1. H1N1 By FATIN NOOR FARAHEIM NORSAAKELLA

2. What is 2009 H1N1 (swine flu)? This is a new influenza A(H1N1) virus that has never before circulated among humans. This virus is not related to previous or current human seasonal influenza viruses. This is a new influenza A(H1N1) virus that has never before circulated among humans. This virus is not related to previous or current human seasonal influenza viruses. The place of origin of the virus is unknown. It is unknown strain, which is a mix of swine, avian and human flu strains. The place of origin of the virus is unknown. It is unknown strain, which is a mix of swine, avian and human flu strains. The new influenza A(H1N1) appears to be as contagious as seasonal influenza, and is spreading fast particularly among young people (from ages 10 to 45). The new influenza A(H1N1) appears to be as contagious as seasonal influenza, and is spreading fast particularly among young people (from ages 10 to 45). The severity of the disease ranges from very mild symptoms to severe illnesses that can result in death. The majority of people who contract the virus experience the milder disease and recover without antiviral treatment or medical care. The severity of the disease ranges from very mild symptoms to severe illnesses that can result in death. The majority of people who contract the virus experience the milder disease and recover without antiviral treatment or medical care. Of the more serious cases, more than half of hospitalized people had underlying health conditions or weak immune systems. Of the more serious cases, more than half of hospitalized people had underlying health conditions or weak immune systems.

3. Why is 2009 H1N1 virus sometimes called “swine flu”? This new virus were very similar to influenza viruses that normally occur in pigs (swine) in North America. This new virus were very similar to influenza viruses that normally occur in pigs (swine) in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and bird (avian) genes and human genes. Scientists call this a "quadruple reassortant" virus. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and bird (avian) genes and human genes. Scientists call this a "quadruple reassortant" virus.

4. Chronology~2009 April 28- first case in Mexico April 28- first case in Mexico April -first case in United States April -first case in United States May 15- first case in Malaysia May 15- first case in Malaysia May 16- first case in Turkey May 16- first case in Turkey May 25- first case in Dubai and Czech Republic May 25- first case in Dubai and Czech Republic May 27- Singapore May 27- Singapore November 22- worldwide more than 207 countries and overseas territories or communities confirmed cases of pandemic influenza H1N1 2009,~over 7820 deaths. November 22- worldwide more than 207 countries and overseas territories or communities confirmed cases of pandemic influenza H1N1 2009,~over 7820 deaths.

8. How do people become infected with the virus? The virus is spread from person-to-person. The virus is spread from person-to-person. It is transmitted as easily as the normal seasonal flu. It is transmitted as easily as the normal seasonal flu. It can be passed to other people by exposure to infected droplets expelled by coughing or sneezing that can be inhaled, or that can contaminate hands or surfaces. It can be passed to other people by exposure to infected droplets expelled by coughing or sneezing that can be inhaled, or that can contaminate hands or surfaces. There are no known instances of people getting infected by exposure to pigs or other animals. There are no known instances of people getting infected by exposure to pigs or other animals. H1N1 flu has caused greater disease burden in people younger than 25 years of age than older people. At this time, there are relatively fewer cases and deaths reported in people 65 years and older. H1N1 flu has caused greater disease burden in people younger than 25 years of age than older people. At this time, there are relatively fewer cases and deaths reported in people 65 years and older.

9. The signs and symptoms Signs of influenza A(H1N1) are : Signs of influenza A(H1N1) are : Flu-likeFlu-like FeverFever CoughCough HeadacheHeadache Muscle and joint painMuscle and joint pain Sore throat and runny noseSore throat and runny nose Sometimes vomiting and diarrhoea.Sometimes vomiting and diarrhoea.

11. “emergency warning signs” In children: In children: Fast breathing or trouble breathing Fast breathing or trouble breathing Bluish skin color Bluish skin color Not drinking enough fluids Not drinking enough fluids Not waking up or not interacting Not waking up or not interacting Being so irritable that the child does not want to be held Being so irritable that the child does not want to be held Flu-like symptoms improve but then return with fever and worse cough Flu-like symptoms improve but then return with fever and worse cough Fever with a rash Fever with a rash In adults: In adults: Difficulty breathing or shortness of breath Difficulty breathing or shortness of breath Pain or pressure in the chest or abdomen Pain or pressure in the chest or abdomen Sudden dizziness Sudden dizziness Confusion Confusion Severe or persistent vomiting Severe or persistent vomiting

12. Diagnosis: Influenza Diagnostic Testing The most common are called “Rapid Influenza Diagnostic Tests”. The most common are called “Rapid Influenza Diagnostic Tests”. These tests can provide results in 30 minutes or less. Unfortunately, the ability of these tests to detect the flu can vary greatly- These tests can provide results in 30 minutes or less. Unfortunately, the ability of these tests to detect the flu can vary greatly- their ability to detect 2009 H1N1 flu can range from 10% to 70%.their ability to detect 2009 H1N1 flu can range from 10% to 70% There are several more accurate and sensitive flu tests available ~ must be performed in specialized laboratories. There are several more accurate and sensitive flu tests available ~ must be performed in specialized laboratories. All of these tests are performed by a health care provider using a swab to swipe the inside of your nose or the back of your throat ~do not require a blood sample. All of these tests are performed by a health care provider using a swab to swipe the inside of your nose or the back of your throat ~do not require a blood sample.

13. One may not be able to find out definitively what flu virus he had~ rapid influenza diagnostic tests cannot distinguish between 2009 H1N1 and seasonal influenza A viruses. One may not be able to find out definitively what flu virus he had~ rapid influenza diagnostic tests cannot distinguish between 2009 H1N1 and seasonal influenza A viruses. Most people with flu symptoms this season will not require testing for 2009 H1N1 because the test results usually do not change how you are treated. As of September 2009, more than 99% of circulating influenza viruses in the United States are 2009 H1N1. Most people with flu symptoms this season will not require testing for 2009 H1N1 because the test results usually do not change how you are treated. As of September 2009, more than 99% of circulating influenza viruses in the United States are 2009 H1N1. None of the rapid tests currently approved by the Food and Drug Administration (FDA) are able to distinguish 2009 H1N1 flu from other flu viruses. None of the rapid tests currently approved by the Food and Drug Administration (FDA) are able to distinguish 2009 H1N1 flu from other flu viruses.

14. There are laboratory tests available that can tell the difference between 2009 H1N1 and other strains of flu, but these can take one to several days to provide results. There are laboratory tests available that can tell the difference between 2009 H1N1 and other strains of flu, but these can take one to several days to provide results. The most accurate laboratory tests, such as real- time reverse transcriptase polymerase chain reaction (rRT-PCR) can be done but are only available in certain laboratories. The most accurate laboratory tests, such as real- time reverse transcriptase polymerase chain reaction (rRT-PCR) can be done but are only available in certain laboratories. It is recommended that this testing be focused on: It is recommended that this testing be focused on: 1) people who are hospitalized with suspected flu;1) people who are hospitalized with suspected flu; 2) people such as pregnant women or people with weakened immune systems, for whom a diagnosis of flu will help their doctor make decisions about their care.2) people such as pregnant women or people with weakened immune systems, for whom a diagnosis of flu will help their doctor make decisions about their care.

15. Prevention Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.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. If soap and water are not available, use an alcohol-based hand rub.*Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.** Avoid touching your eyes, nose or mouth. Germs spread this way.Avoid touching your eyes, nose or mouth. Germs spread this way. Try to avoid close contact with sick people.Try to avoid close contact with sick people. Try to avoid going places with large crowdsTry to avoid going places with large crowds  Get vaccinated-Vaccination is the best way to prevent influenza, whether it’s seasonal flu or H1N1.

17. Vaccination 2009 H1N1 Flu Vaccine 2009 H1N1 Flu Vaccine There are two kinds: There are two kinds: 2009 H1N1 "flu shot" that is given with a needle, usually in the arm; 2009 H1N1 "flu shot" that is given with a needle, usually in the arm;2009 H1N1 "flu shot" 2009 H1N1 "flu shot" 2009 H1N1 nasal spray flu vaccine given via a nasal sprayer. 2009 H1N1 nasal spray flu vaccine given via a nasal sprayer.2009 H1N1 nasal spray flu vaccine 2009 H1N1 nasal spray flu vaccine Target groups : Target groups : pregnant women, pregnant women, people who live with or care for children younger than 6 months of age people who live with or care for children younger than 6 months of age healthcare and emergency medical services personnel healthcare and emergency medical services personnel persons between the ages of 6 months and 24 years old persons between the ages of 6 months and 24 years old and people ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems. and people ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems.

18. Treatment Antiviral drugs: Antiviral drugs:  Tamiflu® (brand name) or oseltamivir (generic name) of a prescription antiviral drug used.  Relenza® (zanamivir) -persons with a history of asthma or another lung disease should not be prescribed zanamivir.

21. Reference…. http://www.who.int/csr/disease/swineflu/frequently_asked _questions/about_disease/en/index.html http://www.who.int/csr/disease/swineflu/frequently_asked _questions/about_disease/en/index.html http://www.who.int/csr/disease/swineflu/frequently_asked _questions/about_disease/en/index.html http://www.who.int/csr/disease/swineflu/frequently_asked _questions/about_disease/en/index.html http://www.cdc.gov/h1n1flu/qa.htm http://www.cdc.gov/h1n1flu/qa.htm http://www.cdc.gov/h1n1flu/qa.htm http://www.cdc.gov/h1n1flu/vaccination/public/vaccination _qa_pub.htm http://www.cdc.gov/h1n1flu/vaccination/public/vaccination _qa_pub.htm http://www.cdc.gov/h1n1flu/vaccination/public/vaccination _qa_pub.htm http://www.cdc.gov/h1n1flu/vaccination/public/vaccination _qa_pub.htm http://www1.voanews.com/english/news/a-13-2009-05- 03-voa2-68815332.html http://www1.voanews.com/english/news/a-13-2009-05- 03-voa2-68815332.html http://health.asiaone.com/Health/News/Story/A1Story2009 0527-144175.html http://health.asiaone.com/Health/News/Story/A1Story2009 0527-144175.html http://health.asiaone.com/Health/News/Story/A1Story2009 0527-144175.html http://health.asiaone.com/Health/News/Story/A1Story2009 0527-144175.html http://www.cdc.gov/h1n1flu/antivirals/quickfacts.htm http://www.cdc.gov/h1n1flu/antivirals/quickfacts.htm http://www.cdc.gov/h1n1flu/antivirals/quickfacts.htm http://gamapserver.who.int/h1n1/geographic- spread/h1n1_geographic-spread.html http://gamapserver.who.int/h1n1/geographic- spread/h1n1_geographic-spread.html