1. Dr AVK Raju 1

2.  Problem statement  The virus  Mode of Spread  Symptoms  What to do  Investigation  Where to go  Treatment  Prevention 2

3. 3 April 2009

4. 17 deaths so far in India (13 Aug 09) 4

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7.  Influenza virus A (H1 N1) “It is a common cold virus” 7

8.  Influenza A (H1 N1) virus result of mutation of virus found in pigs  “Quadruple reassortant virus”  No harm in eating pork  Unlike in Bird Flu culling of pigs not warranted 8

9.  Human to Human !  Mode of spread: sneeze/cough  Contact (oro-nasal secretions) 9

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11.  Children and young adults  Doctors and Para Medics  Chronic Diseases: Cancers, High BP, Diabetes, HIV, Pulm TB, Malnutrition  Other Occupations: crowded and dinghy places, ? Contact with pigs 11

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13.  1 to 2 days  1 day prior to development of illness to 7 - 10 days Period of infectivity 13

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15. No…. not these ! 15

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17.  Fast breathing or trouble breathing  Skin developing bluish discolouration  Not eating or drinking properly  Excessive Irritability  Flu recurs with fever and worsened cough  Fever with rash 17

18.  Difficulty in breathing or shortness of breath  Chest or Abdominal pain  Sudden dizziness  Confusion  Severe or persistent cough 18

19.  Protection  Consult Doctor immediately 19

20.  Investigation and treatment – “Govt designated centres & Govt approved private hospitals”  Investigations  Real Time PCR  Viral Culture, Virus Genome Sequencing  Four fold rise in Swine Flu Influenza A (H1 N1) virus specific neutralising Antibodies 20

21. City Hospital Address Contact Chennai King Institute of Preventive Medicine (24/7 Service)Guindy, Chennai – 32(044) 22501520, 22501521 & 22501522 Communicable Diseases HospitalThondiarpet, Chennai(044) 25912686/87/88, 9444459543 Government General HospitalOpp. Central Railway Station, Chennai – 03(044) 25305000, 25305723, 25305721, 25330300 Pune Naidu HospitalNr Le'Meridian, Raja Bahadur Mill, GPO, Pune - 01(020) 26058243 National Institute of Virology20A Ambedkar Road, Pune - 11(020) 26006290 Kolkata ID Hospital57,Beliaghata, Beliaghata Road, Kolkata - 10‎(033) 23701252 Coimbatore Government General Hospital Near Railway Station, Trichy Road, Coimbatore - 18 (0422) 2301393, 2301394, 2301395, 2301396 Hyderabad Govt. General and Chest Diseases Hospital,Erragadda, Hyderabad(040) 23814939 Mumbai Kasturba Gandhi HospitalArthur Road, N M Joshi Marg, Jacob Circle, Mumbai - 11(022) 23083901, 23092458, 23004512 Sir J J HospitalJ J Marg, Byculla, Mumbai - 08 (022) 23735555, 23739031, 23760943, 23768400 / 23731144 / 5555 / 23701393 / 1366 Haffkine InstituteAcharya Donde Marg, Parel, Mumbai - 12(022) 24160947, 24160961, 24160962 Kochi Government Medical CollegeGandhi Nagar P O, Kottayam - 08(0481) 2597311,2597312 Government Medical CollegeVandanam P O, Allapuzha - 05(0477) 2282015 Taluk HospitalRailway Station Road, Alwaye, Ernakulam(0484) 2624040 Sathyajit - 09847840051 Taluk HospitalPerumbavoor PO, Ernakulam 542(0484) 2523138 Vipin - 09447305200 Gurgaon & Delhi All India Institute of Medical Sciences (AIIMS)Ansari Nagar, Aurobindo Marg Ring Road, New Delhi - 29(011) 26594404, 26861698 Prof. R C Deka - 9868397464 National Institute for Communicable Diseases 22, Sham Nath Marg, New Delhi - 54 (011) 23971272/060/344/524/449/326 Dr. Ram Manohar Lohia Hospital Kharak Singh Marg, New Delhi - 01 (011) 23741640, 23741649, 23741639 Dr. N K Chaturvedi – 9811101704 Vallabhai Patel Chest InstituteUniversity Enclave, New Delhi- 07(011) 27667102, 27667441, 27667667, 27666182 Bangalore Victoria HospitalK R Market, Kalasipalayam, Bangalore - 02(080) 26703294 Dr. Gangadhar - 94480-49863 SDS Tuberculosis & Rajiv Gandhi Institute of Chest DiseasesHosur Road, Hombegowda Nagar, Bangalore - 29(080) 26631923 Dr. Shivaraj - 99801-48780 21

22.  It is a treatable condition  Drug of choice – Tamiflu (Oseltamivir) - Relenza (Zanamivir)  Prophylaxis -..... till 10 days post exposure  Do not take medicine unless advised by Doctor ! 22

23. 23 ५ से ८ तुलसी के पत्ते + ३० बेल के पत्ते + १ चोट्टा चमच कलि मिर्च, ४ लीटर पानी में ३० मिनट के लिए उबालें इस मिश्रण का १ कप दिन में २ बार पियें आपको Swine Flu कभी नहीं होगा !

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25.  One arm’s distance from indl with resp infection  Sick pers – isolation for 7 days  Used tissues – proper disposal  Plenty of rest/sleep  Plenty of water  Good nutritious food  Linen used by sick – proper laundry 25 Avoid hand shake, just say hello !

26.  Gargling  Blowing nose hard  Drinking warm fluids  Jal neti, Sutra neti… if you can  Swabbing nostrils with warm salt water solution  Vit C (Citrus fruits, Amla )  Chavanprash 26

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32. 32 Best treatment to any disease is...... PREVENTION !

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34. 34 Pass the information

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36. 36 HURRY UP Let us out! ‘Rex’ just sneezed, I think he has ‘Swine Flu’