The spread of swine flu is fast emerging as No 1 healthcare emergency not just in the country but

the world over. Despite the issue being in the media for a long time, there continue to be ignorance and
mis-information about the disease and how to handle it. Indian Medical Association, Nagpur Centre, has
come up with a information dossier on the subject. We reproduce it here for the benefit of our readers.

What is H1N1 (swine) flu?

H1N1 (referred to as "swine flu" early on) is a new influenza virus causing illness in people. This new
virus was first detected in people in the United States in April 2009. Other countries, including Mexico and
Canada, have also reported people sick with this new virus. This virus is spreading from person-to-
person, probably in much the same way that regular seasonal influenza viruses spread.

In late March and early April 2009, cases of human infection with swine influenza A (H1N1) viruses were
first reported in Southern California and near San Antonio, Texas.

In the beginning it was difficult to predict the effect of this virus on general population. In seasonal flu,
there are certain people who are at higher risk of serious flu-related complications. This includes people
with 65 years of more age, children below five years, pregnant women, and people of any age with
chronic medical conditions.

This virus is contagious but, at this time, it not known how easily the virus spreads between people. The
symptoms of H1N1 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. Some people have reported
diarrhoea and vomiting associated with H1N1 swine flu. Severe illness (pneumonia and respiratory
failure) and even deaths have been reported with H1N1 swine flu infection. Like seasonal flu, H1N1 swine
flu may cause a worsening of underlying chronic diseases.

What are the symptoms?

In children, emergency warning signs that need urgent medical attention include:
* Fast breathing or difficulty in breathing
* Bluish or gray skin colour
* Not drinking enough fluids
* Severe or persistent vomiting
* Not waking up or not interacting
* Being so irritable that the child does not want to be held
* Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:
* Difficulty in breathing or shortness of breath
* Pain or pressure in the chest or abdomen
* Sudden dizziness
* Confusion
* Severe or persistent vomiting
* Flu-like symptoms improve but then return with fever and worse cough

How do you catch H1N1 (swine) flu?

Spread of H1N1 (swine) flu can occur in two ways:

H1N1 virus appears to be transmitted the same way that seasonal flu spreads. Flu viruses are spread
mainly from person to person through coughing or sneezing by people with influenza. Sometimes people
may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How can someone with the flu infect someone else?

Infected people can infect others right from day one even before they themselves develop any symptoms
up to seven or more days after becoming sick. That means that one can pass on the infection to someone
else before he/she even knows that he/she is sick, as well as while one is sick.

What can I do to protect myself from getting sick?

There is no vaccine available right now to protect against H1N1 (swine) flu. There are everyday actions
that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these
everyday steps to protect your health:

* Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after
you use it.

* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand
cleaners are also effective.

* Avoid touching your eyes, nose or mouth. Germs spread this way.

* Try to avoid close contact with sick people.

* If you get sick with influenza, you should stay at home and not go for work or school and limit contact
with others to prevent them from getting infecting by you.

* Reduce the time spent in the crowded settings.

* Improve airflow in the living space by opening the windows and proper ventilation.

* Practice good health habits including adequate sleep, eating nutritious food, and keeping physically
active.
How long can influenza virus remain viable on objects (such as books and doorknobs)?

Studies have shown that influenza virus can survive on environmental surfaces and can infect a person
for up to 2-8 hours after being deposited on the surface.

Germs can be spread when a person touches something that is contaminated with germs and then
touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move
through the air. Germs can be spread when a person touches respiratory droplets from another person on
a surface like a desk, for example, and then touches his own eyes, mouth or nose before washing hands.

Are there medicines to treat H1N1 (swine) flu?

Yes, use of oseltamivir (brand name Tamiflu?) or zanamivir (brand name Relenza ?) for the treatment
and/or prevention of infection with these H1N1 (swine) influenza viruses. Antiviral drugs are prescription
medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in
your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster.
They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon
after getting sick (within two days of symptoms).

Follow the advice of your local public health department regarding school closures, avoiding crowds and
other measures to reduce flu transmission. These measures will continue to be important after a novel
H1N1 vaccine is available because they can prevent the spread of other viruses that cause respiratory
infections.

What should I do if I get sick?

If you live in areas where people have been identified with new H1N1 flu and become ill with influenza-
like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or
diarrhoea, you should stay home and avoid contact with other people, except to seek medical care. If you
have severe illness or you are at high risk for flu complications, contact your health care provider or seek
medical care. Your health care provider will determine whether flu testing or treatment is needed.

Antiviral drugs may reduce the symptoms and duration of illness, just as they do for seasonal influenza.
They also may contribute to preventing severe disease and death. WHO is in touch with public health
authorities and clinicians in affected countries and is gathering information about how effective the drugs
are.

What about using a mask? What does WHO recommend?

If you are not sick you do not have to wear a mask. If you are caring for a sick person, you can wear a
mask when you are in close contact with the ill person and dispose of it immediately after contact, and
clean your hands thoroughly afterwards.

If you are sick and have to travel or be around others, cover your mouth and nose.
Using a mask correctly in all situations is essential. Incorrect use actually increases the chance of
spreading infection.

How do I know if I have influenza A (H1N1)?

You will not be able to tell the difference between seasonal flu and influenza A (H1N1) without medical
help. Typical symptoms to watch for are similar to seasonal viruses and include fever, cough, headache,
body aches, sore throat and runny nose. Only your medical practitioner and local health authority can
confirm a case of influenza A (H1N1). If they suspect any symptoms they will send your blood sample,
throat swab and nasopharyngeal (nose to mouth) for testing to laboratories. Presently this facility is
available only at certain specified government laboratories.