Prevention of Spread of Swine Flu

Dr.Kedar Karki

 

In Mexico in April this year, a never-before heard strain of swine flu emerge, turning ill more than a thousand Mexicans and causing the death of 68. Swine flu has spread to other parts of the world such as the US and New Zealand when affected individuals (Mexicans or tourists to Mexico), traveled to those places. Swine flu has spread so far and wide that the World Health Organization fears it will bring about the next pandemic. A June 10, 2009 update by the U.N.’s World Health Organization (WHO) states that 74 countries have officially reported 27,737 cases of influenza A (H1N1) infection, including 141 deaths. In India till date 23 cases are being confirmed in city like Hyderabad, Bangalore, New Delhi, and Jallandhar in Punjab. Government of India is now thinking about suspension of air flight to U.S.A as most of confirmed cases in India have been detected from the persons who had recently traveled to U.S cities and had returned from there. WHO’s decision to raise the pandemic alert level to Phase 6 is a reflection of the spread of the virus, not the severity of illness caused by the virus.

This is not the first time the world is threatened by swine flu. Swine flu, which is also referred to as pigfluenza, hog flu, pig flu, or swine influenza, typically affects pigs only. In 1918, an H1N1 virus caused flu pandemic in humans. Scientists speculated that H1N1 was created either when human influenza virus crossed specie boundary and affected pigs, or the other way around.

In 1930, a study confirmed that influenza virus caused the illnesses of pigs; the viral strain was identified as H1N1. Other past outbreaks in humans include the 1976 US outbreak (number of deaths: 5) and the 1988 Wisconsin outbreak (number of deaths: 1).

 

2009 Swine Flu Outbreak

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The strain that caused the swine outbreak in 2009, on the other hand, is different from other types of swine flu viruses before. It infects humans only. Pigs show no sign of infection. As such, scientists are having a difficult time establishing the origins of this new disease. The 2009 swine flu outbreak is caused by a strain that combines a single strain of human flu virus, a single strain of avian or bird flu virus, and two strains of swine flu virus.

Transmission

 

Swine flu virus in pig is transmitted when uninfected animals touch the nose or dried mucus of the infected pig.

Transmission of swine flu from pigs to humans occurs when a person touches an infected pig such as during animal transport or cleaning of pig pens. Swine flu is not acquired by eating pork.

Transmission of swine flu from human to human occurs when airborne viruses brought about by sneezing and coughing are inhaled by another person. Touching of contaminated surfaces and bringing one’s hand to one’s nose or mouth.

Symptoms

 

Symptoms of swine flu in humans are non-specific. They are quite similar to other types of influenza such as common flu and bird flu. People infected with swine flu often the following: Fever, chills, coughing and sneezing, sore throat, muscle pain, discomfort, fatigue, vomiting, and diarrhea.

 

In pigs, swine influenza virus cause:  fever, lethargy, decrease in appetite, abortion, sneezing, coughing, weight loss, poor growth. Difficulty breathing.

 

Because swine flu symptoms are non-specific, a laboratory taste of nose or throat swab is needed to confirm viral presence.

How to Prevent Spread of Swine Flu

 

Among swine: owners should implement facility management and management. Vaccinating the pigs may also help reduce the chances of spreading of the flu.

 

To prevent transmission of swine flu from pigs to humans, farmers, veterinarians, and other people who come in close contact with live pigs should wear masks and gloves when working with infected pigs.

Here are several steps to prevent the spread of the swine flu virus:

 

If you have flu symptoms, stay home from work or school to avoid spreading the disease. Do not return until two days after your symptoms are gone.

 

Cover your nose and mouth when you cough or sneeze, and wash your hands frequently.

 

Go to the hospital if you have severe symptoms such as difficulty breathing. If your symptoms are mild, stay home to avoid spreading the virus to others at the hospital.

 

Masks may be recommended for health care workers, family members and others who come in close contact with swine flu patients, but there is no need for the general public to wear masks.

 

It is safe to eat properly handled pork. Cook it to an internal temperature of at least 160 degrees.

 

At the moment, only Tamiflu and Relenza seem to work against swine flu. Many countries have a supply of these vaccines, though not enough to curb a pandemic if the current swine flu reaches that level.

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The recent swine flu outbreak in Mexico has caused much trepidation among the international community, especially because of the increasing number of fatalities. It is important to recognize swine flu symptoms to prevent the spread of infection and illness.

Swine flu or swine influenza is a respiratory infection caused by the influenza type A virus, endemic in domestic pigs. In the past, swine flu has infected people only rarely – those infected being ones who have had direct and close contact to infected pigs. But the current swine flu outbreak in Mexico is different, caused by a new strain of the swine flu virus. As per recent health reports, swine flu is being transmitted with surprising speed in humans, spreading easily from person to person, causing serious illness among those infected. It has been reported that the disease has been diagnosed in humans who haven’t had any exposure to pigs.

Among pigs, swine flu symptoms include sudden onset of fever, depression, coughing, sneezing, breathing difficulties, redness or inflammation of the eye, going off feed, and discharge from the nose or eyes.

Like the influenza virus affecting humans, swine flu viruses are constantly mutating. Although the swine flu viruses are not the same as human flu viruses, swine flu symptoms resemble those produced by regular human seasonal influenza. In humans, common swine flu symptoms are fever, chills, sore throat, muscle pain, severe headache, coughing, lethargy, lack of appetite, weakness, and general discomfort. Some may even experience runny or stuffy nose, nausea, vomiting and diarrhea.

However in humans, self care measures and appropriate treatment in the early stages of infection can reduce the increased risk of these complications. In order to confirm that the illness is the result of a swine flu virus, one must undergo laboratory testing. Antiviral drugs such as Tamiflu and Relenza are considered effective for the treatment and/or prevention of infection by swine flu viruses.

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Swine H1N1 Flu:2009

Dr.Kedar Karki

 

Swine flu , now known as the 2009 H1N1 flu, is caused by the orthomyxovirus which usually affects pigs but viral mutations allows the virus to cross species to other hosts like humans. The swine influenza virus (SIV) is another example of cross species viral infection which was previously seen with other Zoonotic infections like in civets to humans SARS or Sudden Acute Respiratory Syndrome and from birds to humans as seen with avian (bird) flu.

 

Unlike SARS and bird flu, swine flu has mutated to the point where the virus can now spread from human-to-human. This current mutation is the cause of the global scare of the recent 2009 outbreak which is feared to become a pandemic. With the popularity of air travel, infected passengers from one region can easily travel to other nations and result in new outbreaks occurring in regions that were not prone to swine flu.

 

The current human-to-human transmission of swine flu is caused by droplet spread through the contact with infected body fluids as in saliva or mucus when sneezing.

 

How is Swine Flu H1N1 Spread?

 

 

The incubation period (time between exposure and onset of symptoms) is still uncertain, but it appears to be 3-4 days.

All flus are spread by droplets that spray out as a person sneezes or coughs. You can catch Swine Flu H1N1 or any flu virus if:

You are standing within three feet of an uncovered cough or sneeze and droplets make contact with you or if you inhale them. The droplets land on hard surfaces, like a desk top or keyboard. Even after the droplet dries a flu virus could live for over an hour. You can catch the virus by touching an infected surface then touching your eyes, nose, or mouth. You can give to the flu to somebody else by touching their eyes, nose, or mouth if the virus is on your hand. Somebody coughs sneezes or blows their nose into a tissue, and the wet tissue makes contact with their hand or the tissue tears and the contents make contact with their hand. If they touch hard surfaces or shake hands before they wash their hands then they could spread a virus. Flu viruses can also be spread by handling a contaminated cloth handkerchief then touching people or surfaces. An infected person touches their eyes, nose or mouth then touches other surfaces, objects or people before washing their hands.

 

This is not the same Swine Flu virus people were immunized against in the 1970’s. There is a vaccine for the 2009 Swine Flu Influenza A H1N1 virus under development but even with fast tracking it will take months before it is ready for human trial.

Swine Flu H1N1 is not spread by pigs and you cannot catch Swine Flu H1N1 by eating pork or using medications that are derived from pigs (porcine).

 

Symptoms of Swine Flu

 

Swine flu infection causes symptoms that are similar to the symptoms of influenza infection as seen during the annual ‘flu’ season. This may result in many cases of swine flu being misdiagnosed as a common cold or the ‘flu’ and if infected persons do not seek professional medical treatment, the infection can spread further in the general population.

 

The general symptoms of swine flu include:

 

Fever with or without chills. Sore throat. Respiratory symptoms, usually a cough or less frequently as dyspnoea (difficulty breathing) or pneumonia. Fatigue and lethargy Myalgia (general body aches) Headaches Diarrhea Vomiting

The current swine flu epidemic has seen gastrointestinal symptoms like diarrhea and vomiting that are more severe than previous swine flu outbreaks. Unfortunately these gastrointestinal symptoms may often be misdiagnosed as a ‘gastric flu’ and it is important to consult with your medical practitioner if your symptoms persist.

 

 

 

 

 

Preventing the Spread of Swine Flu H1N1

 

 

According to the CDC, proper hand washing is the most effective means of preventing the spread of disease.

Alcohol-based hand sanitizers are also considered effective. Use disposable tissues, clean your hands after every use. Cough into your elbow or shoulder if you do not have a tissue. Preventative treatments (such as Tamiflu) are not recommended for healthy people as this could potentially lead to resistance. Only seek treatment if you have symptoms. People with flu- like symptoms should avoid public places. If your child’s school is closed do not place your child in group settings such as daycare. If there are confirmed cases in your area, limit exposure by avoiding public places and clean your hands often while out and upon returning home. An infected person is contagious about 1 day before they have symptoms so follow proper hand washing guidelines or use alcohol based hand sanitizers often to prevent the accidental spread of the flu. The contagious period lasts for about 7 days after symptoms start, probably longer in children.

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Swine flu is a type of virus. It’s named for a virus that infects mainly pigs. It normally does not infect people, but human infections can and do happen. The virus is contagious and can spread from human to human. The current swine influenza A (H1N1) virus has components of pig and bird influenza viruses in it, so the humans don’t have any immunity to it. That makes it more likely to become a pandemic virus (have the ability to cause a global outbreak) if it can easily spread from person-to-person. There are antiviral medicines you can take to prevent or treat swine flu. This particular virus is resistant to the antiviral medications amantadine (Symmetrel) and rimantadine (Flumadine), but is sensitive to oseltamivir (Tamiflu) and zanamivir (Relenza). There is no vaccine available right now to protect against swine flu.

Symptoms

The symptoms of swine flu are very similar to the common flu that occurs in humans. The symptoms are mostly fever, cold, cough, runny nose, body aches, diarrhea, vomiting, headache etc. In swine flu the symptoms might be more severe like breathlessness, very high grade fever, loss of appetite and fluid intake, listlessness etc.

The important fact is to prevent the spread of this infection. Since it spreads through fomites i.e. through air, infected articles like tissue, paper, pen etc, the preventive measures are very important.

Prevent spread

The measures that can be taken to prevent spread of this particular swine flu are –

1 Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

2 Wash your hands often with soap and water, especially after you cough or sneeze. You can also use alcohol-based hand sanitizers.

3 Avoid touching your eyes, nose or mouth. Germs spread this way.

4 Try to avoid close contact with sick people.

5 Stay home from work or school if you are sick.

6 Consult a doctor immediately when in doubt about your symptoms.

Important thing to remember is that people with swine flu are likely contagious for one day before and up to seven days after they began to get sick with swine flu symptoms. Also, anti-flu medications, including Tamiflu (oseltamivir) and Relenza (zanamivir), are available to prevent and treat swine flu.

For more tips on prevention and cure of illnesses, post your queries on http://www.simplyanswer.com

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                                                    BY: Dr. GHAZAL SABREEN

                                                                            PHARM: D

SWINE FLUE/ SWINE INFLUENZA

What is swine influenza?

It is the type of influenza that is caused by those strains of influenza virus,(swine influenza virus) that usually infect pigs.

SYNONYMS:

It is also called as: swine flu, hog flu and pig flu.

CAUSATIVE AGENT:

As of 2009 these strains are all found in Influenza C virus and the subtypes of Influenza A virus known as H1N1, H1N2, H3N1, H3N2, and H2N3. Swine influenza is common in pigs in the midwestern United States (and occasionally in other states), Mexico, Canada, South America, Europe (including the United Kingdom, Sweden, and Italy), Kenya, Mainland China, Taiwan, Japan and other parts of eastern Asia.[2]

Of the three genera of influenza viruses that cause human flu, two also cause influenza in pigs, with Influenza virus A being common in pigs and Influenza virus C being rare.[7] Influenza virus B has not been reported in pigs. Within Influenza virus A and Influenza virus 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.

 

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 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 (The simplest definition of a zoonosis is a disease that can be transmitted from other vertebrate animals to humans. A slightly more technical definition is a disease that normally infects other animals, but can also infect humans). 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

After 1918 several outbreaks of swine flue in different years occur but the most current is of 2009

2009 outbreak in humans

The 2009 flu outbreak is due to a new strain of subtype 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 the WHO’s new International Health Regulations when the first cases of the H1N1 virus were reported in the United States. The outbreak, on May 2, 2009, it was reported in pigs at a farm in Alberta, Canada, with a link to the outbreak in Mexico. The 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 apparent reassortment of at least four strains of influenza A virus subtype H1N1, inluding one strain endemic 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 (ie, 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

 

 

HOW IT IS TRANSMITTED:

TRANSMISSION IN HUMAN?

Transmission of swine influenza virus from pigs to humans is not common and does not 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 called zoonotic swine flu. People who work with pigs, especially people with intense exposures, are at increased risk of catching swine flu. In the mid-20th century, identification of influenza subtypes became possible, this allows accurate diagnosis of transmission to humans. Since then, fifty confirmed transmissions have been recorded, Rarely, these strains of swine flu can pass from human to human.

HOW IT IS TRANSMITTED? (CONTINUE)

TRANSMISSION IN PIGS:

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.

 

WHAT ARE THE SYMPTOMS OF SWINE FLUE?

SYMPTOMS IN HUMANS:

In humans, the symptoms of swine flu are similar to those of influenza and of influenza-like illness in general, namely chills, fever- Sudden fever above 38 degrees (100.4 degrees Fahrenheit), aching joints, nasal congestion, general fatiguesore throat, muscle pains, severe headache, coughing, weakness and general discomfort

The 2009 outbreak has shown an increased percentage of patients reporting diarrhea and vomiting.[65] The 2009 H1N1 virus is not zoonotic swine flu, as it is not transmitted from pigs to humans, but from person to person.

 

 

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

 

IS THERE ANY VACCINES AVALABLE FOR SWINE INFLUENZA????

There are no any vaccine uptil now avalable which contain swine influenza virus causing disease in humans. It is not known too that current seasonal influenza vaccines provide the protection. Influenza viruses change very quikly . It is important to develop vaccine for current circulating virus strain, to provide the people maximum protection.

 

HOW THE SWINE INFLUENZA CAN BE TREATED?

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 antiviral, palliative care, at home or in hospital, focuses on controlling fevers and maintaining fluid balance. 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.

TREATMENT In confirmed cases: Mexican authorities have provided patients with flu drugs Seltamivir or Zanamivir under strict medical supervision, and warn against side effects in misuse.

The Mexican government said that the antiviral drugs would only be administered if infection is confirmed.

 

HOW THE HUMAN CAN BE PREVENTED FROM SWINE INFLUENZA?

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

 

HOW THE SWINE INFLUENZA BE DIAGNOSED?

 

DIAGNOSIS: Clinical examination of secretions from the nose and mouth in the first 24-72 hours after presenting symptoms, and a study of blood samples to detect existence of influenza virus.

HOW LONG THE INFECTED PERSON BE THE SOURCE OF INFECTION TO OTHERS?

People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.

What can I do to protect myself from getting sick?

There is no vaccine available right now to protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. Try to avoid close contact with sick people. If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them. Avoid touching your eyes, nose or mouth. Germs spread this way.

FIVE TIPS TO KEEP YPURSELF AWAY FROM SWINE INFLUENZA?

1.Stay home if you’re sick.

2.Avoid close contact with people who are sick

3.Wash your hands often and avoid touching your eyes, nose and mouth.

4.Cover your mouth or nose with a tissue when coughing or sneezing

5.Keep up with health information in your own community

TOPICS COVERED:

1       Definition

2       Synonyms

3       Causative agent

4       History

5       Mode of transmission

6       Sign and symtoms

7       Treatment

8       Vaccines

9       How long the person be source of infection

10 Diagnosis

11 Prevention

12 Health Tips

  “Try to cover every thing in the simple language even the non medical student / person can easily understand”

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