What is it?

It is a respiratory disease caused by type A influenza virus which often infects pigs. Swine flu viruses don’t normally infect humans. However, sporadic human infections occur in persons with direct exposure to pigs. It then can spread from human to human.

Presently , here is a mutation and human –to- human spread is there.

Mode of Spread

  • Swine flu spreads through direct contact with infected pigs.
  • Person to person transmission through coughing, sneezing of people infected with influenza virus
  • People also become infected by touching infected surfaces and then touching their mouth, nose and eyes.

The swine flu outbreak is more deadly than Bird flu because it spreads much more quickly between humans

Period of communicability 

  • Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick

That means spread/passing on the flu to someone else may be there before one knows to be sick or is actually sick.

Symptoms of Swine flu

  • Main symptoms

Fever

Running nose

Sore throat

Cough

  • Other symptoms

Headache

Lethargy

Loss of appetite

Chills

Nausea and vomiting

Muscle aches

Diarrhea

Lab Diagnosis

Recommended Tests

  • PCR for influenza A (RNA detection)
  • Rapid influenza antigen test
  • Immunofluorescence
  • Viral culture

Specimens:

  • Nasopharyngeal swab/aspirate or nasal wash/aspirate in VTM bottles.  If these specimens cannot be collected, a combined nasal swab with an oropharyngeal swab is acceptable
  • The swab specimen collection vials should contain 1-3ml of viral transport medium and to be sent at 2-4 C.

  Presently the test facility is neither available at State Hospitals nor it is available at PGI, Chandigarh.

The test facility is available at National Institute of Communicable Diseases, Delhi and National Institute of Virology, Pune

Prevention

  • Wash your hands properly after coughing and sneezing. While sneezing ,use tissue paper  & discard it.
  • Try to stay in good general health ,
  •  get plenty of sleep ,
  • be physically active,
  • manage your stress,
  • drink plenty of fluids and eat nutritious food,
  • Do not touch surface that may be contaminated with the flu virus.
  • Avoid close contact with people who are sick
  • Wearing of masks to cover nose and mouth and avoiding handshakes and hugs
  • Any passenger coming from abroad with flu like symptoms should be immediately quarantined at the nearby hospital or health authorities be alerted .
  • Swine influenza viruses are not spread by eating pork

Personal Protection

There is no vaccine available right now to protect against  Swine flu

  • Cover your nose and mouth with a tissue when you cough or sneeze and throw the tissue in the trash after use
  • Wash your hands often with soap and water, especially after you cough or sneeze.
  • Avoid touching your eyes, nose or mouth.
  • Avoid close contact with sick/infected people
  • If you get sick with influenza, stay home from work or school and limit contact with others to prevent infecting them
  • Standard surgical masks offer some protection
  • General good hygiene will help
  • Since pigs in India are disease free , there is no ban on pork. As a precaution , however , WHO say the pork should be cooked at over 70 degree Centigrade

Warning Signals

  • Children

–Fast breathing or trouble breathing

–Bluish skin color

–Not drinking enough fluids

–Not walking up or not interacting

–Irritability

–Flu like symptoms improve but then return with fever and worse cough

–Fever with a rash

  • Adults

–Difficulty in breathing or shortness of breath

–Pain or pressure in the chest or abdomen

–Sudden dizziness

–Confusion

–Severe or persistent vomiting

SURVEILLANCE

  • Case defination
  • Lab Diagnosis- NICD& NIV
  • Points of entry
  • Health care facilities
  • Transparency
  • Sharing specimens
  • Dissemination of information
  • Communication &education of public

VACCINE

  • No vaccine is available against new swine virus.
  • Will take minimum 4-6 months to develop vaccine in sizeable quantities, as per WHO technical guidelines.
  • The efficacy of seasonal vaccine as protection against new swine virus is not known.

Oseltamivir Drug Dosage Schedule

Children younger than 1 year: Recommended treatment  for 5 days

Age      Dose

  • <3 months   12 mg twice daily
  • 3-5 months   20 mg twice daily
  • 6-11 months   25 mg twice daily

Case Definitions for Infection with Swine-origin Influenza A (H1N1)

  • A confirmed case of S-OIV infection is defined as a person with an acute febrile respiratory illness with laboratory confirmed S-OIV infection by one or more of the following tests:

–real-time RT-PCR

–viral culture

–Four fold rise in swine influenza A (H1N1)  virus specific antibodies

  • A probable case of S-OIV infection is defined as a person with an acute febrile respiratory illness who is positive for influenza A, but negative for H1 and H3 by influenza RT-PCR

Latest Scenario of Swine flu

  • Global emergency declared by WHO on 30.4.2009 with alert level of phase -5 indicating significant risk of pandemic
  • General health alert to Health and Animal husbandry departments for influenza like cases
  • Spread to more than 20 countries and 2000 + cases of Influenza A (H1N1) virus( 10 May, 2009) with more than 50 deaths.
  • Advisory to avoid travel to Swine flu affected countries i.e. New Zealand, Mexico, USA, Canada , Spain , France and U K. New countries added as Hong kong , S.Korea , Australia and Japan.
  • There is no cause of immediate panic in India but High level of surveillance and vigilance to be maintained for any unusual outbreaks of influenza like illness.

Country wise  reported Confirmed  Cases

Mexico has reported 397 confirmed cases including 16 deaths

  • Austria 1
  • Canada 34
  • China (Hong Kong) 1
  • Denmark 1
  • France 1
  • Germany 4
  • Israel 2
  • Netherlands 1
  • New Zealand 4
  • Republic of Korea 1
  • Spain 13
  • Switzerland 1
  • United Kingdom  13

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