swine flu-

Views:
 
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

SWINE FLU : 

SWINE FLU Information sources- In public interest by Dr. Suhas Patil

What is Swine Flu : 

What is Swine Flu Swine influenza virus (referred to as SIV) refers to influenza cases that are caused by Orthomyxovirus endemic to pig populations. SIV strains isolated to date have been classified either as Influenza(virus C or one of the various subtypes of the genus Influenza virus A)

Case Definitions : 

Case Definitions A confirmed case of swine influenza A (H1N1) virus infection is defined as a person with an acute febrile respiratory illness with laboratory confirmed swine influenza A (H1N1) virus infection at CDC by one or more of the following tests: real-time RT-PCR viral culture A probable case of swine influenza A (H1N1) virus 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, or positive for influenza A by an influenza rapid test or an influenza immunofluorescence assay (IFA) plus meets criteria for a suspected case A suspected case of swine influenza A (H1N1) virus infection is defined as a person with acute febrile respiratory illness with onset within 7 days of close contact with a person who is a confirmed case of swine influenza A (H1N1) virus infection, or within 7 days of travel to community either within the United States or internationally where there are one or more confirmed swine influenza A(H1N1) cases, or resides in a community where there are one or more confirmed swine influenza cases. Source: CDC

Slide 4: 

Credit: L. Stammard, 1995 What is Swine Flu - virus

Different Strains circulate Periodically : 

Different Strains circulate Periodically In the United States the H1N1 subtype was exclusively prevalent among swine populations before 1998; however, since late August 1998, H3N2 subtypes have been isolated from pigs. As of 2004, H3N2 virus isolates in US swine and turkey stocks were triple reassortants, containing genes from human (HA, NA, and PB1), swine (NS, NP, and M), and avian (PB2 and PA) lineages.

Swine Influenza (Flu) : 

Swine Influenza (Flu) Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza that regularly cause outbreaks of influenza among pigs. Swine flu viruses do not normally infect humans, however, human infections with swine flu do occur, and cases of human-to-human spread of swine flu viruses has been documented.

Slide 7: 

Epidemic – a located cluster of cases Pandemic – worldwide epidemic Antigenic drift Changes in proteins by genetic point mutation & selection Ongoing and basis for change in vaccine each year Antigenic shift Changes in proteins through genetic reassortment Produces different viruses not covered by annual vaccine Definitions: General

Pigs can harbour influenza viruses can be adapted to Humans : 

Pigs can harbour influenza viruses can be adapted to Humans

Swine Flu 2009 : 

Swine Flu 2009 In late March and early April 2009, cases of human infection with swine influenza A (H1N1) viruses were first reported in Southern California and near San Antonio, Texas. Other U.S. states have reported cases of swine flu infection in humans and cases have been reported internationally as well.

Update - Status Swine Flu : 

Update - Status Swine Flu The United States Government has reported seven confirmed human cases of Swine Influenza A/H1N1 in the USA (five in California and two in Texas) and nine suspect cases. All seven confirmed cases had mild Influenza-Like Illness (ILI), with only one requiring brief hospitalization. No deaths have been reported.

Cause by Reassortment of different strains : 

Cause by Reassortment of different strains Like all influenza viruses, swine flu viruses change constantly. Pigs can be infected by avian influenza and human influenza viruses as well as swine influenza viruses. When influenza viruses from different species infect pigs, the viruses can reassort (i.e. swap genes) and new viruses that are a mix of swine, human and/or avian influenza viruses can emerge

Swine Flu differs from Human Flu : 

Swine Flu differs from Human Flu The H1N1 swine flu viruses are antigenically very different from human H1N1 viruses and, therefore, vaccines for human seasonal flu would not provide protection from H1N1 swine flu viruses

Present Swine Flu strains : 

Present Swine Flu strains At this time, there are four main influenza type A virus subtypes that have been isolated in pigs: H1N1, H1N2, H3N2, and H3N1. However, most of the recently isolated influenza viruses from pigs have been H1N1 viruses.

How man is exposed : 

How man is exposed 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.

Recirculated Air – and infections : 

Recirculated Air – and infections No UK airline serves nuts. Why? ©2009, E-CO  www.e-co.uk.com UK Airlines recognised that microscopic pieces of nuts were circulating in the cabin and realised that there was a risk of a passenger experiencing an Anaphylactic Shock

Infectious Droplet Nuclei Recirculation in buildings : 

Infectious Droplet Nuclei Recirculation in buildings 16 Reproduced with the kind permission of Steven Welty – Indoor air quality Expert GreenCleanAir@aol.com

How far can Airborne Viruses Travel? : 

How far can Airborne Viruses Travel? *As a Result of Toilet Water Aerosolisation and Mechanical Fan Dispersion into outdoor air (2003 Hong Kong SARS Virus Epidemic) 1. Coughing 1-5 feet 160+ feet 2. Sneezing 8-15 feet 160+ feet 3. Singing, Talking 1-3 feet 160+ feet 4. Mouth Breathing 1-3 feet 160+ feet 5. Diarrhea* 5 feet+ 160+ feet Large/Small Droplets Droplet Nuclei 17 Reproduced with the kind permission of Steven Welty – Indoor air quality Expert GreenCleanAir@aol.com

Airborne Transmission depends on people to launch viruses into the air. People can shed this many Flu Viruses into the air: : 

Airborne Transmission depends on people to launch viruses into the air. People can shed this many Flu Viruses into the air: 1. Coughing 3,000+ 2. Sneezing 3,000+ 3. Breathing Nose-None Mouth-Varies 4. Talking/Singing 1,000+ 5. Vomiting 1,000+ 6. Diarrhea* 20,000+ *As a Result of Toilet Water Aerosolisation 18 Reproduced with the kind permission of Steven Welty – Indoor air quality Expert GreenCleanAir@aol.com

Bacteria v’s Viruses -Know your Airborne Germ : 

Bacteria v’s Viruses -Know your Airborne Germ Reproduced with the kind permission of Steven Welty – Indoor air quality Expert GreenCleanAir@aol.com

What’s Influenza A Virus & How does it infect people? : 

What’s Influenza A Virus & How does it infect people? Influenza A causes disease primarily in the lungs as it loves to infect the lower respiratory system. It is not a rhinovirus which primarily causes infection in the nose and upper respiratory system. Since your fingers can’t touch your lungs, washing your hands won’t likely prevent flu viruses from entering deep into your lungs. NO matter how sterile your hands are, you’ll still be fully exposed to airborne Influenza viruses entering and depositing into your lungs to cause disease. 20 Reproduced with the kind permission of Steven Welty – Indoor air quality Expert GreenCleanAir@aol.com

How does Influenza A Virus kill people? : 

How does Influenza A Virus kill people? Influenza A likes to multiply at 98.6° which is the temperature of the lower respiratory system. (The upper respiratory system- nasal cavity & pharynx- are approx. 93° which rhinoviruses favor for multiplication). Influenza A infects and destroys its victim’s lung tissue.Damaged lung tissue has compromised its protective layers which can lead to pneumonia or massive bacterial infection. Victims may die from aggressive Staph infections like Methicillin Resistant Staphylococcus Aureus (MRSA). 21 Reproduced with the kind permission of Steven Welty – Indoor air quality Expert GreenCleanAir@aol.com

How Swine Flu presents in Humans : 

How Swine Flu presents in Humans The symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza – Fever, Lethargy, Lack of appetite and Coughing. Some people with swine flu also have reported - Runny nose, - sore throat, - Nausea, vomiting and diarrhea

Is the eating Pork infects ? : 

Is the eating Pork infects ? 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 and pork products is safe. Cooking pork to an internal temperature of 160°F kills the swine flu virus as it does other bacteria and viruses

Close proximity with PIGS spread the Infections : 

Close proximity with PIGS spread the Infections Influenza viruses can be directly transmitted from pigs to people and from people to pigs. Human infection with flu viruses from pigs are most likely to occur when people are in close proximity to infected pigs, such as in pig barns and livestock exhibits housing pigs at fairs. Human-to-human transmission of swine flu can also occur.

How Swine flu spread among Pigs : 

How Swine flu spread among Pigs Swine flu viruses are thought to be spread mostly through close contact among pigs and possibly from contaminated objects moving between infected and uninfected pigs. Herds with continuous swine flu infections and herds that are vaccinated against swine flu may have sporadic disease, or may show only mild or no symptoms of infection.

Survival of Influenza Virus on Surfaces and Affect of Humidity & Temperature* : 

Source: Bean B, et al. JID 1982;146:47-51 Survival of Influenza Virus on Surfaces and Affect of Humidity & Temperature* Hard non-porous surfaces 24-48 hours Plastic, stainless steel Recoverable for > 24 hours Transferable to hands up to 24 hours Cloth, paper & tissue Recoverable for 8-12 hours Transferable to hands 15 minutes Viable on hands <5 minutes only at high viral titers Potential for indirect contact transmission *Humidity 35-40%, Temperature 28C (82F)

Viruses Evaporate faster in Low Humidity levels thus creating More Droplet Nuclei. ● Low humidity allows droplet nuclei to stay airborne longer as the droplets do not absorb water weight which would cause them to fall to the ground. ● Indoor Air currents both created by HVAC systems and people movement assure that droplet nuclei will remain airborne indefinitely. ● This allows HVAC systems to remove and redistribute droplet nuclei throughout the building to infect more occupants. : 

Viruses Evaporate faster in Low Humidity levels thus creating More Droplet Nuclei. ● Low humidity allows droplet nuclei to stay airborne longer as the droplets do not absorb water weight which would cause them to fall to the ground. ● Indoor Air currents both created by HVAC systems and people movement assure that droplet nuclei will remain airborne indefinitely. ● This allows HVAC systems to remove and redistribute droplet nuclei throughout the building to infect more occupants. Low Indoor Humidity Increases Droplet Nuclei Levels (winter) 27 Reproduced with the kind permission of Steven Welty – Indoor air quality Expert GreenCleanAir@aol.com

Seek emergency medical care.IF - in Children : 

Seek emergency medical care.IF - in Children In children emergency warning signs that need urgent medical attention include: Fast breathing or trouble breathing Bluish skin color.Not drinking enough fluids Not waking up or not interacting Being so irritable that the child does not want to be held Flu-like symptoms improve but then return with fever and worse cough Fever with a rash

Adults Need attention if Present with : 

Adults Need attention if Present with Difficulty breathing or shortness of breath Pain or pressure in the chest or abdomen Sudden dizziness Confusion Severe or persistent vomiting

Diagnosis : 

Diagnosis A respiratory specimen would generally need to be 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

Influenza A(H1N1) Treatment : 

Influenza A(H1N1) Treatment No vaccine available Antivirals for the treatment and/or prevention of infection: Oseltamivir (Tamiflu) or Zanamivir (Relenza) Use of anti-virals can make illness milder and recovery 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) Warning! Do NOT give aspirin (acetylsalicylic acid) or aspirin-containing products (e.g. bismuth subsalicylate – Pepto Bismol) to children or teenagers (up to 18 years old) who are confirmed or suspected ill case of swine influenza A (H1N1) virus infection; this can cause a rare but serious illness called Reye’s syndrome. For relief of fever, other anti-pyretic medications are recommended such as acetaminophen or non steroidal anti-inflammatory drugs. Source: CDC

Drugs which are effective in Swine Flu : 

Drugs which are effective in Swine Flu There are four different antiviral drugs that are licensed for use in the US for the treatment of influenza: Amantidine, rimantadine, oseltamivir and zanamivir. While most swine influenza viruses have been susceptible to all four drugs

Drugs proved resistant at Present : 

Drugs proved resistant at Present Most recent swine influenza viruses isolated from humans are resistant to Amantidine and Rimantadine

WHO recommends at Present : 

WHO recommends at Present WHO recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with swine influenza viruses

Influenza A(H1N1) Treatment : 

Influenza A(H1N1) Treatment Source: CDC Dosing recommendations for antiviral treatment of children younger than 1 year using oseltamivir. Recommended treatment dose for 5 days. <3 months: 12 mg twice daily; 3-5 months: 20 mg twice daily; 6-11 months: 25 mg twice daily Dosing recommendations for antiviral chemoprophylaxis of children younger than 1 year using oseltamivir. Recommended prophylaxis dose for 10 days. <3 months: Not recommended unless situation judged critical due to limited data on use in this age group; 3-5 months: 20 mg once daily; 6-11 months: 25 mg once daily

How long can an infected person spread swine flu to others? : 

How long can an infected person spread swine flu 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.

How long can viruses live outside the body? : 

How long can viruses live outside the body? We know that some viruses and bacteria can live 2 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.

No Vaccines to HumansBut available to PIGS : 

No Vaccines to HumansBut available to PIGS Vaccines are available to be given to pigs to prevent swine influenza. There is no vaccine to protect humans from swine flu. The seasonal influenza vaccine will likely help provide partial protection against swine H3N2, but not swine H1N1 viruses.

Avoid close contact : 

Avoid close contact Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too. Aerosols spread the virus in any environment

Stay home when you are sick. : 

Stay home when you are sick. If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.

Cover your mouth and nose. : 

Cover your mouth and nose. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick

Clean your hands. : 

Clean your hands. Washing your hands often will help protect you from germs. Hand washing proved to be best procedure in prevention of Majority of Communicable diseases.

Slide 43: 

Hand washing technique

Avoid touching your eyes, nose or mouth. : 

Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

Practice other good health habits. : 

Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious. Unnecessary Migration of people from epidemic and endemic areas to be reduced.

Is eating Pork meat safe during Epidemics : 

Is eating Pork meat safe during Epidemics Swine influenza viruses are not spread by food. You cannot get swine influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe.

Healthy Habits reduces the Attacks : 

Healthy Habits reduces the Attacks

Simple measures carry get good Benefits : 

Simple measures carry get good Benefits Cover your mouth and nose. Use a tissue when you cough or sneeze and drop it in the trash. If you don’t have a tissue, cover your mouth and nose as best you can.

Clean Hands saves you : 

Clean Hands saves you Clean your hands often. Clean your hands every time you cough or sneeze. Hand washing stops germs. Alcohol-based gels and wipes also work well.

Cartoonists Imagination on Swine Flu : 

Cartoonists Imagination on Swine Flu

Summary : 

Summary WHO raised the alert level to Phase 5 902 confirmed cases worldwide (17 countries) with 20 deaths (Case-fatality ~ 2.2%) 2,029 suspected cases worldwide (11 countries) with 146 deaths (Case-fatality ~ 7%) 1,320 needed hospitalization US epidemiological data Median Age 16 years (range: 1-81 years) Over 80% of the cases in <18 years Male Female Ratio = 2:3 In Mexico, healthy young adults, (20-50 years) affected by the disease In EU, healthy young adults, (20-29 years) affected by the disease Huge disparity of mortality seen between Mexico and other countries such as US No vaccine is available Anti-virals available: Oseltamivir (Tamiflu) or Zanamivir (Relenza) EU issues a travel advisory to the 27 EU member countries recommending “non-essential” travel to affected parts of the U.S. and Mexico be suspended US issued a travel advisory that recommends against all non-essential travel to Mexico

Influenza A(H1N1) Current Global Situation : 

Influenza A(H1N1) Current Global Situation The WHO raised the alert level to Phase 5 WHO’s alert system was revised after Avian influenza began to spread in 2004, and April 27 was the first time it was raised above Phase 3 and on April 29 to Phase 5. European Union (EU) issued a travel advisory to the 27 EU member countries recommending that “non-essential” travel to affected parts of the U.S. and Mexico be suspended

Summary : 

Summary Swine flu

Flu & Swine Flu : 

Flu & Swine Flu

Symptoms & Precautionary Measures : 

Symptoms & Precautionary Measures

KEY FACTS : 

KEY FACTS

Antiviral Drugs and Swine Influenza : 

Antiviral Drugs and Swine Influenza

Do’s & Don’ts : 

Do’s & Don’ts

Alert : 

Alert

Created for Awarness on Swine Flu : 

Created for Awarness on Swine Flu Dr.Suhas Patil ,MD Paed. Email docspatil@gmail.com

authorStream Live Help