BIRD FLU
This web site provides concise and straight forward information and news about the potential dangers of pandemic
flu, also known as avian flu or swine flu, and what you must do
now to inform and protect yourself, your family or business.
SWINE FLU
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RECENT NEWS HEADLINES

Sharp rise in serious flu cases

Expert warn of flu outbreak after UK hit

Three Syrians die of H1N1 flu pandemic

U.S. Bracing for 1.8 Million Swine Flu Hospitalizations

New guidelines issued for Swine Flu as school year begins

China Town Sealed off After Plague Kills Two

Swine flu cases still rising - over 22,000 in 69 countries

WHO Raises Flu Threat Level, Warns Pandemic Imminent

Swine Flu kills 159 in Mexico, world closer to pandemic

Deadly H5N1 Avian Flu Found in Hong Kong Birds

China has Bird Flu Outbreak

Human to Human Spread of Bird Flu Confirmed in Pakistan

Human-Human Spread of Bird Flu in Indonesia

Bird Flu Kills Two in Bali

Bird flu outbreak, strain H5N1 confirmed in France

Dozens more H5N1 bird flu cases in Germany

Shortage of pandemic flu vaccine to last five years

U.N. sees Europe-wide bird flu threat

Bird Flu Cases Climb in Indonesia; Virus Kills Poultry in Japan

New Vaccine-Resistant Bird Flu Spreading in Asia

Bird flu virus triggers devastating immune response, scientists find

Bird Flu Kills Younger People, Copying 1918 Pandemic

Bird flu vaccine 10 years away

Leavitt: We're overdue for a pandemic

Oprah Winfrey Show,
1/26/06 "Bird Flu: the untold story"

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Avian Flu Pandemic

Avian Flu Symptoms

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ALERT!
Flu season kicks in with deaths in U.K.
Swine flu is dominate strain

Swine flu death toll at 27 in UK

Pandemic Declared
World Health Organization
Raises Pandemic Alert to Phase 6

Swine Flu Outbreak Spreading Around World
Now in most countries, death toll rising

The Dangers of Swine Flu and Bird Flu

How to Protect Yourself, Family or Business

Presently there is a swine flu epidemic that originated in Mexico and has quickly spread throughout the world. The virus is known as swine influenza A (H1N1).The human swine flu outbreak continues to grow internationally.

According the World Health Organization, an overwhelming majority of countries have officially reported over 250,00 thousand of cases of swine flu, also know as the influenza A(H1N1) infection. The actual number of cases is thought to be far greater, perhaps in the millions. There have been close to 3.000 known deaths so far. After Mexico, the US has the highest number of deaths, where it is already in all 50 states and spreading at an alarming rate.

In response to the intensifying outbreak, the World Health Organization raised the worldwide pandemic alert level to Phase 6, the highest. A Phase 6 pandemic is characterized by increased and sustained transmission in the general population. This is the world's first flu pandemic since 1968.

There is Still no Vaccine Ready for Distribution

Presently early vaccine trials are underway with the hope an effective one will be ready before the regular winter flu season in the northern hemisphere. Even then, quantities will be limited. Initial supplies will be designated for health professionals, first responders and the military. Young school-aged children will also be high on the list. Older adults and senior citizens are reported to be last on the list.

Still in circulation in Asia is the H5N1 bird flu virus, a highly deadly virus carried by birds and other animals. When contracted it often causes rapid and sudden death in 60% of its victims.
So far over 400 people have contracted it and over 60 percent of them have died. It is spreading throughout Africa, Asia and Europe. On March 9, 2006, the U.S. Homeland Security Secretary Michael Chertoff estimated migratory birds could carry the avian flu virus through Canada and to U.S. shores within several months.

As the traditional flu season approaches in the northern hemisphere, there is a fear the spread could intensify. The bigger fear is that the H1N1 swine flu virus, which spreads rapidly and easily, may combine with the highly leathal H5N1 bird flu virus, and mutate into a highly contagious and deadly pandemic flu.

The CDC activated its Emergency Operations Center to coordinate the agency's response to this emerging health threat and on April 26th 2009 the Secretary of the Department Homeland Security, Janet Napolitano, declared a public health emergency in the United States.

Typical of a new virus, such as the H1N1 swine flu, there is virtually no immunity to it and no vaccine. The alarming part about the H5N1 avian flu is that it kills the majority of people that get it, including young healthy people with strong immune systems, whereas normal seasonal influenza causes only mild respiratory symptoms in most people.

Increasing Human-to-Human Spread of both the
H1N1 Swine Flu Virus and the H5N1 Bird Flu Virus

Swine flu is spreading at an alarming rate. According to The World Health Organization, the current outbreaks of highly pathogenic avian influenza are the largest and most severe on record. In July 2009 the W.H.O. decided to stop counting cases. It is estimated that as many as 2 billion people may become infected, including 40% of the U.S. population.

The H5N1 bird flu virus has already mutated with limited person-to-person spread occurring in Indonesia. Health experts fear that as in past pandemics, it will mutate further, into a virus that is easily spread from person-to-person, becoming a deadly human pandemic with millions dying. Many scientists think it is just a question of when.

Being an international travel hub, Britian has been especially hard hit. Britian is already stockpling body bags in preparation for a worst case scenario, a potential 65,000 deaths in the U.K. alone.

We were long overdue for a pandemic, now it is here

Whether it is the currently fast spreading swine flu, avian bird flu, SARS or a totally different viral threat, experts acknowledged we were overdue for a pandemic. "The (bird flu) virus continues to spread in wild birds across the world. There is no reason to believe that at some point it will stop. ... We need to be prepared," said Michael Leavitt, former secretary of the Department of Health and Human Services.

"We've probably never been closer to a pandemic", stated Dr. Julie Gerberding, formerly of the Centers for Disease Control (CDC). "It's not a matter of if, but when...", said Dr Michael Osterholm, one of the world’s foremost infectious disease experts and director of the Center for Infectious Disease Research and Policy (CIDRAP).

There is no way to stop it; everyone is at risk

In response to the bird flu threat, Dr. David Nabarro, United Nations World Health Organization Coordinator for avian and human influenza, estimated a pandemic flu could cause as many as 150 million potential deaths worldwide.

According to Dr. Nabarro: "Once a flu pandemic starts, everyone will be at risk of getting pandemic flu, because no one has natural immunity to the virus. However, certain groups may be at greater risk of dying than others. There are strong indications that the coming bird-flu pandemic may be similar to the influenza pandemic of 1918 and, if so, healthy adults would be most at risk of dying, along with pregnant women and the elderly."  

Why are healthy adults at greatest risk?

In response to the bird flu virus, Dr. Nabarro explained: "It appears that the H5N1 bird-flu virus causes a massive immunological response against the virus in those with the strongest immune systems.  Unfortunately, this causes the release of human enzymes called "cytokines," which destroy lung cells along with viral particles.  This, in turn, causes a deadly outpouring of fluids into the lung, which interferes with the exchange of oxygen and carbon dioxide. This reaction is frequently fatal."

"Let's acknowledge the fact that for the first six months of any pandemic, we're not going to have a vaccine," Health and Human Services Secretary Mike Leavitt told The Associated Press. If they can make a vaccine, it is expected to be too little, too late, with no assurance it will work at all. At best, officials expect there would only be enough vaccine for 25 percent of the population. Health professionals and emergency response workers would get first priority. At a recent avian flu conference, an expert stated that a vaccine could take 10 years to develop.

How can people and their families survive a pandemic flu?

Planning for a pandemic requires immediate action. Most people are not adequately informed or prepared to protect themselves from becoming a victim of this dreadful and deadly disease. The precautions you must take now, as well as after it strikes, are described in detail in the following FREE e-book guide:

The Individual and Family Guide to Pandemic Bird Flu - Swine Flu Preparedness

The guide spells out the critical actions necessary to protect you and your family. It contains many tips and precautions that must be taken to avoid infection, plus valuable web links to help keep you current and informed.

This guide is the result of extensive research from many respected sources including: The World Health Organization, U.S. Department of Health and Human Services, U.S. Center for Disease Control and Prevention, The National Institute of Allergy and Infectious Diseases and others.

In the guide you will learn:

  • What to expect during a pandemic
  • How to prepare
  • Supplies to keep on hand
  • How to tell if a pandemic is about to start
  • How the virus spreads
  • How to tell if you have a cold or the flu
  • What are the symptoms of the avian flu
  • How to avoid infection
  • How to prevent its spread to others
  • Frank advice not found anywhere else
    and more...

Click here to download the FREE Individual and Family Guide to
Pandemic Bird Flu - Swine Flu Preparedness.

BUSINESS OWNERS AND MANAGERS: click below for information on the
Business Guide to Pandemic Preparedness

This guide has been prepared by John Aldridge, M.S., CBCP. Mr. Aldridge has a Master of Science Degree and is an experienced Certified Business Continuity Professional, Certified by the Disaster Recovery Institute International, the preeminent organization for Disaster Recovery Training and Certification in the U.S.

 

 

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Swine Flu or Swine Influenza

Source: Wikipedia

Swine influenza (also called swine flu, hog flu, and pig flu) refers to influenza caused by those strains of influenza virus, called swine influenza virus (SIV), that usually infect pigs.[2] Swine influenza is common in pigs in the midwestern United States (and occasionally in other states), Mexico, Canada, South America, Europe (including the United Kingdom, Sweden, and Italy), Kenya, Mainland China, Taiwan, Japan and other parts of eastern Asia.[2]

Transmission of swine influenza virus from pigs to humans is not common and properly cooked pork poses no risk of infection. When transmitted, the virus does not always cause human influenza and often the only sign of infection is the presence of antibodies in the blood, detectable only by laboratory tests. When transmission results in influenza in a human, it is called zoonotic swine flu. People who work with pigs, especially people with intense exposures, are at risk of catching swine flu. However, only about fifty such transmissions have been recorded since the mid-20th century, when identification of influenza subtypes became possible. Rarely, these strains of swine flu can pass from human to human. In humans, the symptoms of swine flu are similar to those of influenza and of influenza-like illness in general, namely chills, fever, sore throat, muscle pains, severe headache, coughing, weakness and general discomfort.

The 2009 flu outbreak in humans, known as "swine flu", is due to a new strain of influenza A virus subtype H1N1 that contained genes most closely related to swine influenza.[3] The origin of this new strain is unknown. However, the World Organization for Animal Health (OIE) reports that this strain has not been isolated in pigs.[4] This strain can be transmitted from human to human,[5] and causes the normal symptoms of influenza.[6]

Classification

Of the three genera of influenza viruses that cause human flu, two also cause influenza in pigs, with Influenzavirus A being common in pigs and Influenzavirus C being rare.[7] Influenzavirus B has not been reported in pigs. Within Influenzavirus A and Influenzavirus C, the strains found in pigs and humans are largely distinct, although due to reassortment there have been transfers of genes among strains crossing swine, avian, and human species boundaries.

Influenza C

Influenza C viruses infect both humans and pigs, but do not infect birds.[8] Transmission between pigs and humans have occurred in the past.[9] For example, influenza C caused small outbreaks of a mild form of influenza amongst children in Japan,[10] and California.[10] Due to its limited host range and the lack of genetic diversity in influenza C, this form of influenza does not cause pandemics in humans.[11]

Influenza A

Swine influenza is known to be caused by influenza A subtypes H1N1,[12] H1N2,[12] H3N1,[13] H3N2,[12] and H2N3.[14] In pigs, three influenza A virus subtypes (H1N1, H3N2, and H1N2) are the most common strains worldwide.[15] In the United States, the H1N1 subtype was exclusively prevalent among swine populations before 1998; however, since late August 1998, H3N2 subtypes have been isolated from pigs. As of 2004, H3N2 virus isolates in US swine and turkey stocks were triple reassortants, containing genes from human (HA, NA, and PB1), swine (NS, NP, and M), and avian (PB2 and PA) lineages.[16]

History

Swine influenza was first proposed to be a disease related to human influenza during the 1918 flu pandemic, when pigs became sick at the same time as humans.[18] The first identification of an influenza virus as a cause of disease in pigs occurred about ten years later, in 1930.[19] For the following 60 years, swine influenza strains were almost exclusively H1N1. Then, between 1997 and 2002, new strains of three different subtypes and five different genotypes emerged as causes of influenza among pigs in North America. In 1997-1998, H3N2 strains emerged. These strains, which include genes derived by reassortment from human, swine and avian viruses, have become a major cause of swine influenza in North America. Reassortment between H1N1 and H3N2 produced H1N2. In 1999 in Canada, a strain of H4N6 crossed the species barrier from birds to pigs, but was contained on a single farm.[19]

The H1N1 form of swine flu is one of the descendants of the strain that caused the 1918 flu pandemic.[20][21] As well as persisting in pigs, the descendants of the 1918 virus have also circulated in humans through the 20th century, contributing to the normal seasonal epidemics of influenza.[21] However, direct transmission from pigs to humans is rare, with only 12 cases in the U.S. since 2005.[22] Nevertheless, the retention of influenza strains in pigs after these strains have disappeared from the human population might make pigs a reservoir where influenza viruses could persist, later emerging to reinfect humans once human immunity to these strains has waned.[23]

Swine flu has been reported numerous times as a zoonosis in humans, usually with limited distribution, rarely with a widespread distribution. Outbreaks in swine are common and cause significant economic losses in industry, primarily by causing stunting and extended time to market. For example, this disease costs the British meat industry about £65 million every year.[24]

1918 pandemic in humans

The 1918 flu pandemic in humans was associated with H1N1 and influenza appearing in pigs,[21] thus may reflect a zoonosis either from swine to humans, or from humans to swine. Although it is not certain in which direction the virus was transferred, some evidence suggests that, in this case, pigs caught the disease from humans.[18] For instance, swine influenza was only noted as a new disease of pigs in 1918, after the first large outbreaks of influenza amongst people.[18] Although a recent phylogenetic analysis of more recent strains of influenza in humans, birds, and swine suggests that the 1918 outbreak in humans followed a reassortment event within a mammal,[25] the exact origin of the 1918 strain remains elusive.[26]

1976 U.S. outbreak

Main article: 1976 swine flu outbreak

On February 5, 1976, in the United States an army recruit at Fort Dix said he felt tired and weak. He died the next day and four of his fellow soldiers were later hospitalized. Two weeks after his death, health officials announced that the cause of death was a new strain of swine flu. The strain, a variant of H1N1, is known as A/New Jersey/1976 (H1N1). It was detected only from January 19 to February 9 and did not spread beyond Fort Dix.[27]

President Ford receives swine flu vaccination

This new strain appeared to be closely related to the strain involved in the 1918 flu pandemic. Moreover, the ensuing increased surveillance uncovered another strain in circulation in the U.S.: A/Victoria/75 (H3N2) spread simultaneously, also caused illness, and persisted until March.[27] Alarmed public-health officials decided action must be taken to head off another major pandemic, and urged President Gerald Ford that every person in the U.S. be vaccinated for the disease.[28]

The vaccination program was plagued by delays and public relations problems.[29] On October 1, 1976, the immunization program began and by October 11, approximately 40 million people, or about 24% of the population, had received swine flu immunizations. That same day, three senior citizens died soon after receiving their swine flu shots and there was a media outcry linking the deaths to the immunizations, despite the lack of positive proof. According to science writer Patrick Di Justo, however, by the time the truth was known - that the deaths were not proven to be related to the vaccine - it was too late. "The government had long feared mass panic about swine flu - now they feared mass panic about the swine flu vaccinations." This became a strong setback to the program.[30]

There were reports of Guillain-Barré syndrome, a paralyzing neuromuscular disorder, affecting some people who had received swine flu immunizations. This syndrome is a rare side-effect of modern influenza vaccines, with an incidence of about one case per million vaccinations.[31] As a result, Di Justo writes that "the public refused to trust a government-operated health program that killed old people and crippled young people." In total, less than 33% of the population had been immunized by the end of 1976. The National Influenza Immunization Program was effectively halted on Dec. 16.

Overall, there were about 500 cases of Guillain-Barré syndrome (GBS), resulting in death from severe pulmonary complications for 25 people, which, according to Dr. P. Haber, were probably caused by an immunopathological reaction to the 1976 vaccine. Other influenza vaccines have not been linked to GBS, though caution is advised for certain individuals, particularly those with a history of GBS.[32][33] Still, as observed by a participant in the immunization program, the vaccine killed more Americans than the disease did.[34]

1988 zoonosis

In September 1988, a swine flu virus killed one woman in Wisconsin, and infected at least hundreds of others. 32-year old Barbara Ann Wieners was eight months pregnant when she and her husband, Ed, became ill after visiting the hog barn at the Walworth County Fair. Barbara died eight days later, though doctors were able to induce labor and deliver a healthy daughter before she passed away. Her husband recovered from his symptoms.

Influenza-like illnesses were reportedly widespread among the pigs at the farm they had visited, and 76% of the swine exhibitors there tested positive for antibody to SIV, but no serious illnesses were detected among this group. Additional studies suggested between one and three health care personnel who had contact with the patient developed mild influenza-like illnesses with antibody evidence of swine flu infection.[35][36] However, there was no community outbreak.

1998 US outbreak in swine

In 1998, swine flu was found in pigs in four U.S. states. Within a year, it had spread through pig populations across the United States. Scientists found that this virus had originated in pigs as a recombinant form of flu strains from birds and humans. This outbreak confirmed that pigs can serve as a crucible where novel influenza viruses emerge as a result of the reassortment of genes from different strains.[37][38][39]

2007 Philippine outbreak in swine

On August 20, 2007 Department of Agriculture officers investigated the outbreak (epizootic) of swine flu in Nueva Ecija and Central Luzon, Philippines. The mortality rate is less than 10% for swine flu, unless there are complications like hog cholera. On July 27, 2007, the Philippine National Meat Inspection Service (NMIS) raised a hog cholera "red alert" warning over Metro Manila and 5 regions of Luzon after the disease spread to backyard pig farms in Bulacan and Pampanga, even if these tested negative for the swine flu virus.[40][41]

2009 outbreak in humans

Main article: 2009 swine flu outbreak

The 2009 flu outbreak is due to a new strain of subtype H1N1 not previously reported in pigs.[4] Following the outbreak, on May 2, 2009, it was reported in pigs at a farm in Alberta, Canada, with a link to the outbreak in Mexico. The pigs are suspected to have caught this new strain of virus from a farm worker who recently returned from Mexico, then showed symptoms of an influenza-like illness.[42] These are probable cases, pending confirmation by laboratory testing.

The new strain was initially described as apparent reassortment of at least four strains of influenza A virus subtype H1N1, including one strain endemic in humans, one endemic in birds, and two endemic in swine.[43] Subsequent analysis suggested it was a reassortment of just two strains, both found in swine.[3] Although initial reports identified the new strain as swine influenza (ie, a zoonosis originating in swine), its origin is unknown. Several countries took precautionary measures to reduce the chances for a global pandemic of the disease.[44]

Transmission

Transmission between pigs

Influenza is quite common in pigs, with about half of breeding pigs having been exposed to the virus in the US.[45] Antibodies to the virus are also common in pigs in other countries.[45]

The main route of transmission is through direct contact between infected and uninfected animals.[15] These close contacts are particularly common during animal transport. Intensive farming may also increase the risk of transmission, as the pigs are raised in very close proximity to each other.[46][47] The direct transfer of the virus probably occurs either by pigs touching noses, or through dried mucus. Airborne transmission through the aerosols produced by pigs coughing or sneezing are also an important means of infection.[15] The virus usually spreads quickly through a herd, infecting all the pigs within just a few days.[2] Transmission may also occur through wild animals, such as wild boar, which can spread the disease between farms.[48]

Transmission to humans

People who work with poultry and swine, especially people with intense exposures, are at increased risk of zoonotic infection with influenza virus endemic in these animals, and constitute a population of human hosts in which zoonosis and reassortment can co-occur.[49] Vaccination of these workers against influenza and surveillance for new influenza strains among this population may therefore be an important public health measure.[50] Transmission of influenza from swine to humans who work with swine was documented in a small surveillance study performed in 2004 at the University of Iowa.[51] This study among others forms the basis of a recommendation that people whose jobs involve handling poultry and swine be the focus of increased public health surveillance.[49] Other professions at particular risk of infection are veterinarians and meat processing workers, although the risk of infection for both of these groups is lower than that of farm workers.[52]

Interaction with avian H5N1 in pigs

Pigs are unusual as they can be infected with influenza strains that usually infect three different species: pigs, birds and humans.[53] This makes pigs a host where influenza viruses might exchange genes, producing new and dangerous strains.[53] Avian influenza virus H3N2 is endemic in pigs in China and has been detected in pigs in Vietnam, increasing fears of the emergence of new variant strains.[54] H3N2 evolved from H2N2 by antigenic shift.[55] In August 2004, researchers in China found H5N1 in pigs.[56]

Main symptoms of swine flu in swines.[2]

These H5N1 infections may be quite common: in a survey of 10 apparently healthy pigs housed near poultry farms in West Java, where avian flu had broken out, five of the pig samples contained the H5N1 virus. The Indonesian government has since found similar results in the same region. Additional tests of 150 pigs outside the area were negative.[57][58]

Signs and symptoms

In swine

In pigs influenza infection produces fever, lethargy, sneezing, coughing, difficulty breathing and decreased appetite.[15] In some cases the infection can cause abortion. Although mortality is usually low (around 1-4%),[2] the virus can produce weight loss and poor growth, causing economic loss to farmers.[15] Infected pigs can lose up to 12 pounds of body weight over a 3 to 4 week period.[15]

In humans

Main symptoms of swine flu in humans[59]

Direct transmission of a swine flu virus from pigs to humans is occasionally possible (called zoonotic swine flu). In all, 50 cases are known to have occurred since the first report in medical literature in 1958, which have resulted in a total of six deaths.[60] Of these six people, one was pregnant, one had leukemia, one had Hodgkin disease and two were known to be previously healthy.[60] Despite these apparently low numbers of infections, the true rate of infection may be higher, since most cases only cause a very mild disease, and will probably never be reported or diagnosed.[60]

According to the Centers for Disease Control and Prevention (CDC), in humans the symptoms of the 2009 "swine flu" H1N1 virus are similar to those of influenza and of influenza-like illness in general. Symptoms include fever, cough, sore throat, body aches, headache, chills and fatigue. The 2009 outbreak has shown an increased percentage of patients reporting diarrhea and vomiting.[61] The 2009 H1N1 virus is not zoonotic swine flu, as it is not transmitted from pigs to humans, but from person to person.

Because these symptoms are not specific to swine flu, a differential diagnosis of probable swine flu requires not only symptoms but also a high likelihood of swine flu due to the person's recent history. For example, during the 2009 swine flu outbreak in the United States, CDC advised physicians to "consider swine influenza infection in the differential diagnosis of patients with acute febrile respiratory illness who have either been in contact with persons with confirmed swine flu, or who were in one of the five U.S. states that have reported swine flu cases or in Mexico during the 7 days preceding their illness onset."[62] A diagnosis of confirmed swine flu requires laboratory testing of a respiratory sample (a simple nose and throat swab).[62]

Prevention

Prevention of swine influenza has three components: prevention in swine, prevention of transmission to humans, and prevention of its spread among humans.

Prevention in swine

Methods of preventing the spread of influenza among swine include facility management, herd management, and vaccination. Because much of the illness and death associated with swine flu involves secondary infection by other pathogens, control strategies that rely on vaccination may be insufficient.

Control of swine influenza by vaccination has become more difficult in recent decades, as the evolution of the virus has resulted in inconsistent responses to traditional vaccines. Standard commercial swine flu vaccines are effective in controlling the infection when the virus strains match enough to have significant cross-protection, and custom (autogenous) vaccines made from the specific viruses isolated are created and used in the more difficult cases.[63][64] Present vaccination strategies for SIV control and prevention in swine farms typically include the use of one of several bivalent SIV vaccines commercially available in the United States. Of the 97 recent H3N2 isolates examined, only 41 isolates had strong serologic cross-reactions with antiserum to three commercial SIV vaccines. Since the protective ability of influenza vaccines depends primarily on the closeness of the match between the vaccine virus and the epidemic virus, the presence of nonreactive H3N2 SIV variants suggests that current commercial vaccines might not effectively protect pigs from infection with a majority of H3N2 viruses.[65][66] The United States Department of Agriculture researchers say that while pig vaccination keeps pigs from getting sick, it does not block infection or shedding of the virus.[67]

Facility management includes using disinfectants and ambient temperature to control virus in the environment. The virus is unlikely to survive outside living cells for more than two weeks, except in cold (but above freezing) conditions, and it is readily inactivated by disinfectants.[2] Herd management includes not adding pigs carrying influenza to herds that have not been exposed to the virus. The virus survives in healthy carrier pigs for up to 3 months and can be recovered from them between outbreaks. Carrier pigs are usually responsible for the introduction of SIV into previously uninfected herds and countries, so new animals should be quarantined.[45] After an outbreak, as immunity in exposed pigs wanes, new outbreaks of the same strain can occur.[2]

Prevention in humans

Prevention of pig to human transmission

Swine can be infected by both avian and human influenza strains of influenza, and therefore are hosts where the antigenic shifts can occur that create new influenza strains.

The transmission from swine to human is believed to occur mainly in swine farms where farmers are in close contact with live pigs. Although strains of swine influenza are usually not able to infect humans this may occasionally happen, so farmers and veterinarians are encouraged to use a face mask when dealing with infected animals. The use of vaccines on swine to prevent their infection is a major method of limiting swine to human transmission. Risk factors that may contribute to swine-to-human transmission include smoking and not wearing gloves when working with sick animals.[68]

Prevention of human to human transmission

Influenza spreads between humans through coughing or sneezing and people touching something with the virus on it and then touching their own nose or mouth.[69] Swine flu cannot be spread by pork products, since the virus is not transmitted through food.[69] The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can remain contagious for up to ten days. Diagnosis can be made by sending a specimen, collected during the first five days for analysis.[70]

Recommendations to prevent spread of the virus among humans include using standard infection control against influenza. This includes frequent washing of hands with soap and water or with alcohol-based hand sanitizers, especially after being out in public.[71] Although the current trivalent influenza vaccine is unlikely to provide protection against the new 2009 H1N1 strain,[72] vaccines against the new strain are being developed and could be ready as early as June 2009.[73]

Experts agree that hand-washing can help prevent viral infections, including ordinary influenza and the swine flu virus. Influenza can spread in coughs or sneezes, but an increasing body of evidence shows small droplets containing the virus can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the mouth, nose or eyes. Alcohol-based gel or foam hand sanitizers work well to destroy viruses and bacteria. Anyone with flu-like symptoms such as a sudden fever, cough or muscle aches should stay away from work or public transportation and should contact a doctor to be tested.

Social distancing is another tactic. It means staying away from other people who might be infected and can include avoiding large gatherings, spreading out a little at work, or perhaps staying home and lying low if an infection is spreading in a community. Public health and other responsible authorities have action plans which may request or require social distancing actions depending on the severity of the outbreak.

Treatment

In swine

As swine influenza is rarely fatal to pigs, little treatment beyond rest and supportive care is required.[45] Instead veterinary efforts are focused on preventing the spread of the virus throughout the farm, or to other farms.[15] Vaccination and animal management techniques are most important in these efforts. Antibiotics are also used to treat this disease, which although they have no effect against the influenza virus, do help prevent bacterial pneumonia and other secondary infections in influenza-weakened herds.[74]

In humans

If a person becomes sick with swine flu, antiviral drugs can make the illness milder and make the patient feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms). Beside antivirals, palliative care, at home or in hospital, focuses on controlling fevers and maintaining fluid balance. The U.S. Centers for Disease Control and Prevention recommends the use of Tamiflu (oseltamivir) or Relenza (zanamivir) for the treatment and/or prevention of infection with swine influenza viruses, however, the majority of people infected with the virus make a full recovery without requiring medical attention or antiviral drugs.[75] The virus isolates in the 2009 outbreak have been found resistant to amantadine and rimantadine.[76]

In the U.S., on April 27, 2009, the FDA issued Emergency Use Authorizations to make available Relenza and Tamiflu antiviral drugs to treat the swine influenza virus in cases for which they are currently unapproved. The agency issued these EUAs to allow treatment of patients younger than the current approval allows and to allow the widespread distribution of the drugs, including by non-licensed volunteers.[77]

Notes

^ International Committee on Taxonomy of Viruses. "The Universal Virus Database, version 4: Influenza A". http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/00.046.0.01.htm.  

^ a b c d e f g "Swine influenza". The Merck Veterinary Manual. 2008. http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/121407.htm. Retrieved on April 30, 2009.  

^ a b V Trifonov, H Khiabanian, B Greenbaum, R Rabadan (30 April 2009). "The origin of the recent swine influenza A(H1N1) virus infecting humans". Eurosurveillance 4 (17). http://www.eurosurveillance.org/images/dynamic/EE/V14N17/art19193.pdf.  

^ a b Maria Zampaglione (April 29, 2009). "Press Release: A/H1N1 influenza like human illness in Mexico and the USA: OIE statement". World Organisation for Animal Health. http://www.oie.int/eng/press/en_090427.htm. Retrieved on April 29, 2009.  

^ Swine influenza World Health Organization 27 April 2009

^ "Influenza A(H1N1) frequently asked questions". Who.int. http://www.who.int/csr/disease/swineflu/faq/en/index.html. Retrieved on 2009-05-07.  

^ Heinen PP (15 September 2003). "Swine influenza: a zoonosis". Veterinary Sciences Tomorrow. ISSN 1569-0830. http://www.vetscite.org/publish/articles/000041/print.html. "Influenza B and C viruses are almost exclusively isolated from man, although influenza C virus has also been isolated from pigs and influenza B has recently been isolated from seals.".  

^ Bouvier NM, Palese P (September 2008). "The biology of influenza viruses". Vaccine 26 Suppl 4: D49-53. PMID 19230160.  

^ Kimura H, Abiko C, Peng G, et al (April 1997). "Interspecies transmission of influenza C virus between humans and pigs". Virus Res. 48 (1): 71-9. PMID 9140195. http://linkinghub.elsevier.com/retrieve/pii/S0168-1702(96)01427-X.  

^ a b Matsuzaki Y, Sugawara K, Mizuta K, et al (February 2002). "Antigenic and genetic characterization of influenza C viruses which caused two outbreaks in Yamagata City, Japan, in 1996 and 1998". J. Clin. Microbiol. 40 (2): 422-9. PMID 11825952. PMC: 153379. http://jcm.asm.org/cgi/pmidlookup?view=long&pmid=11825952.  

^ Lynch JP, Walsh EE (April 2007). "Influenza: evolving strategies in treatment and prevention". Semin Respir Crit Care Med 28 (2): 144-58. doi:10.1055/s-2007-976487. PMID 17458769.  

^ a b c "Swine Influenza". Swine Diseases (Chest). Iowa State University College of Veterinary Medicine. http://www.vetmed.iastate.edu/departments/vdpam/swine/diseases/chest/swineinfluenza/.  

^ Shin JY, Song MS, Lee EH, Lee YM, Kim SY, Kim HK, Choi JK, Kim CJ, Webby RJ, Choi YK (2006). "Isolation and characterization of novel H3N1 swine influenza viruses from pigs with respiratory diseases in Korea". Journal of Clinical Microbiology 44 (11): 3923-7. doi:10.1128/JCM.00904-06. PMID 16928961.  

^ Ma W, Vincent AL, Gramer MR, Brockwell CB, Lager KM, Janke BH, Gauger PC, Patnayak DP, Webby RJ, Richt JA (26 December 2007). "Identification of H2N3 influenza A viruses from swine in the United States". Proc Nat Acad Sci USA 104 (52): 20949-54. doi:10.1073/pnas.0710286104. PMID 18093945. PMC: 2409247. http://www.pnas.org/content/104/52/20949.full.  

^ a b c d e f g Kothalawala H, Toussaint MJ, Gruys E (June 2006). "An overview of swine influenza". Vet Q 28 (2): 46-53. PMID 16841566.  

^ Yassine HM, Al-Natour MQ, Lee CW, Saif YM (November 2007). "Interspecies and intraspecies transmission of triple reassortant H3N2 influenza A viruses". Virol J 28 (4): 129. doi:10.1186/1743-422X-4-129. PMID 18045494.  

^ "Swine influenza A (H1N1) infection in two children --- Southern California, March--April 2009". Morbidity and Mortality Weekly Report. Centers for Disease Control. 22 April 2009. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5815a5.htm.  

^ a b c Knobler S, Mack A, Mahmoud A, Lemon S, ed. "1: The Story of Influenza". The Threat of Pandemic Influenza: Are We Ready? Workshop Summary (2005). Washington, D.C.: The National Academies Press. p. 75.  

^ a b Olsen CW (May 2002). "The emergence of novel swine influenza viruses in North America". Virus Research 85 (2): 199-210. PMID 12034486. http://linkinghub.elsevier.com/retrieve/pii/S0168170202000278.  

^ "Soft evidence and hard sell". New York Times. 5 September 1976. http://select.nytimes.com/gst/abstract.html?res=F10914FA3E5E14768FDDAC0894D1405B868BF1D3&scp=9&sq=Swine+Flu+epidemic&st=p.  

^ a b c Taubenberger JK, Morens DM (2006). "1918 Influenza: the mother of all pandemics". Emerg Infect Dis 12 (1): 15-22. PMID 16494711. http://www.cdc.gov/ncidod/eid/vol12no01/05-0979.htm.  

^ "U.S. pork groups urge hog farmers to reduce flu risk". Reuters. 26 April 2009. http://www.reuters.com/article/latestCrisis/idUSN26488473.  

^ Heinen, P. (2003), "Swine influenza: a zoonosis", Veterinary Sciences Tomorrow: 1-11, http://www.vetscite.org/publish/articles/000041/print.html, retrieved on 2009-05-04  

^ Kay RM, Done SH, Paton DJ (August 1994). "Effect of sequential porcine reproductive and respiratory syndrome and swine influenza on the growth and performance of finishing pigs". Vet. Rec. 135 (9): 199-204. PMID 7998380.  

^ Vana G, Westover KM (June 2008). "Origin of the 1918 Spanish influenza virus: a comparative genomic analysis". Molecular Phylogenetics and Evolution 47 (3): 1100-10. doi:10.1016/j.ympev.2008.02.003. PMID 18353690.  

^ Antonovics J, Hood ME, Baker CH (April 2006). "Molecular virology: was the 1918 flu avian in origin?". Nature 440 (7088): E9; discussion E9-10. doi:10.1038/nature04824. PMID 16641950.  

^ a b Gaydos JC, Top FH, Hodder RA, Russell PK (January 2006). "Swine influenza a outbreak, Fort Dix, New Jersey, 1976". Emerging Infectious Diseases 12 (1): 23-8. PMID 16494712. http://www.cdc.gov/ncidod/EID/vol12no01/05-0965.htm.  

^ Schmeck, Harold M. (March 25, 1976). "Ford Urges Flu Campaign To Inoculate Entire U.S.". The New York Times. http://select.nytimes.com/gst/abstract.html?res=F50A17FD3C5A167493C7AB1788D85F428785F9.  

^ Richard E. Neustadt and Harvey V. Fineberg. (1978). The Swine Flu Affair: Decision-Making on a Slippery Disease. National Academies Press.

^ "The Last Great Swine Flu Epidemic", Salon.com, April 28, 2009.

^ Vellozzi C, Burwen DR, Dobardzic A, Ball R, Walton K, Haber P (March 2009). "Safety of trivalent inactivated influenza vaccines in adults: Background for pandemic influenza vaccine safety monitoring". Vaccine 27 (15): 2114-2120. doi:10.1016/j.vaccine.2009.01.125. PMID 19356614.  

^ Haber P, Sejvar J, Mikaeloff Y, Destefano F (2009). "Vaccines and Guillain-Barré syndrome". Drug Saf 32 (4): 309-23. doi:10.2165/00002018-200932040-00005 (inactive 2009-04-26). PMID 19388722.  

^ "Influenza / Flu Vaccine". University of Illinois at Springfield. http://www.uis.edu/healthservices/immunizations/influenzavaccine.html. Retrieved on 26 April 2009.  

^ BBC: The World; April 28, 2009.

^ "Key Facts About Swine Flu (CDC)". Cdc.gov. http://www.cdc.gov/swineflu/key_facts.htm. Retrieved on 2009-05-07.  

^ Jason George (April 28, 2009). "Swine flu: Last U.S. swine flu death in 1988 in Wisconsin". Chicago Tribune. http://www.chicagotribune.com/news/local/chi-wisconsin-swine-fluapr28,0,1940041.story.  

^ Stephanie Desmon (April 28, 2009). "Expert: Swine flu virus more complex than typically seen". Baltimore Sun. http://www.baltimoresun.com/news/health/bal-swine-flu-strain0428,0,3165467.story.  

^ "Pork industry is blurring the science of swine flu - Short Sharp Science". New Scientist. http://www.newscientist.com/blogs/shortsharpscience/2009/04/why-the-pork-industry-hates-th.html. Retrieved on 2009-05-07.  

^ "Swine flu: The predictable pandemic? - 29 April 2009". New Scientist. http://www.newscientist.com/article/mg20227063.800-swine-flu-the-predictable-pandemic.html?full=true. Retrieved on 2009-05-07.  

^ "DA probes reported swine flu 'outbreak' in N. Ecija". Gmanews.tv. http://www.gmanews.tv/story/56805/DA-probes-reported-swine-flu-outbreak-in-N-Ecija. Retrieved on 2009-04-25.  

^ "Gov't declares hog cholera alert in Luzon". Gmanews.tv. http://www.gmanews.tv/story/53014/Govt-declares-hog-cholera-alert-in-Luzon. Retrieved on 2009-04-25.  

^ "An Alberta Swine Herd Investigated for H1N1 Flu Virus". The Canadian Food Inspection Agency. May 2, 2009. http://www.inspection.gc.ca/english/corpaffr/newcom/2009/20090502e.shtml. Retrieved on 2009-05-03.  

^ "Deadly new flu virus in US and Mexico may go pandemic". New Scientist. 2009-04-24. http://www.newscientist.com/article/dn17025-deadly-new-flu-virus-in-us-and-mexico-may-go-pandemic.html. Retrieved on 2009-04-26.  

^ "World takes drastic steps to contain swine flu". 30 April 2009. http://news.yahoo.com/s/ap/20090430/ap_on_he_me/eu_swine_flu_drastic_measures.  

^ a b c d "Influenza Factsheet". Center for Food Security and Public Health, Iowa State University. http://www.cfsph.iastate.edu/Factsheets/pdfs/influenza.pdf.  

^ Gilchrist MJ, Greko C, Wallinga DB, Beran GW, Riley DG, Thorne PS (February 2007). "The potential role of concentrated animal feeding operations in infectious disease epidemics and antibiotic resistance". Environ. Health Perspect. 115 (2): 313-6. doi:10.1289/ehp.8837. PMID 17384785.  

^ Saenz RA, Hethcote HW, Gray GC (2006). "Confined animal feeding operations as amplifiers of influenza". Vector Borne Zoonotic Dis. 6 (4): 338-46. doi:10.1089/vbz.2006.6.338. PMID 17187567.  

^ Vicente, J.; Leon-vizcaino, L.; Gortazar, C.; Jose Cubero, M.; Gonzalez, M.; Martin-atance, P. (2002), "Antibodies to selected viral and bacterial pathogens in European wild boars from southcentral Spain", Journal of wildlife diseases 38 (3): 649, http://www.jwildlifedis.org/cgi/reprint/38/3/649.pdf, retrieved on 2009-05-02  

^ a b Gray GC, Kayali G (April 2009). "Facing pandemic influenza threats: the importance of including poultry and swine workers in preparedness plans". Poultry Science 88 (4): 880-4. doi:10.3382/ps.2008-00335. PMID 19276439.  

^ Gray GC, Trampel DW, Roth JA (May 2007). "Pandemic influenza planning: shouldn't swine and poultry workers be included?". Vaccine 25 (22): 4376-81. doi:10.1016/j.vaccine.2007.03.036. PMID 17459539.  

^ Gray GC, McCarthy T, Capuano AW, Setterquist SF, Olsen CW, Alavanja MC (December 2007). "Swine workers and swine influenza virus infections". Emerging Infectious Diseases 13 (12): 1871-8. PMID 18258038. http://www.cdc.gov/eid/content/13/12/1871.htm.  

^ Myers KP, Olsen CW, Setterquist SF, et al (January 2006). "Are swine workers in the United States at increased risk of infection with zoonotic influenza virus?". Clin. Infect. Dis. 42 (1): 14-20. doi:10.1086/498977. PMID 16323086.  

^ a b Thacker E, Janke B (February 2008). "Swine influenza virus: zoonotic potential and vaccination strategies for the control of avian and swine influenzas". J. Infect. Dis. 197 Suppl 1: S19-24. doi:10.1086/524988. PMID 18269323.  

^ Yu, H. (March 2008). "Genetic evolution of swine influenza A (H3N2) viruses in China from 1970 to 2006". Journal of Clinical Microbiology 46 (3): 1067. doi:10.1128/JCM.01257-07. PMID 18199784. http://jcm.asm.org/cgi/content/full/46/3/1067?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=phylogenetic&searchid=1&FIRSTINDEX=230&resourcetype=HWFIG.  

^ Lindstrom Stephen E, Cox Nancy J, Klimov Alexander (15 October 2004). "Genetic analysis of human H2N2 and early H3N2 influenza viruses, 1957-1972: evidence for genetic divergence and multiple reassortment events". Virology 328 (1): 101-19. doi:10.1016/j.virol.2004.06.009. PMID 15380362.  

^ World Health Organization (28 October 2005). "H5N1 avian influenza: timeline" (PDF). http://www.who.int/csr/disease/avian_influenza/Timeline_28_10a.pdf.  

^ "Indonesian pigs have avian flu virus; bird cases double in China". University of Minnesota: Center for Infectious Disease Research & Policy. 27 May 2005. http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/may2705avflu.html. Retrieved on 2009-04-26.  

^ "H5N1 virus may be adapting to pigs in Indonesia". University of Minnesota: Center for Infectious Disease Research & Policy. 31 March 2009. http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/mar3109swine-jw.html. Retrieved on 2009-04-26.   report on pigs as carriers.

^ "Centers for Disease Control and Prevention > Key Facts about Swine Influenza (Swine Flu)". http://www.cdc.gov/swineflu/key_facts.htm. Retrieved on April 27 2009.  

^ a b c Myers KP, Olsen CW, Gray GC (April 2007). "Cases of swine influenza in humans: a review of the literature". Clin. Infect. Dis. 44 (8): 1084-8. doi:10.1086/512813. PMID 17366454. PMC: 1973337. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17366454.  

^ "Swine Flu and You". CDC. 2009-04-26. http://www.cdc.gov/swineflu/swineflu_you.htm. Retrieved on 2009-04-26.  

^ a b Centers for Disease Control and Prevention (April 26, 2009). "CDC Health Update: Swine Influenza A (H1N1) Update: New Interim Recommendations and Guidance for Health Directors about Strategic National Stockpile Materiel". Health Alert Network. http://www.cdc.gov/swineflu/HAN/042609.htm. Retrieved on April 27, 2009.  

^ "Swine flu virus turns endemic". National Hog Farmer. 15 September 2007. http://nationalhogfarmer.com/mag/swine_flu_virus_endemic/.  

^ "Swine". Custom Vaccines. Novartis. http://www.livestock.novartis.com/cv_swine.html.  

^ Gramer Marie René, Lee Jee Hoon, Choi Young Ki, Goyal Sagar M, Joo Han Soo (July 2007). "Serologic and genetic characterization of North American H3N2 swine influenza A viruses". Canadian Journal of Veterinary Research 71 (3): 201-206. PMID 1899866. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1899866.  

^ Myers KP, Olsen CW, Gray GC (April 2007). "Cases of swine influenza in humans: a review of the literature". Clin Infect Dis 44 (8): 1084-8. doi:10.1086/512813. PMID 17366454.  

^ "Swine flu: The predictable pandemic?". 2009-04-29. http://www.newscientist.com/article/mg20227063.800-swine-flu-the-predictable-pandemic.html?full=true/.  

^ Ramirez A, Capuano AW, Wellman DA, Lesher KA, Setterquist SF, Gray GC (June 2006). "Preventing zoonotic influenza virus infection". Emerging Infect. Dis. 12 (6): 996-1000. PMID 16707061. PMC: 1673213. http://www.cdc.gov/ncidod/eid/vol12no06/05-1576.htm.  

^ a b "Q & A: Key facts about swine influenza (swine flu) - Spread of Swine Flu". Centers for Disease Control and Prevention. 24 April 2009. http://www.cdc.gov/swineflu/key_facts.htm. Retrieved on 2009-04-26.  

^ "Q & A: Key facts about swine influenza (swine flu) - Diagnosis". Centers for Disease Control and Prevention. 24 April 2009. http://www.cdc.gov/swineflu/key_facts.htm. Retrieved on 2009-04-26.  

^ "CDC - Influenza (Flu) | Swine Influenza (Flu) Investigation". Cdc.gov. http://cdc.gov/swineflu/investigation.htm. Retrieved on 2009-04-27.  

^ "Q & A: Key facts about swine influenza (swine flu) - Virus Strains". Centers for Disease Control and Prevention. 24 April 2009. http://www.cdc.gov/swineflu/key_facts.htm. Retrieved on 2009-04-26.  

^ Lauren Petty (April 28, 2009). "Swine Flu Vaccine Could Be Ready in 6 Weeks". NBC Connecticut. http://www.nbcconnecticut.com/news/local/CT-Company-Making-Swine-Flu-Vaccine.html. Retrieved on April 28, 2009.  

^ "Influenza Factsheet". Center for Food Security and Public Health, Iowa State University. http://www.cfsph.iastate.edu/Factsheets/pdfs/influenza.pdf.  

^ "www.who.int/csr/disease/swineflu/faq/en/index.html". http://www.who.int/csr/disease/swineflu/faq/en/index.html.  

^ "Antiviral Drugs and Swine Influenza". Centers for Disease Control. http://www.cdc.gov/swineflu/antiviral_swine.htm. Retrieved on 2009-04-27.  

^ "''FDA Authorizes Emergency Use of Influenza Medicines, Diagnostic Test in Response to Swine Flu Outbreak in Humans.'' FDA News, April 27, 2009". Fda.gov. 2009-04-27. http://www.fda.gov/bbs/topics/NEWS/2009/NEW02002.html. Retrieved on 2009-05-07.  

Avian Influenza General Information

Source: US Department of Health and Human Services

Avian Influenza (Bird Flu)

Avian Flu in Birds is Spreading in Asia and Other Countries

  • Avian influenza - commonly called "bird flu" - is an infection caused by influenza viruses that occur naturally in birds.
  • Wild birds can carry the viruses, but usually do not get sick from them. However, some domesticated birds, including chickens, ducks, and turkeys, can become infected, often fatally
  • One strain of avian influenza (bird flu), the H5N1 virus, is endemic in much of Asia and has recently spread into Europe. Avian H5N1 infections have recently killed poultry and other birds in a number of countries.
  • Strains of avian H5N1 influenza may infect various types of animals, including wild birds, pigs, and tigers.
  • Symptoms in birds and other animals vary, but virulent strains can cause death within a few days.

Avian H5N1 Flu in Humans is Currently Very Limited and Not a Pandemic

  • Human H5N1 influenza infection was first recognized in 1997 when this virus infected 18 people in Hong Kong, causing 6 deaths.
  • The World Health Organization is tracking the number of human cases of the H5N1virus. See http://www.pandemicflu.gov/#map, for a map showing the nations with confirmed human cases and the number of cases.
  • Currently, close contact with infected poultry has been the primary source for human infection. Though rare, there have been isolated reports of human-to-human transmission of the virus.
  • Genetic studies confirm that the influenza A virus H5N1 mutates rapidly. Should it adapt to allow easy human-to-human transmission, a pandemic could ensue - it has not done so to date.
  • At this time, it is uncertain whether the currently circulating H5N1 virus will lead to a global disease outbreak in humans - a pandemic.
  • The reported symptoms of avian influenza (bird flu) in humans have ranged from typical influenza-like symptoms (e.g. fever, cough, sore throat, and muscle aches) to eye infections (conjunctivitis), acute respiratory distress, viral pneumonia and other severe, life-threatening complications.

Preventing and Treating Avian Flu or Bird Flu in Humans

  • Vaccines to protect humans against H5N1 viruses currently are under development. In addition, research is underway on methods to make large quantities of vaccine more quickly.
  • So far, research suggests that two antiviral medicines, Oseltamavir (Tamiflu(r)) and Zanamavir (Relenza(r)), may be useful treatments for H5N1 avian influenza. However, H5N1 viruses are generally resistant to two other available antiviral medications, amantadine and rimantadine, so they cannot be used to treat avian flu.

What's Happening Now?

A pandemic is a global disease outbreak. A flu pandemic occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no vaccine. The disease spreads easily person-to-person, causes serious illness, and can sweep across the country and around the world in very short time.

It is difficult to predict when the next influenza pandemic will occur or how severe it will be. Wherever and whenever a pandemic starts, everyone around the world is at risk. Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it.

Health professionals are concerned that the continued spread of a highly pathogenic avian H5N1 virus across eastern Asia and other countries represents a significant threat to human health. The H5N1 virus has raised concerns about a potential human pandemic because:

  • It is especially virulent
  • It is being spread by migratory birds
  • It can be transmitted from birds to mammals and in some limited circumstances to humans, and
  • Like other influenza viruses, it continues to evolve.

Since 2003, a growing number of human H5N1 cases have been reported in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey, and Vietnam. More than half of the people infected with the H5N1 virus have died. Most of these cases are all believed to have been caused by exposure to infected poultry. There has been no sustained human-to-human transmission of the disease, but the concern is that H5N1 will evolve into a virus capable of human-to-human transmission.

Avian Influenza Viruses

Avian (bird) flu is caused by influenza A viruses that occur naturally among birds. There are different subtypes of these viruses because of changes in certain proteins (hemagglutinin [HA] and neuraminidase [NA]) on the surface of the influenza A virus and the way the proteins combine.

Each combination represents a different subtype. All known subtypes of influenza A viruses can be found in birds. The avian flu currently of concern is the H5N1 subtype.

Avian Influenza in Birds

Wild birds worldwide carry avian influenza viruses in their intestines, but usually do not get sick from them. Avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.

Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry, or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.

Avian influenza or bird flu infection in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The "low pathogenic" form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the highly pathogenic form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100%, often within 48 hours. The H5N1 virus is highly pathogenic.

Human Infection with Avian Influenza Viruses

"Human influenza virus" usually refers to those subtypes that spread widely among humans. There are only three known A subtypes of influenza viruses (H1N1, H1N2, and H3N2) currently circulating among humans. It is likely that some genetic parts of current human influenza A viruses originally came from birds. Influenza A viruses are constantly changing, and other strains might adapt over time to infect and spread among humans.

The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. H5N1 is one of the few avian influenza viruses to have crossed the species barrier to infect humans, and it is the most deadly of those that have crossed the barrier.

Most cases of H5N1 influenza infection in humans have resulted from contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretion/excretions from infected birds.

So far, the spread of H5N1 virus from person to person has been limited and has not continued beyond one person. Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another.

In the current outbreaks in Asia, Europe, and Africa, more than half of those infected with the H5N1 virus have died. Most cases have occurred in previously healthy children and young adults. However, it is possible that the only cases currently being reported are those in the most severely ill people, and that the full range of illness caused by the H5N1 virus has not yet been defined.

Symptoms of avian influenza (bird flu) in humans have ranged from typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which virus caused the infection.

Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If H5N1 bird flu virus were to gain the capacity to spread easily from person to person, a pandemic (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.

Vaccination and Treatment for H5N1 Virus in Humans

There currently is no commercially available vaccine to protect humans against H5N1 virus that is being seen in Asia, Europe, and Africa. A pandemic vaccine cannot be produced until a new pandemic influenza virus emerges and is identified.

The U.S. Department of Health and Human Services (HHS), through its National Institute of Allergy and Infectious Diseases (NIAID), is addressing the problem in a number of ways. These include the development of pre-pandemic vaccines based on current lethal strains of H5N1, collaboration with industry to increase the Nation's vaccine production capacity, and seeking ways to expand or extend the existing supply. We are also doing research in the development of new types of influenza vaccines.

Studies done in laboratories suggest that some of the prescription medicines approved in the United States for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to demonstrate the effectiveness of these medicines.

The H5N1 virus (bird flu) that has caused human illness and death in Asia is resistant to Amantadine and Rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, Oseltamavir and Zanamavir, would probably work to treat influenza caused by H5N1 virus, but additional studies still need to be done to demonstrate their effectiveness.

What would be the Impact of a Pandemic?

A pandemic may come and go in waves, each of which can last for six to eight weeks.

An especially severe influenza pandemic could lead to high levels of illness, death, social disruption, and economic loss. Everyday life would be disrupted because so many people in so many places become seriously ill at the same time. Impacts can range from school and business closings to the interruption of basic services such as public transportation and food delivery.

A substantial percentage of the world's population will require some form of medical care. Health care facilities can be overwhelmed, creating a shortage of hospital staff, beds, ventilators and other supplies. Surge capacity at non-traditional sites such as schools may need to be created to cope with demand.

The need for vaccine is likely to outstrip supply and the supply of antiviral drugs is also likely to be inadequate early in a pandemic. Difficult decisions will need to be made regarding who gets antiviral drugs and vaccines.

Death rates are determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations and the availability and effectiveness of preventive measures.

What You Should Know About Avian Flu

Avian influenza in birds

Avian influenza is an infection caused by avian (bird) influenza (flu) viruses. These influenza viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.

Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated secretions or excretions or with surfaces that are contaminated with secretions or excretions from infected birds. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry, or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.

Infection with avian influenza viruses in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The "low pathogenic" form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the highly pathogenic form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100% often within 48 hours.

Human infection with avian influenza viruses

There are many different subtypes of type A influenza viruses. These subtypes differ because of changes in certain proteins on the surface of the influenza A virus (hemagglutinin [HA] and neuraminidase [NA] proteins). There are 16 known HA subtypes and 9 known NA subtypes of influenza A viruses. Many different combinations of HA and NA proteins are possible. Each combination represents a different subtype. All known subtypes of influenza A viruses can be found in birds.

Usually, "avian influenza virus" refers to influenza A viruses found chiefly in birds, but infections with these viruses can occur in humans. The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. However, confirmed cases of human infection from several subtypes of avian influenza infection have been reported since 1997. Most cases of avian influenza infection in humans have resulted from contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretion/excretions from infected birds. The spread of avian influenza viruses from one ill person to another has been reported very rarely, and transmission has not been observed to continue beyond one person.

"Human influenza virus" usually refers to those subtypes that spread widely among humans. There are only three known A subtypes of influenza viruses (H1N1, H1N2, and H3N2) currently circulating among humans. It is likely that some genetic parts of current human influenza A viruses came from birds originally. Influenza A viruses are constantly changing, and they might adapt over time to infect and spread among humans.

During an outbreak of avian influenza among poultry, there is a possible risk to people who have contact with infected birds or surfaces that have been contaminated with secretions or excretions from infected birds.

Symptoms of avian influenza in humans have ranged from typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which virus caused the infection.

Studies done in laboratories suggest that some of the prescription medicines approved in the United States for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to demonstrate the effectiveness of these medicines.

More information

Source: Center for Disease Control and Prevention

Avian Influenza A (H5N1)

Influenza A (H5N1) virus - also called "H5N1 virus" - is an influenza A virus subtype that occurs mainly in birds, is highly contagious among birds, and can be deadly to them. H5N1 virus does not usually infect people, but infections with these viruses have occurred in humans. Most of these cases have resulted from people having direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces.

Human health risks during the H5N1 outbreak

Of the few avian influenza viruses that have crossed the species barrier to infect humans, H5N1 has caused the largest number of detected cases of severe disease and death in humans. However, it is possible that those cases in the most severely ill people are more likely to be diagnosed and reported, while milder cases go unreported.

Of the human cases associated with the ongoing H5N1 outbreaks in poultry and wild birds in Asia and parts of Europe, the Near East and Africa, more than half of those people reported infected with the virus have died. Most cases have occurred in previously healthy children and young adults and have resulted from direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces. In general, H5N1 remains a very rare disease in people. The H5N1 virus does not infect humans easily, and if a person is infected, it is very difficult for the virus to spread to another person.

While there has been some human-to-human spread of H5N1, it has been limited, inefficient and unsustained. For example, in 2004 in Thailand, probable human-to-human spread in a family resulting from prolonged and very close contact between an ill child and her mother was reported. Most recently, in June 2006, WHO reported evidence of human-to-human spread in Indonesia. In this situation, 8 people in one family were infected. The first family member is thought to have become ill through contact with infected poultry. This person then infected six family members. One of those six people (a child) then infected another family member (his father). No further spread outside of the exposed family was documented or suspected.

Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If H5N1 virus were to gain the capacity to spread easily from person to person, an influenza pandemic (worldwide outbreak of disease) could begin.

No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia and Europe very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.

Treatment and vaccination for H5N1 virus in humans

The H5N1 virus that has caused human illness and death in Asia is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, Oseltamavir and Zanamavir, would probably work to treat influenza caused by H5N1 virus, but additional studies still need to be done to demonstrate their effectiveness.

There currently is no commercially available vaccine to protect humans against H5N1 virus that is being seen in Asia and Europe. However, vaccine development efforts are taking place. Research studies to test a vaccine to protect humans against H5N1 virus began in April 2005, and a series of clinical trials is under way.

Ten things you need to know about pandemic influenza

Source: World Health Organization

1. Pandemic influenza is different from avian influenza

Avian influenza refers to a large group of different influenza viruses that primarily affect birds. On rare occasions, these bird viruses can infect other species, including pigs and humans. The vast majority of avian influenza viruses do not infect humans. An influenza pandemic happens when a new subtype emerges that has not previously circulated in humans.

For this reason, avian H5N1 is a strain with pandemic potential, since it might ultimately adapt into a strain that is contagious among humans. Once this adaptation occurs, it will no longer be a bird virus--it will be a human influenza virus. Influenza pandemics are caused by new influenza viruses that have adapted to humans.

2. Influenza pandemics are recurring events

An influenza pandemic is a rare but recurrent event. Three pandemics occurred in the previous century: "Spanish influenza" in 1918, "Asian influenza" in 1957, and "Hong Kong influenza" in 1968. The 1918 pandemic killed an estimated 40-50 million people worldwide. That pandemic, which was exceptional, is considered one of the deadliest disease events in human history. Subsequent pandemics were much milder, with an estimated 2 million deaths in 1957 and 1 million deaths in 1968.

A pandemic occurs when a new influenza virus emerges and starts spreading as easily as normal influenza - by coughing and sneezing. Because the virus is new, the human immune system will have no pre-existing immunity. This makes it likely that people who contract pandemic influenza will experience more serious disease than that caused by normal influenza.

3. The world may be on the brink of another pandemic

Health experts have been monitoring a new and extremely severe influenza virus - the H5N1 strain - for almost eight years. The H5N1 strain first infected humans in Hong Kong in 1997, causing 18 cases, including six deaths. Since mid-2003, this virus has caused the largest and most severe outbreaks in poultry on record. In December 2003, infections in people exposed to sick birds were identified.

Since then, over 100 human cases have been laboratory confirmed in four Asian countries (Cambodia, Indonesia, Thailand, and Viet Nam), and more than half of these people have died. Most cases have occurred in previously healthy children and young adults. Fortunately, the virus does not jump easily from birds to humans or spread readily and sustainably among humans. Should H5N1 evolve to a form as contagious as normal influenza, a pandemic could begin.

4. All countries will be affected

Once a fully contagious virus emerges, its global spread is considered inevitable. Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it. The pandemics of the previous century encircled the globe in 6 to 9 months, even when most international travel was by ship. Given the speed and volume of international air travel today, the virus could spread more rapidly, possibly reaching all continents in less than 3 months.

5. Widespread illness will occur

Because most people will have no immunity to the pandemic virus, infection and illness rates are expected to be higher than during seasonal epidemics of normal influenza. Current projections for the next pandemic estimate that a substantial percentage of the world's population will require some form of medical care. Few countries have the staff, facilities, equipment, and hospital beds needed to cope with large numbers of people who suddenly fall ill.

6. Medical supplies will be inadequate

Supplies of vaccines and antiviral drugs - the two most important medical interventions for reducing illness and deaths during a pandemic - will be inadequate in all countries at the start of a pandemic and for many months thereafter. Inadequate supplies of vaccines are of particular concern, as vaccines are considered the first line of defence for protecting populations. On present trends, many developing countries will have no access to vaccines throughout the duration of a pandemic.

7. Large numbers of deaths will occur

Historically, the number of deaths during a pandemic has varied greatly. Death rates are largely determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations, and the effectiveness of preventive measures. Accurate predictions of mortality cannot be made before the pandemic virus emerges and begins to spread. All estimates of the number of deaths are purely speculative.

WHO has used a relatively conservative estimate - from 2 million to 7.4 million deaths - because it provides a useful and plausible planning target. This estimate is based on the comparatively mild 1957 pandemic. Estimates based on a more virulent virus, closer to the one seen in 1918, have been made and are much higher. However, the 1918 pandemic was considered exceptional.

8. Economic and social disruption will be great

High rates of illness and worker absenteeism are expected, and these will contribute to social and economic disruption. Past pandemics have spread globally in two and sometimes three waves. Not all parts of the world or of a single country are expected to be severely affected at the same time. Social and economic disruptions could be temporary, but may be amplified in today's closely interrelated and interdependent systems of trade and commerce. Social disruption may be greatest when rates of absenteeism impair essential services, such as power, transportation, and communications.

9. Every country must be prepared

WHO has issued a series of recommended strategic actions for responding to the influenza pandemic threat. The actions are designed to provide different layers of defence that reflect the complexity of the evolving situation. Recommended actions are different for the present phase of pandemic alert, the emergence of a pandemic virus, and the declaration of a pandemic and its subsequent international spread.

10. WHO will alert the world when the pandemic threat increases

WHO works closely with ministries of health and various public health organizations to support countries' surveillance of circulating influenza strains. A sensitive surveillance system that can detect emerging influenza strains is essential for the rapid detection of a pandemic virus.

Six distinct phases have been defined to facilitate pandemic preparedness planning, with roles defined for governments, industry, and WHO. The present situation is categorized as phase 3: a virus new to humans is causing infections, but does not spread easily from one person to another.

Questions & Answers - Swine Influenza and You (Source www.cdc.gov)

What is swine flu?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs. People do not normally get swine flu, but human infections can and do happen. Swine flu viruses have been reported to spread from person-to-person, but in the past, this transmission was limited and not sustained beyond three people.

Are there human infections with swine flu in the U.S.?
In late March and early April 2009, cases of human infection with swine influenza A (H1N1) viruses were first reported in Southern California and near San Antonio, Texas. Other U.S. states have reported cases of swine flu infection in humans and cases have been reported internationally as well. An updated case count of confirmed swine flu infections in the United States is kept at http://www.cdc.gov/swineflu/investigation.htm CDC and local and state health agencies are working together to investigate this situation.

Is this swine flu virus contagious?
CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

What are the signs and symptoms of swine flu in people?
The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

How does swine flu spread?
Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How can someone with the flu infect someone else?
Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

What should I do to keep from getting the flu?
First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.

Are there medicines to treat swine flu?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).

How long can an infected person spread swine flu to others?
People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk and then touches their own eyes, mouth or nose before washing their hands.

How long can viruses live outside the body?
We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Frequent handwashing will help you reduce the chance of getting contamination from these common surfaces.

What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:

* Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
* Avoid touching your eyes, nose or mouth. Germs spread this way.
* Try to avoid close contact with sick people.
* If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.

What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.

What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water. or clean with alcohol-based hand cleaner. we recommend that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.

What should I do if I get sick?
If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.

If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children emergency warning signs that need urgent medical attention include:

* Fast breathing or trouble breathing
* Bluish skin color
* Not drinking enough fluids
* 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
* Fever with a rash

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

How serious is swine flu infection?
Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Between 2005 until January 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring. However, swine flu infection can be serious. In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later. A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death.

Can I get swine influenza from eating or preparing pork?
No. Swine influenza viruses are not spread by food. You cannot get swine influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe.

Key Facts About Swine Flu

What is Swine Influenza?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of influenza in pigs. Swine flu viruses cause high levels of illness and low death rates in pigs. Swine influenza viruses may circulate among swine throughout the year, but most outbreaks occur during the late fall and winter months similar to outbreaks in humans. The classical swine flu virus (an influenza type A H1N1 virus) was first isolated from a pig in 1930.

How many swine flu viruses are there?
Like all influenza viruses, swine flu viruses change constantly. Pigs can be infected by avian influenza and human influenza viruses as well as swine influenza viruses. When influenza viruses from different species infect pigs, the viruses can reassort (i.e. swap genes) and new viruses that are a mix of swine, human and/or avian influenza viruses can emerge. Over the years, different variations of swine flu viruses have emerged. At this time, there are four main influenza type A virus subtypes that have been isolated in pigs: H1N1, H1N2, H3N2, and H3N1. However, most of the recently isolated influenza viruses from pigs have been H1N1 viruses.
Swine Flu in Humans

Can humans catch swine flu?
Swine flu viruses do not normally infect humans. However, sporadic human infections with swine flu have occurred. Most commonly, these cases occur in persons with direct exposure to pigs (e.g. children near pigs at a fair or workers in the swine industry). In addition, there have been documented cases of one person spreading swine flu to others. For example, an outbreak of apparent swine flu infection in pigs in Wisconsin in 1988 resulted in multiple human infections, and, although no community outbreak resulted, there was antibody evidence of virus transmission from the patient to health care workers who had close contact with the patient.
How common is swine flu infection in humans?
In the past, CDC received reports of approximately one human swine influenza virus infection every one to two years in the U.S., but from December 2005 through February 2009, 12 cases of human infection with swine influenza have been reported.

What are the symptoms of swine flu in humans?
The symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea.

Can people catch swine flu from eating pork?
No. Swine influenza viruses are not transmitted by food. You can not get swine influenza from eating pork or pork products. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 160°F kills the swine flu virus as it does other bacteria and viruses.

How does swine flu spread?
Influenza viruses can be directly transmitted from pigs to people and from people to pigs. Human infection with flu viruses from pigs are most likely to occur when people are in close proximity to infected pigs, such as in pig barns and livestock exhibits housing pigs at fairs. Human-to-human transmission of swine flu can also occur. This is thought to occur in the same way as seasonal flu occurs in people, which is mainly person-to-person transmission through coughing or sneezing of people infected with the influenza virus. People may become infected by touching something with flu viruses on it and then touching their mouth or nose.

What do we know about human-to-human spread of swine flu?
In September 1988, a previously healthy 32-year-old pregnant woman was hospitalized for pneumonia and died 8 days later. A swine H1N1 flu virus was detected. Four days before getting sick, the patient visited a county fair swine exhibition where there was widespread influenza-like illness among the swine.

In follow-up studies, 76% of swine exhibitors tested had antibody evidence of swine flu infection but no serious illnesses were detected among this group. Additional studies suggest that one to three health care personnel who had contact with the patient developed mild influenza-like illnesses with antibody evidence of swine flu infection.
How can human infections with swine influenza be diagnosed?
To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 10 days or longer. Identification as a swine flu influenza A virus requires sending the specimen to CDC for laboratory testing.

What medications are available to treat swine flu infections in humans?
There are four different antiviral drugs that are licensed for use in the US for the treatment of influenza: amantadine, rimantadine, oseltamivir and zanamivir. While most swine influenza viruses have been susceptible to all four drugs, the most recent swine influenza viruses isolated from humans are resistant to amantadine and rimantadine. At this time, CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with swine influenza viruses.

What other examples of swine flu outbreaks are there?
Probably the most well known is an outbreak of swine flu among soldiers in Fort Dix, New Jersey in 1976. The virus caused disease with x-ray evidence of pneumonia in at least 4 soldiers and 1 death; all of these patients had previously been healthy. The virus was transmitted to close contacts in a basic training environment, with limited transmission outside the basic training group. The virus is thought to have circulated for a month and disappeared. The source of the virus, the exact time of its introduction into Fort Dix, and factors limiting its spread and duration are unknown. The Fort Dix outbreak may have been caused by introduction of an animal virus into a stressed human population in close contact in crowded facilities during the winter. The swine influenza A virus collected from a Fort Dix soldier was named A/New Jersey/76 (Hsw1N1).
Is the H1N1 swine flu virus the same as human H1N1 viruses?
No. The H1N1 swine flu viruses are antigenically very different from human H1N1 viruses and, therefore, vaccines for human seasonal flu would not provide protection from H1N1 swine flu viruses.
Swine Flu in Pigs

How does swine flu spread among pigs?
Swine flu viruses are thought to be spread mostly through close contact among pigs and possibly from contaminated objects moving between infected and uninfected pigs. Herds with continuous swine flu infections and herds that are vaccinated against swine flu may have sporadic disease, or may show only mild or no symptoms of infection.

What are signs of swine flu in pigs?
Signs of swine flu in pigs can include sudden onset of fever, depression, coughing (barking), discharge from the nose or eyes, sneezing, breathing difficulties, eye redness or inflammation, and going off feed.

How common is swine flu among pigs?
H1N1 and H3N2 swine flu viruses are endemic among pig populations in the United States and something that the industry deals with routinely. Outbreaks among pigs normally occur in colder weather months (late fall and winter) and sometimes with the introduction of new pigs into susceptible herds. Studies have shown that the swine flu H1N1 is common throughout pig populations worldwide, with 25 percent of animals showing antibody evidence of infection. In the U.S. studies have shown that 30 percent of the pig population has antibody evidence of having had H1N1 infection. More specifically, 51 percent of pigs in the north-central U.S. have been shown to have antibody evidence of infection with swine H1N1. Human infections with swine flu H1N1 viruses are rare. There is currently no way to differentiate antibody produced in response to flu vaccination in pigs from antibody made in response to pig infections with swine H1N1 influenza.

While H1N1 swine viruses have been known to circulate among pig populations since at least 1930, H3N2 influenza viruses did not begin circulating among US pigs until 1998. The H3N2 viruses initially were introduced into the pig population from humans. The current swine flu H3N2 viruses are closely related to human H3N2 viruses.

Is there a vaccine for swine flu?
Vaccines are available to be given to pigs to prevent swine influenza. There is no vaccine to protect humans from swine flu. The seasonal influenza vaccine will likely help provide partial protection against swine H3N2, but not swine H1N1 viruses.

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