swine flu disease
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What is
Swine Flu?
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a highly contagious acute
respiratory disease caused byany strain of the influenza virus
endemic in pigs (swine) that
regularly cause outbreaks of influenza among pigs. In some
instances, people have developed
the swine flu infection when theyare closely associated with pigs
(for example, farmers, pork
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What is SIV?
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influenza cases that arecaused by Orthomyxovirus
endemic to pig populations.
SIV strains isolated to date
have been classified either as
Influenza(virus C or one of thevarious subtypes of the genus
Influenza virus A)
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Modes of
Transmission
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Most infections occur among people with
direct pig contact.
Sometimes a flu virus can mutate to be
more transmissible to humans.
People who work with swine, especially
people with intense exposures, are at risk ofcatching swine influenza if the swine carry a
strain able to infect humans.
Swine flu cannot be spread by porkproducts, since the virus is not transmitted
through food
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Period of
Communicability
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The swine flu in humans is mostcontagious during the first five
days of the illness although some
people, most commonly children,can remain contagious for up to
ten days.
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Risk Factors
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Direct Contact with Pigs
Smoking
Not Wearing Gloves when Working
with Sick Pigs
Children aged 6 months up to their
19yrs
Pregnant women People 50 years of age and older
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People of any age with certainmedical conditions, such as heart
or lung disease (Asthma, COPD,
Emphysema ), Diabetes or thosewith weakened immune systems
e.g. HIV
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Pathology
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Direct
contact with
Pigs
Weak
Immune
System
Pregnant
Women
Age:
6 mos. up
50 yrs old
upVirus enters the
Respiratory Tract
Bind throughHemogglutinin to the
Epithelial cellsRespiratory tract
becomes swollen andinflammed
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Enters the blood stream
Virus particles attaches to a livingcell and injects the genetic
materialsGenetic materials hijacks the cells
normal RNA/DNA machinery
Cell burst
Virus particles are released
Target cells are infected and
burst
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Diagnostic Tests
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Real-time RT-PCR
- This method allows a specific diagnosis of
novel influenza (H1N1) as opposed to seasonalinfluenza.
Nasopharyngeal Swab Sample
- Done to see if the patient is infected withinfluenza A or B virus.
Viral Culture
- It provides results in 3-10 days. A negative viralculture does not exclude infection with swine-
origin influenza A (H1N1) virus.
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Rapid Influenza Diagnostic Tests &
Immunofluroscence
- These tests can distinguish between
influenza A and B viruses. A patient with a
positive for influenza A may meet criteria for
a suspected case. But they cannotdistinguish between seasonal influenza A
and swine influenza, which is a subtype of A.
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Nursing Diagnoses
with Nursing
Management
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Risk for ineffective breathing r/t response
to infectious process: inflammation 2o
swine flu- Assist patient to assume position, eg.
Elevate the position of the patients head,
facilitates respiratory function by use ofgravity.
- Encourage or assist patient with
abdominal breathing exercises, Providesthe patient with some means to cope with
and control dyspnea and reduced air-
trapping.
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- Observe characteristic of cough, eg.
Persistent, hacking, moist. Assist with
measures to improve effectiveness of
cough effort, coughing is most
effective in an upright or in a head-
down position after chest percussion.
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Fluid Volume Deficit r/t excessive
gastric losses: vomiting 2o swine flu- Monitor V/S, capillary refill, status of mucous
membranes, skin turgor. Indications of
adequacy of circulating volume. Orthostatic
hypotension may occur with risk of falls/injuryfollowing sudden change in position.
- Discuss strategies to stop vomiting and
laxative/diuretics use, patient may obtain from
all intakes with resulting dehydration; or
substitute fluids for caloric intake, disturbing
electrolyte balance.
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-Monitor intake and output balance to
ensure accurate picture of fluid status.-Encourage oral intake, offer fluids
between meals.
-Instruct to have small frequent feedingsafter vomiting stops and provide crackers
only if he always feels nauseated.
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Altered Body Temperature: Hyperthermia r/t
effects of circulating toxins 2o Swine Flu
- Monitor v/s q 4 hours to evaluate pts condition.
- Provide TSB to maintain a normal body
temperature.
- Encourage increase fluid intake to replace fluid
loss.
- Encourage food rich in Vitamin C to boost body
resistance to infection.
- Maintain bed rest to preserve energy.
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s or act v ty nto erance r t
decreased oxygen-carrying
capacity- Evaluate clients actual and perceivedlimitations/ degree of deficit in light of usual
status, provides comparative baseline and
information about needed education regardingquality of life
- Instruct patient in energy conserving techniques,
e.g. carrying out activities at a slower pace,energy saving techniques reduce the energy
expenditure thereby assisting in equalization of
oxygen supply and demand.
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- Facilitate development of appropriate
activity/ rest schedule, alternating rest
and activity conserves energy while
allowing most productivity.
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Medical Management
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Tamiflu (oseltamivir) Relenza (zanamivir)
Vaccination (Prevention)
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Recent Journals
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Cell-Culture HINI swine flu vaccine
launchedHyderabad, Oct 18 : Vaccine maker, Bharat
Biotech, today announced the launch of ''India's
first indigenously developed cell culture H1N1
swine flu vaccine'' under the brand name'HNVAC'.
''HNVAC is the only developing world flu vaccine
to be manufactured in cell culture, a highlysterile and controlled manufacturing process,
instead of eggs''. "HNVAC was tested
extensively in one of the largest Phase I, II and
III clinical trials for flu
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vaccines in India and has proved that it is safe
and well tolerated''.
''Bharat Biotech received the approval from theDrugs Controller General of India earlier this
month to launch HNVAC vaccine.
''HNVAC was developed with approved strainsfrom WHO and CDC Atlanta.
''This single dose vaccine has been developed by
Bharat Biotech's scientists at the Genome
Valley Facility in Hyderabad,'' the company said
in a release here. --UNI
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Swine flu jab 'may trigger rare
nerve disease'London, Oct 18 : Experts have indicated a
possible link between the swine flu jab and an
increased risk of developing a rare nerve
disease.The authorities are carrying out studies to
examine a possible association between the
vaccine and Guillain-Barre Syndrome, acondition that attacks the nervous system and
can cause paralysis and even death, reports
the Telegraph.
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The Medicines and Health care products
Regulatory Agency (MHRA) has published a
report that suggests that further tests are tobe carried out.
It reads, "Given the uncer-tainties in the
available information and as with seasonal fluvaccines, a slightly elevated risk of GBS
following H1N1 vaccines cannot be ruled out.
"Epidemiological studies are ongoing to
further assess this possible association."
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A vaccine used to combat a different form of
swine flu in the US in 1976 led to 25 deathsfrom the condition, compared with just one
death from swine flu itself.
Amid fears there could be a repeat,
neurologists were asked to record cases ofGBS in the UK swine flu outbreak. Government
experts say there is no evidence of an increase
in risk similar to 1976, but the MHRA reportreveals they are calculating if there might be a
smaller raised risk.
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A spokesman for the MHRA said the risk with
the vaccine had not changed and that thereport "simply expands" on ongoing GBS
analysis.
"The position was and remains that there is noconfirmed evidence that the vaccines are a
cause of GBS," he said. --ANI
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Study finds hope for new drugs
that fight flu10/21/2010 : Discovery of new trait in influenzaA may lead to finding drug that can fight all
virus strains
New images of the influenza A virus, whose
strains cause the seasonal flu and the H1N1
"swine" flu, have revealed its Achilles' heel,
researchers say, and the finding could lead toa targeted drug that can fight all strains of the
virus.
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The weakness stems from a basic structure
in all flu viruses, called the M2 channel,
which is key in helping the virus
reproduce.
About four years ago, a tiny change
occurred in this channel, the researcherssaid, making flu drugs such as
amantadine and rimantadine ineffective.
The Centers forDisease Control andPrevention stopped recommending using
the drugs to fight the flu.
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"We think we can pin down the types of
changes that could occur, and find drugs for
all" strains of flu, said study researcherDavidBusath, a biophysicist at Brigham Young
University in Utah.
The finding helps researchers understand whythe virus isn't susceptible to the old influenza
drugs anymore, Busath said.
With a drug developed to target this particularchannel, "you could be safe tomorrow,"
Busath said.
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The flu virus is mutating and changing all the
time, which is why there must be a new flu
vaccine every year to accommodate the newmutations, he said. But every flu virus has an
M2 channel, and it must work properly for the
virus to infect a host."It turns out there's only a small handful of
changes, in the heart of the channel, that still
allow the virus to work well," Busath said. "And
if it can't work, the virus can't reproduce. And
we know all of the possible changes that allow
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it to work.
Previous images of influenza A didn't
reveal the changes in the M2 channel,
making it hard for scientists to develop
a drug that could effectively target the
structure.
Because the structures of the virus are so
tiny, Busath and researchers from
Florida State University used atechnique called solid-state nuclear
magnetic resonance
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which is similar to an MRI, but used on atoms and
molecules to get a refined view of the flu's
structure."We have some new theories to test for possible
compounds that would work on the M2
[channel], and we're excited to try them out,"Busath told MyHealthNewsDaily.
The imaging technique the researchers used
could also be used to provide images of the
proteins in plasma membranes in the nervous
system, he said.
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Swine Flu Variant Linked To Fatal Cases
Might Have Disabled The Clearing
Mechanism Of Lungs,S
tudyS
uggestsDate: 23 Oct 2010
A variant of last year's pandemic influenza
linked to fatal cases carried a mutation thatenabled it to infect a different subset of cells
lining the airway, according to new
research. The study, due to be published
next week in the Journal of Virology,suggests that the mutant virus could have
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impaired the lungs' ability to clear out
germs. The researchers behind the study,
from Imperial College London, the
Medical Research Council National
Institute forMedical Research and the
University ofMarburg said the findingshighlight the potential for deadlier strains
of flu to emerge and spread.
The 2009 pandemic of H1N1 influenzacaused thousands of deaths worldwide,
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but the majority of cases were relatively mild.
A variant of the virus carried a mutation
termed D222G in a protein on the surface of
the virus, and people infected with this
variant were more likely to have severe and
fatal illness. According to a World HealthOrganisation report, the D222G mutation
was found in less than two in every hundred
cases of 2009 pandemic flu, but was
responsible for around seven in every
hundred deaths.
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Viruses infect cells by attaching to receptor
molecules on the cell surface. Different
receptors are present on different celltypes, and a virus can only infect cells that
have the right receptors for the protein on
its own surface.The new research shows that flu virus with
the D222G mutation can bind to a broader
range of receptors in the airway, including
receptors that are present on cells calledciliated cells. These cells, found in the
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lining of the airway, have hair-like projections
called cilia. The cilia sway back and forth to
move mucus with trapped particles upwardtoward the mouth, and this is normally
swallowed or coughed up. When ciliated
cells become infected, the cilia stop movingand this vital clearance function is impaired.
Inhaled viruses and bacteria can then
reach the lung more easily, where they can
potentially cause pneumonia.
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The mutant virus has an increased capacity
to infect ciliated cells, as shown by the
collaborating group at the University ofMarburg. Infection of the ciliated cells
would sabotage the lungs' clearing
mechanism and could be one factor thatmade the D222G mutation more virulent,
the researchers suggest.
"This simple mutation, which swapped one
building block of a virus protein for another,
apparently resulted in a more
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virulent version of the H1N1 virus," said
Professor Ten Feizi from the Department of
Medicine at Imperial College London, who
led the study. "We think this is at least partly
due to the virus being able to bind to
different receptors, which allowed it to infectciliated cells and stop them from clearing
out germs.
"If the mutant virus were to acquire the abilityto spread more widely, the
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consequences could be very serious. The
study goes to show how important it is that
the WHO Global Influenza SurveillanceNetwork continues to monitor closely the
emergence of new variants of the flu virus.
Even though the 2009 pandemic wasrelatively mild, it's vital that we handle
outbreaks cautiously and stay vigilant. The
virus is constantly evolving, and it's possible
that a new form as dangerous as the 1918pandemic could emerge."
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Professor Feizi and her team study the
receptor specificity of different flu viruses
by attaching onto a glass surface a rangeof different carbohydrates, resembling the
receptors present on the surface of airway
lining cells. The virus is then incubated ontop of the glass surface, and using a
fluorescent dye, the researchers can see
the receptors on the plate to which the virus
binds.The study builds on earlier work by
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Professor Feizi and her colleagues which
showed that compared with seasonal
influenza, the 2009 pandemic virus couldbind to a broader range of receptor types.
The previous study showed that pandemic
flu had some affinity for so-called alpha2-3 receptors, as well as the alpha2-6
receptors favoured by seasonal flu. Now
they have shown that this affinity for
alpha2-3 receptors is substantially
enhanced in cases of pandemic flu with
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the D222G mutation. Whereas alpha2-6
receptors are found in the nose, throat and
upper airway, alpha2-3 receptors areprevalent in the lung but also on ciliated
cells throughout the respiratory system.
The study was funded by the WellcomeTrust, the Medical Research Council,
Biotechnology and Biological Sciences
Research Council, the UK Research
Councils' Basic Technology Initiative,
EPSRC's Follow-on Translational grant,
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and German grants from the Von
Behring-Roentgen Foundation andLOEWE Program UGMLC of the
State of Hesse.
Sources: Imperial College London,
AlphaGalileo Foundation.
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Prevention Of
Human To HumanTransmission
Stay Home When You Are Sick :
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Stay Home When You Are Sick :
Stay Home When You Are Sick If possible, stay
home from work, school & errands when youare sick. You will help prevent others from
catching your illness.
Cover Your Mouth & Nose :
Cover YourMouth & Nose Cover your mouth
and nose with a tissue when coughing or
sneezing. If you dont have a tissue, cover
your mouth and nose as best you can. It mayprevent those around you from getting sick
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Clean Your Hands :
Clean Your Hands Clean your handsoften. Clean your hands every time
you cough or sneeze. Hand washing
stops germs .It is the best procedurein prevention of majority of
communicable diseases. Use alcohol
based gels & wipes also worked well .
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Avoid Touching Your Eyes, Nose
or Mouth :
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.
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Healthy Habits Reduces The
Attacks :Healthy Habits Reduces The Attacks
Get plenty of sleep,be physically
active, manage your stress, drinkplenty of fluids, and eat nutritious.
Unnecessary Migration of people
from epidemic and endemic areas tobe reduced.
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_The End_
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