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