swine (h1n1) flu infection

8/14/2019 Swine (H1N1) Flu Infection

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Novel Influnza A H1N1 Virus

Infection

This information is brought to you aspublic service from:

Shreya Life Sciences Pvt. Ltd


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Swine Flu Background

Second outbreak in 1976 in New Jersey

Vaccination halted after 40 million

vaccination due to appearance of Guillain-

Barre Syndrome and 25 deaths.

Increased flu risk in pregnant women,

particularly during the second and third

trimesters.

Increased risk of fetal death or spontaneous

abortions in infected pregnant women.


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Novel H1N1 flu infection

From April 15, 2009 to July 24, 2009, it isestimated that more than one million peoplebecame ill with novel H1N1 flu in the USA.

From April 15, 2009 to July 24, 2009, a total of 43,771 confirmed and probable cases of novelinfluenza A (H1N1) infection were reported.

Of these cases reported, 5,011 people werehospitalized and 302 people died.

In India 782 cases reported - 511 cured - 4 deaths.


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Novel H1N1 flu Global Map

Confirmed death and infections Confirmed infections

Unconfirmed infections


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Swine Flu Features

Duration 4 6 days.

Infectious period 1 day prior to onset of

symptoms to 7 days after onset.

Suspect in pt who present with febrile

respiratory illness

Onset within 7 days of close contact with

confirmed infection.

Onset within 7 days of travel to areas where

sustained human transmission exists

Acute illness in person who resides in

community where atleast 1 confirmed case.


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Symptoms & Complications

Symptoms of swine flu are similar to

influenza infections.

Strong immune response may cause

some collateral tissue damage.

Majority (about 90%-95%) of people

feel terrible but recover with no

problems.


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Symptoms & Complications Some patients develop severe

respiratory symptoms and needrespiratory support.

Patients may get pneumonia

(bacterial secondary infection) if theviral infection persists, and some

develop seizure.

Death often occurs from secondary

bacterial infection of the lungs;

appropriate antibiotics need to be

used in these patients.

Mortalit Rate 1% - 6%


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Novel Influenza A H1N1 virus

Novel H1N1 virus is also called swine flu

because many of the genes in this new virus

were very similar to influenza viruses that

normally occur in pigs (swine).

It has two genes from flu viruses that normally

circulate in pigs, bird (avian) genes and human

genes.

Scientists call this a "quadruple reassortant"

virus.


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Symptoms in hospitalized novelH1N1 flu patients

Symptom Number (%)

Fever* 249 (93%)

Cough 223 (83%)

Shortness of breath 145 (54%)

Fatigue/Weakness 108 (40%)Chills 99 (37%)

Myalgias 96 (36%)

Rhinorrhea 96 (36%)

Sore Throat 84 (31%)Headache 83 (31%)

Vomiting 78 (29%)

Wheezing 64 (24%)

Diarrhea 64 (24%)


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Signs of Emergency

Novel H1N1 swine flu can progress rapidly.

Shortness of breath, either during physical

activity or while resting, difficulty in breathing,

turning blue, bloody or colored (not clear)

sputum, chest pain.

Altered mental status.

High fever that persists beyond three days.

Low blood pressure.

In children, danger signs include fast or difficult

breathing,.


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Emergency in Children

In children, emergency warning signs are:

Fast breathing or trouble breathing

Bluish or gray skin color

Not drinking enough fluids

Severe or persistent vomiting

Not waking up or difficulty in waking

up, not interacting , lack of alertness,

little or no desire to play. Being so irritable that the child does

not want to be held

Flu-like symptoms improve but then

return with fever and worse cough


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Emergency in Adult s

In adults, emergency warning signs are:

Difficulty breathing or shortness of

breath

Pain or pressure in the chest or abdomen

Sudden dizziness

Confusion Severe or persistent vomiting

Flu-like symptoms improve but then

return with fever and worse cough


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Care for Swine Flu

Sick patient

Bed rest, increased fluid consumption, cough

supressants, analgesic antipyretics, avoid

close contact, wash hands after contact, avoid

touching eyes, nose and mouth.

Self isolate in home for 7 days or more if flu

like symptom.

Wear face mask, if going out.

Seek medical help if breathing difficulty or

severe illness .


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Care for Swine Flu

Household not sick

Remain at home at the earliest signs of

sicknes.

Minimize contact with community

Designate single family member as care

taker.

Wash hands with soap and water frequently.

Do not use utensils and linen used by patient,

without washing.


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Estimated community rate of influenza-like-illness approximately 6% - 6.9% of the

population.

Causes greater disease burden on people

younger than 25 years of age than older

people .


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Greater risk of serious flu-related

complications in pts of asthma, diabetes,

heart disease, kidney disease, suppressedimmune system, neurocognitive,

neuromuscular disorder, obesity, age group

65 yr and pregnancy.


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The generation time

acute respiratory illness (ARI) - 2.0-3.1 days

influenza like illness (ILI) - 2.4-3.1 days

A secondary attack rate in household contacts

For acute-respiratory-illness (ARI) -18 % to

19%

For influenza-like-illness (ILI) - 8% to 12%.


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Preventive Care

People infected with novel H1N1 flu shed virus

may be able to infect others from 1 day before

getting sick to 5 to 7 days after.

Cover nose and mouth with a tissue when

you cough or sneeze.

Wash hands often with soap and water,

especially after you cough or sneeze.


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Preventive Care

Avoid touching eyes, nose or mouth.

Try to avoid close contact with sick people.

If sick with flu-like illness, stay home for at

least 24 hours after your fever is gone.

Healthy person with an ill family member at

home can go to work as usual with daily

health monitoring and precautions.


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Case Rate

Hospitalization Rate


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Mortality in 268 Hospitalized Patients


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Contamination & Cleaning

Virus can survive on surfaces and can infect a

person for 2 to 8 hours after being deposited

on the surface.

Virus is destroyed by heat (167-212F [75-

100C, chlorine, hydrogen peroxide,

detergents (soap), iodophors (iodine-based

antiseptics), and alcohols. Virus spread when a person touches

something that is contaminated and then

touches his or her eyes, nose, or mouth .


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Novel H1N1 viruses are not spread by food.

Tap water that has been treated by

conventional disinfection processes does not

spread the virus.

Chlorine treated water in swimming pool water

parks does not spread the virus but

recreational water venues can.


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To prevent the spread of influenza virus

keep surfaces (especially bedside tables,

surfaces in the bathroom, kitchen counters

and toys for children) clean with a

household disinfectant.

Linens, eating utensils, and dishes should

not be shared without washing thoroughly

with soap and water first.

Wear face mask when moving in public

laces


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RecommendedTreatment & Prophylaxis

Treatment

Same as those recommended for seasonal

influenza

Oseltamivir, zanamivir ( amantadine,

rimantadine) for 5 days.

Start drug treatment within 48 hours of

onset of symptoms.

R d d


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RecommendedTreatment & Prophylaxis Chemoprophylaxis

Oseltamivir, zanamivir for 7 days after the last

known exposure to an ill confirmed case.

Household close contacts who are at high-risk for

complications.

School children who had close contact (face-to-

face) with a confirmed or suspected case.

Travel to infection areas if at high-risk for complications.

Health care workers or public health workers who

had unprotected close contact with an ill confirmed

case.


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Preventive Measures In School

Stay home when sick for at least7 days or for

24 hours after no fever, or signs of fever.

Students who have an ill household member

should stay home for five days from the day

the first household member got sick.

Separate ill students and staff and wear face

mask.

Cover nose and mouth when coughing or

sneezing.


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Preventive Measures In School

Wash hands frequently with soap and water.

Frequent cleaning of areas that students and

staff touch in routine manner.

Check students and staff for fever and other

symptoms of flu daily.

Early treatment of high-risk students and staff.

Consideration of selective school closure.


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All the best

swine (h1n1) flu infection

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