Dr Riham Raafat assistant lecturer of chest diseases

What is swine FLU? Swine flu is a respiratory disease,

caused by influenza type A which infects pigs.

There are many types, and the infection is constantly changing.

Can spread from person to person through coughing and sneezing.

It’s a misnomer as pigs were only mixing pot.

It seems likely that the new version of

H1N1 resulted from a mixing of different

versions of the virus, which may usually

affect different species, in the same

animal host. Pigs provide an

excellent 'melting pot' for these viruses to mix and match with

each other.

What is new about this

type of swine flu?

Where is it foundWhere is it found??

How dangerous is it?

.Symptoms of swine flu in humans

appear to be similar to those

produced by standard, seasonal flu.

.These include: fever, cough, sore

throat, runny nose, body aches,

chills, fatigue and sometimes

diarrhea and vomiting.

.Most cases so far reported around

the world appear to be mild, but in

Mexico lives have been lost.

.Eating pork isn’t infectious: .Eating pork isn’t infectious: cooking cooking

pork to an internal temperature of pork to an internal temperature of

160°F kills the swine flu virus as it 160°F kills the swine flu virus as it

does other bacteria and viruses. does other bacteria and viruses.

Till when is it InfectiousTill when is it Infectious?? Adult is infectious for up to 7 days Adult is infectious for up to 7 days

following illness onset. following illness onset.

Children, especially younger Children, especially younger

children, might potentially be children, might potentially be

contagious for longer periodscontagious for longer periods..

Virus can live 2 hours or longer on Virus can live 2 hours or longer on

surfaces like cafeteria tables, door-surfaces like cafeteria tables, door-

knobs, and desks.knobs, and desks.

What should I do to stay safe?

Signs that require urgent medical Signs that require urgent medical

attention include:attention include: Difficulty breathing or shortness of breathDifficulty breathing or shortness of breath Pain or pressure in the chest or abdomenPain or pressure in the chest or abdomen Sudden dizzinessSudden dizziness ConfusionConfusion Severe or persistent vomitingSevere or persistent vomiting Flu-like symptoms that improve but then Flu-like symptoms that improve but then

return with fever and worse cough (return with fever and worse cough (specially those that have been in contact with the swine virus - such as those living or traveling in the areas that have been affected - should seek medical advice)

Everyday actions to stay Everyday actions to stay healthy:healthy:

Cover your nose and mouth when coughing Cover your nose and mouth when coughing

or sneezing with a tissue. Dispose the or sneezing with a tissue. Dispose the

tissue in the trash bin after use.tissue in the trash bin after use. Wash your hands often with soap or hand Wash your hands often with soap or hand

sanitizer after you cough or sneeze. It is a sanitizer after you cough or sneeze. It is a

good practice to wash your hand before good practice to wash your hand before

having your meal.having your meal. Avoid touching or rubbing your eyes, nose Avoid touching or rubbing your eyes, nose

or mouth. Germs will spread in this ways.or mouth. Germs will spread in this ways.

Try to avoid close contact with Try to avoid close contact with

unwell/sick people and avoid unwell/sick people and avoid

crowded places. crowded places. 

Having a healthy diets or supplement Having a healthy diets or supplement

to boosts your immune system.to boosts your immune system.

Get the latest news of the virus Get the latest news of the virus

before planning any overseas trip.before planning any overseas trip.

Stay home when you are sick.Stay home when you are sick.

When contact is When contact is unavoidableunavoidable::

Facemasks (disposable, single use

masks) for persons who enter crowded

settings

Respirators (N95 or higher filtering

facepiece respirator) for persons who

have unavoidable close contact with

infectious person

Is there a VaccineIs there a Vaccine??

No vaccine available to protect

humans from swine flu.

Vaccine for human seasonal

influenza does not protect against

H1N1 swine flu viruses due to

antigenic differences, but may

provide partial protection against

swine H3N2 virus

Is it a PandemicIs it a Pandemic??

How to DiagnoseHow to Diagnose??

.To diagnose swine influenza A .To diagnose swine influenza A

infection, a respiratory specimen is infection, a respiratory specimen is

collected within the first 4 to 5 days collected within the first 4 to 5 days

of illness (when an infected person of illness (when an infected person

is most likely to be shedding virus). is most likely to be shedding virus).

.However, some persons, especially .However, some persons, especially

children, may shed virus for 10 children, may shed virus for 10

days or longer.days or longer.

When to use Chemo-When to use Chemo-prophylaxisprophylaxis??

o Household close contacts (of confirmed, probable, or suspected case) at high-risk for complications of influenza

+ chronic medical conditions + aged ≥ 65 years + aged ≤ 5 years + pregnant womeno School children or children in daycare at

high-risk for complications of influenza (certain chronic medical conditions) who had close contact (face-to-face) with confirmed, probable, or suspected case

o Any healthcare worker at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) working in area with confirmed swine influenza A (H1N1) cases, or who is caring for patients with any acute febrile respiratory illness.

o Non-high risk travelers to areas with an outbreak, or border workers who are working in areas with confirmed cases of swine influenza A (H1N1) virus infection.

Prophylaxis DrugsProphylaxis Drugs?? Pre-exposure – treat during exposure

period and for 10 days after last known exposure to ill confirmed case of swine influenza A (H1N1) virus infection once daily (not used now).

Post-exposure – treat for 10 days after last known exposure to ill confirmed case of swine influenza A (H1N1) virus infection once daily.

o Zanamivir (Relenza):Zanamivir (Relenza): 10 mg (2 10 mg (2

inhalations) once daily for adults & inhalations) once daily for adults &

children ≥ 5 yrs oldchildren ≥ 5 yrs oldo Oseltamivir (Tamiflu):Oseltamivir (Tamiflu): orallyorally

.adults and children ≥ 13 years old - 75 .adults and children ≥ 13 years old - 75 mg once/d mg once/d

.children aged 1-12 years - dose based .children aged 1-12 years - dose based on weight:on weight:

≤ ≤ 15 kg15 kg 30 mg once daily 30 mg once daily

15-23 kg 45 mg once daily15-23 kg 45 mg once daily

23-40 kg 60 mg once daily23-40 kg 60 mg once daily

> 40 kg> 40 kg 75 mg once daily 75 mg once daily

How to Treat casesHow to Treat cases?? Most recent swine influenza viruses Most recent swine influenza viruses

isolated from humans are resistant to isolated from humans are resistant to Amantidine and Rimantadine.Amantidine and Rimantadine.

Zanamivir (Relenza):Zanamivir (Relenza): 10 mg (2 10 mg (2

inhalations) twice daily for adults & inhalations) twice daily for adults &

children ≥ 5 yrs old for 5 days.children ≥ 5 yrs old for 5 days. Oseltamivir (Tamiflu):Oseltamivir (Tamiflu): orallyorally

.adults and children ≥ 13 years old - 75 .adults and children ≥ 13 years old - 75 mg twice/d for 5 daysmg twice/d for 5 days

.children aged 1-12 years - dose based on .children aged 1-12 years - dose based on weightweight