Quality management strategies:

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H1N1 Flu (Swine Flu)and You

• Prof. Dr.
• Mohammad El-Sayed El-Desoky
• Professor Head of Chest Medicine, Mansoura
  University

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Flu Terms Defined

• H1N1 Influenza (H1N1flu) is a respiratory disease
  of pigs caused by type A influenza viruses that
  causes regular outbreaks in pigs. People do not
  normally get swine flu, but human infections can
  and do happen
• Bird flu is commonly used to refer to Avian flu.
  Bird flu viruses infect birds, including
  chickens, other poultry and wild birds such as
  ducks.
• Avian flu (AI) is caused by influenza viruses
  (H5N1).

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Flu Terms Defined

• Pandemic flu is virulent human flu that causes a
  global outbreak, or pandemic, of serious illness.
  Because there is little natural immunity, the
  disease can spread easily from person to person.
  Currently, there is no pandemic flu.
• Seasonal (or common) flu is a respiratory illness
  that can be transmitted person to person. Most
  people have some immunity, and a vaccine is
  available.

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Case definition

• A confirmed case of swine origin influenza virus
  (S-OIV) infection is defined as a person with an
  acute febrile respiratory illness with laboratory
  confirmed S-OIV infection at CDC by one or more
  of the following tests
• - Realtime RT-PCR
• - Viral culture

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Case definition

• Suspected case is a person with an acute febrile
  respiratory illness who
• - Have had close contact with a person who is a
  swine-origin influenza confirmed case or
• - Traveled to a community in USA or
  internationally where there are one or more
  confirmed swine-origin influenza cases or
• - Reside in a community where there are one or
  more confirmed swine-origin influenza A(H1N1)
  cases

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What is H1N1 (swine flu)?

• H1N1 (referred to as swine flu early on) is a
  new influenza virus causing illness in people.
• First detected in people in April 2009 in the U
  S.
• Other countries.
• This virus is spreading from person-to-person

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Why called swine flu?

• Genes in this new virus were very similar to
  influenza viruses that normally occur in pigs in
  North America.
• 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 avian
  genes and human genes. Scientists call this a
  quadruple reassortant virus.

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Are there human infections with this H1N1 virus
in the U.S.?

• Yes Cases of human infection with this H1N1
  influenza virus were first confirmed in the U.S.
  in Southern California and near Guadalupe County,
  Texas. The outbreak intensified rapidly from that
  time and more and more states have been reporting
  cases of illness from this virus.

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Is this new H1N1 virus contagious?

• CDC has determined that this new H1N1 virus is
  contagious and is spreading from human to human.
  However, at this time, it is not known how easily
  the virus spreads between people.

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What are the signs and symptoms of this virus in
people?

• Fever, cough, sore throat, body aches, headache,
  chills and fatigue
• Diarrhea and vomiting.  
• Death

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How does this new H1N1 virus spread?

• Spread of this H1N1 virus is thought to be
  happening in the same way that seasonal flu
  spreads. Flu viruses are spread mainly from
  person to person through coughing or sneezing by
  people with influenza. Sometimes people may
  become infected by touching something with flu
  viruses on it and then touching their mouth or
  nose.

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Can I get infected with this new H1N1 virus from
eating or preparing pork ?

• No. H1N1 viruses are not spread by food. You
  cannot get this new H1N1 virus from eating pork
  or pork products. Eating properly handled and
  cooked pork products is safe.

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How long can an infected person spread this virus
to others?

• At the current time, CDC believes that this virus
  has the same properties in terms of spread as
  seasonal flu viruses.
• With seasonal flu, studies have shown that people
  may be contagious from one day before they
  develop symptoms to up to 7 days after they get
  sick. 
• Children, especially younger children, might
  potentially be contagious for longer periods.

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Infection Control Measures
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• In adults, emergency warning signs that need
  urgent medical attention include
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting

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Complications

• Mild upper respiratory illness( Sinusitis, Otitis
  media, Croup)
• Lower respiratory tract illness (Pneumonia,
  Bronchiolitis, Status asthmaticus
• Cardiac ( Myocarditis , Pericarditis)
• Muscloskeletal (Myositis, Rhabdomyolysis)

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Complications

• Neurologic( Acute and post-infectious
  encephalopathy, Encephalitis, Febrile siezures,
  Status epilepticus)
• Toxic shock syndrome, and secondary bacterial
  pneumonia with or without sepsis.
• Dehydration
• Exacerbation of underlying chronic medical
  conditions
• Death

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High risk groups for seasonal influenza
complications

• Children less than 5 years old
• Persons aged 50 years or older
• Children and adolescents (aged 6 m 18 yr) who
  are receiving long-term aspirin therapy and who
  might be at risk for experiencing Reye syndrome
  after influenza virus infection

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High risk groups for seasonal influenza
complications

• Pregnant women
• Chronic diseases
• Immunosuppression
• Residence of nursing homes and other chronic-care
  facilities.

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