DEFINITION OF TERMS:

 INFLUENZA A VIRUS -causes influenza in birds and some mammals and is the

only species of Influenza virus A. It is a genus of the Orthomyxoviridae family of viruses.
Influenza A viruses are negative sense, single-stranded, segmented RNA viruses. There
are several subtypes, labeled according to an H number (for the type of hemagglutinin)
and an N number (for the type of neuraminidase). There are 16 different H antigens (H1
to H16) and nine different N antigens (N1 to N9).
 HEMAGGLUTININ- is a type of hemagglutinin found on the surface of
the influenza viruses. It is an antigenic glycoprotein. It is responsible for binding the virus
to the cell that is being infected.
 NEURAMINIDASE- is a type of neuraminidase found on the surface of influenza
viruses that enables the virus to be released from the host cell. Neuraminidases
are enzymes that cleave sialic acid groups from glycoproteins and are required for
influenza virus replication.
 RE-ASSORTMENT - is a process that happens if two different types of influenza virus
infect a single cell and it can produce a new strain of influenza. This is because the virus
genome is split between eight independent pieces of RNA, which allows pieces of RNA
from different viruses to mix together and form a novel type of virus as new virus
particles are being assembled.

SWINE FLU/INFLUENZA A(H1N1)

 Influenza A(H1N1) is caused by a new virus that resulted from the re-assortment of 4
viruses from pigs, birds, and human.
 It is a new virus causing illness to people.
 It was first detected in people in April 2009 at USA and Mexico, there were 7 cases
reported and on May 7, it the disease spread rapidly, with the number of confirmed
cases rising to 2,099
 There was no vaccine yet to protect humans from this virus
 But there are existing and recommended medicine that are effective in treating A(H1N1)
virus
 Influenza A(H1N1) can be fatal due to severe respiratory distress (pneumonia)
 On June 11, 2009, the World Health Organization declared the disease pandemic
 On May 30, 2010 worldwide update by WHO more than 214 countries and overseas
territories or communities have reported laboratory confirmed cases of pandemic
influenza H1N1 2009, including over 18138 deaths
  On August 10, 2010, the WHO declared an end to the 2009 A(H1N1) influenza
pandemic. This declaration was based on strong indications that influenza, worldwide, is
transitioning toward seasonal patterns of transmission.

ETIOLOGY:

 There are two main types of influenza virus—type A and type B. The 2009 outbreak is
due to a new mixture of different kinds of influenza A. This strain passes from human to
human, so it may spread rapidly.

MODE OF TRANSMISSION:

 Direct exposure to droplets when an infected person coughs and sneezes

 Touching mouth, nose, or eyes after touching infected things

Risk Factors:

• Contact with an infected person

• Age: children younger than two years old and people aged 65 or older

• People younger than 19 years old

• Being pregnant

• Having recently given birth (last two weeks)

• Diabetes

• Weakened immune systems, such as in:

– People infected with HIV

– People taking immunosuppressive drugs

• Disorders that may affect breathing

• Chronic lung, heart, kidney, liver, nerve, or blood conditions

• Being in a chronic care facility

PATHOPHYSIOLOGY:

Viral HEMAGGLUTININ

replication
 NEURAMINIDASE

SIGNS AND SYMPTOMS:

• Fever and chills

• Sore throat
 • Cough

• Severe muscle aches

• Severe fatigue

• Headache

• Runny nose, nasal congestion

• Sneezing

• Watery eyes

• Gastrointestinal symptoms (e.g. nausea, diarrhea, vomiting)

DIAGNOSTIC TESTS:

 Chest x-ray films

 Pulse oximetry (a test in which a probe connected to a computer is placed on the finger
or ear to measure oxygen saturation in the blood)
 Blood cultures
 Sputum (fluid from the respiratory tract) Gram stain and culture
 Reverse transcription polymerase chain reaction (RT-PCR) - this method allows a
specific diagnosis of novel influenza (H1N1) as opposed to seasonal influenza. It is a
variant of polymerase chain reaction (PCR), a laboratory technique commonly used
in molecular biology to generate many copies of a DNA sequence, a process termed
"amplification".

MEDICAL MANAGEMENT:

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.
  Oseltamivir is an antiviral drug that slows the spread of influenza virus between cells in
the body by stopping the virus from chemically cutting ties with its host cell—median
time to symptom alleviation is reduced by 0.5–1 day. The drug is sold under the trade
name Tamiflu and is taken orally in capsules or as a suspension.
 Zanamivir is a neuraminidase inhibitor used in the treatment
and prophylaxis of Influenzavirus A and Influenzavirus B. Zanamivir works by binding to
the active site of the neuraminidase protein, rendering the influenza virus unable to
escape its host cell and infect others.

What can I do to protect myself from getting Influenza A(H1N1)?

 Always wash hands with soap and water

 You may use alcohol-based hand sanitizers
 Avoid close contact with sick people
 Increase your body’s resistance
o Have at least 8 hours of sleep
o Be physically active
o Manage your stress
o Drink plenty of fluids
o Eat nutritious foods
 Make it a habit to cover your nose and mouth when coughing or sneezing
 Influenza A(H1N1) Vaccination