This document discusses swine flu and influenza pandemics. It provides information on influenza viruses types A and B, past pandemics like the 1918 Spanish Flu, and the prerequisites for a pandemic virus. The 2009 H1N1 virus is described as a hybrid that emerged via genetic reassortment. Signs and symptoms of human influenza are outlined. Non-pharmaceutical interventions to delay transmission and reduce peak burden are recommended, including isolation, quarantine, hand washing, and use of masks and antivirals like Oseltamivir. The importance of early treatment is also emphasized.
Hello friends i am BSc Nursing intern.This presentation of mine covers almost each and every aspect related to swine flu.Hope it will help you to increase your knowledge regarding the topic.Looking forward to your feedback.Thank you
H1N1 is an influenza A virus which is the causative pathogen for swine flu. There have been seasonal outbreaks every year. The reason being, it is contagious, and mutations in the virus strain put everyone at risk every season. Awareness about this disease and its transmission, prevention, and management is critical to control the spread of the disease. We also need to clarify few myths associated with this disease
https://www.icliniq.com/articles/infectious-diseases/swine-flu-everything-you-need-to-know
Hello friends i am BSc Nursing intern.This presentation of mine covers almost each and every aspect related to swine flu.Hope it will help you to increase your knowledge regarding the topic.Looking forward to your feedback.Thank you
H1N1 is an influenza A virus which is the causative pathogen for swine flu. There have been seasonal outbreaks every year. The reason being, it is contagious, and mutations in the virus strain put everyone at risk every season. Awareness about this disease and its transmission, prevention, and management is critical to control the spread of the disease. We also need to clarify few myths associated with this disease
https://www.icliniq.com/articles/infectious-diseases/swine-flu-everything-you-need-to-know
In the last 42 days, Six deaths and 421 cases of swine flu have been reported from 28 districts of the state. Here's what you need to know about the disease.
Swine flu (swine influenza) is a respiratory disease caused by viruses (influenza viruses) that infect the respiratory tract of pigs, resulting in nasal secretions, a barking cough, decreased appetite, and listless behavior.
Swine flu produces most of the same symptoms in pigs as human flu produces in people. Swine flu can last about one to two weeks in pigs that survive. Swine influenza virus was first isolated from pigs in 1930 in the U.S.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
In the last 42 days, Six deaths and 421 cases of swine flu have been reported from 28 districts of the state. Here's what you need to know about the disease.
Swine flu (swine influenza) is a respiratory disease caused by viruses (influenza viruses) that infect the respiratory tract of pigs, resulting in nasal secretions, a barking cough, decreased appetite, and listless behavior.
Swine flu produces most of the same symptoms in pigs as human flu produces in people. Swine flu can last about one to two weeks in pigs that survive. Swine influenza virus was first isolated from pigs in 1930 in the U.S.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
Usually called swine flu, you'll also hear it called 2009 H1N1 flu and novel influenza A (H1N1). No wonder we're all a little baffled. But swine flu isn't that hard to understand; it's a lot like seasonal flu. It has similar symptoms, such as fever, cough, sore throat, stuffy nose, body aches, headache, chills, and fatigue. As a matter of fact, it's hard to tell swine flu from seasonal flu without a lab test.
Flu and you by Dr Pruthvi Puwar (Physician, Vadodara, Guj, India)Falguni Puwar
It includes types of FLu and brief about it. It incorporated basics about Ebola infection and Swine flu infection. Level of presentation is for General practitioners and Lehman people..
Influenza - History, Vaccination, and Public HealthLouise O' Flynn
A presentation exploring the history of Influenza, vaccination for influenza in Ireland, and the impact of Influenza on Public Health, public policy, and health promotion initiatives.
Authors: Tighearnan Corcoran, Stephanie Mulcair, Louise O' Flynn.
It measures lung function, specifically the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. Spirometry is helpful in assessing breathing patterns that identify conditions such as asthma, pulmonary fibrosis, cystic fibrosis, and COPD. I createdasas
Net neutrality is the principle that Internet service providers treat all data on the Internet equally, and not discriminate or charge differently by user, content, website, platform, application, type of attached equipment, or method of communication.[4] For instance, under these principles, internet service providers are unable to intentionally block, slow down or charge money for specific websites and online content. This is sometimes enforced through government mandate.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. 2
Influenza Virus
Types A and B
Type A
(Seasonal, avian, swine
influenza,….)
Type B
(Seasonal influenza)
Can cause significant disease
Generally causes milder
disease but may also cause
severe disease
Infects humans and other
species (e.g., birds; H5N1)
Limited to humans
Can cause epidemics and
pandemics (worldwide epidemics)
Generally causes milder
epidemics
3. 1920 1940 1960 1980 2000
H1N1
H2N2
H3N2
1918: "Spanish Flu" 1957: "Asian Flu" 1968: "Hong Kong Flu"
20-40 million deaths 1-4 million deaths 1-4 million deaths
5. Seasonal Influenza
– A public health
problem each year
– Usually some
immunity built up from
previous exposures to
the same subtype
– Infants and elderly
most at risk
Influenza Pandemics
– Appear in the human
population rarely and
unpredictably
– Human population
lacks any immunity
– All age groups,
including healthy young
adults
Seasonal Epidemics vs. Pandemics
6. The new virus must beThe new virus must be efficientlyefficiently
transmitted from one human to anothertransmitted from one human to another
The new virus must beThe new virus must be efficientlyefficiently
transmitted from one human to anothertransmitted from one human to another
Prerequisites for pandemic influenza
A new influenza virus emerges to
which the general population has
little/no immunity
The new virus must be able to replicate
in humans and cause disease
12. Signs and Symptoms
Human Influenza
Type of infection Upper and lower respiratory
Fever Yes
Headache Yes
Cough Yes
Respiratory symptoms Varies; sore throat to difficulty
breathing
Gastrointestinal
symptoms
Uncommon, except children,
elderly
Recovery 2-7 days
13. Swine flu
• "The entire purpose is to
limit exposure"
• The Centers for Disease Control and
Prevention hopes to have a vaccine to
manufacturers within 6 months (??)
14. Non-pharmaceutical Interventions
1. Delay disease transmission and outbreak peak
2. Decompress peak burden on healthcare infrastructure
3. Diminish overall cases and health impacts
Daily
Cases
#1
#2
#3
Days since First Case
Pandemic outbreak:
No intervention
Pandemic outbreak:
With intervention
16. Voluntary Isolation
• Separation and restricted movement of ill
persons with contagious disease (often in
a hospital setting and Primarily individual
level)
– Isolate severe and mild cases
– Location of isolation (home, hospital) depends on
several factors (severity of illness, the number of
affected persons, the domestic setting)
– Do not wait for lab confirmation
– Plan for large number of severe cases
– Provide medical and social care
17. Voluntary Quarantine
• Separation and restricted movement of
well persons presumed exposed
– Identification of contacts
• Often at home, but may be designated
residential facility or hospital
• Applied at the individual or community
level
• Regular health monitoring is essential
part of quarantine
18. Hand Washing
Method
• Wet hands with clean (not hot) water
• Apply soap
• Rub hands together for at least 20 seconds
• Rinse with clean water
• Dry with disposable towel or air dry
• Use towel to turn off faucet
19. Alcohol-based Hand Rubs
• Effective if hands not visibly soiled
• More costly than soap & water
Method
• Apply appropriate (3ml) amount to
palms
• Rub hands together, covering all
surfaces until dry
20.
21. Patients Cared for at Home
• Potential for transmission
• Must educate family caregivers
• Fever / symptom monitoring
• Infection control measures
– Hand washing
– Use of available material as mask …
29. Antivirals- Oseltamivir
• Treatment is 75 mg twice a day for 5 days.
• Prophylaxis is 75 mg once a day for 7 days
after last exposure.
• Prophylaxis:
– High risk exposure (household contacts)
– Moderate risk (unprotected very close exposure to
sick animals; HCW with unprotected exposure to
patients)
– Low risk exposure: no need for prophylaxis unless
activation of exceptional measures.
While there are three types of influenza viruses—A, B, and C—only two cause significant disease in humans (A and B). Type B influenza viruses are limited to humans, whereas Type A viruses can cause severe disease in humans and affect more species. Influenza Type A Type A influenza is considered to cause the most serious disease among the influenza viruses, although not all strains cause clinical disease. Influenza A can cause severe epidemics (as well as severe worldwide epidemics; or pandemics) among all ages. Influenza type A infects multiple species including people, birds, pigs, horses, and other animals. Wild birds are the natural hosts for these viruses. Influenza Type B Influenza B viruses are usually found only in humans. Influenza B viruses can cause some morbidity and mortality among humans, but in general are associated with less severe epidemics (chiefly among children) than influenza A viruses. Although influenza type B viruses can cause human epidemics, they have not caused pandemics. Because avian influenza and all pandemic viruses are of the Type A variety, we will focus this session on Type A influenza viruses.
While seasonal influenza occurs every year, pandemic influenza rarely occurs. Here we compare some features of seasonal influenza with features of pandemic influenza. While the population usually has some immunity built up from previous exposures to seasonal influenza, the human population lacks any immunity to pandemic influenza strains. In seasonal influenza epidemics, infants and the elderly are most at risk of illness and complications. But during an influenza pandemic, even healthy, young people are at increased risk for serious complications. Seasonal influenza strains are the result of Antigenic Drift, while pandemic influenza strains are the result of Antigenic Shift.
2 of the 3 prerequisites for a human pandemic have been met A novel influenza virus has emerged and the general population has demonstrated little or no immunity And the new virus has been able to replicate in humans The main questions that remains are: Will the virus will develop into a form that is efficiently transmitted from one human to another? (thus meeting the criteria for a pandemic) If so, where, when, how quickly, and how severely? The first two of three prerequisites have been met: A novel virus Virus must be able to replicate in humans and cause disease New virus must be efficiently transmitted from one human to another Virus can improve its transmissibility via two mechanisms: adaptive mutation genetic reassortment (can take place in humans without prior adaptation in another mammalian species, such as the pig)
It can be difficult to tell if a patient has influenza because the signs and symptoms for influenza are similar to those for other diseases that may cause respiratory illnesses. If you do suspect influenza, there are a few differences between human influenza and avian influenza that you can assess, especially in the early days of illness. Human influenza usually causes both upper respiratory (sore throat runny nose) and lower respiratory (cough, bronchitis) symptoms. Common signs and symptoms include fever, headache, cough, sore throat, muscle ache, and exhaustion. Other respiratory symptoms may appear, varying from sore throat to difficulty breathing. Children and the elderly may also have gastrointestinal symptoms like diarrhea, vomiting and nausea, but adults uncommonly have gastrointestinal symptoms, except loss of apetitie. People generally recover anywhere from 2 to 7 days after symptoms appear. However, cough and muscle ache may last more than 14 days. Although influenza generally causes an upper respiratory infection with tracheobronchitis, it can progress to pneumonia and respiratory failure in some cases. Although similar initially, avian influenza differs from human influenza in its course. Avian influenza leads to a lower respiratory illness with variable upper respiratory involvement. Initial symptoms are similar to human influenza. These include fever, headache, cough, sore throat, muscle ache, and exhaustion. Gastrointestinal symptoms of watery diarrhea, vomiting, and abdominal pain have been more commonly reported from H5N1 patients (20-70% diarrhea rate depending on case series). Symptoms of a lower respiratory infection appear early in course of the illness. About five days after symptoms appear, patients often begin to have difficulty breathing leading to respiratory distress, and an increased respiratory rate may also be observed. By this time, cough is prominent, sputum production may occur sometimes containing blood. Most patients develop pneumonia with bilateral pulmonary infiltrates. Ref: Writing Committee on WHO Consultation. NEJM 353:1374-85, 2005
We have just discussed infection control measures in health care facilities to prevent patient to health care worker and patient to patient transmission of avian influenza. Next we will discuss how to prevent person to person spread of avian influenza in the community. Specific infection control policies and procedures may be easier to implement in a controlled environment such as a medical facility, but good infection control practices can also be adapted to prevent and control respiratory disease transmission in the community. The following measures to contain respiratory secretions are recommended for all individuals with symptoms of a respiratory infection such as avian influenza: -Cover the nose and mouth with a mask, tissue or cloth when coughing or sneezing, and dispose of the tissue in the nearest waste receptacle after use. -If a mask, tissues or cloth are not available, cough or sneeze into your upper sleeve versus your hands. -Perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic hand wash) after having contact with respiratory secretions or contaminated objects. (NOTE TO REVIEWERS: PLEASE ADD IN USE OF LOCAL MATERIALS HERE)
While not formally a type of PPE, we will first discuss hand hygiene, because it is the cornerstone of infection control! Always remember to wash hands in between contact with each new patient. This slide describes effective hand hygiene techniques: When washing hands with soap and water, first wet hands with water, then apply the amount of soap recommended by the manufacturer. Rub hands together for at least 20 seconds, covering all surfaces of the hands and fingers. Rinse hands with water, dry them thoroughly with a disposable towel, and use the towel to turn off the faucet. Of course, this assumes that clean water is available. If there is any doubt about this, boiled or bottled water, or water treated with chlorine tablets should be used. *Source: Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.
If hands are not visibly soiled, alcohol-based hand cleaners are also effective. When decontaminating hands with an alcohol-based hand rub, apply product to palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry. The volume to use depends on the manufacturer directions, but usually a coin-sized amount in your hand is sufficient.
As with any infectious disease, there is the potential for avian influenza to be transmitted in the home. Therefore, people within the home of an infected individual should be educated on the risk for transmission, and ideally wear personal protective equipment including gloves, gowns and surgical masks. If PPE items are unavailable, readily available materials such as tissues or cloths should be used. And hand hygiene, as always, is critically important in preventing the spread of avian influenza in the home. Finally, as will be discussed in a moment, anyone handling corpses should wear protective gear.