Swine Flu Report Nepal 2015

Influenza (A) Report

These report was published by NISN Director Dr. Geeta Shakya under the super vision of MOHP.

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
27th Feb. 2015	Kathmandu	17	1
	Pokhara	6	0
	Bharatpur	7	0
	Other	1	0

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
1st   March  2015	Kathmandu	5	0

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
2nd   March  2015	Kathmandu	10	0

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
3rd to 4th March  2015	Kathmandu	15	0
	Pokhara(up to 4th March)	8	0
	Bharatpur(up to 4th March)	4	0

  

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
5th to 7th March  2015	Kathmandu	29	1
	Pokhara	11	0
	Bharatpur	4	0

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
5th to 7th March  2015	Kathmandu	6	0
	Dhangadi	1	0

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
10th to 11th March  2015	Kathmandu	18	0

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
12th to 13th March  2015	Kathmandu	40	0

The total number of cases from 1st jan. 2015 to 13th march 2015 is 234.

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
14th to 15th March  2015	Kathmandu	21	0
	Pokhara	10	0
	Bharatpur	13	0
	Dhangadi	1	0

The total number of cases from 1st jan. 2015 to 15th march 2015 is 278.

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
16th March  2015	Kathmandu	20	0
	Pokhara	5	0
	Bharatpur	5	0

The total number of cases from 1st jan. 2015 to 16th march 2015 is 308.

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
17th  March  2015	Kathmandu	15	0

The total number of cases from 1st jan. 2015 to 17^th  march 2015 is 323.

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
18th  March  2015	Kathmandu	8	0

The total number of cases from 1st jan. 2015 to 18^th  march 2015 is 331.

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
16th March  2015	Kathmandu	34	0
	Pokhara	15	0
	Bharatpur	25	0

The total number of cases from 1st jan. 2015 to 22^nd march 2015 is 405.

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
17th  March  2015	Kathmandu	13	0

The total number of cases from 1st jan. 2015 to 2^nd april 2015 is 523.

Food to avoid swine flu

What to eat ?

As swine flu attacks weak immune system or people who are malnourished. Although there are many ways to prevent an infection, not all of them are foolproof anyone wishing to build a strong immune system can avoid swine flu.


According to Ms.Neelanjana Singh, Clinical Nutritionist, PSRI Hospital, New Delhi some specific foods that have documented evidence of working as immunity enhancers are:

• Holy basil(Tulsi): There are 3 varieties of tulsi and a combination of all three of them can work very effectively to prevent viral infections of all kinds. One could incorporate the leaves to make a kadha (decoction) along with some spices such as cinnamon and black pepper. Add honey to the kadha as honey has antioxidant and anti-viral properties too!
• Consuming Indian Gooseberry (amla) regularly will boost Vitamin C levels in your system and will help prevent even the deadliest of infections. It is therefore not a surprise that Chawanprash has been so popular!
• Almonds- with the skin intact- make for a potent way to keep the viruses at bay. Like almonds, peanuts are also rich in micronutrients that can keep one healthy.
• Garlic should be consumed in the raw form in order to get its full benefit. Its regular intake will keep one free from the current threat of swine flu. After all, garlic is loaded with a sulphur compound Allicin that acts by boosting the white blood cell population in the body.
• Specific probiotic preparations can also play a role in boosting immunity during this season.
• Turmeric or haldi is a well-established immunity enhancer. Use turmeric liberally in your food preparations.

Also,

• Foods rich in protein, like meat, chicken, eggs, fish, milk, beans, nuts, seeds and soy-based foods. Having a minimum of 3 servings of these foods per day will help build a barrier against viral infections like swine flu.
• Lots of bright orange (carrots, pumpkins, apricots, and mangoes) and green (spinach and cabbage) fruits and vegetables. The vitamin A in these foods helps strengthen the respiratory membranes.
• Vitamin D3 is key to immune system health, so it's also a good idea to talk to your doctor about supplementing with this vitamin.
• Vitamin C-rich foods like peppers, spinach, citrus fruits, berries, and peas, which have anti-viral properties and help, mobilize bug-eating macrophage cells.
• Beef, eggs and seafood (especially crabs, oysters and sardines) for Zinc, which helps to form antibodies to fight the infection of swine flu.
• Whole grains and pumpkin seeds, which also build antibodies against swine flu.
• Apples, spinach, and other greens with iron in them.
• Two Echinacea tablets and a 300 mg tablet of St John’s Wort three times a day.
• Herbal tea with equal parts mint, elderflower and yarrow.
  
  
  
• Take immediate action to include these healthy foods in your diet to build up immunity and avoid the swine flu.

While flu shots and wearing masks is useful, having a strong immune system is also very important to prevent the virus from damaging your health. It is important to realise the how your immunity is weakened and the reasons behind it. Poor lifestyle habits like smoking, not getting enough sleep, living a stressful life, not consuming a proper diet, etc. can take a toll on your immunity, making you susceptible to swine flu.

So what should you do to boost your immunity and fight infections strongly?

 Healthy diet: Ensure that your diet is wholesome, which means that that it includes vitamins A, B ,C and E. Your diet should also comprise foods rich in zinc and selenium. Include crustaceans, meat, sunflower seeds and brown rice to build a strong immune system. Also, foods like ginger and garlic help in flushing out toxins from the body.

Include probiotics in your diet: Probiotics are bacteria that are good for your health and help in digestion. They are also known to improve your immunity by creating an acidic environment, which prevents the growth of other harmful bacteria in the stomach. Include foods like milk and curds which are a great natural source of probiotics.

Reduce stress: Be it work stress or emotional stress, it takes a huge toll on your immunity. Increasing  stress levels aid the release of the stress hormone. This hormone affects the working of the thymus, which in turn affects the production of immune cells in the body.

Get enough sleep: A minimum of 7 hours sleep is important for the proper functioning of the body. Interrupted and lack of sleep can compromise your immunity severely as it helps in the release of stress hormones and other inflammatory substances. 

Exercising regularly: Regular exercise improves blood flow, which helps in circulating immune cells throughout the body more efficiently. It also promotes the release of endorphins or ‘feel good’ hormones that help in stimulating the lymphatic system for release of blood cells. 

There are various myths associated about the spread of swine flu like eating chicken can cause swine flu or going vegan can protect you from swine flu. One should realise that these are only myths and not an actual facts.

Swine flu symptoms and recommendation

What to expect from Swine Flu

Since the news of swine flu is out people are worried about many things and uncertain about few things Swine Flu. So here are few things that may help you out.

Although swine flu seems to infect people having lower immunity, people who are high priorities for H1N1 vaccination are:

• Pregnant women

• People who live with or care for children younger than 6 months of age

• Health care and emergency medical services personnel

• People between the ages of 6 months and 24 years

• People ages 25-64 who have chronic health conditions or weak immune systems 

The seasonal flu vaccine doesn't protect against swine flu. The symptoms of H1N1 swine flu is similar to that of seasonal flu so first get treatment for the normal flu before reaching out to swine flu drugs, experts have advised only to take swine flu medicine after you are sure it is swine flu.  And also advised not to leave home if you've got flu-like symptoms. 

Don't rush to the emergency room unless you have certain symptoms. Only seek emergency medical care

 if a child show any of these symptoms:

• Fast breathing or trouble breathing

• Bluish or gray skin color

• Not drinking enough fluids

• Severe or persistent vomiting

• Not waking up or not interacting

• Being so irritable that the child does not want to be held

• Flu-like symptoms improve but then return with fever and cough

  

and for adults symptoms are:

• Difficulty breathing or shortness of breath

• Pain or pressure in the chest or abdomen

• Sudden dizziness

• Confusion

• Severe or persistent vomiting

• Flu-like symptoms improve but then return with fever and worse cough

Doctors’ recommends staying home at least 24 hours after you are free of fever of 100 degrees Fahrenheit, or signs of fever, without taking fever-reducing medicines. Having a high fever for more than three days is another danger sign, according to the WHO.

 In a study seasonal flu or its complications kills an average of 36,000 people per year and hospitalizes more than 200,000 people. Face masks are excellent way to prevent the swine flu infection; experts have said that wearing mask can reduce the chance of being infected by 50%. However, don't rely on a face mask as your only protection -- you still need to take other swine flu prevention steps:

• Wash your hands often.

• Cover your mouth and nose with a tissue when coughing or sneezing.

• Avoid touching your eyes, nose, and mouth.

• If you've got flu-like symptoms, avoid others until you've been free of fever for 24 hours.

• Stay at least 6 feet away from people with flu-like illness.

If you do wear a face mask, don't reuse it. Face masks should be worn once and then thrown out.

One of the golden rules for dealing with swine flu is for sick people to stay home. That means planning ahead in case you or someone in your family gets sick. Staying in isolated environment can prevent the out spread of the virus. So people infected with swine flu are kept in observation wards or are advised to stay home under strict guidance. While laundering linens/clothes of someone who has flu, don’t hug the laundry before washing it, and set the clothes dryer to the hot setting/use hot water. Wash your hands with soap and water (or use an alcohol-based hand sanitizer) immediately after handling dirty laundry.

Swine Flu in Nepal 2015

Influenza A H1N1 in Nepal 2015

The current swine flu outbreak around the world is caused by influenza A viruses that contain gene elements from swine, avian and humans. It started to affect persons in Mexico in March 2009 and  since then has spread to USA, Canada, several countries in Europe, New Zealand, Israel and many other countries around the world have suspected cases. The virus has demonstrated sustained human to human transmission leading WHO to declare pandemic level 5 with the swine flu as of 29 April 2009. Most human cases of swine flu have occurred in previously healthy children and young adults. Symptoms are similar to classic flu with fever, runny nose, sore throat, cough, vomiting, diarrhea. Most cases have been mild but there have been significant number of deaths in Mexico and a single death in USA.

Date	Place	No. of Influenza A H1N1	No. of death from Swine Flu
27th Feb. 2015	Kathmandu	17	1
	Pokhara	6	0
	Bharatpur	7	0
	Other	1	0

Latest report of total swine flu here

Screeening of influenza

According to the  National Influenza Surveillance Network (NISN)  the total influenza H1N1 cases has reached 9 in kathmandu and 4 in chitwan  in the period between 15th feb to 24th feb 2015. The Ministry of Health and Population (MoHP) has sounded an alert that the viral Swine Flu, which is spreading in India, has high chances of entering Nepal. A large number of people cross the open border from India and come to Nepal every day. In a statement addressed to the common people, medical authorities and media persons, the MoHP has stressed the need for adopting necessary safety measures to prevent the outbreak and onslaught of Pandemic Influenza A H1N1. Cases of viral flu, reported as increasing in Rajasthan , New Delhi and Madhya Pradesh of India, have already claimed more than 837 lives. Looking at the spread of the disease across the border, the MoHP has placed western Nepal in the vicinity as being at a greater risk of viral outbreak than other parts of the country. In the far-western development region, the District Public Health Office (DPHO), Kanchanpur, has set up health desks at Gaddachauki and Belauri citing high possibility of the disease entering the country owing to the open border with India as hundreds of Nepalese and Indian nationals enter Nepal through these check point every day. Likewise, high alertness has been maintained in Nawalparasi district. Chief of the District Health Office, Jay BahadurKarki, said that all health workers in the health posts and centres and from different organizations bordering to India have been directed to remain in condition. Hundreds of people enter Nepal from India through different entry points as Maheshpur and Triveni.

 Though the people of bordering towns with India were said to be more susceptible to contracting the disease, two people were found to have been 'infected' with H1N1 influenza virus in Pokhara.

According to Bal Krishna Bhusal, chief of the district public health office at Pokhara, the swine flu was detected while conducting tests on the blood sample of two patients admitted at Western Regional Hospital in Pokhara. The infected are 21-year-old male and an 11-year-old child. Since both are residents of Pokhara, Bhusal stressed on the need to intensify the awareness programme about swine flu in the tourist town.

How is it transmitted ?

Electron microscope image of the re assorted H1N1 influenza virus

The transmission of flu is mostly via droplets produced by an infected person when she /he coughs or sneezes. Infected individuals may also contaminate surfaces with their secretions. Surfaces can harbor infectious material for longer periods of time. Because all influenza viruses have the ability to change, scientists are concerned that the current H1N1 virus could change or mutate to a more virulent form that is capable of spreading more easily from person to person and causing severe disease leading to an influenza pandemic that is capable of causing millions of deaths worldwide.  Because swine flu viruses do not commonly infect humans, there is little or no immune protection against them in the human population.

What are the symptoms and can we do to prevent?

If you have a flu like illness without any history of travel to swine flu affected countries in the past one week, it is suggested that you stay away from school or office. Authorities are looking out for cases in travelers who have visited areas with swine flu outbreaks who may have been in contact with persons with the swine flu. If these persons develop  influenza like illness, a certain precautions are followed. Simple measures like washing hands frequently cuts down the rates of infection. Surfaces, door knobs etc. need to be kept clean at home and in the work place.  Alcohol based hand sanitizers can also be used especially if there is water shortage. Obtain the flu vaccine which will not protect you from the swine flu but it will protect against regular flu.

The U.S. Centers for Disease Control and Prevention recommends the use of oseltamivir (Tamiflu) or zanamivir (Relenza) for the treatment and/or prevention of infection with swine influenza viruses; however, the majority of people infected with the virus make a full recovery without requiring medical attention or antiviral drugs. Nepal has a small stock of this antiviral medication with the Health Ministry and it is believed that this or other antiviral medication will be available should there be cases of swine flu in Nepal. CIWEC have a small stock of Oseltamivir and significant amounts of personal protective equipment for clinic use and will continue to monitor the situation around the world closely. In the meantime, if you have a fever, postpone travel to and from countries with swine flu outbreak. Also, find out if there are any travel restrictions in the countries that you plan to visit. If you have traveled to a country experiencing a swine flu outbreak, monitor your health for one  week after return and see a healthcare provider if fever or respiratory symptoms should develop.

Where to go to test for swine flu ?

In Nepal swine flu test is controlled by National Influenza Surveillance Network (NISN) which is a active body of National Public Health Laboratory which works under the supervision of Ministry of Health and Population (MoHP). For the test you can visit Teku Hospital in Teku and goto the top floor of the National Public Health Laboratory. It is necessary you to show the doctor's prescription. Also it is advised to visit only the person has developed symptoms such high fever, cough, sore throat, body aches, headache, chills and fatigue.

Contact Details of the screening center

Coordinate  27.695438° N  85.306321°E