SWINE FLU (INFLUENZA)
Does the world face a deadly Pandemic?
The head of the World Health Organization (WHO) says the swine flu outbreak in Mexico and the United States could develop into a pandemic. WHO Director-General Margaret Chan says the outbreak involves "an animal strain of the H1N1 virus, and it has pandemic potential."
Fukuda, WHO assistant director-general for Health Security and Environment, said, the outbreak has spread widely enough that efforts must focus on mitigation, because containment of the virus is no longer feasible.
A rising number of infections is causing concern across the globe. The flu has killed more than 150 people in Mexico. Nearly 100 people have been infected in other countries, including the United States, Canada, Spain and New Zealand. The number of infections is steadily rising around the globe. The Center for Disease Control officials have said they believe the virus is spreading person-to-person, but are unsure how quickly it spreads or how long it takes for the infection to appear.
What is the Swine flu?
The Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses (H1N1) that causes regular outbreaks in pigs. People do not normally get swine flu, but human infections can and do happen as indicated with the current worldwide outbreak. This new strain of the swine flu virus actually has a mixture of swine and avian components (not to be confused with the deadly avian flu of Southeast Asia).
Is this swine flu virus contagious?
The Swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it not known how easily the virus spreads between people. 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. The incubation time is between 24 and 48 hours, however it can be as long as 5 days. Flu symptoms can last between 7 to 10 days
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. Sneezing can spread the virus to people up to 5 to 20 feet. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
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.
What can I do to protect myself 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 to touch surfaces that may be contaminated with the flu virus.
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, it is recommended that you stay home from work or school and limit contact with others to keep from infecting them.
Are there medicines to treat swine flu?
Yes the use of oseltamivir or zanamivir (brand names Tamiflu and Relenza) for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better 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).
Is there a vaccine for Swine Flu?
No, there is no current vaccine for the swine Flu. However the CDC and WHO has this current strain of virus and will consider whether to add it to next year’s flu vaccine as time goes on.
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
• Severe or persistent vomiting
The earliest known case was at a Mexican pig farm nearby La Gloria whose nearby neighbors had been complaining about the smell and flies. The outbreak was first detected in Mexico City, where surveillance began picking up a surge in cases of Influenza like illness (ILI) starting March 18. The surge was assumed by Mexican authorities to be "late-season flu" (which usually coincides with a mild Influenzavirus B peak) until April 21, when a U.S. Centers for Disease Control and Prevention alert concerning two isolated cases of a novel swine flu was reported in the media. The first two cases identified (and confirmed) as swine flu were two children living in the United States, in San Diego County and Imperial County, California, who became ill on March 28 and 30. This new strain was promptly confirmed in Mexico, connecting the new strain to the ongoing outbreak of ILI. The first deadly case seems to go back to April 13, where it is believed that the first case was in a woman from Oaxaca. Some samples were sent to the U.S.-based CDC on April 18. News of the connection was broadcast live in Mexico on April 23, 2009.
In March and April 2009, over 1000 cases of suspected swine flu in humans were detected in Mexico and the southwestern United States. The strain appears to be unusually lethal in Mexico, causing 152 deaths (20 confirmed) so far, mostly in Mexico City. There have also been cases reported in the states of San Luis Potosí, Hidalgo, Querétaro and Mexico State, all in central Mexico; Some cases in Mexico and the United States have been confirmed by the World Health Organization to be a never-before-seen strain of H1N1. The Mexican fatalities are mainly young adults of 25 to 45, a hallmark of pandemic flu. A new swine flu strain was confirmed in 16 of the deaths and at least 100 others were being tested as of April 24, 2009. Mexican Health Minister José Ángel Córdova on April 24, said "We’re dealing with a new flu virus that constitutes a respiratory epidemic that so far is controllable."
The origins of the new virus strain remain unknown. One theory is that Asian and European strains traveled to Mexico in migratory birds or in people, then combined with North American strains in Mexican pig factory farms before jumping over to farm workers. The Mexican health agency acknowledged that the original disease vector of the virus may have been flies multiplying in manure lagoons of pig farms near Perote, Veracruz.
Confirmed cases as of 04/27/2009
Canada: 6 cases
Mexico: 149 deaths
Spain: 1 case
U.K.: 2 cases
U.S.: 40 cases
Suspected cases as of 04/27/2009
Mexico: 1,614 cases
France: 1 case
Israel: 1 case
New Zealand: 10 cases
Spain: 7 cases
World Health Organization Pandemic Influenza Phases
The World Health Organization raised the pandemic alert to phase 4 on Monday (April 27,2009) in reaction to the rapidly spreading swine flu. Phase 4 signifies a sharp increase in the risk of a global flu epidemic, but does not mean a pandemic is certain. Phase 6 is the alert for a full-blown pandemic.
•Phase 1 no viruses circulating among animals have been reported to cause infections in humans.
•Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.
•Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.
•Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.
•Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.
•Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.
• During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.
• Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.
• In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required.
Worse case (using USA as an Example)
A full-scale pandemic — if it ever comes — could be expected to claim the lives of about 2 percent of those infected, about 2 million Americans.
The government estimates that a pandemic like the 1918 Spanish flu would sicken 90 million Americans, or about 30 percent of the population. Of those, nearly 10 million would have to be admitted to a hospital, and nearly 1.5 million would need intensive care. About 750,000 would need the help of mechanical ventilators to keep breathing.
No one would be immune from the consequences, even those who don't get sick, according to worst-case exercises run by local and national agencies.
• Schools would be closed to try to block the spread of illness, for example, but school buses might be used to take flu victims to alternative clinics rather than overcrowded hospitals.
• Businesses would be forced to use telecommuting to remain in business
• A 2006 report on the Washington region found both Maryland and Virginia would run out of hospital beds within two weeks of a moderate outbreak.
• People who got sick would be isolated, and their relatives could be quarantined.
• But even if families weren't required to stay home, many would do so to take care of sick relatives, or because they were afraid of getting sick themselves.
• Hotels, restaurants and airlines would face loss of business as business travel and meetings would be replaced by teleconferences.
• Families, businesses, churches and Governmental agencies would be vastly affected.
Worldwide, The disease would skip from city to city over an 18-to-24 month period, infecting more than a third of the population. World health Organization officials believe as many as 1.5 billion people around the globe would seek medical care and nearly 30 million would seek hospitalization. Based on the last pandemic and current world population, as many as 7 million people could die, epidemiologists said.