BEST SKY

We’ve been told how quickly it can be upon us and to be prepared well in advance for just such an occurrence.  There are no social systems in place robust enough to deliver all the care that will be required when a pandemic influenza develops; and when push comes to shove we all will want to be as self-reliant and independent as possible.

Even so, watching the progress of the medical news story coming out of Mexico about the recent swine flu outbreak, it has been astonishing how quickly the infection has spread.  It may have been difficult to imagine, before this weekend, how it could be so.  But to see the news early last Friday of a swine flu outbreak in Mexico, and that outbreaks were soon occurring in Texas, California and New York within hours of the first news was truly sobering.  And we now have 6 confirmed cases in Canada; in Nova Scotia, and in B.C.

The following web site will be helpful in tracking the flu’s progress.  Fortunately, whether a pandemic results from a bird flu virus, or from a swine flu virus, the preparations to protect yourself, your family, and your business are the same.  http://hisz.rsoe.hu/alertmap/

We include some answers to frequently asked questions to refresh you for what may or may not result in a pandemic.  Whether this circumstance does become pandemic, or another virus does, officials are watching carefully and using all the precautions they have put in place.

What is swine flu?
It is a form of virus that normally infects pigs.  Many forms of flu and virus have the ability to exchange genes with one another.  The form of flu originating in Mexico is a mutation of viruses that have been seen in pigs, birds, and people.

How do people catch swine flu?
Though they are still studying this particular swine flu, an influenza virus is generally transmitted through the respiratory system.  Droplets of infected body fluids transmit flu when people cough or sneeze.

What are the symptoms of swine flu?
It usually takes one to four days between infection and the onset of symptoms.  Coughing, sneezing, headaches, body aches, fever, chills, and sometimes vomiting and diarrhea are accompanying symptoms.  It may be difficult to distinguish from other strains of flu and colds.  Severe cases of flu that lead to death are normally seen in very young and very old people whose immune systems are too weak to fight off the virus.  This particular virus appears to attack young adults as well with deadly results.

Why are health officials concerned about the swine flu?
The swine flu virus from Mexico appears to have the ability to spread quickly and be lethal according to the World health Organization.  When flu viruses mix their genes (mutate) with others they adapt to new environments and become harder for the immune system to defend against.  With little resistance from the immune system they can grow quickly and invade many tissues and organs which may set off a harmful immune system overreaction called a “cytokine storm,” that may be lethal in itself.

Researchers are investigating this virus right now to determine how easily the virus spreads in people and how dangerous it is.

What is a flu pandemic?
Influenza pandemics occur when new influenza viruses develop and spread quickly and few people have immunity to them.  Some pandemics are relatively mild, killing just a few million people globally.  The most severe flu pandemic on record was the 1918 Spanish Flu.  Researchers estimate it killed about 50 million people around the world.

Is there a vaccine against the swine flu from Mexico?
There is no vaccine currently that exactly matches this swine flu.  Flu vaccines generally contain a dead or weakened form of the circulating virus.  The vaccine prepares the body’s immune system to fend off true infections.  If the virus is sufficiently similar to circulating forms of flu that are included in the current vaccine they may offer some limited protection from swine flu.  Making a new flu vaccine can take three to six months.

Are there drugs that treat swine flu?
Tamiflu and Relenza, the two common antiviral drugs, have some effect against swine flu.  Flu viruses however sometimes develop resistance to antiviral drugs.  There is no evidence yet of the anti-viral drugs’ effectiveness with this particular swine flu strain.

How can I protect myself from swine flu?
Personal hygiene measures, such as avoiding people who are coughing or sneezing, and frequent hand-washing, may prevent flu infection.  Avoid contact with sick people.  People who get sick with flu symptoms should say home.  Closing schools, theaters, and canceling gatherings may be measures that public health officials use to limit its spread.

Stay well.  Take care.

A 13 year old cat in Iowa was diagnosed and treated last week suffering from the swine flu virus. The Iowa State University College of Veterinary Medicine confirmed the illness, and that the feline has recovered. Officials in Oregon and Nebraska have also confirmed that there were two confirmed cases of the virus affecting ferrets, one in each state. The ferret in Nebraska died, but according to Oregon Veterinary Medical Association, the ferret in their state was recovering.

According to the Associated Press (AP), the Centers of Disease Control (CDC) spokesperson Tom Skinner, said “we’ve known certainly, it’s possible this could happen” He reportedly further stated that “This may be the first instance where we have documentation that transmission occurred involving cats and dogs”

In the case of the cat, Dr. Brett Sponseller, the veterinarian who treated the cat, reportedly said that two of the three people who reside in the cat’s home in Iowa came down with flu-like symptoms prior to the cat illness. The case has been confirmed, according to the AP, by Iowa State and the US Department of Agriculture.

According to the AP, Sponseller claims that other influenza strains have crossed the species in the past. He warned not to interpret too much from the incident of the cat, or be concerned whether animals could get the virus. He stated “It is well documented in influenza in general, but this is the first highly suspected case of H1N1 going from humans into a cat” The vet revealed that the cat displayed symptoms of lethargy, loss of appetite, and seemed to have difficulty breathing.

Officials are reportedly warning pet owners to exercise the same precautions with pets, as they would with humans, to prevent the disease from spreading. Parents are being warned that it is important to get their children vaccinated, as this will help in the prevention of the virus spreading to their pets. Currently there are no swine flu vaccines for pets.  

Moving closer to top pandemic alert as Swine flue spreads globally

H1N1, or more popular called the Swine flue has spread from its original places North America and Mexico to Australia, Britain, Chile, Japan and Spain and has moved the world closer to the top pandemic alert, the World Health Organisation said on June 2nd 2009.

Keiji Fukuda, acting WHO assistant director-general told that we are at Phase 5 but are getting closer to Phase 6.

There are a signals that a number of countries that appear to be in transition, moving from travel-related cases to more established community types of spread. Some of these countries are the countries been followed for quite a while, but also include countries such as the UK and Spain in Europe, Japan in Asia, Chile in South America and also Australia.

According to the latest figures from WHO, the new influenza strain, also known as swine flu, has been found in 64 countries, and remains most prevalent in North America. WHO laboratories have confirmed nearly 19,000 infections including 117 people who have died.

Those figures might not show the full reach of the contagious disease that has afflicted young people more than normal seasonal flu, and has caused mainly mild symptoms as it has spread around the world.

WHO can not tell the full number of people who are infected across the entire spectrum and they expect that the future impact of this infection has yet to unfold.

The WHO is working on revamping its six-point pandemic scale so that the top alert reflects the severity of the flu and not just the geographical pattern of its spread.

WHO works on the idea to add a three-point severity scale within the highest marker, so that the overall level could reach 6 even if the flu’s symptoms remained moderate, and it could be adjusted later if it had more serious effects.

It is not enough just to say we are at a certain phase and that a virus has spread to a certain extent. That kind of announcement really has to be accompanied by some indication of what is the severity, and some guidance to countries on how they can modify their approaches to what is going on.

The latest country to report a case was done by the Health Ministry of Ukraine who reported that it is with 99 percent certainty that the first case of H1N1 flu was registered in Ukraine as of May 30th 2009.  An 24 years old Ukrainian who had spent two years in the United States returned to Ukraine a week ago was tested with symptoms. The case will be verified within two to three weeks. The man had been in contact with more than 70 people who were now under observation. None had reported any flu symptoms.

The A (H1N1) virus Swine flu virus infection has now climbed steadily over the week-end to 21,940 cases according to the World Health Organisation (WHO), who are monitoring the situation, with Mexico, USA, and Canada as the worst affected countries. Saudi Arabia having their first case of Swine flu, bringing the total number of Countries to 69.
The WHO scale of infection through 1-6, has reached 5, one short of a full scale pandemic.
What are the effects of this particular flu and how does it manifest itself, and how do we prevent swine flu?

This strain of flu is the same strain as the Spanish Flu in 1918 which killed between 50-100 million people with mortality rates up to 90%. With the significant increase in worldwide population since this time, and global interaction, this would equate to over 300 million at today’s figures!

Strangely, it infected young children, men and women aged between 25 and 35 in the prime of their life and those with a pre-existing medical condition, the old and infirm.
So, why is it so deadly, and what can we learn from past events. This strain of flu, similar to the Spanish Flu has the ability to turn a person’s immune system inside-out. Breathing becomes impossible as it eats up the victims lungs, causing acute respiratory distress syndrome known as Cytokine Storm.

Normally most of the population has some immunity to flu strains and recognise them as such. But, with a new strain, the body has no idea how to cope with it, and goes into overdrive to try to shut it down as
quickly as possible, hence the storm, an overreaction really.

THE IMMUNE SYSTEM

The ‘Storm’ really is reference to the severity of the condition as in chaotic weather events, where the fury of nature is released uncontrollably, so the word ‘storm’ has no medical connotation. The Cytokine does…. and it’s alarming. So what does Cytokine mean, in layman’s terms, and simply, what effect does it have in our bodies?
They are important let’s say elements of the immune system that act as messengers or couriers if you like between cells. The immune system latches on to a virus that it has not seen before or does not recognise is in the case of H1N1 and all hell breaks loose releasing a cascade of biochemical’s, such as interferon, and interleukin, really overacting, causing respiratory distress similar to Asthma but much worse. Consequently, the lungs self ingest, suffocating the victim as a result of the body’s reaction.
I have seen some references to it as the Purple Death which signals the lack of oxygen in the body.

So how we can help ourselves to prevent swine flu?
What we have to remember is that viruses can survive for up to three days, so they can hang about where you least expect them.
As we all know now coughs and sneezes spreads diseases, so my mother used to drill into me, and how true today with a pandemic imminent. There are some basic hygiene rules to follow to prevent swine flu.

• Cover each Cough and Sneeze with a tissue, bin it then wash ones hands as soon as possible. The virus can linger on door handles, elevator buttons, toilet flush handles,

• The virus can linger on door handles, elevator buttons, toilet flush handles, store trolley handles, even on your car steering wheel. Computer keyboards and TV remote control stations.

• In our Gym there are antiseptic wipe dispensers for first aid and personal use, mainly though to wipe down a machine after use. So why not keep a box in your car to wipe down your steering wheel (recommended), and all items of equipment manually controlled. Researchers have found that it is more beneficial to wipe one small area at a time and then throw the wipe away, used on multi surfaces can spread viruses very effectively.
For more information on how to prevent swine flu and optimise your immune system, follow me in my next blog.

As the nights get cooler, and the trees begin to change color, there is no doubt that fall is on the way.  And with fall comes flu season.  This year, in particular, many are worried about the H1N1 virus, commonly referred to as “swine flu.”  Many are concerned about the reported shortage of H1N1 vaccine.

Because of the serious threat posed by this strain of flu, health authorities are on alert.  Unfortunately, however, the US health department reports that 120 million doses of swine flu vaccine will be required to protect the population.  Only one third of that number will be available in October when flu season begins!

What is the reason for this shortage?  Dr. Robin Robinson, of the US Dept of HHS (Health & Human Services) was quoted in Reuters (8/18/09) as stating:  “We’re trying to bring on more manufacturing…hopefully there are ways to bring that number up.”  

The Dept of HHS is attempting to add new manufacturing companies because the logjam seems to lie with current capacity.  

Since there is a shortage of H1N1 vaccine, the supply will not cover the entire population.  Accordingly,  the government is planing to ration the swine flu vaccine.  As flu season begins, the only people that will be able to be inoculated are pregnant women, people who work in  public health, and children that are under the age of four.

How serious is the problem?  Even though the H1N1 vaccination will be the largest in human history, the White House Council for Science has estimated that there could be 30,000 to 90,000 deaths resulting from the swine flu strain during this 2009 flu season.

Are public health officials concerned?   Naturally.  They are worried that people that do not receive vaccinations will become ill.  

The World Health Organization has declared a pandemic, because the H1N1 flu strain affects the entire globe, not just the United States.

Reportedly, dosages available in the United States should increase to about 80 million by early November (well into the flu season), according to health officials.  Even so, one third of the population will remain without vaccine.  

There is no question that there is a shortage of H1N1 vaccine.

As we go into this flu season, avoid public places like schools and large public buildings if you possibly can.   Do your best to stay away from people who are coughing or sneezing.  Practice ritual hand washing with soap and hot water.  When a sink is not available, use hand sanitizers.  And if you become ill, stay home!  Isolate yourself or your sick family members so that they will not infect others!

A pregnant woman is more exposed to swine flu than the general population for her immune system is weakened, therefore more vulnerable. Like the seasonal influenza, swine flu could favor the occurrence of pulmonary complications in a future mother with a body already sensitized.

Some metabolisms are more susceptible to attacks of A H1N1. Everyone may be affected by the swine flu virus, but the most sensitive are the children, elderly and pregnant women.

Fever, one of the symptoms of influenza, can cause suffering, but no risk of malformations of the baby. If, however, fever continues contractions might occur, which increases the risk of premature pregnancy.
However, influenza A H1N1 should not scare you more than another cause. There are means of prevention and treatment, even if you are pregnant.

Influenza A H1N1, after birth

Placing in maternity should be as short as possible, and after birth you should meet with the doctor in a private office or a clinic, avoiding crowded hospitals.

If the mother was contaminated with the H1N1 virus is contagious, with the risk to transmit the disease to the new-born baby. A person affected by influenza A is contagious 24 to 48 hours before the first symptoms and between 4 and 5 days after their disappearance.

Regarding breastfeeding is not recommended to stop in case of flu. Breast milk is not contaminated, but rather is recognized for the transmission of antibodies from mother to child and will protect the newborn from possible infection. If you can not breastfeed directly, extract your milk to feed your baby with a bottle. Wash your hands and nipples before each feeding or extraction and wear a protective mask. Milking milk will be placed in a sterilized bottle.

Symptoms of influenza A H1N1 resembles very much the classic flu: fever, cough, headache, trouble breathing, etc.. If you suffer from any of these symptoms is appropriate to ask for medical advice.

Treatment for Pregnant Women

Health of a pregnant women should be monitored carefully. In the case of the flu, the doctor is the one that will recommend appropriate treatment. In general, it may consist of:

* Fever drop;
* Fluids;
* Rest;
* Treatment with antivirals but only if your doctor decides that.

Measures to prevent illness

The influenza virus is transmitted by air, mostly through saliva drops or nasal secretions (coughing, sneezing, runny nose ). To limit the risk of transmission, whatever the time of pregnancy, is recommended to respect certain rules of hygiene:

* Wash your hands regularly with soap and water
* Avoid direct contact with any person:hugs, hand shake, etc.
* Keep a minimum distance of 2 m from a person with symptoms of respiratory diseases;
* Do not borrow a towel from the bathroom, toothbrush, soap or other item of personal hygiene to any family member (husband, child, etc.);
* Clean surfaces regularly contact: handles, switches, cover the toilet etc.
* Avoid going to places where there is risk of contamination: hospitals, schools, transportation, public gatherings etc.

What is “Swine flu”?

Swine flu is a viral infection basically found in pigs that is caused by swine influenza virus. It is very rare to get swine flu in humans except in some cases where people have direct contact with pigs. Currently, the nature of swine flu virus transmission has changed and it can be transmitted from humans to humans even if there is no prior contact with pigs. There are four main sub-types of the virus, but the most recent isolated influenza viruses from pigs have been H1N1 viruses.

For more information visit www.askmedicaldoctor.com

How does the swine flu spread?

In the present outbreak of swine flu, the virus is spread by air borne contact. Infection can be transmitted through cough, sneeze, or even by touching the objects that have been touched by an infected individual. Chances of infection are more if after touching these objects one touches the eyes, mouth, or nose.

Can you get swine flu by eating pork?

Swine flu cannot be spread by pork products, since the virus is not transmitted through food. Cooking pork to an internal temperature of 70ºC and above kills the swine flu virus.

What are the symptoms of swine flu?

Since it is a viral infection, its symptoms are similar to Influenza. In humans, the symptoms include:

-Fever

-Cough

-Sore throat

-Runny nose

-Headache

-Fatigue

-General body aches

-Diarrhea and vomiting

-Neurological symptoms (Especially in children)

How to prevent swine flu?

There are several ways to prevent swine flu. Wash your hands with soap and water or alcohol based sanitizers after being out in the public. Also eat a healthy nutritious diet and drink plenty of fluids and keep your household articles clean with disinfectant or diluted chlorine bleach. Avoid close contact with people who might be infected. Wear a face mask (consider using an N95 respirator) if you must come into close contact with a sick person.

How to diagnose swine flu?

Diagnosis of swine flu is done by collecting respiratory specimens during the first 4 to 5 days of illness (10 days in children) and getting real-time RT-PCR and/or viral culture specifically for Swine Influenza A (H1N1) Virus. Hence, if one has any of the swine flu symptoms, a doctor’s consultation is necessary.

For more information visit www.askmedicaldoctor.com

What is the treatment of swine flu?

As it is a viral illness, hence, majority make a full recovery without requiring medical attention or antiviral drugs. However, the use of Tamiflu (oseltamivir) or Relenza (zanamivir) for the treatment and/or prevention of infection with swine influenza viruses has been found to be effective. In the recent outbreak, the virus has been found to be resistant to amantadine and rimantadine.

Is there a vaccine for swine flu?

There is no vaccine for swine flu as yet. But vaccines are being made in large quantities and clinical tests will begin in August 2009.

How to deal with a swine flu patient at home?

If any of your family members have fever with cough or sore throat, make sure to consult your doctor at the earliest. Suspected person should stay home for seven days after symptoms begin and should wear a face mask or N95 respirator. He/ She should throw the used tissues and other disposable items in the trash and immediately wash his hands afterwards. Alternatively, wipes or gels with alcohol in them can be used to clean hands. Linens, eating utensils and dishes belonging to suspected cases should be washed by using household laundry soap and tumbled dry. One should wash one’s hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry and other household items of suspected individuals. Children should be strictly prohibited from close contact and an infected breast feeding mother should express her breast milk, and the child should be fed by someone else. If the investigations come out positive, then the infected individual should be quarantined in an isolated ward in a hospital and treatment started to prevent complications.

What is the role of face masks in swine flu prevention?

The role of face masks and respirators as the first line of defense against the virus is still controversial. But these offer additional protection against the air borne illness.N-95 respirators are better than face masks or surgical masks but it is hard to breathe through them for extended periods and are inconvenient to wear for children and people with facial hair.

What is the prognosis of patients with swine flu?

Most of the patients of swine flu recover with no complications. Patients with depressed immune function or those who are seriously ill have worse prognosis compared to those who are immunocompetent.

How does swine flu kill?

Swine flu being an air borne infection infects the respiratory system chiefly lungs and causes lung infections. It can also cause secondary infection which can affect the vital organs of the body and lead to death.

What precautions should you take while travelling?

Apart from the general measures described above to prevent swine flu, if you become ill in any way while in the country, you should seek medical advice immediately.Also consult your health care provider and discuss the various risks associated with the disease if you are travelling to any country that has reported cases of flu among birds, swine, or humans.

For more information visit www.askmedicaldoctor.com