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 "Global health authorities warned on Wednesday that swine flu was threatening to bloom into a pandemic" April 29, 2009.

 A few days later other reports emerged " All countries should immediately now activate their pandemic preparation plans," Dr Chan, World Health Organization (WHO) Director General told the reporters in Geneva. "It really is all of humanity that is under threat in a pandemic."

    

SO WHAT IS SWINE INFLUENZA?

It is a respiratory disease of pigs caused by type “A” strains of the influenza virus. It regularly causes high flu outbreaks in pigs but with low death rates. There are four main subtypes of the virus, but the most recent isolated influenza viruses from pigs have been H1N1 viruses.

HOW DOES IT SPREAD?

Swine flu viruses do not typically infect humans though they do occur through close proximity or contact with infected pigs or contaminated areas. Cases of human-to-human spread have been documented.

HOW DID THIS WIDE SPREAD START?

Scientists believe that somewhere in the world, months or even a year ago, a pig virus jumped to a human and mutated, and has been spreading between humans ever since. Unlike with bird flu, doctors have no evidence suggesting a direct pig-to-human infection from this strain.

WHAT ARE THE SYMPTOMS?

The symptoms are similar to those of regular flu like:-

-Fever

-Lethargy and fatigue

-Body aches and chills

-Runny nose

-Cough

-Sore throat

-Lack of appetite

-Vomiting and diarrhoea in some cases.

HOW COMMON IS SWINE FLU INFECTION IN HUMANS?

In the past reports of about one human swine flu virus infection had been received every one to two years in the United States. From December 2005 till February 2009, 12 cases have been reported.

Lately, it has been mentioned that H1N1 swine flu is seen as the biggest risk since H5N1 avian flu re-emerged in 2003, killing 257 people of 421 infected in 15 countries. In 1968, a "Hong Kong" flu pandemic killed about 1 million people globally, and a 1957 pandemic killed about 2 million.  Strangely enough, seasonal flu kills 250,000 to 500,000 people in a normal year, including healthy children in rich countries.

HAS THIS STRAIN OF FLU BEEN SEEN BEFORE?

No. Flu mutates constantly, so it is common for new strains to emerge. Pigs can also be infected with both human and avian influenza, and the current circulating swine flu strain appears to contain genetic elements from all three.

WHAT ARE THE MODES OF INFECTION?

It is well known that the virus can survive on non porous surfaces 24-48 hours and on porous surfaces up to 12 hours.

It is an airborne virus so it can be transmitted by sneezing, coughing then touching. Even skin to skin contact with an infected person is a mode of infection.

CAN SWINE FLU BE TREATED WITH ANTIVIRAL DRUGS AND FLU VACCINE?

The swine flu is resistant to the two common antiviral drugs – Amantadine and Rimantadine. The H1N1 swine flu viruses are very different from human H1N1 viruses. Therefore, vaccine for human seasonal flu would not provide protection.

CAN PEOPLE CATCH SWINE FLU BY EATING PORK?

No, swine influenza viruses are not transmitted by food.  Eating properly handled and cooked pork and pork products are safe. Cooking pork to an internal temperature of 70 C and above kills the swine flu virus.

HOW LONG IS SOMEONE WITH SWINE FLU CONSIDERED CONTAGIOUS?

Usually people with swine flu are considered potentially contagious 1 day before symptoms appear although the symptomatic stage up to 7 days following onset of illness. Children, especially younger children, might potentially be contagious for longer periods,

WHO ARE THE MOST VULNERABLE PEOPLE TO CATCH THE SWINE FLU?

Extremes of age like very young and very old people are at high risk. Also those who are under immuno-suppresive medications or cortico steroids are considered high risk groups. Medical personnel and those in schools and day care centers and nurseries are also from the highly vulnerable groups. Regular check and proper isolaton and medicaton to suspected cases with flu symptoms should be done promptly and as soon as any signs appear.

WHAT CAN WE DO TO PROTECT OURSELVES FROM SWINE FLU?

This can be achieved by preventing spread of germs that cause respiratory illnesses like influenza by:

-          Covering your nose and mouth with a disposable tissue or handkerchief when you cough or sneeze. Throw the tissue in the waste basket after you use it.

-          Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also helpful.

-          Try to avoid close contact with sick people.  If you get sick with influenza, stay at home and limit contact with others to keep from infecting them.

-          Avoid touching your eyes, nose or mouth.

-          Consult your nearest healthcare facility, if you think you have any of the symptoms.

 

 IS AN EFFECTIVE VACCINE ALREADY AVAILABLE AGAINST H1N1 VIRUS?

No, but work is already under way to develop such a vaccine. For the vaccine to protect as well as possible, the virus in it should match the circulating "wild-type" virus relatively closely. Since this H1N1 virus is new, there is now vaccine currently available made with this particular virus. Making a completely new influenza vaccine can take five to six months.

ARE THERE ANY MEDICATIONS AGAINST H1N1 SWINE FLU VIRUS?

Two antiviral drugs namely Relenza and Tamiflu, have been shown to work against the H1N1 strain.

SO WHAT IS HAPPENING AROUND THE WORLD?

The WHO has raised its pandemic alert for swine flu to the second highest level, which means that there was an imminent outbreak of the disease. It was the first time the WHO has declared a phase 5 outbreak.

A phase 5 alert means there is sustained transmission among people in at least two countries. Once the virus shows effective transmission in two different regions of the world, a full pandemic outbreak – phase 6 – would be declared, meaning a global epidemic of a new and deadly disease.

SO WHAT IS THE MOST IMPORTANT THING TO DO NOW?

-          If you are suffering from the above mentioned flu manifestations, you have to consult your doctor.

-          If you are suffering from those manifestations, stay at home, avoid contact with others especially the high risk groups and take your medications properly.

 

 

 

For any further enquiries please contact me on:

My email: rafeekramzy@hotmail.com

Contact number: 012 314 9593

Or send your questions to the Red Sea Bulletin

                                                                           Dr Rafeek Ramzy

                                                            Pediatrician and Neonatologist

                                             Member of American Academy of Pediatrics ( AAP )

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