SWINE FLU OUTBREAK

2009
Dr.T.V.Rao MD
 SWINE FLU 2009
2009 swine flu outbreak is the epidemic
spread of a new strain of influenza virus
that was clinically identified in April 2009
The new virus strain is a type of influenza
A (H1N1) virus, commonly called the
swine flu. The outbreak has also been
called the H1N1 influenza, 2009 H1N1
flu, Mexican flu, or swine-origin
influenza.
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 WHO alerts it as Phase 5
WHO to change its
pandemic alert phase
to "Phase 5", which is
defined as "...human-
to-human spread of
the virus into at least
two countries in one
WHO region
 Qualifies as Phase 5
By April 28, the new
strain was confirmed to
have spread to Spain, the
United Kingdom, New
Zealand, and Israel, and
the virus was suspected
in many other nations,
with a total of over 4,400
candidate cases,
prompting the WHO to
change its pandemic alert
phase to "Phase 5"
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Early cases - Mexico
Although the exact time
and location of the
outbreak is unknown, it is
believed to have been
first detected when an
influenza-like illness was
reported by both health
agencies and local news
media in Mexico

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A New Strain of Influenzae Virus
The virus
responsible was
clinically identified
as a new strain on
April 24, 2009

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A serious Concern to Health
Authorities
In late April officials from
both World Health
Organization (WHO) and
the CDC expressed
serious concern about the
situation, stating that the
virus had the potential to
become a flu pandemic.

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Virologists Optimistic
By late April,
however, some
virologists believed
that this strain was
unlikely to cause as
many fatalities as
earlier pandemics,
and may not even be
as damaging as a
typical flu season.
New virus is a Reassortment
The new strain is an apparent reassortment of
four strains of influenza A virus subtype H1N1
Analysis at the United States Centers for
Disease Control and Prevention (CDC) identified
the four component strains as one endemic in
humans, one endemic in birds, and two endemic
in pigs (swine). One swine strain was
widespread in the United States, the other in
Euras

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 Why Called as Swine Flu
Although called swine flu
due to it predominantly
containing swine strains,
the World Organisation
for Animal Health have
proposed the name
North American
influenza.

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Flu in Pigs Identified
By May 2, some pigs
in Canada were
diagnosed with H1N1.
The Canadian Food
Inspection Agency
(CFIA) indicates that
it has found H1N1 flu
virus in a swine herd
in Alberta.

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Proper Handling of Pig meat a
Priority
Influenza viruses do not
affect the safety of pork,
according to the World
Health Organization
(WHO) and the Food and
Agriculture Organization
of the United Nations
(FAO). As with any raw
meat, pork should always
be properly handled and
cooked to eliminate a
range of food safety
concerns.
New Virus a New combination
The CDC determined that
the strain contained
genes from four different
flu viruses – North
American swine
influenza, North American
avian influenza, human
influenza, and swine
influenza virus typically
found in Asia and Europe
– "an unusually
mongrelised mix of
genetic sequences.
 The pig strains carry several
other genes
But the North American
pig strain was itself the
product of previous
reassortments, and has
carried an avian PB2
gene for at least ten
years and a human PB1
gene since 1993. These
genes were passed on to
the new virus.
Pigs a Mixing vessel
Pigs can catch human
and avian or bird flu.
When flu viruses from
different species
infect pigs, they can
mix inside the pig and
new, mixed viruses
can emerge.

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 Pigs infect Humans
Pigs can pass
mutated viruses back
to humans, and these
can be passed from
human to human.
Transmission among
humans is thought to
occur in the same
way as with seasonal
flu.
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Case Definitions for Infection with Swine-origin
Influenza A (H1N1) Virus (S-OIV)

A confirmed case of S-
OIV infection is
defined as a person
with an acute febrile
respiratory illness with
laboratory confirmed
S-OIV infection at CDC
by one or more of the
following tests.
Real-time RT-PCR
Viral culture
 A probable case of S-OIV
A probable case of
S-OIV 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-
PC PCR
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 A suspected case of S-OIV
suspected case of S-OIV 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 S-OIV infection, or
Within 7 days of travel to community either within the
United States or internationally where there are one or
more confirmed cases of S-OIV infection, or
Resides in a community where there are one or more
confirmed cases of S-OIV infection.

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Simple Measures Help
By touching
something
contaminated with flu
viruses and then
touching one's mouth
or nose, and through
coughing or sneezing.
One of the most
effective prevention
measures is regular
hand washing.
 Eating Pork Safe?
People cannot catch
swine flu from eating pork
or pork products. Cooking
pork to an internal
temperature of 160
degrees Fahrenheit (71
degrees Celsius) kills the
swine flu virus along with
other bacteria and viruses

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Yet no fully protective Vaccine
Vaccines are available to
be given to pigs to
prevent swine influenza.
There is no vaccine to
protect humans from
swine flu, although the
CDC is formulating one.
The seasonal influenza
vaccine may help to
provide partial protection
against swine H3N2, but
not against swine H1N1
viruses like the one
circulating now.
Past Vaccines proved not safe
In 1976 a new strain of swine flu started infecting
people and worried U.S. health officials started
widespread vaccination. More than 40 million
people were vaccinated. But several cases of
Guillain-Barré syndrome, a severe and
sometime fatal condition that can be linked to
come vaccines, caused the U.S. government to
stop the program. The incident led to
widespread distrust of vaccines in general

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Prevention is best option
Covering your nose
and mouth with a
tissue when you
cough or sneeze.
Throw the tissue in
the trash after you
use it.

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Clean Hands – Safe Hands
Washing your hands
often with soap and
water, especially after
you cough or sneeze.
You can also use
alcohol-based hand
cleaners.

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 Avoid Unnecessary Actions
Avoiding touching
your eyes, nose or
mouth. Germs spread
this way
Trying to avoid close
contact with sick
people.

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Staying at home if sick
Staying home from
work or school if you
are sick

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Several countreis effected WHO
The following countries have
reported laboratory confirmed
cases with no deaths - Austria
(1), Canada (34), China, Hong
Kong Special Administrative
Region (1), Denmark (1),
France (1), Germany (4), Israel
(2), Netherlands (1), New
Zealand (4), Republic of Korea
(1), Spain (13), Switzerland (1)
and the United Kingdom (13).

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Prompt to seek Medical Attention
There is also no risk of
infection from this virus
from consumption of well-
cooked pork and pork
products. Individuals are
advised to wash hands
thoroughly with soap and
water on a regular basis
and should seek medical
attention if they develop
any symptoms of
influenza-like illness
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 Drug options in Swine Flu
There are four influenza antiviral drugs approved for use
in the United States (oseltamivir, zanamivir, Amantidine
and rimantadine). The swine influenza A (H1N1) viruses
that have been detected in humans in the United States
and Mexico are resistant to Amantidine and rimantadine
so these drugs will not work against these swine
influenza viruses. Laboratory testing on these swine
influenza A (H1N1) viruses so far indicate that they are
susceptible (sensitive) to oseltamivir and zanamivir

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Drugs are Highly Beneficial
If you get sick, antiviral drugs can make your
illness milder and make you feel better faster.
They may also prevent serious influenza
complications. Influenza antiviral drugs work
best when started soon after illness onset (within
two 2 days), but treatment with antiviral drugs
should still be considered after 48 hours of
symptom onset, particularly for hospitalized
patients or people at high risk for influenza-
related complications.
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 CDC Recommends
CDC recommends
the use of
oseltamivir or
zanamivir for the
treatment and/or
prevention of infection
with swine influenza
viruses.

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Oseltamivir
Oseltamivir (brand
name Tamiflu ®) is
approved to both treat
and prevent influenza
A and B virus
infection in people
one year of age and
older

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 Zanamivir
Zanamivir (brand name
Relenza ®) is approved
to treat influenza A and B
virus infection in people 7
years and older and to
prevent influenza A and B
virus infection in people 5
years and older.

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Spread the Message of Flu to
Everyone
 A good health preparedness
Possible Option in Prevention
Updates on Swine Flu
2009
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Dr.T.V.Rao MD
Email
doctortvrao@gmail.com