Health Advice

 

 


Facts About Swine Influenza

 

 

 

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. The virus is spread among pigs by aerosols, direct and indirect contact, and carrier pigs without symptoms. 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. Although swine influenza viruses are normally species specific and only infect pigs, they do sometimes cross the species barrier to cause disease in humans.

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

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.

To protect yourself, practice general preventive measures for influenza:

  • Avoid close contact with people who appear unwell and who have fever, cough, sorethroat, bodyaches, headache, chills, fatique and diahhrea/vomiting.
  • 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 or someone in my family has swine influenza?

If you or your children 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 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.

Where have human cases occurred?

As of today no cases have been reported in Indonesia but there has been  sickened: 26 confirmed in Mexico, with up to 6,000 people showing symptoms; 68 confirmed in U.S.; 13 confirmed in Canada; two confirmed in Scotland; 14 confirmed in New Zealand; two confirmed in Spain; and two confirmed in Israel.

How do people become infected?

People usually get swine influenza from infected pigs, however, some human cases lack contact history with pigs or environments where pigs have been located. Human-to-human transmission has occurred in some instances but was limited to close contacts and closed groups of people.

Is it safe to eat pork and pork products?

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 160°F/70°C, corresponding to the general guidance for the preparation of pork and other meat.

What about the pandemic risk?

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 there a human vaccine to protect from swine influenza?

There are no vaccines that contain the current swine influenza virus causing illness in humans. It is not known whether current human seasonal influenza vaccines can provide any protection. Influenza viruses change very quickly. It is important to develop a vaccine against the currently circulating virus strain for it to provide maximum protection to the vaccinated people. This is why WHO needs access to as many viruses as possible in order to select the most appropriate candidate vaccine virus.

What drugs are available for treatment?

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.

 

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Mycoplasma is a type of bacteria.
Mycoplasma can cause sore throat, bronchitis and pneumonia
 
Mycoplasma is usually spread from person-to-person through the air and by direct contact
Mycoplasma is found in the throat of infected persons and is spread to other people through the air by sneezing and coughing. It can also spread by touching tissues or other things recently soiled by secretions from the nose or throat of an infected person.
 
People of any age can get Mycoplasma
Children under five years usually have mild symptoms or no symptoms at all. The illness is recognised more in school-age children and young adults.
 
Symptoms to look for include:
  • Headache
  • Tiredness
  • Cough, often in spasms
  • Chest discomfort
  • Sore throat
  • Fever
 
Symptoms start from 6 to 32 days after exposure. The illness can last for a few days to a month or more (especially coughing). Complications do not happen often. The infected person remains contagious for probably less than 20 days.
 
Mycoplasma pneumonia is usually diagnosed by blood tests and x-ray of the chest
 
Treatment is available
 
The disease can be treated with antibiotics. While antibiotics help an infected person to feel better faster, they do not remove the bacteria from the throat. Mycoplasma can remain in the throat for as long as 13 weeks.
 
Steps to take to prevent the spread of Mycoplasma infection
 
  • Cover the mouth when coughing or sneezing
  • Use tissues when coughing, sneezing and wiping or blowing the nose and throw them away
  • Wash hands after coughing, sneezing and wiping or blowing the nose
  • Avoid crowded living and sleeping quarters whenever possible

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What is dengue infection?
Dengue is an acute flu-like fever caused by a virus. It occurs in two forms:
(a)   Dengue fever (DF)
(b)   Dengue hemorrhagic fever (DHF)
Dengue fever is marked by an onset of sudden high fever, severe headache, pain behind the eyes and pain in the muscles and joints.
 
Dengue hemorrhagic fever (DHF) is a more severe form in which bleeding and sometimes shock occurs. This can lead to death. Symptoms of bleeding usually occur after 2 to 3 days of fever.
 
The high fever continues for 5 to 6 days (103-105°F or 39-40°C). It comes down on the third or on the fourth day but rises again. The person feels a lot of discomfort and is very weak after the illness.
 
Recognition of Dengue Fever
  • Sudden onset of high fever
  • Severe headache (mostly in the forehead)
  • Pain behind the eyes which worsens with eye movement
  • Body aches and joint pains
  • Nausea or vomiting
Recognition of Dengue Hemorrhagic Fever and Shock
Symptoms similar to dengue fever, plus any one or a combination of the following:
  • Severe and continuous pain in the abdomen
  • Bleeding from the nose, mouth and gums or skin bruising
  • Frequent vomiting with or without blood
  • Black stools like coal tar
  • Excessive thirst (dry mouth)
  • Pale, cold skin
Diagnosis
Confirmation of DF and DHF can be done by specific laboratory tests.
 
Treatment
Persons suspected of having DF or DHF must be examined by a doctor
 
Proper and early treatment can relive the symptoms and prevent complications. Aspirin and Brufen should be avoided in dengue fever, as they are known to increase the bleeding tendency and may lead to serious complications. Severe abdominal pain, (black stools), bleeding on the skin or from the nose or gums, sweating and cold skin, etc are danger signs, if any of them is noticed, take the person to a hospital immediately.
 
Fluids are very important to reduce complications and accelerate recovery. Fluids include drinking water but fruit juices and tea are also good options. In a healthy individual it means drinking 2-3 liters per day.
 
Basic facts on Dengue
  1. How does dengue spread? Dengue is spread through the bite of an infected Aedes aegypti mosquito. The mosquito gets the virus by biting an infected person. The first symptoms of the disease occurs about 5 to 7 days after the infected bite.
  2. Where does this mosquito live? This mosquito rests indoors, in closets and other dark places. Outside, it rests where it is cool and shaded. The female mosquito lays her eggs in water containers in and around homes and other areas. These eggs become adults in about 10 days.
  3. Where does the mosquito breed? Dengue mosquitoes breed in stored, exposed, water collection systems. The favoured breeding places barrels, drums, jars, pots, buckets, flower vases, plant saucers, tanks, discarded bottles/tins, tyres, water coolers, etc, and a lot more places where rainwater collects or is stored.
 
Prevention of Dengue
  1. Dengue Mosquitoes Bite During the Daytime - Protect yourself from the bite
  2. Wear full-sleeve clothes and long dresses to cover the limbs.
  3. Use repellents
  4. Use mosquito coils
  5. Use mosquito nets to protect babies, old people and others who may rest during the day.
 
Prevent the multiplication of mosquitoes
Mosquitoes which spread dengue live and breed in stagnant water in and around houses
 
  1. Drain out the water from tanks, barrels, drums, buckets, etc when not in use
  2. Remove all objects containing water (plant saucers, etc) from the house
  3. All stored water containers should be kept covered at all times
  4. Collect and destroy discarded containers in which water collects ( bottles, plastic bags, tins, tyres, etc)

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Avian Influenza, commonly known as bird flu, has been prevalent in Indonesia since 2003 when the first cases were detected in chickens. The first human cases were detected in 2005 and Indonesia now has recorded the largest number of human cases in the world with over 123 people infected and over 103 deaths.
As a standard precaution WHO offers the following information.

Cleanliness is one of the most effective means of preventing illness from contaminated foods. All uncooked meat, seafood and chicken contain bacteria that can make you ill. Wash your hands in hot soap water before and after preparing foods. It is just as important to properly clean the utensils you use to prepare foods. If possible sue plastic cutting boards and wash them after every use with hot soap water and a disinfectant. Do not forget the dishcloths. Wash them often in hot water to prevent spreading bacteria throughout your kitchen.

Separating raw poultry from ready to eat foods is a critical step to prevent the spread of bacteria and viruses. When you are grocery shopping, keep raw meats away from fresh produce and other ready-to-eat foods. Never place cooked food on a plate that previously held raw meats and use a separate cutting board for raw meat products. It is wise to use one colour cutting board for raw meats and another for fruits, vegetables and cooked foods. The difference in colours will also assist domestic helpers to remember which board to use.

Cooking. Foods properly and thoroughly will kill harmful bacteria and viruses that cause food borne illness. The most effective way to ensure that poultry is cooked properly is to use a meat thermometer. It should be cooked to an internal temperature of 180F or 70C. The meat should not be pink and there should be no red blood in the bones.

Eggs can carry both bacteria and viruses. To ensure they are safe, eggs must be cooked until both the whites and the yolks are firm. Wash the eggs and refrigerate them promptly after buying. Remember to wash your hands after handling eggs.
Prevent cross-contamination, hand washing and proper cooking of poultry and eggs are critical points for preventing disease transmission.
 
For more information about Avian Influenza visit http://www.who.int, http://www.cdc.gov/flu/avian.