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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
  Doctortvrao's ‘e’ learning series

      Dr.T.V.Rao MD
            Email
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