All About Swine Flu

What is swine flu?

Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of influenza in pigs. The virus currently spreading among people is now generally referred to as swine flu. Swine flu viruses are usually of the H1N1 sub-type. The swine flu that has spread to humans is a version of this virus. Swine influenza viruses may circulate among swine throughout the year, but most outbreaks occur during the late fall and winter months similar to outbreaks in humans.

Why is swine flu affecting humans?

The swine flu virus has changed and is now able to infect humans and transmit between them. Most commonly, these cases occur in persons with direct exposure to pigs (e.g. children near pigs at a fair or workers in the swine industry). In addition, there have been documented cases of one person spreading swine flu to others.

How do people become infected with the virus?

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.

What surfaces are most likely to be sources of infection?

Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air.

How long can viruses live outside the body?

We know that some viruses and bacteria can live two hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Frequent hand washing will help you reduce the chance of getting contamination from these common surfaces.

What are the symptoms of swine flu in humans?

The symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing.

Some of the symptoms are:

* Fast breathing or trouble breathing
* Bluish or gray skin color
* Not drinking enough fluids
* Not interacting
* Irritation
* Flu-like symptoms improve but then return with fever and worse cough
* Pain or pressure in the chest or abdomen
* Sudden dizziness
* Confusion
* Severe or persistent vomiting
* Sore throat
* Nausea
* Diarrhea

Can people catch swine flu from eating pork?

No. Swine influenza viruses are not transmitted by food. You can not get swine influenza from eating pork or pork products. Eating properly handled and cooked pork is safe. Cooking pork to an internal temperature of 160°F/ 71°C kills the swine flu virus as it does other bacteria and viruses.

How can human infections with swine influenza be diagnosed?

To diagnose swine influenza A infection, a respiratory specimen is collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 10 days or longer. Identification as a swine flu influenza A virus requires sending the specimen for laboratory testing.

What treatment should I take?

* Mild influenza illness does not require specific anti viral medicine.
* Medicines should be taken only on advice of the doctor.
* Paracetamol for fever and ibuprofen for myalgia can be taken as per the advice of the dooctor.
* Oseltamivir,if prescribed/advised by the doctor only.
* Children need to be given paediatric preparation and dosage of the above drugs.
* Medicines (other than paracetamol) available for fever, headache, body ache in general groceries, pan shops etc should not be taken as they may contain aspirin.
* Aspirin should not be given for fever or body ache.
* Patients should take plenty of fluids.
* If fever is not responding, there is worsening of symptoms and in particular altered sensorium (confusion, incoherent speech etc) / loss of consciousness or difficulty in breathing, patient should be referred to nearest identified health facility.

Which people are most vulnerable from swine flu?

In particular, patients with co-morbid condition (hypertension, diabetes, bronchial asthma, chronic bronchitis or Obstructive airway diseases etc) need to be observed for worsening of symptoms.

Those who are more at risk from becoming seriously ill with swine flu are people with:

* chronic (long-term) lung disease, including people who have had drug treatment for their asthma within the past three years,
* chronic heart disease,
* chronic kidney disease,
* chronic liver disease,
* chronic neurological disease (neurological disorders include motor neurone disease, Parkinson's disease and multiple sclerosis),
* suppressed immune systems (whether caused by disease or treatment),
* diabetes,
* pregnant women,
* people aged 65 or older, and
* young children under five.

Are pregnant women with swine flu more at risk of complications?

Most pregnant women with swine flu will only have mild symptoms, the same as most other people with swine flu. However, pregnant women have an increased risk of complications from any type of flu, because their immune system is naturally supressed in pregnancy. Possible complications are pneumonia (an infection of the lungs), difficulty breathing and dehydration, which are more likely to happen in the second and third trimester.

There is a small chance that these complications will lead to premature labour or miscarriage. There is not yet enough information to know precisely how likely these birth risks are.

Are people with asthma or chronic obstructive pulmonary disease (COPD) more at risk of catching swine flu?

You are no more likely to catch swine flu than anyone else. However, if you do catch a respiratory infection, including swine flu, it may add to any breathing difficulties you

Can I take antivirals if I have asthma or COPD?

Yes, Tamiflu is safe to take. However, Relenza (an inhaler) is usually not given to people with asthma as on rare occasions it can cause breathing complications.

I have diabetes. Am I at more at risk of catching swine flu?

You are no more likely to catch swine flu than anyone else. However, if you do catch it, your blood glucose may increase and your diabetes treatment may need to be adjusted accordingly.

Is there any advice for people with liver disease?

If you have liver disease you are no more likely to catch swine flu than anyone else. If you do catch it, antivirals are safe to take. There is no interaction between these and other antivirals you may already be taking.

Can swine flu be treated?

Testing has shown that the swine flu can be treated with the antiviral medicines oseltamavir (Tamiflu) and zanamivir (Relenza). However, the drugs must be taken at or near the start of the illness to be effective. You should only take an antiviral if your doctor 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.

How effective are Relenza and Tamiflu?

Relenza reduces the duration of flu symptoms by one-and-a-half days on average. Tamiflu reduces the duration of symptoms by up to two days.

How can antiviral drugs help in Swine flu?

* Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight against the flu by keeping flu viruses from reproducing in your body.
* Antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications.
* Antiviral drugs are not sold over-the-counter and are different from antibiotics.
* Antiviral drugs may be especially important for people who are very sick (hospitalized) or people who are sick with the flu and who are at increased risk of serious flu complications, such as pregnant women, young children and those with chronic health conditions.
* For treatment, antiviral drugs work best if started within the first 2 days of symptoms.
* Relieves some of the symptoms,
* Reduces the potential for serious complications, such as pneumonia.

Is it possible to catch swine flu twice?

Yes, because the virus can mutate (change). If you become infected with the swine flu virus, your body produces antibodies against it, which will recognise and fight off the virus if the body ever meets it again. However, if the virus mutates, your immune system may not recognise this different strain and you may become ill again, although you may have some protection from having had a similar virus previously.

What about using a mask?

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.

Why shouldn't the general public wear facemasks?

There is no evidence to suggest that this is a useful preventative measure.

The virus is spread by people touching infected surfaces, or by someone coughing or sneezing at very close range. So unless you are standing very close to someone with the virus, wearing a facemask will not make a difference. It is more important to keep your hands clean, stay at home if you feel unwell and cover your mouth when you cough or sneeze.

Precautions

* Get a yearly seasonal flu vaccine as the first and most important step in protecting against seasonal influenza.
* People at high risk of serious flu complications, including young children, pregnant women, people with chronic health conditions like asthma, diabetes or heart and lung disease and people 65 years and older should get vaccination.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
* Avoid touching your eyes, nose or mouth. Germs spread this way.
* Try to avoid close contact with sick people.
* If you are sick with flu-like illness, stay home for at least 24 hours after your fever is gone
* While sick, limit contact with others to keep from infecting them
* 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

Precautions for a sick person:

* Keep the sick person in a room separate from the common areas of the house. (For example, a spare bedroom with its own bathroom, if that’s possible.) Keep the sickroom door closed.
* Wear mask all the time. Three layered surgical mask should be provided by the hospital / community health worker. If mask is not readily available, mouth and nose should be covered with a piece of cloth / handkerchief / tissue paper.
* avoid smoking
* The sick person should clean his hands with soap and water or an alcohol-based hand rub often, especially after coughing and/or sneezing.
* Unless necessary, person with the flu should not leave the home when he has a fever or during the time that he is most likely to spread the infection to others
* Avoid going into the community, school, office, markets
* If person with the flu needs to leave the home (for example, for medical care), he should cover the nose and mouth when coughing or sneezing
* Have the sick person wear a surgical mask if they need to be in a common area of the house near other persons
* If possible, sick persons should use a separate bathroom. This bathroom should be cleaned daily with household disinfectant

Precautions for other people at home:

* Everyone in the household must clean their hands often, using soap and water or an alcohol-based hand rub
* Visitors should not come in close contact with the sick person other than caregiver.
* If possible, have only one adult in the home take care of the sick person.
* Avoid having pregnant women care for the sick person. (Pregnant women are at increased risk of influenza-related complications and immunity can be suppressed during pregnancy).
* They should use paper towels for drying hands after hand washing or dedicate cloth towels to each person in the household.
* If possible, consideration should be given to maintaining good ventilation in shared household areas
* Monitor yourself and household members for flu symptoms and the local H1N1

Precaution for the caregiver:

* Avoid being face-to-face with the sick person.
* When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face
* Clean your hands with soap and water or use an alcohol-based hand rub after you touch the sick person or handle used tissues, or laundry
* Caregiver should talk to your Doctor about taking antiviral medication to prevent from getting the flu