swine flu

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SITABAI THITE COLLEGE OF PHARMACY(POLY.),SHIRUR PROJECT PRESENT BY Chetan B.Phalke Vaishali R.Pingale Chaitali A.Pokharana Sonali G. Potghan (S.Y.D.PHARM) GUIDED BY Ms.Bhandari. S. S M.Pharm Lecturer

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INTRODUCTION -This article discusses the pathogenic disease in pigs. For the global spread of H1N1 in 2009, see Pandemic Influenza A (H1N1) in 2009. -The swine flu is a viral disease that attacks the pig but is occasionally transmitted to humans. -The swine flu (also known as swine flu or flu pork) is an infectious disease caused by any virus belonging to the family Orthomyxoviridae, which is endemic in populations pig. -These strains virus, known as swine influenza virus or SIV have been classified into Influenza virus C or one of the subtypes of the genus Influenza virus A (being the best known strains H1N1, H3N2, H3N3, isolated in Quebec - and H1N2, isolated in Japan and Europe).

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- The H1N1 is a descendant of the Spanish Flu which was a pandemic disease in the 2 nd decade of the 20 th century during 1918-1920 . -After the completion of the pandemic virus persisted in pigs, and with it the descendants of the 1918 virus have circulated in humans over the course of the twentieth century, contributing to the appearance of normal seasonal influenza annually. However, direct transmission from pigs to humans is quite rare, with only 12 cases have shown in the United States since 2005. -The influenza virus has been considered one of the most elusive until now known by medical science because of its constant change to get around the antibody protectors have been developed after a previous exposure or flu vaccines. HISTORY

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CLASSIFICATION Influenza C -It is a virus belonging to the family Orthomyxoviridae, which includes the viruses causing the flu. -The only species of this genus is called "influenza C". -It has been confirmed that influenza C viruses infect humans and pigs, causing flu. -However, influenza type C is not very common in comparison with influenza A virus and influenza B virus, but can become severe and cause epidemics premises.

Influenza A :

Influenza A -It is known that the swine flu caused by viruses of influenza A (H1N1), H1N2, H3N1, H3N2 and H2N3. -In the town there are three subtypes of swine influenza A (H1N1, H3N2 and H1N2) circulating throughout the world. -In the United States, the H1N1 subtype has been a frequent cause of infection among the population before swine until 1998, but since late August of that year, the H3N2 subtype was isolated from pigs. Since 2004, the H3N2 virus strains isolated in Turkey and United States, but came to find genetic traces of human (HA, NA and PB1), swine (NS, NP, and M) and poultry (PB2 and PA ).

PRECAUTION :

PRECAUTION

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Hand washing stops germs. Alcohol-based gels and wipes also work well. Washing Hands

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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 Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. Avoid close contact

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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

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THE SURGICAL MASK Prevents droplets and viruses that are more than 4 microns in diameter Made of paper with a gelatinous layer. Advantages Comfortable, provides good ventilation, tie straps can be adjusted to fit heads of different sizes, including children Disadvantages Must be changed every four hours, or once it becomes wet with fluid. For people who wear specs, vapour will keep forming on their lenses.

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The material used generates static electricity, which is effective in catching very small particles. Particles above 0.3 micron cannot pass through. Advantages Made of polypropylene fibre, using a nonwoven technology that increases the density and filtering function Disadvantages Wearer might experience breathing difficulties Children may not be able to cover up the nose and mouth completely THE N-95 MASK

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During Hospital Care Admitted directly to the isolation facility To wear a three layer surgical mask, gowns, goggles, gloves, cap and shoe cover The identified medical, nursing and paramedical personnel Attending the suspect/ probable/ confirmed case should wear Full complement of PPE (including N95 mask). If splashing with blood or other body fluids is anticipated, a water proof apron should be worn over the PPE. Aerosol-generating procedures ( endotracheal intubation, nebulisation , induction and aspiration of sputum, airway suction, chest physiotherapy and ppv ) should be performed by the treating physician/ nurse wearing PPE

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Patient rooms/areas should be cleaned daily Daily cleaning of floors and disinfecting frequently touched surfaces. To avoid possible aerosolization of the virus, damp sweeping should be performed. Horizontal surfaces should be dusted by moistening a cloth with a small amount of disinfectant. Precautions should continue in an adult patient for 7 days and 14 days after resolution of symptoms for children younger than 12 years

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Typical symptoms are: A sudden fever - 100 degrees F or above A sudden cough Other symptoms may include: Headaches Tiredness Chills Cough and sneezing Headache Weakness and fatigue Aching muscles and joints Sore throat Runny nose Diarrhea or stomach upset Loss of appetite SYMPTOMS

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Swine flu is presumptively diagnosed clinically by the patient's history of association with people known to have the disease and their symptoms listed above. Usually, a quick test (for example, nasopharyngeal swab sample) is done to see if the patient is infected with influenza A or B virus. Most of the tests can distinguish between A and B types Confirmation requires using a ‘Swine Influenza Test Kit’ to analyse samples from nasal, nasopharyngeal or throat swabs. DIAGNOSIS

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The best treatment for influenza infections in humans is prevention by vaccination . It is approved for use in healthy individuals ages 2 through 49. Two antiviral agents have been reported to help prevent or reduce the effects of swine flu. They are zanamivir (Relenza) and oseltamivir (Tamiflu), both of which are also used to prevent or reduce influenza A and B symptoms. These drugs should not be used indiscriminately, because viral resistance to them can and has occurred. TREATMENT

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GENERIC NAME: Oseltamivir BRAND NAME: Tamiflu STRUCTURE ( 3R,4R,5S)-4-acetylamino-5-amino-3(l- ethylpropoxy )-l- cyclohexene -l-carboxylic acid, ethyl ester, phosphate TAMIFLU

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PREPARATIONS : Capsules: 30, 45, and 75 mg. Suspension: 12 mg/ml STORAGE: Oseltamivir should be stored at room temperature, 15-30 C (59-86 F). SIDE EFFECTS : The most frequent side effects of oseltamivir are nausea , vomiting , diarrhea , bronchitis , abdominal pain , headache and dizziness . Administering oseltamivir after meals helps reduce nausea. Other reported adverse events include allergic reactions , skin reactions, seizures , behavioral disturbances, and aggravation of diabetes . For treatment twice a day for 5 days < 15 kg 30 mg 15 – 23 kg 45 mg 23 – 40 kg 60 mg > 40 kg 75 mg

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STRUCURE GENERIC NAME: zanamivir BRAND NAME: Relenza 5­( acetylamino )-4-[( aminoiminomethyl )-amino]-2,6-anhydro-3,4,5-trideoxy-D-glycero-D-galacto­non-2-enonic acid. RELENZA

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SIDE EFFECTS : The most frequent side effects are headaches , diarrhea , nausea , cough, vomiting and dizziness . Sinusitis , ear , nose, and throat infections may occur. Skin reactions, allergic reactions , bronchospasms , and behavioral disturbances have been reported. Patients who have asthma or other breathing problems that make them sensitive to inhaled particles should have a fast acting, inhaled bronchodilator available to treat any breathing problem that may occur when zanamivir is used PREPARATIONS : Inhalation Powder: 5 mg STORAGE: Zanamivir should be stored at room temperature, 15-30 C (59-86 F)

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VACCINE NASOVAC DESCRIPTION NASOVAC (Influenza Vaccine ( Human,Live Attenuated)) Pandemic (H1N1), freeze dried is a live monovalent vaccine for administration by intranasal spray. The influenza vaccine contains Influenza virus cultivated on embryonated eggs. COMPOSITION [Propagated in Embryonated hen eggs (SPF)] Each single dose of 0.5 ml contains: A/17/California/2009/38 > 10 7 EID50 Gelatin (Partially hydrolyzed) 2.5%, Sorbitol 5%, L- Alanine 0.1%, L- Histidine 0.21%, Tricine 0.3%, L-Arginine hydrochloride 1.6%, Lactalbumin hydrolysate 0.35%, Phosphate buffer saline Base Reconstitute with Sterile Water for Inhalation USP. The vaccine contains no preservatives.

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CONTRAINDICATIONS Hypersensitivity NASOVAC is contraindicated in individuals with a history of hypersensitivity, especially anaphylactic reactions, to eggs, egg proteins, gentamicin, gelatin, or arginine or with life-threatening reactions to previous influenza vaccinations. Concomitant Pediatric and Adolescent Aspirin Therapy and Reye's syndrome NASOVAC is contraindicated in children and adolescents (3-17 years of age) receiving aspirin therapy or aspirin containing-therapy, because of the association of Reye's syndrome with aspirin and wild-type influenza infection

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STORAGE NASOVAC (Influenza Vaccine( Human,Live Attenuated)) Intranasal SHOULD BE STORED IN A REFRIGERATOR AT 2-8ºC (35-46ºF) UPON RECEIPT AND UNTIL USE. THE PRODUCT MUST BE USED BEFORE THE EXPIRATION DATE ON THE LABEL. The cold chain (2 to 8ºC) must be maintained when transporting Influenza Vaccine(Human, Live Attenuated) Intranasal

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