The WHO designation of a pandemic alert Phase 6 reflects the fact that there are now ongoing community level outbreaks in multiple parts of world.

1. Swine Flu-Type A Influenza H1N1 Prof. Marcos Nascimento,Md. Respiratory Care PUCPR 2009 www.pulmaosa.com.br

2. SwINE FLU ? What is Hapenning?

5. TYPE A Influenza Influenza type A - H1N1 (isolated in 1930 - pig) Although called the swine flu, New strain does not infect pigs Has never been seen in animals * Genetically different strain Seasonal influenza virus H1N1 (human) Has circulated the world in recent years The new virus DNA contains typical human viruses, avian and swine (European and Asian)

6. TYPE A Influenza Symptoms: Highfever * Cough * Myalgia * Sorethroat, headache, chills, fatigue; Possible: diarrheaandvomiting; Severe: pneumonia / RespiratoryInsuficiency; Decompensationandexacerbationofunderlyingdisease; Incubationperiod: 1 to 7 days! www.pulmaosa.com-Faqs

7. TYPE A Influenza DO NOT transmit for food: pork Surge - "SwineFlu" 1976 - soldiers - Fort Dix - New Jersey Swine H1N1 virus ~ human H1N1 virus (Vaccine does notprotect 100%) Cross-reaction? * Eg. Epidemicof Dengue Virus in Brazil!  www.pulmaosa.com.br-Faqs

8. TYPE A Influenza Prevention: Prevention: Oseltamivir ®1: tablet (1cp) 75mg qd 10dias Zanamivir ®2: inhaled (2puffs) 10mg qd 10-28dias 1.Roche® RegisterBrand .2. Glaxo® RegisterBrand www.pulmaosa.com.br-Faqs - Cover mouth and nose! (When coughing or sneezing) - Wash your hands! - Avoid touching eyes, nose and mouth! Avoid contact with sick person! * Communicating to school or Company any trip to an endemic region!

9. H1N1 Treatment: Oseltamivir®: Tablet (1cp) 75mg bid 5dias (Tamiflu ®) Zanamivir®: inhaled (2puffs) 10mg bid 5dias (Relenza ®) AmantadineResistanceandRimantadinesideeffect

10. TYPE A Influenza Brazil Created: "Standing Office of Emergency" For an outbreak of Type A InfluenzaConsist of: - Ministry of Health - ANVISA - Ministry of Agriculture WHO: Control of the daily number of cases in the world.

11. TYPE A Influenza WHO warned of the potential to cause a pandemic (global epidemic) The H1N1 virus meets the three requirements : It is new viral strain This genetic combination has never been seen before  It is Transmissible from person to person! contagion between persons of the classic swine flu virus was rare, the new strain appears easy! The disease causes serious morbid State and could leaves to Death! In number of cases in the world: 12022 23/05/2009) -8:00 GMT ¡80 people have died in Mexico/10 in USA / Canada 1 / C. Rica 1

12. FLU HISTORIC Pandemics1918 - "SpanishFlu" - A (H1N1) - 20milhões deaths1957 - "Asianflu" - A (H2N2) - 86mil deaths1968 - "Hong Kong flu" - A (H3N2) - 34mil deaths1976 - "SwineFlu" - A (H1N1) 1997 - "BirdFlu" - A (H5N1) Hong Kong - newstrain2009 - "Swine-Flu H1N1-type A"

13. What is Flu ?

14. FLU X Cold FLU Pathogens: influenza virus Transmission : air System often Sudden onset High fever Treatment : yesVaccine yes! Cold Pathogen: Rino, coronavirus, adenovirusTransmission :hands’ secretion! Systemic: occasionalGradual onsetFeverabsentorlowSymptomatictreatmentVaccine: no! www.pulmaosa.com.br-Faqs

15. FLU Vaccine Composition: Recomendação OMS – 2009 – SouthernHemisphere A / Brisbane / 59/ 2007 (H1N1) A / Brisbane / 10/ 2007 (H3N2) B / Florida / 4/ 2006 Effectiveness: 70-80% Duration: 01 years Peak: 3 months www.pulmaosa.com.br-Faqs

16. THANKS! 16 Wash hands frequently with soap and water for 20 seconds (long enough to sing the "Sesame hand-washing" song twice). Alcohol-based hand cleaners are also effective. Wash, wash, wash my hands,Make them nice and clean!Rub the bottoms and the topsAnd fingers in between Avoid touching your eyes, nose or mouth. Germs spread that way. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. www.pulmaosa.com.br

17. References: www.pulmaosa.com.br-Faqs Ministry of Health of BrazilCDC- Center for Diseases Control