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Swine influenza is endemic in pigsElectron microscopeimage of the reasserted H1N1 influenza virus photographed atthe CDC Influenza Laboratory. The viruses are 80–120nanometersin diameter.

Swine influenza

(also called

swine flu

hog flu

, and

pig flu

) is an infection of a hostanimal by any one of several specific types of microscopic organisms called "swineinfluenzavirus". A

swine influenza virus

(

SIV

) is any strain of the influenza familyof virusesthat is usually hosted by (isendemicin) pigs. As of 2009, the known SIV strains are the influenza C virus and the subtypes of theinfluenza A virusknown as H1N1, H1N2,H3N1,H3N2, andH2N3. Swine influenza is common in pigs in the Midwestern United States (and occasionally in other states), Mexico, Canada, SouthAmerica, Europe (including the United Kingdom, Sweden, and Italy), Kenya,Mainland China, Taiwan, Japan and other parts of eastern Asia.Transmission of swine influenza virus from pigs to humans is not common and doesnot always cause human influenza, often only resulting in the production of antibodies in the blood. The meat of the animal poses no risk of transmitting the virus when properly cooked. If transmission does cause human influenza, it is calledzoonotic swine flu. People who work with pigs, especially people with intense exposures, are atincreased risk of catching swine flu. In the mid-20th century, identification of influenza subtypes became possible, this allows accurate diagnosis of transmission tohumans. Since then, fifty confirmed transmissions have been recorded, Rarely, thesestrains of swine flu can pass from human to human. In humans, the symptoms of swine flu are similar to those of influenzaand of influenza-like illness in general, namely chills, fever ,sore throat,muscle pains,severeheadache, coughing, weakness andgeneral discomfort.The2009 swine flu outbreak in humans is due to a new strain of influenza A virus subtype H1N1that contains genes closely related to swine influenza The origin of thisnew strain is unknown. However, the World Organization for Animal Health(OIE) reports that this strain has not been isolated in pigs.

[4]

This strain can be transmittedfrom human to human, and causes the normal symptoms of influenza.Pigs can become infected with human influenza, and this appears to have happened during the1918 flu

Transmission

Transmission to humans

People who work with poultry and swine, especially people with intense exposures,are at increased risk of zoonoticinfection with influenza virus endemic in these animals, and constitute a population of human hosts in whichzoonosisandresentment can co-occur. Vaccination of these workers against influenza and surveillance for newinfluenza strains among this population may therefore be an important public healthmeasure. Transmission of influenza from swine to humans who work with swine wasdocumented in a small surveillance study performed in 2004 at the University of Iowa. This study among others forms the basis of a recommendation that peoplewhose jobs involve handling poultry and swine be the focus of increased public healthsurveillance. Other professions at particular risk of infection are veterinarians andmeat processing workers, although the risk of infection for both of these groups islower than that of farm workers.

Signs and symptoms In humans

Main symptoms of swine flu in humansDirect transmission of a swine flu virus from pigs to humans is occasionally possible(calledzoonoticswine flu). In all, 50 cases are known to have occurred since the firstreport in medical literature in 1958, which have resulted in a total of six deaths.

[67]

Of these six people, one was pregnant, one hadleukemia,one hadHodgkin diseaseand 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 verymild disease, and will probably never be reported or diagnosed.

Prevention in humans

Prevention of pig to human transmissionThe transmission from swine to human is believed to occur mainly in swine farmswhere farmers are in close contact with live pigs. Although strains of swine influenzaare usually not able to infect humans this may occasionally happen, so farmers andveterinarians 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 limitingswine to human transmission. Risk factors that may contribute to swine-to-humantransmission include smoking and not wearing gloves when working with sick animals.

[75]

Prevention of human-to-human transmission

Influenza spreads between humans through coughing or sneezing and people touchingsomething with the virus on it and then touching their own nose or mouth.

[76]

Swine

flu cannot be spread by pork products, since the virus is not transmitted throughfood.

[76]

The swine flu in humans is most contagious during the first five days of theillness although some people, most commonly children, can remain contagious for upto ten days. Diagnosis can be made by sending a specimen, collected during the firstfive days for analysis.

[77]

Recommendations to prevent spread of the virus among humans include usingstandardinfection control against influenza. This includes frequent washing of handswith soap and water or with alcohol-based hand sanitizers, especially after being outin public.

[78]

Chance of transmission is also reduced by disinfecting householdsurfaces, which can be done effectively with a diluted chlorine bleach solution.

[79]

Although the current trivalent influenza vaccine is unlikely to provide protectionagainst the new 2009 H1N1 strain,

[80]

vaccines against the new strain are beingdeveloped and could be ready as early as June 2009.

[81]

Experts agree that hand-washing can help prevent viral infections, including ordinaryinfluenza and the swine flu virus. Influenza can spread in coughs or sneezes, but anincreasing body of evidence shows small droplets containing the virus can linger ontabletops, telephones and other surfaces and be transferred via the fingers to themouth, nose or eyes. Alcohol-based gel or foam hand sanitizers work well to destroyviruses 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 contacta doctor for advice.Social distancing is another tactic. It means staying away from other people whomight be infected and can include avoiding large gatherings, spreading out a little atwork, or perhaps staying home and lying low if an infection is spreading in acommunity.Public healthand other responsible authorities have action plans whichmay request or require social distancing actions depending on the severity of theoutbreak

Treatment 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 flucomplications. For treatment, antiviral drugs work best if started soon after gettingsick (within 2 days of symptoms). Beside antivirals, palliative care,at home or in hospital, focuses on controlling fevers and maintaining fluid balance. The U.S.Centers for Disease Control and Preventionrecommends 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 virusmake a full recovery without requiring medical attention or antiviral drugs.

[82]

Thevirus isolates in the 2009 outbreak have been found resistant to amantadineand rimantadine. In the U.S., on April 27, 2009, theFDA issued Emergency Use Authorizationsto make availableRelenzaandTamiflu antiviral drugsto treat the swine influenza virus in cases for which they are currently unapproved. The agency issued these EUAs to