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Swine Flu H1 N1 2009
Posted: 05-Aug-2009

How to prevent yourself & children from swine flu Respiratory disease of pigs
- Cause by type A influenza virus (H1N1) out break regularly in pigs
- Human cases happen in people who are around pigs, also spread person to person
- Susceptible pig cells possess receptors for both avian and human influenza strain and allow for the reassortment of  influenza virus from different species
- Out breaks in 2009 was caused by strain that represent a genetic reassortment of swine, human and avian  influenza


How Do You Catch  Swine Flu
1.  Through contact with infected pigs or environment contaminated with swine flu viruses. No evidence of transmission by eating pork
2.  Through contact with a person with swine flu- Person to person spread through infected respiratory droplets  (large particle aerosol), incubation period 1-7 days.


What are Signs and Symptom of New  A/H1N1
Similar to seasonal influenza,  High fever (37.8oC or 100.4o F),   Headache / myalgia ,  Cough / sore throat, sneezing, Tired / fatigue , Sudden onset,  Vomiting / diarrhea ,  Pneumonia / respiratory failure in severe cases, Death
Infants and young children:  fever and lethargy without respiratory symptoms severe may include rapid breathing, cyanosis, dehydration, extreme irritability


Duration  of  Viral  Shedding
- Unknown for Swine Flu
- Base on seasonal influenza virus infection Infected persons are assumed to be shedding virus one day prior to illness onset until resolution of fever, contagious up to 7 days from illness onset, may be up to 10-14 days in young infants or children or immuno suppressed  persons.


High Risk Groups- Similar to Seasonal Influenza
1.  Children < 5 yrs of age,     > 65 yrs of age or older,       Children & adolescents (6 months – 18 yrs) who are receiving long term aspirin Rx.
2.  Pregnant women
3.  Chronic medical illness :
 - asthma, cardiovascular disease, malignancy, liver diseaserenal disease, DM
 - immunosuppressed (HIV, chemotherapy, steroid)  ,    neurologic condition,     nursing home, chronic care (residents) ,  hemoglobinopathies


Complications of Swine Flu
1. Fatal / non fatal pneumonia have occurred
2. Young children (<5 yrs of age), pregnant women those with comorbidities are at increased risk base on seasonal flu such as
 - exacerbation of underlying chronic medical condition
 - upper respiratory tract disease (sinusitis, otitis media, cough)
 - lower respiratory tract disease (pneumonia, bronchiolitis, febrile seizure)
 - Cardiac (myocarditis, pericarditis)
 - Neurologic (post infectious encephalopathy, encephalitis, febrileseizure, status epilepticus
 - Toxic shock syndrome
 - Secondary bacterial pneumonia with or without sepsis
 - Spontaneous abortion or preterm birth in pregnancy


To Prevent the Spread of  Swine Flu
1. - Avoid contact with ill persons
 - Cover nose and mouth when sneeze or cough with tissue or sleeve, throw used tissue in a trash can, wash hands with soup and water or alcohol based hand gel
 - Used face mask
 - If you think you are ill with flu avoid close contact with others,stay at home or in hotel room, seek medical care  if symptoms are severe for antiviral medication, don't
    go to work, schoolor travel while ill
2. Social level =  Do not work, close school, avoid social gathering, meetings


Recommendations for ill Person
 - If symptoms not severe:  - no high fever, no lethargy, able to eat /drink well can stay home, use Paracetamol (not aspirin), adequate rest and plenty of fluid intake.
- Do not go to work or to school until resolution of symptoms.
- Avoid contact with others, use tissue, handkerchief, sleeves to close mouth/ nose upon sneezing or cough.
- Use face mask when stay with others or cough/ sneezing.
- Frequent hand wash with soap / water or alcohol base hand gel after each cough or sneeze.
- See physician ASAP if symptoms are worse especially vomiting, difficulty breathing and drowsy.


Recommendations for Public
1.  Frequent hand wash with soap and water or alcohol base hand gel.
2.  Do not use drinking glass, straw, utensils, handkerchief, hand/wash towel with other people.
3.  Avoid contact with people who are ill with respiratory symptoms.
4.  Make oneself healthy with enough rest, exercise, proper diet.
5.  Avoid places that are crowded or poor ventilation.
6.  Follow recommendation from department of health.


Recommendations for Travelers
1.  Avoid travel to crowded area, if not possible use face mask.
2.  Avoid contact with ill person who has Flu symptoms.
3.  Make oneself healthy with exercise, enough rest, proper diet and frequent hand wash with soap and water or  alcohol base hand gel.
4.  If you are ill with fever, cough, aching pain, running nose, you should wear face mask to protect others and see clinicians.
5.  Follow recommendations / advice from the country of visiting.


Recommendations for School
1.  Advise students who have symptoms suggestive of influenza to stay home or see clinicians.
2.  Check missing students daily, if more than 3 students in one class on that day, inform department of health.
3.  Returned students from abroad should be quarantine / isolated for 7 days.              
4.  Allow sick students to leave school when ill, may close school after evaluation by department of health.
5.  Clean all surfaces of school room, door opener, telephone, ladder steps, computers, sinks with soap and water once or twice daily
6. Provide adequate soap, water, sinks also ventilator system.


Recommendations for Place of Work, Company and Banking, etc.
As in school but not recommend to close the place, also advise reengineering system
Samitivej hospitals take the threat of a flu pandemic very seriously.  We are screening patients at risk in an isolated service area, using separate lab and patient room for infected patients with Negative Pressure and Airborne Infected Isolation Room for ventilation system and freshening air in the hospital for infection control according to CDC guideline.
Influenza Vaccine supply prevent influenza pandemic but not for Influenza A (H1N1). CDC suggests taking a vaccine shot during pandemic of disease to reduce the threat from North American influenza mononucleosis.

 

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