Aaaaanchu! *snif snif*! Doctor I’ve got a bad cold and was wondering if this could be swine flu?
Doctor my fever is on since three days with lots of cough and yellowish sputum, I’m taking medicines but the cough doesn’t go – could this be swine flu?
Doctor my child goes to school and his classmate has a bad cough – could he be having queries are just a few which we, as practicing doctors encounter on a daily basis – especially with the recent case reports and epidemic status of the dreaded disease – SWINE FLU – has now become an infamous and popular name amongst most householdsswine flu? What precautions should we be taking?
Well, the above.
- Swine flu is a respiratory disease caused by the influenza viruses that infect the respiratory tract of pigs and result in a barking cough, decreased appetite, nasal secretions, and listless behavior; the virus can be transmitted to humans.
- Swine flu viruses may mutate (change) so that they are easily transmissible among humans.
- Swine influenza is known to be caused by influenza A subtypes H1N1, H1N2, H2N3, H3N1, and H3N2.
- Investigators decided the 2009 so-called “swine flu” strain, first seen in Mexico, should be termed novel H1N1 flu since it was mainly found infecting people and exhibits two main surface antigens, H1 (hemagglutinin type 1) and N1 (neuraminidase type1).
- The World Health Organization declared the infection a global pandemic in August 2010
- Swine flu is transmitted from person to person by inhalation or ingestion of droplets containing virus from people sneezing or coughing; it is not transmitted by eating cooked pork products.
- People who work with poultry and swine, especially those with intense exposures, are at increased risk of infection with this influenza virus.
SIGNS AND SYMPTOMS:
- In humans the symptoms of “swine flu” H1N1 virus are similar to those of influenza and of influenza-like illness in general.
- Symptoms include fever, cough, sore throat, body aches, headache, chills and fatigue. Also at time studies have shown patients reporting diarrhea and vomiting.
- The most common cause of death is respiratory failure. Other causes of death are pneumonia (leading to sepsis), high fever (leading to neurological problems), dehydration (from excessive vomiting and diarrhea), electrolyte imbalance and kidney failure.
- Fatalities are more likely in young children and the elderly, or previously sick patients like on dialysis, uncontrolled sugars, weak immune system etc.
How to diagnose Swine Flu:
Patient complains of above symptoms and has a history of exposure to a diagnosed case of swine flu should raise suspicion about the same.
Sudden onset of flu like symptoms, with sudden worsening of clinical condition noted by the patient and confirmed by healthcare provider at hospital. Changes in chest x ray and blood work with quick progression from simple flu symptoms to respiratory failure.
Diagnosis: investigation confirmation by the REAL TIME PCR of nasal and oral secretions. This test in Hyderabad is done by – IPM, Narayanaguda, HYDERABAD.
Who test for influenza A, SW-InfA and SW-InfH1
Criteria guidelines by Ministry of Health:
Category A: Mild fever plus cough / sore throat with or without body ache, headache, diarrhea and vomiting will be categorized as Category-A. They do not require Oseltamivir. No testing required just observation and symptomatic treatment with a doctor.
Category B: In addition to all the signs and symptoms mentioned under Category-A, if the patient has high grade fever and severe sore throat and or High risk conditions shall be treated with Oseltamivir like:
- Children less than 5 years old;
- Pregnant women;
- Persons aged 65 years or older;
- Patients with lung diseases, heart disease, liver disease, kidney disease, blood disorders, diabetes, neurological disorders, cancer and HIV/AIDS;
- Patients on long term cortisone therapy.
This category requires assessment by qualified health care professional and to test/treat by antiviral only if necessary. Patient needs home isolation.
Category C: In addition to the above signs and symptoms of Category-A and B, if the patient has Breathlessness, chest pain, drowsiness, and fall in blood pressure, sputum mixed with blood, bluish discoloration of nails or Irritability among small children, refusal to accept feed or worsening of underlying chronic conditions,
All these patients require testing, immediate hospitalization and treatment.
Prevention in swine – herd management / vaccination in animals.
Contact a qualified doctor immediately if suspecting disease.
Drug: Doctor after necessary assessment and high suspicion can start ANTIVIRAL – OSELTAMIVIR as per age/weight dosing.
Vaccination: Influenza vaccine, most available influenza vaccines now come with H1N1 strains which may be taken especially for high risk cases.
Thanks and be safe –
Dr Shaeq Mirza – Dept. of Internal Medicine,
Consultant Physician & Diabetes Specialist
(Treated multiple surviving swine flu cases)