pandemic influenza


Influenza (“flu”) is a respiratory illness that can be transmitted from person to person. Flu viruses are of two main genetic types: Influenza A and B. Influenza A strains are further identified by two important surface proteins that are responsible for virulence: hemagglutinin (H) and neuraminidase (N).

Swine flu occurs naturally and may cause outbreaks among wild and domestic swine. People do not normally get swine flu, but each year CDC identifies a few isolated cases of human flu that are caused by flu strains typically associated with swine.

What is swine influenza?
Swine influenza is a respiratory disease of pigs caused by type A influenza viruses. In affected pigs, it causes cough, fever, nasal discharge, lethargy and difficulty breathing. Influenza A viruses are classified by two components of the viral surface, hemagglutinin (H) and neuraminidase (N). Different types of influenza A viruses are infectious to avian and mammalian species. Pigs and people are susceptible to influenza A viruses from both avian and mammalian sources. Infection with multiple viruses can lead to the creation of new “reassorted” viruses with components of pig, bird and human flu origin. Classical swine flu (H1N1) was first isolated in 1930, and many other subtypes have since been identified (e.g. H3N2, H1N2). In the United States, swine influenza outbreaks are most common in fall and winter. In Minnesota, we see peaks of swine flu activity in April through May and September through November.

Avian flu (“bird flu”) is caused by viruses that occur naturally among wild birds, and that may also affect domestic poultry. In 1997 a new H5N1 strain of avian flu emerged in Asia, and has since caused millions of deaths among domestic poultry, and hundreds of deaths in humans. Health officials have been concerned that this strain could cause a human pandemic, and governments around the world have carried out a number of preparedness activities, including vaccine development and stockpiling, and planning for continuity of services.

Pandemic flu is caused when a novel strain of human flu (i.e., one that spreads from person to person) emerges and causes a global outbreak, or pandemic, of serious illness. Because there is little natural immunity, the disease is often more severe than is typical of seasonal flu.

Influenza is an infectious disease caused by the influenza virus. The disease is commonly called flu or grippe. The word influenza is sometimes used to refer generally to either influenza or similar illnesses. The symptoms of influenza include chills, fever, headache, aches, and weakness. The symptoms usually disappear in about a week. The patient's resistance may be lowered, so that secondary infections, such as bacterial pneumonia, follow the influenza.

How influenza spreads. Influenza is mainly a respiratory disease. The virus is inhaled and comes in contact with cells of the upper air passages. It penetrates the cells that line these passages and reproduces within them. In time, new influenza viruses are released from the infected cells and infect other cells along the respiratory tract. Influenza may spread deep within the lungs. The virus may also be carried away in exhaled air and infect other people.

One of the worst global epidemics of influenza occurred in 1918-1919. About 20 million people, including more than 500,000 Americans, died in this epidemic. In 1957-1958, Asian flu caused a worldwide epidemic, as did Hong Kong flu in 1968-1969. Far fewer deaths resulted from these epidemics, due largely to the control of secondary infections with antibiotics.




1. You will probably be sick for several days with fever and respiratory symptoms.

2. Take Medications as Prescribed:
• Take all of the antiviral medication as directed (where applicable).
• Continue to cover your cough and wash your hands often (even when taking antiviral medications), to prevent spreading influenza to others.
• Call the clinic/GP if you (or your child) experience any side effects; i.e. nausea, vomiting, rash, or unusual behaviour.
• Take medications for symptom relief as needed for fever and pain such as paraectamol or ibuprofen. These medicines do not need to be taken regularly if your symptoms improve.
• Do not give aspirin (acetylsalicylic acid) or products that contain aspirin to children or teenagers 18 years old or younger.
• Children younger than 4 years of age should not be given over-the-counter cold medications without first speaking with a health care provider.

3. Seek Emergency Care:
If your child experiences any of the following:
• Fast breathing or trouble breathing
• Bluish or grey skin colour
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms improve but then return with fever and worse cough

4. Follow These Home Care Recommendations:
• Stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer.
• Drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated.
• Dishes can be done with hot soapy water.
• Throw away tissues and other disposable items used by the sick person in the trash. Wash your hands after touching used tissues and similar waste.
• Have everyone in the household wash hands often with soap and water, especially after coughing or sneezing. Alcoholbased hand cleaners are also effective.
• Avoid touching your eyes, nose and mouth. Germs spread this way.
• Continue with medication for chronic diseases as prescribed (e.g. ART).



Source :
The National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS) In collaboration with: The South African National Department of Health and World Health Organisation (WHO).

What is swine influenza?
Influenza Defined
Influenza Viruses - Types, Subtypes, and Strains
What is pandemic influenza A(H1N1) 2009 virus?
Definitions for identification of pandemic influenza A(H1N1) 2009
Case Management & Infection Control
Who should be tested?
Step-by-step guide for specimen collection, storage and transportation
Doctors/Nurses directions to Patients/Parents
How Influenza Viruses Change: Drift and Shift
The 2009 Influenza Pandemic
International Health Regulations
Vaccine Development and Use
Naming the Virus Strain
Information for Families and Visitors
New Pandemic Influenza A (H1N1) 2009
Pandemic (H1N1) 2009 Influenza Guidance
Recent Results from Studies with the new 2009 A/H1N1 Influenza A Virus
Continued pandemic influenza virus detections across Europe with increased activity in the UK (Northern Ireland)
Highly Pathogenic Avian Influenza Virus H5N1 and Wild Birds