Dr Saroj Naithani

Dr. Saroj Naithani
Hon'ble CMO
Haridwar, Uttarakhand.
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Swineflu
What is swine flu?
  • pandemic Influenza A(H1N1) (swine flu) is a respiratory disease of pigs caused by Type A influenza viruses that causes regular outbreaks globally.
  • 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.

Is the current swine flu virus contagious?
  • Various international agencies (US Centers for Disease Control & Prevention, World Health Organization) have determined that this swine influenza A (H1N1) virus is most common circulating strain all over the world human to human.
  • WHO has escalated the world Pandemic Phase from Phase 3 to Phase 6 (in a 6-scale Phase), indicating that a worldwide pandemic due to swine flu H1N1 is possible.

ABOUT VIRUS
  • It is an enveloped RNA virus and belongs to orthomyxoviridae.
  • Three types of influenza A virus namely A, B, &C.
  • Virus contains two surface antigens H (hemagluttinin) & N (neuraminidase).
  • Incubation period – 1- 7 days.
  • Survival of virus – 8- 48 hrs.

Influenza At A Glance
  • Influenza, commonly called "the flu," is caused by viruses that infect the respiratory tract.
  • Influenza viruses are divided into three types, designated A, B, and C.

What are the signs and symptoms of swine flu in adults?
  • 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. 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.

What are the signs and symptoms of swine flu in children?
  • Infant may present with fever and lethargy, & may not have cough or other respiratory symptoms.
  • Severe cases may include apnoea , tachypnoea, dysponea, cyanosis, dehydration, altered mental sensorium & extreme irritability.

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 live flu viruses on it and then touching their mouth or nose.

How are human infections with swine influenza diagnosed?
  • To diagnose swine influenza A infection, an upper respiratory specimen ie. Naspharyngeal swab,nasal swab, throat swab, nasal aspirate, & endotracheal aspirate 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.

Management of suspected patient

Category A -
  • patient with mild fever plus cough/ sore throat with or without bodyache, headache, diarrhoea and vomiting.
  • Require symptomatic treatment only.
  • No testing required.
  • Home isolation done.

Category B -
  • signs of cat. A +High grade fever& severe sore throat. Or children< 5yr, pregnant women, > 65 yr, pt with lung, heart, liver, kidney ds. ,blood & neurological disorders, diabetes, cancer and HIV/ AIDS & pt. on long cortisone therapy.
  • Require home isolation & Oseltamivir
  • No test required.

Category C –
  • cat. A +cat B + one or more of the following-
  • Breathlessness, chest pain, drowsiness, fall in BP, sputum mixed with blood, bluish discoloration of nails.
  • Irritability among young children , refusal to accept feed.
  • Worsening of underlying chronic conditions.
  • All require testing, immediate hospitalization, oseltamivir, RT - PCR.

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.

Is there a vaccine for Pandemic Flu?
  • Because the virus has varying degree of adaptability only yearly vaccine is available.
  • Vaccination is recommended only in epidemic conditions.
  • 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).

Dose of Oseltamivir

Body weigt(kg) Age (yrs) Dose for 5 days
< 15 1 -2 30 mg twice daily
> 15-23 3 -5 45 mg twice daily
>23 -40 6 -9 60 mg twice daily
> 40 10 - 12 75 mg twice daily


Dose for < 1yr

Dose by age For 5 days (concentration 12mg /ml
< 3 months 12 mg(1 ml ) twice daily
3 - 5 months 20 mg ( 1.6 ml ) twice daily
6- 11 months 25 mg ( 2 ml ) twice daily


What can I do to protect myself from getting sick?
  • 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.
  • Avoid touching your eyes, nose or mouth. The virus can spread this way.
  • Try to avoid close contact with sick people.
  • If you get sick with influenza, stay home from work or school and limit contact with others to keep from infecting them.