Sunday, August 9, 2009

2009 flu pandemic

The 2009 flu pandemic is a global outbreak of a new strain of influenza virus, officially named the "new H1N1", first identified in April 2009, and commonly called "Swine flu." It is thought to be a mutation of four known strains of the influenza A virus, subtype H1N1: one endemic in (normally infecting) humans, one endemic in birds, and two endemic in pigs (swine). Experts assume the virus "most likely" emerged from pigs in Asia, and was carried to North America by infected persons.[76] There is also evidence that the new strain had been circulating among pigs on other continents for years before infecting humans. But transmission is human to human, with cooked pork products safe to eat as the virus cannot be transmitted by eating foods.

The outbreak began in Mexico, with evidence that Mexico was already in the midst of an epidemic for months before the outbreak was recognized. Soon after, their government closed down most of Mexico City's public and private offices and facilities to help contain the spread. In early June, as the virus spread globally, the World Health Organization (WHO) declared the outbreak to be a pandemic, but also noted that most illnesses were of "moderate severity." The virus has since spread to the Southern Hemisphere which entered its winter flu season, and to many less developed countries with limited healthcare systems. Because the virus was spreading with "unprecedented speed", and many clinics were overwhelmed testing and treating patients, WHO stopped requiring countries to report all cases, but is still monitoring unusually large outbreaks.[77][78]

The virus typically spreads from coughs and sneezes or by touching contaminated surfaces and then touching the nose or mouth. Symptoms, which can last up to a week, are similar to those of seasonal flu, and may include fever, sneezes, sore throat, coughs, headache, and muscle or joint pains. The U.S. Centers for Disease Control and Prevention (CDC) notes that most cases worldwide have been mild so far and most hospitalizations and deaths have been of persons that also had underlying conditions such as asthma, diabetes, obesity, heart disease, or a weakened immune system. Then again, Dr Anne Schuchat from CDC thinks, "this is a virus that's capable of causing a spectrum of illness that includes severe complications and death". "It's very important we take this virus seriously".As the virus spreads easily between people, through the air or surface contact, those who get the flu are recommended to stay home from school or work and avoid crowds to avoid spreading the infection further.

In an attempt to slow the spread of the illness, a number of countries, especially in Asia, have quarantined airline passengers with flu symptoms, while some are also pre-screening passengers. WHO does not expect to have a full vaccine before the end of 2009, and vaccines available sooner may be limited and given first to healthcare workers, pregnant women, and other higher risk groups. Two or three injections will be required for maximum immunity from both the swine flu and seasonal flu. There is also concern if the new virus mutates further, it could become more virulent and less susceptible to any new vaccine.

What is the best way to keep from spreading the virus through coughing or sneezing?

If you are sick, limit your contact with other people as much as possible. If you are sick, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket. Then, clean your hands, and do so every time you cough or sneeze.

What should I do to keep from getting the flu?

First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.

Are there other ways to prevent the spread of illness?

All Americans share in the responsibility to plan for this fall’s flu season. Given the unique combination of regular seasonal flu , as well as the H1N1 virus, it’s important for every and take action to reduce the transmission of influenza. American families and businesses should prepare their own household and business plans and think through the steps they will need to take if a family member or a co-worker contracts the flu. We ask all Americans to visit our website at FLU.GOV to find information that will help them take the necessary steps to prepare for flu season and limit the spread of the flu virus. Here are some everyday actions that you and your family can take to stay healthy.
  • 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.
  • 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 hands cleaners are also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread that way.
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.

Is my potbelly pig in danger? Can I get it from my pet?

There is no evidence at this time that the virus is in U.S. swine. Swine owners should learn the warning signs of swine influenza. Signs of swine flu in pigs can include sudden onset of fever, depression, coughing (barking), discharge from the nose or eyes, sneezing, breathing difficulties, eye redness or inflammation, and going off feed. If your pig is showing any of these signs, call your veterinarian. Buy your animals from reputable sources and ensure that you have documentation of your new pet's origin. Be sure that you get your new animals checked by a veterinarian. Keep your pigs and areas around them clean. If you have been around other animals, make sure that you clean your shoes, clothing, and other items. And don't forget to wash your hands with warm water and soap for 20 seconds before and after handling your pet.

Can H1N1 influenza virus be spread at recreational water venues outside of the water?

Yes, recreational water venues are no different than any other group setting. The spread of this novel H1N1 flu is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

Can the new H1N1 flu virus be spread through water in swimming pools, spas, water parks, interactive fountains, and other treated recreational water v

Can the new H1N1 flu virus be spread through water in swimming pools, spas, water parks, interactive fountains, and other treated recreational water venues?

Influenza viruses infect the human upper respiratory tract. There has never been a documented case of influenza virus infection associated with water exposure. Recreational water that has been treated at CDC recommended disinfectant levels does not likely pose a risk for transmission of influenza viruses. No research has been completed on the susceptibility of the H1N1 influenza virus to chlorine and other disinfectants used in swimming pools, spas, water parks, interactive fountains, and other treated recreational venues. However, recent studies have demonstrated that free chlorine levels recommended by CDC (1–3 parts per million [ppm or mg/L] for pools and 2–5 ppm for spas) are adequate to disinfect avian influenza A (H5N1) virus. It is likely that other influenza viruses such as novel H1N1 virus would also be similarly disinfected by chlorine.

Is there a risk from drinking water?

Tap water that has been treated by conventional disinfection processes does not likely pose a risk for transmission of influenza viruses. Current drinking water treatment regulations provide a high degree of protection from viruses. No research has been completed on the susceptibility of the novel H1N1 flu virus to conventional drinking water treatment processes. However, recent studies have demonstrated that free chlorine levels typically used in drinking water treatment are adequate to inactivate highly pathogenic H5N1 avian influenza. It is likely that other influenza viruses such as novel H1N1 would also be similarly inactivated by chlorination. To date, there have been no documented human cases of influenza caused by exposure to influenza-contaminated drinking water.

What surfaces are most likely to be sources of contamination?

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 their own eyes, mouth or nose before washing their hands.

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.

Do pigs carry this virus and can I catch this virus from a pig?

At this time, there is no evidence that swine in the United States are infected with this new virus. However, there are flu viruses that commonly cause outbreaks of illness in pigs. Most of the time, these viruses do not infect people, but influenza viruses can spread back and forth between pigs and people.

Can people catch H1N1 (swine) flu from eating pork?

No. H1N1 (swine) influenza viruses are not transmitted by food. You can not get H1N1 (swine) influenza from eating pork or pork products. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 160°F kills the H1N1 (swine) flu virus as it does other bacteria and viruses

How can someone with the flu infect someone else?

Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are 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, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Are there other ways to prevent the spread of illness?

All Americans share in the responsibility to plan for this fall’s flu season. Given the unique combination of regular seasonal flu , as well as the H1N1 virus, it’s important for every and take action to reduce the transmission of influenza. American families and businesses should prepare their own household and business plans and think through the steps they will need to take if a family member or a co-worker contracts the flu. We ask all Americans to visit our website at FLU.GOV to find information that will help them take the necessary steps to prepare for flu season and limit the spread of the flu virus. Here are some everyday actions that you and your family can take to stay healthy.
  • 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.
  • 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 hands cleaners are also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread that way.
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.

There is speculation that the novel H1N1 flu virus was created in a laboratory and its appearance in the population is due to an accidental release.

There is speculation that the novel H1N1 flu virus was created in a laboratory and its appearance in the population is due to an accidental release. Is that true?

All available evidence to date indicates that this is a naturally occurring strain.

We are aware of a hypothesis claiming that the novel influenza A H1N1 virus was produced in a laboratory. Govt's extensive analysis of the genetic sequences of the 2009 H1N1 virus and its ancestors does not support this hypothesis.

How long can an infected person spread H1N1 (swine) flu to others?

People with H1N1 (swine) influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.

Are there medicines to treat H1N1 (swine) flu?

Yes. CDC recommends the 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 2 days of symptoms).

How does this new H1N1 virus spread?

Spread of this H1N1 virus is thought to be happening in 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 do you catch H1N1 (swine) flu?

Spread of H1N1 (swine) flu can occur in two ways:
  • Through contact with infected pigs or environments contaminated with swine flu viruses.
  • Through contact with a person with H1N1 (swine) flu. Human-to-human spread of H1N1 (swine) flu has been documented also and is thought to occur in the same way as seasonal flu. Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

How severe is illness associated with this new H1N1 virus?

It’s not known at this time how severe this virus will be in the general population. CDC is studying the medical histories of people who have been infected with this virus to determine whether some people may be at greater risk from infection, serious illness or hospitalization from the virus. In seasonal flu, there are certain people that are at higher risk of serious flu-related complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with chronic medical conditions. It’s unknown at this time whether certain groups of people are at greater risk of serious flu-related complications from infection with this new virus. CDC also is conducting laboratory studies to see if certain people might have natural immunity to this virus, depending on their age.

How serious is H1N1 (swine) flu infection?

Like seasonal flu, H1N1 (swine) flu in humans can vary in severity from mild to severe. Between 2005 until January 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring. However, swine flu infection can be serious. In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later. A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death.

What is the difference between a vaccine and an antiviral?

Vaccines are usually given to prevent infections. Influenza vaccines are made from either pieces of the killed influenza virus or weakened versions of the live virus that will not lead to disease. When vaccinated, the body’s immune system makes antibodies which will fight off infection if exposure to the virus occurs.

Antivirals are drugs that can treat people who have already been infected by a virus. They also can be used to prevent infection when given before or shortly after exposure and before illness occurs. A key difference between a vaccine and antiviral drug is that the antiviral drug will prevent infection only when administered within a certain time frame before or after exposure and is effective during the time that the drug is being taken while a vaccine can be given long before exposure to the virus and can provide protection over a long period of time.

What are the signs and symptoms of H1N1 (swine) flu in 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 diarrhea and vomiting associated with H1N1 (swine) flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with H1N1 (swine) flu infection in people. Like seasonal flu, H1N1 (swine) flu may cause a worsening of underlying chronic medical conditions.


In children emergency warning signs that need urgent medical attention include:
  • Fast breathing or trouble breathing
  • Bluish or gray skin color
  • 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 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

Is this H1N1 (swine) flu virus contagious?

CDC has determined that this virus is contagious and is spreading from human to human. However, at this time, it not known how easily the virus spreads between people.

How many H1N1 (swine) flu viruses are there?

Like all influenza viruses, swine flu viruses change constantly. Pigs can be infected by avian influenza and human influenza viruses as well as swine influenza viruses. When influenza viruses from different species infect pigs, the viruses can reassort (i.e. swap genes) and new viruses that are a mix of swine, human and/or avian influenza viruses can emerge. Over the years, different variations of swine flu viruses have emerged. At this time, there are four main influenza type A virus subtypes that have been isolated in pigs: H1N1, H1N2, H3N2, and H3N1. However, most of the recently isolated influenza viruses from pigs have been H1N1 viruses.

Are there human infections with H1N1 (swine) flu in the U.S.?

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. CDC and local and state health agencies are working together to investigate this situation. An updated case count of confirmed H1N1 (swine) flu infections in the United States is kept at http://www.cdc.gov/swineflu/investigation.htm. CDC and local and state health agencies are working together to investigate this situation.

Why is this new H1N1 virus sometimes called “swine flu”?

This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes. Scientists call this a “quadruple reassortant” virus.

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 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.