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Swine-Origin Influenza?
An Imminent Pandemic
Fever
Lethargy
Lack of appetite
Coughing
Runny nose
Sore throat
Nausea/Vomiting
Diarrhea
DOH National Epidemiology Center
Transmission
1. Directly pigs to humans
close proximity to infected pigs
such as in pig barns and livestock exhibits
housing pigs at fairs.
2. Human to Human
coughing or sneezing
touching something with flu viruses on it and
then touching their mouth or nose
Transmission: Food-Borne?
NO
Swine influenza viruses are not
transmitted through food
Safe to eat properly handled and cooked
pork and pork products
Cook pork at an internal temperature of
70C (160F)
DOH National Epidemiology Center
Treatment
Recommended
1. Oseltamivir
2. Zanamivir
Showed Resistance in the past
1. Amantadine
2. Rimantadine
DOH National Epidemiology Center
Vaccination
NO vaccines for humans
seasonal influenza vaccine can help
provide partial protection against swine
H3N2
pig vaccines are available
Genetic Reassortment
SIV
Profile of Cases
cases with pneumonia required
mechanical ventilation
the progression of the disease was rapid
fatal
Laboratory Findings
genetically are reassortant of AmericaEurasian swine influenza viruses
have not been previously detected in pigs
or humans
sensitive to Oseltamivir
Cases
Deaths
US
91
Mexico
26
Canada
13
United Kingdom
Spain
New Zealand
Germany
Israel
Austria
148
Total
WHO Recommendations
Public Health Emergency of International
Concern (PHEIC)
Serious Public Health Impact
Unusual or Unexpected
International disease spread
Interference with international travel or trade
WHO Recommendations
Communications
Travel Advisory
The World Health Organization advises
no restriction of regular travel or closure
of borders. It is considered prudent for people
to delay international travel and for people
developing symptoms following international
travel to seek medical attention, in line with
Guidance from national authorities.
Influenza sub-groups
Influenza A
highly infective
infects many species
causes frequent widespread epidemics and pandemics
Influenza B
only found in humans
capable of producing severe disease
cause of regional epidemics
Influenza C
causes mild disease
humans are natural hosts but isolates also found in pigs
does not cause epidemics
DOH National Epidemiology Center
(HA) Hemagglutinin
1. An antigenic glycoprotein
found on the surface of
the influenza viruses.
2. Is responsible for binding
the virus to the cell that is
being infected.
(NA) Neuraminidase
1. An antigenic glycosylated
enzyme found on the surface
of the influenza viruses.
2. It facilitates the release of
progeny viruses from
infected cells.
Influenza Epidemiology
Incubation period = Time from infection until onset of
symptoms
Period of communicability = Time a case is infectious to
others
Infection
Time
Symptoms
2
Incubation period
Period of communicability
DOH National Epidemiology Center
Days
Exposure
Incubation
Period
Prodromal
Stage
Lower
Respiratory
Stage
1-7 days
early dyspnea
crackles
rapid progress to
respiratory
distress respiratory failure
Antiviral Agents
Tamiflu (oseltamivir phosphate)
An oral anti-viral drug for the treatment of uncomplicated influenza in
patients one year and older whose flu symptoms have not lasted more
than two days
Dosage:
Treatment of Flu (all twice a day for 5 days)
Adults and teens over 13 take 75mg
The dosage for younger children who are 1 year and older depends on their weight:
<33lbs - 30mg - need 1 bottle
>33 to 51lbs - 45mg - need 2 bottles
>51 to 88lbs - 60mg - need 2 bottles
>88lbs - 75mg - need 3 bottles
Prevention of Flu
Adults and teens take 75mg once a day for 10 days
Children over age 1 take the same dose they would for treatment of the flu, but take it
just once a day for 10 days
Number of Cases
Number of Death
2254
0.09
2.8
Mexico
1626
45
Canada
280
0.4
Costa Rica
12.5
Spain
93
United Kingdom
39
France
12
Germany
11
Italy
Israel
New Zealand
Brazil
Japan
Netherlands
Panama
Korea
El Salvador
China
Columbia
Denmark
Guatemala
Ireland
Poland
Portugal
Sweden
Switzerland
Argentina
Australia
Austria
TOTAL
4329
49
1.13