1. The Swine Flu The Things You Need to Know! An ETSI Technologies Wellness Program Presentation of Raymond A. Federe, M.D., O.H.

2. A Respiratory Disease that is causing pandemonium to millions of people WORLDWIDE.

3. INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  3 Types of INFLUENZA  Type A  Type B  Type C  These are single stranded RNA viruses which are structurally & biologically similar but vary antigenically.

4. INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  SWINE FLU is a respiratory disease caused by influenza viruses A(H1N1)  INFLUENZA Type A with H emagglutinin Type 1 & N euraminidase Type 1 as surface antigens

5. INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  1st isolated in the U.S. (1930)  Infections have remained in local areas with people closely associated with pigs (farmers, pork processors)

6. Mexico Influenza A(H1N1) - 2009

7. INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  PIGS is a unique intermediary host because its respiratory cells can be infected directly with BIRD, HUMAN & other mammalian flu viruses.

8. Human Influenza Avian Influenza Swine Influenza A (H1N1)

9. Mode of Transmission INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  Respiratory Secretions  Cough  Sneeze  Has incubation period of 1-3 days

10. What are the Symptoms? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  Fever (> or = 37.8 Centigrade)  Cough  Colds  Sore Throat  Fatigue  Headache  Nausea  Vomiting  Diarrhea

11. How Is It Diagnosed? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  History (Travel to countries with cases of A(H1N1))  Diagnosed CLINICALLY  Nasopharyngeal Swab

12. NASOPHARYNGEAL SWAB (Done 3-7 days after exposure)  Distinguish between Type “A” and Type “B”  If test is Negative, no Swine Flu  If test is Positive for Type B, NOT Swine Flu  If test is Positive for Type A, COULD be conventional Flu or Swine Flu

13. NASOPHARYNGEAL SWAB (Done 3-7 days after exposure) Preliminary results can be obtained in HOURS but the final results take 2 days

14. Is There a Treatment? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  No available Vaccine YET  2 Antivirals available in the market:  oseltamivir (Tamiflu), 75mg BID  zanamivir (Relenza), 10mg BID  These drugs are NOT used indiscriminately or routinely used for prevention because of development of RESISTANCE to the Virus

15. Complications? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  Primary Influenza Pneumonia  Secondary Bacterial Pneumonia  S. Aureus, S. Pneumonia & H. Influenza  Myocarditis and Pericarditis

16. How can we Prevent it? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  Regular Influenza Vaccination yearly (Effective 10-14 days after admin.)

17. "Influenza vaccination is the most effective method for preventing influenza virus infection and its potentially severe complications." -USCDC

18. How can we Prevent it? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  Build your IMMUNE SYSTEM  Have at least 8 hours of sleep  Be physically active  Manage your stress  Drink plenty of fluids  Eat nutritious food

19. How can we Prevent it? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  PRECAUTIONS:  Cover your nose and mouth with a tissue when coughing or sneezing

20. How can we Prevent it? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  PRECAUTIONS:  Wash hands regularly with soap & water, especially after you cough or sneeze. Alcohol-based hand cleaners may also be used

21. Since the virus can remain viable and infectious for about 48 hours on many surfaces

22. How can we Prevent it? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  PRECAUTIONS:  Avoid close contact with sick people

23. How can we Prevent it? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  PRECAUTIONS:  If sick, self-monitor and stay home from work or school and LIMIT contact with others

24. How can we Prevent it? INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  PRECAUTIONS:  Consult your doctor immediately should signs and symptoms of flu persist

25. The Latest World Update INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  08 June 2009:  73 countries have officially reported 25,288 cases of influenza A (H1N1) infection with 139 deaths.  U.S. has reported 13,217 laboratory confirmed human cases, including 27 deaths  Mexico has reported 5717, including 106 deaths

26. The Latest World Update INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  03 June 2009:  66 countries have officially reported 19,273 cases of influenza A (H1N1) infection with 117 deaths.  Canada has reported 2115 cases including 3 deaths  Chile has 411 cases with 1 death.  Costa Rica has reported 68, including 1 death

27. The Latest World Update INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY ArgentinaCosta RicaGuatemalaMexicoSlovakia AustraliaCubaHondurasNetherlandsSpain AustriaCyprusHungaryNew ZealandSweden BahamasCzech RepublicIcelandNicaraguaSwitzerland BahrainDenmarkIndiaNorwayThailand BarbadosDominicaIrelandPanama Trinidad and Tobago Belgium Dominican Republic IsraelParaguayTurkey BoliviaEcuadorItalyPeru United Arab Emirates BrazilEgyptJamaicaPhilippinesUnited Kingdom BulgariaEl SalvadorJapanPoland United States of America CanadaEstonia Korea, Republic of PortugalUruguay Cayman Islands, UKOT FinlandKuwaitRomaniaVenezuela ChileFranceLebanonRussiaViet Nam ChinaGermanyLuxembourgSaudi Arabia ColombiaGreeceMalaysiaSingapore

30. D.O.H. Preventive role INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  International Airport Screening

31.  Research Institute for Tropical Medicine (RITM) ALABANG, MUNTINLUPA  San Lazaro Hospital - MANILA  Lung Center of the Philippines - QUEZON CITY  Vicente Sotto Medical Center - CEBU CITY  Davao Medical Center - DAVAO CITY

32.  Confirmed cases: 54  Since May 1, 2009, the DOH has monitored a total of 599 cases  There are 58 new Cases Under Observation (CUOs) www.doh.gov.ph AH1N1 Setting in the Philippines As of JUNE 9, 2009

33. NO Community Outbreak

34. Summary INTRODUCTION TRANSMISSION SYMPTOMS DIAGNOSIS TREATMENT COMPLICATIONS PREVENTION SWINE FLU (WORLD) SWINE FLU (PHILIPPINES) SUMMARY  It is OK to eat PORK  Have your yearly FLU Shots  Consult your doctor, DON’T Self Medicate!  Prevention is better than cure

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