Sunday, April 26, 2009

Swine Flu? What You Got To Know


The United States declared a public health emergency. Federal health officials said Sunday that 20 swine flu cases have been reported so far in New York, Ohio, Kansas, Texas and California. Patients have ranged in age from 9 to over 50. At least two were hospitalized. All recovered or are recovering.

In Mexico, health officials say a strain of swine flu has killed up to 86 people and sickened 1,400. Whereas in other countries, the governments raced to avoid both a pandemic and global hysteria Sunday as more possible swine flu cases surfaced from Canada to New Zealand.


What is swine influenza? 

Swine influenza, or “swine flu”, is a highly contagious acute respiratory disease of pigs, caused by one of several swine influenza A viruses. The virus is spread among pigs by aerosols and direct and indirect contact, and asymptomatic carrier pigs exist. Swine influenza viruses are most commonly of the H1N1 subtype, but other subtypes are also circulating in pigs (e.g., H1N2, H3N1, H3N2). Pigs can also be infected with avian influenza viruses and human seasonal influenza viruses as well as swine influenza viruses. The H3N2 swine virus was thought to have been originally introduced into pigs by humans. Sometimes pigs can be infected with more than one virus type at a time, which can allow the genes from these viruses to mix. This can result in an influenza virus containing genes from a number of sources, called a "reassortant" virus. Although swine influenza viruses are normally species specific and only infect pigs, they do sometimes cross the species barrier to cause disease in humans.


What are the implications for human health and the symptoms? 

Generally clinical symptoms are similar to seasonal influenza but reported clinical presentation ranges broadly from asymptomatic infection to severe pneumonia resulting in death. The most common symptoms are fever, fatigue, lack of appetite and coughing, although some people also develop a runny nose, sore throat, vomiting or diarrhea, according to the CDC.

Since typical clinical presentation of swine influenza infection in humans resembles seasonal influenza and other acute upper respiratory tract infections, most of the cases have been detected by chance through seasonal influenza surveillance. Mild or asymptomatic cases may have escaped from recognition, therefore the true extent of this disease among humans is unknown


How do people become infected? 

People usually get swine influenza from infected pigs, however, some human cases lack contact history with pigs or environments where pigs have been located. Human-to-human transmission has occurred in some instances but was limited to close contacts and closed groups of people. 


Is it safe to eat pork and pork products? 

Yes. Swine influenza has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. The swine influenza virus is killed by cooking temperatures of 160°F/70°C, corresponding to the general guidance for the preparation of pork and other meat.


What about the pandemic risk? 

It is likely that most of people, especially those who do not have regular contact with pigs, do not have immunity to swine influenza viruses that can prevent the virus infection. If a swine virus established efficient human-to human transmission, it can cause an influenza pandemic. The impact of a pandemic caused by such a virus is difficult to predict: it depends on virulence of the virus, existing immunity among people, cross protection by antibodies acquired from seasonal influenza infection and host factors. Swine influenza viruses can give a rise to a hybrid virus by mixing with a human influenza virus and can cause pandemic. 


Is there a human vaccine to protect from swine influenza? 

No. Influenza viruses change very quickly and the match between the vaccine and the circulating virus is very important to give adequate protective immunity to vaccinated people. This is why WHO needs to select vaccine viruses twice a year for seasonal influenza protection, once for the northern hemisphere winter and another for the southern hemisphere. Current seasonal influenza vaccine produced based on WHO recommendation does not contain swine influenza virus. It is unknown whether the seasonal vaccines can provide any cross protection to ongoing swine influenza virus infection in the United States and Mexico. WHO is working closely with its partner institutions for further advise on the use of seasonal influenza vaccine in preventing the swine influenza infection. 


What drugs are available for treatment?

Antiviral drugs for seasonal influenza are available in some countries and effectively prevent and treat the illness. There are two classes of such medicines, 1) adamantanes (amantadine and remantadine), and 2) inhibitors of influenza neuraminidase (oseltamivir and zanamivir). Most of the previously reported swine influenza cases recovered fully from the disease without requiring medical attention and without antiviral medicines. 

Main Source: WHO
More Q & A on Swine Flu here


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