Swine flu: H1N1

(Survival Manual/6. Medical/b) Disease/Swine flu H1N1)

The respiratory infection popularly known as swine flu is caused by an influenza virus first recognized in spring 2009, near the end of the usual Northern Hemisphere flu season.
The new virus, 2009 H1N1, spreads quickly and easily. A few months after the first cases were reported, rates of confirmed H1N1-related illness were increasing in almost all parts of the world. As a result, the World Health Organization declared the infection a global pandemic. That official designation remained in place for more than a year.
Technically, the term “swine flu” refers to influenza in pigs. Occasionally, pigs transmit influenza viruses to people, mainly hog farm workers and veterinarians. Less often, someone infected occupationally passes the infection to others. You can’t catch swine flu from eating pork.

A retroactive look at the Spanish flu of 1918-19
The 1918-19 Spanish flu epidemic was the Krakatau of all epidemics, putting more people underground than any other worldwide epidemic in  history. Incredibly, the  virus mutated simultaneously at distant places around the world  (thousands of miles apart) exploding out from Sierra Leone on the west coast of Africa, from Brest, France and Boston, MA on virtually the same day!
Total US casualties from the flu killed more Americans than those killed in action during the war, yet the 16 volume, P.F. Collier History of WW I, doesn’t even mention the flu or the casualties it caused.
While 26% of American public caught the Spanish flu, ‘only’ ½% or 675,000 died from it. The official history of the epidemic concluded that 20 million died in India, no comprehensive, official records were kept in China. Probable worldwide death estimates from the Spanish flu of 1918-19 are between 40-50 million. The Spanish flu’s death toll made it an even worse disease than those other feared diseases of the past: black plague, small pox, yellow fever or malaria.

Things learned from the Spanish flu survivors:
1.  Significant numbers of fatalities attributed to the flu were actually caused by secondary pneumonia infections amongst weakened sufferers. They did not have our ‘miracle drugs’ in 1918.
2.  It is important to follow medical news closely when any new disease organisms threaten.
3.  We now know the flu is spread as a result of public gatherings, that avoiding gatherings will greatly reduce your chance of contracting a airborne communicable disease.
4.  Remote areas, ie., the Appalachia and rural areas of Maine, with no visitors, had no flu incidents.

Flu notes
• The Flu virus cannot live over 1 hour outside a human host.
• Serious flu epidemic outbreaks occur about once every 10 years, as this is the time it takes for the organism to evolve away from human immunities and for a new, young population to grow up that has no immunities.
• New flu strains get their start when the flu organism jumps from ducks to people to hogs and then in a more virulent form back to humans again. It may also be from ducks to hogs to people, but this is how the new strains get their start.

Swine flu symptoms in humans are similar to those of infection with other flu strains:
• Fever
• Cough
• Sore throat
• Body aches
• Headache
• Chills
• Fatigue
• Diarrhea
• Vomiting
Swine flu symptoms develop three to five days after you’re exposed to the virus and continue for about eight days, starting one day before you get sick and continuing until you’ve recovered.

When to see a doctor
 It’s not necessary to see a doctor if you’re generally healthy and you develop swine flu symptoms, such as fever, cough and body aches. Do call your doctor, however, if you have flu symptoms and you’re pregnant or you have a chronic disease, such as emphysema or a heart condition.

Influenza viruses infect the cells lining your nose, throat and lungs. The virus enters your body when you inhale contaminated droplets or transfer live virus from a contaminated surface to your eyes, nose or mouth on your hand.

Risk factors
If you’ve traveled to an area where lots of people are affected by swine flu H1N1, you may have been exposed to the virus, particularly if you spent time in large crowds.
Swine farmers and veterinarians have the highest risk of true swine flu because of their exposure to pigs.

Influenza complications include:
• Worsening of chronic conditions, such as heart disease, diabetes and asthma
• Pneumonia
• Respiratory failure

Treatments and drugs
Most cases of flu, including H1N1 flu, need no treatment other than symptom relief. If you have a chronic respiratory disease, your doctor may prescribe additional medication to decrease inflammation, open your airways and help clear lung secretions.
The antiviral drugs oseltamivir (Tamiflu) and zanamivir (Relenza) can reduce the severity of symptoms, but flu viruses can develop resistance to them. To make development of resistance less likely and maintain supplies of these drugs for those who need them most, antivirals are reserved for people at high risk of complications.

High-risk groups are those who:
•  Are hospitalized
•  Have shortness of breath along with other flu symptoms
•  Are younger than 5 years of age
•  Are 65 years and older
•  Are pregnant
•  Are younger than 19 years of age and are receiving long-term aspirin therapy, because of an increased risk for Reye’s syndrome
•  Have certain chronic medical conditions, including asthma, emphysema, heart disease, diabetes, neuromuscular disease, and kidney, liver or blood disease
•  Are immunosuppressed due to medications or HIV

Lifestyle and home remedies
If you come down with any type of flu, these measures may help ease your symptoms:
•  Drink plenty of liquids. Choose water, juice and warm soups to prevent dehydration. Drink enough so that your urine is clear or pale yellow.
•  Rest. Get more sleep to help your immune system fight infection.
•  Consider pain relievers. Use an over-the-counter pain reliever such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) cautiously, as needed. Don’t give aspirin to children or teens because of the risk of Reye’s syndrome, a rare but potentially fatal disease.
Remember, pain relievers may make you more comfortable, but they won’t make your symptoms go away any faster and may have side effects. Ibuprofen may cause stomach pain, bleeding and ulcers. If taken for a long period or in higher than recommended doses, acetaminophen can be toxic to your liver.

Influenzas tend to kill most of their victims in two ways: dehydration and lung congestion. Even the Avian flu, which is respiratory, usually starts with stomach flu symptoms. Stomach flus usually induce diarrhea which rapidly dehydrates the victim.
•  To fight this, you need to stock up on both anti-diarrhea medicines (such as Imodium AD–an anti-spasmodic) and electrolyte solutions such as Pedialyte. (The latter is available in bulk though large chain “warehouse” stores.)
•  The various sports type drinks (such as Gatorade) can be used as oral rehydration solutions too. However, I prefer to dilute them about 50% with water, they have a lot of glucose in them which will exacerbate diarrhea symptoms.

If commercial Oral rehydration Solutions are not available, I have read that you can make an emergency solution as follows:
•  1/2 teaspoon of salt
•  2 tablespoons honey, sugar, or rice powder
•  1/4 teaspoon potassium chloride (table salt substitute)
•  1/2 teaspoon trisodium citrate (can be replaced by baking soda)
•  1 quart of clean water

Items to have on hand at home
•  Imodium is a trade name for Loperamide. It can be purchased generically for relatively little cost, at such places as warehouse stores. The generic (house brands) are just fine.
•  Stock up on Acetominophen (Tylenol) and Ibuprofen (Motrin) as well – for treating fevers. These two antipyretics can be taken together or on an alternating 4 hour schedule (take each every 4 hours but split them, for example at 8 AM take acetaminophen, at 10 AM take ibuprofen, etc. This makes it easier to monitor the patient and get them to drink fluids, if they’re up every 2 hours they will have to drink some fluids).
•  Either have a traditional glass thermometer for each person, or a digital thermometer with lots of disposable sleeves. The thermometers are a couple of bucks at most drug stores. The sleeves are a buck or so per hundred. Don’t cross-contaminate your patients.
Pasted from <http://www.survivalblog.com/asianflu.html>

The Centers for Disease Control and Prevention now recommend flu vaccination for all Americans older than 6 months of age. The vaccine developed to prevent infection with the 2009 H1N1 virus is one component of the seasonal flu shot for 2010-2011. The flu shot also protects against two other influenza viruses that are expected to be the most common during the 2010-2011 flu season.
The vaccine will be available as an injection or a nasal spray.
These measures also help prevent flu and limit its spread:
• Stay home if you’re sick. If you do have swine flu, you can give it to others starting about 24 hours before you develop symptoms and ending about seven days later.
• Wash your hands thoroughly and frequently. Use soap and water, or if they’re unavailable, use an alcohol-based hand sanitizer. Flu viruses can survive for two hours or longer on surfaces, such as doorknobs and countertops.
• Contain your coughs and sneezes. Cover your mouth and nose when you sneeze or cough. To avoid contaminating your hands, cough or sneeze into a tissue or into the inner crook of your elbow.
• Avoid contact. Stay away from crowds if possible.
• Reduce exposure within your household. If a member of your household has swine flu, designate one other household member to be responsible for the ill person’s close personal care.
• Read document: Medical/Personal Protective Equipment.
Pasted from <http://www.mayoclinic.com/health/swine-flu/DS01144/DSECTION=prevention>

(1)  In pigs, a synergistic association between swine influenza virus and Haemophilus suis is necessary for swine influenza. Similar situations between human influenza virus and H. influenzae have been observed in chick embryos and infant rats.
(2) A significant human pathogenic bacterium, S. pneumoniae was recognized as a major cause of pneumonia in the late 19th century. Pneumococcal pneumonia is more common in the very young and the very old.
(3) A very small bacterium that causes the disease mycoplasma pneumonia, a form of bacterial pneumonia. Antibiotics with activity against these organisms include erythromycin, azithromycin, clarithromycin, fluoroquinolones and their derivatives (e.g., levofloxacin), and tetracyclines, e.g., doxycycline.


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