Author Topic: H1N1 Influenza (Swine Flu)  (Read 6335 times)

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Offline dr-awale

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H1N1 Influenza (Swine Flu)
« on: May 12, 2009, 07:17:53 PM »
Introduction
Swine influenza is a highly contagious respiratory disease in pigs caused by one of several swine influenza A viruses. In addition, influenza C viruses may also cause illness in swine. Current strategies to control swine influenza virus (SIV) in animals typically include one of several commercially available bivalent swine influenza virus vaccines.

Transmission of swine influenza viruses to humans is uncommon. However, the swine influenza virus can be transmitted to humans via contact with infected pigs or environments contaminated with swine influenza viruses. Once a human becomes infected, he or she can then spread the virus to other humans, presumably in the same way as seasonal influenza is spread (ie, via coughing or sneezing).

History

The ability to trace outbreaks of swine flu in humans dates back to investigation of the 1918 Spanish influenza pandemic, which infected one third of the world’s population (an estimated 500 million people) and caused approximately 50 million deaths. In 1918, the cause of human influenza and its links to avian and swine influenza was not understood. The answers did not begin to emerge until the 1930s, when related influenza viruses (now known as H1N1 viruses) were isolated from pigs and then humans.1

In humans, the severity of swine influenza can vary from mild to severe. From 2005 until January 2009, 12 human cases of swine flu were reported in the United States. None were fatal. In 1988, however, a previously healthy 32-year-old pregnant woman in Wisconsin died of pneumonia as a complication of swine influenza.

A 1976 outbreak of swine influenza in Fort Dix, New Jersey, involved more than 200 cases, some of them severe, and one death.2 The first discovered case involved a soldier at Fort Dix who complained of feeling weak and tired. He died the next day.

The fear of an influenza pandemic in 1976 led to a national campaign in the United States designed to immunize nearly the entire population. In October, 1976, approximately 40 million people received the A/NewJersey/1976/H1N1 vaccine (ie, swine flu vaccine) before the immunization initiative was halted because of the strong association between the vaccine and Guillain-Barré syndrome (GBS).3,4 About 500 cases of GBS were reported, with 25 deaths due to associated pulmonary complications.5

A recent investigation sought to determine the link between GBS and the 1976 swine flu vaccine, since subsequent influenza vaccines did not have this strong association. Nachamkin et al (2008) found that inoculation of the 1976 swine flu vaccine, as well as the 1991-1992 and 2004-2005 influenza vaccines, into mice prompted production of antibodies to antiganglioside (anti-GM1), which are associated with the development of GBS. They proposed that further research regarding influenza vaccine components is warranted to determine how these components elicit antiganglioside effects.6




This preliminary negative stained transmission electron micrograph depicts some of the ultrastructural morphology of the A/CA/4/09 swine flu virus. Courtesy of CDC/ C. S. Goldsmith and A. Balish.
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This preliminary negative stained transmission electron micrograph depicts some of the ultrastructural morphology of the A/CA/4/09 swine flu virus. Courtesy of CDC/ C. S. Goldsmith and A. Balish.


This preliminary negative stained transmission electron micrograph depicts some of the ultrastructural morphology of the A/CA/4/09 swine flu virus. Courtesy of CDC/ C. S. Goldsmith and A. Balish.
[ CLOSE WINDOW ]

This preliminary negative stained transmission electron micrograph depicts some of the ultrastructural morphology of the A/CA/4/09 swine flu virus. Courtesy of CDC/ C. S. Goldsmith and A. Balish.


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Offline dr-awale

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Re: H1N1 Influenza (Swine Flu)
« Reply #1 on: May 12, 2009, 07:28:26 PM »
Current H1N1 influenza (formerly called swine influenza) outbreakHuman cases of influenza A (H1N1) have been reported worldwide. In 2009, cases of influenzalike illness were first reported in Mexico on March 18; the outbreak was subsequently confirmed as H1N1 influenza A.7 Investigation is continuing to clarify the spread and severity of H1N1 influenza (swine flu) in Mexico. Suspected clinical cases have been reported in 19 of the country's 32 states. Although only 97 of the Mexican cases have been laboratory-confirmed as Influenza A/H1N18 (12 of them genetically identical to Influenza A/H1N1 viruses from California7 ). As of May 5th, 2009, nearly 600 H1N1 influenza cases have been confirmed in Mexico, including 25 deaths.9

According to the WHO, as of May 4, 2009, H1N1 influenza had been laboratory-confirmed in 20 countries.8 For an updated tally of affected countries and counts, see WHO's Influenza A (H1N1) Web page. Cases are also suspected in Brazil.

On April 17, 2009, the CDC determined that two cases of febrile respiratory illness in children who resided in adjacent counties in southern California were caused by infection with a swine influenza A (H1N1) virus.10 By April 26, 2009, the US Department of Health and Human Services declared a national public health emergency involving H1N1 influenza A, citing its significant potential to affect national security.11 By May 5, 2009, more than 400 cases of H1N1 influenza had been confirmed in nearly all states within the United States and more than 1000 cases in 21 countries worldwide.8,12

For an updated tally and case counts in specific states, see the CDC's H1N1 Flu (Swine Flu) Web page. All affected patients have had mild influenzalike illness, with only two requiring brief hospitalization. As of May 1, 2009, only one death attributed to H1N1 flu had been reported in the United States, involving a 23-month-old child from Mexico who was visiting relatives in the United States.

Government and public health officials are monitoring this situation worldwide to assess the threat from H1N1 influenza and to provide guidance to health care professionals and the public. Because the situation is changing rapidly, it is important to check regularly for changes in recommendations as new information becomes available. Online resources for daily guidance include the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and Medscape's H1N1 Influenza A (Swine Flu) Alert Center.


Morbidity and Mortality
H1N1 influenza (swine flu) tends to cause high morbidity but low mortality rates (1%-4%).

Symptoms
Manifestations of H1N1 influenza (swine flu) are similar to those of seasonal influenza. Patients present with symptoms of acute respiratory illness, including at least 2 of the following:



Fever
Cough
Sore throat
Body aches
Headache
Chills and fatigue
Diarrhea and vomiting (possible)
Persons with these symptoms should call their health care provider promptly. If an antiviral agent is warranted, it should ideally be initiated with 48 hours from the onset of symptoms (see Medications). The duration of illness is typically 4-6 days. The infectious period for a confirmed case is defined as 1 day prior to the onset of symptoms to 7 days after onset.

In children, signs of severe disease include apnea, tachypnea, dyspnea, cyanosis, dehydration, altered mental status, and extreme irritability
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Offline dr-awale

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Re: H1N1 Influenza (Swine Flu)
« Reply #2 on: May 12, 2009, 07:29:43 PM »
Treatment Recommendations
Treatment is largely supportive and consists of bedrest, increased fluid consumption, cough suppressants, and antipyretics and analgesics (eg, acetaminophen, nonsteroidal anti-inflammatory drugs) for fever and myalgias. Severe cases may require intravenous hydration and other supportive measures. Antiviral agents may also be considered for treatment or prophylaxis (see Medications).


Patients should be encouraged to stay home if they become ill, to avoid close contact with people who are sick, to wash their hands often, and to avoid touching their eyes, nose, and mouth. The CDC recommends the following actions when human infection with H1N1 influenza (swine flu) is confirmed in a community13 :

Home isolation

Patients who develop flulike illness (ie, fever with either cough or sore throat) should be strongly encouraged to self-isolate in their home for 7 days after the onset of illness or at least 24 hours after symptoms have resolved, whichever is longer.
To seek medical care, patient should contact their health care providers to report illness (by telephone or other remote means) before seeking care at a clinic, physician's office, or hospital.
Patients who have difficulty breathing or shortness of breath or who are believed to be severely ill should seek immediate medical attention.
If the patient must go into the community (eg, to seek medical care), he or she should wear a face mask to reduce the risk of spreading the virus in the community when coughing, sneezing, talking, or breathing. If a face mask is unavailable, ill persons who need to go into the community should use tissues to cover their mouth and nose while coughing.
While in home isolation, patients and other household members should be given infection control instructions, including frequent hand washing with soap and water. Use alcohol-based hand gels (containing at least 60% alcohol) when soap and water are not available and hands are not visibly dirty. Patients with H1N1 influenza should wear a face mask when within 6 feet of others at home.
Household contacts who are not ill


Remain home at the earliest sign of illness.
Minimize contact in the community to the extent possible.
Designate a single household family member as caregiver for the patient to minimize interactions with asymptomatic persons.
School dismissal and childcare facility closure

Strong consideration should be given to close schools upon a confirmed case of H1N1 flu or a suspected case epidemiologically linked to a confirmed case.
Decisions regarding broader school dismissal within these communities should be left to local authorities, taking into account the extent of influenzalike illness within the community.
Cancelation of all school or childcare related gatherings should also be announced.
Encourage parents and students to avoid congregating outside of the school if school is canceled.
Duration of schools and childcare facilities closings should be evaluated on an ongoing basis depending on epidemiological findings.
Consultation with local or state health departments is essential for guidance concerning when to reopen schools. If no additional confirmed or suspected cases are identified among students (or school-based personnel) for a period of 7 days, schools may consider reopening.
Schools and childcare facilities in unaffected areas should begin preparation for possible school closure.
Social distancing

Large gatherings linked to settings or institutions with laboratory-confirmed cases should be canceled (eg, sporting events or concerts linked to a school with cases); other large gatherings in the community may not need to be canceled at this time.
Additional social distancing measures are currently not recommended.
Persons with underlying medical conditions who are at high risk for complications of influenza should consider avoiding large gatherings
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Offline Dr.Adnan

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Re: H1N1 Influenza (Swine Flu)
« Reply #3 on: May 13, 2009, 05:16:47 PM »
Dr-awale thank you for your informative post about A/Mexico/2006/H1swineN1 or simply the swine influenza.

But for general information I just want to add that the general readers should not panic too much, because it is not as fatal as the media makes it , several weeks ago I have seen a question on aljazeera ( Does the swine influenza will terminate humanity - something like that in arabic-) I joked my food because swine influenza was not and is not that bad , Frankly speaking, media should talk about more serious infectious diseases than swine influenza by the way they don't add that those die because of this swine influenza are people of extreme age groups ( Less than 5 and more than 65) and immune compromised people. 
**Ruuxaan Dantiisiyo aqoon, waxa daryeelaaya**
**Inuu Deeqda Eebahay ka qaday, dib u xusuusnaada**
Hadraawi...

Offline Robert

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Re: H1N1 Influenza (Swine Flu)
« Reply #4 on: March 14, 2011, 12:15:26 PM »
Swine influenza is a hugely catching wheezing disease in pigs caused by one of several swine influenza A viruses.

Offline Aelred

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Re: H1N1 Influenza (Swine Flu)
« Reply #5 on: May 25, 2011, 06:49:07 AM »
Thanks dr-awale for your posting about the  swine flu and your posting is much helpful in all the aspects and have the much knowledge in that one postings..........


 

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