H1N1 - Breaking News 26.04.2009

Pandemic hysteria scarier than the flu

- Wash your hands or use hand sanitizer.
- If you don't have a tissue, sneeze into your sleeves.
- Don't kiss any pigs.
...While some people running around worrying the sky is falling - take a deep breath, keep your hands clean and try not to cough on anyone!
You know - like every other day!

FAQ's:

	What do we know about Swine flu H1N1?
	Did we already had an outbreak of Swine flu?
	How is the current situation worldwide?
	How does the swine flu spread?
	What can i do to prevent an infection?
	Are there medicines to treat an infection with H1N1?

Introduction

	1000 people have been infected in as many as 14 of Mexico's 32 states, 68 have died - case-fatality rate = ~7% (25.04.2009).
	Since March 2009, 8 human cases of new strain of influenza A (H1N1) virus, the swine flu, have been confirmed in California and Texas. All cases have recovered (25.04.2009).
	Disease is highly contagious.
	A vaccine is available since September 2009.
	Anti-virals, oseltamivir (Tamiflu) or zanamivir (Relenza) are recommended for treatment and/or prevention of infection with these swine influenza viruses.
	Guidelines for Clinicians, Laboratory Workers, General Population available on our medicalQM-Website.

What we know:

Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza that regularly cause outbreaks of influenza among pigs. Swine flu viruses do not normally infect humans, however, human infections with swine flu do occur, and cases of human-to-human spread of swine flu viruses has been documented. Most commonly, human cases of swine flu happen in people who are around pigs but it’s possible for swine flu viruses to spread from person to person also.

History:

A swine flu outbreak in Fort Dix, New Jersey, USA occurred in 1976 that caused more than 200 cases with serious illness in several people and one death. In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later. From December 2005 through February 2009, a total of 12 human infections with swine influenza were reported from 10 states in the United States.

Current Situation Worldwide:

As of 29 November 2009, worldwide more than 207 countries and overseas territories or communities have reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 8,768 deaths.

In the temperate zone of the northern hemisphere, the early arriving winter influenza season continues to intensify across central Europe and in parts of central, eastern, and southern Asia. Disease activity has peaked and is declining in North America and has either recently peaked or is currently peaking in much of western and northern Europe.

In both Canada and the United States, influenza virus circulation remains active and geographically widespread, however, disease activity appears to have peaked in past 3 to 4 weeks. In the United States, deaths due to pneumonia and influenza continued to increase past the epidemic threshold for the past 8 weeks and cumulative rates of hospitalizations for the current influenza season have exceeded rates seen in recent seasons among all age groups except those aged 65.

In Europe, widespread and intense transmission of pandemic influenza virus continued to be observed across most of the continent. In western and northern Europe the peak of disease activity has passed in Belgium, Iceland, Ireland, Netherlands, Norway and parts of the United Kingdom (Northern Ireland, Wales); activity may be peaking or plateauing in Spain, Portugal, Italy, Sweden and Denmark. Influenza activity continues to increase in much of Central Europe in the region between the Baltic and Balkan countries and from Germany to Romania. In Eastern Europe, recent peaks or plateaus in disease activity have also been observed in Ukraine, Belarus, Bulgaria and the Republic of Moldova. In the Russian Federation, influenza activity remains active and intense in some regions, with an overall increasing trend. A moderate impact on the healthcare system has been reported in parts of Northern and Eastern Europe. Over 99% of subtyped influenza A viruses in Europe were pandemic H1N1 2009.

In Western and Central Asia, influenza transmission remains active. Disease activity continues to increase in Kazakhstan, Kyrgyzstan, Uzbekistan, Iran and Iraq, while activity may have peaked in Israel, Jordan, and Afghanistan.

In East Asia, increasing influenza-like-illness or respiratory disease activity has been reported in Southern China and Japan. A recent decline in activity has been observed in Northern China. In South and Southeast Asia, influenza activity continues to increase in the north-western parts of India, Nepal, Sri Lanka and Cambodia, while activity in the rest of region remain low.

In the tropical zone of Central and South America and the Caribbean, influenza transmission remains geographically widespread but overall disease activity has been declining except for focal areas of increasing activity in Jamaica, Venezuela and Ecuador.

In Africa, pandemic H1N1 2009 virus continues to be isolated from all parts of the continent, and there is evidence of continued co-circulation of pandemic (H1N1) 2009 and seasonal H3N2 viruses.

In the temperate region of the southern hemisphere, little pandemic influenza activity has been reported.

How does the swine flu spread:

• Through contact with infected pigs or environments contaminated with swine flu viruses.

• Through contact with a person with swine flu. Human-to-human spread of swine flu has been documented also and is thought to occur in the same way as seasonal flu. Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.

What can I do?

There is a vaccine available to protect against swine flu. There are also everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. These everyday steps are recommended for protection against swine flu:

	Covering nose and mouth with a tissue when coughing or sneezing. Throw the tissue in the trash after use.
	Wash hands often with soap and water, especially after coughing or sneezing. Alcohol-based hand cleaners are effective.
	Avoid close contact with sick people.
	If sick with influenza, stay home from work or school and limit contact with others to keep from infecting them. Avoid touching eyes, nose or mouth. Germs spread this way.

Medicines to treat swine flu:

CDC recommends the use of oseltamivir (Tamiflu) or zanamivir (Relenza) for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If sick, antiviral drugs can make illness milder and recovery 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).

(26.04.2009 - tho)

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