It is hard not to have been bombarded by information in the past year regarding swine flu, or Influenza A H1N1, as it is known in the medical community. The inundation of news about H1N1 flu has resulted in many people becoming annoyed or skeptical about the impact of this new strain of flu. While scientists have been awaiting a pandemic from avian flu, swine flu has taken over the front lines of the media.
H1N1 flu, or more commonly, swine flu, as its name implies, came from pigs, though pigs do not transmit the virus directly onto humans, nor do they suffer sequelae. It is a virus found in pigs and which has mutated to cause human disease. The initial case was reported in Mexico, as well as the first death. Within a short period, it reached global proportions and a pandemic was declared four months after it was recognized.
Initially, there was widespread panic in response to swine flu. This has decreased due to public education as well as the fact that so far, swine flu has only caused mild illness. Though there have been deaths, they are not as high as feared. Yet, the death rate from H1N1 flu is higher than from seasonal flu currently.
H1N1 flu symptoms are very similar to seasonal flu; however, there does seem to be more gastrointestinal complaints of vomiting and diarrhea, as compared to seasonal flu. Also, a significant number of confirmed cases of swine flu have no associated fever.
The complications from H1N1 flu are similar to seasonal flu. It should be noted that swine flu appears to be more virulent than seasonal flu. Yet, the consequences have not been as devastating. This may be a reflection of the preparedness of the world for a global pandemic.
Because it is more virulent, preventive measures to contain the virus have included recommendations of quarantine and use of N95 face-masks in certain circumstances. Many schools have closed and even Mexico had declared a city shutdown at one stage. Good hand hygiene is important, though there had been a controversial report disclaiming its benefits.
There are tests available for the confirmation of swine flu. These include rapid testing, as well as a fluorescent testing, which is more accurate, but takes longer to confirm. However, because people have been discouraged from seeing their doctors to decrease the risk of exposure to everyone, many are treated based on their symptoms, rather than on test results.
During the wait for a swine flu vaccine, many people had hosted swine flu parties, in the hope of exposing themselves to a mild form of the illness. However, this has been discouraged, as it is unclear how severe an
illness they can induce, or whether they may pass it on to someone else who is immunocompromised. Consequently, it would be unethical and irresponsible to encourage such an activity.
The H1N1 flu vaccine is now available. Healthcare workers and those at risk for serious consequences of flu are encouraged to take it. It may and should be taken in conjunction with the regular seasonal flu vaccine. One vaccine does not cover the other. The swine flu vaccine has all the same precautions and side effects as the regular flu vaccine.
Treatment for swine flu is mainly with the antivirals, Tamiflu and Relenza. Because the risks of swine flu infection is greater than the risk of side effects of Tamiflu, children as young as two may be prescribed the antiviral at a reduced dose. It is also available to those younger, on an emergency authorized basis. The difficulty with the delivery of Relenza and its contraindication in those with respiratory conditions prevent its use. Moreover, because Tamiflu has been used more often, there is more resistance to this drug. Newer antivirals are still in development.
Because of the pandemic situation, many people have also been treated prophylactically, in the hope of containing the infection. The prophylactic dose is half the regular dose, but it is given over 7 days, rather than 5. Only those who have been exposed to confirmed cases of swine flu should be given this prophylactic treatment.
Again, those who have progressive symptoms should seek emergency treatment, as there may be a misdiagnosis and inappropriate treatment for swine flu. On the other hand, some people require further supportive treatment in addition to the antivirals. These include IV hydration, antibiotics for complications of a superimposed infection, or even respiratory support with oxygen or mechanical ventilation. Signs and symptoms of progressive illness include blue lips, respiratory distress, confusion, and seizures.
Syd James is a freelance writer, specializing in health related topics. He contributes to The Healthy Blogger health blog.
H1N1 Testing at Intermountain Medical Center in Salt Lake City, Utah
