Doctors told to be alert

As the world braces itself for an influenza pandemic, an appeal was made for doctors in Malta to help with influenza surveillance.

The chairman of the National Influenza Pandemic Standing Committee, Tanya Melillo said that in the absence of adequate surveillance, a pandemic could "creep on us without our knowing".

This year Malta will be able to conduct tests to determine the virus subtype affecting a person suffering from influenza. Newly-bought equipment will prove especially crucial when the pandemic strikes because the health authorities will know when the virus causing the pandemic would have arrived and so would be in a position to start taking public health measures, including the possible closure of public places.

The importance of surveillance was reiterated by the director of the Royal College of General Practitioners' research unit Douglas Fleming, who said it was only through proper surveillance that the country would know whether it was facing a pandemic or an epidemic and who was being worst affected.

Dr Fleming does not believe that the pandemic will be striking this winter, but he had told The Times earlier this week that the threat for the next two to five years is "quite substantial".

Tens of Maltese doctors attended a lecture on influenza earlier this week and were addressed by various top influenza officials who were in Malta for the Second European Influenza Conference, organised by the European Scientific Working Group on Influenza.

Speaking during the lecture, Dr Melillo said the committee is recommending that doctors do not see patients at their clinics and this in order to decrease the spread of the virus. This will in turn increase the burden on general practitioners who would be inundated with calls for home visits.

Dr Fleming offered a solution: doctors needed to make more use of the telephone for consultations.

Moreover, he said, doctors will have to educate their patients as to what symptoms to expect and whether symptoms would differ in age groups.

"The responsibility lies with doctors to give accurate information and not wind people up," he said.

Dr Fleming urged doctors to take the pandemic threat seriously and recognise the important role they will. Dr Melillo said that during a pandemic doctors will need to convince people to only take antivirals when they are told to do so by them.

"Once it is determined that a person is suffering from the pandemic virus, if he has antivirals at home he can take them while the others will be sent to the health centres, where they will be checked again and if they fall under the criteria established by the government they will be given antivirals," she explained.

Dr Melillo said family members of those who get sick should keep checking their temperature regularly and keep their eyes open for any other symptoms. She stressed that even those who would have stocked their antivirals should be seen by a doctor before taking them.

With regard to the annual influenza jab, Dr Melillo told doctors not to start giving the vaccine before October. She emphasised the need for people to be covered until at least the end of March, adding that the vaccine's effect lasted for about six months.

WHO's scientist in charge of influenza control, Klaus Stöhr, said that about 500,000 people died every year in developed countries after catching the flu.

"In Europe more people die because of influenza than in traffic accidents. But although all drivers have a car insurance, not everyone takes the annual jab," he said.