SWINE FLU OUTBREAK
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SWINE FLU OUTBREAK
2009
Dr.T.V.Rao MD
Professor of Microbiology
Sri Deva Raj Urs University Medical College,
Kolar India
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SWINE FLU 2009
2009 swine flu outbreak is the epidemic spread
of a new strain of influenza virus that was
clinically identified in April 2009 The new virus
strain is a type of influenza A (H1N1) virus,
commonly called the swine flu. The outbreak
has also been called the H1N1 influenza, 2009
H1N1 flu, Mexican flu, or swine-origin
influenza.
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WHO alerts it as Phase 5
WHO to change its
pandemic alert phase to
"Phase 5", which is
defined as "...human-to-
human spread of the
virus into at least two
countries in one WHO
region
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Qualifies as Phase 5
By April 28, the new strain
was confirmed to have
spread to Spain, the United
Kingdom, New Zealand, and
Israel, and the virus was
suspected in many other
nations, with a total of over
4,400 candidate cases,
prompting the WHO to
change its pandemic alert
phase to "Phase 5"
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Early cases - Mexico
Although the exact time
and location of the
outbreak is unknown, it
is believed to have been
first detected when an
influenza-like illness was
reported by both health
agencies and local news
media in Mexico
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A New Strain of Influenzae Virus
The virus responsible
was clinically
identified as a new
strain on April 24,
2009
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A serious Concern to Health Authorities
In late April officials from
both World Health
Organization (WHO) and
the CDC expressed serious
concern about the situation,
stating that the virus had the
potential to become a flu
pandemic.
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Virologists Optimistic
By late April, however,
some virologists believed
that this strain was
unlikely to cause as many
fatalities as earlier
pandemics, and may not
even be as damaging as a
typical flu season.
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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 Centers 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
Euras
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Why 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.
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Flu in Pigs Identified
By May 2, some pigs in
Canada were diagnosed
with H1N1.
The Canadian Food
Inspection Agency
(CFIA) indicates that it
has found H1N1 flu
virus in a swine herd in
Alberta.
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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.
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New 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.
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The pig strains carry several other genes
But the North American
pig strain was itself the
product of previous
reassortments, and has
carried an avian PB2
gene for at least ten years
and a human PB1 gene
since 1993. These genes
were passed on to the
new virus.
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Pigs 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.
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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.
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Case Definitions for Infection with Swine-origin Influenza
A (H1N1) Virus (S-OIV)
A confirmed case of S-
OIV infection is defined
as a person with an acute
febrile respiratory illness
with laboratory
confirmed S-OIV
infection at CDC by one
or more of the following
tests.
Real-time RT-PCR
Viral culture
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A probable case of S-OIV
A probable case of S-
OIV infection is defined
as a person with an acute
febrile respiratory illness
who is positive for
influenza A, but negative
for H1 and H3 by
influenza RT-PC PCR
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A suspected case of S-OIV
suspected case of S-OIV infection is defined as a
person with acute febrile respiratory illness with onset
Within 7 days of close contact with a person who is a
confirmed case of S-OIV infection, or
Within 7 days of travel to community either within the
United States or internationally where there are one or
more confirmed cases of S-OIV infection, or
Resides in a community where there are one or more
confirmed cases of S-OIV infection.
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Simple Measures Help
By touching something
contaminated with flu
viruses and then
touching one's mouth or
nose, and through
coughing or sneezing.
One of the most
effective prevention
measures is regular
hand washing.
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Eating Pork Safe?
People cannot catch swine
flu from eating pork or pork
products. Cooking pork to an
internal temperature of 160
degrees Fahrenheit (71
degrees Celsius) kills the
swine flu virus along with
other bacteria and viruses
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Yet no fully protective Vaccine
Vaccines are available to be
given to pigs to prevent
swine influenza. There is no
vaccine to protect humans
from swine flu, although the
CDC is formulating one. The
seasonal influenza vaccine
may help to provide partial
protection against swine
H3N2, but not against swine
H1N1 viruses like the one
circulating now.
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Past Vaccines proved not safe
In 1976 a new strain of swine flu started infecting
people and worried U.S. health officials started
widespread vaccination. More than 40 million people
were vaccinated. But several cases of Guillain-Barré
syndrome, a severe and sometime fatal condition that
can be linked to come vaccines, caused the U.S.
government to stop the program. The incident led to
widespread distrust of vaccines in general
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Prevention 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.
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Clean 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.
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Avoid Unnecessary Actions
Avoiding touching your
eyes, nose or mouth.
Germs spread this way
Trying to avoid close
contact with sick people.
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Staying at home if sick
Staying home from work
or school if you are sick
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Several countreis effected WHO
The following countries have
reported laboratory confirmed
cases with no deaths - Austria (1),
Canada (34), China, Hong Kong
Special Administrative Region (1),
Denmark (1), France (1), Germany
(4), Israel (2), Netherlands (1), New
Zealand (4), Republic of Korea (1),
Spain (13), Switzerland (1) and the
United Kingdom (13).
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Prompt to seek Medical Attention
There is also no risk of
infection from this virus
from consumption of well-
cooked pork and pork
products. Individuals are
advised to wash hands
thoroughly with soap and
water on a regular basis and
should seek medical
attention if they develop
any symptoms of
influenza-like illness
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Drug 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
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Drugs are Highly Beneficial
If you get sick, antiviral drugs can make your illness
milder and make you feel better faster. They may also
prevent serious influenza complications. Influenza
antiviral drugs work best when started soon after illness
onset (within two 2 days), but treatment with antiviral
drugs should still be considered after 48 hours of
symptom onset, particularly for hospitalized patients or
people at high risk for influenza-related complications.
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CDC Recommends
CDC recommends the
use of oseltamivir or
zanamivir for the
treatment and/or
prevention of infection
with swine influenza
viruses.
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Oseltamivir
Oseltamivir (brand name
Tamiflu ®) is approved
to both treat and prevent
influenza A and B virus
infection in people one
year of age and older
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Zanamivir
Zanamivir (brand name
Relenza ®) is approved to
treat influenza A and B virus
infection in people 7 years
and older and to prevent
influenza A and B virus
infection in people 5 years
and older.
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Spread the Message of Flu to Everyone
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A good health preparedness
Possible Option in Prevention
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Updates on Swine Flu
2009
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Dr.T.V.Rao MD
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