San José, Costa Rica. January, 2016.

Interview with
Jorge Cortés Rodríguez 
Medical Director of the Clínica Bíblica Hospital

In the last weeks, a high expectation has been created among the population with regard to the issue of H1N1. Costa Rica is not under any health emergency declaration. What variables are taken into account by the epidemiologists to define whether there is an emergency or not?

Several elements are required, for example: there should be a health services network in the country, region or territory that has the capability of monitoring the diseases defined as subject to “epidemiological surveillance”. This report should be sent to a central module (in our case INCIENSA) that compares the number of cases with the historical median of these. That implies the production of an indicator of positive cases and their variation (greater or lesser) with the previous numbers. According to this measurement, there can be areas or regions, or large territories, which can be considered with an abnormal behavior. All of this together with the characteristics of the disease, its seriousness and the capability of contagion, should be considered when indicating an emergency declaration.

Is an over-alert being generated in the population? What is the danger in this?

Fear, panic and conditions that generate irrational attitudes in the population are not only undesirable but they can provoke more damage than benefit. In this case, asking the population to be alert and to follow basic hygiene measures, should be part of a permanent education campaign, since hygiene measures are not only oriented to fighting influenza but also a large variety of medical conditions.

Why do some catalogue this outbreak of H1N1 “within that which is normal” and others as something “atypical and that is being minimized”?

The current presentation of the flu has been very particular given that it appears in a time of the year when it does not usually appear and when due to the period of end-of-the-year festivities could impact on the response capacity of the surveillance system and on the analysis of the variables to take into account, and from there, the perception of these groups one way or the other.

Is this the time to be vaccinated?

In normal conditions, the recommendation for risk groups is to be vaccinated every year. That indication persists and has not been changed by our authorities so that if you belong to one of the risk groups, you should proceed as you usually would. Obviously, the vaccine does not “protect” you immediately but its “protecting effect” can be seen as of the second week, but if the prevention measures are added, we can say with certainty that we are doing the right thing.

When should you go to the medical center?

Within the health and disease logic, one should resort to the emergency medical services only when one´s life is in danger. Therefore, one should go to be assessed if the usual and customary symptoms of a cold are accentuated in ranges that are not usual, or if you are a person that belongs to the groups in risk of developing the issues that have been mentioned (people with respiratory deficiencies, sick people with chronic ailments, or populations who require special care such as the elderly, pregnant women, children under five years-old).

It is said that the population “lowered its guard”, how do we do it correctly now and on time in order to prevent similar situations in the future? At what times in the year should we be vaccinated and against what?

Vaccination must be performed every year both for adults as well as for children. It is part of the national recommendations of our health authorities and we should comply with them, for our own benefit. In the same way, the education campaigns should be permanent; it is not about washing hands only when there is a warning of possible epidemics for example. Vaccination against the flu was traditionally performed in October but according to the coverage of the different strains, the Epidemiological Surveillance Department of the Health Ministry, established as from 2015 the month of May. This would be the only annual vaccination that we should have, but there are other vaccines with their established dosage and intervals (pneumonia, tetanus, hepatitis, yellow fever, etc.)

If you have further questions, you may address them to our specialized physicians.

In order to obtain further information or to request an appointment in any of the medical specialties with the best doctors of Costa Rica, please contact the private hospital Clínica Bíblica at telephone number 2522-1000, at email citas@clinicabiblica.com or vía chat on the website www.clinicabiblica.com