swine flu

Swine influenza

sarasheedall@gmail.com (Swine flu) — Thu, 10 Sep 2009 00:21:00 -0700

For information on ways to decrease one's chances of contracting swine influenza, see influenza prevention.

For the 2009 outbreak, see 2009 flu pandemic.

Influenza (flu)

2009 flu pandemic (Swine flu)
Virus
Avian influenza
Swine influenza
Flu season
Research
Vaccine
Treatment
A/H5N1
subtype
A/H1N1 subtype
Pandemic

Swine influenza is endemic in pigs

Electron microscope image of the reassorted H1N1 influenza virus photographed at the CDC Influenza Laboratory. The viruses are 80–120 nanometres in diameter.

Swine influenza (also called swine flu, hog flu, and pig flu) is an infection by any one of several types of swine influenza virus. Swine influenza virus (SIV) is any strain of the influenza family of viruses that is endemic in pigs. As of 2009, the known SIV strains includeinfluenza C and the subtypes of influenza A known asH1N1, H1N2, H3N1, H3N2, and H2N3.
Swine influenza virus is common throughout pig populations worldwide. Transmission of the virus from pigs to humans is not common and does not always lead to human influenza , often resulting only in the production of antibodies in the blood. If transmission does cause human influenza, it is called zoonotic swine flu. People with regular exposure to pigs are at increased risk of swine flu infection. The meat of an infected animal poses no risk of infection when properly cooked.

During the mid-20th century, identification of influenza subtypes became possible, allowing accurate diagnosis of transmission to humans. Since then, only 50 such transmissions have been confirmed. These strains of swine flu rarely pass from human to human. Symptoms of zoonotic swine flu in humans are similar to those of influenza and of influenza-like illness in general, namelychills, fever, sore throat
, muscle pains, severe headache, coughing, weakness and general discomfort.

2.1 1918 pandemic in humans
2.2 1976 U.S. outbreak
2.3 1988 zoonosis
2.4 1998 US outbreak in swine
2.5 2007 Philippine outbreak in swine
2.6 2009 outbreak in humans
3 Transmission

3.1 Transmission between pigs
3.2 Transmission to humans
3.3 Interaction with avian H5N1 in pigs
4 Signs and symptoms

4.1 In swine
4.2 In humans
4.3 Diagnosis
5 Prevention
5.1 Prevention in swine
5.2 Prevention in humans
7 See also
8 Notes
9 Further reading
10 External links

Classification

Of the three genera of influenza viruses that cause human flu, two also cause influenza in pigs, withinfluenza A being common in pigs and influenza C being rare. Influenza B has not been reported in pigs. Within influenza A and influenza C, the strains found in pigs and humans are largely distinct, although due to reassortment there have been transfers of genes among strains crossing swine, avian, and human species boundaries.

Influenza C

Influenza C viruses infect both humans and pigs, but do not infect birds. Transmission between pigs and humans have occurred in the past For example, influenza C caused small outbreaks of a mild form of influenza amongst children in Japan and California. Due to its limited host range and the lack of genetic diversity in

Influenza A

Swine influenza is known to be caused by influenza A subtypes. H1N1, H1N2, H2N3 H3N1, and H3N2 In pigs, three influenza A virus subtypes (H1N1, H1N2, and H3N2) are the most common strains worldwide. In the United States, the H1N1 subtype was exclusively prevalent among swine populations before 1998; however, since late August 1998, H3N2 subtypes have been isolated from pigs. As of 2004, H3N2 virus isolates in US swine and turkey stocks were triple reassortants, containing genes from human (HA, NA, and PB1), swine (NS, NP, and M), and avian (PB2 and PA) lineages.

Surveillance

Although there is no formal national surveillance system in the United States to determine what viruses are circulating in pigs,there is an informal surveillance network in the United States that is part of a world surveillance network.

Veterinary medical pathologist, Tracey McNamara, set up a national disease surveillance system in zoos because the zoos do active disease surveillance and many of the exotic animals housed there have broad susceptibilities. Many species fall below the radar of any federal agencies (including dogs, cats, pet prairie dogs, zoo animals, and urban wildlife), even though they may be important in the early detection of human disease outbreaks.

History

Swine influenza was first proposed to be a disease related to human influenza during the 1918 flu pandemic, when pigs became sick at the same time as humans. The first identification of an influenza virus as a cause of disease in pigs occurred about ten years later, in 1930. For the following 60 years, swine influenza strains were almost exclusively H1N1. Then, between 1997 and 2002, new strains of three different subtypes and five different genotypes emerged as causes of influenza among pigs in North America. In 1997-1998, H3N2 strains emerged. These strains, which include genes derived by reassortment from human, swine and avian viruses, have become a major cause of swine influenza in North America. Reassortment between H1N1 and H3N2 produced H1N2. In 1999 in Canada, a strain of H4N6 crossed the species barrier from birds to pigs, but was contained on a single farm.

The H1N1 form of swine flu is one of the descendants of the strain that caused the 1918 flu pandemic. As well as persisting in pigs, the descendants of the 1918 virus have also circulated in humans through the 20th century, contributing to the normal seasonal epidemics of influenza. However, direct transmission from pigs to humans is rare, with only 12 cases in the U.S. since 2005. Nevertheless, the retention of influenza strains in pigs after these strains have disappeared from the human population might make pigs a reservoir where influenza viruses could persist, later emerging to reinfect humans once human immunity to these strains has waned.

Swine flu has been reported numerous times as a zoonosis in humans, usually with limited distribution, rarely with a widespread distribution. Outbreaks in swine are common and cause significant economic losses in industry, primarily by causing stunting and extended time to market. For example, this disease costs the British meat industry about £65 million every year.

1918 pandemic in humans

The 1918 flu pandemic in humans was associated with H1N1 and influenza appearing in pigs; this may reflect a zoonosis either from swine to humans, or from humans to swine. Although it is not certain in which direction the virus was transferred, some evidence suggests that, in this case, pigs caught the disease from humans. For instance, swine influenza was only noted as a new disease of pigs in 1918, after the first large outbreaks of influenza amongst people. Although a recent phylogenetic analysis of more recent strains of influenza in humans, birds, and swine suggests that the 1918 outbreak in humans followed a reassortment event within a mammal, the exact origin of the 1918 strain remains elusive. It is estimated that anywhere from 50 to 100 million people were killed worldwide.

1976 U.S. outbreak

Main article: 1976 swine flu outbreak

On February 5, 1976, in the United States an army recruit a Fort Dix t said he felt tired and weak. He died the next day and four of his fellow soldiers were later hospitalized. Two weeks after his death, health officials announced that the cause of death was a new strain of swine flu. The strain, a variant of,H1N1 is known as A/New Jersey/1976 (H1N1). It was detected only from January 19 to February 9 and did not spread beyond Fort Dix.

President Ford receives swine flu vaccination

This new strain appeared to be closely related to the strain involved in the 1918 flu pandemic. Moreover, the ensuing increased surveillance uncovered another strain in circulation in the U.S.: A/Victoria/75 (H3N2) spread simultaneously, also caused illness, and persisted until March. Alarmed public-health officials decided action must be taken to head off another major pandemic, and urged President Gerald Ford that every person in the U.S. be vaccinated for the disease.

The vaccination program was plagued by delays and public relations problems. On October 1, 1976, the immunization program began. That same day, three senior citizens died soon after receiving their swine flu shots and there was a media outcry linking the deaths to the immunizations, despite the lack of positive proof. According to science writer Patrick Di Justo, however, by the time the truth was known—that the deaths were not proven to be related to the vaccine—it was too late. "The government had long feared mass panic about swine flu—now they feared mass panic about the swine flu vaccinations." This became a strong setback to the program.

There were reports of Guillain-Barré syndrome, a paralyzing neuromuscula disorder, affecting some people who had received swine flu immunizations. This syndrome is a rare side-effect of modern influenza vaccines, with an incidence of about one case per million vaccinations. As a result, Di Justo writes that "the public refused to trust a government-operated health program that killed old people and crippled young people." In total, 48,161,019 Americans, or just over 22% of the population, had been immunized by the time the National Influenza Immunization Program (NIIP) was effectively halted on December 16, 1976.

Overall, there were 1098 cases of Guillain-Barré Syndrome (GBS) recorded nationwide by CDC surveillance, 532 of which were linked to the NIIP vaccination, resulting in death from severe pulmonary complications for 25 people, which, according to Dr. P. Haber, were probably caused by an immunopathological reaction to the 1976 vaccine. Other influenza vaccines have not been linked to GBS, though caution is advised for certain individuals, particularly those with a history of GBS. Still, as observed by a participant in the immunization program, the vaccine killed more Americans than the disease did.

1988 zoonosis

In September 1988, a swine flu virus killed one woman and infected others. 32-year old Barbara Ann Wieners was eight months pregnant when she and her husband, Ed, became ill after visiting the hog barn at a county fair in Walworth County, Wisconsin. Barbara died eight days later, after developing pneumonia. The only pathogen identified was an H1N1 strain of swine influenza virus. Doctors were able to induce labor and deliver a healthy daughter before she died. Her husband recovered from his symptoms.

Influenza-like illness (ILI) was reportedly widespread among the pigs exhibited at the fair. 76% of 25 swine exhibitors aged 9 to 19 tested positive for antibody to SIV, but no serious illnesses were detected among this group. Additional studies suggested between one and three health care personnel who had contact with the patient developed mild influenza-like illnesses with antibody evidence of swine flu infection. However, there was no community outbreak.

1998 US outbreak in swine

In 1998, swine flu was found in pigs in four U.S. states. Within a year, it had spread through pig populations across the United States. Scientists found that this virus had originated in pigs as a recombinant form of flu strains from birds and humans. This outbreak confirmed that pigs can serve as a crucible where novel influenza viruses emerge as a result of the reassortment of genes from different strains.

2007 Philippine outbreak in swine

Please help improve this article by expanding it. Further information might be found on the talk page. (April 2009)

On August 20, 2007 Department of Agriculture officers investigated the outbreak (epizootic) of swine flu in Nueva Ecija and Central Luzon, Philippines. The mortality rate is less than 10% for swine flu, unless there are complications like . hog choleraOn July 27, 2007, the Philippine National Meat Inspection Service (NMIS) raised a hog cholera "red alert" warning over Metro Manila and 5 regions of Luzon after the disease spread to backyard pig farms in Bulacan and Pampanga, even if these tested negative for the swine flu virus.

2009 outbreak in humans

Main article: 2009 flu pandemic

TheH1N1 viral strain implicated in the 2009 flu pandemic among humans often is called "swine flu" because initial testing showed many of the genes in the virus were similar to influenza viruses normally occurring in North American swine. But further research has shown that the outbreak is due to a new strain of H1N1 not previously reported in pigs.

In late April, Margaret Chan, the World Health Organization's director-general, declared a "public health emergency of international concern" under the rules of theWHO's new International Health Regulations when the first cases of the H1N1 virus were reported in the United States Following the outbreak, on May 2, 2009, it was reported in pigs at a farm in Alberta, Canada, with a link to the . outbreak in MexicoThe pigs are suspected to have caught this new strain of virus from a farm worker who recently returned from Mexico, then showed symptoms of an influenza-like illness. These are probable cases, pending confirmation by laboratory testing.

The new strain was initially described as an apparent reassortment of at least four strains of influenza A virus subtype H1N1, including one strainendemic in humans , one endemic in birds, and two endemic in swine. Subsequent analysis suggested it was a reassortment of just two strains, both found in swine. Although initial reports identified the new strain as swine influenza (i.e., a zoonosis originating in swine), its origin is unknown. Several countries took precautionary measures to reduce the chances for a global pandemic of the disease. The 2009 swine flu has been compared to other similar types of influenza virus in terms of mortality: "in the US it appears that for every 1000 people who get infected, about 40 people need admission to hospital and about one person dies". There are fears that swine flu will become a major global pandemic in the winter months, with many countries planning major vaccination campaigns.

Transmission

Transmission between pigs

Influenza is quite common in pigs, with about half of breeding pigs having been exposed to the virus in the US. Antibodies to the virus are also common in pigs in other countries.

The main route of transmission is through direct contact between infected and uninfected animals. These close contacts are particularly common during animal transport. Intensive farming may also increase the risk of transmission, as the pigs are raised in very close proximity to each other The direct transfer of the virus probably occurs either by pigs touching noses, or through dried mucus. Airborne transmission through the aerosols produced by pigs coughing or sneezing are also an important means of infection. The virus usually spreads quickly through a herd, infecting all the pigs within just a few days. Transmission may also occur through wild animals, such as wild boar, which can spread the disease between farms.

Transmission to humans

People who work with poultry and swine, especially people with intense exposures, are at increased risk of zoonotic infection with influenza virus endemic in these animals, and constitute a population of human hosts in which zoonosis and reassortment can co-occur. Vaccination of these workers against influenza and surveillance for new influenza strains among this population may therefore be an important public health measure. Transmission of influenza from swine to humans who work with swine was documented in a small surveillance study performed in 2004 at the University of Iowa. This study among others forms the basis of a recommendation that people whose jobs involve handling poultry and swine be the focus of increased public health surveillance. Other professions at particular risk of infection are veterinarians and meat processing workers, although the risk of infection for both of these groups is lower than that of farm workers.

Interaction with avian H5N1 in pigs

Pigs are unusual as they can be infected with influenza strains that usually infect three different species: pigs, birds and humans. This makes pigs a host where influenza viruses might exchange genes, producing new and dangerous strains. Avian influenza virus H3N2 is endemic in pigs in China and has been detected in pigs in Vietnam, increasing fears of the emergence of new variant strains.H3N2 evolved fromb H2N2y antigenic shift. In August 2004, researchers in China found H5N1 in pigs.

Main symptoms of swine flu in swine.

These H5N1 infections may be quite common: in a survey of 10 apparently healthy pigs housed near poultry farms in West Java, where avian flu had broken out, five of the pig samples contained the H5N1 virus. The Indonesian government has since found similar results in the same region. Additional tests of 150 pigs outside the area were negative.

Signs and symptoms

In swine

In pigs influenza infection produces fever, lethargy, sneezing, coughing, difficulty breathing
and decreased appetite. In some cases the infection can cause abortion. Although mortality is usually low (around 1-4%),the virus can produce weight loss and poor growth, causing economic loss to farmers. Infected pigs can lose up to 12 pounds of body weight over a 3 to 4 week period.

In humans

Main symptoms of swine flu in humans

Direct transmission of a swine flu virus from pigs to humans is occasionally possible (called zoonotic swine flu). In all, 50 cases are known to have occurred since the first report in medical literature in 1958, which have resulted in a total of six deaths. Of these six people, one was pregnant, one had leukemia, one ha Hodgkin disease
dand two were known to be previously healthy. Despite these apparently low numbers of infections, the true rate of infection may be higher, since most cases only cause a very mild disease, and will probably never be reported or diagnosed.

In this video, Dr. Joe Bresee, with CDC's Influenza Division, describes the symptoms of swine flu and warning signs to look for that indicate the need for urgent medical attention.
See also: See this video with subtitles on YouTube

According to the Centers for Disease Control and Prevention (CDC), in humans the symptoms of the 2009 "swine flu" H1N1 virus are similar to those of influenza and of influenza-like illness in general. Symptoms include fever, cough, sore throat, body aches, headache, chills
and fatigue. The 2009 outbreak has shown an increased percentage of patients reporting diarrhea and vomiting. The 2009 H1N1 virus is not zoonotic swine flu, as it is not transmitted from pigs to humans, but from person to person.

Because these symptoms are not specific to swine flu, a differential diagnosis of probable swine flu requires not only symptoms but also a high likelihood of swine flu due to the person's recent history. For example, during the 2009 swine flu outbreak in the United States
, CDC advised physicians to "consider swine influenza infection in the differential diagnosis of patients with acute febrile respiratory illnesswho have either been in contact with persons with confirmed swine flu, or who were in one of the five U.S. states that have reported swine flu cases or in Mexico during the 7 days preceding their illness onset." A diagnosis of confirmed swine flu requires laboratory testing of a respiratory sample (a simple nose and throat swab).

The most common cause of death is respiratory failure. Other causes of death are pneumonia (leading to sepsis), high fever (leading to neurological problems), dehydration (from excessive vomiting and diarrhea) and electrolyte imbalance. Fatalities are more likely in young children and the elderly.

Diagnosis

Thermal scanning of passengers arriving at Singapore Changi airport.

This section requires expansion.

Different medical kits are available for diagnosis of swine flu.

The two major tests that are being used are the nasopharyngeal (or back of the throat) swab for viral culture, the gold standard, and the indirect evidence test by detection of antibodies to novel H1N1 with PCR studies.

Prevention

Prevention of swine influenza has three components: prevention in swine, prevention of transmission to humans, and prevention of its spread among humans.

Prevention in swine

Methods of preventing the spread of influenza among swine include facility management, herd management, and vaccination(ATCvet code: QI09AA03). Because much of the illness and death associated with swine flu involves secondary infection by other pathogens, control strategies that rely on vaccination may be insufficient.

Control of swine influenza by vaccination has become more difficult in recent decades, as the evolution of the virus has resulted in inconsistent responses to traditional vaccines. Standard commercial swine flu vaccines are effective in controlling the infection when the virus strains match enough to have significant cross-protection, and custom (autogenous) vaccines made from the specific viruses isolated are created and used in the more difficult cases. Present vaccination strategies for SIV control and prevention in swine farms typically include the use of one of several bivalent SIV vaccines commercially available in the United States. Of the 97 recent H3N2 isolates examined, only 41 isolates had strong serologic cross-reactions with antiserum to three commercial SIV vaccines. Since the protective ability of influenza vaccines depends primarily on the closeness of the match between the vaccine virus and the epidemic virus, the presence of nonreactive H3N2 SIV variants suggests that current commercial vaccines might not effectively protect pigs from infection with a majority of H3N2 viruses. The United States Department of Agriculture researchers say that while pig vaccination keeps pigs from getting sick, it does not block infection or shedding of the virus.

Facility management includes using disinfectants and ambient temperature to control virus in the environment. The virus is unlikely to survive outside living cells for more than two weeks, except in cold (but above freezing) conditions, and it is readily inactivated by disinfectants. Herd management includes not adding pigs carrying influenza to herds that have not been exposed to the virus. The virus survives in healthy carrier pigs for up to 3 months and can be recovered from them between outbreaks. Carrier pigs are usually responsible for the introduction of SIV into previously uninfected herds and countries, so new animals should be quarantined. After an outbreak, as immunity in exposed pigs wanes, new outbreaks of the same strain can occur.

Prevention in humans

Prevention of pig to human transmission

Swine can be infected by both avian and human influenza strains of influenza, and therefore are hosts where the antigenic shifts can occur that create new influenza strains.

The transmission from swine to human is believed to occur mainly in swine farms where farmers are in close contact with live pigs. Although strains of swine influenza are usually not able to infect humans this may occasionally happen, so farmers and veterinarians are encouraged to use a face mask when dealing with infected animals. The use of vaccines on swine to prevent their infection is a major method of limiting swine to human transmission. Risk factors that may contribute to swine-to-human transmission include smoking and not wearing gloves when working with sick animals.

Prevention of human to human transmission

Influenza spreads between humans through coughing or sneezing and people touching something with the virus on it and then touching their own nose or mouth. Swine flu cannot be spread by pork products, since the virus is not transmitted through food. The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can remain contagious for up to ten days. Diagnosis can be made by sending a specimen, collected during the first five days for analysis. Recommendations to prevent spread of the virus among humans include using standard infection control against influenza. This includes frequent washing of hands with soap and water or with alcohol-based hand sanitizers, especially after being out in public. Chance of transmission is also reduced by disinfecting household surfaces, which can be done effectively with a diluted chlorine bleach solution.

Experts agree that hand-washing can help prevent viral infections, including ordinary influenza and the swine flu virus. Also avoiding touching eyes, nose and mouth with hands prevents flu. Influenza can spread in coughs or sneezes, but an increasing body of evidence shows small droplets containing the virus can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the mouth, nose or eyes. Alcohol-based gel or foam hand sanitizers work well to destroy viruses and bacteria. Anyone with flu-like symptoms such as a sudden fever, cough or muscle aches should stay away from work or public transportation and should contact a doctor for advice.

Social distancing is another tactic. It means staying away from other people who might be infected and can include avoiding large gatherings, spreading out a little at work, or perhaps staying home and lying low if an infection is spreading in a community. Public health and other responsible authorities have action plans which may request or require social distancing actions depending on the severity of the outbreak.

Vaccination

Vaccines are available for different kinds of swine flu. Although the current trivalent influenza vaccine is unlikely to provide protection against the new 2009 H1N1 strain, vaccines against the new strain are being developed and could be ready as early as November 2009.

Treatment

In swine

As swine influenza is rarely fatal to pigs, little treatment beyond rest and supportive care is required. Instead veterinary efforts are focused on preventing the spread of the virus throughout the farm, or to other farmsVaccination and animal management techniques are most important in these efforts. Antibiotics are also used to treat this disease, which although they have no effect against the influenza virus, do help prevent bacterial pneumonia and other secondary infections in influenza-weakened herds.

In humans

If a person becomes sick with swine flu, antiviral drugs can make the illness milder and make the patient feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms). Beside antivirals, supportive care at home or in hospital, focuses on controlling fevers, relieving pain and maintaining fluid balance, as well as identifying and treating any secondary infections or other medical problems. The U.S. Centers for Disease Control and Prevention recommends the use of Tamiflu (oseltamivir) or Relenza (zanamivir) for the treatment and/or prevention of infection with swine influenza viruses; however, the majority of people infected with the virus make a full recovery without requiring medical attention or antiviral drugs. The virus isolates in the 2009 outbreak have been found resistant to amantadine and rimantadine.

In the U.S., on April 27, 2009, the Food and Drug Administration (FDA) issued Emergency Use Authorizations to make available Relenza and Tamiflu antiviral drugs to treat the swine influenza virus in cases for which they are currently unapproved. The agency issued these EUAs to allow treatment of patients younger than the current approval allows and to allow the widespread distribution of the drugs, including by non-licensed volunteers.

Notes

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External links

UK National Pandemic Flu Service
Official UK government information on swine flu from Directgov
Official swine flu advice and latest information from the UK National Health Service
Tri-Air Developments Air purification system for protection against H1N1: tested UK HPA Centre for Emergency Preparedness and Response, Porton Down, Sep 24, 2007
8 minute video answering common questions about the subject on fora.tv
Swine flu charts and maps Numeric analysis and approximation of current active cases
Worried about swine flu? Then you should be terrified about the regular flu.
Centers for Disease Control and Prevention (CDC) - Swine Flu
Pandemic Flu US Government Site
World Health Organization (WHO): Swine influenza
Medical Encyclopedia Medline Plus: Swine Flu
Swine Flu News and Updates From Around the World
Swine Flu Tracker

v • d • e

Influenza

General topics

Research - Vaccine - Treatment - Genome sequencing - Reassortment - Superinfection - Season

Influenza viruses

Orthomyxoviridae - Influenza A - Influenza B - Influenza C

Influenza A virus
Subtypes

H1N1 - H1N2 - H2N2 - H2N3 - H3N1 - H3N2 - H3N8 - H5N1 - H5N2 - H5N3 - H5N8 - H5N9 - H7N1 - H7N2 - H7N3 - H7N4 - H7N7 - H9N2 - H10N7

H1N1

Pandemics	1918 flu pandemic (Spanish flu) - 2009 flu pandemic (Swine flu)

Science	2009 A/H1N1

H5N1

Science	Genetic structure - Transmission and infection - Global spread - Clinical Trials - Human mortality - Social impact - Pandemic preparation

Outbreaks	Croatia (2005) - India (2006) - UK (2007) - West Bengal (2008)

Treatments

Antiviral drugs	Arbidol - adamantane derivatives (Amantadine, Rimantadine) - neuraminidase inhibitors (Oseltamivir, Laninamivir, Peramivir, Zanamivir) Experimental (Paramecia)

Flu vaccines	FluMist - Fluzone

Influenza epidemics & pandemics

Pandemics	Russian flu (1889–1890) - Spanish flu - Asian flu - Hong Kong flu - 2009 flu pandemic

Epidemics	Russian flu (1977–1978) - Fujian flu (H3N2)

Non-human

Mammals	Canine influenza - Cat influenza Cat influenza - Equine influenza (2007 Australian outbreak) - Swine influenza

Non-mammals	Avian influenza - Fujian flu (H5N1)

Related

Influenza-like illness

Source: http://en.wikipedia.org/wiki/Swine_influenza

Swine Flu Advisory

sarasheedall@gmail.com (Swine flu) — Wed, 9 Sep 2009 03:11:00 -0700

With the swine flu deaths being recorded in India now, it is crucial for every citizen to get aware of this disease, its correct symptoms and the right place for treatment. Information on swine flu will be helpful in saving yourself and also in guiding someone you know having the symptoms to the right hospital. (Click here for a list of all authorized hospital in India for treatment of Swine flu) This article is aimed at providing you with the details about swine flu, its symptoms and the actions that need to be initiated so that we can stop the spread of this pandemic and treat the affected ones with timely and accurate treatment.

Overview :

Swine Flu/Swine Influenza refers to influenza caused by any strain of the influenza virus endemic in pigs (swine)
Swine flu is common in swine and rare in humans
People who work with swine are at risk of getting swine influenza if the swine carries a virus strain capable to infect humans (zoonotic transmission)
The outbreak of swine flu is due to mutation of Swine Influenza Virus (SIV) into a form which can pass easily from human to human
Swine Flu is also known as H1N1 flu, hog flu, and pig flu

Cause:

Agent: For the 2009 swine flu outbreak, the known SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H3N1, H3N2 and H2N3 – these are a genetic mixture of viruses that have been seen in pigs, birds and people but it is called Swine Flu as the structure of this virus is similar to SIV
Source of Infection: This virus spreads when an infected person coughs or sneezes around you or by touching something (like desk, doorknob, phone handset, etc.) with the flu virus on it and then touching your mouth, nose or eyes with your now infected hands
Infected people may be able to infect others beginning one day before symptoms develop and up to seven or more days after becoming sick which means that you may be able to pass on the flu to someone else before you know you are sick as well as while you are sick

Signs & Symptoms:

In humans the symptoms of swine flu are similar to those of influenza which includes: Fever, Chills, Cough, Sore Throat, Body Aches, Headache and Fatigue
Some people have reported diarrhoea and vomiting associated with swine flu
Swine flu may cause a worsening of underlying chronic medical conditions
Severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people

In children emergency warning signs that need urgent medical attention include

Fast breathing or trouble breathing
Bluish skin colour
Not drinking enough fluids
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms improve but then return with fever and worse cough
Fever with a rash

In adults, emergency warning signs that need urgent medical attention include

Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting

Investigation:

The rRT-PCR Swine Flu Panel diagnostic test is used to scan samples from flu patients to determine if they have the new strain but the current tests cannot detect all the virus subtypes that are suspected of creating the new strain of swine flu
In the rRT-PCR Swine Flu Panel diagnostic test, a nasal or nasopharyngeal swab is used to amplify the genetic profile of the virus. A positive test result presumably concludes that the patient is carrying the swine flu but it cannot determine the stage of infection and a negative test result does not conclude that a person does not carry the swine flu virus
This test is done in a specialized laboratory and is not done by many clinics or hospital laboratories

Prevention:

Some hygiene steps that can help in preventing the spread of germs are:

Try to avoid close contact with sick people
Washing your hands often will help protect you from germs
Avoid touching your eyes, nose or mouth as the virus can spread this way
Avoid being in crowded settings. If you happen to be in crowded places then the time spent should be as short as possible
Use of face masks and respirators to some extent help but should be combined with other preventive measures for effective prevention
Facemasks should be considered for use by individuals who enter crowded settings in order to protect their nose and mouth from other people’s coughs and sneezes. This will also reduce the wearer’s possibility of coughing or sneezing on others
Respirators should be considered for use by those individuals for whom close contact with an infectious person is unavoidable like people taking care of a sick person
If you get sick with influenza, stay home from work or school and limit contact with others to keep from infecting them
Cover your nose and mouth with a tissue when you sneeze or cough and throw the tissue in the trash after you use it
Cover your mouth with hands while you sneeze or cough if you do not have a tissue. Then, clean your hands and do so every time you cough or sneeze.
Linens, eating utensils, and dishes used by the ill person should be thoroughly washed with soap and water before use by other persons
If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms like fever, body aches, runny nose, sore throat, cough, nausea or vomiting or diarrhoea then you should contact your doctor. Your doctor will determine whether influenza testing or treatment is needed.

Treatment:

Antivirals: Oseltamivir and Zanamivir - are recommended for the treatment and prevention of the infection with swine flu virus
If a person gets sick, antiviral drugs, which work best if started within 2 days of getting symptoms, can make the illness milder as well as prevent serious flu complications, and hence, make the patient feel better faster
These drugs should not be used indiscriminately as viral resistance to them can occur
Severe infections in some patients may require additional supportive measures such as ventilation support and treatment of other infections/complications like pneumonia that can occur in patients with a severe flu infection

Some Facts:

Pork and other pig-derived products (like ham, sausages, etc) if properly handled and cooked do not transmit swine flu as the flu virus is killed by cooking temperature of 160 degree F (70 degree C)
As per research studies, any new virus which is able to spread from an animal to a person and then spread from person to person - is always a source of concern as such virus when in human to human transmission can continue to mutate making it difficult to treat
Studies also say that a new strain of the flu virus can spread faster because people do not have natural immunity and the development of vaccine to such virus may take months
If you have any symptoms then it is advisable to refer to your doctor at the earliest as an early treatment is found to be effective in the cases of swine flu

GOVERNMENT AUTHORIZED HOSPITALS FOR TREATMENT OF SWINE FLU IN INDIA

CITY	HOSPITAL	ADDRESS	CONTACT
*CHENNAI*	King Institute of Preventive Medicine (24/7 Service)	Guindy, Chennai – 32	(044) 22501520, 22501521 & 22501522
	Communicable Diseases Hospital	Thondiarpet, Chennai	(044) 25912686/87/88, 9444459543
	Government General Hospital	Opp. Central Railway Station, Chennai – 03	(044) 25305000, 25305723, 25305721, 25330300
*PUNE*	Naidu Hospital	Nr Le'Meridian, Raja Bahadur Mill, GPO, Pune - 01	(020) 26058243
*PUNE*	National Institute of Virology	20A Ambedkar Road, Pune - 11	(020) 26006290
*KOLKATA*	ID Hospital	57,Beliaghata, Beliaghata Road, Kolkata - 10ý	(033) 23701252
*COIMBATORE*	General HospGovernment ital	Near Railway Station, Trichy Road, Coimbatore - 18	(0422) 2301393, 2301394, 2301395, 2301396
*HYDERABAD*	Govt. General and Chest Diseases Hospital	Erragadda, Hyderabad	(040) 23814939
*MUMBAI*	Kasturba Gandhi Hospital	Arthur Road, N M Joshi Marg, Jacob Circle, Mumbai - 11	(022) 23083901, 23092458, 23004512
	Sir J. J. Hospital	J J Marg, Byculla, Mumbai - 08	(022) 23735555, 23739031, 23760943, 23768400 / 23731144 /5555 / 23701393 /1366
	Haffkine Institute	Acharya Donde Marg, Parel, Mumbai - 12	(022) 24160947, 24160961, 24160962
*KOCHI*	Government Medical College	Gandhi Nagar P O, Kottayam - 08	(0481) 2597311,2597312
	Government Medical College	Vandanam P O, Allapuzha - 05	(0477) 2282015
	Taluk Hospital	Railway Station Road, Alwaye, Ernakulam	(0484) 2624040 Sathyajit - 09847840051
	Taluk Hospital	Perumbavoor PO, Ernakulam 542	(0484) 2523138 Vipin - 09447305200
GURGAON & DELHI	All India Institute of Medical Sciences (AIIMS)	Ansari Nagar, Aurobindo Marg Ring Road, New Delhi - 29	(011) 26594404, 26861698 Prof. R C Deka - 9868397464
	National Institute for Communicable Diseases	22, Sham Nath Marg, New Delhi - 54	(011) 23971272/060/344/524/449/326
	Dr. Ram Manohar Lohia Hospital	Kharak Singh Marg, New Delhi - 01	(011) 23741640, 23741649, 23741639 Dr. N K Chaturvedi – 9811101704
	Vallabhai Patel Chest Institute	University Enclave, New Delhi - 07	(011) 27667102, 27667441, 27667667, 27666182
*BANGALORE*	Victoria Hospital	K R Market, Kalasipalayam, Bangalore - 02	(080) 26703294 Dr. Gangadhar - 9448049863
*BANGALORE*	SDS Tuberculosis & Rajiv Gandhi Institute of Chest Diseases	Hosur Road, Hombegowda Nagar, Bangalore - 29	(080) 26631923 Dr. Shivaraj - 9980148780

Soure:

http://www.healthizen.com/swine-flu.aspx?gclid=CKf99ail5JwCFQEupAodFUHDGw

Swine flu vaccines to come in October

sarasheedall@gmail.com (Swine flu) — Wed, 9 Sep 2009 03:01:00 -0700

Kristine Guerra

Issue date: 9/9/09 Section: News

Media Credit: Megan Harris

With more cases of H1N1, also known as swine flu, expected this fall, Sacramento State will offer free swine flu vaccines to students, faculty and staff members, along with seasonal flu vaccines given every year.

Specific immunization schedules for the H1N1 vaccines are not yet determined, but the vaccines have already been pre-ordered and are expected to arrive in late October, said student health Services director Joy Stewart-James.

Yearly vaccinations for the seasonal flu are scheduled during Phlagleblast from 9 a.m. to 2 p.m. today in the University Union and during the Natural High Health Fair from 10 a.m. to 2 p.m. on Oct. 21 in the Library Quad. Seasonal flu shots, which have to be purchased by the Student Health Center, are offered for free to students and are $15 to faculty and staff members.

The swine flu's higher-risk groups, as determined by the Centers for Disease Control and Prevention, are pregnant women, caregivers of children age 6 months and younger, health care workers, persons between ages 6 months and 24 years and adults between ages 25 and 65 years with high-risk medical conditions, such as chronic health disorders and compromised immune systems.

Lourdes Davila, undeclared freshman, said she'll probably take the swine flu vaccine as a precaution. "We can't afford to get sick," Davilla said.

Stewart-James said two doses will likely be required, with the second dose given three weeks after the initial dose.

In response to the onset of swine flu this summer, Sac State has taken the necessary steps to inform and prepare the campus community in case of an outbreak, said risk management and business continuity interim director for Sac State, Kirtland Stout.

Faculty and staff that fall in the higher risk group will be vaccinated at no charge, Stewart-James said.

Vaccinations for both swine flu and seasonal flu are voluntary, however people who fall under the swine flu high-risk categories are encouraged to get the vaccine, Stewart-James said.

Unlike H5N1, or avian flu, that has a mortality rate of 60 percent, swine flu is a fairly mild flu with a mortality rate of less than tenth of a percent, Stout said.

"I really don't think it's (swine flu) going to be as horrible as they portray in the news," said Anna Brown-Dawson, junior criminal justice major. "I think vaccination is necessary to people who live in dorms because they live in close proximity with other students, but to others who commute it's a personal choice."

The health center's worst case so far has already recovered, Stewart-James said.

"The university has been on top of this as we could possibly be," Stout said.

Stout said Sac State's plan for this flu season has guidelines to keep people with flu-like symptoms from spreading it to others.

"One of the things that we're really trying to stress is prevention," Stewart-James said.

Students, faculty and staff members who experience flu-like symptoms are encouraged to stay at home or to self-isolate until they are fever-free for at least 24 hours, Stout said.

Students should call the health center if they are experiencing flu-like symptoms. The health center has set up a phone triage system that will enable a student to talk directly to a medical provider, who will then evaluate the severity of the case and determine if the student needs to be seen at the clinic, Stewart-James said.

In most cases, students recover well on their own just by getting plenty of rest and keeping themselves hydrated, Stewart-James said.

Students living in apartments and dorms are also encouraged to have "flu buddies" who will help and monitor them. That way, people experiencing the symptoms will not be spreading them to others and will not get very ill because no one is watching after them, Stout said.

Stewart-James said they have done presentations at residence halls this summer to make students and staff more aware of preventive measures.

In campus divisions, staff members are asked to have a "succession list" that will determine who will take over a job if a staff member gets sick, Stout said.

Faculty members are asked to advise students who become infected to stay at home and to modify classroom guidelines as needed.

More information about the swine flu is available at http://www.csus.edu/hlth/.

Kristine Guerra can be reached at

kguerra@statehornet.com.

Source:

http://media.www.statehornet.com/media/storage/paper1146/news/2009/09/09/News/Swine.Flu.Vaccines.To.Come.In.October-3766044.shtml

The Importance of Child Health

sarasheedall@gmail.com (Swine flu) — Wed, 9 Sep 2009 02:50:00 -0700

Note: New estimates of child health mortality, morbidity, and prevalence have been released since the launch of this website. We are currently in the process of updating these pages. In the meantime, please visit UNICEF’s State of the World’s Children 2009 Report for the latest data.

Children under the age of five face multiple obstacles, including birth injuries, infectious diseases, malnutrition, home environments that lack intellectual stimulation, and environments with polluted water and air. Neonatal mortality has persisted and currently 38 percent of all deaths (4 million) occur during the first month of life.

Each year, more than 9 million children die, mostly from preventable and treatable causes.¹
Impressive gains have been made in reducing child mortality in the past forty years—globally, child deaths have halved from 20 million in 1960 to well under 10 million in 2009.² But progress has been geographically uneven, with child mortality rates either increasing or remaining constant in at least 26 countries.³ Africa has shown the slowest progress in reducing child deaths, reducing child deaths by only 14% between 1990 and 2006.²
Millions of children suffer from short- and long-term adverse consequences of illnesses, malnutrition and injuries that impact their well-being and options in life, including fewer educational opportunities and diminished future economic prospects.⁴
Child health is closely related to maternal health, as nutrition during pregnancy, birth conditions, birth spacing, and health status of the mother impact the health of the child prior to, during and after birth. Largely because of these factors, 3 million infants are stillborn each year.

In many parts of the world, widespread introduction of simple, inexpensive interventions have successfully targeted the major killers of infants and children. Highly effective and often “low-tech” solutions, as well as improvements in health delivery systems, have enabled rapid declines in child mortality to occur, even in developing countries.

At least 6 million child deaths can be prevented each year, if affordable health interventions are made available to the mothers and children who need them. Cost-effectiveness has been increased by providing packages of interventions that address multiple health issues through known and cost-effective interventions.
Healthy and well-educated children contribute to the security, economic growth and civil stability of nations.
Governments of developing and donor nations alike must be motivated to make the necessary investments in children, who are voiceless and powerless. However, such programs are vastly under funded, limiting the services and materials provided to those in need.

In 2000, 189 nations agreed upon eight Millennium Development Goals (MDGs) that provide a framework for improving health, education, gender equity, economic and environmental conditions in developing countries.

MDG 4 focuses on reducing the 1990 child mortality rate by 2/3 by 2015; currently few of the 68 high-mortality, high-priority countries are on-track to reach this goal.³
Other MDGs contribute to improving child health by targeting hunger and nutrition, education, gender empowerment for girls, maternal health, infectious diseases and environmental stability.

Source:

http://www.globalhealth.org/childhealth/?gclid=CLCrjYSh5JwCFUwwpAodGm-WFw

H1N1 Flu (Swine Flu)

sarasheedall@gmail.com (Swine flu) — Wed, 9 Sep 2009 02:11:00 -0700

Also called: Swine flu

Swine flu is an infection caused by a virus. It's named for a virus that pigs can get. People do not normally get swine flu, but human infections can and do happen. The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.

There are antiviral medicines you can take to prevent or treat swine flu. There is no vaccine available right now to protect against swine flu. You can help prevent the spread of germs that cause respiratory illnesses like influenza by

Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
Washing your hands often with soap and water, especially after you cough or sneeze. You can also use alcohol-based hand cleaners.
Avoiding touching your eyes, nose or mouth. Germs spread this way.
Trying to avoid close contact with sick people.
Staying home from work or school if you are sick.

Centers for Disease Control and Prevention

Source:

http://www.nlm.nih.gov/medlineplus/h1n1fluswineflu.html

Local Universities Report Cases of Suspected Swine Flu

sarasheedall@gmail.com (Swine flu) — Wed, 9 Sep 2009 02:04:00 -0700

By Daniel de Vise

Washington Post Staff Writer
Tuesday, September 8, 2009; 5:14 PM

Cases of suspected swine flu at the University of Maryland have multiplied from 64 to 172, a college spokeswoman said Tuesday, and at least three other colleges and universities are reporting likely H1N1 cases.

The University of Virginia had 55 cases of flu-like illness as of Tuesday, according to spokeswoman Marian Anderfuren. Johns Hopkins University notified students and staff Tuesday that six students had developed flu-like symptoms over the past week, with one student testing positive for Type A influenza Tuesday. Washington & Lee University reported four cases of influenza-like illness Tuesday, and Catholic University reported one suspected case.

A survey by the American College Health Association last week found 55 percent of 165 institutions queried were reporting "influenza-like" illnesses. Of the 1,640 cases reported at those schools, one student had been hospitalized and none had died.

A freshman at Troy University in Alabama died Friday, possibly the first flu-related death of a college student in the new academic year, according to the Dothan, Ala., Eagle newspaper.

Source:

http://www.washingtonpost.com/wp-dyn/content/article/2009/09/08/AR2009090802829.html?hpid=moreheadlines

swine flu

Swine influenza

Contents

<br />//<![CDATA[ if (window.showTocToggle) { var tocShowText = "show"; var tocHideText = "hide"; showTocToggle(); } //]]>Classification

Influenza C

Influenza A

Surveillance

History

1918 pandemic in humans

1976 U.S. outbreak

1988 zoonosis

1998 US outbreak in swine

2007 Philippine outbreak in swine

2009 outbreak in humans

Transmission

Transmission between pigs

Transmission to humans

Interaction with avian H5N1 in pigs

Signs and symptoms

In swine

In humans

Prevention

Prevention in swine

Prevention in humans

Treatment

In swine

In humans

See also

Notes

Further reading

External links

Swine Flu Advisory

Overview :

Cause:

Signs & Symptoms:

Investigation:

Prevention:

Treatment:

Some Facts:

GOVERNMENT AUTHORIZED HOSPITALS FOR TREATMENT OF SWINE FLU IN INDIA

Swine flu vaccines to come in October

Kristine Guerra

The Importance of Child Health

H1N1 Flu (Swine Flu)

Local Universities Report Cases of Suspected Swine Flu

Classification