viernes, 1 de mayo de 2009

Swine Influenza Update - 1 May 2009

The situation continues to evolve rapidly. As of 06:00 GMT, 1 May 2009, 11 countries have officially reported 331 cases of influenza A(H1N1) infection.

The United States Government has reported 109 laboratory confirmed human cases, including one death. Mexico has reported 156 confirmed human cases of infection, including nine deaths.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (34), Germany (3), Israel (2), Netherlands (1), New Zealand (3), Spain (13), Switzerland (1) and the United Kingdom (8).

Further information on the situation will be available on the WHO website on a regular basis. WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

miércoles, 29 de abril de 2009

Current phase of pandemic alert

 

phase4

In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.

In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.

In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.

In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required.

 

martes, 28 de abril de 2009

Swine Influenza - update 28 April

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The human swine flu outbreak continues to grow in the United States and internationally. Today, CDC reports additional cases of confirmed swine influenza and a number of hospitalizations of swine flu patients. Internationally, the situation is more serious too, with additional countries reporting confirmed cases of swine flu. In response to the intensifying outbreak, the World Health Organization raised the worldwide pandemic alert level to Phase 4External Web Site Policy.. A Phase 4 alert is characterized by confirmed person-to-person spread of a new influenza virus able to cause “community-level” outbreaks.” The increase in the pandemic alert phase indicates that the likelihood of a pandemic has increased.

CDC has activated its emergency operations center to coordinate the agency’s emergency response. CDC ’s goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by this swine influenza virus. Yesterday, CDC issued a travel warning recommending that people avoid non-essential travel to Mexico. CDC continues to issue interim guidance daily on the website and through health alert network notices. CDC’s Division of the Strategic National Stockpile (SNS) is releasing one-quarter of its antiviral drugs, personal protective equipment, and respiratory protection devices to help states respond to the outbreak. The swine influenza A (H1N1) virus is susceptible to the prescription antiviral drugs oseltamivir and zanamivir. This is a rapidly evolving situation and CDC will provide updated guidance and new information as it becomes available.

 

lunes, 27 de abril de 2009

Development of the virus H1N1 - Swine Virus

 

Swine Influenza update - 27 April 2009

 

27 April 2009 -- The current situation regarding the outbreak of swine influenza A(H1N1) is evolving rapidly. As of 27 April 2009, the United States Government has reported 40 laboratory confirmed human cases of swine influenza A(H1N1), with no deaths. Mexico has reported 26 confirmed human cases of infection with the same virus, including seven deaths. Canada has reported six cases, with no deaths, while Spain has reported one case, with no deaths.

Further information on the situation will be available on the WHO website on a regular basis.

WHO advises no restriction of regular travel or closure of borders. It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.

There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

 

Centers for Disease, control and prevention. What You Can Do to Stay Healthy?

 

Indications from Centers for Disease, control and prevention:

There are everyday actions people can take to stay healthy.

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread that way.

Try to avoid close contact with sick people.

  • Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
  • If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

How can I protect myself from getting swine influenza from infected people?

 

gasmask

In the past, human infection with swine influenza was generally mild but is known to have caused severe illness such as pneumonia For the current outbreaks in the United States and Mexico however, the clinical pictures have been different. None of the confirmed cases in the United States have had the severe form of the disease and the patients recovered from illness without requiring medical care. In Mexico, some patients reportedly had the severe form of the disease.

mask


To protect yourself, practice general preventive measures for influenza:
• Avoid close contact with people who appear unwell and who have fever and cough.
• Wash your hands with soap and water frequently and thoroughly.
• Practice good health habits including adequate sleep, eating nutritious food, and keeping physically active.
If there is an ill person at home:
• Try to provide the ill person a separate section in the house. If this is not possible, keep the patient at least 1 meter in distance from others.
• Cover mouth and nose when caring for the ill person. Masks can be bought commercially or made using the readily available materials as long as they are disposed of or cleaned properly.
• Wash your hands with soap and water thoroughly after each contact with the ill person.
• Try to improve the air flow in the area where the ill person stays. Use doors and windows to take advantage of breezes.
• Keep the environment clean with readily available household cleaning agents.


If you are living in a country where swine influenza has caused disease in humans, follow additional advice from national and local health authorities.

 


What should I do if I think I have swine influenza?


If you feel unwell, have high fever, cough and/or sore throat:
• Stay at home and keep away from work, school or crowds as much as possible.
• Rest and take plenty of fluids.
• Cover your mouth and nose with disposable tissues when coughing and sneezing and dispose of the used tissues properly.
• Wash your hands with soap and water frequently and thoroughly, especially after coughing or sneezing.
• Inform family and friends about your illness and seek help for household chores that require contact with other people such as shopping.


If you need medical attention:


• Contact your doctor or healthcare provider before travelling to see them and report your symptoms. Explain why you think you have swine influenza (for example, if you have recently travelled to a country where there is a swine influenza outbreak in humans). Follow the advice given to you for care.
• If it is not possible to contact your healthcare provider in advance, communicate your suspicion of having swine influenza immediately upon arrival at the healthcare facility.
• Take care to cover your nose and mouth during travel.

What drugs are available for treatment?

pills

There are two classes of such medicines, 1) adamantanes (amantadine and remantadine), and 2) inhibitors of influenza neuraminidase (oseltamivir and zanamivir).
Most of the previously reported swine influenza cases recovered fully from the disease without requiring medical attention and without antiviral medicines.
Some influenza viruses develop resistance to the antiviral medicines, limiting the effectiveness of treatment. The viruses obtained from the recent human cases with swine influenza in the United States are sensitive to oselatmivir and zanamivir but resistant to amantadine and remantadine.
Information is insufficient to make recommendation on the use of the antivirals in treatment of swine influenza virus infection. Clinicians have to make decisions based on the clinical and epidemiological assessment and harms and benefit of the treatment of the patient2. For the ongoing outbreak of the swine influenza infection in the United States and Mexico, the national and the local authorities are recommending to use oseltamivir or zanamivir for treatment of the disease based on the virus’s susceptibility profile.

 

What about the pandemic risk of swine influenza?

flu

It is likely that most of people, especially those who do not have regular contact with pigs, do not have immunity to swine influenza viruses that can prevent the virus infection. If a swine virus establishes efficient human-to human transmission, it can cause an influenza pandemic. The impact of a pandemic caused by such a virus is difficult to predict: it depends on virulence of the virus, existing immunity among people, cross protection by antibodies acquired from seasonal influenza infection and host factors.

 

Is it safe to eat pork and pork products?

 

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Yes. Swine influenza has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. The swine influenza virus is killed by cooking temperatures of 160F/70C, corresponding to the general guidance for the preparation of pork and other meat.

 

Etiquetas de Technorati: ,,,,,

Swine Influenza: What are the implications for human health?

 

Outbreaks and sporadic human infection with swine influenza have been occasionally reported. Generally clinical symptoms are similar to seasonal influenza but reported clinical presentation ranges broadly from asymptomatic infection to severe pneumonia resulting in death.
Since typical clinical presentation of swine influenza infection in humans resembles seasonal influenza and other acute upper respiratory tract infections, most of the cases have been detected by chance through seasonal influenza surveillance. Mild or asymptomatic cases may have escaped from recognition; therefore the true extent of this disease among humans is unknown.

 

 

What is Swine influenza?

 

Swine influenza, or “swine flu”, is a highly contagious acute respiratory disease of pigs, caused by one of several swine influenza A viruses. Morbidity tends to be high and mortality low (1-4%). The virus is spread among pigs by aerosols, direct and indirect contact, and asymptomatic carrier pigs. Outbreaks in pigs occur year round, with an increased incidence in the fall and winter in temperate zones. Many countries routinely vaccinate swine populations against swine influenza.
Swine influenza viruses are most commonly of the H1N1 subtype, but other subtypes are also circulating in pigs (e.g., H1N2, H3N1, H3N2). Pigs can also be infected with avian influenza viruses and human seasonal influenza viruses as well as swine influenza viruses. The H3N2 swine virus was thought to have been originally introduced into pigs by humans. Sometimes pigs can be infected with more than one virus type at a time, which can allow the genes from these viruses to mix. This can result in an influenza virus containing genes from a number of sources, called a "reassortant" virus. Although swine influenza viruses are normally species specific and only infect pigs, they do sometimes cross the species barrier to cause disease in humans.