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Microsoft word - swine flu qa250409 _2_.docSwine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs. People do not normally get swine flu, Q2) How common and serious is swine flu infection in general? Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Between 2005 until Jan 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring. However, swine flu infection can be serious. 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. A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death. Q3) Is this particular swine flu virus contagious in HUMAN? CDC has determined that this swine influenza A (H1N1) virus is a new virus subtype containing a combination of gene segments that "previously has not been reported among swine or human influenza viruses." It is contagious and can spread from Q4) What is the current situation in US and Mexico? As of 26 April 2009, the United States Government has reported 20 laboratory confirmed human cases of swine influenza A/H1N1 (8 in New York, 7 in California, 2 in Texas, 2 in Kansas and 1 in Ohio). All 20 cases have had mild Influenza-Like Illness with only one requiring brief hospitalization. No deaths have been reported. All 20 viruses have the same genetic pattern based on preliminary testing. The virus is being described as a new subtype of A/H1N1 not previously detected in swine or The Government of Mexico has reported three separate events. In the Federal District of Mexico, surveillance began picking up cases of ILI (influenza –like illness) starting 18 March. The number of cases has risen steadily through April and as of 23 April there are now more than 854 cases of pneumonia from the capital. Of those, 59 have died. In San Luis Potosi, in central Mexico, 24 cases of ILI, with three deaths, have been reported. And from Mexicali, near the border with the United States, four cases of ILI, with no deaths, have been reported. Investigation is continuing to clarify the spread and severity of the disease in Mexico. Suspect clinical cases have been reported in 19 of the country's 32 states. As of 26 April, the Government of Mexico has reported 18 laboratory confirmed cases of swine influenza A/H1N1. On Saturday, 25 April, upon the advice of the Emergency Committee called under the rules of the International Health Regulations, the Director-General declared this event a Public Health Emergency of International Concern 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 Q6) What are the signs and symptoms of swine flu in people? The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions. Q7) How long can an infected person spread swine flu to others? People with swine influenza virus infection should be considered potentially contagious as from 1 day prior to the onset of symptoms to up to 7 days following illness onset. Children, especially younger children, might potentially be contagious Influenza viruses can be directly transmitted from pigs to people and from people to pigs. Human infection with flu viruses from pigs are most likely to occur when people are in close proximity to infected pigs, such as in pig barns and livestock exhibits housing pigs at fairs. Human-to-human transmission of swine flu can also occur and the spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads; that is, mainly through coughing or sneezing and sometimes through touching something with flu viruses on it and then touching their Q9) What surfaces are most likely to be sources of contamination? Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk and then touches their own eyes, mouth or nose before washing their hands. Q10) How long can viruses live outside the body? We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Frequent hand-washing will help you reduce the chance of getting contamination from these common surfaces. Q11) What would the doctor consider when I attend the clinic? Clinicians would consider the possibility of swine influenza virus infections in patients presenting with febrile respiratory illness who 1. Live in an area where human cases of swine influenza A (H1N1) has been 2. Have traveled to an area where human cases of swine influenza A (H1N1) has 3. Have been in contact with ill persons from these areas in the 7 days prior to Q12) How can human infections with swine influenza be diagnosed? To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 10 days or longer. Identification as a swine flu influenza A virus might require sending the specimen to relevant local health authority for laboratory testing. Q13) Are there medicines to treat swine flu? 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 (Tamiflu) or Zanamivir (Relenza) for treatment of the disease based on the virus’s susceptibility profile. These 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 you get sick, antiviral drugs can make your illness milder and make you feel better 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). Q14) What can I do to protect myself from getting sick? There is no vaccine available right now to protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too. If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Washing your hands often will help protect you from germs. Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. If used correctly, surgical face masks and N95 face mask can help prevent some exposures, but they should be always used along with other preventive measures, such as avoiding close contact and maintaining good hand hygiene. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, Q15) What is the best technique for washing my hands to avoid getting the flu? Washing your hands often will help protect you from germs. Wash with soap and water or clean with alcohol-based hand cleaner. We recommend that when you wash your hands -- with soap and warm water -- that you wash for 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers (containing 70% alcohol) may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands. Q16) What is the interim recommendation for facemask and N 95 masks? When crowded settings or close contact with others cannot be avoided, the use of facemasks or N95 masks in areas where transmission of swine influenza A (H1N1) virus has been confirmed should be considered as follows: 1. Whenever possible, rather than relying on the use of facemasks or respirators, close contact with people who might be ill and being in crowded settings 2. Surgical facemasks should be considered for use by individuals who enter crowded settings, both to protect their nose and mouth from other people's coughs and to reduce the wearers' likelihood of coughing on others; the time spent in crowded settings should be as short as possible. 3. N95 facemask should be considered for use by individuals for whom close contact with an infectious person is unavoidable. This can include selected individuals who must care for a sick person (e.g., family member with a If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed. If you are sick, you should stay home and avoid contact with other people as much as possible to keep Q18) What are the warning signs that require urgent medical attention? In children emergency warning signs that need urgent medical attention include: Being so irritable that the child does not want to be held Flu-like symptoms improve but then return with fever and worse cough In adults, emergency warning signs that need urgent medical attention include: Difficulty breathing or shortness of breath Pain or pressure in the chest or abdomen Vaccines are available to be given to pigs to prevent swine influenza. There is no vaccine to protect humans from swine flu. The seasonal influenza vaccine will NOT provide protection against the swine H1N1 viruses. Q20) I have not had the flu shot for 2009, can I get the flu vaccination for In general, the seasonal flu vaccination is recommended for the prophylaxis of human flu (NOT swine flu), especially in the young and the elderly as well as people with chronic medical conditions. Having the human flu vaccination in majority of the population would also reduced the chance of having concurrent human and swine flu in the same individual and thus reduced the risk of further cross matching and mutation of the swine flu virus. Hence, it is still beneficial to have the current flu vaccination. In northern hemisphere including Hong Kong, the new flu vaccine for year 2010 would usually be available from September 2009. If one decides to have the current vaccine, it would confer protection until September and should still have the new vaccine in September 2009. Since the demand of the 2010 flu vaccines are likely to be high and the supply is tight, one might need to consult the clinician for reservation and pre-ordering of the flu vaccines. Q21) Can people catch swine flu from eating pork? No. Swine influenza viruses are not transmitted by food. You can not get swine influenza from eating pork or pork products. Eating properly handled and cooked pork and pork-products is safe. Cooking pork to an internal temperature of 160°F/ 70°C kills the swine flu virus as it does other bacteria and viruses. Q22) What is the government doing for the border control? Surveillance measures at boundary control points had been stepped up to detect travellers with fever and respiratory symptoms and coming from places where cases of human infection of Swine Influenza were reported. Airlines had been asked to broadcast health advice messages on all direct flights coming from the affected places. Passengers with respiratory symptoms are urged to approach Port Health officers at the Airport for follow-up investigations Q23) We are going to USA for business trip next week, what should we do? The World Health Organization has not advised on any travel restriction yet. People traveling to the affected places should take precautionary measures. These measures include avoiding contact with sick people; avoiding touching one's eyes, nose or mouth; wash hands frequently with soap and water or apply alcohol-based hand cleaners. They should also bring along surgical masks for use whenever appropriate. People who develop respiratory illness within 7 days after returning from the affected places should put on a surgical mask and seek medical consultation from public
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