Influenza – A (H1N1) (earlier know as swine flu) is a new influenza virus causing illness in people.
Influenza A (H1N1) virus is contagious and spread from human to human
• Swine Influenza (swine flu) is a respiratory disease of pigs caused by Type A influenza viruses that causes regular outbreaks in pigs.
• 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.
• Various international agencies (US Centers for Disease Control & Prevention, World Health Organization) have determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human.
• WHO has escalated the world Pandemic Phase from Phase 3 to Phase 4 (in a 6-scale Phase), indicating that a worldwide pandemic due to swine flu H1N1 is possible.
How are human infections with swine influenza 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 10 days or longer.
• Identification as a swine flu influenza A virus requires sending the specimen to a hospital laboratory for testing।
• 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.
• Number of cases worldwide: >134,500
• Over 810 deaths as on 27-Jul-09
India has 574 positive cases of H1N1 infection expects the number to rocket over the next few months.
How Influenza - AH1N1 or Swine Flu Spreads
- Coughing
- Sneezing
- Contact with respiratory droplets
It can also spread through surface contacts
The majority of these cases have occurred in otherwise healthy young adults.
Incubation Period 1-7 days
Influenzas can spread quickly:
– May be contagious BEFORE developing symptoms
– Virus can survive on hard surfaces for many hours
• Important clinical features of swine influenza include fever, and upper respiratory symptoms such as cough and sore throat.
• Head ache, body ache, running nose or stuffy nose
• Fatigue diarrhea and vomiting have also been observed.
If you become ill and experience any of the warning signs, seek emergency मेडिकल care
In Children
- Fast breathing or trouble breathing
- Bluish or gray skin colour
- Not drinking enough fluids
- Severe or persistent vomiting
- Not waking up or interacting
- Flu like symptoms improve but return with fever and worse cough
In Adults
- Difficulty breathing or shortness of breath
- Pain or pressure in the chest or abdomen
- Sudden dizziness
- Severe or persistent vomiting
- Flu like symptoms improve but return with fever and worse cough
Precautions
• Follow simple steps as cough etiquettes (covering mouth & nose with handkerchief or tissue paper while coughing)
• Stay at least an arm’s length from persons coughing or sneezing, avoid gathering and wash your hands frequently
• Wash your hands often with soap and water, especially after you cough or sneeze.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids and eat nutritious food.
• Try to stay in good general health
If infected with influenza, one must stay at home, away from work or school and limit contact with others to keep from infecting them and should seek medical assistance at designated centers immediately
Guidelines by Health Ministry of India
• Any person with flu like symptoms such as fever, cough, sore throat, cold, running nose etc. should go to a designated Government facility for giving his/her sample for testing for the H1N1 virus
• After clinical assessment, the designated medical officer would decide on the need for testing
• If tested as positive for H1N1 and the patient opts for home isolation and treatment, he/she would be provided with detailed guidelines / safety measures to be strictly adhered to by the entire household of the patient
• He/ she would have to provide full contact details of his entire household. The house hold and social contacts would be provided with the preventive treatment.
Is there a vaccine for Pandemic Flu?
• Because the virus is new, there will be no vaccine ready to protect against pandemic flu.
• Vaccine against Swine Flu virus H1N1 needs at least 6-12 months to be produced.
• Seasonal flu vaccine or past flu immunization will not provide protection.
Are there medicines to treat swine flu?
• Yes. The US CDC recommends the use of oseltamivir (Tamiflu®) or zanamivir (Relenza®) 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.
• 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 viruses live outside the body?
• We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks.
• Frequent hand washing will help you reduce the chance of getting contamination from these common surfaces।
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.
• 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 (next 2 slides), seek emergency medical care.
Household Cleaning, Laundry, and Waste Disposal
• Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste.
• Keep surfaces (esp bedside tables, surfaces in the bathroom, children’s toys, phone handles, doorknobs) clean by wiping them down with a household disinfectant according to directions on the product label.
• Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
• Wash linens (such as bed sheets and towels) by using household laundry soap and tumble dry on a hot setting. Avoid “hugging” laundry prior to washing it to prevent contaminating yourself. Clean your hands with soap and water or alcohol-based hand rub right after handling dirty laundry.
• Eating utensils should be washed either in a dishwasher or by hand with water and soap.
The Union Government has identified hospitals in all cities for testing suspected swine flu patients। Also screening facility available at all International airport for all the inbound passengers to prevent the spread of H1N1. Doctors from the Hospital are round the clock screening the passengers at the Airport.
GOVERNMENT AUTHORIZED HOSPITALS FOR TREATMENT OF SWINE FLU
City /Hospital /Address /Contact
Chennai
King Institute of Preventive Medicine (24/7 Service)
Guindy, Chennai – 32
(044) 22501520, 22501521 & 22501522
Communicable Diseases Hospital
Thondiarpet, Chennai
(044) 25912686/87/88, 9444459543
Government General Hospital
Opp. Central Railway Station, Chennai – 03
(044) 25305000, 25305723, 25305721, 25330300
Pune
Naidu Hospital
Nr Le'Meridian, Raja Bahadur Mill, GPO, Pune - 01
(020) 26058243
National Institute of Virology
20A Ambedkar Road, Pune - 11
(020) 26006290
Kolkata
ID Hospital
57,Beliaghata, Beliaghata Road, Kolkata - 10
(033) 23701252
Coimbatore
Government General Hospital
Near Railway Station,Trichy Road, Coimbatore - 18
(0422) 2301393, 2301394, 2301395, 2301396
Hyderabad
Govt. General and Chest Diseases Hospital,
Erragadda, Hyderabad
(040) 23814939
Mumbai
Kasturba Gandhi Hospital
Arthur Road, N M Joshi Marg, Jacob Circle, Mumbai - 11
(022) 23083901, 23092458, 23004512
Sir J J Hospital
J J Marg, Byculla, Mumbai - 08
(022) 23735555, 23739031, 23760943, 23768400 / 23731144 / 5555 / 23701393 / 1366
Haffkine Institute
Acharya Donde Marg, Parel, Mumbai - 12
(022) 24160947, 24160961, 24160962
Kochi
Government Medical College
Gandhi Nagar P O, Kottayam - 08
(0481) 2597311,2597312
Government Medical College
Vandanam P O, Allapuzha - 05
(0477) 2282015
Taluk Hospital
Railway Station Road, Alwaye, Ernakulam
(0484) 2624040 Sathyajit - 09847840051
Taluk Hospital
Perumbavoor PO, Ernakulam 542
(0484) 2523138 Vipin - 09447305200
Gurgaon & Delhi
All India Institute of Medical Sciences (AIIMS)
Ansari Nagar, Aurobindo Marg Ring Road, New Delhi - 29
(011) 26594404, 26861698 Prof. R C Deka - 9868397464
National Institute for Communicable Diseases
22, Sham Nath Marg,New Delhi - 54
(011) 23971272/060/344/524/449/326
Dr. Ram Manohar Lohia Hospital
Kharak Singh Marg, New Delhi - 01
(011) 23741640, 23741649, 23741639Dr. N K Chaturvedi – 9811101704
Vallabhai Patel Chest Institute
University Enclave, New Delhi- 07
(011) 27667102, 27667441, 27667667, 27666182
Bangalore
Victoria Hospital
K R Market, Kalasipalayam, Bangalore - 02
(080) 26703294 Dr. Gangadhar - 94480-49863
SDS Tuberculosis & Rajiv Gandhi Institute of Chest Diseases
Hosur Road, Hombegowda Nagar, Bangalore - 29
(080) 26631923 Dr. Shivaraj - 99801-48780
NEW DEVELPMENTS:
Cipla has launched a new drug against Swine Flu (Virenza), as an alternative option to Osetalmavir drug.
Virenza
Zanamivir
COMPOSITION
Each capsule contains Zanamivir…5 mg
INDICATIONS
Treatment of Influenza VIRENZA is indicated for treatment of uncomplicated acute illness due to influenza A and B virus in adults and pediatric patients 7 years and older that has been symptomatic for no more than 2 days.
Prophylaxis of Influenza VIRENZA is indicated in adults and pediatric patients 5 years of age and older for prophylaxis of influenza.
VIRENZA is not recommended for treatment of patients with underlying airways disease (such as asthma or chronic obstructive pulmonary disease)
DOSAGE AND ADMINISTRATION
VIRENZA is for administration to the respiratory tract by oral inhalation using Revolizer device only.
Patients scheduled to use an inhaled bronchodilator at the same time as VIRENZA should use their bronchodilator before taking VIRENZA.
Treatment of Influenza The recommended dose of VIRENZA for treatment of influenza in adults and pediatric patients aged 7 years and older is 2 inhalations (one 5-mg capsule per inhalation for a total dose of 10 mg) twice daily (approximately 12 hours apart) for 5 days.
Two doses should be taken on the first day of treatment whenever possible provided there is at least 2 hours between doses. On subsequent days, doses should be about 12 hours apart (e.g., morning and evening) at approximately the same time each day. There are no data on the effectiveness of treatment with Zanamivir when initiated more than 2 days after the onset of signs or symptoms.
Prophylaxis of Influenza Household Setting: The recommended dose of VIRENZA for prophylaxis of influenza in adults and pediatric patients 5 years of age and older in a household setting is 10 mg once daily for 10 days. The 10-mg dose is provided by 2 inhalations (one 5-mg blister per inhalation). The dose should be administered at approximately the same time each day. There are no data on the effectiveness of prophylaxis with VIRENZA in a household setting when initiated more than 1.5 days after the onset of signs or symptoms in the index case.
Community Outbreaks: The recommended dose of VIRENZA for prophylaxis of influenza in adults and adolescents in a community setting is 10 mg once daily for 28 days. The 10-mg dose is provided by 2 inhalations (one 5-mg blister per inhalation). The dose should be administered at approximately the same time each day. There are no data on the effectiveness of prophylaxis with VIRENZA in a community outbreak when initiated more than 5 days after the outbreak was identified in the community. The safety and effectiveness of prophylaxis with VIRENZA have not been evaluated for longer than 28 days duration.
CONTRAINDICATIONS
VIRENZA is contraindicated in patients with a known hypersensitivity to any component of the formulation
PACKAGING INFORMATION
VIRENZA is available in a container with 20 capsules and the Revolizer.
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