SWINE FLU

OUTBREAK
2009
Dr.T.V.Rao MD
Professor of Microbiology
Sri Deva Raj Urs University Medical College,
Kolar India
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 SWINE FLU 2009
 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.
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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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 Qualifies as Phase 5
 By April 28, the new
strain was confirmed
to have spread to
Spain, the United
Kingdom, New
Zealand, and Israel,
and the virus was
suspected in many
other nations, with a
total of over 4,400
candidate cases,
prompting the WHO to
change its pandemic
alert phase to "Phase
5"
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Early cases - Mexico
 Although the exact
time and location
of the outbreak is
unknown, it is
believed to have
been first detected
when an influenza-
like illness was
reported by both
health agencies
and local news
media in Mexico
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 A New Strain of Influenzae
Virus
 The virus
responsible was
clinically
identified as a
new strain on
April 24, 2009

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A serious Concern to Health
Authorities
 In late April officials
from both World
Health Organization
(WHO) and the CDC
expressed serious
concern about the
situation, stating that
the virus had the
potential to become a
flu pandemic.

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Virologists Optimistic
 By late April,
however, some
virologists believed
that this strain was
unlikely to cause
as many fatalities
as earlier
pandemics, and
may not even be
as damaging as a
typical flu season.
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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 Centers 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 Euras


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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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Flu in Pigs Identified
 By May 2, some
pigs in Canada
were diagnosed
with H1N1.
 The Canadian Food
Inspection Agency
(CFIA) indicates
that it has found
H1N1 flu virus in a
swine herd in
Alberta.

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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
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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
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sequences.
 The pig strains carry several
other genes
 But the North
American pig strain
was itself the
product of previous
reassortments, and
has carried an
avian PB2 gene for
at least ten years
and a human PB1
gene since 1993.
These genes were
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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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 Case Definitions for Infection with Swine-
origin Influenza A (H1N1) Virus (S-OIV)

 A confirmed case
of S-OIV infection
is defined as a
person with an
acute febrile
respiratory illness
with laboratory
confirmed S-OIV
infection at CDC by
one or more of the
following tests.
Real-time RT-PCR
Viral culture

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 A probable case of S-OIV
 A probable case
of S-OIV infection is
defined as a person
with an acute
febrile respiratory
illness who is
positive for
influenza A, but
negative for H1
and H3 by
influenza RT-PC
PCR
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A suspected case of S-OIV
 suspected case of S-OIV infection is
defined as a person with acute febrile
respiratory illness with onset
 Within 7 days of close contact with a
person who is a confirmed case of S-OIV
infection, or
 Within 7 days of travel to community
either within the United States or
internationally where there are one or
more confirmed cases of S-OIV infection,
or
 Resides in a community where there are
one or more confirmed cases of S-OIV
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Simple Measures Help
 By touching
something
contaminated with
flu viruses and
then touching
one's mouth or
nose, and through
coughing or
sneezing. One of
the most effective
prevention
measures is
regular
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 Eating Pork Safe?
 People cannot catch
swine flu from eating
pork or pork products.
Cooking pork to an
internal temperature
of 160 degrees
Fahrenheit (71
degrees Celsius) kills
the swine flu virus
along with other
bacteria and viruses

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Yet no fully protective
Vaccine
 Vaccines are available
to be given to pigs to
prevent swine
influenza. There is no
vaccine to protect
humans from swine
flu, although the CDC
is formulating one.
The seasonal influenza
vaccine may help to
provide partial
protection against
swine H3N2, but not
against swine H1N1
viruses like the one
circulating now.
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 Past Vaccines proved not
safe
 In 1976 a new strain of swine flu started
infecting people and worried U.S. health
officials started widespread vaccination.
More than 40 million people were
vaccinated. But several cases of Guillain-
Barré syndrome, a severe and sometime
fatal condition that can be linked to come
vaccines, caused the U.S. government to
stop the program. The incident led to
widespread distrust of vaccines in general

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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.

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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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 Avoid Unnecessary Actions
 Avoiding touching
your eyes, nose or
mouth. Germs
spread this way
 Trying to avoid
close contact with
sick people.

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Staying at home if sick
 Staying home from
work or school if
you are sick

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 Several countreis effected
WHO
 The following countries
have reported laboratory
confirmed cases with no
deaths - Austria (1),
Canada (34), China, Hong
Kong Special
Administrative Region (1),
Denmark (1), France (1),
Germany (4), Israel (2),
Netherlands (1), New
Zealand (4), Republic of
Korea (1), Spain (13),
Switzerland (1) and the
United Kingdom (13).

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Prompt to seek Medical
Attention
 There is also no risk of
infection from this
virus from
consumption of well-
cooked pork and pork
products. Individuals
are advised to wash
hands thoroughly with
soap and water on a
regular basis and
should seek medical
attention if they
develop any
symptoms of
influenza-like
illness
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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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 Drugs are Highly Beneficial
 If you get sick, antiviral drugs can make
your illness milder and make you feel
better faster. They may also prevent
serious influenza complications. Influenza
antiviral drugs work best when started
soon after illness onset (within two 2
days), but treatment with antiviral drugs
should still be considered after 48 hours of
symptom onset, particularly for
hospitalized patients or people at high risk
for influenza-related complications.
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 CDC Recommends
 CDC recommends
the use of
oseltamivir or
zanamivir for the
treatment and/or
prevention of
infection with
swine influenza
viruses.

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Oseltamivir
 Oseltamivir (brand
name Tamiflu ®)
is approved to both
treat and prevent
influenza A and B
virus infection in
people one year of
age and older

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 Zanamivir
 Zanamivir (brand
name Relenza ®) is
approved to treat
influenza A and B
virus infection in
people 7 years and
older and to prevent
influenza A and B
virus infection in
people 5 years and
older.

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Spread the Message of Flu to
Everyone

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A good health preparedness
Possible Option in Prevention

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Updates on Swine
Flu
2009
Doctortvrao's ‘e’ learning series
Dr.T.V.Rao MD
Email
doctortvrao@gmail.com

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