Swine Flu

Swine flu outbreaks have always been common - except known to occur only among pigs. However, this recent strain that we has caused so much damaged amongs humans is a variant or a subtype of influenze A (h1N1).

First detected among the people of United States of American in April 2009, this virus is rapidly spreading via human-to-human contact in fear of which the WHO has already issued a warning that a pandemic of H1N1 may be fast approaching. Infact, currently the WHO has maintained a level 5 alert for a Swine Flu Pandemic!

Clinical Features?

Patients clinically present which quite the same features as common flu/cold or upper respiratory tract illneses.

• Rhinorrhea or nasal congestion;


• Fever;


• Cough;


• Sore throat;


• Bodyaches/malaise;


• Chills and
• Diarrhea and vomitting may even be present!

How dangerous is H1N1 Swine flu?

According to analysis, most people who contracted Swine Flu have recovered without hospitalizations, complications and even medical treatment. However, some have met their deaths due to this condition.

People who are classified in the high risk group are;

• Young children


• Immunocompromised individuals


• Pregnant women


• Diabetics


• Heart or kidney disease patients


• Asthma patients


• Neurocognitive or neuromuscular disorder patients


• People who live near the areas where Swine Flu cases have been confirmed to exist

*Interestingly, people older than 65 years are least likely to get infected by Swine Flu because more fraction of them have acquired the antibody against H1N1 virus!

*Deaths have usually occured due to complicated respiratory illness causes like pneumonia, respiratory failure and acute respiratory distress syndrome.

Period of Infectivity?

A person may infect others 1 day before getting sick till about 5-7 days after the symptoms appear. This, ofcourse, can be varied from individual to individual.

*H1N1 virus can survive on environmental surfaces for 2 to 8 hours long and therefore may infect individuals during this time period.

*It is killed by heat ( 75 -100°C) and several chemical germicides (Hydrogen Peroxide, Cholrine, Iodine based products and alcohol)

Which investigations to undertake?

• Respiratory Secretion Analysis - usually the specimen is obtained from nasopahryngeal aspirate

• A real-time RT-PCR for Influenza A - which will test positive strongly for Influenza A and negative for H1 and H3.

• Immunoflourescence (DFA or IFA) tests

• Isloation of H1N1 by viral culture - usually not preffered as it takes too much time.

Treatment options?

Suspected cases

Treat with zanamivir alone or with a combination of oseltamivir and either amantadine or rimantadine as soon as possible after the onset of symptoms and for a duration of 5 days.

Confirmed cases

Zanamivir or oseltamivir should be administered for 5 days.

Pregnant women

Antiviral medications are in Pregnancy Category C, so they should be used during pregnancy only if the potential benefit outweighs the potential risk to the embryo or fetus.

Children younger than 1 year

Infants with swine influenza A (H1N1) are likely to have better prognosis if put on oseltamivir.

STAR SIGNS - if appear; you need to seek URGENT medical help!

In children:

• Fast breathing rater or labored breathing


• Cyanosis


• Inability to drink


• Drowsiness

• Re-appearance of flu-like symptoms with worsening condition


• Fever accompanied by a rash

In adults:

• Dyspnea


• Pain or pressure in chest/abdomen


• A sudden attack of dizziness


• Confusion


• Severe persistent vomiting

SIMPLE WAYS THAT CAN SAVE YOU FROM SWINE FLU:

• First step remains the newly generated Swine Flu vaccine that can efficiently prevent the flu. Both live, attenuated and inactivated influenza A (H1N1) 2009 monovalent vaccine formulations are available.

The dozes are:

Children aged 6 - 9 years: 2 shots separated by 4 weeks

10 years or Older: A single shot

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.


• Wash your hands often with soap and water. Or an alcohol based hand sanitizer.


• Avoid touching your eyes, nose or mouth.


• Limit close contact with sick people.


• Try to avoid going out when you are sick!

Resources: Medscape/CDC/eMedicine; the article shall be updated as new information pours about Swine Flu - as most of the studies are underway regarding this disease.

*Goodluck avoiding Swine Flu!