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Swin flu

Swin flu

H1N1 flu is also known as swine flu. It’s called swine flu because in the past, the people who caught it had direct contact with pigs. That changed several years ago, Now it spreads from human to human.HINI is a new strain of influenza virus A. It was responsible for the flu pandemic in 2009.. The other viruses are influenza virus B and influenza virus A/H3N2.This season it has spread in various parts of the world. Reports from swine-flu hit states viz. Gujarat, Rajasthan, Maharashtra, Delhi etc. suggest that a prolonged winter, inadequate testing facilities, non-availability of swine flu vaccine, limited Tamiflu availability and failure to rope in private hospitals are prime reasons for failure to check spread of the disease. With over 1700 precious lives lost and over 30000 citizens detected to have suffered from this deadly virus, and prospect of further infections due to excessive March rains,  health ministry experts  are still wondering ‘it is  hard to explain why H1N1 virus behaved the way it did. It is an unpredictable virus’. The Ministry is now in the process of putting in an advanced system for surveillance of seasonal influenza with the National Centre for Disease Control (NCDC), the apex body responsible for monitoring and responding to outbreaks. It will guide vaccination policy on the issue from next season, said a ministry expert. As of today, India has no vaccine policy on swine flu with the government recommending it only for high-risk health workers. Ideally this exercise should have started before September 2014.

Unfortunately media and the health workers have created a scare among the public and not educated them on simple issues like when to suspect swine flu, when and where to go for consultation, when and where to go for the test, when and where is the medicine dispensed, where and when to get hospitalized, vaccines if any and the outcome in a majority of cases.

 

Everyday items at home and in public places may have the virus, e.g. door handles, remote controls, hand rails, paper money and computer keyboards. The viruses enters the body through nose/mouth, generally from the droplet infection from a patient’s cough or sneeze  and get settled in the lung or upper airway of the victim. The body immunity is able to fight and contain the virus in most cases. It starts like a common flu with symptoms like fever, cough, running nose, sore throat, mild body ache, chill, fatigue, but within a day or two the patient may develop high fever, severe headache, loss of appetite, marked lethargy and weakness, may be pain abdomen/ chest or vomiting and diarrhea. In severe cases patient starts developing breathlessness and low BP. A serious complication is pneumonia.

Suspected patient need to go to a designated centre which is equipped to deal with them e.g. PGI Chandigarh. Tami flu is the only drug that is available and effective, if it is started within 3-4 days after the test confirms the presence of specific virus. The dose for treatment is 75 mg twice a day for 5 days. Prophylaxis is 75 mg once a day for 7 days. Having medication when you don’t need it can unnecessarily expose you to potential allergic reactions and side effects. It may also reduce the future effectiveness of the drug against the influenza virus. Remember that most of the cases belong to common flu category and most of the confirmed cases of swine flu virus do not deteriorate, if treatment is instituted in 1-3 days. Patients with chronic diseases or with low immunity, heart diseases, kidney ailments, diabetes, lung or liver diseases, or pregnant women, obese, aged or kids are given treatment immediately without waiting for test results, if the symptoms are severe. 

How to prevent the spread? 

If you are sick or have any flu-like symptoms, stay home and get isolated. Let the patient and his contacts wear a face mask. Do not go to school or work. Cough or sneeze into the crook (inside elbow) of your arm. Swine flu is very contagious, and can spread easily by touching an infected object and then touching your face. Wash hands repeatedly to avoid spread. Anything you have touched may be infected, so washing hands thoroughly with soap and water will help you avoid infection.
Carry hand sanitizer with you. In addition, avoid shaking hands or other hand to hand contact whenever possible. Also avoid kissing on the cheek or other face to face contact as a greeting/intimacy gesture.  Avoid touching public handles and pens especially when you are travelling by air/train/bus etc. Do not touch your eyes, nose, mouth and face after touching to others body or his personal items. Since common mode of spread is through breath, stay away from crowded places, as much as possible. Close proximity to other people will heighten your chances to get swine flu. Try to stay at least 4-6 feet away from suspected people.

WHO guidelines for prevention of HINI are given in the figure below: 

 

There is no proven specific vaccine against HINI for mass vaccination. More so the virus undergoes mutation frequently, so producing a specific vaccine will not be easy. Available seasonal influenza vaccine contains antigens representing 3-4 influenza virus strains: one H1N1 virus strain, one H3N2 virus strain, and either one or two influenza type B virus strains. It may be effective in 50-60% cases. Influenza vaccines may be administered as an injection or as a nasal spray, under guidance. It may have some side effects like soreness and redness of at the injection point, or flu like symptoms

 

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