Just like seasonal flu, novel H1N1 flu, or swine flu is a viral disease caused by a new flu virus that has never circulated before in humans. Now Because the virus is “new” in the human population , i.e. none of us have been exposed to it before , we do not have immunity against the virus. As a result, the virus is spreading from person-to-person. As all of you may know, on the 11 th of June, the WHO declared that a novel H1N1 pandemic is underway. Now, The fact that swine flu is now officially a pandemic doesn't mean that the virus is very deadly, but it rather implies the infection has spread around the world.
The virus was initially called swine flu, because it has many genes similar to flu viruses that normally circulate among pigs in North America. On further studies, scientists realized that this virus is very different and it is affecting people who have had no contact with pigs. It has genes not only from flu viruses that affect pigs, but also genes from flu viruses that affect birds and humans. So it is a quadruple reassortment virus, and the term “swine flu” is technically a misnomer, but since it was the initial name used, we continue to use it.
Many people are asking whether there is a differentiating or unique symptom based on which we can tell if a person has swine flu? Well, the answer is NO. Symptoms of swine flu are very much like regular flu symptoms and include fever, cough, sore throat, body aches, headache, chills, and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. You must remember that these symptoms can be caused by ordinary seasonal flu and many other respiratory diseases and that means that you and your doctor can't know, just based on your symptoms, if you've got swine flu. Only a lab test can tell whether it's swine flu or some other condition.
The new swine flu virus apparently spreads just like regular flu. You could pick up the swine flu virus directly from an infected person, when they cough or sneeze. The other mode of transmission is infected surfaces. The flu virus can survive in the environment for 2 to 8 hours. If you touch an infected surface and then touch your eyes, mouth, or nose, you can become infected.
With so much of news in the media about swine flu, there is a general perception that it is a very severe disease . Going by the observation of cases so far, this is in fact not true. Illness caused by swine flu can range from mild to severe. Most healthy people who get infected with the virus will experience a mild illness, similar to seasonal flu, and recover without any specific medical treatment. But yes, hospitalizations and deaths because of swine flu have occurred. As per the latest data available with the WHO, 1462 deaths have been reported globally. .
At this point, I would like to mention that though these figures may look alarming at the first instance, you should keep in mind that about 36000 deaths occur in the US alone because of seasonal flu. In India, about 400 people die of tuberculosis everyday. So we should interpret the data in this perspective. You could ask, then why so much news and fear around swine flu? The reason is that the agent is new and the number of people who are likely to get the infection is very high. Therefore, it is important to raise public awareness, so that people can take the measures necessary to protect themselves as much as possible. If you are a healthy adult and only have mild flu symptoms, you don't need medical attention. But it is important to know that some people are at high risk of complications. Such individuals should get medical help at the first sign of flu-like symptoms. On the next slide, we will see who is at high risk of flu complications.
The people who are at high risk of complications are: 1. Children under 5 years of age 2. Adults who are 65 years of age or older 3. Persons with chronic diseases does such as heart, lung, kidney, or liver disease 4. Individuals with diabetes 5. Immunosuppressed people: this includes those with HIV or those taking immunosuppressive medications 6. Residents of nursing homes and other chronic care facilities
Now we come to the most pertinent question: What can you do to protect yourself The first and foremost thing that can help you would be to avoid close contact with any person showing flu-like symptoms It is also advisable to avoid crowded settings Wash your hands with soap and water several times in the day so that you get rid of germs that you may have picked up from the enviornment Make a conscious effort to avoid touching your nose, mouth and eyes Maintain general good health, avoid excessive stress, and keep your living spaces well ventilated The last two points are more to do with what you can do to prevent the spread of the virus:
There has also been a lot of discussion around the use of masks to prevent swine flu. Wearing a standard surgical mask, or other facemask that is not designed to filter sub-microscopic organisms (i.e., to fit correctly and filter correctly), will not help you avoid breathing viruses on droplets in the air. Viruses are small enough to pass right through the masks, or can enter around the sides of the mask. Surgical masks are designed to keep the respiratory droplets of the wearer contained (like covering your mouth with a tissue does) when coughing or sneezing. The masks may, however, when worn by others who are infected with the influenza, prevent their spreading the virus to you on respiratory droplets when they sneeze or cough. And the surgical masks can help assure that you (or a family member with the flu in the home), do not give the virus to others when coughing or sneezing (by catching the respiratory droplets released during the cough and sneeze). Information on the effectiveness of facemasks and respirators for decreasing the risk of influenza infection in community settings is extremely limited. Thus, it is difficult to assess their potential effectiveness in decreasing the risk of novel influenza A (H1N1) virus transmission in these settings. In the absence of clear scientific data, the interim recommendations below have been developed on the basis of public health judgment, the historical use of facemasks and respirators in other settings for preventing transmission of influenza and other respiratory viruses, and on current information on the spread and severity of the novel influenza A (H1N1) virus. There are important differences between facemasks and respirators. Facemasks do not seal tightly to the face and are used to block large droplets from coming into contact with the wearer’s mouth or nose. Most respirators (e.g. N95) are designed to seal tightly to the wearer’s face and filter out very small particles that can be breathed in by the user. For both facemasks and respirators, however, limited data is available on their effectiveness in preventing transmission of H1N1 (or seasonal influenza) in various settings. However, the use of a facemask or respirator is likely to be of most benefit if used as early as possible when exposed to an ill person and when the facemask or respirator is used consistently. When respiratory protection is required in an occupational setting, respirators must be used in the context of a comprehensive respiratory protection program as required under OSHA’s Respiratory Protection standard (29 CFR 1910.134). This includes fit testing, medical evaluation and training of the worker. When required in the occupational setting, tight-fitting respirators cannot be used by people with facial hair that interferes with the face seal. The CDC recommends, if at all possible, keeping a distance of 6 feet from someone confirmed to have this virus. Specific situations when the CDC suggests wearing a respirator or facemask: Crowded community setting with current Novel H1N1 cases, either facemask or respirator is recommended to be worn by those who can not avoid the area, and who are high risk persons (see below for definition). Caregiver in home setting who is caring for a person with Novel H1N1 and who is high risk themselves should wear either. (Suggested that others provide the care instead. They, unless high risk, would not have to wear masks or respirators.) Non Health Care Occupational settings with current Novel H1N1: non-high risk persons who can not avoid the setting should consider the respirators or facemasks. Non Health Care Occupational settings with current Novel H1N1: high risk persons who can not avoid the setting should consider the respirators or facemasks. Health Care Occupational settings with known or probable cases of Novel H1N1: Caregivers and other personnel who are non-high risk should wear respirators . Health Care Occupational settings with known or probable cases of Novel H1N1: Caregivers and other personnel who are high risk should consider temporary reassignment or should wear respirators .
If you are sick, you may be ill for a week or longer. You should stay home and keep away from others as much as possible, including avoiding travel and not going to work or school, for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of fever-reducing medicine.) If you leave the house to seek medical care, wear a facemask, if available and tolerable, and cover your coughs and sneezes with a tissue. In general, you should avoid contact with other people as much as possible to keep from spreading your illness, especially people at increased risk of severe illness from influenza. With seasonal flu, people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods. People infected with the novel H1N1 are likely to have similar patterns of infectiousness as with seasonal flu . If you are sick and sharing a common space with other household members in your home, wear a facemask, if available and tolerable, to help prevent spreading the virus to others. For relief of fever, other anti-pyretic medications are recommended such as acetaminophen or non steroidal anti-inflammatory drugs. Aspirin or aspirin-containing products (e.g., bismuth subsalicylate – Pepto Bismol) should not be administered to any confirmed or suspected ill case of novel influenza A (H1N1) virus infection aged 18 years old and younger due to the risk of Reye’s syndrome.
Antiviral medicines for the prevention of swine flu: Antiviral medicines can also be used to prevent swine flu in a person who is not ill, but who has been or may be near a person with swine flu. These drugs are about 70% to 90% effective in preventing swine flu. The duration of treatment required for the prevention of swine flu will vary depending on the swine flu situation in a particular place and the person’s risk of contracting the illness.
Children should get urgent medical attention if they have fast breathing or trouble breathing, have bluish or gray skin color, are not drinking enough fluid, are not waking up or not interacting, have severe or persistent vomiting, are so irritable that the child doesn't want to be held, have flu-like symptoms that improve but then return with fever and a worse cough, have fever with a rash, or have fever and then have a seizure or sudden mental or behavioral change. Adults should seek urgent medical attention if they have trouble breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting, or flu-like symptoms that improve, but then come back with worsening fever or cough.
1918: Spanish influenza pandemic. Some 20 to 40 percent of the worldwide population became ill and more than 50 million people died. Between September 1918 and April 1919, it killed more than 600,000 people in the United States alone. In a normal flu season, about 36,000 people die in the United States, and 250,000 to 500,000 globally. ** The virus that caused the 1957 Asian flu pandemic was quickly identified, and vaccines were available by August 1957. The elderly had the highest rates of death. The Asian flu killed 2 million people globally, according to the World Health Organisation. The 1968 influenza pandemic was first detected in Hong Kong . Those over the age of 65 were most likely to die. It killed an estimated 1 million people globally, according to WHO, making it making the mildest pandemic in the 20th century. In 1976, a strain of swine flu started infecting people in Fort Dix, New Jersey, and worried U.S. health officials because the virus was thought to be related to the 1918 Spanish flu virus. Forty million people were vaccinated but the program was halted after several cases of Guillain-Barre syndrome, a severe and sometimes fatal condition linked to some vaccines, were reported. The virus never moved outside the Fort Dix area. H5N1 avian flu is the most recent pandemic threat. It first surfaced in 1997 and continues to infect humans who have direct contact with chickens. The H5N1 or avian influenza virus does not spread easily from one person to another.Since 2003, H5N1 virus has infected 421 people in 15 countries and killed 257. It has killed or forced the culling of more than 300 million birds in 61 countries in Asia, the Middle East, Africa and Europe.
What Is Novel H1N1 Flu
(Swine Flu)? A new influenza virus causing illness in people. Spreading worldwide, probably in much the same way that regular seasonal influenza viruses spread. On June 11, 2009, the (WHO) signaled that a pandemic of novel HH1N1 flu was underway. www.HealthcareMagic.com
Why Is It Called “Swine
Flu”? Has many genes similar to flu viruses that normally occur in pigs (swine). Further study has shown that this new virus is very different. Its affecting people who have had no contact with pigs. It has genes from 4 flu viruses: 2 that normally circulate in pigs, 1 that affects birds, and 1 that affects humans. www.HealthcareMagic.com
What Are The Signs and
Symptoms Of Swine Flu? Fever (usually >100₀ F) Cough Sore throat Runny or stuffy nose Body aches and headache Chills and fatigue Diarrhea and vomiting Pneumonia in complicated cases Cannot be differentiated from seasonal flu or other viral respiratory illnesses based on symptoms
How Does Novel H1N1 Spread?
Mainly from person to person through coughing or sneezing. You could get the swine flu virus from an infected person, when they cough or sneeze. The other mode of transmission is infected surfaces. The flu virus can survive in the environment for 2 to 8 hours. If you touch an infected surface and then touch your eyes, mouth, or nose, you can become infected. www.HealthcareMagic.com
Is Swine Flu A Very
Severe Disease? Illness ranges from mild to severe Most people recover without needing medical treatment But hospitalizations and deaths have occurred So far, 177457 reported cases globally and 1462 deaths* •Source: WHO. Data as on 12th August 2009. www.HealthcareMagic.com
Mortality Due to Some Conditions
in India Tuberculosis: About 900 to 1000 per day Pneumonia: About 1000 under 5 children per day Diarrhea: About 1000 under 5 children per day Pregnancy and childbirth: About 300 women per day www.HealthcareMagic.com
Who Is At High Risk
Of Complications? Children younger than 5 years old Adults 65 years of age and older Persons with chronic lung, heart, kidney, liver, blood, nervous system disease, or diabetes Immunosuppressed Pregnant women Residents of nursing homes and other chronic chronic-care facilities www.HealthcareMagic.com
What Can I Do To
Protect Myself From Getting Sick? Try to avoid close contact with people with flu flu-like symptoms Minimize the time spent in crowded settings Avoid touching your eyes, nose or mouth Wash your hands often with soap and water. Alcohol-based hand cleaners are also effective. Maintain general good health, avoid excessive stress, and keep your living spaces well ventilated Cover your nose and mouth with a tissue when you cough or sneeze. If you are sick with flu-like illness stay home for at least 24 hours after your fever is gone without the use of a fever fever-reducing medicine.
What About the Use of
Masks? Ordinary facemasks do not protect against breathing in very small particle aerosols that may contain viruses Persons with known, probable or suspected flu should preferably wear a mask when in contact with others N 95 masks are designed to protect the person wearing the respirator against breathing in very small particle aerosols that may contain viruses In community and home settings, the use of facemasks is generally not recommended but can be considered particularly for high-risk persons considered, If you are a caregiver, wear a mask when in close contact with the ill person. High risk- persons should avoid being caregiver or otherwise must use a proper mask Health workers caring for persons with known, probable or suspected novel H1N1 or influenza-like illness should use N95 mask influenza Dispose the mask immediately after contact, and cleanse your hands thoroughly Using a mask correctly in all situations is essential. Incorrect use actually increases the chance of spreading infection
What to Do If You
Get Flu-Like Symptoms? If you have flu you may be ill for a week or longer. Stay home and keep away from others as much as possible. Do not rush to a testing center. First see your nearby doctor. Anti-pyretic medications are recommended for relief of fever. Supportive care at home – take rest and drink plenty of fluids. * Source: WHO. Data as on 31st July 2009. www.HealthcareMagic.com
Antivirals Against Swine Flu Two
antivirals are available for use against swine flu – oseltamivir (Tamiflu) and zanamivir (Relenza) Can reduce the severity and duration of illness Tamiflu is indicated for treatment of patients one year of age and older. Oral dose is 75 mg twice daily for 5 days in adolescents and adults. Zanamivir is indicated for treatment of influenza in adults and children (> years). 2 inhalations (2 x 5mg) (>5 twice daily for 5 days. Are Prescription Drugs. Do not take unless prescribed by your doctor. * Source: WHO. Data as on 31st July 2009. www.HealthcareMagic.com
When to Seek Urgent Medical
Care? Emergency Warning Signs In children, emergency warning signs include: • Fast breathing or trouble breathing • Bluish or gray skin color • Not drinking enough fluids • Severe or persistent vomiting • Not waking up or not interacting • Flu-like symptoms improve but then return with fever and worse cough like In adults, emergency warning signs include: • Difficulty breathing or shortness of breath • Pain or pressure in the chest or abdomen • Sudden dizziness • Confusion • Severe or persistent vomiting • Flu-like symptoms improve but then return with fever and worse cough like
What Can Organizations Do To
Protect Employees? Provide flexible and non non-penalizing leave policies Ask employees to stay at home if they are sick. Make backup plans for the possibility of unscheduled leaves Display posters about hand washing, respiratory hygiene, and cough etiquette Provide sufficient facilities for hand washing Provide sufficient tissues and disinfectants to wipe work surfaces Disinfect commonly commonly-touched surfaces at regular intervals Arrange for brief education and communication sessions for the employees
Is It Safe To Travel?
At this time, the WHO does not recommend against travel to any country Travelers should check the website of the embassy of the country to which they are traveling for the latest updates on entry or exit screening procedures which may impact their travel Ill persons should postpone travel . * Source: WHO. Data as on 31st July 2009. www.HealthcareMagic.com