Swine flu in Pakistan

By Dr Asif Javed Butt

Influenza or flu in humans is caused by influenza viruses A, B and C. Influenza virus B is exclusive to humans whereas other two are not human specific. Influenza virus C can infect humans, dogs and pigs whereas Influenza virus A has many strains and many of them infect both humans and other animals. H1N1 strain which causes swine flu and H5N1 strain which causes bird flu are more famous ones.

Some forms of H1N1 strain of influenza A are endemic to pigs and some to humans and only occasionally it can transfer from pigs to humans. Only 50 cases of zoonotic swine flu have been identified since first known case in 1958. Infected humans can infect others via airborne droplets. The 2009 H1N1 virus was not zoonotic swine flu, as it was not transmitted from pigs to humans, but from person to person through airborne droplets.

Right from the start of 2016, in addition to common cold and other forms of influenza, H1N1 swine flu is also on the rise in Pakistan. Although not declared an epidemic, according to media reports it has killed more than 19 people mostly in Multan, Lahore and Sargodha districts. In general Symptoms include fever; cough, sore throat, watery eyes, body aches, shortness of breath, headache, weight loss, chills, sneezing, runny nose, coughing, dizziness, abdominal pain, lack of appetite and fatigue. Because these symptoms are not specific to swine flu, a differential diagnosis of probable swine flu requires not only symptoms, but also a high likelihood of swine flu due to the person’s recent and past medical history.

The U.S. Centers for Disease Control and Prevention (CDC) recommends real-time PCR as the method of choice for diagnosing H1N1. The oral or nasal fluid collection and RNA virus preserving filter paper card is commercially available in some countries. This method allows a specific diagnosis of novel influenza (H1N1) as opposed to seasonal influenza.

To prevent spread of swine flu, don’t touch your nose, mouth or eyes during some common symptoms of flu. Frequently wash your hands especially after coughing or sneezing, stay at home if you are ill, avoid large gathering when swine flu is common in season, avoid close contact with sick people, and do regular exercise. Patients of swine flu, their attendants, and health care providers should use face mask. Vaccines are available for different kinds of swine flu. The U.S. Food and Drug Administration (FDA) approved the new swine flu vaccine for use in the United States in September 2009.  Studies by the National Institutes of Health show a single dose creates enough antibodies to protect against the virus within about 10 days. Although general influenza vaccines are being used for a while now, availability of swine flu specific vaccines in Pakistan is not known.

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 two days of symptoms). Beside antivirals, supportive care at home or in a 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 CDC recommends the use of oseltamivir (Tamiflu) or zanamivir (Relenza) 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. The virus isolated in the 2009 outbreak was found to be resistant to amantadine and rimantadine.

The most common cause of death is respiratory failure. Other causes of death are pneumonia, high fever (leading to neurological problems), dehydration, electrolyte imbalance and kidney failure. Fatalities are more likely in young children pregnant and the elderly.

On March 30th, 2016, posted in: Blog by
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