A [H1N1] Flu

 

Prepared by: Dr. Ghazi Hamadeh

KFUPM, Medical Center

 

What is Swine flu?

·        Swine flu is a viral infection caused by flu virus known as A [H1N1] virus.

·        This virus affects the human respiratory system.

·        It is a mixture of genes for the three flu viruses (human, birds & pigs).

 

What are modes of disease transmission?

·        The virus spreads directly by air droplets from infected persons.

·        Touching nose, mouth and eyes after touching contaminated surface.

 

Who are at higher risk?

·        Children less than 5 years.

·        Pregnant ladies

·        People with chronic diseases [diabetes, asthma, immunocompromised]

·        Most cases affect people less than 25 years.

 

What is the incubation period?

·        Incubation period is 3-7 days

[From exposure until appearance of  Symptoms].

 

How long can the virus live on contaminated surfaces?

·        H1N1 virus can live on contaminated tables, door handles and other office furniture, for more than 2 hours, Therefore it is advised to wash hands with water and soap or disinfect them by antiseptic gel regularly.

 

What are the symptoms?

·        Symptoms are not different from the seasonal flu. It is characterized by fever, cough, running nose, sore throat, general body aches especially muscles and joints, headache, chills and marked fatigue.

·        This type of flu may be accompanied with nausea, vomiting and diarrhea.

·        Some cases may lead to serious complications and leads to death.

·        Although majority of cases are mild.

 

How to protect ourselves?

•         Wash your hands thoroughly for about 20 seconds with soap and water. (Scrub all parts of your hands, front, back and between).

•         Hand antiseptic cleaners can be used (alcohol 70%).

•         Use disposable tissue when sneezing or coughing to cover the mouth and nose then through it in the proper garbage basket.

•         Don’t touch your hands to any part of your face because the virus can spread from contaminated hands through these orifices and pass down to your throat & lungs.

•         Avoid contact with infected person.

•         Avoid crowded area as much as possible.

•         Keep one meter distance between you and others.

•         Avoid shake hands or exchange kisses and say Alsalam Alikom or any equivalent words.

•         On a bus, don’t held on an overhead strap or to a pole .Instead; warp your arm around the pole to support yourself.

•         When climbing stairs, don’t hold on to the railing unless absolutely have to.

•         Keep on healthy life style (balanced diet, good physical activity, adequate sleep); this will support your immunity.

•         Keep up with health advice.

•         Use sodium hypochlorite 1000 part per million to disinfect contaminated surfaces. 

 

Should I wear mask?

•    No, unless you are sick and want to prevent spread the disease to others, or been in crowded places, then you may use a mask temporarily until you leave the crowded place.

•    *** remember:

      a) Dispose the mask in a proper garbage container.

       b) Wash or disinfected your hands thoroughly.

 

When to consult the doctor?

•    If any of the following symptoms appear you are kindly advised to see the doctor as follows:

 

A) Adult:

-      Dyspnea (difficulty in breathing).

-      Chest pain or compression.

-      Disturbed Consciousness.

-      Severe or continuous vomiting.

-      Blood mixed sputum (hemoptysis)

-      If fever didn’t improve after 3 days or symptoms relapse after improvement.

 

B) Children:

-      Rapid or shortness of breath.

-      Cyanosed skin.

-      Acute or continuous vomiting.

-       Extra ordinarily irritable or lazy child.

-       Recovered then relapse of symptoms with fever & cough.

 

Is there a vaccine?

•    Vaccine is going to be available soon

•    The detailed directions from ministry of health will be distributed with vaccine.

 

Is it contagious?

•    Yes it may be a little more contagious than seasonal flu.

•    About ¼ of people who have had close exposure to someone with swine flu have gotten the virus.

•    All flu viruses love cold dry air that makes flu virus more contagious.

 

How serious is the illness?

•    Normal flu kills 1/1000 people who are infected (35.000 in USA every year (.

•    It is expected that swine flu may kill 2/1000.

[However, vaccination, treatment and preventive measures may change this expectation].

 

How diagnosis is confirmed?

•    Nasal or nasopharyngeal swabs are taken, if culture is positive diagnosis is confirmed.

 

What should I do if I get the disease?

•    Stay at home for 5 days.

•    Try to stay away from others as much as possible.

•    Try to stay in one room and have others avoid that room.

•    If you have multiple bathrooms claim one as your own and don’t share it with others.

•    Use tissues to cough or sneeze, (don’t sneeze into your hands), dispose the tissue in a waste basket and wash your hands immediately.

•    Don’t shake hands with people or exchange kisses.

•    Avoid crowded situations, (restaurant and public transportation…).

 

How long is the incubation period?

    Incubation period is 3 – 5 days.

How long are infected people contagious?

•    Adults are contagious for 7 days from the start of symptoms.

•    Children are contagious for 10-14 days from the start of symptoms.

 

Priority to vaccination:

1.   Pregnant women (higher complications and infant protection).

2.   House hold contacts, and care givers for children younger than 6 months of age.

3.   Health care and emergency medical service personnel.

4.   Children 6 months through 4 years (higher risk of complications).

5.   Children 5 years through 18 years with chronic medical conditions.

  

If the virus is plentiful then:

1.   All people from 5 years to 24 years

     a) 6 month to 18 years.

     b) 19 years to 24 years.

2.  Age 25 through 64 years with health conditions.

3.  Everyone from 25 through 64 years.

 [Risk of 65 years and above are less than younger age group because of some degree of immunity]

 

Treatment

1- Tamiflu:

·        Adult: 75 mg (1 tablet x twice daily x 5 days)

·        Children: < 15 kg (30 mg, twice daily x 5 days)

·        Children: 15-23 kg (45 mg, twice daily x 5 days)

·        Children: 23-40 kg (60 mg, twice daily x 5 days)

·        Children: > 40 kg (same as adult dose)

 

2- Treatment strategy:

      Since 16 Rajab 1430  Tamiflu is prescribed to patients with fever and flu symptoms if they have chronic disease, but those who did suffer from chronic disease and have fever and other flu symptoms will be prescribed Tamiflu if fever persists more than 24 hours.   

References:

·        Ministry of health KSA, Posters, Pamphlets.

·        Harvard Medical School. Health beat.

 

 

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