ARTICLE 5: SWINE FLU LATEST

 Introduction :
 Swine influenza (also called H1N1 flu, swine flu, hog flu, and pig
flu) is an infection by any one of several types of swine influenza
virus. Swine influenza virus (SIV) is any strain of the influenza
family of viruses that is endemic in pigs.[2] As of 2009, the known
SIV strains include influenza C and the subtypes of influenza A known
as H1N1, H1N2, H3N1, H3N2, and H2N3.
History:
 Swine influenza was first proposed to be a disease related to human
influenza during the 1918 flu pandemic, when pigs became sick at the
same time as humans.[16] The first identification of an influenza
virus as a cause of disease in pigs occurred about ten years later, in
1930.[17] For the following 60 years, swine influenza strains were
almost exclusively H1N1. Then, between 1997 and 2002, new strains of
three different subtypes and five different genotypes emerged as
causes of influenza among pigs in North America. In 1997-1998, H3N2
strains emerged. These strains, which include genes derived by
reassortment from human, swine and avian viruses, have become a major
cause of swine influenza in North America. Reassortment between H1N1
and H3N2 produced H1N2. In 1999 in Canada, a strain of H4N6 crossed
the species barrier from birds to pigs, but was contained on a single
farm.[17]
The H1N1 form of swine flu is one of the descendants of the strain
that caused the 1918 flu pandemic.[18][19] As well as persisting in
pigs, the descendants of the 1918 virus have also circulated in humans
through the 20th century, contributing to the normal seasonal
epidemics of influenza.[19] However, direct transmission from pigs to
humans is rare, with only 12 cases in the U.S. since 2005.[20]
Nevertheless, the retention of influenza strains in pigs after these
strains have disappeared from the human population might make pigs a
reservoir where influenza viruses could persist, later emerging to
reinfect humans once human immunity to these strains has waned.[21]

Transmission:
 Transmission between pigs
Influenza is quite common in pigs, with about half of breeding pigs
having been exposed to the virus in the US.[51] Antibodies to the
virus are also common in pigs in other countries.[51]
The main route of transmission is through direct contact between
infected and uninfected animals.[11] These close contacts are
particularly common during animal transport. Intensive farming may
also increase the risk of transmission, as the pigs are raised in very
close proximity to each other.[52][53] The direct transfer of the
virus probably occurs either by pigs touching noses, or through dried
mucus. Airborne transmission through the aerosols produced by pigs
coughing or sneezing are also an important means of infection.[11] The
virus usually spreads quickly through a herd, infecting all the pigs
within just a few days.[2] Transmission may also occur through wild
animals, such as wild boar, which can spread the disease between
farms.[

Transmission to humans: People who work with poultry and swine,
especially people with intense exposures, are at increased risk of
zoonotic infection with influenza virus endemic in these animals, and
constitute a population of human hosts in which zoonosis and
reassortment can co-occur.[55] Vaccination of these workers against
influenza and surveillance for new influenza strains among this
population may therefore be an important public health measure.[56]
Transmission of influenza from swine to humans who work with swine was
documented in a small surveillance study performed in 2004 at the
University of Iowa.[57] This study among others forms the basis of a
recommendation that people whose jobs involve handling poultry and
swine be the focus of increased public health surveillance.[55] Other
professions at particular risk of infection are veterinarians and meat
processing workers, although the risk of infection for both of these
groups is lower than that of farm workers.[

Main symptoms of swine flu in swine:
These H5N1 infections may be quite common: in a survey of 10
apparently healthy pigs housed near poultry farms in West Java, where
avian flu had broken out, five of the pig samples contained the H5N1
virus. The Indonesian government has since found similar results in
the same region. Additional tests of 150 pigs outside the area were
negative.[63][64]
Signs and symptoms:
In swine
In pigs influenza infection produces fever, lethargy, sneezing,
coughing, difficulty breathing and decreased appetite.[11] In some
cases the infection can cause abortion. Although mortality is usually
low (around 1-4%),[2] the virus can produce weight loss and poor
growth, causing economic loss to farmers. Infected pigs can lose up to
12 pounds of body weight over a 3 to 4 week period
The H1N1 viral strain implicated in the 2009 flu pandemic among humans
often is called "swine flu" because initial testing showed many of the
genes in the virus were similar to influenza viruses normally
occurring in North American swine.[43] But further research has shown
that the outbreak is due to a new strain of H1N1 not previously
reported in pigs.

The most common cause of death is respiratory failure, other causes of
death are pneumonia (leading to sepsis)[69], high fever (leading to
neurological problems), dehydration (from excessive vomiting and
diarrhea) and electrolyte imbalance. Fatalities are more likely in
young children and the elderly.
Diagnosis:
Different medical kits are available for diagnosis of Swine Flu
Prevention in humans:
Prevention of pig to human transmission
Swine can be infected by both avian and human influenza strains of
influenza, and therefore are hosts where the antigenic shifts can
occur that create new influenza strains.
The transmission from swine to human is believed to occur mainly in
swine farms where farmers are in close contact with live pigs.
Although strains of swine influenza are usually not able to infect
humans this may occasionally happen, so farmers and veterinarians are
encouraged to use a face mask when dealing with infected animals. The
use of vaccines on swine to prevent their infection is a major method
of limiting swine to human transmission. Risk factors that may
contribute to swine-to-human transmission include smoking and not
wearing gloves when working with sick animals.[

Prevention of human to human transmission
Influenza spreads between humans through coughing or sneezing and
people touching something with the virus on it and then touching their
own nose or mouth.[77] Swine flu cannot be spread by pork products,
since the virus is not transmitted through food.[77] The swine flu in
humans is most contagious during the first five days of the illness
although some people, most commonly children, can remain contagious
for up to ten days. Diagnosis can be made by sending a specimen,
collected during the first five days for analysis.[
Recommendations to prevent spread of the virus among humans include
using standard infection control against influenza. This includes
frequent washing of hands with soap and water or with alcohol-based
hand sanitizers, especially after being out in public.[79] Chance of
transmission is also reduced by disinfecting household surfaces, which
can be done effectively with a diluted chlorine bleach solution.[80]
Experts agree that hand-washing can help prevent viral infections,
including ordinary influenza and the swine flu virus. Influenza can
spread in coughs or sneezes, but an increasing body of evidence shows
small droplets containing the virus can linger on tabletops,
telephones and other surfaces and be transferred via the fingers to
the mouth, nose or eyes. Alcohol-based gel or foam hand sanitizers
work well to destroy viruses and bacteria. Anyone with flu-like
symptoms such as a sudden fever, cough or muscle aches should stay
away from work or public transportation and should contact a doctor
for advice.
Social distancing is another tactic. It means staying away from other
people who might be infected and can include avoiding large
gatherings, spreading out a little at work, or perhaps staying home
and lying low if an infection is spreading in a community. Public
health and other responsible authorities have action plans which may
request or require social distancing actions depending on the severity
of the outbreak.
Vaccination:  Vaccines are available for different kinds of Swine Flu.
Although the current trivalent influenza vaccine is unlikely to
provide protection against the new 2009 H1N1 strain,[81] vaccines
against the new strain are being developed and could be ready as early
as November 2009.[82]
Treatment:
In swine
As swine influenza is rarely fatal to pigs, little treatment beyond
rest and supportive care is required.[51] Instead veterinary efforts
are focused on preventing the spread of the virus throughout the farm,
or to other farms.[11] Vaccination and animal management techniques
are most important in these efforts. Antibiotics are also used to
treat this disease, which although they have no effect against the
influenza virus, do help prevent bacterial pneumonia and other
secondary infections in influenza-weakened herds.[51]
In humans
If a person becomes sick with swine flu, antiviral drugs can make the
illness milder and make the patient feel better faster. They may also
prevent serious flu complications. For treatment, antiviral drugs work
best if started soon after getting sick (within 2 days of symptoms).
Beside antivirals, supportive care at home or in hospital, focuses on
controlling fevers, relieving pain and maintaining fluid balance, as
well as identifying and treating any secondary infections or other
medical problems. The U.S. Centers for Disease Control and Prevention
recommends the use of Tamiflu (oseltamivir) or Relenza (zanamivir) 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.[83] The virus isolates in the 2009 outbreak have been found
resistant to amantadine and rimantadine.

dr. jitender aggarwal
ceo
sarthak educational trust



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