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Dr.T.V.Rao MD 1SWINE FLU OUTBREAKS H1N1 TO H3N2 AN UPDATE Dr.T.V.Rao MD
Dr.T.V.Rao MD 2 What is Swine influenza• Swine influenza (also calledH1N1 flu, swine flu, hog flu, andpig flu) is an infection by any oneof several types of swine influenzavirus. Swine influenza virus (SIV)is any strain of the influenza familyof viruses that is endemic in pigs
Dr.T.V.Rao MD 3 SWINE FLU• 2009 swine flu outbreak is theepidemic spread of a new strain ofinfluenza virus that was clinicallyidentified in April 2009 The new virusstrain is a type of influenza A (H1N1)virus, commonly called the swine flu.The outbreak has also been called theH1N1 influenza, 2009 H1N1 flu,Mexican flu, or swine-origininfluenza.
Dr.T.V.Rao MD 4Out breaks among Pigs • Outbreaks among pigs normally occur in colder weather months (late fall and winter) and sometimes with the introduction of new pigs into susceptible herds. Studies have shown that the swine flu H1N1 is common throughout pig populations worldwide, with 25 % of animals showing antibody evidence of infection.
Dr.T.V.Rao MD 6 H1 and N1 kills many• Between 2009 and mid-2010, more than 17,000 people died worldwide from the highly contagious H1N1 swine flu strain, leading the World Health Organization to call the strain a pandemic.
Dr.T.V.Rao MD 7 How man is exposed• Most commonly, these cases occur in persons with direct exposure to pigs (e.g. children near pigs at a fair or workers in the swine industry). In addition, there have been documented cases of one person spreading swine flu to others.
Dr.T.V.Rao MD 8WHO alerts it as Phase 5• WHO to change itspandemic alertphase to "Phase 5",which is defined as"...human-to-humanspread of the virusinto at least twocountries in oneWHO region
Dr.T.V.Rao MD 9 Swine flu – A Acute respiratory infection• Swine flu is an infection caused by a virus. Its named for a virus that pigs can get. People do not normally get swine flu, but human infections can and do happen. The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.
Dr.T.V.Rao MD 10 A New Strain of Influenza Virus•The virusresponsiblewas clinicallyidentified asa new strainon April 24,2009
Dr.T.V.Rao MD 12Swine flu spreads through Respiratory route • The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes.
Dr.T.V.Rao MD 13 Swine flu can begin with• Fever with Sudden symptoms of• Aches• Chills• Tiredness
Dr.T.V.Rao MD 14 May Preset with more severe symptoms• Fever (usually high)• Headache• Muscle aches• Chills• Extreme tiredness• Dry cough• Runny nose may also occur but is more common in children than adults• Stomach symptoms, such as nausea, vomiting, and diarrhea, may also occur but are more common in children than adults• Donot self Diagnose Visit a Health Centre
Dr.T.V.Rao MD 16 New Virus is a Reassortment• The new strain is an apparent reassortment of four strains of influenza A virus subtype H1N1 Analysis at the United States Centres for Disease Control and Prevention (CDC) identified the four component strains as one endemic in humans, one endemic in birds, and two endemic in pigs (swine). One swine strain was widespread in the United States, the other in other countries
Dr.T.V.Rao MD 17Why Called as Swine Flu• Although called swine flu due to it predominantly containing swine strains, the World Organisation for Animal Health have proposed the name North American influenza.
Dr.T.V.Rao MD 18New Virus a New combination • The CDC determined that the strain contained genes from four different flu viruses – North American swine influenza, North American avian influenza, human influenza, and swine influenza virus typically found in Asia and Europe – "an unusually mongrelised mix of genetic sequences.
Dr.T.V.Rao MD 19Pigs a Mixing vessel • Pigs can catch human and avian or bird flu. When flu viruses from different species infect pigs, they can mix inside the pig and new, mixed viruses can emerge.
Dr.T.V.Rao MD 20 Pigs infect Humans• Pigs can pass mutated viruses back to humans, and these can be passed from human to human. Transmission among humans is thought to occur in the same way as with seasonal flu.
Dr.T.V.Rao MD 21 Diagnosis• To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 10 days or longer. Identification as a swine flu influenza A virus
Dr.T.V.Rao MD 23Rapid Diagnosis •RT PCR can make rapid Diagnosis
Dr.T.V.Rao MD 24Prevention is best option • Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
Dr.T.V.Rao MD 25Clean Hands – Safe Hands • Washing your hands often with soap and water, especially after you cough or sneeze. You can also use alcohol- based hand cleaners.
Dr.T.V.Rao MD 26Drug options in Swine Flu• There are four influenza antiviral drugs approved for use in the United States (oseltamivir, zanamivir, Amantidine and rimantadine). The swine influenza A (H1N1) viruses that have been detected in humans in the United States and Mexico are resistant to Amantidine and rimantadine so these drugs will not work against these swine influenza viruses. Laboratory testing on these swine influenza A (H1N1) viruses so far indicate that they are susceptible (sensitive) to oseltamivir and zanamivir
Dr.T.V.Rao MD 27Using N95 mask reduces the Risk• You can cut your risk of contracting the flu or other respiratory viruses by as much as 80 percent by wearing a mask over your nose and mouth, according to a new study. Emerging Infectious Diseases, the journal of the Centres for Disease Control and Prevention (CDC) .
Dr.T.V.Rao MD 28Avoid close contact • Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too. • Aerosols spread the virus in any environment
Dr.T.V.Rao MD 29Prevention is the Best option • Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use
Dr.T.V.Rao MD 30 Clean your hands.• Washing your hands often will help protect you from germs.• Hand washing proved to be best procedure in prevention of Majority of Communicable diseases.
Dr.T.V.Rao MD 31 Swine flu Vaccination• Everyone 6 months of age and older should get vaccinated against the flu as soon as the 2010-2011 season vaccine is available. People at high risk of serious flu complications include young children, pregnant women, people with chronic health conditions like asthma, diabetes or heart and lung disease and people 65 years and older.
Dr.T.V.Rao MD 32Health care workers and Vaccination • Vaccination also is important for health care workers, and other people who live with or care for high risk people to keep from spreading flu to high risk people.
Dr.T.V.Rao MD 33 "flu shot”• The "flu shot" — an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.
Dr.T.V.Rao MD 34Nasal vaccination • The nasal-spray flu vaccine —a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for "live attenuated influenza vaccine" or FluMist®). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant.
Dr.T.V.Rao MD 35Care for common materials used by Swine flu patients • Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Dr.T.V.Rao MD 36 Proper Handling of Pig meat a Priority• Influenza viruses do not affect the safety of pork, according to the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO). As with any raw meat, pork should always be properly handled and cooked to eliminate a range of food safety concerns.
Dr.T.V.Rao MD 38Newly identified Strain H3N2 • The new identified variant contains genes of the H3N2 swine influenza that has been circulating in North American pigs since 1998 as well as the gene from the pandemic virus H1N1, making it a kind of hybrid.
Dr.T.V.Rao MD 39 Is the H3N2 is Dangerous ?• The new swine flu strain, H3N2, has shown at least some potential for human-to-human transmission in those infected individuals, which makes it especially dangerous
Dr.T.V.Rao MD 40Current update on FLU • The A(H3N2)v swine flu strain that has infected at least 18 Americans since Sept. 2010 has shown the potential for human-to- human transmission. According to the paper, which was published in the Proceedings of the National Academy of Sciences, the H3N2 strains "resemble viruses with pandemic potential.
Dr.T.V.Rao MD 41Antigenic Clusters from 2002 to 2010
Dr.T.V.Rao MD 42 CDC plans for creating a New Vaccine for H3N3• CDC is looking to create a vaccine for the new H3N2v. Hopefully we won’t need it — but as the furor over man-made killer H5N1 flu viruses and the emergence of a new pandemic just three years ago shows, there are no guarantees with the flu.
Dr.T.V.Rao MD 43Genetic Analysis of New Strain H3N2 • Genetic analyses revealed that the 2 children had been infected with similar but not identical influenza A (H3N2) viruses. Their viruses also are similar to H3N2 flu viruses found in US pigs since 1998 and in 8 human infections reported in the United States since 2010
Dr.T.V.Rao MD 44 CDC Updates• CDC testing indicates the H3N2v is similar to a human H3N2 strain that circulated in the mid-1990s. (Humans actually gave the H3N2 virus to pigs back then — which shows just how interconnected and vulnerable we all are Wish to Read more: http://healthland.time.com/2011/12/30/how-a-new-swine-flu-virus-could-complicate-influenza-season/#ixzz1ptttueai
Dr.T.V.Rao MD 45 Scientific update on Vaccine for H3N2• US Centre for Disease Control andPrevention (CDC) announcement inNovember 2011 that it had developed acandidate vaccine virus and provided it tomanufacturers. The swine-origin H3N2reassortant strain (H3N2v) includes the Mgene from the 2009 H1N1 virus. The 12infections were all reported in 2011,occurring mostly in children.
Follow me for more articles of interest on issues on Infectious diseases Dr.T.V.Rao MD 46
Dr.T.V.Rao MD 47• Programme created by T.V.Rao MD as Medical Update on Swine Flu from 2009 to 2012 for Medical and Health care Workers in the Developing World • Email • firstname.lastname@example.org