About Flu H1N1 (swine) influenza

H1N1 (swine) influenza
Treatment
Most people who get H1N1 flu will likely recover without needing medical care. Doctors, however, can prescribe antiviral drugs to treat people who become very sick with the flu or are at high risk for flu complications.

If you need treatment for H1N1 flu, the CDC recommends that your doctor give you zanamivir (Relenza) or osteltamivir (Tamiflu). These drugs work best if you receive them within 2 days of becoming ill. You may get them later if you are very sick or if you have a high risk for complications.

To prevent infection with H1N1 flu, people living in the same house as someone diagnosed with the virus should ask their doctor if they also need a prescription for these medicines. Careful respiratory hygiene and frequent hand-washing are also recommended steps for reducing the risk of getting H1N1 flu.

Aspirin or products that contain aspirin should not be given to anyone 18 years old or younger.

Causes
In the spring of 2009, cases of human infection with H1N1 flu were confirmed in Mexico and in several states in the United States. Cases of infection in humans were also reported in other countries.

The H1N1 flu virus is contagious and can spread from human to human. At this time, it is unknown how easily it can spread between people.

It is known that flu viruses can spread from pigs to people, and from people to pigs. However, you CANNOT get H1N1 flu virus from eating pork.

Human-to-human infection with the H1N1 flu virus likely occurs the same way as seasonal flu, when an infected person coughs or sneezes into air that others breathe in. People may also get infected by touching something with the virus on it, such as a door knob or counter, and then touching their mouth or nose.

You can find an updated case count of confirmed H1N1 flu infections in the U.S. at the Centers for Disease Control and Prevention (CDC) web site.

Tests & diagnosis
If you think you have been exposed to H1N1 influenza, call your health care provider before your visit. This will give the staff a chance to take proper precautions to protect them and other patients during your office visit.

If the H1N1 flu becomes widespread, there will be little need to continue testing people, so your health care provider may decide not to test for the flu virus.

Your doctor may perform the following physical exam:

Auscultation (to detect abnormal breath sounds)
Chest x-ray
Your doctor can test for the H1N1 flu virus using a nasopharyngeal swab (a swab of the back of the inside of your nose), or grow it in a culture. However, this will likely happen only if:

You are at high risk for flu complications.
You are very sick.

Prognosis
The outlook depends on the severity of the infection and the type of H1N1 influenza virus that caused it.

The H1N1 flu outbreak in Mexico has resulted in 106 confirmed deaths thus far. At least 27 deaths had been reported in the U.S. at the time of this writing. Deaths have occurred in other countries as well. Officials were preparing for more.

For more information, visit:

CDC – www.cdc.gov/swineflu
World Health Oganization – www.who.int/csr/disease/swineflu/en/index.html

Prevention
People who work with pigs who might be infected should use protective clothing and special breathing masks.

Other steps you can take:

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue away after using it.
Wash your hands often with soap and water, especially after you cough or sneeze. You may also use alcohol-based hand cleaners.
Avoid touching your eyes, nose, or mouth, to avoid getting infected by germs.
Avoid close contact with sick people.
If you do get sick, consider staying home from work or school.

Complications
Severe illness may occur along with:

Pneumonia
Respiratory failure
Death
Like seasonal flu, H1N1 flu may make other chronic medical problems worse.

A vaccination used to treat swine flu in 1976 was associated with some cases of Guillain-Barre syndrome, a disorder that leads to nerve inflammation that causes muscle weakness.

When to contact a doctor
If you are ill and have any of the following warning signs, seek emergency medical care.

In children, emergency signs include:

Fast breathing or trouble breathing
Bluish or gray skin color
Not drinking enough fluids
Severe or persistent vomiting
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 a worse cough
In adults, emergency signs include:

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 a worse cough

Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae (the influenza viruses), that affects birds and mammals. The name influenza is Italian and means “influence” (Latin: influentia). The most common symptoms of the disease are chills, fever, sore throat, muscle pains, severe headache, coughing, weakness and general discomfort. Sore throat, Fever and coughs are the most frequent symptoms. In more serious cases, influenza causes pneumonia, which can be fatal, particularly for the young and the elderly. Although it is often confused with other influenza-like illnesses, especially the common cold, influenza is a much more severe disease than the common cold and is caused by a different type of virus. Influenza may produce nausea and vomiting, particularly in children, but these symptoms are more common in the unrelated gastroenteritis, which is sometimes called “stomach flu” or “24-hour flu”.

Typically, influenza is transmitted through the air by coughs or sneezes, creating aerosols containing the virus. Influenza can also be transmitted by direct contact with bird droppings or nasal secretions, or through contact with contaminated surfaces. Airborne aerosols have been thought to cause most infections, although which means of transmission is most important is not absolutely clear.[4] Influenza viruses can be inactivated by sunlight, disinfectants and detergents. As the virus can be inactivated by soap, frequent hand washing reduces the risk of infection.

Influenza spreads around the world in seasonal epidemics, resulting in the deaths of hundreds of thousands worldwide annually, and millions in pandemic years. On average 41,400 people died each year in the United States between 1979 and 2001 from influenza.

Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans. Often, these new strains appear when an existing flu virus spreads to humans from other animal species, or when an existing human strain picks up new genes from a virus that usually infects birds or pigs. An avian strain named H5N1 raised the concern of a new influenza pandemic, after it emerged in Asia in the 1990s, but it has not evolved to a form that spreads easily between people. In April 2009 a novel flu strain evolved that combined genes from human, pig, and bird flu, initially dubbed “swine flu” and also known as influenza A/H1N1, emerged in Mexico, the United States, and several other nations. The World Health Organization officially declared the outbreak to be a “pandemic” on June 11, 2009. The WHO’s declaration of a pandemic level 6 was an indication of spread, not severity.

Vaccinations against influenza are usually given to people in developed countries and to farmed poultry.The most common human vaccine is the trivalent influenza vaccine (TIV) that contains purified and inactivated material from three viral strains. Typically, this vaccine includes material from two influenza A virus subtypes and one influenza B virus strain. The TIV carries no risk of transmitting the disease, and it has very low reactivity. A vaccine formulated for one year may be ineffective in the following year, since the influenza virus evolves rapidly, and new strains quickly replace the older ones. Antiviral drugs can be used to treat influenza, with neuraminidase inhibitors being particularly effective.

Prevent Swine Flu – Good Advice

The only portals of entry are the nostrils and mouth/throat. In a global epidemic of this nature, it’s almost impossible to avoid coming into contact with H1N1 in spite of all precautions. Contact with H1N1 is not so much of a problem as proliferation is.

While you are still healthy and not showing any symptoms of H1N1 infection, in order to prevent proliferation, aggravation of symptoms and development of secondary infections, some very simple steps, not fully highlighted in most official communications, can be practiced (instead of focusing on how to stock N95 or Tamiflu):

1. Frequent hand-washing (well highlighted in all official communications).

2. “Hands-off-the-face” approach. Resist all temptations to touch any part of face (unless you want to eat, bathe or slap).

3. *Gargle twice a day with warm salt water (use Listerine if you don’t trust salt). *H1N1 takes 2-3 days after initial infection in the throat/ nasal cavity to proliferate and show characteristic symptoms. Simple gargling prevents proliferation. In a way, gargling with salt water has the same effect on a healthy individual that Tamiflu has on an infected one. Don’t underestimate this simple, inexpensive and powerful preventative method.

4. Similar to 3 above, *clean your nostrils at least once every day with warm salt water. *Not everybody may be good at Jala Neti or Sutra Neti (very good Yoga asanas to clean nasal cavities), but *blowing the nose hard once a day and swabbing both nostrils with cotton buds dipped in warm salt water is very effective in bringing down viral population.*

5. *Boost your natural immunity with foods that are rich in Vitamin C (Amla and other citrus fruits). *If you have to supplement with Vitamin C tablets, make sure that it also has Zinc to boost absorption.

6. *Drink as much of warm liquids (tea, coffee, etc) as you can. *Drinking warm liquids has the same effect as gargling, but in the reverse direction. They wash off proliferating viruses from the throat into the stomach where they cannot survive, proliferate or do any harm.