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Swine flu
GUIDE LINES TO FIGHT SWINE FLU
Symptoms of H1N1 do not differ from other viral infections. The usual symptoms are:
Sudden onset of –
- High fever
- Rhinitis
- Conjunctivitis
- Cough
- Body ache
- Vomiting,
- Diarrhea
Children below 2 years can present with all the above symptom and convulsions or prolonged fever.
The duration of illness is usually one week.
The patient is infectious from 1 day prior to onset of illness and up to 7-10 days.
On Examination observe if the patient is toxic or non-toxic.
If the patient is toxic and having respiratory distress, refer to :
good hospitals in your city .
If patient is non-toxic, treat symptomatically as follows-
- Advise home quarantine
- Abstain from school till resolution(7 days)
- Manage fever with simple medications like paracetamol
- Adequate fluid intake
- Regular hand wash, especially after sneezing and coughing.
- Seek medical attention if poor intake or rapid breathing
- Antibiotics are of little use in influenza
- Antiviral(Tamiflu) should be given in a small percentage of patients and under medical supervision(available only at National health outlets)
- Most patients recover spontaneously
- A small percentage may need hospitalization
- Call for review
- why it is now comming on human being ???
Many researchers now consider that two main series of events can lead to swine flu (and also avian or bird flu) becoming a major cause for influenza illness in humans.First, the influenza viruses (types A, B, C) are enveloped RNA viruses with a segmented genome; this means the viral RNA genetic code is not a single strand of RNA but exists as eight different RNA segments in the influenza viruses. A human (or bird) influenza virus can infect a pig respiratory cell at the same time as a swine influenza virus; some of the replicating RNA strands from the human virus can get mistakenly enclosed inside the enveloped swine influenza virus. For example, one cell could contain eight swine flu and eight human flu RNA segments. The total number of RNA types in one cell would be 16; four swine and four human flu RNA segments could be incorporated into one particle, making a viable eight RNA segmented flu virus from the 16 available segment types. Various combinations of RNA segments can result in a new subtype of virus (known as antigenic shift) that may have the ability to preferentially infect humans but still show characteristics unique to the swine influenza virus (see Figure 1). It is even possible to include RNA strands from birds, swine, and human influenza viruses into one virus if a cell becomes infected with all three types of influenza (for example, two bird flu, three swine flu, and three human flu RNA segments to produce a viable eight-segment new type of flu viral genome). Formation of a new viral type is considered to be antigenic shift; small changes in an individual RNA segment in flu viruses are termed antigenic drift and result in minor changes in the virus. However, these can accumulate over time to produce enough minor changes that cumulatively change the virus' antigenic makeup over time (usually years).
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Second, pigs can play a unique role as an intermediary host to new flu types because pig respiratory cells can be infected directly with bird, human, and other mammalian flu viruses. Consequently, pig respiratory cells are able to be infected with many types of flu and can function as a "mixing pot" for flu RNA segments (see Figure 1). Bird flu viruses, which usually infect the gastrointestinal cells of many bird species, are shed in bird feces. Pigs can pick these viruses up from the environment and seem to be the major way that bird flu virus RNA segments enter the mammalian flu virus population.
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| Figure 1. |
What are the symptoms of swine (H1N1) flu?
Symptoms of swine flu are similar to most influenza infections: fever (100F or greater), cough, nasal secretions, fatigue, and headache, with fatigue being reported in most infected individuals. Some patients also get nausea, vomiting, and diarrhea. In Mexico, many of the patients are young adults, which made some investigators speculate that a strong immune response may cause some collateral tissue damage. Some patients develop severe respiratory symptoms and need respiratory support (such as a ventilator to breathe for the patient). Patients can get pneumonia (bacterial secondary infection) if the viral infection persists, and some can develop seizures. Death often occurs from secondary bacterial infection of the lungs; appropriate antibiotics need to be used in these patients. The usual mortality (death) rate for typical influenza A is about 0.1%, while the 1918 "Spanish flu" epidemic had an estimated mortality rate ranging from 2%-20%. Swine flu in Mexico (as of April 2009) has had about 160 deaths and about 2,500 confirmed cases, which would correspond to a mortality rate of about 6%, but it is far too early to be sure this is the true mortality rate because the data is still being collected and there are new infections being reported in Mexico. By June 2009, the virus had reached 74 different countries on every continent except Antarctica.
Next: How is swine flu (H1N1) diagnosed? »
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