Influenza experts meeting in Malta

Early next month influenza experts from all over the world will meet in Malta for a conference organised by an international scientific influenza working group.

The timing seems perfect, as fears of an influenza pandemic, possibly caused by the H5N1 avian flu virus, are on the increase.

It was recently reported that birds infected with the virus were found in the Chelyabinsk region of Siberia, close to the Ural mountains that separate Europe from Asia.

Although the virus is still confined to birds, particularly poultry, and it has not yet mutated so that it could be transmitted from one person to another, experts are still concerned that this could happen and a pandemic could ensue.

Confronted with this worldwide challenge, part of the conference is expected to focus on the pandemic.

Dr Tanya Melillo, chairman of the National Influenza Pandemic Standing Committee, said we are fortunate that the meeting was being held in Malta.

"Over 700 people will be attending, with influenza experts from all over the world, including the World Health Organisation. The talks will cover a wide range of topics, like the impact of influenza on the elderly and children, the social and economic impact of a pandemic, the cost effectiveness of vaccination, the importance of surveillance, the different types of diagnostic testing, the burden of influenza, stockpiling antivirals and public health measures," she said.

Asked whether the fact that the virus had been found in Siberia meant that it was moving closer to us, Dr Melillo said it had not yet been detected in any European country, including Malta.

Moreover, she explained, the Food and Veterinary Regulatory Authority was following European Union guidelines and regularly checking local poultry for the avian virus.

Dr Melillo said indications showed that it was "very unlikely" for the pandemic to strike this coming season.

Yet the local influenza committee is still working on preparations for the pandemic. Dr Melillo said regular meetings and discussions were taking place with many stakeholders, especially in the health sector.

Meetings, she explained, were also being held with the police, the armed forces and the Civil Protection Department. There are decisions to be made on how the hospital, primary health care and essential services, will work during the pandemic.

Dr Melillo said the committee was also communicating and discussing with its counterparts in other European countries on which protocols and guidelines to adopt. Among the committee's most important work is monitoring updates on the latest information and studies being carried out.

It is also the committee's job to prepare and divulge information to the media, health care workers and the public. Asked whether there was enough public awareness about the pandemic, Dr Melillo said, although there was awareness, many people were very confused.

"Unfortunately, some journalists are confused themselves, and so the message they are sending out is further confusing people. Some doctors and pharmacists also do not know the facts well, and they too are confusing people. People should ask for information from the proper authorities, especially the department of public health," she said.

Some of the confusion concerns antiviral drugs, and whether people should buy them now and keep them for future use. Antivirals would prove very important during the pandemic, especially during the first few months, when no vaccine against the virus causing the pandemic will be available.

When taken within 48 hours from the onset of symptoms, antivirals will help reduce viral shedding, shorten the period of illness, reduce the severity of symptoms, and possibly lead to fewer complications.

The Health Division recently issued a statement warning that it was illegal for doctors to sell medicine directly to patients and for pharmacies to order and supply medicines and vaccines against the influenza pandemic virus without a prescription.

Dr Melillo said the director-general of health was issuing a circular to all doctors and pharmacies with instructions on what they can, and cannot, do by law.

"Vaccines can be ordered by both doctors and pharmacies, but antivirals can only be ordered through pharmacies. For each antiviral sold, the health department will be requesting details of the person buying it, details of the doctor prescribing it and details of the pharmacy dispensing it to keep track of the antiviral availability across the island," she said.

Asked whether the public can buy antivirals before the pandemic strikes and stock them to use if they get sick, Dr Melillo explained that there is no law, here or abroad, about the stockpiling of medicines. In fact, she continued, other countries were facing the same problem with antivirals as Malta.

"People should discuss the issue with their private doctor, and take his or her advice. This is a prescription medicine, and people should only take it if they fall ill with the virus causing the pandemic during the pandemic. Before taking the medicine, people should consult their doctor, and only take antivirals if the doctor confirms that they are suffering from the pandemic influenza and are within the time frame during which the antivirals work," she said.

Dr Melillo explained that antivirals work within the first 24 to 48 hours - preferably before 30 hours - of developing symptoms of the pandemic influenza.

"This medicine should only be used to treat those patients who fall ill during the pandemic, and not with the usual colds in winter," she emphasised.

In a bid to avoid confusion, the Health Ministry has prepared a leaflet with frequently asked questions about the pandemic. It is also available online at www.sahha.gov.mt . For more information, call the pandemic flu helpline tel: 2132-4086 between Monday and Friday from 8 a.m. to 2 p.m.