According to the chief state sanitary inspector of Monitoring, the Michigan flu is predominantly young, and the complications are much worse.
– Dr. Kunchev, for a short time there were several deaths that were supposed to be associated with complications from the flu. At the same time, hospitals are crowded. Is the epidemic situation worse this year, or is it unnecessary panic?
“Overall, I cannot say that there are any surprises in terms of the time of the flu, as well as the expected strain of Michigan. WHO has long indicated that WHO is the likely cause of the seasonal epidemic this year. Of course, we also need to point out that there is a parallel circulation of H3N2, but to a much lesser extent. We can say that in different weeks, H1N1 "Michigan" prevailed in 80% of cases of influenza. This is the difference between this year’s epidemic and last year’s epidemic, since it is not very different in intensity. Even patients this winter less, but the number of complications and their weight more. It is normal that every year from January 15 to February 15 there will be no places in hospitals. The difference is that this year the age was different. You know that flu usually affects people over 65. Now those who are active and adolescent have suffered the most. Mostly people aged 30-40 years. It is not by chance that you will see that those who died of proven flu belong to this age group. This impression this year, because it is still young people. Another characteristic is the severity of the symptoms. In percentage terms, complications are not as different as in other years, but harder. Very fast pneumonia has developed in hospitals, and especially if they are late and self-medicate at home, have serious complications – they develop respiratory failure, sometimes with pneumonia, which is difficult to treat. That is why it comes to a fatal end. These are two distinctive features.
– Can you tell exactly how many deaths this year are from the tested flu?
– No, no one can give accurate information about this.
“It turns out that in hospitals they simply assume that deaths have occurred from the flu, but they do not send samples for research.” It cost them financially, is it so expensive?
– All training sessions are loaded, but this does not mean that we should work blindly. We must not allow this to happen. Thus, no one will want to do this in order to know exactly which antibiotic to prescribe to the patient. Medicine is not cheap. But here is a complete virological study, in which you can even specify the strain. Mass in hospitals is somewhat less accurate, but suitable for screening tests. They are expressive and show whether this is due to the flu and from the strain. That is enough, they are much cheaper. They are in a few minutes and not so expensive. We conduct free screening every year, especially at the beginning of the epidemic. Thus, we determine which viruses are circulating. Last week we had over 300 samples that were released for free. But in a situation where about 200,000 people are ill, it is clear that this burden is very great for everyone – for hospitals, for laboratories, and for X-rays. Viral pneumonia is sometimes absent. They are barely audible on the phone, there is no bacterial component and no wheezing is heard, but they are very clearly visible on the X-ray. Therefore it is necessary.
How to treat these pneumonia after viral diseases?
– only antivirus.
“And is there a statistic of how many people got sick last year and from what did they die?”
– No, but if a person fell ill with the flu, and then fell ill with pneumonia and died, then the cause of death is the flu of 99%. Regardless of whether it is investigated or not, these are details. But usually, in the act of death, comorbidities are referred to as the cause.
– We reached the peak of the flu, however, or is it still ahead in early February, as some experts say?
– We reached it. Even some areas, such as Pernik, are already out of the epidemic. I expect by the end of the week there will be others who were among the first to be affected by the flu. Therefore, it is unlikely that the incidence will grow more than we are currently seeing. Then it will begin to decrease. It is true that in areas that later announced an epidemic, such as Lovech, Vratsa, Montana, there may be more patients this week, but the country as a whole has already reached its peak.
– Is there a new wave, say, in March? I heard about this hypothesis of doctors a few days ago.
“There is always such an opportunity, but no one can say when and if this happens at all. Sometimes, though not very often, two waves occur with the flu. The second peak is about a month and a half after the first one, but it has never been so intense. It happened, but not always.
– You said that self-healing is extremely dangerous, what do people mean? Just the heat should make us go to the doctor?
"Not only is she, the general condition too. If you have a severe headache, fatigue or lack of appetite for several days, it is recommended to consult a doctor. Because it is an illusion that everyone should immediately go to the general practitioner, as some colleagues recommend. I wonder what will happen if all 200,000 people go straight to the jeep. There will be sick and healthy people in one place, and 90% of the flu, no matter how hard, will pass. The essence is to help and save those who have chronic diseases and weak immunity em.
“Are there unnecessary hysteria, are people afraid of you?”
– They are usually scared, but not for long, until the situation is serious. Then they forget about it, and when in September we remind them that they should be vaccinated, no reaction occurs. It is true that there is no need to immunize the entire population, but it is important to vaccinate people over the age of 65. As I said, the flu usually throws them. So it's good that there is a national plan, and I very much hope that free vaccinations will be given to older people.
– And more this year more people were vaccinated, because it turned out that the vaccines were exhausted at the beginning of the season?
– Yes, this is indicative, because, as a rule, the number of vaccines is the same every year. But the fact that they were exhausted already in the middle of November is quite significant. And companies can not respond at the beginning of the season. One of the large companies managed to redirect 7,000 doses, but this is a drop in the ocean.
“Does this mean that more doses will be announced next year?”
– I really hope. Moreover, there is a national project that provides free vaccine for the elderly, let's raise the percentage.
“What other viruses are there now, what else should we be careful about?”
“In fact, there are not many other viruses in the flu epidemic. They do not disappear, but the main stress is very aggressive and repels others. This year, as I have already said, H3N2 “Singapore” circulated – about 10-15%, we should keep this in mind, but there are no other viruses in these respiratory weeks.
– In Romania, a difficult situation with the flu, and this year a lot of deaths. Has this happened before?
“It all depends on death. When we hear that a 9-year-old child is dead, everyone learns. This does not apply to older people. This is a purely social phenomenon.
“But can we protect ourselves and how effective are the masks we use?”
– Here, my opinion does not coincide with other colleagues. In my opinion, they have their place, but if they are sick, not healthy. And we usually see how people love to protect themselves. As long as you have the initial symptoms, sneezing and coughing, this pure mechanical barrier in front limits the dispersion of the smallest drops that carry the virus. Otherwise, the usual medical mask after 15-20 minutes of breathing is moistened and does not protect us.
– And is there an increase in models?
– There are those who are not prepared. That is, where it is impossible to interfere and limit the spread, for example, measles and rubella. Cases of chicken pox and scarlet fever, for which we do not yet have a vaccine, vary according to the epidemic. They start from December to March-April most.
Born October 19, 1959
In 1985 he graduated from the Medical Institute in Plovdiv. Since 1986 he has been working in the department of anti-epidemic control at the university in Haskovo.
Since 2001, he has been working in the anti-epidemic control section of the Ministry of Health.
Since 2008, he has been heading “Infectious Disease Surveillance” at the Ministry of Health.