1. Swine Flu Dr Anil Ballani Consultant Physician Hinduja & Lilavati Hospital

2. Swine Flu, Hog Flu, Pig Flu It is a strain of influenza family of viruses and the sub type is influenza A. It is also known as H1N1. Swine influenza is very common throughout pig population in the world. People with regular exposure to Pigs are at an increased risk of contracting the infection. The meat of an infected animal poses NO RISK of infection when properly cooked.

3. History The first swine Flu was detected in 1918 pandemic. The H1N1 form of Swine Flu is one of the desendents that caused the 1918 pandemic. In the pandemic about 50 million people were killed world wide. 1976 outbreak in US. 2007 outbreak in Philippines in swine. 2009 outbreak in Humans.

4. Signs and Symptoms Fever Cough Sore Throat Body ache Head ache Chills Fatigue Diarrhea Vomiting

5. The most common causes of death –1. Respiratory failure –2. Pneumonia –3. High Fever –4. Dehydration

6. Deaths are more common in Immunocompromised host In asthmatics In COPD In diabetics In HIV patients In cirrhotics In children

7. Prevention of Human to Human transmission Spreads from Human to Human through coughing, sneezing and people touching objects with the virus on it. Humans are most contagious in the first 5 days. To prevent : –Washing hands with soap and water or using alcohol based hand sanitisers.

8. Small droplets containing virus can linger on table tops, telephones, door handles, lift buttons. Virus can spread upto a distance of 1 metre by coughing or sneezing. Social distancing. Prevention of Human to Human transmission

9. You can prevent the spread the germs by: –Covering your nose and mouth with a tissue when you cough or sneeze. –Throw the tissue in the trash after you use it. –Washing your hands often with soap and water especially after you cough or sneeze / can use alcohol based hand sanitisers. –Avoiding touching your eyes, nose or mouth.Germs spread this way. –Trying to avoid close contact with sick people. –Staying home from work if you sick.

10. WHO has recommended that wearing of masks can reduce the transmission of the influenza virus. Mainly, correct use, regular supplies and proper disposal facility. Specially, individuals who are in close contact with people with flu like symptoms.For example providing care to family members. Using a mask incorrectly however may actually increase the risk of transmission.

11. General Advice Following general measures are more important than wearing a mask For individuals who are well : Maintain a distance of atleast one metre who has flu like symptoms. Refrain from touching mouth and nose Perform hand hygiene frequently. Reduce the time spent in close contact with the person as much as possible. Reduce time spent in crowded settings.

12. Improve air flow in your living space by opening windows. For individuals with flu like symptoms: Stay at home and follow health recommendations. Keep distance from healthy individuals of atleast 1 m. Cover your mouth or nose while coughing or sneezing with tissues. Dispose tissues immediately after use or wash the napkin. Clean hands immediately.

13. Treatment Two drugs are effective : Oseltamivir (Tamiflu) - 75 mg twice daily for 5 days.Should be started within 2 days of the suspected disease. Chemoprophylaxis - 75 mg daily after last known exposure atleast 5 - 7 days. Zanamivir - available as inhaled powder.10 mg twice daily for 5 days. Side effects: Mild to moderate nausea vomiting. Occasional serious skin reactions, allergic reactions.

14. Diagnosis The only way to diagnose it is to give your blood samples at Kasturba hospital. A throat swab is taken, fasting not required and the report is got after 48 hours. Actually the samples are sent National Institute of Virology, Pune for testing H1N1. Incase positive, Tamiflu is to be started immediately.

15. No Vaccine against H1N1 available so far.

16. Thank You