SWINE FLU OUTBREAKS H1N1 TO H3N2

AN UPDATE

Dr.T.V.Rao MD

Dr.T.V.Rao MD 1

What is Swine influenza

•Swine influenza (also called

H1N1 flu, swine flu, hog flu, and

pig flu) is an infection by any one

of several types of swine influenza

virus. Swine influenza virus (SIV)

is any strain of the influenza family

of viruses that is endemic in pigs

Dr.T.V.Rao MD 2

SWINE FLU •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.

Dr.T.V.Rao MD 3

Out 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.

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Swine Flu A Global Concern

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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.

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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.

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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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Swine flu –

A Acute respiratory infection • Swine flu is an infection caused by a virus. It's 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.

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A New Strain of Influenza Virus

•The virus responsible was clinically identified as a new strain on April 24, 2009

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Dr.T.V.Rao MD 11

Swine 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.

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Swine flu can begin with

•Fever

with Sudden

symptoms of

•Aches

•Chills

•Tiredness

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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

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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 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

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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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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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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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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

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Rapid Diagnosis

•RT PCR

can make

rapid

Diagnosis

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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.

D

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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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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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Using 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) .

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Avoid 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

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Prevention 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

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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.

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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.

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Health 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.

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"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.

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Nasal 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.

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Care 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.

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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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NEWLY IDENTIFIED

INFLUENZA STRAIN

H3N2

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Newly 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 38

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

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Current 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.

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Antigenic Clusters from 2002 to 2010

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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.

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Genetic 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

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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

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Scientific update on Vaccine for

H3N2 • US Centre for Disease Control and

Prevention (CDC) announcement in

November 2011 that it had developed a

candidate vaccine virus and provided it to

manufacturers. The swine-origin H3N2

reassortant strain (H3N2v) includes the M

gene from the 2009 H1N1 virus. The 12

infections were all reported in 2011,

occurring mostly in children.

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•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

• doctortvrao@gmail.com

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