10. H1N1 is a flu virus.
When it was first
detected in 2009,
it was called
โswine fluโ
because the virus
was similar to
those found in
pigs.
11. โข The H1N1 virus is currently a
seasonal flu virus found in
humans.
12. โข Swine flu (H1N1 and H3N2v
influenza virus) facts. Swine flu is a
respiratory disease caused by
influenza viruses that infect the
respiratory tract of pigs and result in
a barking cough, decreased
appetite, nasal secretions, and
listless behavior; the virus can be
transmitted to humans.
15. CASE DEFINITIONS
โข SUSPECTED CASE: A suspected
case of influenza A 2009 is
defined as a person with acute
febrile respiratory illness (fever
>38 degree Celsius) with onset
within 7 days of close contact
with a person who is a
confirmed case orโฆโฆ
16. Contโฆ..
โข Within 7 days of travel to areas
where there are one or more
confirmed cases, or resides in a
community where there are one
or more confirmed H1N1 cases.
17. PROBABLE CASE
โข A probable case of influenza
2009 is defined as a person with
an acute febrile respiratory
illness who is positive for
influenza A, butโฆโฆ.
Contโฆ.
18. Contโฆ..
โข Unsubtypable for H1 and H3 by
influenza RT-PCR or reagents
used to detect seasonal
influenza virus infection, orโฆ..
Contโฆ
19. Contโฆ..
โข Is positive for influenza A by an
influenza rapid test or an
Influenza Immunofluoresence
Assay (IFA) and meets criteria for
a suspected case, orโฆโฆ
Contโฆ
20. Contโฆ.
โข Individual with a clinically
compatible illness who died of
an unexplained acute respiratory
illness who is considered to be
epidemiologically linked to a
probable or confirmed case.
21. CONFIRMED CASE
โข A confirmed case of pandemic
influenza A 2009 virus infection is
defined a person with an acute
febrile respiratory illness with
laboratory confirmed influenza A
2009 at WHO approved laboratory
by one or more of the following
test, โฆโฆโฆโฆโฆContโฆ
22. Contโฆ
โข Real time PCR.
โข Viral culture.
โข Four-fold rise in influenza A virus
specific neutralizing antibodies.
23.
24. CLINICAL FEATURES
โข The clinical features range from
non febrile mild upper
respiratory illness or severe
complications including
pneumonia.
25. UNCOMPLICATED INFLUENZA
โข Influenza Like Illness (ILI) include
fever, cough, sore throat,
rhinorrhea, headache, muscle
pain and malaise, but no
dysnoea.
26.
27.
28. โข Gastro intestinal illness may also
be present such as diarrhoea and
or vomiting especially in
children.
29.
30.
31. SEVERE/COMPLICATED
INFLUENZA
โข Presents clinical and radiological
signs of lower respiratory tract
(pneumonia, CNS involvement โ
encephalopathy, encephalitis,
severe dehydration, renal failure
and septic shock,
rhabdomyolysis & myocarditis.
32. A complicated condition
also may include
โข Exacerbation of underlying
chronic disease including
asthma, COPD, Hepatic Failure,
Renal Failure & other
Cardiovascular conditions. โฆ or
any signs of progressive disease
requiring hospitalization.
33.
34. RISK FACTORS FOR SEVERE
DISEASE include :
โข Infants, young children, Pregnant
women, persons with COPD,
persons with cardiovascular
disease, persons with metabolic
disorders, children receiving
chronic aspirin therapy, persons
aged above 65 years.
35. LABORATORY DIAGNOSIS
โข Reverse Transcriptase
Polymerase Chain Reaction (RT-
PCR) provides the most timely
and sensitive detection of the
infection.
36. โข Clinical specimens to be
collected include, respiratory
samples. (combination of nasal
or nasopharyngeal samples,
throat swab.
37. INFECTION CONTROL
โข CAN BE ACHIEVED BY,
โข Strict adherence to hand hygiene
with soap and water or an
alcohol based hand sanitizer.
38. โข To cover the mouth and nose
with tissue or handkerchief
when coughing or sneezing.
โข If ill person have to go out for
medical treatment they should
wear a face mask to reduce the
risk of spreading the virus in the
community.
39.
40.
41. โข Isolation (of patients) procedure
must be adhered to at least for 7
days.
42. PREVENTION
โข Vaccine is available. (Live
attenuated vaccine, inactivated
unadjuvanted vaccines and vaccines
containing A/California/7/2009 like
virus, and โฆโฆ.. Contโฆ..(next slide)
46. INACTIVATED VACCINE
โข Monovalent vaccine containing
antigen equivalent to
A/California/7/2009(H1N1) V โ
like strain, 15 micrograms of
heamagglutinin per 0.5 ml dose.
47. โข Inactivated vaccines contain
Thiomersal if they are supplied
in multi-dose vials (10 dose of
0.5 ml).
โข It is a commonly used vaccine
preservative to prevent vaccine
contamination by bacteria
during use.
48. โข The vaccine should be stored
between 2 to 8 Celsius. It should
not be frozen.
โข The vaccine is administered as
single dose intramuscular
injection in the upper arm.
49. โข In infants aged more than 6
months and young children thigh
is preferred site for vaccination.
50. SIDE EFFECTS
โข Inactivated influenza vaccines,
administered by injection,
commonly cause local reactions
such as soreness, swelling and
redness at the injection site.
โข These symptoms generally last for
two days and require no medical
attention.
51. โข Rarely influenza vaccine can
cause allergic reactions such as
hives, rapid swelling of deeper
skin layers and tissues, asthma
or a severe multisystem allergic
reaction due to hypersensitivity
to certain components.
52. CONTRAINDICATIONS
โข Vaccine should not be administered to :
โข People who have severe allergy to
chicken egg.
โข Individuals with anaphylactic reactions.
โข Individuals with Guillain Barre
Syndrome.
โข Children less than 6 months.
62. ANTI VIRAL TREATMENT
REGIMEN
โข Oseltamivir is indicated for the
treatment of influenza.
โข The recommended dose for
adults is 75mg twice daily for 5
days.
63.
64. TREATMENT OF INFANT
โข Oseltamivir- THE RECOMMENDED DOSE FOR
INFANTS IS AS FOLLOWS.
AGE DOSE
> 3Mo 3 mg/kg, twice daily for 5
days.
> 1 Mo to 3 Mo 2.5mg/Kg, twice daily for
5 days
0 to 1 Mo 2mg/kg, twice daily for 5
days.
65. TREATMENT OF OLDER
CHILDREN
WEIGHT DOSE
15 Kg OR Less 30 mg twice a day *5 days
15-23 Kg 45 mg twice a day *5 days
24-40 Kg 60 mg twice a day *5 days
> 40 Kg 75 mg twice day * 5 days
66. โข Zanamivir is indicated for
treatment of influenza in adults
and children (>5 years).
โข The recommended dose for
treatment of adults and children
from the age of 5 years is TWO
INHALATIONS (2X5 Mg)twice
daily for 5 days.
67. CHEMOPROPHYLAXIS
โข Oseltamivir is the drug of choice
for prophylaxis to health care
personnel and close contacts and
suspects.
โข It should be administered till 10
days after exposure.