Swine Flu

SWINE FLUSWINE FLUDr.T.V.Rao MDDr.T.V.Rao MD

What is Swine FluWhat is Swine Flu

Swine influenza virusSwine influenza virus (referred to (referred to as as SIVSIV) refers to influenza cases that ) refers to influenza cases that are caused by Orthomyxovirus are caused by Orthomyxovirus endemic to pig populations. SIV endemic to pig populations. SIV strains isolated to date have been strains isolated to date have been classified either as Influenza(virus C classified either as Influenza(virus C or one of the various subtypes of the or one of the various subtypes of the genus Influenza virus A)genus Influenza virus A)

Different Strains circulate Different Strains circulate PeriodicallyPeriodically

In the United States the H1N1 subtype In the United States the H1N1 subtype was exclusively prevalent among swine was exclusively prevalent among swine populations before 1998; however, populations before 1998; however, since late August 1998, H3N2 subtypes since late August 1998, H3N2 subtypes have been isolated from pigs. As of have been isolated from pigs. As of 2004, H3N2 virus isolates in US swine 2004, H3N2 virus isolates in US swine and turkey stocks were triple and turkey stocks were triple reassortants, containing genes from reassortants, containing genes from human (HA, NA, and PB1), swine (NS, human (HA, NA, and PB1), swine (NS, NP, and M), and avian (PB2 and PA) NP, and M), and avian (PB2 and PA) lineages.lineages.

MAP of H1 N1 Swine FluMAP of H1 N1 Swine Flu

Swine Influenza (Flu)Swine Influenza (Flu)

Swine Influenza (swine flu) is a Swine Influenza (swine flu) is a respiratory disease of pigs caused by respiratory disease of pigs caused by type A influenza that regularly cause type A influenza that regularly cause outbreaks of influenza among pigs. outbreaks of influenza among pigs. Swine flu viruses do not normally infect Swine flu viruses do not normally infect humans, however, human infections humans, however, human infections with swine flu do occur, and cases of with swine flu do occur, and cases of human-to-human spread of swine flu human-to-human spread of swine flu viruses has been documented. viruses has been documented.

Pigs can harbour influenza Pigs can harbour influenza viruses can be adapted to viruses can be adapted to

HumansHumans

Swine Flu-Present StatusSwine Flu-Present Status

From December 2005 through February From December 2005 through February 2009, a total of 12 human infections 2009, a total of 12 human infections with swine influenza were reported from with swine influenza were reported from 10 states in the United States. Since 10 states in the United States. Since March 2009, a number of confirmed March 2009, a number of confirmed human cases of a new strain of swine human cases of a new strain of swine influenza A (H1N1) virus infection in the influenza A (H1N1) virus infection in the U.S. and internationally have been U.S. and internationally have been identified. An investigation into these identified. An investigation into these cases is ongoing. cases is ongoing.

Swine Flu 2009Swine Flu 2009

In late March and early April 2009, In late March and early April 2009, cases of human infection with swine cases of human infection with swine influenza A (H1N1) viruses were first influenza A (H1N1) viruses were first reported in Southern California and reported in Southern California and near San Antonio, Texas. Other U.S. near San Antonio, Texas. Other U.S. states have reported cases of swine states have reported cases of swine flu infection in humans and cases flu infection in humans and cases have been reported internationally as have been reported internationally as well. well.

Update - Status Swine Update - Status Swine FluFlu

The United States Government has The United States Government has reported seven confirmed human reported seven confirmed human cases of Swine Influenza A/H1N1 in cases of Swine Influenza A/H1N1 in the USA (five in California and two in the USA (five in California and two in Texas) and nine suspect cases. All Texas) and nine suspect cases. All seven confirmed cases had mild seven confirmed cases had mild Influenza-Like Illness (ILI), with only Influenza-Like Illness (ILI), with only one requiring brief hospitalization. No one requiring brief hospitalization. No deaths have been reported. deaths have been reported.

Swine Flu in MexicoSwine Flu in Mexico

In the Federal District of Mexico, In the Federal District of Mexico, surveillance began picking up cases of surveillance began picking up cases of ILI starting 18 March. The number of ILI starting 18 March. The number of cases has risen steadily through April cases has risen steadily through April and as of 23 April there are now more and as of 23 April there are now more than 854 cases of pneumonia from the than 854 cases of pneumonia from the capital. Of those, 59 have died. In San capital. Of those, 59 have died. In San Luis Potosi, in central Mexico, 24 cases Luis Potosi, in central Mexico, 24 cases of ILI, with three deaths, have been of ILI, with three deaths, have been reported. reported.

Swine Flu and VirusSwine Flu and Virus Swine Influenza (swine flu) is a respiratory Swine Influenza (swine flu) is a respiratory

disease of pigs caused by type A influenza disease of pigs caused by type A influenza virus that regularly causes outbreaks of virus that regularly causes outbreaks of influenza in pigs. Swine flu viruses cause influenza in pigs. Swine flu viruses cause high levels of illness and low death rates in high levels of illness and low death rates in pigs. Swine influenza viruses may circulate pigs. Swine influenza viruses may circulate among swine throughout the year, but most among swine throughout the year, but most outbreaks occur during the late fall and outbreaks occur during the late fall and winter months similar to outbreaks in winter months similar to outbreaks in humans. The classical swine flu virus (an humans. The classical swine flu virus (an influenza type A H1N1 virus) was first influenza type A H1N1 virus) was first isolated from a pig in 1930. isolated from a pig in 1930.

Cause by Reassortment of Cause by Reassortment of different strainsdifferent strains

Like all influenza viruses, Like all influenza viruses, swine flu viruses change swine flu viruses change constantly. Pigs can be constantly. Pigs can be infected by avian influenza infected by avian influenza and human influenza and human influenza viruses as well as swine viruses as well as swine influenza viruses. When influenza viruses. When influenza viruses from influenza viruses from different species infect different species infect pigs, the viruses can pigs, the viruses can reassort (i.e. swap genes) reassort (i.e. swap genes) and new viruses that are a and new viruses that are a mix of swine, human mix of swine, human and/or avian influenza and/or avian influenza viruses can emerge viruses can emerge

Swine Flu differs from Swine Flu differs from Human FluHuman Flu

The H1N1 swine flu The H1N1 swine flu viruses are viruses are antigenically very antigenically very different from human different from human H1N1 viruses and, H1N1 viruses and, therefore, vaccines therefore, vaccines for human seasonal for human seasonal flu would not provide flu would not provide protection from H1N1 protection from H1N1 swine flu viruses swine flu viruses

Out breaks among PigsOut breaks among Pigs Outbreaks among pigs Outbreaks among pigs

normally occur in normally occur in colder weather months colder weather months (late fall and winter) (late fall and winter) and sometimes with and sometimes with the introduction of new the introduction of new pigs into susceptible pigs into susceptible herds. Studies have herds. Studies have shown that the swine shown that the swine flu H1N1 is common flu H1N1 is common throughout pig throughout pig populations worldwide, populations worldwide, with 25 percent of with 25 percent of animals showing animals showing antibody evidence of antibody evidence of infection. infection.

Present Swine Flu Present Swine Flu strainsstrains

At this time, there are At this time, there are four main influenza four main influenza type A virus subtypes type A virus subtypes that have been that have been isolated in pigs: H1N1, isolated in pigs: H1N1, H1N2, H3N2, and H1N2, H3N2, and H3N1. However, most H3N1. However, most of the recently of the recently isolated influenza isolated influenza viruses from pigs have viruses from pigs have been H1N1 viruses. been H1N1 viruses.

How man is exposedHow man is exposed

Most commonly, these Most commonly, these cases occur in persons cases occur in persons with direct exposure with direct exposure to pigs (e.g. children to pigs (e.g. children near pigs at a fair or near pigs at a fair or workers in the swine workers in the swine industry). In addition, industry). In addition, there have been there have been documented cases of documented cases of one person spreading one person spreading swine flu to others. swine flu to others.

How How Swine FluSwine Flu presents in presents in HumansHumans

The symptoms of swine The symptoms of swine flu in people are flu in people are expected to be similar expected to be similar to the symptoms of to the symptoms of regular regular human human seasonal influenzaseasonal influenza and include fever, and include fever, lethargy, lack of lethargy, lack of appetite and coughing. appetite and coughing. Some people with Some people with swine flu also have swine flu also have reported runny nose, reported runny nose, sore throat, nausea, sore throat, nausea, vomiting and diarrhea vomiting and diarrhea

Is the eating Pork infects Is the eating Pork infects ??

No. Swine influenza No. Swine influenza viruses are not viruses are not transmitted by food. transmitted by food. You can not get swine You can not get swine influenza from eating influenza from eating pork or pork products. pork or pork products. Eating properly Eating properly handled and cooked handled and cooked pork and pork products pork and pork products is safe. Cooking pork is safe. Cooking pork to an internal to an internal temperature of 160°F temperature of 160°F kills the swine flu virus kills the swine flu virus as it does other as it does other bacteria and viruses bacteria and viruses

Close proximity with PIGS Close proximity with PIGS spread the Infectionsspread the Infections

Influenza viruses can Influenza viruses can be directly transmitted be directly transmitted from pigs to people from pigs to people and from people to and from people to pigs. Human infection pigs. Human infection with flu viruses from with flu viruses from pigs are most likely to pigs are most likely to occur when people are occur when people are in close proximity to in close proximity to infected pigs, such as infected pigs, such as in pig barns and in pig barns and livestock exhibits livestock exhibits housing pigs at fairs. housing pigs at fairs. Human-to-human Human-to-human transmission of swine transmission of swine flu can also occur. flu can also occur.

How Swine flu spread How Swine flu spread among Pigsamong Pigs

Swine flu viruses are Swine flu viruses are thought to be spread thought to be spread mostly through close mostly through close contact among pigs and contact among pigs and possibly from possibly from contaminated objects contaminated objects moving between moving between infected and uninfected infected and uninfected pigs. Herds with pigs. Herds with continuous swine flu continuous swine flu infections and herds that infections and herds that are vaccinated against are vaccinated against swine flu may have swine flu may have sporadic disease, or may sporadic disease, or may show only mild or no show only mild or no symptoms of infection. symptoms of infection.

Seek emergency medical careSeek emergency medical care..IF -IF - in Childrenin Children

In children emergency warning signs that In children emergency warning signs that need urgent medical attention include: need urgent medical attention include:

Fast breathing or trouble breathing Bluish Fast breathing or trouble breathing Bluish skin color.Not drinking enough fluids skin color.Not drinking enough fluids

Not waking up or not interacting Not waking up or not interacting Being so irritable that the child does not Being so irritable that the child does not

want to be held want to be held Flu-like symptoms improve but then return Flu-like symptoms improve but then return

with fever and worse cough with fever and worse cough Fever with a rash Fever with a rash

Adults Need attention if Adults Need attention if Present withPresent with

Difficulty breathing or shortness of Difficulty breathing or shortness of breath breath

Pain or pressure in the chest or Pain or pressure in the chest or abdomen abdomen

Sudden dizziness Sudden dizziness Confusion Confusion Severe or persistent vomiting Severe or persistent vomiting

DiagnosisDiagnosis To diagnose swine To diagnose swine

influenza A infection, a influenza A infection, a respiratory specimen respiratory specimen would generally need would generally need to be to be collected within collected within the first 4 to 5 days the first 4 to 5 days of illnessof illness (when an (when an infected person is most infected person is most likely to be shedding likely to be shedding virus). However, some virus). However, some persons, especially persons, especially children, may shed children, may shed virus for 10 days or virus for 10 days or longer. Identification as longer. Identification as a swine flu influenza A a swine flu influenza A virus virus

CDC helps in DiagnosisCDC helps in Diagnosis

Requires sending Requires sending the specimen to the specimen to CDC for laboratory CDC for laboratory testing as many testing as many laboratories in laboratories in Developing world Developing world do not have do not have facilitiesfacilities

Drugs which are effective in Drugs which are effective in Swine FluSwine Flu

There are four different There are four different antiviral drugs that are antiviral drugs that are licensed for use in the licensed for use in the US for the treatment of US for the treatment of influenza: influenza: Amantidine, Amantidine, rimantadine, rimantadine, oseltamivir and oseltamivir and zanamivirzanamivir. While most . While most swine influenza viruses swine influenza viruses have been susceptible have been susceptible to all four drugsto all four drugs

Drugs proved resistant at Drugs proved resistant at PresentPresent

Most recent swine Most recent swine influenza viruses influenza viruses isolated from isolated from humans are humans are resistant to resistant to Amantidine and Amantidine and Rimantadine Rimantadine

CDCCDC recommends at recommends at PresentPresent

CDC recommends CDC recommends the use of the use of oseltamivir or oseltamivir or zanamivirzanamivir for the for the treatment and/or treatment and/or prevention of prevention of infection with infection with swine influenza swine influenza viruses viruses

How long can an infected How long can an infected person spread swine flu to person spread swine flu to

othersothers?? People with swine influenza virus People with swine influenza virus

infection should be considered infection should be considered potentially contagious as long as potentially contagious as long as they are symptomatic and possible they are symptomatic and possible for up to 7 days following illness for up to 7 days following illness onset. Children, especially younger onset. Children, especially younger children, might potentially be children, might potentially be contagious for longer periods. contagious for longer periods.

How long can viruses live How long can viruses live outside the body?outside the body?

We know that some viruses and We know that some viruses and bacteria can live 2 hours or longer on bacteria can live 2 hours or longer on surfaces like cafeteria tables, surfaces like cafeteria tables, doorknobs, and desks. Frequent hand doorknobs, and desks. Frequent hand washing will help you reduce the washing will help you reduce the chance of getting contamination chance of getting contamination from these common surfaces. from these common surfaces.

No Vaccines to HumansNo Vaccines to HumansBut available to PIGSBut available to PIGS

Vaccines are available Vaccines are available to be given to pigs to to be given to pigs to prevent swine prevent swine influenza. influenza. There is no There is no vaccine to protect vaccine to protect humans from swine humans from swine fluflu. The seasonal . The seasonal influenza vaccine will influenza vaccine will likely help provide likely help provide partial protection partial protection against swine H3N2, against swine H3N2, but not swine H1N1 but not swine H1N1 viruses. viruses.

Avoid close contactAvoid close contact

Avoid close contact Avoid close contact with people who are with people who are sick. When you are sick. When you are sick, keep your sick, keep your distance from distance from others to protect others to protect them from getting them from getting sick too.sick too.

Aerosols spread Aerosols spread the virus in any the virus in any environment environment

Stay home when you are Stay home when you are sicksick..

If possible, stay If possible, stay home from work, home from work, school, and errands school, and errands when you are sick. when you are sick. You will help You will help prevent others prevent others from catching your from catching your illness. illness.

Cover your mouth and Cover your mouth and nose.nose.

Cover your mouth Cover your mouth and nose with a and nose with a tissue when tissue when coughing or coughing or sneezing. It may sneezing. It may prevent those prevent those around you from around you from getting sick getting sick

Clean your hands.Clean your hands.

Washing your hands Washing your hands often will help often will help protect you from protect you from germs.germs.

Hand washing Hand washing proved to be best proved to be best procedure in procedure in prevention of prevention of Majority of Majority of Communicable Communicable diseases. diseases.

Avoid touching your eyes, Avoid touching your eyes, nose or mouth.nose or mouth.

Germs are often Germs are often spread when a spread when a person touches person touches something that is something that is contaminated with contaminated with germs and then germs and then touches his or her touches his or her eyes, nose, or eyes, nose, or mouth. mouth.

Practice other good health Practice other good health habits.habits.

Get plenty of sleep, Get plenty of sleep, be physically active, be physically active, manage your stress, manage your stress, drink plenty of drink plenty of fluids, and eat fluids, and eat nutritious.nutritious.

Unnecessary Unnecessary Migration of people Migration of people from epidemic and from epidemic and endemic areas to be endemic areas to be reduced.reduced.

Is eating Pork meat safe Is eating Pork meat safe during Epidemicsduring Epidemics

Swine influenza Swine influenza viruses are not viruses are not spread by food. You spread by food. You cannot get swine cannot get swine influenza from influenza from eating pork or pork eating pork or pork products. Eating products. Eating properly handled properly handled and cooked pork and cooked pork products is safe. products is safe.

Healthy Habits reduces the Healthy Habits reduces the AttacksAttacks

Simple measures carry get Simple measures carry get good Benefitsgood Benefits

Cover your mouth and nose. Use a tissue when you cough or sneeze and drop it in the trash. If you don’t have a tissue, cover your mouth and nose as best you can.

Clean Hands saves youClean Hands saves you

Clean your hands often. Clean your hands every time you cough or sneeze. Hand washing stops germs. Alcohol-based gels and wipes also work well.

Cartoonists Imagination on Cartoonists Imagination on Swine FluSwine Flu

Visit for UpdatesVisit for Updates

CDCCDC CDC ( Center of CDC ( Center of

Disease) control Disease) control updates the updates the current current information.information.

The topic made as The topic made as

per guidelines ofper guidelines of CDCCDC

Created for Created for Awarness on Swine Awarness on Swine

FluFlu

Dr.T.V.Rao MDDr.T.V.Rao MD

EmailEmail

[email protected]@gmail.com