Swine Flu
As the
virus of the spine flue is spread from person
to person in United States and Mexico triggering
global concerns
CNN) -- The World Health Organization has called
it a "public
health emergency of international concern. Seemingly out of
nowhere, the swine flu virus has spread from person to person
in Mexico and the United States, triggering global concerns
as governments scramble to find ways to prevent further outbreak."Swine
Flu FAQ
WebMD Provides Answers to Your Questions About Swine Flu
By Daniel J.
DeNoon
WebMD Health News
Reviewed by Louise
Chang, MD
The swine flu virus in the U.S. is the same one causing a deadly
epidemic in Mexico. What is swine flu? What can we do about
it? WebMD answers your questions.
What Is Swine Flu?
Like humans, pigs get the flu. Four different types A swine
flu strains commonly circulate among pigs. Most recent swine
flu viruses have belonged to the H1N1 and H3N2 subtypes. Pigs
typically get sick but usually don't die from swine flu.
The new swine flu virus infecting humans is very unusual. It's
somehow acquired genes from swine, bird, and human flu bugs.
And it's also got genes from Eurasian swine flu viruses that
aren't supposed to be in North America.
Do's & Dont's
Do Humans Get Swine Flu?
Normally, swine flu bugs don't infect people. Historically,
there's a case every year or two in the U.S. among people who
have contact with live pigs.
But from December 2005 to January 2009 there was an uptick
in swine flu cases. There were 12 human swine flu infections
during this time. Eleven of these people had direct or indirect
contact with pigs; in the twelfth case it was not known whether
there was pig contact.
It's possible this uptick was due to improved reporting systems,
but the CDC says "genetic changes in swine flu viruses
and other factors might also be a factor."
The new swine flu virus is different. It's not yet clear that
it's here to stay. But it is infecting humans, and that has
world health officials keeping a close eye on it.
What Are the Symptoms of Swine Flu?
Swine flu symptoms are similar to regular flu symptoms and
include cough, sore throat, fever, chills, headache, and fatigue.
Some patients have also reported nausea and diarrhea. There
is no easy way to distinguish swine flu from other types of
flu or other germs. It takes a lab test to tell whether it's
swine flu.
Can Swine Flu Spread From Person to Person?
The U.S. residents infected with swine flu virus had no direct
contact with pigs. The CDC says it's likely that the infections
represent widely separated cycles of human-to-human infections.
Have There Been Previous Swine Flu Outbreaks?
If swine flu sounds familiar to you, it's probably because
you remember or have read about the 1976 swine flu outbreak
at Fort Dix, N.J., among military recruits. It lasted about
a month and then went away as mysteriously as it appeared.
As many as 240 people were infected; one died.
The swine flu that spread at Fort Dix was the H1N1 strain.
That's the same flu strain that caused the disastrous flu pandemic
of 1918-1919, resulting in tens of millions of deaths.
Concern that a new H1N1 pandemic might return with winter led
to a crash program to create a vaccine and vaccinate all Americans
against swine flu. That vaccine program ran into all kinds
of problems -- not the least of which was public perception
that the vaccine caused excessive rates of dangerous reactions.
After more than 40 million people were vaccinated, the effort
was abandoned.
As it turned out, there was no swine flu epidemic.
I Got a Flu Shot. Am I Protected Against Swine Flu?
No. There is currently no swine flu
vaccine.
It's possible that the seasonal flu vaccine might provide partial
protection against H3N2 swine flu bugs. But the strain that
appeared in California is the H1N1 swine flu strain. It is
very different from the H1N1 human flu strain included in the
seasonal flu vaccine.
It's not known whether previous infection with human type A
H1N1 flu might provide partial protection against the type
A H1N1 swine flu in the current outbreak.
However, the CDC has made a "vaccine seed" from swine
flu isolated from an infected person, and has begun the process
of developing a vaccine should the need arise. Whether a vaccine
could be produced in quantity by next flu season is a huge
question.
How Serious Is the Public Health Threat of a Swine Flu Epidemic?
Any flu epidemic is worrisome, especially when a new strain
of flu bug is involved.
"Influenza A viruses new to the human population that are able to efficiently
transmit from person to person and cause illness may represent a pandemic threat," the
CDC warns.
It's worrisome that, unlike seasonal flu, the swine flu outbreak
in Mexico is attacking healthy young people. That's a hallmark
of pandemic flu bugs.
But it takes more than a new virus spreading among humans to
make a pandemic. The virus has to be able to spread efficiently
from one person to another, and transmission has to be sustained
over time. In addition, the virus has to spread geographically.
Is There a Treatment for Swine Flu?
Yes. While the swine flu bug is resistant to older flu medicines,
it remains sensitive to Tamiflu and to Relenza.
Can You Get Swine Flu by Eating Pork?
No. You can only catch swine flu from being around an infected
pig -- or, if it's the new swine flu virus, from an infected
person.
Swine flu symptoms: If you're about to Google "swine
flu symptoms," we can save you some trouble. There isn't
a special set of symptoms unique to swine flu. It's pretty
much flu, and it takes a lab test to tell whether it's swine
flu.
Here's what the CDC's web site says about swine flu symptoms: "The
symptoms of swine flu in people are expected to be similar
to the symptoms of regular human seasonal influenza and include
fever, lethargy, lack of appetite and coughing. Some people
with swine flu also have reported runny nose, sore throat,
nausea, vomiting and diarrhea."
What is the swine flu?
Sporadic swine influenza A virus (SIV) infection of humans
may produce a wide range of clinical signs and symptoms. Many
human cases of swine influenza A virus infection have had a
history of recent direct physical contact with pigs prior to
illness onset. However, close (within 6 feet), but not direct
contact with pigs, also has been reported among human swine
influenza A virus cases. Limited, non sustained human-to-human
swine influenza A virus transmission has been documented in
the published literature. In addition, some confirmed swine
influenza A virus cases have not had a history of exposure
to pigs.
What are the symptoms of swine flu?
Although uncomplicated influenza-like illness (fever,
cough or
sore throat) has been reported in many cases, mild respiratory
illness (nasal congestion, rhinorrhea)
without fever and occasional severe disease also has been
reported. Other symptoms reported with swine influenza A
virus infection include vomiting,
diarrhea, myalgia,
headache, chills,
fatigue,
and dyspnea.
Conjunctivitis is
rare, but has been reported. Severe disease (pneumonia,
respiratory failure) and fatal outcomes have been reported with swine
influenza A virus infection. The potential for exacerbation of
underlying chronic medical conditions or invasive bacterial
infection with swine influenza A virus infection should be
considered.
This document provides interim guidance on infection control,
antiviral treatment
and chemoprophylaxis,
and monitoring of close contacts of cases of swine influenza
virus infection, including guidance for health care workers
and public
health personnel. The guidance will be updated as needed.
Recommendations
For clinical care or collection of respiratory specimens from
a symptomatic individual (acute respiratory symptoms with or
without fever) who is a confirmed case, or a suspected case
(ill close contact of a confirmed case) of swine influenza
A virus infection:
Infectious Period
Persons with swine influenza virus infection should be considered
potentially contagious for up to 7 days following illness onset.
Persons who continue to be ill longer than 7 days after illness
onset should be considered potentially contagious until symptoms
have resolved. Children, especially younger children, might
potentially be contagious for longer periods. The duration
of infectiousness might vary by swine influenza A virus strain.
Case definitions
A confirmed case of swine influenza virus infection (SIV) is
defined as a person with an acute respiratory illness with
laboratory confirmed swine influenza A virus at CDC by one
or more of the following tests:
- real-time RT-PCR
- viral culture
- four-fold rise in swine influenza A virus specific neutralizing
antibodies
A suspected case of swine influenza A virus is defined
as a person with an acute respiratory illness who was a close
contact to a confirmed case of swine influenza A virus infection
while the case was ill, or is an acutely ill person (acute
respiratory illness) with a recent history of contact with
an animal with confirmed or suspected swine influenza A virus
infection.
- Close contact is defined as: within about
6 feet of an ill person who is a confirmed case of swine
influenza A virus infection
Acute respiratory illness is defined as recent onset of at
least two of the following: rhinorrhea or nasal congestion,
sore throat, cough (with or without fever or feverishness)
Recommendations for public health personnel
For interviews of healthy individuals (i.e. without a current
respiratory illness), including close contacts of cases of
confirmed swine influenza virus infection, no personal protective
equipment or antiviral chemoprophylaxis is needed. See section
on antiviral chemoprophylaxis for further guidance.
For interviews of an ill, suspected or confirmed swine influenza
A virus case, the following is recommended:
- Keep a distance of at least 6 feet from the ill person;
or
- Personal protective equipment: fit-tested N95 respirator
[if unavailable, wear a medical (surgical mask)].
For collecting respiratory specimens from an ill confirmed
or suspected swine influenza A virus case, the following is
recommended:
- Personal protective equipment: fit-tested disposable N95
respirator [if unavailable, wear a medical (surgical mask)],
disposable gloves, gown, and goggles.
- When completed, place all PPE in a biohazard bag for appropriate
disposal.
- Wash hands thoroughly with soap and water or alcohol-based
hand gel.
Infection Control
Recommended Infection Control for a non-hospitalized patient
(ER, clinic or home visit):
- Separation from others in single room if available until
asymptomatic.
If the ill person needs to move to another part of the house,
they should wear a mask. The ill person should be encouraged
to wash hand frequently and follow respiratory hygiene practices.
Cups and other utensils used by the ill person should be
thoroughly washed with soap and water before use by other
persons.
Recommended Infection Control for a hospitalized patient:
- Standard, Droplet and Contact precautions for 7 days after
illness onset or until symptoms have resolved.
- In addition, personnel should wear N95 respirators when
entering the patient room.
- Use an airborne infection isolation room (AIIR) with negative
pressure air handling, if available; otherwise use a single
patient room with the door kept closed.
- For suctioning, bronchoscopy,
or intubation, use a procedure room with negative pressure
air handling.
Recommended PPE for personnel providing clinical care to ill
individuals:
- Disposable gown, gloves, goggles, N95 respirator.
Antiviral Treatment
Antiviral treatment for confirmed or suspected ill case of
swine influenza virus infection may include either oseltamivir
(Tamiflu) or zanamivir, with no preference given at this time.
Recommendations for use of antivirals may change as data on
antiviral susceptibilities become available.
Initiate treatment as soon as possible after the onset of symptoms.
Oseltamivir (Tamiflu):
- The treatment dosing recommendation for children who weigh
15 kg or less is 30 mg twice a day. For children who weigh
more than 15 kg and up to 23 kg, the dose is 45 mg twice
a day. For children who weigh more than 23 kg and up to 40
kg, the dose is 60 mg twice a day. For children who weigh
more than 40 kg, the dose is 75 mg twice a day.
- For ages 13 years and older: 75mg twice a day for five
days
Zanamivir (Relenza)
Zanamivir (Relenza)
is an alternative for treatment of influenza in patients
aged 7 years and older; dosage varies by age. This drug is
not approved for treatment of influenza in children aged <7
years. It is an orally inhaled drug that is administered
using a disk inhaler device twice a day for five days.
- The treatment dosing recommendation for persons aged 7
years and older is 2 inhalations twice a day for five days
(2 inhalations of 5mg each twice a day for five days)
Antiviral Chemoprophylaxis
Antiviral chemoprophylaxis (pre-exposure or post-exposure)
can be considered for close contacts of a confirmed or highly
suspected case of swine influenza virus infection.
- Close contact is defined as: within about
6 feet of an ill person who is a confirmed case of swine
influenza A virus infection (e.g. post-exposure chemoprophylaxis
following unprotected close exposure).
Duration of antiviral chemoprophylaxis is 7 days after the
last known exposure
Oseltamivir: Administered by mouth once
a day for seven days following the last known exposure; dosage
varies by age and weight for children aged 1 year to 12 years
(available in suspension, 30mg, 45mg, 75mg capsules)
- The chemoprophylaxis dosing recommendation for children
who weigh less than 15 kg is 30 mg once a day. For those
who weigh more than 15 kg and up to 23 kg, the dose is 45
mg once a day. For children who weigh more than 23 kg and
up to 40 kg, the dose is 60 mg once a day. For children who
weigh more than 40 kg, the dose is 75 mg once a day.
- For ages 13 years and older: 75 mg once a day for seven
days
Zanamivir is an alternative for chemoprophylaxis
for patients aged 5 years and older; dosage varies by age.
It is an orally inhaled drug that is administered using a disk
inhaler device.
- Dosing is 2 oral inhalations once a day for seven days
(2 inhalations of 5mg each once a day for seven days)
Follow-up Monitoring of Exposed Close Contacts
Close contacts are defined as persons who were within about
6 feet of the confirmed swine influenza case while the case
was ill up to 7 days after the case's illness onset. Examples
include household members, social contacts, public health care
workers, medical health care workers, and others.
- Close contacts should be monitored daily for fever (temp ≥38.0
C; ≥100.4 F) and/or any respiratory symptoms up to 7 days
following the last known exposure to an ill person who is
a confirmed case of swine influenza virus infection.
- Close contacts of an ill person who is a confirmed case
of swine influenza virus infection should be educated about
the signs and symptoms of swine influenza virus infection
and advised to contact public health staff if fever or feverishness
or any respiratory tract symptoms occur up to 7 days following
the last known exposure to the ill case.
Swine Flu Index
Featured: Swine
Flu Main Article
Sporadic swine influenza A virus (SIV) infection (swine flu)
is an infection that generally is transferred from an infected
pig to a human, however there have been reported cases where
infection has occured with no contact with infected pigs. Symptoms
of swine flu are "flu-like" for example fever, cough,
or sore throat. Treatment is generally with the antibiotics
oseltamivir (Tamiflu) or zanamivir (Relenza).
Medications
- oseltamivir,
Tamiflu
- zanamivir,
Relenza
Procedures & Tests
View
All 7 Swine
Flu Related Diseases & Conditions »
FDA Drug Labels on RxList.com
- Tamiflu (oseltamivir
phosphate) Capsules And For Oral Suspension )
- Relenza(zanamivir)
Inhalation Powder, for oral inhalation
Swine Flu
Related Conditions
- Diarrhoea
- Fever
- Headache
- Headaches
in Children
- Pink
Eye
- Sore
Throat (Pharyngitis)
- Chronic cough
Q. What is swine flu?
A. Swine influenza, or flu, is a contagious
respiratory disease that affects pigs. It is caused by a
type-A influenza virus. Outbreaks in pigs occur year-round.
The most common version is H1N1. The current strain is a new
variation of an H1N1 virus, which is a mix of human and animal
versions.
Q. Does swine flu affect humans?
A. While the virus causes regular outbreaks in pigs, people
usually are not struck by swine flu. However, there have been instances of
the virus spreading to people -- and then from one person to another. The only
difference is, says the CDC, transmission in the past did not spread beyond
three people -- as it has done this time.
Q. What is behind the spread of the virus this time?
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A. Researchers do not know yet know. People
usually get swine flu from infected pigs. For example, farmers
handling infected pigs can contract the virus. However, some
human cases have occurred without contact with pigs or places
they inhabited.
Q. What are the symptoms of swine flu?
A. The symptoms are similar to the common
flu. They include fever, lethargy, lack of appetite, coughing,
runny nose, sore throat, nausea, vomiting and diarrhea.
Q. How does the virus spread?
A. The virus spreads the same way the seasonal
flu does. When an infected person coughs or sneezes around
another person, the latter is put at risk. People can become
infected by touching something with the flu virus on it and
then touching their mouth, nose or eyes. An infected person
can pass the virus to another before any symptoms even develop.
Q. Why is this spread troubling?
A. Scientists are concerned whenever a new
virus is able to jump from an animal to a person -- and then
spread from person to person. When the flu spreads person
to person, it can continue to mutate, making it harder to
treat or fight off.
The World Health Organization has said the current outbreak
has "pandemic potential," and has urged governments
to take precautions to prevent its spread. If the virus continues
to mutate, drug makers won't be able to come up with vaccines
fast enough.
Q. Can swine flu be fatal?
A. Just like the regular flu, swine flu worsens pre-existing
medical conditions in people. So people with already compromised immune systems
can die after contracting it.
Q. But doesn't the common flu kill more people?
A. Yes, common seasonal flu kills 250,000 to 500,000 people
every year. But what worries officials is that a new strain of the flu virus
can spread fast because people do not have natural immunity and vaccines can
take months to develop.
Q. Have there been swine flu outbreaks in the past?
A. From 2005 to January 2009, 12 human cases of swine flu
were detected in the United States, without deaths occurring, the CDC said.
In September 1988, a healthy 32-year-old pregnant woman in Wisconsin was hospitalized
for pneumonia after being infected with swine flu and died a week later. And
in 1976, a swine flu outbreak in Fort Dix, New Jersey, caused more than 200
illnesses and one death.
Q. What does the World Health Organization mean when it says
swine flu has "pandemic potential"?
A. If the virus spreads over a wide geographic area and affects
a large segment of the population, it is upgraded from an "epidemic" to
a "pandemic."
Q. How deadly have pandemics been in the past?
A. In 1968, a "Hong Kong" flu pandemic killed about
1 million people worldwide. And in 1918, a "Spanish" flu pandemic
killed as many as 100 million people.
Q. How can one keep from getting swine flu?
A. There are no vaccines available. But several everyday steps
can help prevent the spread of germs: Washing hands frequently; avoiding close
contact with people who are sick; and avoiding touching surfaces that might
be contaminated.
Health Library
- MayoClinic.com:
Influenza (flu)
Q. Are there medicines to treat swine flu?
A. Yes, the CDC recommends using anti-viral
drugs. They keep the virus from reproducing inside the body.
And in an infected person, the drugs make the illness milder.
Q. Can one contract swine flu from eating
or preparing pork?
A. No. Pork and other pig-derived products,
if properly handled and cooked, do not transmit swine flu.
The flu virus is killed by cooking temperatures of 160°F (70°C).
Definition
Swine flu is a respiratory infection caused by influenza A
viruses. The outbreak of what is popularly called swine flu
involves a new H1N1 type A influenza strain that's a genetic
combination of swine, avian and human influenza viruses. It
can spread from human to human.
True swine flu ordinarily causes illness in pigs. Pig-to-human
transmission is unusual, and human-to-human transmission of
true swine flu is also possible but infrequent.
Based on its wide spread, the World Health Organization has
declared the 2009 outbreak of the new H1N1 flu a global pandemic.
The new swine flu strain is being called by various names:
swine-origin influenza A, swine influenza A (H1N1), influenza
A/California/H1N1, swine origin influenza virus, North American
flu and influenza A (H1N1).
The best approach you can take is to avoid infection. If you
develop symptoms of swine flu, seek prompt medical attention
to give yourself the best chance of antiviral drugs being effective.
Symptoms
Swine flu symptoms in humans are similar to those of infection
with other flu strains:
- Fever
- Cough
- Sore throat
- Body aches
- Headache
- Chills
- Fatigue
- Diarrhea
- Vomiting
Swine flu symptoms develop three to five days after you're
exposed to the virus and continue for about eight days, starting
one day before you get sick and continuing until you've recovered.
When to see a doctor
See your doctor immediately if you develop swine flu symptoms,
such as fever, cough and body aches, and you have recently
traveled to an area where H1N1 swine flu has been reported.
Be sure to let your doctor know when and where you traveled.
Also see your doctor if you develop what appear to be swine
flu symptoms after you've been in close contact with someone
who may have been exposed to H1N1 swine flu.
Doctors have rapid tests to identify the flu virus, but there
is no rapid test to differentiate swine influenza A H1N1 from
other influenza A subtypes.
Causes
Influenza viruses infect the cells lining your nose, throat
and lungs. The virus enters your body when you inhale contaminated
droplets or transfer live virus from a contaminated surface
to your eyes, nose or mouth on your hand.
Risk Factors
If you've traveled to an area where lots of people are affected
by human swine flu H1N1, you may have been exposed to the
virus, particularly if you spent time in large crowds.
Swine farmers and veterinarians have the highest risk of true
swine flu because of their exposure to pigs.
Complications
Influenza complications include:
- Worsening of chronic conditions, such as heart disease,
diabetes and asthma
- Pneumonia
- Respiratory failure
Severe complications of human swine flu H1N1 seem to develop
and progress rapidly.
Treatments and drugs
Most cases of flu, including human swine flu, need no treatment
other than symptom relief. If you have a chronic respiratory
disease, your doctor may prescribe additional medication to
decrease inflammation, open your airways and help clear lung
secretions.
Antiviral drugs can reduce the severity of symptoms. Two classes
of antiviral medications are used to reduce symptoms and duration
of the flu — adamantane antivirals and neuraminidase
inhibitors — but flu viruses can develop resistance to
them.
Human swine flu H1N1 is sensitive to oseltamivir (Tamiflu)
and zanamivir (Relenza), both of which are neuraminidase inhibitors.
It's important to start treatment as soon as possible after
you become ill. These antiviral medications are most effective
if treatment begins within 48 hours of developing symptoms.
Lifestyle and home remedies
If you come down with any type of flu, these measures may
help ease your symptoms:
- Drink plenty of liquids. Choose water,
juice and warm soups to prevent dehydration. Drink enough
so that your urine is clear or pale yellow.
- Rest. Get more sleep to help your immune
system fight infection.
- Consider pain relievers. Use Paracetamol
if needed.
Remember, pain relievers may make you more comfortable, but
they won't make your symptoms go away any faster and may have
side effects. Ibuprofen may cause stomach pain, bleeding and
ulcers. If taken for a long period or in higher than recommended
doses, acetaminophen can be toxic to your liver.
Talk to your doctor before giving acetaminophen to children.
And don't give aspirin to children or teens because of the
risk of Reye's syndrome, a rare but potentially fatal disease.
Prevention
These measures may help prevent flu:
- Stay home if you're sick. If you do have
swine flu, you can give it to others starting about 24 hours
before you develop symptoms and ending about seven days later.
- Wash your hands thoroughly and frequently. Use
soap and water, or if they're unavailable, use an alcohol-based
hand sanitizer. Flu viruses can survive for two hours or
longer on surfaces, such as doorknobs and countertops.
- Avoid contact. Stay away from crowds if
possible.
- Reduce exposure within your household. If
a member of your household has swine flu, designate one other
household member to be responsible for the ill person's close
personal care.
H1N1 Flu (Swine Flu)
Also called: Swine flu
Swine flu is an infection caused by a virus. It's named for
a virus that pigs can get. People do not normally get swine
flu, but human infections can and do happen. The virus is contagious
and can spread from human to human. 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.
There are antiviral medicines you can take to prevent or treat
swine flu. There is no vaccine available right now to protect
against swine flu. You can help prevent the spread of germs
that cause respiratory illnesses like influenza by
- Covering your nose and mouth with a tissue when you cough
or sneeze. Throw the tissue in the trash after you use it.
- Washing your hands often with soap and water, especially
after you cough or sneeze. You can also use alcohol-based
hand cleaners.
- Avoiding touching your eyes, nose or mouth. Germs spread
this way.
- Trying to avoid close contact with sick people.
- Staying home from work or school if you are sick.
How many swine flu viruses are there?
Like all influenza viruses, swine flu viruses change constantly.
Pigs can be infected by avian influenza and human influenza
viruses as well as swine influenza viruses. When influenza
viruses from different species infect pigs, the viruses can
reassort (i.e. swap genes) and new viruses that are a mix
of swine, human and/or avian influenza viruses can emerge.
Over the years, different variations of swine flu viruses
have emerged. At this time, there are four main influenza
type A virus subtypes that have been isolated in pigs: H1N1,
H1N2, H3N2, and H3N1. However, most of the recently isolated
influenza viruses from pigs have been H1N1 viruses.
Swine Flu in Humans
Can humans catch swine flu?
Swine flu viruses do not normally infect humans. However, sporadic
human infections with swine flu have occurred. Most commonly,
these cases occur in persons with direct exposure to pigs
(e.g. children near pigs at a fair or workers in the swine
industry). In addition, there have been documented cases
of one person spreading swine flu to others. For example,
an outbreak of apparent swine flu infection in pigs in Wisconsin
in 1988 resulted in multiple human infections, and, although
no community outbreak resulted, there was antibody evidence
of virus transmission from the patient to health care workers
who had close contact with the patient.
How common is swine flu infection in humans?
In the past, CDC received reports of approximately one human
swine influenza virus infection every one to two years in the
U.S., but from December 2005 through February 2009, 12 cases
of human infection with swine influenza have been reported.
What are the symptoms of swine flu in humans?
The symptoms of swine flu in people are expected to be similar
to the symptoms of regular human seasonal
influenza and include fever, lethargy, lack of appetite
and coughing. Some people with swine flu also have reported
runny nose, sore throat, nausea, vomiting and diarrhea.
How does swine flu spread?
Influenza viruses can be directly transmitted from pigs to
people and from people to pigs. Human infection with flu viruses
from pigs are most likely to occur when people are in close
proximity to infected pigs, such as in pig barns and livestock
exhibits housing pigs at fairs. Human-to-human transmission
of swine flu can also occur. This is thought to occur in the
same way as seasonal flu occurs in people, which is mainly
person-to-person transmission through coughing or sneezing
of people infected with the influenza virus. People may become
infected by touching something with flu viruses on it and then
touching their mouth or nose.
What do we know about human-to-human spread of swine flu?
In September 1988, a previously healthy 32-year-old pregnant
woman was hospitalized for pneumonia and died 8 days later.
A swine H1N1 flu virus was detected. Four days before getting
sick, the patient visited a county fair swine exhibition where
there was widespread influenza-like illness among the swine.
In follow-up studies, 76% of swine exhibitors tested had antibody
evidence of swine flu infection but no serious illnesses were
detected among this group. Additional studies suggest that
one to three health care personnel who had contact with the
patient developed mild influenza-like illnesses with antibody
evidence of swine flu infection.
How can human infections with swine influenza be 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 CDC
for laboratory testing.
What medications are available to treat swine flu infections in humans?
There are four different antiviral drugs that are licensed
for use in the US for the treatment of influenza: amantadine,
rimantadine, oseltamivir and zanamivir. While most swine influenza
viruses have been susceptible to all four drugs, the most recent
seven swine influenza viruses isolated from humans are resistant
to amantadine and rimantadine. At this time, CDC recommends
the use of oseltamivir or zanamivir for the treatment and/or
prevention of infection with swine influenza viruses. More
information on treatment recommendations can be found at www.cdc.gov/flu/swine/recommendations.htm.
What other examples of swine flu outbreaks are there?
Probably the most well known is an outbreak of swine flu among
soldiers in Fort Dix, New Jersey in 1976. The virus caused
disease with x-ray evidence of pneumonia in at least 4 soldiers
and 1 death; all of these patients had previously been healthy.
The virus was transmitted to close contacts in a basic training
environment, with limited transmission outside the basic training
group. The virus is thought to have circulated for a month
and disappeared. The source of the virus, the exact time of
its introduction into Fort Dix, and factors limiting its spread
and duration are unknown. The Fort Dix outbreak may have been
caused by introduction of an animal virus into a stressed human
population in close contact in crowded facilities during the
winter. The swine influenza A virus collected from a Fort Dix
soldier was named A/New Jersey/76 (Hsw1N1).
Is the H1N1 swine flu virus the same as human H1N1 viruses?
No. The H1N1 swine flu viruses are antigenically very different
from human H1N1 viruses and, therefore, vaccines for human
seasonal flu would not provide protection from H1N1 swine flu
viruses.
Is there a vaccine for swine flu?
Vaccines are available to be given to pigs to prevent swine
influenza. There is no vaccine to protect humans from swine
flu. The seasonal influenza vaccine will likely help provide
partial protection against swine H3N2, but not swine H1N1 viruses.