Today is our topic of discussion Swine flu
Swine flu
Definition:
Swine flu refers to influenza cases that are caused by Swine influenza virus (referred to as SIV) endemic in pig populations.
Public health importance:
Like all influenza viruses, swine flu viruses change constantly. Pigs can be infected by avian influenza and human influenza viruses, as well as by swine influenza viruses. When influenza viruses from different species infect pigs, the viruses can reassort and new viruses that are a mix of swine, human and/or avian influenza viruses can emerge. Virus isolation from US swine in 2004 outbreak reveals triple reassorment of the virus containing genes from human, swine, and avian lineages. If such a virus infects humans, it may result into unnatural global pandemic, not amenable to traditional treatment.
Mode of transmission:
1. Directly transmitted from pigs to people and from people to pigs.
2. Peoples in close proximity to infected pigs, such as workers in the swine industry.
3. Human-to-human transmission of swine flu can also occur.
4. Ingestion of food containing pork products not properly handled and cooked.
[Cooking pork to a temperature of 160°F kills the swine flu virus as it does other bacteria and viruses]
Clinical manifestations:
1. Fever
2. Lethargy
3. Lack of appetite
4. Coughing
5. Runny nose, sore throat, nausea, vomiting and diarrhea.
6. The following warning signs in a child need urgent medical attention
a. Fast breathing or trouble breathing
b. Bluish skin color
c. Not drinking well
d. Not waking up or not interacting
e. Being so irritable that the child does not want to be held
f. Flu-like symptoms improve but after that fever and worse cough
g. Fever with a rash
Diagnosis:
Respiratory specimen collected within first 4 to 5 days of illness and sending the specimen to CDC-USA for laboratory testing.
Treatment:
1. Bed rest
2. Adequate hydration
3. Acetaminophen, ibuprofen, naproxen
4. Avoid aspirin in children
5. Antiviral drugs: Oseltamivir or zanamivir
6. Dose of oseltamivir: 75 mg bd for 5 days. Prophylaxis is 75 mg OD for 7 days after last exposure.
7. Prophylaxis: Household contacts, unprotected very close exposure to sick animals & health care workers with unprotected exposure to patients.
Indication for hospitalization:
a. Persistent fever
b. Productive cough
c. Increasing difficulty breathing
d. Improvement, followed by relapse
e. Pain or pressure in the chest or abdomen
f. Sudden dizziness.
g. Confusion
h. Severe or persistent vomiting
Prevention:
1. Yearly vaccinations.
2. Washing hands regularly
3. Avoid touching eyes, nose and mouth
4. Avoid close contact with sick people
5. Staying at home when sick
6. Covering the cough
Isolation precautions include:
1. Proper patient placement
2. Hand hygiene
3. Patient transport
4. Linen and laundry
5. Waste management
6. Decontamination of the materials used
7. Using personal protective equipments
Some facts about vaccine:
1. Vaccination does result in a mild reaction.
2. Influenza vaccines can reduce clinical illness, hospital admissions and deaths.
3. It requires 900 million eggs to make the 300 million doses of vaccine. If adequate chicken not available due to culling, it may result in inadequacy of sufficient doses of vaccine.
4. If someone is allergic to eggs he/she cannot be vaccinated using these vaccines.
5. So, due to this short supply, there remain doubts, that if a global pandemic starts, will the vaccine be
available for the Bangladeshi’s?
6. May or may not be. But, we can predict that most probably the vaccine may not reach to this level.
7. For this reason, better to take measure to boost our natural immune system by increasing intake of vitamins C and E, carotenoids and bioflavonoids, zinc and selenium, garlic, omega-3 fatty acid, lot of fruits and vegetables and fish.
8. Should avoid food habit that weakens our immune system. Such as: overdosing on sugar – one can of soft drink will reduce the ability of white blood cells by 40% for five hours; Excess alcohol – deprives the body of important nutrients and weaken the immune system; Too much fat/obesity depresses the immune system.
9. So, its time to get healthy. To do exercise, eat well and sleep.
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