Весна пришла, а грипп не сдается

Чем страшен вирус и как от него защититься – советы специалиста

Эпидемия гриппа в России идет на спад, но, по прогнозам эпидемиологов Роспотребнадзора, специалистов из НИИ гриппа, о полной ее «капитуляции» можно говорить не раньше, чем через месяц. О том, как складывается ситуация в стране сегодня, что в принципе нужно знать о вирусах гриппа и что необходимо предпринимать во время эпидемии, рассказывает кандидат медицинских наук, заведующий НОО ФБГУ «НИИ гриппа» Минздрава России Игорь Никоноров.

 

— Игорь Юрьевич, какая ситуация с гриппом в России в настоящий момент? Эпидемия еще не закончилась?

— Мы все еще наблюдаем превышение эпидемического порога – на 4,2 процента. Это не много, на самом деле. По регионам ситуация такая: в Северо-Западном федеральном округе эпидемия продолжалась в пяти городах, значительно превышен порог эпидемии в Вологде – примерно на 48 процентов. Причем, в разных регионах болеют разные возрастные группы. В Калининграде и Великом Новгороде это дети от 7 до 14 лет, в Сыктывкаре чаще болели дети от 3 до 6 лет, а в Мурманске – подростки старше 15 лет.

— Почему в одних регионах болеют дети, а других, например, пожилые люди?

— Для ответа на этот вопрос надо посмотреть динамику заболеваемости гриппом и ОРВИ за весь период эпидемического сезона, т.е. с октября по апрель включительно. Кроме того, чаще болеют те, кто не привит от гриппа. В каждом новом сезоне картина заболеваемости может немного меняться. И сейчас, когда эпидемический сезон еще не закончился, делать какой-то общий анализ ситуации рано.

— В этом году больше гриппа А или В?

— По данным лабораторных исследований на текущий момент чаще в основном диагностируется вирус гриппа типа А(H3N2), а в последние недели — и вирус гриппа В. Эпидемия гриппа, которая вызывается вирусом А(Н3N2), обычно более длительная, чем вызываемая вирусом А(Н1N1), который вызывал заболевание гриппом в прошлом сезоне.

— Все с ужасом ждали в этом году какого-то особенно жестокого «гонконгского гриппа». Он был замечен в России?

— В феврале 2016 года ВОЗ рекомендовала в состав гриппозных вакцин штамм А/Hong Kong/4801/2014(H3N2). Место выделения вируса, на основе которого был разработан вакцинный штамм, Гонконг, напомнило о пандемии 1968 года, которая получила название «гонконгской» как места первого выделения нового в то время вируса А(H3N2). Вирусы А(H3N2), которые циркулируют сегодня — это дальние потомки вируса 1968 года и генетически не идентичны.

— Ученые ведь могут предполагать, какой вирус будет в следующем сезоне?

— Да, конечно. В Женеве недавно прошло заседание по вакцинам и штаммам, и там  приняли изменения, которые будут внесены в вакцину от гриппа на следующий сезон. 10 марта в нашем институте на Комиссии по вакцинным штаммам рассмотрены вопросы циркуляции штаммов вируса гриппа в текущем эпидемическом сезоне и даны рекомендации производителям иммунобиологических препаратов по составу вакцин на сезон 2017-2018. В состав вакцин будут включены следующие штаммы вирусов гриппа: А/Michigan/45/2015 (H1N1); А/Hong Kong/4801/2014 (H3N2); В/Brisbane/60/2008.

— А с учетом чего вносится эти изменения? Смотрят на текущее состояние с эпидемиями, со штаммами вирусов?

— Проводятся исследования в национальных центрах во всех странах, они дают данные по тем возбудителям, которые циркулируют на территории их стран, проводят анализ заболеваемости, какими возбудителями она вызвана в Южном полушарии, в Северном. И на основании этого дается прогноз и рекомендации на следующий сезон. Бывает, что появляется новый штамм вирусов гриппа уже после изменения состава вакцин — как это было, например в 2009 году.

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