What You Should Know About Swine Influenza (Swine Flu)

PANDEMIC DECLARED
What you should know about swine influenza (swine flu)

Background

It has been over almost three months since the initial reports of a new swine influenza virus (Influenza A: H1N1) emerging as the cause of an acute respiratory illness. These reports originated from Mexico and in the ensuing weeks, cases have been reported throughout the world. As a result of continued swine influenza activity, the World Health Organization (WHO) has declared the swine influenza outbreak a pandemic which signifies a global epidemic. It is being characterized as moderate in severity. As of this report, over 100 countries have reported close to 100,000 cases of swine influenza, with 429 deaths. Of note, about half of the deaths have occurred in previously young and healthy individuals, which is not the typical at risk group for deaths from influenza. However, the risk of pneumonia and death with swine flu continue to be highest for those with underlying medical conditions, especially chronic respiratory illnesses.

WORLD HEALTH ORGANIZATION ( WHO) UPDATE JULY 2009

The World Health Organization (WHO) is expected to reccomend countries with major swine flu outbreaks to discontinue time consuming laboratory confirmation of cases and to focus instead on other indicators, "such as the number of people with flu-like symptoms and cases of pneumonia," according to WHO assistant director-general Dr. Keiji Fukuda in a telephone news conference.

Labs are reportedly becoming overwhelmed and reporting it is  "very hard to keep up" with testing. New WHO guidelines will "ease the burden on laboratories," as most major outbreaks show over 95% of flu cases lab-test as H1N1.

"In countries with no cases, we will continue to recommend that people be tested so the presence of the new virus can be confirmed. In all countries, we will continue to stress testing for unusual cases, clusters, unusually severe cases and new symptoms." sadi Fukuda

In the Western hemisphere, the United States, Canada and Mexico have the greatest number of reported cases. The Centers for Disease Control have been tracking cases since initial reports and there are now cases reported in every state. There have been almost 34,000 confirmed cases in the United States with 170 confirmed deaths. Wisconsin has the highest number of cases with almost 6000 cases. There have been almost 2000 cases in California with 21 deaths, including patients in Los Angeles County attributed to the virus. Most of the reported cases remain mild in severity. It is estimated that over 1 million Americans have been infected with the virus, although most cases have been mild. Transmission of the virus appears to be through human-to-human contact.

While there has been an expected seasonal decline in overall influenza, H1N1 influenza has continued to circulate and has become the predominant strain of influenza A with 98% of isolates in California identified as H1N1. It is anticipated that patients with influenzal illnesses will continue to seek medical attention throughout the summer months. H1N1 influenza is spreading rapidly through South America and Europe. It is espected that there will be about 100,000 daily cases in Great Britain by the end of August.

It remains too early to characterize the full impact of this new strain of influenza. Its impact on the upcoming influenza season is not predictable. Most people have little or no immunity to this strain, and there is no current vaccine, although a vaccine should be available in the latter part of this calendar year in time for the traditional influenza season. As with any viral or influenzal illness, common sense measures outlined in this article and hand washing remain crucial for disease control.

What are symptoms of swine flu?

Symptoms associated with swine flu are the same as with any influenza (flu-like) illness. The incubation period is 1-7 days and the most common symptoms include fever, headache, cough, sore throat and myalgias (muscle aching). Other symptoms include a runny nose, nausea, vomiting, and diarrhea.

What happens to people with swine flu infections?

For most, the illness is mild and people recover without any special treatment. The illness lasts about 4-6 days and resolves with supportive care (fluids, rest, anti-pyretics such as acetaminophen or ibuprofen).
Note that aspirin or aspirin containing products (e.g. bismuth subsalicylate - Pepto Bismol®) SHOULD NOT be given to children with suspected influenzae or swine influenza who are under the age of 18 years because of the risk of Reye syndrome).

However, the illness can be more severe in some patients. Those who develop worsening symptoms such as breathing difficulties, severe dehydration, dizziness, confusion, persistent lethargy, or fever with a rash should seek immediate medical attention as these symptoms may warrant additional treatment including hospitalization.

Is there a treatment for swine flu?There is no current vaccine for swine flu. However, you can still be vaccinated if you have not been vaccinated with this season's flu. There are still flu cases in the community.

This strain appears to be sensitive to neuraminidase inhibitors, a type of antiviral agent and patients who warrant treatment should be managed according to guidelines. Contact your physician if there are questions.

Antiviral doses and schedules recommended for treatment of swine influenza A (H1N1) virus infection are the same as those recommended for seasonal influenza. For more information, click here.

How can one reduce the risk of getting swine flu?

There are common sense measures that can help prevent respiratory illnesses like influenza.

• Cover the nose and mouth whenever one coughs or sneezes. Use a tissue and then throw the tissue in the trash.
• Good hand washing with soap and water, especially after coughing or sneezing. Alcohol-based hand cleaners are also effective. Wash or use hand cleaners frequently.
• Avoid close contact with sick people, especially if they are coughing or sneezing.
• If you get sick with influenza, stay home from work or school to limit contact with others to keep from spreading the infection.

Can I get swine influenza from eating or preparing pork?

No. 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.

For the most current US information see Centers for Disease Control website.

Please note that this information is changing rapidly, should be considered interim and is being updated as new information becomes available.
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