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Swine flu

INTRODUCTION

The 2009 flu pandemic is a global outbreak of a new strain of an influenza A virus
subtype H1N1, referred to as the "novel H1N1",[1] first identified in April 2009, and
commonly called "swine flu”. The outbreak began in Mexico, with evidence that Mexico
was already in the midst of an epidemic for months before the outbreak was recognized
In early June, as the virus spread globally, the World Health Organization (WHO)
declared the outbreak to be a pandemic, but also noted that most illnesses were of
moderate severity. The virus has since spread to the Southern Hemisphere which entered
its winter flu season, and to many less developed countries with limited healthcare
systems. The virus typically spread via coughing, sneezing or touching contaminated
surfaces and then touching the nose or mouth. Symptoms, which could last up to a week,
were similar to those of seasonal flu, and may have included fever, sneezes, sore throat,
coughs, headache, and muscle or joint pains. The U.S. Centers for Disease Control and
Prevention (CDC) noted that although this was a very serious virus, cases worldwide
were usually mild, and most hospitalizations and deaths had been of persons that also had
underlying conditions such as asthma, diabetes, obesity, heart disease, or a weakened
immune system

2009 flu pandemic data


Confirmed deaths 3,55 (+285
(increase in last 7 days) 5 )
source: ECDC - September 10, 2009

EU and EFTA 127 (+16)


Other European Countries
0 (+0)
& Central Asia
Mediterranean & Middle East 85 (+14)
Africa 42 (+7)
North America 875 (+54)
Central America & Caribbean 109 (+14)
1,66 (+107
South America
5 )
North-East & South Asia 187 (+50)
South-East Asia 278 (+18)
Australia & Pacific 187 (+5)
What is the new influenza A(H1N1)?

This is a new influenza A(H1N1) virus that has never before circulated among humans.
This virus is not related to previous or current human seasonal influenza viruses.

SPREAD

The virus is spread from person-to-person. It is transmitted as easily as the normal


seasonal flu and can be passed to other people by exposure to infected droplets expelled
by coughing or sneezing that can be inhaled, or that can contaminate hands or surfaces.

There are no known instances of people getting infected by exposure to pigs or other
animals.

SYMPTOMS

Symptoms of influenza A(H1N1) are flu-like, including fever, cough, headache, muscle
and joint pain, sore throat and runny nose, and sometimes vomiting and diarrhea.

MEDICAL CARE

A person should seek medical care if they experience shortness of breath or difficulty
breathing, or if a fever continues more than three days. For parents with a young child
who is ill, seek medical care if a child has fast or labored breathing, continuing fever or
convulsions (seizures).

Supportive care at home - resting, drinking plenty of fluids and using a pain reliever for
aches - is adequate for recovery in most cases. (A non-aspirin pain reliever should be
used by children and young adults because of the risk of Reye's syndrome.)

TREATMENT

DRUGS

So far most people who have contracted the new A (H1N1) virus have
experienced influenza-like symptoms (such as sore throat, cough,
runny nose, fever, malaise, headache, joint/muscle pain) and
recovered without antiviral treatment.

Antiviral drugs may reduce the symptoms and duration of illness, just
as they do for seasonal influenza. They also may contribute to
preventing severe disease and death. Influenza A (H1N1) is a new virus
and only a small number of people with the infection have been
treated for it with antiviral drugs.

To which antiviral drugs does this influenza virus respond?


There are two classes of antiviral drugs for influenza: inhibitors of
neuraminidase such as oseltamivir and zanamivir; and adamantanes,
such as amantadine and rimantadine. Tests on viruses obtained from
patients in Mexico and the United States have indicated that current
new H1N1 viruses are sensitive to neuraminidase inhibitors, but that
the viruses are resistant to the other class, the adamantanes.

Resistance can develop to antiviral drugs used for influenza.

Under what circumstances should antiviral drugs be


administered?

Antiviral drugs are to be used according to national pandemic influenza


preparedness plans. Where antiviral drugs are available for treatment,
clinicians should make decisions based on assessment of the individual
patient's risk. Risks versus benefits should also be evaluated on a case
by case basis.

Should one take an antiviral now just in case one catches the
new virus?

No. You should only take an antiviral, such as oseltamivir or zanamivir,


if your health care provider advises you to do so. Individuals should not
buy medicines to prevent or fight this new influenza without a
prescription, and they should exercise caution in buying antivirals over
the internet.

VACCINATION
WHO expects the swine flu vaccine to be widely available until the end of 2009. In the
U.S. initial quantities of vaccine will become available in mid-October and the CDC
recommends that the first doses should go to priority groups such as pregnant women,
people who live with or care for babies under six months old, children six months to four
years old and health-care workers. Although the seasonal flu vaccine provides little or no
protection against H1N1 swine flu, health experts recommend immunization to help
prevent people from being infected with both at once. Two injections will be required
three weeks apart for the swine flu and a third will be needed for seasonal flu to provide
maximum immunity

HOME REMEDIES
The Mayo Clinic and Medline list a number of ways to help ease symptoms, including
adequate liquid intake and rest, soup to ease congestion, and over-the-counter drugs to
relieve pain. Aspirin, for instance, "is very effective for treating fever in adults" although
in children and adolescents, aspirin is not usually given due to the risk of Reye's
syndrome. While over-the-counter drugs relieve symptoms, they do not kill the virus.
Most patients were expected to recover without medical attention, although those with
pre-existing or underlying medical conditions were more prone to complications.

In one article, Health magazine advised readers not to try to prevent or treat influenza,
colds, or sinus problems by taking antibiotics, large doses of vitamins and minerals (such
as vitamin C or zinc), or by taking herbal remedies such as Echinacea.

PRECAUTIONS

The main route of transmission of the new influenza A(H1N1) virus seems to be similar
to seasonal influenza, via droplets that are expelled by speaking, sneezing or coughing.
One can prevent getting infected by avoiding close contact with people who show
influenza-like symptoms (trying to maintain a distance of about 1 meter if possible) and
taking the following measures:

• avoid touching your mouth and nose;


• clean hands thoroughly with soap and water, or cleanse them
with an alcohol-based hand rub on a regular basis (especially if
touching the mouth and nose, or surfaces that are potentially
contaminated);
• avoid close contact with people who might be ill;
• reduce the time spent in crowded settings if possible;
• improve airflow in your living space by opening windows;
• Practice good health habits including adequate sleep, eating
nutritious food, and keeping physically active.

MASKS

If you are not sick you do not have to wear a mask.

If you are caring for a sick person, you can wear a mask when you are in close contact
with the ill person and dispose of it immediately after contact, and cleanse your hands
thoroughly afterwards.

If you are sick and must travel or be around others, cover your mouth and nose.

Using a mask correctly in all situations is essential. Incorrect use actually increases the
chance of spreading infection.
o If you feel unwell, have high fever, cough or sore throat:

• stay at home and keep away from work, school or crowds;


• rest and take plenty of fluids;
• cover your nose and mouth when coughing and sneezing and, if
using tissues, make sure you dispose of them carefully. Clean
your hands immediately after with soap and water or cleanse
them with an alcohol-based hand rub;
• if you do not have a tissue close by when you cough or sneeze,
cover your mouth as much as possible with the crook of your
elbow;
• use a mask to help you contain the spread of droplets when you
are around others, but be sure to do so correctly;
• inform family and friends about your illness and try to avoid
contact with other people;
• If possible, contact a health professional before traveling to a
health facility to discuss whether a medical examination is
necessary.

o RECOMMENDATIONS FOR SCHOOLS

WHO continues to recommend that students, teachers, and other staff


who feel unwell should stay home. Plans should be in place, and space
made available, to isolate students and staff who become ill while at
school.

Schools should promote hand hygiene and respiratory etiquette and be


stocked with appropriate supplies. Proper cleaning and ventilation and
measures to reduce crowding are also advised.

Q&A

Q.1) should 1 take an antiviral now just in case ONE catches


the new virus?

No. You should only take an antiviral, such as oseltamivir or zanamivir, if your health
care provider advises you to do so. Individuals should not buy medicines to prevent or
fight this new influenza without a prescription, and they should exercise caution in
buying antivirals over the Internet.

Q.2) What about breastfeeding? Should 1 stop if 1 is ill?

No, not unless your health care provider advises it. Studies on other influenza infections
show that breastfeeding is most likely protective for babies - it passes on helpful maternal
immunities and lowers the risk of respiratory disease. Breastfeeding provides the best
overall nutrition for babies and increases their defense factors to fight illness.

Q.3) Should 1 go to work if 1 has the flu but feeling OK?

No. Whether you have influenza A(H1N1) or a seasonal influenza, you should stay home
and away from work through the duration of your symptoms. This is a precaution that can
protect your work colleagues and others.

Q.4) Can 1 travel?

If you are feeling unwell or have symptoms of influenza, you should not travel. If you
have any doubts about your health, you should check with your health care provider.

Q.5) Is it safe to travel?

Yes. WHO is not recommending travel restrictions related to the


outbreak of the influenza A(H1N1) virus. Today, global travel is
commonplace and large numbers of people move around the world for
business and leisure. Limiting travel and imposing travel restrictions
would have very little effect on stopping the virus from spreading, but
would be highly disruptive to the global community.

Q.6)Does WHO recommend screenings at country entry and


exit points to detect if ill people are traveling?

No. WHO does not believe entry and exit screenings would work to
reduce the spread of this disease. However country-level measures to
respond to a public health risk are the decision of national authorities,
under the International Health Regulations 2005
Cases Deaths
Country
Officially Confirmed
confirmed‡‡ (Suspected)

ECDC total[1] (262,172) 3,751

Reports Total 379,051 4,090

United States^ (50,298)[5] 649[6]

Mexico 25,214[10] 217[1](77)[11]

India 6,800[13] 212[1]

Australia 36,138[15] 171[1]

United Kingdom# (13,322)[22][1] 76[1]

Canada (12,038)[24] 76[1]

Malaysia 7,000[25] 76[1]

Venezuela 1,183[26] 72[26]

Spain (1,538)[1] 27[35]

France~ (2,954)[37][38] 26[39]

Singapore (1,217)[44] 18[1]

Greece 2,101[57] 3[1]

Norway (1,313)[59] 3[60]


Egypt 860[33] 2[1]

Ireland (831)[1] 2[1]

Belgium (2,353) [66] 1[1]

Italy 2,186[1] 1[1]

Other 47,118 0

AS ON 17/09/2009
2009 flu pandemic data
Confirmed deaths
(increase in last 7 days) 3,751 (+222)
source: ECDC - September 16, 2009[1]

EU and EFTA 137 (+16)


Other European Countries
0 (+0)
& Central Asia
Mediterranean & Middle East 97 (+12)
Africa 59 (+18)
North America 886 (+13)
Central America & Caribbean 117 (+8)
South America 1,718 (+57)
North-East & South Asia 251 (+72)
South-East Asia 293 (+17)
Australia & Pacific 193 (+9)