Influenza in Russia. What threatens public health and why not panic?
Seasonal exacerbation of influenza diseases continues in Russia. In a number of regions of the country the epidemiological threshold of morbidity has been seriously exceeded, there are also lethal cases. In addition to the quite typical for this time of year SARS, the so-called “swine flu” - A (H1N1) is distributed.
In a number of mass media, and especially in social networks, rumors are spreading that you cannot call anything but panic. Some users write that the flu literally "mows down" the Russians, almost hundreds of them die in every city. Of course, the actual situation is very different from what conscious or spontaneous alarmists write about. Doctors ask people not to panic, keep calm and sober mind, but many do not always succeed. Of course, there are reasons for this - in the information society, any information, including negative information, is spread very quickly. And often - by the method of "spoiled phone". Each user adds to the information received their own conjectures, rumors, often without any basis, and in this form already translates the information further. In an interview with Lente.ru, the chief researcher of the Institute of Vaccines and Serums named after I.I. Mechnikova Yuri Gendon assures that there is no emergency situation associated with a massive flu epidemic. According to the doctor, this is the most common flu epidemic that occurs every year. Winter weather, temperature drops - all this leads to a wide spread of ARVI. But many people do not consider it necessary to be vaccinated, and pharmacies in insufficient quantities purchase pharmaceutical products. We can add to these words of a specialist only that the shortage of medicines in pharmacies in several cities is directly related to the spread of panic among the population. People rush to buy medicines, medical masks literally on an “industrial scale”.
Epidemiological threshold exceeded in regions
A difficult situation has developed in Moscow and St. Petersburg. Rospotrebnadzor reported that the epidemiological threshold in Moscow was exceeded by 40%, and therefore quarantine was announced in the Russian capital.
Elena Andreeva, the chief sanitary doctor of Moscow, told Russian journalists that the situation in the capital is estimated as epidemiological. According to Rospotrebnadzor, 61% of people with influenza are children. In St. Petersburg, as reported by the media, the 22 person has already died from pneumonia. Rospotrebnadzor also reported that last week 18-24 in January exceeded the epidemiological thresholds in 47 regions of the Russian Federation, and among large cities - in Vladimir, Kursk, Kaliningrad, Kazan, Cheboksary, Samara, Syktyvkar, Yekaterinburg.
The most severe epidemiological situation with the incidence of influenza has developed in the south of Russia. Mass incidence of influenza is noted in the Rostov and Volgograd regions, the Krasnodar Territory, Adygea, other territories, regions and republics of the region. In Adygea, according to press reports, 11 people died, on the Don - 8 people. Lyudmila Tsybalova, Deputy Director of the Flu Research Institute of the Ministry of Health and Social Development of the Russian Federation, explains the increased incidence of southerners by the fact that earlier the flu was not so common in the regions of Southern Russia and the North Caucasus, therefore the majority of people in the region are not immune to the disease. Recently it became known that the Ministry of Health of the Rostov Region acknowledged the fact that the epidemiological threshold for the incidence of influenza and ARVI in the region was exceeded. According to the regional Ministry of Health, in Rostov-on-Don, there were about 8 000 cases of influenza and ARVI. This figure is 73% higher than the incidence of a week ago. In addition, it is known only about those cases of the disease, when patients seek help from doctors. But many people prefer to carry the disease "on their feet." And this is especially dangerous - by endangering their own health, they infect other people by contacting them at work, school, in public transport, in crowded places. Eight deaths are also known. So, in one of the city hospitals died a three-year-old girl. Young men also died - 31 and 35 years. The disease does not spare health workers. So, January 26 became aware of the death of pneumonia by the head of the maternity ward of the Central City Hospital of Kamensk-Shakhtinsky Rostov region. Nina Fedorovna Shumilina died on January 25 near 22.00. An unprecedented incident occurred in one of the Rostov hospitals - a young 34-year-old man died of pneumonia right in the hospital lobby, not waiting for his turn to see a doctor. However, doctors say that the flu itself can not be fatal, but its complications, which include pneumonia, may well be fatal. But, according to the Minister of Health of the Rostov Region, Tatyana Bykovskaya, all deaths are associated with very late treatment for qualified medical care. As the head of the medical department noted, already on the second day, the doctors see changes in the lungs, on the third day pneumonia begins, and after five to six days the disease can become irreversible. Deputy Head of the Administration of Rostov-on-Don on Social Issues, Viktor Berezhnoy, stressed that the city’s epidemiological threshold was indeed exceeded, but it’s not worth talking about a critical situation. Most of the city’s institutions operate normally. It is known that 6 schools and 13 kindergartens were closed in the Rostov region in connection with cases of mass incidence of influenza and ARVI, 42 classes in 11 schools and 27 groups in 20 kindergartens were partially closed. All educational institutions are closed for quarantine, where the epidemiological threshold of morbidity has been exceeded. However, the overwhelming majority of schools and kindergartens of the region function normally. Deputy Head of the Administration of Rostov-on-Don on Social Issues, Viktor Berezhnoy, at a meeting with the Head of Administration Sergey Gorban, said that so far the city has not exceeded the epidemiological threshold for influenza in the city.
However, the fact that the incidence of influenza is indeed very increased, indicates the extension of the time of work of district clinics. Emergency help can now be obtained before 22.00. In addition, the leadership of the regional Ministry of Health agreed with the Rostov State Medical University that interns and interns will come to the aid of the current doctors and medical assistants. This decision was made in order to increase the speed of medical services for the population. After all, ambulance crews and district therapists are struggling to cope with large flows of patients. Polyclinics of the Krasnodar Territory also switched to enhanced operation. In the cities and villages of Kuban, the situation with the incidence of influenza also remains very serious. Although the regional authorities have not yet announced an epidemic, nevertheless, deaths also occur in the Krasnodar Territory. One of the first victims of the deadly flu in the Krasnodar Territory was a pregnant woman from a small Armavir. In late January, she was to give birth to a child. According to representatives of the regional medical department, the woman herself repeatedly refused to go to the hospital. On the other hand, the relatives of the deceased tell reporters that, on the contrary, medical facilities did not accept her. Krasnodar Region Health Minister Yevgeny Filippov claims that 40% of the population received flu vaccinations in the region and, like his Rostov colleague Tatyana Bykovskaya, stresses that in no case should you resort to self-treatment. The situation in neighboring Adygea, where about a thousand people got the flu, is no easier. The number of vaccinated, judging by the publications in the press, is less here than in the Krasnodar Territory - 25% of the population of the republic received vaccinations. The Adygea Health Minister Rustem Meretukov claims that it is premature to talk about the swine flu epidemic in the republic. But here, as well as in other regions of the South of Russia, hospitals are forced to open additional chambers - there are not enough places for all incoming patients with influenza and ARVI. In the Volgograd region, more than 30% of the population was vaccinated. However, here, as Anatoly Sebelev, deputy chairman of the oblast health committee, notes, swine flu is diagnosed in 75% of cases.
Influenza come from Ukraine?
Meanwhile, the Minister of Health and Social Development of the Russian Federation, Veronika Skvortsova, not so long ago stated that the massive incidence of influenza could be the consequence of bringing the disease from neighboring Ukraine. Indeed, in Ukraine, the situation with the medical care of the population and, especially, preventive maintenance, has deteriorated several times after the general destabilization of the political and socio-economic situation in the country. In the conditions of war, economic crisis, destruction of the former social infrastructure, the state of health of the population is much worse than it was before the authorities. And this is despite the fact that even before the events on Maidan, the Ukrainian healthcare system was not distinguished by high efficiency. Therefore, although the liberal opposition is skeptical about the assertion of the penetration of the disease from neighboring Ukraine, this version seems quite reasonable. On the other hand, in the conditions of a large-scale crisis in a neighboring country, the Russian authorities were supposed to take measures that minimize the risks of dangerous diseases entering the Russian Federation from the territory of Ukraine. In the first place - to tighten sanitary control over the citizens of this state entering the territory of the Russian Federation. Of course, these measures would not completely eliminate the spread of the flu, but at least they could contribute to more effective prevention of morbidity in Russia itself. The representatives of the Kiev regime themselves do not hide the fact that an extremely serious situation with the incidence of influenza has developed in Ukraine. Thus, the Minister of Health of Ukraine, Alexander Kvitashvili, told reporters that the epidemiological threshold for the incidence of influenza and ARVI was exceeded in 18 from 24 regions of Ukraine. Oleg Ruban, chief state sanitary doctor of the city of Kiev, told reporters that the situation with the incidence of influenza is severe in the Ukrainian capital - the growth rate is 50%, in just one day several thousand people visit Kiev hospitals. The main problem is that people go to a medical facility already at the 7-8 day of illness, when doctors may be powerless, because the process of destruction of the lungs has gone very far. In addition to Kiev, a very difficult situation is observed in the Rivne region, a rather difficult situation in a number of other regions of Western Ukraine. Thus, the epidemic has spread to almost the entire country. Against the background of mass impoverishment of the population, even the acquisition of elementary drugs for many Ukrainian citizens becomes a real problem.
The network has information that the flu "mows down" the ranks of the Ukrainian military in the Donbas. So, even representatives of the Ministry of Defense of Ukraine recognized that more than 400 people were ill among Ukrainian soldiers and officers. True, there are no official reports of deaths among military personnel, but given the general reluctance of the Ukrainian command to draw attention to this problem, it is possible that they have already taken place - especially in the units operating in the Donbas. It is known that the Ukrainian soldiers fighting in the Donbas are in very poor living conditions. As a rule, they live in tents, in rainy weather the hastily built tent camps are flooded with water. In these conditions, even without an epidemic, many soldiers suffer from various forms of bronchitis and pneumonia. Naturally, the proper preventive work among the existing units is practically not conducted. Therefore, the spread of the influenza virus found fertile ground in the army units in the Donbas. Almost immediately after the start of the epidemic, the soldiers of the Ukrainian army began to get sick dozens. With medical care from 1 on January 2016, the hospital and medical units turned 189 soldiers and officers in the Donetsk area, 104 - in Lugansk and 67 in the Mariupol direction, - said the spokesman for the headquarters of the "antiterrorist operation" . However, representatives of the press service of the Ukrainian Ministry of Defense, called the situation satisfactory and asked not to raise panic - they say, there are not so many sick soldiers. Meanwhile, representatives of the Ministry of Defense of the Donetsk People's Republic speak about a much larger scale of the flu epidemic among Ukrainian servicemen. According to the information that is available in the Ministry of Defense of the DPR, there are already not enough places in the hospitals of the Ukrainian army, such a large number of sick soldiers. The version that the spread of the disease could have been caused by the leakage of the flu strain from some secret laboratory located near Kharkov was also voiced. In this laboratory, American bacteriological specialists could conduct their tests. arms, some media reported. By the way, representatives of the health system of the DPR do not deny the fact of the spread of the flu. According to Donetsk doctors, to date, people in the republic have already died from complications of influenza 12. That is, the situation with the spread of influenza in the DPR remains very difficult.
By the way, if we turn to the version of the spread of swine flu as a consequence of an accidental or intentional “leakage of strains” from a secret American laboratory, then we cannot ignore the strange events on the border between Armenia and Georgia. There are flu cases around 10 people. It is quite an ordinary situation, if it were not for the fact that even in this area, outbreaks of a variety of dangerous diseases occurred - anthrax, swine flu, bird flu. Some media outlets are suspected of being involved in the spread of disease by an American research center operating in Georgia.
"Spaniard" killed millions of people
History knows examples of mass epidemics of influenza, whose victims were thousands of people in various countries of the world. One of the largest such epidemics has become the famous epidemic of the “Spanish flu” - the Spanish flu. She followed in 1918-1919, immediately after the end of the First World War. However, in terms of the number of deaths from the disease, the “Spanish flu” fairly quickly exceeded human losses as a result of the First World War itself. There are several major versions of the origin of the flu epidemic in 1918-1920. According to the first of them, the flu to Europe was brought by American soldiers who landed to participate in the First World War. According to this version, the disease began at Fort Riley in the US state of Kansas in January-February 1918, from where it was subsequently brought to Europe. There were cases of bronchitis among British soldiers who fought on the territory of France. The second version claims not the American, but the Asian origin of the disease - according to this version, the Chinese labor battalions, also landed in France, brought the flu to Europe. Finally, the third version suggests the possibility of the emergence of influenza directly in Spain, where in 1918, mass cases of the incidence of bronchitis began to be noted. Doctors have identified the main symptoms of the disease - blue complexion (cyanosis), pneumonia, cough with hemoptysis. But in most cases, the disease was asymptomatic. Some people died the very next day after infection, and among the dead there were not only risk categories - pregnant women, children, the elderly, but also young people between the ages of twenty and forty. The cause of the high mortality rate of the disease is a particularly dangerous form of influenza, soon named “Spanish”, was hypercytokinemia, which resulted in the destruction of inflamed lung tissue and filling of the lungs with liquid.
The spread of the disease went very quickly. Since the period of the end of World War I was characterized by large displacements of people, the disease spread due to migration flows. European and then American states took a wide variety of measures to prevent the spread of the disease, most often prohibitive. Public places were closed - schools, theaters, cinemas, even churches and judicial institutions. The disease acquired the most epidemic character in France, where by the end of April 1918 it had spread to Paris. Almost simultaneously with France, the disease entered Italy, then - to Switzerland, Portugal, Serbia, Greece. In June 1918, the epidemic began in Great Britain, Germany, Sweden, and in July 1918 in Denmark, the Netherlands, Belgium, and Poland. In Spain alone, by May 1918, more than 8 million people had the flu, which at that time made up 39% of the country's population. Among the sick was the Spanish king Alfons XIII himself. Around the same time, the spread of the disease began outside of Europe - in North Africa, then - in India. However, by August 1918, a decline in the incidence of disease began. Given the initially low mortality from the disease, there was no particular panic at the beginning of 1918. The situation changed dramatically after the start of the second wave of the epidemic. Unlike the first wave, the second wave appeared outside Europe - in West Africa, and more precisely - in the British colony of Sierra Leone, from where at the end of August 1918 the disease spread again - first to all of West Africa, then to the United States. The disease was brought to North America by soldiers returning from Europe after the end of the First World War. The epidemic took on a catastrophic scale in India, where tens of millions of people fell ill. Entire villages died out of the epidemic in some parts of India, which was not surprising in general, given the general lack of hygiene, lack of drugs and medical specialists. By the end of 1918, the disease spread to almost all countries of the world, with the exception of Australia, New Caledonia and Madagascar. In Great Britain, the Spaniard was most widespread in London, where a massive disease of the working population began, accompanied by extremely high mortality. British only navy deaths amounted to 2 people, although military sailors are not the category that could have previously complained about poor health.
In February, 1919 began the third wave of the epidemic, which, unlike the first two waves, penetrated into remote island territories. The third wave was also accompanied by an extremely high mortality rate among sick people, and not only representatives of risk categories died, but also young people. The exact number of people who have been ill with the flu is still unknown, apparently, it’s about 500-600 million people. The disease has even penetrated Australia and New Zealand - and this despite the extremely tough quarantine measures taken by the leadership of these countries. Back in 1918, Australia was free from an epidemic, but at the beginning of 1919, Australian soldiers who had fought on the fronts of World War I began to return to the country. Accordingly, the quarantine regime weakened, and together with the “demobilization”, the epidemic of the “Spanish flu” penetrated into the country. In New Zealand, the epidemic "Spaniard" began even earlier - in August 1918, then it spread to the Samoa archipelago, where, due to insufficient level of medical care, the disease died to 25% of the island population. However, in Eastern Samoa, due to very tough quarantine measures, the epidemic has not penetrated - all the victims of the disease lived in Western Samoa.
It was 1920 the number of deaths from influenza in the territory of Soviet Russia (RSFSR) was 3 people, in China - 000 people, in India - 000 people, in Indonesia - 9 people, in Mexico - about 500 people, in the USA - 000 people. As we can see, the greatest victims of the “Spanish flu” fall in the countries of Asia and Latin America, where there was an unsatisfactory level of medical care, and the population did not even have initial ideas about hygiene. But even in developed countries, the epidemic has caused the death of hundreds of thousands of people. Thus, in the United States of America, the second wave of influenza has spread 28 August 1918. Only in Massachusetts, from the "Spaniard" died for 4 of the month 15 thousands of people. In October 1918 the flu has spread to the largest cities in the country - New York, San Francisco and New Orleans. The disease has even penetrated Alaska. It is known that in 1918-1920's. "Spanish flu" has had about a third of the US population. 675 of thousands of American citizens died, and mortality was highest in certain social, age and ethnic groups of the American population. So, in one of the Eskimo settlements, 85% of the population died. The epidemic of "Spanish" has spread to the US Army. If during the First World War, 34 killed thousands of troops of the American army, then two years of an epidemic caused the death of 43 to thousands of American soldiers and officers. The epidemic dealt a severe blow to demographics in the United States of America. But in continental Europe, from where the Spaniard began its mass distribution, a large number of people died. Practically in every European country, from tens of thousands to several hundred thousand people died: in Spain there are about 300 000 people, in France - 420 000 people, in Germany - 600 000 people. Modern researchers, speaking of the number of victims of the "Spaniard", reported more than 41 million. man who died from this disease. Among the famous victims of the “Spaniard” are the famous Russian revolutionary and one of the leaders of the Soviet government, Jacob Sverdlov, the classic of sociology Max Weber, the French poet Guillaume Apollinaire, the Russian film actress Vera Cold. A serious situation has developed in Soviet Russia, where, as a result of the revolutionary confusion, the social infrastructure, including the medical care of the population, was significantly weakened. At the same time, it should be noted that in the terrible years of the Civil War, the “Spanish flu” was just one of the dangerous epidemics that swept over the territory of Russia. So, at the beginning of 1918 on the territory of present-day Kazakhstan, outbreaks of the plague began. Between 1920 and 1922 there were outbreaks of plague in Transbaikalia and Manchuria. In Manchuria, about 4,5 thousands of people died from plague in the Far East - 600 people died. In 1918 was outbreaks of cholera were observed in 40 Russian provinces in Central Asia and Siberia. In 1921 was cholera epidemic reached its apogee, differing enormous casualties among the population. At the same time, in 1918-1920, Russia was also overtaken by a colossal epidemic of typhus and relapsing typhus. People died from typhus by thousands, hospitals could not accommodate all patients. Among patients with typhus, dying to 18-20%. In a number of areas of the Volga region, the Caucasus, Central Asia, an epidemic of malaria has begun, which has spread far beyond the usual territories of the spread of this disease. Only in 1921 11,3% of the total number of cases of malaria died. However, it should be noted that at that time the diseases spread across Russia unevenly, covering different groups of the population. That is, the epidemiological picture was very complicated and "mosaic" - in one region cholera could rage, in the other - typhoid.
We must not panic, and engage in prevention
Although nowadays there are more and more parallels between the epidemic of the “Spanish flu” of the early twentieth century and the current rapid spread of the virus of “swine flu” in Russia, yet it would be wrong to put an equal sign between the two cases. First of all, because the scale of morbidity and the number of victims in both cases are extremely different. Chief Researcher, Institute of Vaccines and Serums Mechnikova, Yuri Gendon, in an interview with Lente.ru, reports that in comparison with ordinary epidemics, the current epidemic is not so terrible. The scientist connects the presence of a significant number of deaths of the disease with the fact that people diagnose the disease and begin treatment too late. Many Russians rely on their own health, self-medicating, while continuing to go to work. Yuri Gendon emphasizes that it is impossible to stop the massive spread of the virus without vaccination. But there are elementary rules that should be followed in case of illness. First of all, when symptoms of the disease appear, one should not leave the house - it is necessary to observe the regime, and not to go out. Otherwise, inevitable complications, and not only associated with pneumonia, but also with other serious diseases. For example, there is a risk of getting otitis and, as a result, deafness.
It should be noted that the spread of influenza in the Russian Federation, like any other epidemic, is a threat to the national security of the Russian state. Therefore, first of all, the state should take care to take the measures that will be directed: 1) to minimize the further spread of the disease, 2) to increase the overall efficiency of medical services for the population of the country, 3) to strengthen the external sanitary security of the Russian state. In particular, we are talking about increasing the control over foreign citizens arriving in the Russian Federation. It is widely known that in many former Soviet republics after the collapse of the USSR, the health care system turned out to be virtually destroyed. A full-fledged medical examination of the population is not being conducted; in schools, children practically do not inculcate ideas about hygiene and the prevention of dangerous diseases. Therefore, visitors from a number of socially and economically and politically unfavorable countries are a potential risk factor for the spread of diseases in Russia. Currently, it is known that Norway deports a part of Syrian refugees who have entered the country from the territory of Russia, back to the territory of the Russian Federation. Accordingly, materials appeared on the press about whether refugees from Syria would contribute to the further spread of a dangerous disease. However, Russian doctors have so far denied this threat, reporting that among Syrian refugees deported from Norway to the Russian Federation, no cases of influenza have been identified yet.
The second important point is the timely organization of preventive maintenance of the population. It is difficult to deny the fact that the collapse of the Soviet Union had a negative impact on the general state of domestic health care. Despite the fact that Soviet medicine was far from perfect, it covered the entire population of the country, including preventive control. In the Soviet Union, many dangerous diseases were defeated, and the general health of the population was seriously monitored. The collapse of large-scale industry, in which millions of Soviet citizens worked, led to the actual destruction of medicine in enterprises. The quality of medical control in educational institutions has significantly decreased. Naturally, all of this in aggregate affected the overall state of the Russian health care system and what we are seeing today - in connection with cases of massive flu-related illness - including is a natural consequence of the deterioration of the disease prevention system. However, no one has abolished the need for individual prophylaxis by every person seeking to protect himself, his family and friends from being infected with the flu. Former Chief Sanitary Inspector of the Russian Federation, Deputy Prime Minister Gennady Onishchenko called for special attention to be paid to the prevention of influenza. He advises citizens: 1) to wear a gauze bandage to protect others and himself; 2) get a flu shot; 3) adjust the food in the direction of the use of more vitamins; 4) reject attempts to treat colds through the use of alcoholic beverages - this will only adversely affect the general state of health; 5) air the room more often; 6) wash hands more often; 7) avoid hypothermia; 8) do not self-medicate and in the case of symptoms of the disease, consult a doctor. However, despite the undoubted correctness of Gennady Onishchenko in the cited recommendations, it is still worth noting that no individual prevention will be as effective on a national scale as a centralized strategy of preventive measures implemented by the state.
Another point - the state of pharmacies. Despite the fact that the number of private pharmacies in modern Russia has increased many times over the Soviet period of national history, in crisis and difficult situations, many pharmacy chains demonstrate their unwillingness to fulfill their main function - providing the population with topical drugs. It is known that the spread of the flu caught many of the country's pharmacies by surprise. Medical masks, ointments, pills were instantly bought up, after which in a number of cities residents began to complain about the shortage of pharmaceuticals. This is also a direct omission of the existing health care system, which, in fact, does not control the pharmacist-private owners and their work. Another extremely negative point should also be noted - the reluctance of local officials to inform about the real situation with the disease and the higher authorities and the population. And if the population is not informed for reasons of preventing panic, then regional and municipal officials are simply afraid to inform higher authorities. But after all, alarmists, including conscious, prepaid ones, who are trying to force the situation to make at least a small contribution to the destabilization of the political situation in the country, play on the hushing up of the real situation. It is possible that the deliberate fanning of the hype around a difficult situation with the flu is associated precisely with the desire of certain external and internal forces to destabilize the political situation in the country. Indeed, in the conditions of the spread of alarming rumors, the emergence of panic, the masses are becoming more susceptible to all sorts of manipulative technologies and “stuffing” than can be used by anti-state forces.
In fact, almost every year, about 40 000 people die from flu in Russia. Of course, the official cause of their death is not the flu, but its complications - pneumonia, meningitis, heart failure. But medical specialists are well aware of what is at stake. Unfortunately, people are mortal and there are always those whose body, weakened by chronic diseases or other factors, is not able to cope with the disease - especially if treatment is started out of time or doctors turned for help too late. In fact, every adult person should himself control his state of health and, when it changes for the worse, turn to medical specialists. But in order for such a concern for one’s own health to take root among the Russian population, it is necessary to create appropriate conditions on the part of the state. This - and increasing the availability of medicine - medical services, medicines, not only in the material sense of accessibility, but also in terms of the ability to find the right medicine at a pharmacy or visit a specialist doctor. Of course, to ensure the health of the population applies to monitoring compliance with employer labor legislation. It is known that many private entrepreneurs prefer not to give their employees sick leave, forcing even sick employees to come to work. This creates a threat to the health and life of not only the employees themselves, but also their colleagues, any other people with whom they communicate in the process of work. Therefore, such cases should be identified and severely punished, especially if the profile of the activity of a particular enterprise involves systematic work with people. In the meantime, the Russians can only wait for the end of the epidemic, observing the necessary preventive recommendations. According to the Chief Therapist of the Ministry of Health and Social Development of the Russian Federation, Alexander Chuchalin, the flu epidemic in Russia will end only by May 2016. Medic calls attention to three waves of flu. The most intense wave usually lasts two to three weeks, and then gradually subsides. The second wave comes five to six weeks after the start of the first wave and is characterized by a less active pace. Finally, the third wave comes in April-May and in these months the flu is no longer as aggressive as in the winter period, and the death rate from the flu significantly decreases.
In a number of mass media, and especially in social networks, rumors are spreading that you cannot call anything but panic. Some users write that the flu literally "mows down" the Russians, almost hundreds of them die in every city. Of course, the actual situation is very different from what conscious or spontaneous alarmists write about. Doctors ask people not to panic, keep calm and sober mind, but many do not always succeed. Of course, there are reasons for this - in the information society, any information, including negative information, is spread very quickly. And often - by the method of "spoiled phone". Each user adds to the information received their own conjectures, rumors, often without any basis, and in this form already translates the information further. In an interview with Lente.ru, the chief researcher of the Institute of Vaccines and Serums named after I.I. Mechnikova Yuri Gendon assures that there is no emergency situation associated with a massive flu epidemic. According to the doctor, this is the most common flu epidemic that occurs every year. Winter weather, temperature drops - all this leads to a wide spread of ARVI. But many people do not consider it necessary to be vaccinated, and pharmacies in insufficient quantities purchase pharmaceutical products. We can add to these words of a specialist only that the shortage of medicines in pharmacies in several cities is directly related to the spread of panic among the population. People rush to buy medicines, medical masks literally on an “industrial scale”.
Epidemiological threshold exceeded in regions
A difficult situation has developed in Moscow and St. Petersburg. Rospotrebnadzor reported that the epidemiological threshold in Moscow was exceeded by 40%, and therefore quarantine was announced in the Russian capital.
Elena Andreeva, the chief sanitary doctor of Moscow, told Russian journalists that the situation in the capital is estimated as epidemiological. According to Rospotrebnadzor, 61% of people with influenza are children. In St. Petersburg, as reported by the media, the 22 person has already died from pneumonia. Rospotrebnadzor also reported that last week 18-24 in January exceeded the epidemiological thresholds in 47 regions of the Russian Federation, and among large cities - in Vladimir, Kursk, Kaliningrad, Kazan, Cheboksary, Samara, Syktyvkar, Yekaterinburg.
The most severe epidemiological situation with the incidence of influenza has developed in the south of Russia. Mass incidence of influenza is noted in the Rostov and Volgograd regions, the Krasnodar Territory, Adygea, other territories, regions and republics of the region. In Adygea, according to press reports, 11 people died, on the Don - 8 people. Lyudmila Tsybalova, Deputy Director of the Flu Research Institute of the Ministry of Health and Social Development of the Russian Federation, explains the increased incidence of southerners by the fact that earlier the flu was not so common in the regions of Southern Russia and the North Caucasus, therefore the majority of people in the region are not immune to the disease. Recently it became known that the Ministry of Health of the Rostov Region acknowledged the fact that the epidemiological threshold for the incidence of influenza and ARVI in the region was exceeded. According to the regional Ministry of Health, in Rostov-on-Don, there were about 8 000 cases of influenza and ARVI. This figure is 73% higher than the incidence of a week ago. In addition, it is known only about those cases of the disease, when patients seek help from doctors. But many people prefer to carry the disease "on their feet." And this is especially dangerous - by endangering their own health, they infect other people by contacting them at work, school, in public transport, in crowded places. Eight deaths are also known. So, in one of the city hospitals died a three-year-old girl. Young men also died - 31 and 35 years. The disease does not spare health workers. So, January 26 became aware of the death of pneumonia by the head of the maternity ward of the Central City Hospital of Kamensk-Shakhtinsky Rostov region. Nina Fedorovna Shumilina died on January 25 near 22.00. An unprecedented incident occurred in one of the Rostov hospitals - a young 34-year-old man died of pneumonia right in the hospital lobby, not waiting for his turn to see a doctor. However, doctors say that the flu itself can not be fatal, but its complications, which include pneumonia, may well be fatal. But, according to the Minister of Health of the Rostov Region, Tatyana Bykovskaya, all deaths are associated with very late treatment for qualified medical care. As the head of the medical department noted, already on the second day, the doctors see changes in the lungs, on the third day pneumonia begins, and after five to six days the disease can become irreversible. Deputy Head of the Administration of Rostov-on-Don on Social Issues, Viktor Berezhnoy, stressed that the city’s epidemiological threshold was indeed exceeded, but it’s not worth talking about a critical situation. Most of the city’s institutions operate normally. It is known that 6 schools and 13 kindergartens were closed in the Rostov region in connection with cases of mass incidence of influenza and ARVI, 42 classes in 11 schools and 27 groups in 20 kindergartens were partially closed. All educational institutions are closed for quarantine, where the epidemiological threshold of morbidity has been exceeded. However, the overwhelming majority of schools and kindergartens of the region function normally. Deputy Head of the Administration of Rostov-on-Don on Social Issues, Viktor Berezhnoy, at a meeting with the Head of Administration Sergey Gorban, said that so far the city has not exceeded the epidemiological threshold for influenza in the city.
However, the fact that the incidence of influenza is indeed very increased, indicates the extension of the time of work of district clinics. Emergency help can now be obtained before 22.00. In addition, the leadership of the regional Ministry of Health agreed with the Rostov State Medical University that interns and interns will come to the aid of the current doctors and medical assistants. This decision was made in order to increase the speed of medical services for the population. After all, ambulance crews and district therapists are struggling to cope with large flows of patients. Polyclinics of the Krasnodar Territory also switched to enhanced operation. In the cities and villages of Kuban, the situation with the incidence of influenza also remains very serious. Although the regional authorities have not yet announced an epidemic, nevertheless, deaths also occur in the Krasnodar Territory. One of the first victims of the deadly flu in the Krasnodar Territory was a pregnant woman from a small Armavir. In late January, she was to give birth to a child. According to representatives of the regional medical department, the woman herself repeatedly refused to go to the hospital. On the other hand, the relatives of the deceased tell reporters that, on the contrary, medical facilities did not accept her. Krasnodar Region Health Minister Yevgeny Filippov claims that 40% of the population received flu vaccinations in the region and, like his Rostov colleague Tatyana Bykovskaya, stresses that in no case should you resort to self-treatment. The situation in neighboring Adygea, where about a thousand people got the flu, is no easier. The number of vaccinated, judging by the publications in the press, is less here than in the Krasnodar Territory - 25% of the population of the republic received vaccinations. The Adygea Health Minister Rustem Meretukov claims that it is premature to talk about the swine flu epidemic in the republic. But here, as well as in other regions of the South of Russia, hospitals are forced to open additional chambers - there are not enough places for all incoming patients with influenza and ARVI. In the Volgograd region, more than 30% of the population was vaccinated. However, here, as Anatoly Sebelev, deputy chairman of the oblast health committee, notes, swine flu is diagnosed in 75% of cases.
Influenza come from Ukraine?
Meanwhile, the Minister of Health and Social Development of the Russian Federation, Veronika Skvortsova, not so long ago stated that the massive incidence of influenza could be the consequence of bringing the disease from neighboring Ukraine. Indeed, in Ukraine, the situation with the medical care of the population and, especially, preventive maintenance, has deteriorated several times after the general destabilization of the political and socio-economic situation in the country. In the conditions of war, economic crisis, destruction of the former social infrastructure, the state of health of the population is much worse than it was before the authorities. And this is despite the fact that even before the events on Maidan, the Ukrainian healthcare system was not distinguished by high efficiency. Therefore, although the liberal opposition is skeptical about the assertion of the penetration of the disease from neighboring Ukraine, this version seems quite reasonable. On the other hand, in the conditions of a large-scale crisis in a neighboring country, the Russian authorities were supposed to take measures that minimize the risks of dangerous diseases entering the Russian Federation from the territory of Ukraine. In the first place - to tighten sanitary control over the citizens of this state entering the territory of the Russian Federation. Of course, these measures would not completely eliminate the spread of the flu, but at least they could contribute to more effective prevention of morbidity in Russia itself. The representatives of the Kiev regime themselves do not hide the fact that an extremely serious situation with the incidence of influenza has developed in Ukraine. Thus, the Minister of Health of Ukraine, Alexander Kvitashvili, told reporters that the epidemiological threshold for the incidence of influenza and ARVI was exceeded in 18 from 24 regions of Ukraine. Oleg Ruban, chief state sanitary doctor of the city of Kiev, told reporters that the situation with the incidence of influenza is severe in the Ukrainian capital - the growth rate is 50%, in just one day several thousand people visit Kiev hospitals. The main problem is that people go to a medical facility already at the 7-8 day of illness, when doctors may be powerless, because the process of destruction of the lungs has gone very far. In addition to Kiev, a very difficult situation is observed in the Rivne region, a rather difficult situation in a number of other regions of Western Ukraine. Thus, the epidemic has spread to almost the entire country. Against the background of mass impoverishment of the population, even the acquisition of elementary drugs for many Ukrainian citizens becomes a real problem.
The network has information that the flu "mows down" the ranks of the Ukrainian military in the Donbas. So, even representatives of the Ministry of Defense of Ukraine recognized that more than 400 people were ill among Ukrainian soldiers and officers. True, there are no official reports of deaths among military personnel, but given the general reluctance of the Ukrainian command to draw attention to this problem, it is possible that they have already taken place - especially in the units operating in the Donbas. It is known that the Ukrainian soldiers fighting in the Donbas are in very poor living conditions. As a rule, they live in tents, in rainy weather the hastily built tent camps are flooded with water. In these conditions, even without an epidemic, many soldiers suffer from various forms of bronchitis and pneumonia. Naturally, the proper preventive work among the existing units is practically not conducted. Therefore, the spread of the influenza virus found fertile ground in the army units in the Donbas. Almost immediately after the start of the epidemic, the soldiers of the Ukrainian army began to get sick dozens. With medical care from 1 on January 2016, the hospital and medical units turned 189 soldiers and officers in the Donetsk area, 104 - in Lugansk and 67 in the Mariupol direction, - said the spokesman for the headquarters of the "antiterrorist operation" . However, representatives of the press service of the Ukrainian Ministry of Defense, called the situation satisfactory and asked not to raise panic - they say, there are not so many sick soldiers. Meanwhile, representatives of the Ministry of Defense of the Donetsk People's Republic speak about a much larger scale of the flu epidemic among Ukrainian servicemen. According to the information that is available in the Ministry of Defense of the DPR, there are already not enough places in the hospitals of the Ukrainian army, such a large number of sick soldiers. The version that the spread of the disease could have been caused by the leakage of the flu strain from some secret laboratory located near Kharkov was also voiced. In this laboratory, American bacteriological specialists could conduct their tests. arms, some media reported. By the way, representatives of the health system of the DPR do not deny the fact of the spread of the flu. According to Donetsk doctors, to date, people in the republic have already died from complications of influenza 12. That is, the situation with the spread of influenza in the DPR remains very difficult.
By the way, if we turn to the version of the spread of swine flu as a consequence of an accidental or intentional “leakage of strains” from a secret American laboratory, then we cannot ignore the strange events on the border between Armenia and Georgia. There are flu cases around 10 people. It is quite an ordinary situation, if it were not for the fact that even in this area, outbreaks of a variety of dangerous diseases occurred - anthrax, swine flu, bird flu. Some media outlets are suspected of being involved in the spread of disease by an American research center operating in Georgia.
"Spaniard" killed millions of people
History knows examples of mass epidemics of influenza, whose victims were thousands of people in various countries of the world. One of the largest such epidemics has become the famous epidemic of the “Spanish flu” - the Spanish flu. She followed in 1918-1919, immediately after the end of the First World War. However, in terms of the number of deaths from the disease, the “Spanish flu” fairly quickly exceeded human losses as a result of the First World War itself. There are several major versions of the origin of the flu epidemic in 1918-1920. According to the first of them, the flu to Europe was brought by American soldiers who landed to participate in the First World War. According to this version, the disease began at Fort Riley in the US state of Kansas in January-February 1918, from where it was subsequently brought to Europe. There were cases of bronchitis among British soldiers who fought on the territory of France. The second version claims not the American, but the Asian origin of the disease - according to this version, the Chinese labor battalions, also landed in France, brought the flu to Europe. Finally, the third version suggests the possibility of the emergence of influenza directly in Spain, where in 1918, mass cases of the incidence of bronchitis began to be noted. Doctors have identified the main symptoms of the disease - blue complexion (cyanosis), pneumonia, cough with hemoptysis. But in most cases, the disease was asymptomatic. Some people died the very next day after infection, and among the dead there were not only risk categories - pregnant women, children, the elderly, but also young people between the ages of twenty and forty. The cause of the high mortality rate of the disease is a particularly dangerous form of influenza, soon named “Spanish”, was hypercytokinemia, which resulted in the destruction of inflamed lung tissue and filling of the lungs with liquid.
The spread of the disease went very quickly. Since the period of the end of World War I was characterized by large displacements of people, the disease spread due to migration flows. European and then American states took a wide variety of measures to prevent the spread of the disease, most often prohibitive. Public places were closed - schools, theaters, cinemas, even churches and judicial institutions. The disease acquired the most epidemic character in France, where by the end of April 1918 it had spread to Paris. Almost simultaneously with France, the disease entered Italy, then - to Switzerland, Portugal, Serbia, Greece. In June 1918, the epidemic began in Great Britain, Germany, Sweden, and in July 1918 in Denmark, the Netherlands, Belgium, and Poland. In Spain alone, by May 1918, more than 8 million people had the flu, which at that time made up 39% of the country's population. Among the sick was the Spanish king Alfons XIII himself. Around the same time, the spread of the disease began outside of Europe - in North Africa, then - in India. However, by August 1918, a decline in the incidence of disease began. Given the initially low mortality from the disease, there was no particular panic at the beginning of 1918. The situation changed dramatically after the start of the second wave of the epidemic. Unlike the first wave, the second wave appeared outside Europe - in West Africa, and more precisely - in the British colony of Sierra Leone, from where at the end of August 1918 the disease spread again - first to all of West Africa, then to the United States. The disease was brought to North America by soldiers returning from Europe after the end of the First World War. The epidemic took on a catastrophic scale in India, where tens of millions of people fell ill. Entire villages died out of the epidemic in some parts of India, which was not surprising in general, given the general lack of hygiene, lack of drugs and medical specialists. By the end of 1918, the disease spread to almost all countries of the world, with the exception of Australia, New Caledonia and Madagascar. In Great Britain, the Spaniard was most widespread in London, where a massive disease of the working population began, accompanied by extremely high mortality. British only navy deaths amounted to 2 people, although military sailors are not the category that could have previously complained about poor health.
In February, 1919 began the third wave of the epidemic, which, unlike the first two waves, penetrated into remote island territories. The third wave was also accompanied by an extremely high mortality rate among sick people, and not only representatives of risk categories died, but also young people. The exact number of people who have been ill with the flu is still unknown, apparently, it’s about 500-600 million people. The disease has even penetrated Australia and New Zealand - and this despite the extremely tough quarantine measures taken by the leadership of these countries. Back in 1918, Australia was free from an epidemic, but at the beginning of 1919, Australian soldiers who had fought on the fronts of World War I began to return to the country. Accordingly, the quarantine regime weakened, and together with the “demobilization”, the epidemic of the “Spanish flu” penetrated into the country. In New Zealand, the epidemic "Spaniard" began even earlier - in August 1918, then it spread to the Samoa archipelago, where, due to insufficient level of medical care, the disease died to 25% of the island population. However, in Eastern Samoa, due to very tough quarantine measures, the epidemic has not penetrated - all the victims of the disease lived in Western Samoa.
It was 1920 the number of deaths from influenza in the territory of Soviet Russia (RSFSR) was 3 people, in China - 000 people, in India - 000 people, in Indonesia - 9 people, in Mexico - about 500 people, in the USA - 000 people. As we can see, the greatest victims of the “Spanish flu” fall in the countries of Asia and Latin America, where there was an unsatisfactory level of medical care, and the population did not even have initial ideas about hygiene. But even in developed countries, the epidemic has caused the death of hundreds of thousands of people. Thus, in the United States of America, the second wave of influenza has spread 28 August 1918. Only in Massachusetts, from the "Spaniard" died for 4 of the month 15 thousands of people. In October 1918 the flu has spread to the largest cities in the country - New York, San Francisco and New Orleans. The disease has even penetrated Alaska. It is known that in 1918-1920's. "Spanish flu" has had about a third of the US population. 675 of thousands of American citizens died, and mortality was highest in certain social, age and ethnic groups of the American population. So, in one of the Eskimo settlements, 85% of the population died. The epidemic of "Spanish" has spread to the US Army. If during the First World War, 34 killed thousands of troops of the American army, then two years of an epidemic caused the death of 43 to thousands of American soldiers and officers. The epidemic dealt a severe blow to demographics in the United States of America. But in continental Europe, from where the Spaniard began its mass distribution, a large number of people died. Practically in every European country, from tens of thousands to several hundred thousand people died: in Spain there are about 300 000 people, in France - 420 000 people, in Germany - 600 000 people. Modern researchers, speaking of the number of victims of the "Spaniard", reported more than 41 million. man who died from this disease. Among the famous victims of the “Spaniard” are the famous Russian revolutionary and one of the leaders of the Soviet government, Jacob Sverdlov, the classic of sociology Max Weber, the French poet Guillaume Apollinaire, the Russian film actress Vera Cold. A serious situation has developed in Soviet Russia, where, as a result of the revolutionary confusion, the social infrastructure, including the medical care of the population, was significantly weakened. At the same time, it should be noted that in the terrible years of the Civil War, the “Spanish flu” was just one of the dangerous epidemics that swept over the territory of Russia. So, at the beginning of 1918 on the territory of present-day Kazakhstan, outbreaks of the plague began. Between 1920 and 1922 there were outbreaks of plague in Transbaikalia and Manchuria. In Manchuria, about 4,5 thousands of people died from plague in the Far East - 600 people died. In 1918 was outbreaks of cholera were observed in 40 Russian provinces in Central Asia and Siberia. In 1921 was cholera epidemic reached its apogee, differing enormous casualties among the population. At the same time, in 1918-1920, Russia was also overtaken by a colossal epidemic of typhus and relapsing typhus. People died from typhus by thousands, hospitals could not accommodate all patients. Among patients with typhus, dying to 18-20%. In a number of areas of the Volga region, the Caucasus, Central Asia, an epidemic of malaria has begun, which has spread far beyond the usual territories of the spread of this disease. Only in 1921 11,3% of the total number of cases of malaria died. However, it should be noted that at that time the diseases spread across Russia unevenly, covering different groups of the population. That is, the epidemiological picture was very complicated and "mosaic" - in one region cholera could rage, in the other - typhoid.
We must not panic, and engage in prevention
Although nowadays there are more and more parallels between the epidemic of the “Spanish flu” of the early twentieth century and the current rapid spread of the virus of “swine flu” in Russia, yet it would be wrong to put an equal sign between the two cases. First of all, because the scale of morbidity and the number of victims in both cases are extremely different. Chief Researcher, Institute of Vaccines and Serums Mechnikova, Yuri Gendon, in an interview with Lente.ru, reports that in comparison with ordinary epidemics, the current epidemic is not so terrible. The scientist connects the presence of a significant number of deaths of the disease with the fact that people diagnose the disease and begin treatment too late. Many Russians rely on their own health, self-medicating, while continuing to go to work. Yuri Gendon emphasizes that it is impossible to stop the massive spread of the virus without vaccination. But there are elementary rules that should be followed in case of illness. First of all, when symptoms of the disease appear, one should not leave the house - it is necessary to observe the regime, and not to go out. Otherwise, inevitable complications, and not only associated with pneumonia, but also with other serious diseases. For example, there is a risk of getting otitis and, as a result, deafness.
It should be noted that the spread of influenza in the Russian Federation, like any other epidemic, is a threat to the national security of the Russian state. Therefore, first of all, the state should take care to take the measures that will be directed: 1) to minimize the further spread of the disease, 2) to increase the overall efficiency of medical services for the population of the country, 3) to strengthen the external sanitary security of the Russian state. In particular, we are talking about increasing the control over foreign citizens arriving in the Russian Federation. It is widely known that in many former Soviet republics after the collapse of the USSR, the health care system turned out to be virtually destroyed. A full-fledged medical examination of the population is not being conducted; in schools, children practically do not inculcate ideas about hygiene and the prevention of dangerous diseases. Therefore, visitors from a number of socially and economically and politically unfavorable countries are a potential risk factor for the spread of diseases in Russia. Currently, it is known that Norway deports a part of Syrian refugees who have entered the country from the territory of Russia, back to the territory of the Russian Federation. Accordingly, materials appeared on the press about whether refugees from Syria would contribute to the further spread of a dangerous disease. However, Russian doctors have so far denied this threat, reporting that among Syrian refugees deported from Norway to the Russian Federation, no cases of influenza have been identified yet.
The second important point is the timely organization of preventive maintenance of the population. It is difficult to deny the fact that the collapse of the Soviet Union had a negative impact on the general state of domestic health care. Despite the fact that Soviet medicine was far from perfect, it covered the entire population of the country, including preventive control. In the Soviet Union, many dangerous diseases were defeated, and the general health of the population was seriously monitored. The collapse of large-scale industry, in which millions of Soviet citizens worked, led to the actual destruction of medicine in enterprises. The quality of medical control in educational institutions has significantly decreased. Naturally, all of this in aggregate affected the overall state of the Russian health care system and what we are seeing today - in connection with cases of massive flu-related illness - including is a natural consequence of the deterioration of the disease prevention system. However, no one has abolished the need for individual prophylaxis by every person seeking to protect himself, his family and friends from being infected with the flu. Former Chief Sanitary Inspector of the Russian Federation, Deputy Prime Minister Gennady Onishchenko called for special attention to be paid to the prevention of influenza. He advises citizens: 1) to wear a gauze bandage to protect others and himself; 2) get a flu shot; 3) adjust the food in the direction of the use of more vitamins; 4) reject attempts to treat colds through the use of alcoholic beverages - this will only adversely affect the general state of health; 5) air the room more often; 6) wash hands more often; 7) avoid hypothermia; 8) do not self-medicate and in the case of symptoms of the disease, consult a doctor. However, despite the undoubted correctness of Gennady Onishchenko in the cited recommendations, it is still worth noting that no individual prevention will be as effective on a national scale as a centralized strategy of preventive measures implemented by the state.
Another point - the state of pharmacies. Despite the fact that the number of private pharmacies in modern Russia has increased many times over the Soviet period of national history, in crisis and difficult situations, many pharmacy chains demonstrate their unwillingness to fulfill their main function - providing the population with topical drugs. It is known that the spread of the flu caught many of the country's pharmacies by surprise. Medical masks, ointments, pills were instantly bought up, after which in a number of cities residents began to complain about the shortage of pharmaceuticals. This is also a direct omission of the existing health care system, which, in fact, does not control the pharmacist-private owners and their work. Another extremely negative point should also be noted - the reluctance of local officials to inform about the real situation with the disease and the higher authorities and the population. And if the population is not informed for reasons of preventing panic, then regional and municipal officials are simply afraid to inform higher authorities. But after all, alarmists, including conscious, prepaid ones, who are trying to force the situation to make at least a small contribution to the destabilization of the political situation in the country, play on the hushing up of the real situation. It is possible that the deliberate fanning of the hype around a difficult situation with the flu is associated precisely with the desire of certain external and internal forces to destabilize the political situation in the country. Indeed, in the conditions of the spread of alarming rumors, the emergence of panic, the masses are becoming more susceptible to all sorts of manipulative technologies and “stuffing” than can be used by anti-state forces.
In fact, almost every year, about 40 000 people die from flu in Russia. Of course, the official cause of their death is not the flu, but its complications - pneumonia, meningitis, heart failure. But medical specialists are well aware of what is at stake. Unfortunately, people are mortal and there are always those whose body, weakened by chronic diseases or other factors, is not able to cope with the disease - especially if treatment is started out of time or doctors turned for help too late. In fact, every adult person should himself control his state of health and, when it changes for the worse, turn to medical specialists. But in order for such a concern for one’s own health to take root among the Russian population, it is necessary to create appropriate conditions on the part of the state. This - and increasing the availability of medicine - medical services, medicines, not only in the material sense of accessibility, but also in terms of the ability to find the right medicine at a pharmacy or visit a specialist doctor. Of course, to ensure the health of the population applies to monitoring compliance with employer labor legislation. It is known that many private entrepreneurs prefer not to give their employees sick leave, forcing even sick employees to come to work. This creates a threat to the health and life of not only the employees themselves, but also their colleagues, any other people with whom they communicate in the process of work. Therefore, such cases should be identified and severely punished, especially if the profile of the activity of a particular enterprise involves systematic work with people. In the meantime, the Russians can only wait for the end of the epidemic, observing the necessary preventive recommendations. According to the Chief Therapist of the Ministry of Health and Social Development of the Russian Federation, Alexander Chuchalin, the flu epidemic in Russia will end only by May 2016. Medic calls attention to three waves of flu. The most intense wave usually lasts two to three weeks, and then gradually subsides. The second wave comes five to six weeks after the start of the first wave and is characterized by a less active pace. Finally, the third wave comes in April-May and in these months the flu is no longer as aggressive as in the winter period, and the death rate from the flu significantly decreases.
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