A total of 22 countries have assisted Ukraine in fighting its flu epidemic.[70]

See also

References
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Official status reports
Background information
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