Prevent Swine Flu

Posts Tagged ‘influenza a h1n1’

Like seasonal flu, 2009 H1N1 flu in humans can fluctuate in seriousness from mild to severe. Formerly known as swine flu, the 2009 H1N1 flu virus infection can cause a wide range of symptoms, including fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people with the flu may also experience symptoms of vomiting and diarrhea. It has been noted that certain groups might be more likely to develop a severe illness from 2009 H1N1 flu infection, such as pregnant women and persons with chronic medical conditions.

Influenza viruses are thought to spread from person to person by respiratory droplets coming from coughs and sneezes of an infected person. This can happen when droplets from a cough or sneeze of an infected person are spread through the air and settles on the mouth or nose of someone close by.  Influenza viruses may also be spread when a person touches respiratory droplets that may be on another person or an object and then touches their own mouth or nose before washing their hands.

The preferred course of action, of course, would be to avoid close contact with persons infected with the flu as much as humanly possible.  Close contact would be considered less than about 6 feet away from the infected person.  If you must come into contact with a sick person spend the least amount of time possible near them and try to wear a facemask or surgical mask or N95 disposable respirator if at all possible. An N95 respirator that fits snugly on your face can filter out small particles that can be inhaled around the edges of a facemask. It may harder to breathe through an N95 mask for long periods of time compared to a facemask. Facemasks and respirators can be found for purchase at a pharmacy, building supply or hardware store.

Some helpful hints to keep in mind if you find yourself in need of wearing a facemask or N95 respirator are the following:

• Wear an N95 respirator if you help a sick person with respiratory treatments using a nebulizer or inhaler, as directed by their doctor. Respiratory treatments should be performed in a separate room away from common areas of the house when at all possible.
• Used facemasks and N95 respirators should be taken off and placed immediately in the regular trash so they don’t touch anything else.
• Avoid re-using disposable facemasks and N95 respirators, if possible. If a reusable fabric facemask is used, it should be laundered with normal laundry detergent and tumble-dried in a hot dryer.
• After you take off a facemask or N95 respirator, clean your hands with soap and water or an alcohol-based hand sanitizer.

Things to look for – protect yourself from H1N1

How do you Prevent Flu?
Experts are recommending that if you are showing signs of flu-like symptoms this flu season, staying home and avoiding contact with other people except to get medical care is the best option. The thought is to keep the spread of flu-like symptoms to a minimum.  Most people who have come down with the 2009 H1N1 have had mild illness and have not needed medical care or antiviral drugs.  This is also true of seasonal flu.

In the event that you are one of the people who are more likely to get flu complications then you should talk to a health care provider about whether you need to be examined if you get flu symptoms this season. People who fall into a higher risk category are children younger than 5, but especially children younger than 2 years old, people 65 and older and pregnant women.  Others at risk are people who have the following:

o    Cancer

o    Blood disorders (including sickle cell disease)

o    Chronic lung disease [including asthma or chronic obstructive pulmonary disease (COPD)]

o    Diabetes

o    Heart disease

o    Kidney disorders

o    Liver disorders

o    Neurological disorders (including nervous system, brain or spinal cord)

o    Neuromuscular disorders (including muscular dystrophy and multiple sclerosis)

o    Weakened immune systems (including people with AIDS)

There are drugs your doctor may prescribe for treating both seasonal and 2009 H1N1 called antiviral drugs. These drugs can make you better faster and may also prevent serious complications. This flu season, antiviral drugs are being used mainly to treat people who are very sick, such as people who need to be hospitalized, and to treat sick people who are more likely to get serious flu complications like those mentioned above. Your health care provider will decide whether antiviral drugs are needed to treat your illness. If you get sick with flu symptoms and are at high risk of flu complications or you are concerned about your illness, talk to your doctor. It is not advised to go to the emergency room because if you do not have the flu, you may catch it from sick people who are there.

Symptoms of the flu could be one or a combination of fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue and sometimes diarrhea and vomiting.  An important side note to keep in mind is that not everyone suffering from the flu will show signs of a fever.  Remember, most people with 2009 H1N1 have had mild illness and have not needed medical care or antiviral drugs and the same is true of seasonal flu.  Also, it’s possible for healthy people to develop severe illness from the flu so anyone concerned about their illness should consult a health care provider.

H1N1 Vaccine – Jury is still out

Teens and young adults continue to account for the majority of cases of H1N1 around the world, with numbers of hospitalized cases highest in very young children. One% to ten% of patients with clinical illnesses will require hospitalization. Of those hospitalized patients anywhere from 10% to 25% will need to be admitted to an intensive care unit. Of those cases, 2% to 9% end up being fatal.  This information is according to the Strategic Advisory Group of Experts (SAGE) on Immunization, which advises the World Health Organization (WHO) on policies and strategies for vaccines and immunization.

A recent session of the SAGE October 27^th – 29^th meeting was dedicated to the discussion of pandemic influenza vaccines. The experts at SAGE reviewed the current epidemiological situation of the pandemic worldwide and considered issues and options from a public health perspective. Overall, from 7% to 10% of all hospitalized patients are pregnant women in their second or third trimester of pregnancy. Pregnant women are ten times more likely to need care in an intensive care unit when compared with the general population.  Based on data and the substantially elevated risk for a severe outcome in pregnant women infected with the pandemic virus, The Strategic Advisory Group of Experts on Immunization (SAGE) recommended that any licensed vaccine can be used in pregnant women, provided no specific opposition has been identified by the regulatory authority.

The SAGE experts also advised WHO on the number of doses of vaccine needed to provide protection across all different age groups, the joint dispensing of seasonal and pandemic vaccines, and vaccines for use in pregnant women. Recommendations on the formulation of seasonal influenza vaccines for the southern hemisphere in 2010 were also provided.  Other agenda items discussed included the status of vaccine availability, results from clinical trials on vaccine immunogenicity, and early results from safety monitoring in countries where dispensation of the H1N1 pandemic vaccine is currently under way.

Early results of the monitoring of people who have received pandemic vaccines were reviewed by the experts from SAGE and there were no indications of unusual adverse reactions found. Some adverse events following vaccination have been noticed, but these are well within the range of those seen with seasonal vaccines. All of which are believed to have an excellent safety profile.  Although early results are encouraging, they suggested monitoring for adverse events should be continued. The group also suggested that data on immunogenicity in children older than 6 months and younger than 10 years are limited and more studies are needed. National authorities have made children a priority for early vaccination. The SAGE recommendation is that precedence be given to the allocation of one dose of vaccine to as many children as possible.

The CDC says that a good way to prevent any flu disease is to avoid exposure to the virus. This is done by frequent hand washing, not touching your hands to your face.  Be especially careful to avoid the nose and mouth and avoiding any close proximity to or touching any person who may have flu symptoms. Since the virus can remain live and infectious for about 48 hours on many surfaces it is essential to practice good hygiene like cleaning with soap and water or alcohol-based hand disinfectants. Some physicians say face masks may help prevent getting airborne flu viruses from a cough or sneeze but others think it would be better for the people who actually have symptoms and sneeze or cough to wear the masks.

The use of Tamiflu or Relenza may help prevent the flu if taken before symptoms develop or reduce symptoms if taken within about 48 hours after symptoms develop. The vaccine recommendations as of October 2009 from the CDC say the following groups should get the vaccine as soon as it is available:

* people who live with or provide care for children younger than 6 months of age,
* pregnant women,
* health-care and emergency medical services personnel,
* people between 6 months and 24 years of age, and
* people from the ages of 25 through 64 who are at higher risk because of chronic health disorders such as asthma, diabetes, or a weakened immune system.

Generally speaking, about 90%-95% of people who get the disease feel dreadful but eventually bounce back with no problems.  This has been seen in patients in both Mexico and the U.S. Caution is still crucial as the swine flu (H1N1) is still spreading and has become a pandemic. So far, young adults been hit hardest, and in Mexico, this group currently has the highest mortality rate. This data however is constantly changing.

At this time the CDC is stating that people ages 10 and above are likely to need only one vaccine shot to provide protection against novel H1N1 swine flu and further suggest that these shots will be effective in about 76% of people who obtain the vaccine. One type of vaccine (currently named Influenza A [H1N1] 2009 Monovalent Vaccine Live, Intranasal) has been made available during the first week in October 2009. It is a live attenuated novel H1N1 flu vaccine that contains no thimerosal.  This vaccine is produced by MedImmune, LLC, and is administered by spraying it into the nostrils. This vaccine is only for healthy people 2-49 years of age. Children 2-9 years of age should receive two doses (0.1 ml in each nostril; total equals 0.2 ml per dose) and the second dose should be given the same way about one month after the first dose.  Children, adolescents and adults, 10-49 years of age should receive one dose (0.1 ml in each nostril; total equals 0.2 ml per dose).

Pneumonia and Influenza Hospitalization and Death Tracking system was implemented on August 30, 2009, and replaces the weekly report of laboratory confirmed 2009 H1N1-related hospitalizations and deaths that began in April 2009. Jurisdictions can now report to CDC either laboratory confirmed or pneumonia and influenza based counts of hospitalizations and deaths resulting from all types or subtypes of influenza, not just those from 2009 H1N1 influenza virus. To allow jurisdictions to implement the new case definition, counts were reset to zero on August 30, 2009. From August 30 – October 10, 2009, 4,958 laboratory-confirmed influenza associated hospitalizations, 292 laboratory-confirmed influenza associated deaths, 15,696 pneumonia and influenza syndrome-based hospitalizations, and 2,029 pneumonia and influenza syndrome-based deaths, were reported to CDC. CDC will continue to use its traditional surveillance systems to track the progress of the 2009-10 influenza season.

A flu pandemic occurs when a new influenza A virus emerges for which there is little or no immunity in the human population. As we have seen the virus causes serious illness and spreads easily from person-to-person worldwide. On June 11, 2009, the World Health Organization (WHO) declared that a global pandemic of H1N1 flu is in progress. Nearly 5,000 people have died from swine flu infections since the A(H1N1) virus made its debut in April, the World Health Organization said on Friday. The death toll marked an increase of about 265 over the 4,735 deaths reported to the WHO a week ago.  The majority of the fatal cases which number 3,539 have been recorded in North and South America, the UN health agency said in its latest update on the escalating flu pandemic.

Overseas countries like Iceland, Sudan, and Trinidad and Tobago reported their first fatal cases over the past week.  Mongolia, Rwanda, and Sao Tome and Principe also recorded pandemic influenza cases for the first time, as the virus continued to spread.  Perhaps some good news is the  A(H1N1) influenza was declining in tropical areas of the world.  That is with the exception of Cuba and Colombia.  There was also no significant pandemic related activity over the past week in warmer areas of the southern hemisphere, the WHO said.  At this time respiratory disease activity persists in spreading and growing in intensity in the northern hemisphere, predominately in North America.  Extensive efforts are ongoing to track and monitor the spread of all flu viruses. In the U.S., epidemiologists at the Centers for Disease Control (CDC) are working diligently with the states affected to collect, compile and analyze reports of flu outbreaks.  As of September 2009, the current calculations are that about 90,000 deaths will take place in the U.S. from novel H1N1 swine flu. This is the estimate set out by the president’s advisory committee. There has been no revision of these numbers by the advisory committee or the CDC as of October 2009.

Hot List: What You Can Do to Stay Healthy

According to the latest information the government recommendations to
avoid contracting swine flu include these simple steps. Of course this
is not an all inclusive list and some items on the list are impossible
to do — like getting a vaccination right now but here is the best
list we have:

Get vaccinated. Vaccination is the best protection we have against
flu. Seasonal flu vaccine is available now and initial doses of 2009
H1N1 flu vaccine also are available, with additional doses available
later this year.
Influenza is thought to spread mainly person-to-person through
coughing or sneezing of infected people.
Take everyday actions to stay healthy.

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. If soap and water are not
available, use an alcohol-based hand rub.
Avoid touching your eyes, nose and mouth. Germs spread that way.
Stay home if you get sick. CDC recommends that you stay home from work
or school and limit contact with others to keep from infecting them.

Follow public health advice regarding school closures, avoiding crowds
and other social distancing measures.
Find healthy ways to deal with stress and anxiety.
Stay informed. This website will be updated regularly as information
becomes available.
Call 1-800-CDC-INFO for more information.

Flu activity in the U.S. is reported to now be widespread in 41 states. Across the nation visits to doctors for influenza-like-illness continued to be on the rise and are now about equal to or higher than what is seen at the height of most normal flu seasons. Flu-related hospitalizations and deaths are also continuing to mount and are above expectations for this time of year.

The CDC continues to remind health providers and the public of the need to continue hand and cough hygiene measures for the period of any influenza symptoms, even while taking antiviral medications in order to combat the spread of antiviral resistant virus strains. The influenza activity reported by both state and territorial epidemiologists shows geographic spread of both seasonal influenza and 2009 influenza A (H1N1) viruses.

Each week CDC evaluates information collected about influenza disease activity in the United States and issues findings of key flu indicators in a report called FluView. A review of the key indictors found that during the week of October 4-10, 2009 influenza activity continued to increase in the United States from the previous week. Below is a summary of the latest significant indicators:

· Visits to doctors for influenza-like illness (ILI) continued to increase in the United States, and overall, are higher than what is expected for this time of the year. ILI activity now is equal to or higher than what is seen at the peak of many regular flu seasons.

· Total influenza hospitalization rates for laboratory-confirmed flu are climbing and are higher than expected for this time of year.

· The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report has increased and exceeds what is normally expected at this time of year. In addition, 11 flu-related pediatric deaths were reported this week; 10 of these deaths were confirmed 2009 H1N1, and one was influenza A virus, but unsubtyped. Since April 2009, there have been 86 confirmed pediatric 2009 H1N1 deaths; 39 of these have been reported to CDC since August 30, 2009.

· Forty-one states are reporting widespread influenza activity at this time. They are: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Texas, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. This many reports of widespread activity are unprecedented during seasonal flu.

· Almost all of the influenza viruses identified so far is 2009 H1N1 influenza A viruses. These viruses remain similar to the virus chosen for the 2009 H1N1 vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir with rare exception.

The ongoing outbreak of novel influenza A (H1N1) continues to expand in the United States and internationally. CDC expects that more cases, more hospitalizations and more deaths from this outbreak will occur over the coming days and weeks.

CDC continues to take aggressive action to respond to an expanding outbreak caused by novel H1N1 flu.

CDC’s response goals are to:

1. Reduce transmission and illness severity, and
2. Provide information to help health care providers, public health officials and the public address the challenges posed by this emergency.

CDC is issuing updated interim guidance daily in response to the rapidly evolving situation. This includes updated interim guidance for clinicians on how to identify and care for people who are sick with novel H1N1 flu now that more widespread illness has been detected in the United States. CDC recommends that testing and antiviral treatment be prioritized for those with severe respiratory illness and those at highest risk of complications from seasonal influenza. This includes children younger than 5 years old, pregnant women, people with chronic medical conditions and weakened immune systems, and people 65 years and older. In addition, CDC has provided information for the public on what to do if they develop flu-like symptoms.

CDC has completed deployment of 25 percent of the supplies in the Strategic National Stockpile (SNS) to all states in the continental United States. These supplies and medicines will help states and U.S. territories respond to the outbreak. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against the novel H1N1 flu virus.

Response actions are aggressive, but they may vary across states and communities depending on local circumstances. Communities, businesses, places of worship, schools and individuals can all take action to slow the spread of this outbreak. People who are sick are urged to stay home from work or school and to avoid contact with others, except to seek medical care. This action can avoid spreading illness further.

Check out this handy PowerPoint presentation on Swine flu Prevention measures.