Swine Influenza and You

What is swine influenza?

Swine influenza, or “swine flu”, is a highly contagious acute respiratory disease of pigs, caused by one of several swine influenza A viruses. Morbidity tends to be high and mortality low (1-4%). The virus is spread among pigs by aerosols, direct and indirect contact, and asymptomatic carrier pigs. Outbreaks in pigs occur year round, with an increased incidence in the fall and winter in temperate zones. Many countries routinely vaccinate swine populations against swine influenza.

Swine influenza viruses are most commonly of the H1N1 subtype, but other subtypes are also circulating in pigs (e.g., H1N2, H3N1, H3N2). Pigs can also be infected with avian influenza viruses and human seasonal influenza viruses as well as swine influenza viruses.

The H3N2 swine virus was thought to have been originally introduced into pigs by humans. Sometimes pigs can be infected with more than one virus type at a time, which can allow the genes from these viruses to mix. This can result in an influenza virus
containing genes from a number of sources, called a “reassortant” virus. Although swine influenza viruses are normally species specific and only infect pigs, they do sometimes cross the species barrier to cause disease in humans.

What are the implications for human health?

Outbreaks and sporadic human infection with swine influenza have been occasionally reported. Generally clinical symptoms are similar to seasonal influenza but reported clinical presentation ranges broadly from asymptomatic infection to severe pneumonia resulting in death.

What are the signs and symptoms of swine flu in people?

The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

How does swine flu spread?

Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How can someone with the flu infect someone else?

Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

What should I do to keep from getting the flu?

First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.

Is there a human vaccine to protect from swine influenza?

There are no vaccines that contain the current swine influenza virus causing illness in humans. It is not known whether current human seasonal influenza vaccines can provide any protection. Influenza viruses change very quickly. It is important to develop a
vaccine against the currently circulating virus strain for it to provide maximum protection to the vaccinated people. This is why WHO needs access to as many viruses as possible in order to select the most appropriate candidate vaccine virus.

What drugs are available for treatment?

There are two classes of such medicines, 1) adamantanes (amantadine and remantadine), and 2) inhibitors of influenza neuraminidase (oseltamivir and zanamivir). Most of the previously reported swine influenza cases recovered fully from the disease without requiring medical attention and without antiviral medicines. Some influenza viruses develop resistance to the antiviral medicines, limiting the effectiveness of treatment. The viruses obtained from the recent human cases with swine influenza in the United States are sensitive to oselatmivir and zanamivir but resistant to amantadine and remantadine.

Information is insufficient to make recommendation on the use of the antivirals in treatment of swine influenza virus infection. Clinicians have to make decisions based on the clinical and epidemiological assessment and harms and benefit of the treatment of the patient2. For the ongoing outbreak of the swine influenza infection in the United States and Mexico, the national and the local authorities are recommending to use oseltamivir or zanamivir for treatment of the disease based on the virus’s susceptibility profile.

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.

What can I do to protect myself from getting sick?

There is no vaccine available right now to protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread this way.
  • Try to avoid close contact with sick people.
  • If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

What should I do if I get sick?

If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.

If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.

If you become ill and experience any of the following warning signs, seek emergency medical care.

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

In adults, emergency warning signs that need urgent medical attention include:

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting

Guidance for Clinicians & Public Health Professionals

Clinicians

Clinicians should consider the possibility of swine influenza virus infections in patients presenting with febrile respiratory illness.

If swine flu is suspected, clinicians should obtain a respiratory swab for swine influenza testing and place it in a refrigerator (not a freezer). Once collected, the clinician should contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory.

State Public Health Laboratories

Laboratories should send all unsubtypable influenza A specimens as soon as possible to the Viral Surveillance and Diagnostic Branch of the CDC’s Influenza Division for further diagnostic testing.

Public Health /Animal Health Officials

Officials should conduct thorough case and contact investigations to determine the source of the swine influenza virus, extent of community illness and the need for timely control measures.

Guidance Documents

  1. Interim Guidance for Swine influenza A (H1N1): Taking Care of a Sick Person in Your Home Apr 25, 2009
  2. Interim Guidance on Antiviral Recommendations for Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection and Close Contacts Apr 25, 2009
  3. Interim CDC Guidance for Nonpharmaceutical Community Mitigation in Response to Human Infections with Swine Influenza (H1N1) Virus Apr 26, 2009, 11:45 PM ET
  4. Swine Influenza A (H1N1) Virus Biosafety Guidelines for Laboratory Workers Apr 24, 2009
  5. This guidance is for laboratory workers who may be processing or performing diagnostic testing on clinical specimens from patients with suspected swine influenza A (H1N1) virus infection, or performing viral isolation.
  6. Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting Apr 24, 2009
  7. Interim Guidance on Case Definitions to be Used For Investigations of Swine Influenza A (H1N1) Cases Apr 26, 2009

 

KEY CONTACTS FOR CENTERS INVOLVED IN RESEARCH TOUCHING VIRUSES

 USAMRU-K GEIS Program at KEMRI
National Influenza Centre
Kenyatta National Hospital Complex
Hospital Road
P.O. Box 29893 -00202
Nairobi
Kenya
Office: +254 20 272 9303; Fax: +254 272 145 92

 Principal investigator: : Wallace D. Bulimo, PhD
EMAIL: WBulimo@wrp-nbo.org

Centre for Virus Research (CVR)
Physical Location: KEMRI Headquarters Complex, Nairobi
Kenya Medical Research Institute
P.O. Box 54840,00200
Tel +254 20 2722541
Fax +254 20 2720030
Nairobi, Kenya

Director: Dr. F.A.Okoth
EMAIL: FOkoth@kemri.org

In case you suspect yourself or some else is infected contact urgently

KENYATTA NATIONAL HOSPITAL

Physical Location
KNH is located along the Hospital Road (off Ngong Road). On the northern side, It faces Ngong Road near its round about with Mbagathi Road. On the eastern side is Hospital Road and to the West is Mbagathi Road. To the south of the hospital compound is the Nairobi Kisumu railway line.

Public Transport
The Hospital is about 4 km from the General Post Office (GPO) and you can reach us by using bus route No. 7C. Public transport services (taxis, car hire) are familiar with our location.

Telephone
+254 20 2726300 19 Ext 43121, Hotline: +254 20 2737390, Mobile: +254 722 829 500-2 or +254 733 606 400.
E-mai:l knhadmin@knh.or.ke
Postal address: P. O. Box 20723 – 00202 Nairobi. Fax +254 020 2725272

 

Disclaimer: Links to outside this blog are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by Afyanet Africa, and none should be inferred. Afyanet Africa is not responsible for the content of the individual organization Web pages found at these links. Most of this content has been adapted from WHO and CDC websites

 

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