Swine flu

What is swine flu?
Like people, pigs can get influenza (flu), but swine flu viruses aren't the same as human flu viruses. Swine flu doesn't often infect people, and the rare human cases that have occurred in the past have mainly affected people who had direct contact with pigs. But the current "swine flu" outbreak is different. It's caused by a new swine flu virus that has changed in ways that allow it to spread from person to person -- and it's happening among people who haven't had any contact with pigs.

That makes it a human flu virus. To distinguish it both from flu viruses that infect mainly pigs and from the seasonal influenza A H1N1 viruses that have been in circulation for many years, the CDC calls the virus "novel influenza A (H1N1) virus" and the World Health Organization calls it "pandemic (H1N1) 2009." The CDC calls swine flu illness "H1N1 flu" and the World Health Organization calls it "pandemic influenza A (H1N1)."

What are swine flu symptoms?
Symptoms of swine flu are like regular flu symptoms and include fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue. Many people with swine flu have had diarrhea and vomiting. Nearly everyone with flu has at least two of these symptoms. But these symptoms can also be caused by many other conditions. That means that you and your doctor can't know, just based on your symptoms, if you've got swine flu. Health care professionals may offer a rapid flu test, although a negative result doesn't necessarily mean you don't have the flu.

Like seasonal flu, pandemic swine flu can cause neurologic symptoms in children. These events are rare, but, as cases associated with seasonal flu have shown, they can be very severe and often fatal. Symptoms include seizures or changes in mental status (confusion or sudden cognitive or behavioral changes). It's not clear why these symptoms occur, although they may be caused by Reye's syndrome. Reye's syndrome usually occurs in children with a viral illness who have taken aspirin -- something that should always be avoided.

Only lab tests can definitively show whether you've got swine flu. State health departments can do these tests. But given the large volume of samples coming in to state labs, these tests are being reserved for patients with severe flu symptoms. Currently, doctors are reserving antiviral drugs for people with or at risk of severe influenza.

Who is at highest risk from H1N1 swine flu?
Most U.S. cases of H1N1 swine flu have been in older children and young adults. It's not clear why, and it's not clear whether this will change.

But certain groups are at particularly high risk of severe disease or bad outcomes if they get the flu:

Young children, especially those under 12 months of age .
Elderly people are at high risk of severe flu disease. But relatively few swine flu cases have been seen in people over age 65.

People with cardiovascular conditions (except high blood pressure)
People with liver problems
People with kidney problems
People with blood disorders, including sickle cell disease
People with neurologic disorders
People with neuromuscular disorders
People with metabolic disorders, including diabetes
People with immune suppression, including HIV infection and medications that suppress the immune system, such as cancer chemotherapy or anti-rejection drugs for transplants
Residents of a nursing home or other chronic-care facility
People in these groups should seek medical care as soon as they get flu symptoms.

A striking number of adults who developed severe swine flu complications have been morbidly obese. However, obesity itself does not seem to be the issue. The vast majority of extremely obese people suffer respiratory problems and/or diabetes, which seem to be the underlying reason for their severe flu complications.

Children should be given urgent medical attention if they:
Have fast breathing or trouble breathing
Have bluish or gray skin color
Are not drinking enough fluid
Are not waking up or not interacting
Have severe or persistent vomiting
Are so irritable that the child does not want to be held
Have flu-like symptoms that improve but then return with fever and a worse cough
Have fever with a rash
Have a fever and then have a seizure or sudden mental or behavioral change.

Adults should seek urgent medical attention if they have:
Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting
Flu-like symptoms that improve, but then come back with worsening fever or cough.

How does swine flu spread? Is it airborne?
The new swine flu virus apparently spreads just like regular flu. You could pick up germs directly from droplets from the cough or sneeze of an infected person, or by touching an object they recently touched, and then touching your eyes, mouth, or nose, delivering their germs for your own infection. That's why you should make washing your hands a habit, even when you're not ill. Infected people can start spreading flu germs up to a day before symptoms start, and for up to seven days after getting sick, according to the CDC.

The swine flu virus can become airborne if you cough or sneeze without covering your nose and mouth, sending germs into the air. Ferret studies suggest that swine flu spreads less easily by small, airborne droplets than does seasonal flu. But it does spread by this route, and it may begin to spread even more readily as the new virus fully adapts to humans.

The new swine flu virus is a human virus spread by people and not by pigs. The only way to get the new swine flu is from another person.

How can I prevent swine flu infection?
The CDC recommends taking these steps:

Wash your hands regularly with soap and water, especially after coughing or sneezing. Or use an alcohol-based hand cleaner if soap and water are not available.
Avoid close contact -- that is, being within 6 feet -- with people who have flu-like symptoms.
Avoid touching your mouth, nose, or eyes. That's not easy to do, so keep those hands clean.
If you have flu-like symptoms -- fever plus at least cough or sore throat or other flu symptoms -- stay home for seven days after symptoms begin or until you've been symptom-free for 24 hours -- whichever is longer.
Wear a face mask (consider using an N95 respirator) if you must come into close contact with a sick person. "Close contact" means within 6 feet. Note: There is no definitive proof that a face mask prevents flu transmission. Do not rely solely on a face mask to prevent infection.
Wear an N95 respirator if helping a sick person with a nebulizer, inhaler, or other respiratory treatment. Note: There is no definitive proof that a respirator prevents flu transmission. Do not rely solely on a respirator to prevent infection.
People who have or are suspected of having swine flu should wear a face mask, if available and tolerable, when sharing common spaces with other household members, when outside the home, or when near children or infants.
Breastfeeding mothers with swine flu symptoms should express their breast milk, and the child should be fed by someone else.

Should I wear a face mask or respirator?
Short answer: Maybe. Face masks and respirators may very well offer extra protection, but should not be your first line of defense against either pandemic or seasonal flu.

Every day, newspapers carry pictures of people wearing face masks to prevent swine flu transmission. But very little is known about whether face masks actually protect against the flu.

There's a difference between a face mask and a respirator. A face mask does not seal tightly to the face. Face masks include masks labeled as surgical, dental, medical procedure, isolation, or laser masks. Respirators are N95- or higher-rated filtering face pieces that fit snugly to the face. Respirators filter out virus particles when correctly adjusted -- which is not as simple as it sounds. But it's hard to breathe through them for extended periods, and they cannot be worn by children or by people with facial hair.

People who have flu-like symptoms should carry disposable tissues to cover their coughs and sneezes. When going out in public, or when sharing common spaces around the home with family members, they should put on a face mask -- if one is available and tolerable.

People not at risk of severe flu illness can best protect themselves from swine flu with frequent hand washing and by staying at least 6 feet away from people with flu symptoms. But if swine flu is circulating in the community, a face mask or respirator may be protective in crowded public places.

People at increased risk of severe flu illness -- pregnant women, for example -- should add a face mask to these tried-and-true precautions when providing assistance to a person with flu-like illness. And anyone else who cannot avoid close contact with someone who has swine flu (if you must hold a sick infant, for example) may try using a face mask or respirator.


The World Health Organization has declared swine flu to be a pandemic. That means that all nations can expect to see swine flu infections -- and should prepare for them -- but does not mean the virus has become more severe.

The H1N1 swine flu outbreak came at the end of the U.S. flu season. The virus spread across the nation and around the globe in the spring and summer, seasons when flu usually ebbs to nearly undetectable levels in the Northern Hemisphere.

In the Southern Hemisphere, most nations have seen large numbers of H1N1 swine flu cases. Fortunately, there's no sign that the pandemic flu bug has become more deadly, more resistant to new flu drugs, or less likely to be stopped by the H1N1 swine flu vaccine now in production.

Nobody knows how bad the swine flu will be during the Northern Hemisphere flu season. But the CDC is warning Americans to prepare for a bad flu season this fall. It's better to over-prepare and look a little silly if nothing happens than to be unprepared for an emergency.

(source:www.webmd.com)

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