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2009 H1N1 Flu: International Situation Update

This report provides an update to the international flu situation using data collected through March 28, 2010, and reported by the World Health Organization (WHO) on April 1. WHO continues to report laboratory-confirmed 2009 H1N1 flu cases and deathsExternal Web Site Icon on its Web page. These laboratory-confirmed cases represent a substantial underestimation of total cases in the world, as most countries focus surveillance and laboratory testing only on people with severe illness.

Currently, 2009 H1N1 influenza activity is highest in the tropical regions of Asia, the Americas and Africa. In the temperate areas of the Northern and Southern Hemisphere, 2009 H1N1 influenza virus continues to circulate at low levels. Although the 2009 H1N1 virus continues to be the predominant influenza virus circulating worldwide, influenza B viruses are predominant in most of East Asia and have been detected at low levels across Southeast and Western Asia, East Africa, and parts of Eastern and Northern Europe. Seasonal influenza A viruses are still being detected in parts of Asia and Australia.


Selected Highlights

* According to WHO, the majority of 2009 H1N1 virus isolates tested worldwide remain sensitive to oseltamivir, an antiviral medicine used to treat flu. Among 2009 H1N1 isolates tested worldwide, 268 have been found to be resistant to oseltamivir – 64 of these isolates were detected in the United States.
* Influenza B remains the predominant flu strain in East Asia, accounting for 66.7% of all influenza viruses reported in the Republic of Korea, 71.6% in the Russian Federation, 84.2% in China, and 100% in Mongolia and Iran. An increase in influenza B activity has also been reported in some European countries.
* Seasonal influenza A activity has been reported recently in some countries in recent weeks, including China, Ghana and Thailand.
* On February 18, 2010, WHO published recommendations for the following viruses to be used for influenza vaccines in the 2010-2011 influenza season of the Northern Hemisphere:

o an A/California/7/2009 (H1N1)-like virus;
o an A/Perth/16/2009 (H3N2)-like virus*;
o a B/Brisbane/60/2008-like virus.

* A/Wisconsin/15/2009 is an A/Perth/16/2009 (H3N2)-like virus and is a 2010 Southern Hemisphere vaccine virus.

Swine Flu Cases Appear To Have Peaked

The Los Angeles Times:"The current wave of pandemic H1N1 appears to have peaked, with four weeks of declines in several key indicators, the Centers for Disease Control and Prevention said Monday. Despite the decrease, the outbreak is continuing to take a heavy toll of hospitalizations and deaths, especially among children. Widespread activity of H1N1, also called swine flu, was reported in 32 states ... in the week ending Nov. 21, down from 43 states the week before and 48 a month ago. Influenza-like illnesses accounted for 4.3% of all visits to doctors' offices during the week, down from nearly double that proportion in October. That is still well above the normal level, 2.3%, for this time of year, however" (Maugh, 12/1).

The Washington Post: "While officials warned that the number of people getting infected with the H1N1 virus remains high, and cases could surge again, the extended period of falling activity suggests that the intensity of the outbreak has reached a high. ... 'We're far from being out of the woods,' [Thomas Skinner, spokesman for the Centers for Disease Control and Prevention in Atlanta] said. 'There's still a lot of flu out there. And we wouldn't be surprised to see another uptick in activity as we approach the end of December and beginning of January, when kids come back from Christmas break.' But other experts said they thought the wave had peaked" (Stein, 12/1).

USA Today reports: "The steady decline in the USA and elsewhere prompted the World Health Organization to propose Friday that swine flu may have peaked in North America, the Caribbean and parts of Europe, though the 'winter influenza season continues to be intense.' U.S. officials challenged WHO's hopeful assessment, saying it is too soon to declare that swine flu is tapering off. ... As of Monday, 66 million doses of swine flu vaccine were available for states to order, and more were on the way, the CDC's Thomas Skinner says" (Sternberg, 11/30).

Meanwhile, The San Bernardino (Calif.) Sun reports that fewer blacks are receiving the vaccine: "San Bernardino County public health officials this week plan to make a special pitch to get more blacks to roll up their sleeves for the H1N1 vaccine. ... Alonzo Louis Plough, director of emergency preparedness and response at the Los Angeles County Department of Public Health, said last week that his agency had already made attempts at special outreach and participation in the H1N1 campaign, and participation is still lagging. ... Dr. Eric Frykman, health officer for Riverside County, said that he has asked clinic managers to informally start tracking participation by ethnic group" (Steinberg, 11/29).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at

Online Test Helps You Self-Diagnose H1N1 Flu

Feeling sick? Wondering if it's the H1N1 flu or just a regular old go-away-don't-come-near-me, flu?

Face it, your doctor may not be able to squeeze you right in. But you may be able to figure it out using a Web-based self-assessment tool developed by researchers at Emory University in Atlanta. The tool is now available on several national Web sites, including flu.gov , the Centers for Disease Control and Prevention (CDC), and Microsoft's H1N1 Response Center .

The online test includes questions like, do you have a fever? Have you been short of breath? Do you have a pain or pressure in your chest that you didn't have before? Were you feeling better and now a fever or cough is returning?

The online test includes questions like, do you have a fever? Have you been short of breath? Do you have a pain or pressure in your chest that you didn't have before? Were you feeling better and now a fever or cough is returning?

The H1N1 flu , also widely known as the swine flu, is a fairly new influenza virus that has spread around the world. The CDC reports that it first appeared in the United States this past April. By June 11, the World Health Organization categorized it as a pandemic . Because its extremely contagious, hospitals and health care workers have been bracing for the H1N1 to hit hard this fall.

With concerns about the new flu running high , health care providers expect to get slammed with a mounting wave of people rushing in to find out if they have the H1N1 virus.

The online test, dubbed the Strategy for Off-Site Rapid Triage, is designed to help a lot of people figure out if they need to see their doctor or go to a hospital.

"This Web site is carefully designed to encourage those who are severely ill, and those at increased risk for serious illness, to contact their doctor, while reassuring large numbers of people with a mild illness that it is safe to recover at home," Arthur Kellermann, professor of emergency medicine and an associate dean at the Emory School of Medicine, said in a statement. "Hopefully, providing easy-to-understand information to the public will reduce the number of people who are needlessly exposed to H1N1 influenza in crowded clinic and ER waiting rooms, and allow America's doctors and nurses to focus their attention on those who need us most."

Swine Flu Emergency Should Put IT on Alert

Though the H1N1 flu has been declared a national emergency by President Barack Obama, experts say that many companies remain ill-prepared for its potential consequences, which could include employee absentee rates of 40% or more.

While last month's emergency declaration is targeted mostly at helping health care providers and government agencies bypass regulatory requirements to provide critical care, experts say it should also be a red flag for the IT and business communities.

Organizations probably have not allocated enough resources for virtual private networks nor tested VPNs for the fact that 80% of their staff could be working from home," said Al Berman, executive director of DRI International, a training institute that focuses on helping businesses prepare for emergencies. "We ran some tests with companies, and they ran out of TCP/IP addresses in five minutes."

Berman said that many businesses are probably delaying VPN upgrades because of increasing bandwidth costs. For example, he said, DRI recently met with officials of a large insurance provider and found that it would cost the company $1 million to boost bandwidth enough to support 40% of its staff working from home.

The federal government's Flu.gov Web site, managed by the U.S. Department of Health and Human Services, offers guidance to businesses about what to do in the event of a pandemic. Its suggestions range from making sure sick employees stay home to appointing a pandemic coordinator or team to oversee the preparation and implementation of a disaster plan.

Employers should "send a very strong message to employees to stay home if they're sick. No one is that essential," said Kim Elliott, deputy director of Trust for America's Health, a public health advocacy group. "You don't want employees coming in and infecting others to the point where your business shuts down."

The pandemic coordinator or team should monitor employees to ensure that they follow basic rules of hygiene, such as washing their hands, and make sure that face masks are available, according to the Flu.gov Web site.

Elliott said that the planning process should also include an assessment of how the absence of a large number of employees would affect operations, with recommendations on how to keep things running under such circumstances.

"That may mean cross-training employees in some key business functions," Elliott said, citing IT infrastructure maintenance, bookkeeping and accounting duties, and some customer-facing activities.

Businesses should also develop a plan to communicate with municipal agencies, which determine whether bus routes, schools or even businesses need to be shut down, Berman said.
The national emergency declaration came after a weekly U.S. Centers for Disease Control and Prevention report called FluView noted that 43 states are now reporting widespread influenza activity and that H1N1 has caused 1,000 deaths in the U.S.

elevating its health emergency alert status to Phase 6 -- its highest level. At that time, the number of influenza cases was close to 30,000 worldwide. The WHO now says there are 414,000 confirmed cases of H1N1 and that there have been nearly 5,000 H1N1-related deaths.

iPhone App Tracks Swine Flu

A new, free iPhone app from the creators of HealthMap shows the outbreaks of the H1N1 swine flu in your area and elsewhere. The app, called Outbreaks Near Me, finds your location and shows a map with red pins indicating recent outbreaks.

The app updates every hour using reports from more than 30,000 sources. Users can report updates such as school closings through the app. The app was launched last month and now has been downloaded 81,000 times.

Red pins dot the state of California, with heavy concentrations in Los Angeles and the San Francisco Bay Area. Perhaps one of those red pins includes my friend (and many in his East Bay company) who came down with the swine flu a couple of weeks ago.

There are no warning signs, he says. One day you're happily working in your cubicle, and the next you're fighting a fever, vomiting and worse. He lost eight pounds in only a few days after losing his appetite for food and liquids. Luckily, I hadn't caught up with him in a while.

John Brownstein, an assistant professor at Children's Hospital Boston and one of HealthMap's creators, told the Wall Street Journal that the goal of the free app isn't to spark panic, rather to spread the word. To this end, he says, an app solely running on the iPhone isn't ideal. HealthMap is currently developing an app for Google's Android and, later, for RIM's BlackBerry.

Pvt hospitals still not ready for Swine flu

More than a week after Delhi Government's second deadline expired on September 15, private hospitals are yet to open doors to influenza A H1N1 patients.

Delhi reported 2,079 cases - 80 new cases - and 9 deaths till Wednesday evening. While most of the hospitals claimed to be ready and waiting for the state health department's approval, State Health Minister Kiran Walia said they were not.

"Our experts are going on a round of private hospitals virtually every day, and there are minor things that are hampering the approval process like system of ventilation," said Walia. "These hospitals aren't used to the concept of isolation and mostly work in a centralised system.

We may delay it by a few days but absolute compliance is a must. We can't cut corners and risk lives of people," she said.

"Our set-up is ready and we have conveyed this to the health department. Now, we are waiting for their inspection," said B.K. Rao, chairman of Sir Ganga Ram Hospital.

"Our infrastructure is in place, but we are awaiting formal approval from the government," said the Moolchand Medcity spokesperson. Similar reactions were given by Indraprastha Apollo Hospital, which said the hospital was waiting for the second inspection before starting the facility for swine flu patients.

On August 12, Principal Secretary (health) J.P. Singh issued a circular directing "all 200-bed non-government medical institutions/hospitals to set up a 10-bed isolation treatment facility with 15 days". The direction was issued under section 2 of the Epidemic Disease Act, 1897, which empowers the state government to take special measures and prescribe regulations in case of a dangerous epidemic disease.

"The step was taken as a precautionary measure in case the disease takes epidemic shape," said Singh. The hospitals had asked for more time and the state government extended the deadline by 15 days.

But none of the wards were functional

H1N1 vaccine data shows no side effects

Early data on the H1N1 vaccines show the vaccines to be highly effective with no adverse effects. Two peer-reviewed articles now published in the online first addition of new England Journal of medicine, which has the preliminary data of the monovalent H1N1 vaccine, have shown that the vaccines are working in a large number of healthy adults.

The two rivals, Greenberg et al and Clark et al, describe preliminary data on the immunogenicity of the influenza A (H1N1) 2009 monovalent vaccine. This data has been awaited, as governments, public health officials, and other stakeholders respond to the first influenza pandemic in over 40 years.

The study by Greenberg et al. shows that a single dose of nonadjuvanted vaccine containing the usual 15 �g of hemagglutinin (HA) antigen is immunogenic, or creates immunity, in a high proportion of healthy young and middle-aged adults. The study was conducted in Australia during a time when the virus was circulating, and one participant had laboratory-confirmed infection with the 2009 H1N1 virus.

The report evaluates immunogenicity and safety of the vaccine 21 days after the first of two scheduled doses is given. A total of 240 subjects, equally divided into two age groups, less than and over 50 years of age, underwent randomisation to receive either 15 �g or 30 �g of hemagglutinin antigen by intramuscular injection. No deaths or serious adverse events were reported, but mild discomfort like headaches were reported in a few cases.

The study by Clark et al, involving 175 adults between 18 to 50 years of age, to test the monovalent influenza A/California/2009 (H1N1) surface-antigen vaccine, concluded that the vaccine generates antibody responses within 14 days after a single dose is administered. The antibody tier protection was higher in those who had received two doses of the same vaccine.

China's mass swine flu vaccination

China is to become the first country in the world to start a mass swine flu vaccination programme for its population following a big surge in the number of cases.

No one's died yet from the virus in China but the authorities there describe the situation as 'grim'.

The big rise coincides with the start of the school year and the approaching winter.

Quentin Somerville reports.

Most Germans don't want swine flu vaccinations

The German government has ordered 18 million more vaccinations against swine flu. But two-thirds of Germans say they don't want to be immunized.

In the latest step to fight an anticipated breakout of the H1N1 swine flu virus, Germany's 16 state health ministers have announced they plan to order another 18 million vaccination units. That's enough to immunize nine million more people and ensures there is enough stock should demand surge later in the year.

The health ministers have already ordered 50 million swine flu vaccinations for 25 million people, as each person requires two doses of the vaccine. That means there will be enough vaccine to cover 40 percent of the German population.

The latest order is subject to funding being available. The thorny question of who will bear the cost of this – the federal government, the health insurers, the state health departments or local authorities – is being discussed at a special working group meeting in Berlin on Wednesday.

Two-thirds reject swine flu immunization

A new study conducted by the Forsa Institute for DAK, one of Germany's largest health insurers, revealed that a surprising number of Germans do not plan to get immunized.

In the study of 1,001 people aged between 18 and 60 years, 62 percent said they would "definitely not," or "almost definitely not" let themselves be vaccinated this autumn when the first swine flu vaccines become available.

Eighty-two percent of Germans said that swine flu poses a "fairly low" or "very low" danger.

Bavarians, in Germany's south, in particular rejected vaccination. Only nine percent said they would "definitely" go to their doctor to be immunized compared to 14 percent of Germans on average. It's a different picture in eastern Germany, where almost a quarter of those who took part in the study said they were "definitely" going to get immunized.

"If the situation changes in the next few weeks, than we expect the number of people prepared to vaccinate themselves to increase sharply," said Horst Boelle, the director of the claims department at DAK.

Are vaccinations worth the risk?

The German Medical Association is urging the government to reassess its mass vaccinations plan, the largest such scheme in postwar history.

"Many people have already had swine flu and never even noticed that had it," said Frank Ulrich Montgomery, the association's vice president.

Montgomery also questioned whether the risks of vaccinating outweigh those of actually getting swine flu. Swine flu is highly infectious but it produces fairly mild symptoms and no one in Germany has died of it so far.

"The disease could take a turn for the worse, and claim its first fatalities," said Deputy Health Minister Klaus Theo Schroeder.

"I have the impression that we are now able to do that which we need to do in the next few weeks," he added.

The first vaccinations are expected to be available in October and more units will be delivered on a weekly basis. Schroeder said mass vaccinations should be completed by the end of January or early February next year.

Testing of the vaccine is ongoing. In one pilot study, it was shown that a single vaccination was enough to provide protection in 80 percent of all test persons.

What scientists know about swine flu

Preliminary analysis of the swine flu virus suggests it is a fairly mild strain, scientists say.

It is believed that a further mutation would be needed in order for the H1N1 virus to cause the mass deaths that have been estimated by some.

But at this point, it is impossible to predict with any accuracy how the virus will continue to evolve.

UK experts at the National Institute for Medical Research outlined on Friday the work they are due to start on samples of the virus sent from the US.

The research, being done at the World Influenza Centre in Mill Hill, will be vital for working out the structure of the virus, where it came from, how quickly it is capable of spreading and its potential to cause illness.

Structure

Analysis done so far suggests what they are dealing with is a mild virus and nowhere near as dangerous as the H5N1 avian flu strain that has caused scientists so much concern over the past decade.

Influenza A viruses are classified according to two proteins on the outer surface of the virus - hemagglutinin (H) and neuraminidase (N).


The swine flu strain is a H1N1 virus, the same type as seasonal flu which circulates throughout the world every year, and kills roughly 0.1% of those infected or higher in an epidemic year.

Professor Wendy Barclay, chair in influenza virology at Imperial College London says initial indications suggest there is nothing about the genetic make-up of the new virus which is a cause for particular concern.

The key to its potential lies largely in the H1 protein.

"There are two aspects - one is which receptors the virus tends to bind to and what we see is that it is binding to the upper respiratory tract rather than deep in the lungs."

When a flu virus binds to the upper respiratory tract, it tends to cause mild illness but can be easily spread as people cough and sneeze, Professor Barclay explains.

If a virus binds further down in the lungs, it tends to cause much more severe illness, as in the case of the H5N1 avian flu virus which has caused concern in recent years.

"With the H1 gene we also look at the cleavage site," she adds.

"The virus has to be cut into two pieces to be active and it uses an enzyme in the host to do that.

"Most influenza viruses are restricted to the respiratory tract because they use enzymes in the lungs.

"But some, like H5 viruses can evolve to cut into two pieces outside the lungs, so they can replicate outside the respiratory tract."


Analysis

These initial indications are largely guesswork from looking at the genetic sequence of the virus and comparing that to what is known from work on other influenza viruses.

It will take weeks and months of biological analysis to properly get a handle on the potential of the H1N1 virus.

The team at Mill Hill, one of four World Health Organisation's centres for influenza research will be working in close collaboration with the Health Protection Agency who are carrying out testing in the UK, and their findings will also feed into the development of a potential vaccine.


Soon, the Wellcome Trust Sanger Institute in Cambridge will begin the genetic sequencing of the virus and will also be monitoring any mutations or changes in how virulent it is.

However, there is one other reassuring aspect about what is known so far.

That is there seems to be nothing unusual as yet in another protein in the centre of the virus, called NS1, which is linked to the strength of the immune response the virus produces.

In some more pathogenic viruses, it is this NS1 protein which initiates a "cytokine storm", a particularly severe immune reaction that can be fatal in even healthy young people.

Predictions

Scientists have also played down concerns that the milder H1N1 virus, could combine with the more dangerous H5N1 avian flu virus, causing a super virus that has the ability to both spread easily between humans and cause severe illness.

This is unlikely - or at least just as unlikely as it ever was and the H5N1 virus has been around for a decade without combining with normal seasonal flu.

Professor Jonathan Ball, an expert in molecular virology at the University of Nottingham said: "The chance of swine H1N1 combining with H5N1 is as likely as any other strain recombining.

"What this outbreak does highlight is how difficult it is to predict new pandemic strains.

"Many people suspected that H5N1 was the most likely candidate for the next pandemic strain, but now it appears that this was a mistake - but that's not to say H5N1 or another reassortment containing parts of H5N1 may not happen in the future.

"That's the trouble - you can't predict."

Deal 'close' over swine flu jabs

Doctors' leaders say they are hopeful that an agreement can soon be reached in negotiations with government over the swine flu vaccination programme.


Ministers unveiled plans on Thursday to vaccinate over 13 million people in the first wave of the UK programme.

But officials were forced to admit GPs had still not signed up to the deal.

The British Medical Association has asked for extra funds to administer the two-shot jab, which some campaigners have dubbed ludicrous.

The government had hoped to have the GPs on board by the time it announced its plan this week.
But negotiations have taken longer than expected. Doctors are paid £7.51 for each seasonal flu vaccine and other jabs, such as travel inoculations.

They are not expecting that amount for what may turn out to be a mass vaccination programme, but have argued in talks that they need extra money to cover staffing and administration costs and the overtime they may need to do.

They have also asked for their bonus payments to be protected if work such as blood pressure checks is affected.

Under the programme put forward, people with health conditions, such as heart disease and diabetes, pregnant women, those with weakened immune systems and frontline health and social care workers will be the first to receive the jab.

This amounts to more than 13 million - about a fifth of the UK population.

It has not been decided whether the rest of the population will then be immunised, although the government has ordered enough vaccine to do so.

There is still time to broker a deal as the vaccination programme will not be started until regulators have approved the vaccine. This is not likely to happen until the end of September at the earliest.

'Ludicrous'
Dr Laurence Buckman, chairman of the British Medical Association's GPs committee, said: "Talks with the government remain ongoing and we are hopeful that these discussions will conclude shortly.

"Currently, the health service is working well in response to this enormous challenge and all doctors will continue to work hard on behalf of all their patients."

But Susie Squire, political director at the Taxpayers' Alliance, said: "It is the job of GPs to provide frontline healthcare - and they are well paid by taxpayers for this service.

"To pay them extra to administer swine-flu injections is ludicrous. As doctors they should understand that public health is unpredictable and sometimes there are epidemics or accidents that have to be dealt with, and this can mean unpaid overtime."

A Department of Health spokesman said: "We are now working with BMA and NHS organisations to reach a comprehensive swine flu vaccine implementation plan for this first stage of the programme."

Aishwarya denies swine flu rumour

During a press conference held in Hyderabad on Saturday after the launch of Swiss watchmaker Longines' new collection Conquest Ceramic sports watches at a store in Nagarjuna Hills, India's much-celebrated actress Aishwarya Rai Bachchan has denied all the rumours that she was down with flu for four days. The former Miss World said: My father-in-law Amitabh Bachchan had mentioned on his blog that I was down with flu but many misunderstood it to be swine flu. I am healthy and back to my work. Replying to a question about endorsing international brands, the actress said she was lucky to work with ace film directors, technicians and photographers and gave the credit to them and her family for all the name and fame she has acquired. On her plans to host television shows in the footsteps of superstar Amitabh Bachchan, she said, Many production companies did approach me but my schedule is too full and I had to decline their offers.

Swine flu could kill as many as 30,000 to 90,000 people in US

Washington, August 25 (ANI): In a recently released report, the Obama administration's advisory group on Science and Technology has said that the H1N1 flu virus, dubbed 'Swine flu', could cause as many as 30,000 and 90,000 deaths in the United States and pose a serious health threat.

According to Fox News, deaths would be concentrated among children and young adults, determined the report.

In contrast, the typical seasonal flu kills between 30,000 and 40,000 annually - mainly among people over 65.

The report predicts 1.8 million will be hospitalized during the epidemic, with up to 300,000 patients requiring intensive care units.

These patients could occupy 50-100 percent of all ICU beds in affected regions at the peak of the epidemic and would place "enormous stress" on ICU units.

More needs to be done to speed up the "preparation of flu vaccine for distribution to high-risk individuals," otherwise the vaccine campaign - currently scheduled to begin in mid October - will have potentially missed the peak of the epidemic, according to the report.

The report from the President's Council of Advisors on Science and Technology, PCAST, shows a sober assessment of the dangers of a pandemic, but also serves as a pat on the back for a White House preparing for its first public health crisis.

"Based on the history of influenza pandemics over the past hundred years, PCAST places the current outbreak somewhere between the two extremes that have informed public opinion about influenza," stated the report.

"On the one hand, the 2009-H1N1 virus does not thus far seem to show the virulence associated with the devastating pandemic of 1918-19. On the other hand, the 2009-H1N1 virus is a serious threat to our nation and the world," it added.

This is due to the likelihood that more people will be infected because so few people have immunity to the strain.

As a result, PCAST recommends that the Food and Drug Administration "accelerate a decision about the availability of antiviral drugs for intravenous use."

The current expectation is that the vaccine will be available in mid-October.

According to Harold Varmus, PCAST co-chair and President of Memorial Sloan-Kettering Cancer Center, despite the long 'to-do' list, the Obama administration has thus far done a good job of preparing for a national outbreak.

"The Federal Government's response has been truly impressive and we've all been pleased to see the high level of cooperation among the many departments and agencies that are gearing up for the expected fall resurgence of H1N1 flu," he said.

Real SWIN FLU Guide for India in Emergency get it handy

Hi all watchers from Swin Flu infected area in India if required please let us know . How we can help you more .

What are the symptoms?

Swine flu symptoms are similar to the symptoms of regular flu and include fever of over 100.4°F, fatigue, lack of appetite, and cold. Some people with swine flu have also reported runny nose, sore throat, nausea, vomiting and diarrhoea. Nearly everyone with flu has at least two of these symptoms.

So, how do you know if you have flu or just cold?
There is one clue: when you have the flu, you feel flu symptoms sooner than you would cold symptoms, and they come on with much greater intensity. With the flu, you may feel very weak and fatigued for up to 2 or 3 weeks. You'll have muscle aches and periods of chills and sweats as fever comes and goes. You may also have a stuffy or runny nose, headache, and sore throat.

Can I compare flu symptoms with cold symptoms?
Yes. The following chart can help you compare flu symptoms with cold symptoms. Use it to lean the differences and similarities between flu and cold symptoms. Then, if you get flu symptoms, call your doctor and ask about an antiviral drug.


Symptoms : a)Fever,b) Headache ,c)General Aches ,Pains, d)Fatigue,Weakness, e) Extreme Exhaustion, f) Stuffy Nose , g) Chest discomfort ,Cough

Cold : a) Rare, b) Rare, c) Slight , d) Quite mild, e) Never, f) Common ,g) Mild to moderate ,hacking cough

Flu : a) Characteristic, high 100-102 degrees F); lasts 3-4 days, b) Prominent, c) Usual; often severe,d) Can last up to 2-3 weeks, e) Early and prominent, f) Sometimes, g) Common; can become severe

You cannot confirm if you have swine flu just based on your symptoms. Like seasonal flu, pandemic swine flu can cause neurologic symptoms in children. These events are rare, but, as cases associated with seasonal flu have shown, they can be very severe and often fatal.

Doctors may offer a rapid flu test, but what you need to understand is a negative result doesn't necessarily mean you don't have the flu. Only lab tests can definitively show whether you've got swine flu. State health departments can do these tests.


What should you do immediately?

Those of you who have travelled from the affected countries in the past ten days and show symptoms swine flu like fever, cough, sore throat and difficulty in breathing should immediately contact the telephone number given below or visit the nearby Government Hospital.

Important contact numbers:
Outbreak Monitoring Cell (Control Room, NICD): 011-23921401

Websites: www.mohfw.nic.in and www.nicd.nic.in
You can also contact a toll free number 2392 1401 at the National Institute of Communicable Disease

Contact number for each cities:
Bangalore
BIAL Swine Flu Center - 91-80-22001490

SDS TUBERCULOSIS & RAJIV GANDHI INSTITUTE OF CHEST DISEASES(Govt. of Karnataka), Hosur Road, Bangalore - 560029
Helpline No: 91-80-26631923

Chennai
Communicable Disease Hospital, 87, T.H. Road, Tondiarpet, Chennai, Tamil Nadu

Hyderabad
Govt. General and Chest Diseases Hospital, Erragadda , Hyderabad
Hospital Helpline Number - 040-23814939

Kolkata
Beliaghata Infectious Diseases Hospital, 57, Beliaghata Main Road, Kolkata

Mumbai
Kasturba Hospital, Arthur Road, Sane Guruji Marg, Mumbai 400011
Ph: 022- 23083901 / 23092458 / 23000889

New Delhi
Yellow Fever Quarantine Centre, Near AAI Residential Colony, New Delhi
Ph: 91-11-25652129

Influenza Ward, Ward no 5, Second Floor, New Building, RML Hospital, Delhi-1
RML- 91-11-24525211,23404328,23365525- Ext 4328


What is the treatment?

Antiviral drugs can be used to treat swine flu or to prevent infection with swine flu viruses. The anti-viral medicines oseltamivir (Tamiflu) and zanamivir (Relenza) are being used to treat people with swine flu. Antiviral drugs work by preventing the flu virus from reproducing. To be effective you need to take them within 48 hours of the symptoms beginning. These flu drugs can decrease the duration of the flu by 1 to 2 days if used within this early time period. These antivirals are usually given for a period of about 5-7 days. It's unclear whether these drugs can prevent complications of the flu. Tamiflu is approved for prevention and treatment in people 1 year old and older. Relenza is approved for treatment of people 7 years old and older and for prevention in people 5 years old and older. These medications must be prescribed by a health care professional.

Side effects: Side effects of antiviral drugs may include nervousness, poor concentration, nausea, and vomiting. Relenza is not recommended for people with a history of breathing problems, such as asthma, because it may cause a worsening of breathing problems. Discuss side effects with your doctor.

Self medication: Antibiotics are a no-no. Chances are that antibiotics will not help your flu symptoms. That's because flu, colds, and most sore throats and bronchitis are caused by viruses. In addition, taking antibiotics when you have a virus may do more harm than good. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment. Antibiotics only cure certain infections due to bacteria -- and if taken carelessly, you may get more serious health problems than you bargained for.

Is there a vaccine to treat swine flu virus? No, there isn’t a vaccine yet. But vaccines are being made in large quantities. Clinical tests will begin in August 2009. Depending on how long federal officials wait for the results of these tests, tens of millions of doses of swine flu vaccine could be ready as soon as September 2009, with more vaccine becoming available each month thereafter. The first doses of vaccine likely will go to pregnant women and young children ages 6 months to 4 years, with older school kids to follow.

Who is at risk?

Those who are more at risk from becoming seriously ill with swine flu are people with:

chronic (long-term) lung disease, including people who have had drug treatment for their asthma within the past three years,
chronic heart disease,
chronic kidney disease,
chronic liver disease,
chronic neurological disease (neurological disorders include motor neurone disease, Parkinson's disease and multiple sclerosis),
suppressed immune systems (whether caused by disease or treatment),
diabetes,
pregnant women,
people aged 65 or older, and
young children under five.

How does it spread?

The new swine flu virus is highly contagious, that is it spreads from person to person. The virus is spread through the droplets that come out of the nose or mouth when someone coughs or sneezes. If someone coughs or sneezes and they do not cover it, those droplets can spread about one metre (3ft). If you are very nearby you might breathe them in.

Or, if someone coughs or sneezes into their hand, those droplets and the virus within them are easily transferred to surfaces that the person touches, such as door handles, hand rails, telephones and keyboards. If you touch these surfaces and touch your face, the virus can enter your system, and you can become infected.

Can it be prevented?

Influenza antiviral drugs also can be used to prevent influenza when they are given to a person who is not ill, but who has been or may be near a person with swine influenza. When used to prevent the flu, antiviral drugs are about 70% to 90% effective. When used for prevention, the number of days that they should be used will vary depending on a person’s particular situation.

Follow this general procedure to reduce the risk of catching or spreading the virus, you should:

Cover your mouth and nose when coughing and sneezing, using a tissue
Throw the tissue away quickly and carefully
Wash your hands regularly with soap and water
Clean hard surfaces (like door handles and remote controls) frequently with a normal cleaning product
Keep away from others as much as possible. This is to keep from making others sick. Do not go to work or school while ill
Stay home for at least 24 hours after fever is gone, except to seek medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine.)
Drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated
Wear a facemask – if available and tolerable – when sharing common spaces with other household members to help prevent spreading the virus to others.

Will it help to wear a mask?

Information on the effectiveness of facemasks and respirators for decreasing the risk of influenza infection in community settings is extremely limited. So, it is difficult to assess their potential effectiveness in decreasing the risk of Swine Flu virus transmission in these settings. However, a well-fitted, FDA-approved mask together with other preventive measures MAY reduce the risk of contracting the flu. Those who are sick or caring for someone who is ill should consider using a mask or respirator if leaving the house becomes necessary.

What precautions should one take at home?

Two things - soap and water can reduce the chance of infection by 30 per cent. All you need to do is keep washing your hand with soap and water frequently. Wash hands frequently with soap and water or use alcohol-based hand cleaner when soap and water are not available. Avoid touching your eyes, nose and mouth

Eat healthy: Proteins are essential to help your body maintain and build strength. Lean meat, poultry, fish, legumes, dairy, eggs, and nuts and seeds are good sources of protein.

The Food and Drug Administration recommends that adults eat 50 grams of protein per day. Pregnant and nursing women need more. By eating foods high in protein, we also get the benefit of other healing nutrients such as vitamins B6 and B12, both of which contribute to a healthy immune system.

Vitamin B6 is widely available in foods, including protein foods such as turkey and beans as well as potatoes, spinach, and enriched cereal grains. Proteins such as meats, milk, and fish also contain vitamin B12, a powerful immune booster.

Minerals such as selenium and zinc work to keep the immune system strong. These minerals are found in protein rich foods such as beans, nuts, meat, and poultry.

Exercise: Regular exercise may help prevent the flu. According to recent findings, when moderate exercise is repeated on a near daily basis, there is a cumulative immune-enhancing effect. That is, your strong immune system can fight flu better. When you exercise, your white blood cells -- the blood cells that fight infections in the body -- travel through your body more quickly, fighting bacteria and viruses (such as flu) more efficiently. To maintain good health, experts recommend at least 30 minutes of aerobic activity such as walking, swimming, biking, or running each day.
What precautions should one take at schools?


Avoid close contact with people who are sick
People who are sick with an influenza-like illness should stay home and keep away from others as much as possible, including avoiding travel, for at least 24 hours after fever is gone except to get medical care or for other necessities. (Fever should be gone without the use of fever-reducing medicine). Cover your mouth and nose with a tissue when coughing or sneezing
Wash your hands often
Avoid touching your eyes, nose or mouth

Is it safe to travel?

Avoid travelling unnecessarily. However, if you must travel, check how the country you're going to handles swine flu. Although, the WHO doesn't recommend travel restrictions, many countries have set up their own H1N1 policies, and some travellers have been screened or quarantined in other countries because of swine flu concerns.

Precautions to keep swine flu

Here are ten tips for you to keep away from the pandemic.

1. Wash your hands frequently

Use the antibacterial soaps to cleanse your hands. Wash them often, at least 15 seconds and rinse with running water.

2. Get enough sleep

Try to get 8 hours of good sleep every night to keep your immune system in top flu-fighting shape.

3. Drink sufficient water

Drink 8 to10 glasses of water each day to flush toxins from your system and maintain good moisture and mucous production in your sinuses.

4. Boost your immune system

Keeping your body strong, nourished, and ready to fight infection is important in flu prevention. So stick with whole grains, colorful vegetables, and vitamin-rich fruits.

5. Keep informed

The government is taking necessary steps to prevent the pandemic and periodically release guidelines to keep the pandemic away. Please make sure to keep up to date on the information and act in a calm manner.

6. Avoid alcohol

Apart from being a mood depressant, alcohol is an immune suppressant that can actually decrease your resistance to viral infections like swine flu. So stay away from alcoholic drinks so that your immune system may be strong.

7. Be physically active

Moderate exercise can support the immune system by increasing circulation and oxygenating the body. For example brisk walking for 30-40 minutes 3-4 times a week will significantly perk up your immunity.

8. Keep away from sick people

Flu virus spreads when particles dispersed into the air through a cough or sneeze reach someone else's nose. So if you have to be around someone who is sick, try to stay a few feet away from them and especially, avoid physical contact.

9. Know when to get help

Consult your doctor if you have a cough and fever and follow their instructions, including taking medicine as prescribed.

10. Avoid crowded areas

Try to avoid unnecessary trips outside.

British child gets Swin flu in Greece

UK, July 30, 2009, (Pal Telegraph) - The 16-year-old is on a life-support machine after suffering lung damage and complications believed to be linked to swine flu, according to the Daily Express.

The teenager, known as Sasha, had been island hopping with her family but was admitted to hospital on the island of Cephalonia.

She was flown to the country's main children's hospital in Athens on Tuesday after her condition deteriorated and she became unconscious.

Her parents, businessman Julian Newman and theatrical agent Nikki Boughton, are at her bedside. Mr Newman said: "Natasha is very bad. She has chronic respiratory failure. She has complications like pneumonia."

Doctors at the Ayia Sofia children's hospital have described the teenager's condition as "very grave".

Dr Lina Sianidou, head of the intensive care unit, said: "There is no doubt that she is suffering from swine flu. She is in a critical condition and very much struggling.

"It is clear she had this new virus for at least eight days before she sought help and that has made her condition worse."

Another hospital doctor, who asked not to be named, said: "Her condition is very grave. She was in a very bad state, running a very high temperature when she got here. She developed acute breathing problems and eventually lost consciousness in Cephalonia."

The family left their £1 million house in Highgate, north London, three weeks ago for a month's holiday. Mr Newman owns north London company J Newman Textiles Ltd.

Natasha is a pupil at prestigious public school Gordonstoun in Elgin, Scotland, where Prince Charles attended. She has recently completed her GCSE exams and is a keen musician.

Medical authorities said they were not aware she has underlying health problems. Natasha is one of three swine flu victims in intensive care in Greece, authorities revealed.

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First Swine Flu death in India

Swin flu pandemic song
Uploaded by gloubi77. - News videos from around the world.

Pune, August 03 2009: India recorded its first Swine flu death today in Pune.

A young girl named Riya Shiekh died at a private hospital in Pune on Monday, 3rd August.

She was on a ventilator in an ICU for a number of days, reports swin-flu.india.org.

Pune has recorded the most number of cases of Swine flu in India.

India now has over 551 confirmed cases flu out of which 422 have been cured and discharged.

However there have been a number of cases where the virus has reappeared in patients.

Statistics have revealed that children below the age of 15 are more susceptible to the virus.

Q&A: Advice about swine flu fro BBC

Swine flu has spread across the world since emerging in Mexico and is now officially the first flu pandemic for 40 years. Experts fear millions of people will be infected.

What is swine flu and what are the symptoms?

Symptoms:
1. High temperature, tiredness and lowered immunity
2. Headache, runny nose and sneezing
3. Sore throat
4. Shortness of breath
5. Loss of appetite, vomiting and diarrhoea
6. Aching muscles, limb and joint pain


Swine flu is a respiratory disease, caused by a strain of the influenza type A virus known as H1N1.

H1N1 is the same strain which causes seasonal outbreaks of flu in humans on a regular basis.

But this latest version of H1N1 is different: it contains genetic material that is typically found in strains of the virus that affect humans, birds and swine.

Although the strain may have originated in pigs, it is now a wholly human disease.

It can be spread from person to person by coughing and sneezing.

Symptoms of swine flu in humans appear to be similar to those produced by standard, seasonal flu.

A fever - which is a temperature of 38ºC (100.4ºF) - is the key symptom, combined with other complaints which may include a cough, sore throat, body aches, chills and aching limbs. Some people with the virus have also reported nausea and diarrhoea.

As with normal flu, the severity of symptoms will depend on treatment and the individual. Many people have only suffered mildly and have begun to recover within a week.

People are most infectious soon after they develop symptoms, but they cease to be a risk once those symptoms have disappeared. The incubation period may be as little as two days.

Apparently healthy people are dying from the virus. Does that means it is getting worse?

Experts say this does not change anything, and that if anything it is surprising that it has taken this long in the UK for someone without underlying health problems to die.
Apparently healthy people can die of any flu-related virus if it causes complications such as pneumonia so these latest deaths do not give any extra cause for concern.

Indeed, so far, many people who have developed symptoms of infection have not needed drugs to make a full recovery, according to the WHO.

Flu expert Professor Peter Openshaw, of Imperial College London, says about one in every three people who become infected will not realise they have had swine flu because they will have had no or only very few symptoms.

"About 98% of people who get infected will recover fully without any hospital treatment so I think the public needs to be reassured."

The real fear is that the strain will mutate and become more virulent which would pose a greater threat. This has been the feature of previous flu pandemics.

But this has not yet happened - and in any event it is worth remembering that seasonal flu often poses a serious threat to public health - each year it kills 250,000 - 500,000 around the world.

What should I do if I think I have it?

Anyone with flu-like symptoms who suspects they might have the swine flu virus are being advised to stay at home and use the "swine flu symptom checker" on the NHS Direct website, or phone NHS Direct - NHS 24 in Scotland.

If swine flu is suspected, your GP should be contacted - and he or she will issue a voucher for anti-flu drugs.

The infected person would then be expected to arrange for a friend or family member to pick up the anti-viral treatment for them from a collection point, most probably a pharmacy.

In the initial phase of the outbreak, lab testing was done to diagnose the flu but this is no longer happening routinely.

How is it treated?

Two drugs commonly used to treat flu, Tamiflu and Relenza, are effective at treating infection.

However, the drugs must be administered at an early stage to be effective.

Use of these drugs may also make it less likely that infected people will pass the virus on to others.

The UK government already has a stockpile of Tamiflu, ordered as a precaution against a pandemic.

However, there is concern that if too many people start taking anti-virals as a precaution, it could raise the risk of the virus developing resistance, reducing the drugs' effectiveness. There is however no evidence at present that this is happening.

In any event there is little point taking these drugs as a precaution as each tablet only provides a day's worth of cover. Given that the virus may be with us for many months - or indeed years - taking a regular pill is ill-advised as the long-term side effects are not known.

What measures then can I take to prevent infection?

As yet there is no vaccine, but manufacturers are trying to develop one. Good progress is being made and the first doses may be available in the UK by August. However the NHS says it may be next year before everyone can be immunised.

Older people and those under 16 - as well as health workers and those with existing clinical conditions - will be given priority.

It is hoped that even if the virus mutates in coming months, the vaccine would still confer a high degree of protection against related strains.

In the meantime, avoid close contact with people who appear unwell and who have fever and cough.

General infection control practices and good 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 and disposing of it promptly.

It is also important to wash your hands frequently with soap and water to reduce the spread of the virus from your hands to face or to other people, and cleaning hard surfaces like door handles frequently using a normal cleaning product.

In Mexico masks have been handed out to the general public, but experts are sceptical about how useful this is.

Some suggest it may even be counterproductive.

What is the advice for pregnant women?

The Department of Health has clarified its advice on how expectant mothers should protect themselves following a series of apparently mixed messages.

Concerns were heightened after a woman with swine flu died last week shortly after giving birth prematurely.

Pregnant women are among the groups at increased risk from swine flu. It is important that they follow the advice about hand hygiene.

They may also want to avoid very crowded places and unnecessary travel, but experts stressed people should use their own judgement and should carry on with their daily lives.

Where can I get further advice?

Further information and advice on swine flu can be found at websites of leading health and research organisations around the world. The World Health Organisation gives background information on the virus.

The UK's government services website is carrying regularly updated health and travel information. The Health Protection Agency advises the public about what to do if returning from an affected area. NHS Choices outlines how swine flu is different from other flu.

The European Centre for Disease Prevention and Control is another good source of information.

The US government's Centers for Disease Control and Prevention is counting the number of cases in the US.

You can also track spread of swine flu reports using unofficial sources. Google is mapping search term data as an indicator of flu activity both across the US down to state level and in Mexico. Healthmaps maps viruses using news reports. Social media guide Mashable lists a range of ways to track the virus .

Information and links to useful websites are being shared on Twitter, the micro-blogging service, while social networking website Facebook is tracking swine flu discussion amongst users.

For more information read this article

Pregnant women and young children most at risk as swine flu cases hit 100,000

Under-fives and pregnant women are emerging as key swine flu risk groups, according to hospital figures and the age profiles of those who have already died.

The Health Protection Agency (HPA) altered its advice this week to include the youngest age range – the under-fives – in the category of those "predominantly affected" while the Royal College of Midwives gave fresh advice todayon giving expectant women anti-viral drugs.

The shift in emphasis by health officials is a reminder that even if the final death rates from the pandemic are the same as normal seasonal flu, the social impact will be significantly different, with the disease apparently targeting the young more than elderly people. In normal seasonal flu it is the elderly who usually succumb through developing pneumonia.

Altogether, 29 people have died from swine flu in the UK. A patient from Swindon and a female tourist who died in Scotland after being admitted to hospital three weeks ago are among recent deaths. Figures from the West Midlands show that at one stage this month 23 of the 79 patients receiving treatment in hospital for swine flu were less than five years old.

On Thursday the chief medical officer, Sir Liam Donaldson, produced statistics showing that under-fives were three times more likely to need inpatient care than those in other age groups.

At least five of those who died are known to have been young children or babies. The NHS in London today confirmed that a baby less than six months old was among the fatalities. Some, like nine-year-old Asmaa Hussain, from Dewsbury, who suffered from epilepsy, had other prior conditions.

The Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists issued joint advice on prescribing anti-virals, suggesting that pregnant women with flu symptoms be given a course of Relenza, using an inhaler.

"It is recommended for pregnant women because it easily reaches the throat and lungs, where it is needed, and does not reach significant levels in the blood or placenta," the advice said. "This has the theoretical advantage of not affecting the pregnancy or the growing baby." It added: "A few cases of severe illnesses among pregnant women and infants have been reported in the UK and from other countries. These have mostly affected women with pre-existing health problems. In previous pandemics, and in reports from some countries in this pandemic, there is evidence that pregnancy can increase the risk for influenza complications for the mother and the foetus."

As many as 100,000 people may now have contracted swine flu in the UK, according to estimates by the Health Protection Agency.

Fears that meningitis could be confused with swine flu were raised today after news that Gemma Drury, 17, of Brimington, Chesterfield, was first diagnosed with swine flu but then rushed to hospital with meningitis days later.

The Department for Children, Schools and Families said today that some schools and nurseries might not open as usual at the start of the autumn term.

The Department of Health dismissed fears that the threat of high death rates could endanger the international supply of vaccines. The UK has ordered 132m doses of vaccine, sufficient for all the UK population. The first doses could be ready as early as August.

Italy yesterday advised its citizens to take extra precautions when travelling to Britain. Italy's health ministry said travellers should first visit their doctor to see if they have any conditions that put them at risk, and should avoid crowded places.