Government unveils measures to curtail H1N1 pandemic in Turkey

Health Minister Recep Akdağ predicted that swine flu cases will possibly increase during winter starting in December and extend to the early months of 2010. He said the Health Ministry has already drawn up contingency plans for a number of possible scenarios and imported 40 million doses of the swine flu vaccine. The first shipment is expected to arrive on Oct. 15.

According to ministry statistics, as of October 2009, 472 cases of swine flu were confirmed in Turkey, and no death was reported from the pandemic so far. According to health officials, all patients diagnosed with swine flu have recovered completely.

To prevent the spread of the flu, the ministry previously set up thermal cameras at borders and airports to survey travelers suspected of having swine flu. But Akdağ said thermal cameras do not catch all cases as only 22 H1N1 cases out of 315 travelers who were later found to have swine flu had been caught at the border so far. Akdağ said the ministry still intends to keep thermal cameras in airports but will focus more on other precautionary measures. Apart from international travelers, Akdağ said 157 cases originated domestically.

The government submitted two scenarios, one projecting what would happen if measures were taken and vaccines were provided, and another one projecting what would happen if no measures were taken by the government. If no measures are taken, the Health Ministry expects 21 million people will catch the H1N1 flu, and 5,300 people will likely die from it in Turkey. It will cost the economy $1.1 billion in terms of loss in labor and other related costs.

If people in the high risk group get vaccinated for H1N1, the number of people who will likely die from flu complications declines sharply -- around 400 people, the ministry estimates.

The cost to the economy in this projection will be slashed in half, falling to $640 million. Akdağ cautioned that all these scenarios are simply projections and may never come to pass. He underlined that health officials would like to err on the side of caution and have taken all necessary measures imaginable to prevent the swine flu from spreading in the country.

The government predicts 39 million people are in the high risk group and in need of the vaccination as soon as possible. It estimates that the country needs 43 million doses of the vaccine to prepare for swine flu. The Health Ministry has already drawn up plans to purchase 40 million doses -- 3 million of them were already purchased from three suppliers.

Akdağ also disclosed that the cost of one shot is 5.2 euros plus value-added tax, on average. The total cost to the government for a total of 43 million shots will be TL 556 million, the ministry revealed.

Vaccinations will be provided free of charge to almost 30 million people along the guidelines announced by the World Health Organization (WHO). Among the first groups who will get shots are first aid workers, security personnel, sufferers of chronic disease, students and pregnant women. The government will screen all schools and provide free H1N1 shots and instruct health clinics to screen people in the high risk group.

Turkey expects to vaccinate around 80 percent of people in the high risk group -- a rate Akdağ described as far greater than the rate in most developed countries. As for children, the rate of vaccination may climb as high as 98 percent. “We have a well-placed screening system and can reach most people in this group with our health network,” he said.

Akdağ also said only the government at this time will be able to provide shots for the H1N1 flu as drug companies said they could not market vaccines to pharmacies and private enterprises in 2009. “The trend that the government is the only provider is the same for all countries in the world,” Akdağ said, adding that in 2010 pharmacies would also be able to sell the vaccine.

Comprehensive measures

The government has put in place a number of measures to monitor swine flu cases. The Pandemic Watchboard within the Health Ministry constantly monitors cases in hospitals, and the ALO-184 hotline was established for reporting cases. The Health Ministry is also establishing a special agency to deal with H1N1 cases.

Seasonal flu typically kills 250,000 to 500,000 people globally, mostly the elderly but also very young children, pregnant women and people with chronic diseases. H1N1 is a new strain that appeared in March and became a pandemic in June. Like the seasonal flu, H1N1 is usually mild and requires no medical care. But H1N1 also differs from seasonal flu because it is more likely to infect children and young people than the elderly.

The ministry will launch a series of meetings to brief the public on the pandemic on Oct. 15. “We will inform the public for 45 consecutive days through a variety of methods. We should not panic, but the outbreak is about to start. When it starts, we will work to slow it down,” he said.

Akdağ stated that people should seek treatment at the nearest health clinic if they suspect influenza-type illnesses with symptoms such as difficulty breathing, chest pain, lips appearing blue or purple, vomiting and being unable to keep liquids down or showing signs of dehydration including dizziness.

If these symptoms do not present, Akdağ said, the ministry recommends that people with H1N1 stay home from work, school, travel, shopping, social events and public gatherings. The main remedies for any mild illness are rest and ample fluids such as water, broth, sports drinks or electrolyte beverages, which help prevent dehydration in small children. In the meantime, Akdağ recommends frequent hand washing, covering coughs and sneezes and avoiding greeting people with handshakes and kisses.