Swine flu -dr.kassab

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Information about Swine flu -dr.kassab
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Published on May 8, 2009

Author: kassab

Source: authorstream.com

swine flu : swine flu DR.KASSAB H1N1 Flu (Swine Flu) : H1N1 Flu (Swine Flu) The ongoing outbreak of novel influenza A (H1N1) continues to expand in the United States. CDC expects that more cases, more hospitalizations and more deaths from this outbreak will occur over the coming days and weeks. CDC : 8/5/2009 What is H1N1 (swine flu)? : 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 April 2009 Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs. What is swine flu? : What is swine flu? People do not normally get swine flu, but human infections can and do happen. Swine flu viruses have been reported to spread from person-to-person, but in the past, this transmission was limited and not sustained beyond three people. How many swine flu viruses are there? : How many 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 Slide 7: 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 Is this swine flu virus contagious? : Is this swine flu virus contagious? CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it not known how easily the virus spreads between people. Can humans catch swine flu? : Can humans catch swine flu? Swine flu viruses do not normally infect humans. However, sporadic human infections with swine flu have occurred. Most commonly, these cases occur in persons with direct exposure to pigs (e.g. children near pigs at a fair or workers in the swine industry). In addition, there have been documented cases of one person spreading swine flu to others. How severe is illness associated with this new H1N1 virus? : 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. Slide 11: In seasonal flu, there are certain people that are at higher risk of serious flu-related complications. This includes young children, pregnant women, people with chronic medical conditions and people 65 and older. What are the signs and symptoms of swine flu in people? : What are the signs and symptoms of swine flu in people? The symptoms of 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 swine flu. Slide 13: In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people . Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions. How can human infections with swine influenza be diagnosed? : How can human infections with swine influenza be diagnosed? To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 7 days or longer. How does swine flu spread? : How does swine flu spread? Spread of this swine influenza A (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 of 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? : 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 should I do to keep from getting the flu? : 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, Slide 20: 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. How long can influenza virus remain viable on objects (such as books and doorknobs)? : 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 What kills influenza virus? : What kills influenza virus? Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective , For example, wipes or gels with alcohol in them can be used to clean hands. The gels should be rubbed into hands until they are dry. How should waste disposal be handled to prevent the spread of influenza virus? : How should waste disposal be handled to prevent the spread of influenza virus? To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste. What household cleaning should be done to prevent the spread of influenza virus? : What household cleaning should be done to prevent the spread of influenza virus? To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant . Are there medicines to treat swine flu? : Are there medicines to treat swine flu? Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with these 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. Slide 28: 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 long can an infected person spread swine flu to others? : How long can an infected person spread swine flu to others? People with 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. What surfaces are most likely to be sources of contamination? : 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 and then touches their own eyes, mouth or nose before washing their hands. What can I do to protect myself from getting sick? : What can I do to protect myself from getting sick? There is no vaccine available right now to protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Slide 32: 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. Slide 33: 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. What is the best way to keep from spreading the virus through coughing or sneezing? : 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. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. Slide 36: It may prevent those around you from getting sick Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze. What is the best technique for washing my hands to avoid getting the flu? : What is the best technique for washing my hands to avoid getting the flu? Washing your hands often will help protect you from germs. Wash with soap and water. Or clean with alcohol-based hand cleaner. we recommend that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. Slide 38: When soap and water are not available, alcohol-based disposable hand wipes or gel may be used. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work. What should I do if I get sick? : What should I do if I get sick? If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed. Slide 41: If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others. If you become ill and experience any of the following warning signs, seek emergency medical care. Slide 42: In children emergency warning signs that need urgent medical attention include: Fast breathing or trouble breathing Bluish skin color Not drinking enough fluids 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 Fever with a rash Slide 43: 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 Case Definitions for Infection with Swine Influenza A (H1N1) Virus : Case Definitions for Infection with Swine Influenza A (H1N1) Virus A confirmed case of swine influenza A (H1N1) virus infection is defined as a person with an acute febrile respiratory illness with laboratory confirmed swine influenza A (H1N1) virus infection at CDC by one or more of the following tests: real-time RT viral culture Slide 50: probable case of swine influenza A (H1N1) virus 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-PCR, or positive for influenza A by an influenza rapid test or an influenza immunofluorescence assay (IFA) plus meets criteria for a suspected case Slide 51: suspected case of swine influenza A (H1N1) virus 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 swine influenza A (H1N1) virus infection, or within 7 days of travel to community either within the United States or internationally where there are one or more confirmed swine influenza A(H1N1) cases, or resides in a community where there are one or more confirmed swine influenza cases Slide 52: Infectious period for a confirmed case of swine influenza A (H1N1) virus infection is defined as 1 day prior to the case’s illness onset to 7 days after onset. Close contact is defined as: within about 6 feet of an ill person who is a confirmed or suspected case of swine influenza A (H1N1) virus infection during the case’s infectious period. Slide 53: Acute respiratory illness is defined as recent onset of at least two of the following: rhinorrhea or nasal congestion, sore throat, cough (with or without fever or feverishness) High-risk groups: A person who is at high-risk for complications of swine influenza A (H1N1) virus infection is defined as the same for seasonal influenza ,these risk groups might be revised: Slide 54: Children younger than 5 years old. The risk for severe complications from seasonal influenza is highest among children younger than 2 years old. Adults 65 years of age and older. Persons with the following conditions: Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus); Slide 55: Immunosuppression, including that caused by medications or by HIV. Pregnant women. Persons younger than 19 years of age who are receiving long-term aspirin therapy. Residents of nursing homes and other chronic-care facilities. Slide 56: Special Considerations for ChildrenAspirin or aspirin-containing products (e.g. bismuth subsalicylate – Pepto Bismol) should not be administered to any confirmed or suspected ill case of swine influenza A (H1N1) virus infection aged 18 years old and younger due to the risk of Reye syndrome. For relief of fever, other anti-pyretic medications are recommended such as acetaminophen or non steroidal anti-inflammatory drugs What medications are available to treat swine flu infections in humans? : What medications are available to treat swine flu infections in humans? There are four different antiviral drugs that are licensed for use in the US for the treatment of influenza: amantadine, rimantadine, oseltamivir and zanamivir. While most swine influenza viruses have been susceptible to all four drugs, the most recent H1N1 influenza viruses isolated from humans are resistant to amantadine and rimantadine Antiviral Treatment : Antiviral Treatment Confirmed, Probable and Suspected Cases Empiric antiviral treatment should be considered for confirmed, probable or suspected cases of swine influenza A (H1N1) virus infection. Treatment of hospitalized patients and patients at higher risk for influenza complications should be prioritized. Slide 60: Antiviral treatment with zanamivir or oseltamivir should be initiated as soon as possible after the onset of symptoms. Evidence for benefits from treatment in studies of seasonal influenza is strongest when treatment is started within 48 hours of illness onset. Slide 61: However, some studies of treatment of seasonal influenza have indicated benefit, including reductions in mortality or duration of hospitalization even for patients whose treatment was started more than 48 hours after illness onset Slide 62: Recommended duration of treatment is five days. Recommendations for use of antivirals may change as data on antiviral susceptibilities and effectiveness become available.  Antiviral doses recommended for treatment of swine influenza A (H1N1) virus infection in adults or children 1 year of age or older are the same as those recommended for seasonal influenza (Table 1). Slide 64: Oseltamivir use for children < 1 year old was recently approved by the U.S. Food and Drug Administration (FDA) under an Emergency Use Authorization (EUA), and dosing for these children is a Antiviral Chemoprophylaxis : Antiviral Chemoprophylaxis For antiviral chemoprophylaxis of swine influenza A (H1N1) virus infection, either oseltamivir or zanamivir are recommended (Table 1). Duration of antiviral chemoprophylaxis post-exposure is 10 days after the last known exposure to an ill confirmed case of swine influenza A (H1N1) virus infection Slide 67: For pre-exposure protection, chemoprophylaxis should be given during the potential exposure period and continued for 10 days after the last known exposure to an ill confirmed case of swine influenza A (H1N1) virus infection. Oseltamivir can also be used for chemoprophylaxis under the EUA for children < 1 year old (Table 3). Slide 69: Antiviral chemoprophylaxis (pre-exposure or post-exposure) with either oseltamivir or zanamivir is recommended for the following individuals: Household close contacts who are at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women) of a confirmed, probable or suspected case. Slide 70: School children who are at high-risk for complications of influenza (children with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed, probable, or suspected case. Slide 71: Travelers to Mexico who are at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women Slide 72: Health care workers or public health workers who were not using appropriate personal protective equipment during close contact with an ill confirmed, probable, or suspect case of swine influenza A (H1N1) virus infection during the case’s infectious period Slide 73: Pre-exposure antiviral chemoprophylaxis with either oseltamivir or zanamivir can be considered for the following: Slide 74: Any health care worker who is at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women) who is working in an area of the healthcare facility that contains patients with confirmed swine influenza A (H1N1) cases, or who is caring for patients with any acute febrile respiratory illness. Slide 75: Non-high risk persons who are travelers to Mexico, first responders, or border workers who are working in areas with confirmed cases of swine influenza A (H1N1) virus infection. Is there a vaccine for swine flu? : Is there a vaccine for swine flu? Vaccines are available to be given to pigs to prevent swine influenza. There is no vaccine to protect humans from swine flu. The seasonal influenza vaccine will likely help provide partial protection against swine H3N2, but not swine H1N1 viruses. Exposure/ Possible Exposure : Exposure/ Possible Exposure In the 7 days prior to onset of symptoms the person was in an area where cases of Swine Influenza A(H1N1) virus had been identified Exposure (contact within touching/speaking distance) in the 7 days before onset of illness to confirmed or probable Swine Influenza A(H1N1) case Exposure to swine in the 7 days prior to onset of symptoms Slide 78: DR.KASSAB

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