swine flu

Swine Flu : 

Swine Flu By Dr. Mustatab Ahmad H1N1 Flu

Antigenic shift : 

Antigenic shift "swine flu" technically is not swine flu. It is due to a new strain of influenza A virus subtype H1N1 derives from one strain of human influenza, one strain of avian influenza, two separate strains of swine influenza

Antigenic shift : 

Antigenic shift H1N1

H1N1 : 

H1N1

History : 

History The H1N1 form of swine flu is one of the descendants of the Spanish flu that caused a devastating pandemic in humans in 1918–1919 In 1957, an Asian flu pandemic infected some 45 million Americans and killed 70,000. It caused about 2 million deaths globally Eleven years later, lasting from 1968 to 1969, the Hong Kong flu pandemic afflicted 50 million Americans and caused 33,000 deaths In 1976, about 500 soldiers became infected with swine flu over a period of a few weeks.

Signs and symptoms : 

Signs and symptoms

Signs and symptoms : 

Signs and symptoms the symptoms of swine flu are similar to those of influenza and of influenza-like illness in general these symptoms are not specific to swine flu, a probable swine flu requires not only symptoms but also a high likelihood of swine flu due to the person's recent history.

Guidelines from CDC : 

Guidelines from CDC

Case Definitions for Infection with Swine Influenza A (H1N1) Virus : 

Case Definitions for Infection with Swine Influenza A (H1N1) Virus Confirmed case acute febrile respiratory illness with laboratory confirmed swine influenza A (H1N1) one or more of the following tests: real-time RT-PCR viral culture Probable case   a person with an acute febrile respiratory illness who is: positive for influenza A, 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.

Case Definitions for Infection with Swine Influenza A (H1N1) Virus : 

suspected case  a person with acute febrile respiratory illness with onset within 7 days of close contact with a person who is a confirmed case 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. Case Definitions for Infection with Swine Influenza A (H1N1) Virus

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Infectious period for a confirmed case of swine influenza A (H1N1) virus infection is defined as 1 day prior to the case’s illness onset to 7 days after onset. Close contact is defined as: within about 6 feet of an ill person who is a confirmed or suspected case of swine influenza A (H1N1) virus infection during the case’s infectious period Acute respiratory illness  is defined as recent onset of at least two of the following: rhinorrhea or nasal congestion, sore throat, cough (with or without fever or feverishness)

Antiviral Resistance : 

Antiviral Resistance sensitive (susceptible) to the neuraminidase inhibitor antiviral medications zanamivir and oseltamivir resistant to the adamantane antiviral medications, amantadine and rimantadine.

Treatment : 

Treatment Antiviral treatment with Zanamivir or Oseltamivir should be initiated as soon as possible after the onset of symptoms. Empiric antiviral treatment should be considered for confirmed, probable or suspected Treatment of hospitalized patients and patients at higher risk for influenza complications should be prioritized.

Treatment : 

Evidence for benefits from treatment is strongest when treatment is started within 48 hours of illness onset. Recommended duration of treatment is five days Recommendations for use of antiviral may change as data on antiviral susceptibilities and effectiveness become available. Treatment

Antiviral Chemoprophylaxis : 

Antiviral Chemoprophylaxis For antiviral chemoprophylaxis, either oseltamivir or zanamivir are recommended Duration of antiviral chemoprophylaxis post-exposure is 10 days after the last known exposure to an ill confirmed case. For pre-exposure protection, chemoprophylaxis should be given during the potential exposure period and continued for 10 days after the last known exposure to an ill confirmed case of swine influenza

Antiviral chemoprophylaxis : 

recommended for the following individuals: Household close contacts who are at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women) School children who are at high-risk for complications of influenza (children with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed, probable, or suspected case. Travelers who are at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women). Antiviral chemoprophylaxis

Antiviral chemoprophylaxis : 

Antiviral chemoprophylaxis Health care workers or public health workers who were not using appropriate personal protective equipment during close contact with an ill confirmed, probable, or suspect case of swine influenza A (H1N1) virus infection during the case’s infectious period.

Pre-exposure antiviral chemoprophylaxis : 

Pre-exposure antiviral chemoprophylaxis Any health care worker who is at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women) who is working in an area of the healthcare facility that contains patients with confirmed swine influenza A (H1N1) cases, or who is caring for patients with any acute febrile respiratory illness. Non-high risk persons who are travelers to Mexico, first responders, or border workers who are working in areas with confirmed cases of swine influenza A (H1N1) virus infection.

Pregnant Women : 

Pregnant Women Oseltamivir and zanamivir are "Pregnancy Category C" medications Because zanamivir is an inhaled medication and has less systemic absorption, some experts prefer zanamivir over oseltamivir for use in pregnant women when feasible.

combination of actions to reduce the risk for infection : 

combination of actions to reduce the risk for infection No single action will provide complete protection, but an approach combining the following steps can help decrease the likelihood of transmission. handwashing, covering coughs, having ill persons stay home, to seek medical care, minimize contact with others in the household voluntary home quarantine of members of households with confirmed or probable swine influenza cases, reduction of unnecessary social contacts, and avoidance whenever possible of crowded settings.

Face Masks & Respirators : 

Face Masks & Respirators If used correctly, facemasks and respirators may help reduce the risk of getting influenza, but they should be used along with other preventive measures, such as avoiding close contact and maintaining good hand hygiene.

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Whenever possible, rather than relying on the use of facemasks or respirators, close contact with people who might be ill and being in crowded settings should be avoided. Facemasks should be considered for use by individuals who enter crowded settings, both to protect their nose and mouth from other people's coughs and to reduce the wearers' likelihood of coughing on others; the time spent in crowded settings should be as short as possible.

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Respirators should be considered for use by individuals for whom close contact with an infectious person is unavoidable. This can include selected individuals who must care for a sick person (e.g., family member with a respiratory infection) at home

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"Facemasks" refers to disposable masks cleared by the U.S. Food and Drug Administration (FDA) for use as medical devices. This includes facemasks labeled as surgical, dental, medical procedure, isolation, or laser masks. "Respirator" refers to an N95 or higher filtering facepiece respirator certified by the U.S. National Institute for Occupational Safety and Health (NIOSH).

Correct way to put Respirator : 

Correct way to put Respirator

Countries Affected till now : 

Countries Affected till now

Mass Screening on Airports : 

Mass Screening on Airports

Things to do in Hospital : 

Things to do in Hospital Activate Infection Control Committee Hand Sanitizing spirits for wards and A&E Respirators in good amount for the staff Nurses to make sure that Doctors and other hospital staff do Hand washing. Administration to chalk down policies and procedures for Isolation & transfer of patients to MOH designated isolation areas Immediate procurement of Antiviral Drugs for staff and patients And many more………….

Message to take home : 

Message to take home

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Thank You