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Hpa - reports of swine influenza in mexico and us - an update

Reports of swine influenza in Mexico and US - an update 25 April 2009
Human cases of swine influenza A (H1N1) virus infection have been identified in California and Texas in the Unites
States and in four districts in Mexico.

No cases of swine flu have been identified in the UK or anywhere in Europe.
The reported events in the US and Mexico are unusual and warrant further investigation and vigilance on the part ofother countries.
More investigation and testing is needed to determine the severity of the disease and the ease with which it canspread. These investigations are currently underway by Mexican and US authorities with the support of the WorldHealth Organization (WHO).
The HPA is monitoring this situation closely and is working with the UK government to review the current incident andany threat it poses to UK public health.
There has been no change to the WHO pandemic alert level which is currently at WHO Phase 3.
There is currently a very low level of flu activity in the UK. The HPA and the NHS have systems in place, which will alertpublic health authorities of any unusual strain circulating in the UK.
Testing has shown that the human swine influenza H1N1 can be treated with the antiviral oseltamavir (Tamiflu®) andzanamivir (Relenza®).
There are no current travel restrictions on those who are planning to visit the affected areas of Mexico and/or theUnited States*. However, it is always good practice to follow respiratory and hand hygiene such as:Covering your nose and mouth when coughing or sneezing, using a tissue when possible.
Disposing of dirty tissues promptly and carefully.
Maintaining good basic hygiene, for example washing hands frequently with soap and water to reduce the spread ofthe virus from your hands to face or to other people.
Cleaning hard surfaces (eg door handles) frequently using a normal cleaning product.
Making sure your children follow this advice.
Travellers to affected areas are advised to consult a doctor immediately if they show signs of flu-like symptoms.
Anyone who has recently travelled to the affected areas and is experiencing influenza like illness should stay at hometo limit contact with others, and seek medical advice from a local health professional or by contacting NHS Direct.
Swine influenza in Mexico & US: Questions & Answers
What is swine influenza?
Swine Influenza is a respiratory disease of pigs caused by type A influenza viruses. Outbreaks of swine influenza
happen regularly in pigs. People do not normally get swine influenza, but human infections can and do happen. Mostcommonly, human cases of swine influenza happen in people who are around pigs but it’s possible for swineinfluenza viruses to spread from person to person also.
Recently, cases of human infection with swine influenza A (H1N1) viruses have been reported in Southern Californiaand near San Antonio, Texas. In addition, isolation of the same virus from cases in an outbreak in Mexico hasindicated more widespread human-to-human transmission.
Is this swine flu virus contagious?
It has been determined that this virus is contagious and is spreading from human to human. However, at this time, it
not known how easily the virus spreads between people.
How common are cases of swine influenza?
Infection with swine influenza virus has been detected occasionally in humans since the 1950s and human disease
is usually clinically similar to disease caused by infections with human influenza viruses.
Cases of swine influenza in humans usually occur after a history of exposure to pigs, i.e. direct or close contact with
infected pigs. Person-to-person transmission, as suspected in the cases currently under investigation in the US and
Mexico, have been previously reported but appear to be rare.
There have been no cases identified in the UK for at least ten years.
Through the regular seasonal influenza surveillance that is done in Europe, a single case was reported in November
2008 in Spain, with mild symptoms.
In the US there is an active swine influenza surveillance programme to monitor pig viruses as they see more diversity
in viruses than in any other country.
What are the symptoms of swine influenza?
The symptoms of swine influenza in people are similar to the symptoms of regular human seasonal influenza
infection and include fever, fatigue, lack of appetite, coughing and sore throat. Some people with swine flu have also
reported vomiting and diarrhoea.
What is the difference between seasonal influenza, avian influenza, swine influenza and an influenza pandemic?
Influenza viruses are commonly circulating in the human and animal environment. Different strains can cause illness
in humans, bird and pigs.
Seasonal influenza is caused by influenza viruses that are adapted to spread in humans (human influenza). Humans
have some natural immunity to the strains that are in common circulation, and this immunity can be boostered by
immunisation with a seasonal influenza vaccine.
Avian influenza is caused by influenza viruses adapted for infection in birds. Similarly, swine influenza is caused by
influenza viruses adapted for infection in pigs.
These illnesses all elicit the same respiratory symptoms in their hosts. Sometimes, humans and animals can pass
strains of influenza back and forth to one another, such as when humans become ill with avian or swine influenza,
usually from direct contact with animals who are ill.
Mixing of human and animal influenza viruses can lead to the development of changed viruses with the ability to
cause infection and spread in the human population. There may be little or no immunity in the human population to
these new viruses.
An influenza pandemic is defined as a new or novel influenza virus that spreads easily between humans. When new
influenza viruses are introduced into the environment, humans don’t have any natural immunity to protect against
them. Therefore, there is a risk that that new influenza viruses could develop into a pandemic if the virus passes
easily from human-to-human.
Is this the next influenza pandemic?
It is too early to say whether the cases in Mexico and the US will lead to a larger outbreak or could represent the
appearance of potential pandemic strain of influenza virus.
There is currently insufficient evidence to understand the extent to which cases in Mexico and the US are firmly linkedor to make a complete assessment of the health implications of this new virus.
The Director-General of the World Health Organization (WHO) is the decision maker in terms of declaring an influenzapandemic and elevating the global stages of pandemic alert. Experts from around the world are working in closecollaboration with WHO to help determine what risk this situation poses to global public health.
Is treatment available?
Testing has shown that the human swine influenza H1N1 is sensitive to can be treated with the antivirals oseltamavir
(Tamiflu) and zanamivir (Relenza).
What measures can I take to prevent infection?
General infection control practices and good respiratory hand hygiene can help to reduce transmission of all viruses,
including the human swine influenza. This includes:
· Covering your nose and mouth when coughing or sneezing, using a tissue when possible.
· Disposing of dirty tissues promptly and carefully.
· Maintaining good basic hygiene, for example washing hands frequently with soap and water to reduce the spread of
the virus from your hands to face or to other people.
· Cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product.
· Making sure your children follow this advice.
If someone who has been to the affected areas of Mexico and/or the U.S is feeling sick what should they do?
Anyone who has recently traveled to the affected areas and is experiencing influenza like illness should stay at home
to limit contact with others, and seek medical advice from a local health professional or by contacting NHS Direct.
*The affected areas are as follows:San Diego County, California, USAImperial County, California, USASan Antonio, Texas, USAFederal District of Mexico City, MexicoSan Luis Potosi, MexicoMexicali, MexicoOaxaca, Mexico More information for UK travellers visiting or returning from the Unites States and/or Mexico can be found on the FCOwebsite - http://www.fco.gov.uk/en/travelling-and-living-overseas/travel-advice-by-country/north-central-america/mexico

Source: http://www.ncccusa.org/pdfs/SFHPA.pdf

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GINA SONG UNC Eshelman School of Pharmacy ♦ (919)966-1622 ♦ gsong@email.unc.edu EDUCATION  University of North Carolina , Chapel Hill, NC  Present Eshelman School of Pharmacy Division of Pharmacotherapy and Experimental Therapeutics Ph.D. student  University of Minnesota , Minneapolis, MN  May 2005 – May 2008  Ewha Women’s University, Seoul, Republ

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