Antiviral drugs are prescription medicines (pills, liquid or an inhaler) with activity against influenza viruses, including swine influenza viruses. Antiviral drugs can be used to treat swine flu or to prevent infection with swine flu viruses. These medications must be prescribed by a health care professional. Influenza antiviral drugs only work against influenza viruses -- they will not help treat or prevent symptoms caused by infection from other viruses that can cause symptoms similar to the flu.
There are four influenza antiviral drugs approved for use in the United States (oseltamivir, zanamivir, amantadine and rimantadine). The swine influenza A (H1N1) viruses that have been detected in humans in the United States and Mexico are resistant to amantadine 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. MRSA Latest Update
Benefits of Antiviral Drugs
Treatment: 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.
Prevention: Influenza antiviral drugs also can be used to prevent influenza when they are given to a person who is not ill, but who has been or may be near a person with swine influenza. When used to prevent the flu, antiviral drugs are about 70% to 90% effective. When used for prevention, the number of days that they should be used will vary depending on a person’s particular situation.
CDC Recommendation
CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with swine influenza viruses.
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.
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.
Recommendations for using antiviral drugs for treatment or prevention of swine influenza will change as we learn more about this new virus.
Clinicians should consider treating any person with confirmed or suspected swine influenza with an antiviral drug.
Sunday, May 24, 2009
Stpes To Take Care Of Swine Flu Sick Person
Taking Care of a Sick Person in Your Home
Swine influenza A virus infection (swine flu) can cause a wide range of symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Severe disease with pneumonia, respiratory failure and even death is possible with swine flu infection. Certain groups might be more likely to develop a severe illness from swine flu infection, such as persons with chronic medical conditions. Sometimes bacterial infections may occur at the same time as or after infection with influenza viruses and lead to pneumonias, ear infections, or sinus infections.
The following information can help you provide safer care at home for sick persons during a flu pandemic.
How Flu Spreads
The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.
People with swine flu who are cared for at home should:
check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema check with their health care provider about whether they should take antiviral medications
stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer get plenty of rest drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated cover coughs and sneezes. Clean hands with soap and water or an alcohol-based hand rub often and especially after using tissues and after coughing or sneezing into hands.
Avoid close contact with others – do not go to work or school while ill
be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention
Swine influenza A virus infection (swine flu) can cause a wide range of symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Severe disease with pneumonia, respiratory failure and even death is possible with swine flu infection. Certain groups might be more likely to develop a severe illness from swine flu infection, such as persons with chronic medical conditions. Sometimes bacterial infections may occur at the same time as or after infection with influenza viruses and lead to pneumonias, ear infections, or sinus infections.
The following information can help you provide safer care at home for sick persons during a flu pandemic.
How Flu Spreads
The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.
People with swine flu who are cared for at home should:
check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema check with their health care provider about whether they should take antiviral medications
stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer get plenty of rest drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated cover coughs and sneezes. Clean hands with soap and water or an alcohol-based hand rub often and especially after using tissues and after coughing or sneezing into hands.
Avoid close contact with others – do not go to work or school while ill
be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention
Monday, May 4, 2009
SWINE FLU BREAKING NEWS 2: Global case update, eyeing phase 6, probable cases, southern hemisphere viruses, WHO gathers clinical experts
The World Health Organization (WHO) reported 1,085 confirmed cases of influenza A/H1N1 (swine flu) and 26 deaths in 21 countries as of 18:00 GMT (noon US EST) today, up from 985 cases in 20 countries reported earlier in the day. Mexico has reported 590 confirmed cases and 25 deaths. The WHO's latest total reflects today's updated US numbers from the Centers for Disease Control and Prevention (CDC), which stand at 286 cases and 1 death. [WHO update 14]
At a WHO media briefing today, Keiji Fukuda, MD, the WHO's assistant director-general for health security, emphasized that the rationale for any future move to pandemic alert phase 6 wouldn't be based on disease severity, but rather on sustained outbreaks in more than one WHO region. On Apr 29 the WHO raised the pandemic alert to its current level, phase 5, which signifies sustained community outbreaks in two or more countries within one WHO region.
The CDC will begin reporting "probable" cases of flu in addition to confirmed cases to give a better sense of the size of the US epidemic, acting director Dr. Richard Besser said Monday. In addition to the 286 confirmed cases, there are more than 700 probable cases in the United States.
The CDC will work with international health authorities to monitor the southern hemisphere's flu season, beginning shortly, to see how the novel H1N1 strain behaves in competition with other flu viruses. "That will tell us a lot about whether the virus is changing and what measures we might want to take in the fall," Besser said.
Tomorrow the WHO will host its second scientific teleconference to address clinical issues surrounding patients who have influenza A/H1N1 (swine flu) infections, the WHO's Fukuda said today at a media briefing. The conference will allow scientists to share information on crucial topics such as disease severity. The topic of the first teleconference, held on Apr 29, was the influenza situation in Mexico.
At a WHO media briefing today, Keiji Fukuda, MD, the WHO's assistant director-general for health security, emphasized that the rationale for any future move to pandemic alert phase 6 wouldn't be based on disease severity, but rather on sustained outbreaks in more than one WHO region. On Apr 29 the WHO raised the pandemic alert to its current level, phase 5, which signifies sustained community outbreaks in two or more countries within one WHO region.
The CDC will begin reporting "probable" cases of flu in addition to confirmed cases to give a better sense of the size of the US epidemic, acting director Dr. Richard Besser said Monday. In addition to the 286 confirmed cases, there are more than 700 probable cases in the United States.
The CDC will work with international health authorities to monitor the southern hemisphere's flu season, beginning shortly, to see how the novel H1N1 strain behaves in competition with other flu viruses. "That will tell us a lot about whether the virus is changing and what measures we might want to take in the fall," Besser said.
Tomorrow the WHO will host its second scientific teleconference to address clinical issues surrounding patients who have influenza A/H1N1 (swine flu) infections, the WHO's Fukuda said today at a media briefing. The conference will allow scientists to share information on crucial topics such as disease severity. The topic of the first teleconference, held on Apr 29, was the influenza situation in Mexico.
Flu virus's likely human-to-swine jump triggers concern
The tentative detection of the novel swine influenza H1N1 virus in an Alberta swine herd over the weekend shook Canada's pork industry and raised concern about the potential for new hybrid viruses to emerge.
Canadian authorities said on May 2 that preliminary testing detected the virus in an Alberta herd and that it probably came from a Canadian carpenter who works on the farm and had a flu-like illness when he returned from a visit to Mexico in mid-April
Dr. Brian Evans of the Canadian Food inspection Agency (CFIA) said the worker had contact with the pigs on Apr 14 and that about 220 pigs in the herd of 2,200 began showing signs of sickness on Apr 24, according to a Canadian Press report.
The carpenter has recovered and the pigs were recovering, the CFIA said. The farm has been quarantined.
A US Department of Agriculture (USDA) statement said the worker's family also had a flu-like illness but were recovering. The agency said it would take anywhere from 5 days to 2 weeks to get the final test results on the Canadian herd.
Pigs are often infected with flu viruses, including strains from humans and birds. They are described as a mixing vessel where different viruses can trade genes (reassort) and produce new variants. The novel H1N1 virus itself has been said to contain genetic material from swine, avian, and human flu viruses.
"Reassortment is a concern that people express because pigs have their own influenza virus, so if they get infected with this [human] one, do you have to worry about other reassortant viruses coming out? Yes, it seems that would be a risk," said David A. Halvorson, PhD, a veterinarian and avian influenza expert at the University of Minnesota in St. Paul.
Global animal and human health officials said the Canadian finding is not a big surprise.
"The human-to-animal transmission that occurred in Canada does not come as a surprise as influenza viruses are capable of transmitting from humans to animals," said Joseph Domenech, chief veterinary officer of the United Nations Food and Agriculture Organization (FAO) said in a statement today.
At a news briefing yesterday, Peter Ben Embarek of the World Health Organization (WHO) said the virus isolated from the swine does not appear to differ from the virus spreading among humans. "There is no sign that it has changed at all. But this could of course happen like with any other flu viruses," he said. He added that it's important to increase surveillance in humans and animals so as to detect any mutations.
Despite repeated official assurances that proper cooking destroys any flu viruses in pork, ten countries have banned Canadian pork products since the Alberta finding, CBC News reported today. China specifically banned pork from Alberta.
Canada's trade minister, Stockwell Day, called China's action "disappointing and unwarranted," the CBC reported.
The Canadian finding added to fears in some quarters about the safety of pork, given that the illness caused by the new virus infecting people in 21 countries is unofficially called swine flu.
The US Department of Agriculture (USDA) said pork and pork products remain safe and the finding would not affect US trade with Canada.
Humans occasionally pick up influenza viruses from pigs. Reports of human-to-pig transmission are apparently rare, but such cases are assumed to happen.
"We really don't know how common that might be; there's no way of knowing that," said Halvorson. "We do know that pigs have been harboring a virus that has genes form human viruses in it. Those genes had to come from someplace, and presumably they came from a human flu virus getting into pigs." He said the virus, an influenza A/H3N2 subtype, has been found in pigs in many parts of the United States.
The FAO advised that when swine show signs of respiratory illness, operators should use strict biosecurity measures, including restricting the movement of pigs, goods, and people.
Also, people who work with pigs should not go to work if they have any signs of respiratory disease, fever, or any flu-like illness, the FAO said. At the same time, the agency said there is "absolutely no need to slaughter animals" to prevent the spread of the novel H1N1 virus.
Meanwhile, the USDA said it is "actively working to develop an H1N1 vaccine for swine, just as the CDC is doing for humans."
At the WHO briefing, Ben Embarek said at least two laboratories are experimentally exposing pigs to the new virus to see how it affects them. Also, the World Organization for Animal Health (OIE) said today it is awaiting the results of experiments to determine the susceptibility of various animals to the H1N1 virus.
Canadian authorities said on May 2 that preliminary testing detected the virus in an Alberta herd and that it probably came from a Canadian carpenter who works on the farm and had a flu-like illness when he returned from a visit to Mexico in mid-April
Dr. Brian Evans of the Canadian Food inspection Agency (CFIA) said the worker had contact with the pigs on Apr 14 and that about 220 pigs in the herd of 2,200 began showing signs of sickness on Apr 24, according to a Canadian Press report.
The carpenter has recovered and the pigs were recovering, the CFIA said. The farm has been quarantined.
A US Department of Agriculture (USDA) statement said the worker's family also had a flu-like illness but were recovering. The agency said it would take anywhere from 5 days to 2 weeks to get the final test results on the Canadian herd.
Pigs are often infected with flu viruses, including strains from humans and birds. They are described as a mixing vessel where different viruses can trade genes (reassort) and produce new variants. The novel H1N1 virus itself has been said to contain genetic material from swine, avian, and human flu viruses.
"Reassortment is a concern that people express because pigs have their own influenza virus, so if they get infected with this [human] one, do you have to worry about other reassortant viruses coming out? Yes, it seems that would be a risk," said David A. Halvorson, PhD, a veterinarian and avian influenza expert at the University of Minnesota in St. Paul.
Global animal and human health officials said the Canadian finding is not a big surprise.
"The human-to-animal transmission that occurred in Canada does not come as a surprise as influenza viruses are capable of transmitting from humans to animals," said Joseph Domenech, chief veterinary officer of the United Nations Food and Agriculture Organization (FAO) said in a statement today.
At a news briefing yesterday, Peter Ben Embarek of the World Health Organization (WHO) said the virus isolated from the swine does not appear to differ from the virus spreading among humans. "There is no sign that it has changed at all. But this could of course happen like with any other flu viruses," he said. He added that it's important to increase surveillance in humans and animals so as to detect any mutations.
Despite repeated official assurances that proper cooking destroys any flu viruses in pork, ten countries have banned Canadian pork products since the Alberta finding, CBC News reported today. China specifically banned pork from Alberta.
Canada's trade minister, Stockwell Day, called China's action "disappointing and unwarranted," the CBC reported.
The Canadian finding added to fears in some quarters about the safety of pork, given that the illness caused by the new virus infecting people in 21 countries is unofficially called swine flu.
The US Department of Agriculture (USDA) said pork and pork products remain safe and the finding would not affect US trade with Canada.
Humans occasionally pick up influenza viruses from pigs. Reports of human-to-pig transmission are apparently rare, but such cases are assumed to happen.
"We really don't know how common that might be; there's no way of knowing that," said Halvorson. "We do know that pigs have been harboring a virus that has genes form human viruses in it. Those genes had to come from someplace, and presumably they came from a human flu virus getting into pigs." He said the virus, an influenza A/H3N2 subtype, has been found in pigs in many parts of the United States.
The FAO advised that when swine show signs of respiratory illness, operators should use strict biosecurity measures, including restricting the movement of pigs, goods, and people.
Also, people who work with pigs should not go to work if they have any signs of respiratory disease, fever, or any flu-like illness, the FAO said. At the same time, the agency said there is "absolutely no need to slaughter animals" to prevent the spread of the novel H1N1 virus.
Meanwhile, the USDA said it is "actively working to develop an H1N1 vaccine for swine, just as the CDC is doing for humans."
At the WHO briefing, Ben Embarek said at least two laboratories are experimentally exposing pigs to the new virus to see how it affects them. Also, the World Organization for Animal Health (OIE) said today it is awaiting the results of experiments to determine the susceptibility of various animals to the H1N1 virus.
CDC, states weigh usefulness of school closures
The Centers for Disease Control and Prevention (CDC) signaled today that it will change its current recommendation—which is to close schools for at least 2 weeks when a confirmed case of novel H1N1 swine flu is found among students—as health officials in the Seattle area and Minnesota scaled back their guidance to reflect more of a seasonal influenza approach.
Acting CDC director Dr. Richard Besser said in a press briefing that the virus is so widespread in the United States that "closing the schools as a means of not letting [the novel flu] spread through the community is not very effective."
"I would expect that as we get more information we will be looking to revise that guidance," he said.
The CDC's advice to close schools for 2 weeks has been "very aggressive—you may only get one chance to get out in front of a new infectious disease," Besser said. But the rapid spread of the virus across the country, plus information from multiple locations that the spectrum of disease is about as severe as average seasonal flu, has caused the agency to reconsider.
Therefore, he said, the CDC is considering changing its advice from automatically closing schools to asking schools and parents to weed out sick children and individually send them home for at least a week.
That procedure is already followed in Canada and in Seattle, which "asks people to really push hard on personal responsibility," Besser said, and today Minnesota followed suit. Health and education officials in that state released updated school closure guidance that asks parents and teachers to identify and isolate children who have a fever and a recent onset of flu like symptoms.
Besser said that, in those areas, parents are asked to check their children in the morning, and, if they are sick or are starting to feel a little sick, to keep them home for a full 7 days, even if they start to feel better before that period is up. In addition, schools and individual teachers are asked to take a close look at children as they arrive in the morning, and to send them home if the school believes they are developing illness—for 7 days or until they are proven not to have flu.
Public Health Seattle and King County, in its revised school closure guidance posted yesterday, said its policy change is an enhanced version of the approach it uses for seasonal influenza and is based on what is known about the new influenza virus and its spread. The guidance notes that the new strain, already spread widely, will continue for some time and that illness severity doesn't appear to be greater than typical seasonal influenza.
"Individualized school closure based on reports of diagnosed cases is less effective, in addition to being impractical, as a control measure," the Seattle-King County health department said. However, officials added that, consistent with seasonal influenza policy, some schools might be closed if large numbers of students or faculty become ill.
As the outbreak progresses, laboratory diagnosis will identify a shrinking proportion of cases, as testing demand exceeds capacity and many people who have mild infections won't see their doctors. "Closing schools where cases happen to be diagnosed while leaving most schools with undiagnosed cases open does not make sense as an ongoing influenza control strategy in our community," the department said.
Public Health Seattle and King County has several tools for schools and parents on its Web site, including a guide for parents on when to keep a child home from school, a flu symptom checklist, and advice on how to care for someone who has influenza.
Minnesota officials today unveiled similar guidance aimed at keeping students and staff with influenza symptoms out of schools, rather than routinely closing schools. They said in a statement that it's not possible to identify every case of novel influenza, because the symptoms mimic those of other respiratory diseases. "We also know that we have other acute viral respiratory infections circulating in Minnesota," they said in the statement.
"The fact that the novel influenza is currently behaving like regular flu does not mean we can relax,” said Sanne Magnan, MD, Minnesota commissioner of health, in a press release today. "Seasonal flu is a major health concern in its own right. It's one of our leading causes of death, year in and year out."
Schools that have a confirmed novel influenza case have three options: remain open with the individual isolated at home, close schools based on public health and community assessment, or close schools for a set number of days based on CDC guidance, which could change.
Minnesota officials also said they are developing enhanced school-based surveillance for influenza-like illnesses.
Acting CDC director Dr. Richard Besser said in a press briefing that the virus is so widespread in the United States that "closing the schools as a means of not letting [the novel flu] spread through the community is not very effective."
"I would expect that as we get more information we will be looking to revise that guidance," he said.
The CDC's advice to close schools for 2 weeks has been "very aggressive—you may only get one chance to get out in front of a new infectious disease," Besser said. But the rapid spread of the virus across the country, plus information from multiple locations that the spectrum of disease is about as severe as average seasonal flu, has caused the agency to reconsider.
Therefore, he said, the CDC is considering changing its advice from automatically closing schools to asking schools and parents to weed out sick children and individually send them home for at least a week.
That procedure is already followed in Canada and in Seattle, which "asks people to really push hard on personal responsibility," Besser said, and today Minnesota followed suit. Health and education officials in that state released updated school closure guidance that asks parents and teachers to identify and isolate children who have a fever and a recent onset of flu like symptoms.
Besser said that, in those areas, parents are asked to check their children in the morning, and, if they are sick or are starting to feel a little sick, to keep them home for a full 7 days, even if they start to feel better before that period is up. In addition, schools and individual teachers are asked to take a close look at children as they arrive in the morning, and to send them home if the school believes they are developing illness—for 7 days or until they are proven not to have flu.
Public Health Seattle and King County, in its revised school closure guidance posted yesterday, said its policy change is an enhanced version of the approach it uses for seasonal influenza and is based on what is known about the new influenza virus and its spread. The guidance notes that the new strain, already spread widely, will continue for some time and that illness severity doesn't appear to be greater than typical seasonal influenza.
"Individualized school closure based on reports of diagnosed cases is less effective, in addition to being impractical, as a control measure," the Seattle-King County health department said. However, officials added that, consistent with seasonal influenza policy, some schools might be closed if large numbers of students or faculty become ill.
As the outbreak progresses, laboratory diagnosis will identify a shrinking proportion of cases, as testing demand exceeds capacity and many people who have mild infections won't see their doctors. "Closing schools where cases happen to be diagnosed while leaving most schools with undiagnosed cases open does not make sense as an ongoing influenza control strategy in our community," the department said.
Public Health Seattle and King County has several tools for schools and parents on its Web site, including a guide for parents on when to keep a child home from school, a flu symptom checklist, and advice on how to care for someone who has influenza.
Minnesota officials today unveiled similar guidance aimed at keeping students and staff with influenza symptoms out of schools, rather than routinely closing schools. They said in a statement that it's not possible to identify every case of novel influenza, because the symptoms mimic those of other respiratory diseases. "We also know that we have other acute viral respiratory infections circulating in Minnesota," they said in the statement.
"The fact that the novel influenza is currently behaving like regular flu does not mean we can relax,” said Sanne Magnan, MD, Minnesota commissioner of health, in a press release today. "Seasonal flu is a major health concern in its own right. It's one of our leading causes of death, year in and year out."
Schools that have a confirmed novel influenza case have three options: remain open with the individual isolated at home, close schools based on public health and community assessment, or close schools for a set number of days based on CDC guidance, which could change.
Minnesota officials also said they are developing enhanced school-based surveillance for influenza-like illnesses.
Friday, May 1, 2009
Swine Flu Affected In Hyderabad India
A Hyderabadi student, pursuing his higher education in engineering in Texas, returned to the city three days ago with symptoms of flu and voluntarily approached the doctors at Institute of Preventive Medicine, who suspected it to be a case of Swine Flu.
The identity and other particulars of the student were kept secret by the doctors, on the request of his parents, in order to avoid panic reaction among their relatives, friends and other people of Hyderabad. Later, he was referred to the Government Chest Hospital, where he was quarantined and is now undergoing symptomatic treatment.
State medical and health minister K Rosaiah, who on Thursday confirmed that tests had been conducted on the boy, said, “We keep confidential the details of this boy of marriageable age”.
He said the doctors had conducted tests on him as a part of the special screening for foreigners and NRIs, who arrived in city in the last 10 days. And the student was found to have symptoms of Swine Flu.
The identity and other particulars of the student were kept secret by the doctors, on the request of his parents, in order to avoid panic reaction among their relatives, friends and other people of Hyderabad. Later, he was referred to the Government Chest Hospital, where he was quarantined and is now undergoing symptomatic treatment.
State medical and health minister K Rosaiah, who on Thursday confirmed that tests had been conducted on the boy, said, “We keep confidential the details of this boy of marriageable age”.
He said the doctors had conducted tests on him as a part of the special screening for foreigners and NRIs, who arrived in city in the last 10 days. And the student was found to have symptoms of Swine Flu.
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