Human Swine Influenza, frequently asked questions

[NicNak]

Public Health Agency of Canada
April 26th, 2009

General Information
For more information, please contact : 1-800-454-8302

Fact Sheet Human Swine Influenza

Surveillance
Human swine influenza has been reported in Canada, Mexico and the United States. The Public Health Agency of Canada (PHAC) is working collaboratively with Mexican and American officials to further investigate this situation.

Governments around the world and the World Health Organization are engaged to investigate and address this situation.

Six cases of human swine influenza have been reported in Canada to date. As of April 26th, 2009

PHAC continues to work with federal, provincial and international governments to address this situation, and will share more information with Canadians as it becomes available.

Frequently Asked Questions

I have heard that people are becoming sick with swine influenza. What is it?
Human swine influenza has been reported in Canada, Mexico and the United States.

Swine influenza (sometimes called swine flu) is a strain of the influenza virus that usually affects pigs, but which may also make people sick.

Human swine influenza is a respiratory illness that causes symptoms similar to those of the regular human seasonal flu. The symptoms include fever, fatigue, lack of appetite, coughing and sore throat. Some people with human swine influenza have also reported vomiting and diarrhea.

How can an influenza virus spread from pigs to people?
Different strains of influenza are commonly circulating in our environment, including strains that can cause illness in humans, birds and pigs.

Sometimes, humans and animals can pass strains of flu back and forth to one another through direct close contact - such as in pig production barns and livestock exhibits at fairs. For people in close contact with pigs, the recommendations to avoid infection are the same as for regular seasonal influenza – frequent handwashing, getting an annual flu shot, covering coughs and sneezes, and staying home when ill.

When a swine influenza virus does affect a human, there is also a risk that the animal influenza can mutate and then spread directly between humans.

Is human swine influenza contagious? How does it spread between people?
Yes, this virus is contagious. Since some of the people who have become ill in the United States and Mexico have not been in direct contact with pigs, we know that the virus has spread from person to person.

More investigation is needed on how easily the virus spreads between people, but it is believed that it is spread the same way as regular seasonal influenza.

Influenza and other respiratory infections are transmitted from person to person when germs enter the nose and/or throat. Coughs and sneezes release germs into the air where they can be breathed in by others. Germs can also rest on hard surfaces like counters and doorknobs, where they can be picked up on hands and transmitted to the respiratory system when someone touches their mouth and/or nose.

What can I do to protect myself from infection?
The Public Health Agency advises Canadians to:

• Wash hands thoroughly with soap and warm water, or use hand sanitizer
• Cough and sneeze in your arm or sleeve
• Get your annual flu shot
• Keep doing what you normally do, but stay home if sick
• Check www.fightflu.ca for more information
• Check www.voyage.gc.ca for travel notices and advisories
• Talk to a health professional if you experience severe flu-like symptoms

Why are people concerned about this particular strain?
The strain of human swine influenza (H1N1) reported in Canada, Mexico and the United States is a new, or novel, influenza virus.

Since this is a new strain, people will likely have no natural immunity to protect against the virus. International experts are concerned that this strain could spread quickly. Investigation is underway to learn more about the way the virus spreads. Governments around the world and the World Health Organization are engaged to investigate and address this situation.

Are all cases of human swine influenza severe?
No. The cases of human swine influenza reported in Canada and in the United States were milder than those reported in Mexico. All of the cases reported to date in Canada and the U.S. have recovered. The cases reported in Mexico have been more severe, involving mostly healthy young people who rapidly progressed from mild illness to severe respiratory distress, within an average of five days.

Now that human swine influenza cases have been detected in Canada, what additional steps will the Government of Canada take to contain the virus?
Our primary goal is to slow the spread of the disease.

A number of steps are involved in doing this:

• Surveillance is being increased and frontline health care workers are actively looking for and reporting positive cases.
• Health care workers have been provided with detailed advice on how to manage suspect and/or confirmed cases.
• If they are needed, antiviral medications from Canada’s stockpile will be used both to treat active illness and to prevent onset of illness in people close to the affected patient – this is called “prophylaxis”.

Does the Government of Canada recommend the closing of schools, and other gathering places to limit the spread of the virus?
In Canada, decisions about school closures are made by local authorities and under certain circumstances, this may be advisable. PHAC recommends that people who are sick stay at home to reduce the risk of spreading infection. If this influenza virus spreads, people may want to avoid crowds to decrease the chance of exposure.

Should Canadians take any extra measures like wearing surgical masks to avoid catching human swine influenza?
Canadians should continue to take normal precautions to protect themselves as they would from a regular flu. While we are investigating to learn more about how this virus spreads, our best advice is for Canadians to wash their hands frequently, cover coughs and sneezes, and stay home when ill.

The Public Health Agency of Canada does not recommend that members of the general public wear surgical masks to protect against contracting human swine influenza. Evidence shows that this is not effective in preventing transmission of influenza in the general public. People often use masks incorrectly, or contaminate them when putting them on and taking them off, which could actually increase the risk of infection.

I have heard that World Health Organization (WHO) has declared a public health emergency. What does this mean for Canada?
The Government of Canada has already engaged measures to step up vigilance against this disease, including increased surveillance and sharing of information – which have been recommended by WHO through this declaration.

What measures will be taken internationally to slow the spread of disease?

• If necessary, travel advisories will be issued recommending that people avoid non-essential travel to affected areas.
• Internationally, the level of surveillance will increase.
• Quarantine officers are stationed in airports, at the Halifax, Montreal and Vancouver Port, and at borders and will detain individuals with symptoms of illness so that they can be assessed.

How are antiviral medications made available if needed?
Antiviral medications are prescription drugs. Initially, they may be obtained from a pharmacy with a regular prescription.

There is a national stockpile of antiviral medication, and some provinces and territories also have their own stockpiles. Every province and territory has access to the national stockpile and antivirals have been distributed on a per-capita basis.

Will the antivirals work against this strain of human swine influenza?
Laboratory tests from the first cases indicate that this strain of human swine influenza is susceptible to the antivirals we have in the stockpiles.

If this develops into a pandemic, how long will it take for Canada to develop a vaccine to protect against it?
Canada has a plan for a vaccine to be produced domestically if a pandemic occurs. Once the virus is identified, it takes about six months for an effective vaccine to be developed and tested. Enough pandemic vaccine will be produced to cover all Canadians.

What is the difference between an antiviral and a vaccine?
Antivirals are drugs used for the prevention and early treatment of influenza. If taken shortly after getting sick (within 48 hours), they can reduce influenza symptoms, shorten the length of illness and potentially reduce the serious complications of influenza.

Antivirals work by reducing the ability of the virus to reproduce but do not provide immunity against the virus. The human swine influenza H1N1 can be treated with two different antivirals, osletamavir (Tamiflu) and zanamivri (Relenza).

A vaccine is any preparation intended to produce immunity to a disease by stimulating the production of antibodies. Vaccines are the primary means to prevent illness and death from influenza. They stimulate the production of antibodies against the flu virus components included in the vaccine, providing immunity against the virus.

In order to provide the best protection, a vaccine must be tailored to fight off specific strains of influenza.

I got my flu shot this year. Will it protect me against human swine influenza?
This year’s annual influenza immunization, or flu shot, protects against the human strain of H1N1 influenza. The human swine influenza H1N1 strain is different than the human strain. It is unlikely that the seasonal flu shot will provide protection against human swine influenza. The flu shot will protect against the seasonal flu, which is still circulating in Mexico.

What protection will the Government of Canada offer to healthcare workers to protect against human swine influenza?
Healthcare workers will need to practice frequent hand washing. When in close contact with affected patients, healthcare workers will use added safeguards such as wearing masks and eye protection.

Should people be avoiding exposure to pigs?
In this case, we know that this human swine influenza (H1N1) is spreading between humans – not directly from pigs to people. As a result, there is little increased risk from proximity to pigs.

However, because humans can also spread the disease to pigs, individuals with influenza symptoms should avoid close contact with pigs to reduce the possibility of further disease transmission in the animal population.

Government officials are conducting investigations to find out more about how this particular strain of human swine influenza spreads.

Is this the next influenza pandemic?
It is too soon to know. Pandemic influenza is defined as a new influenza virus that spreads easily between humans and affects a wide geographic area. In this case, more investigation and information is needed to determine how easily the virus spreads. This investigation is ongoing.

Are all pandemics severe?
No. An influenza pandemic may be mild or severe. An influenza pandemic means the virus is spread easily between humans, and affects a wide geographic area. A pandemic influenza does not necessarily cause more severe illness.

I have plans to travel to Mexico (or the Southern United States). Should I cancel my trip?
No travel restrictions have been issued, but the Public Health Agency of Canada has issued some travel advice

When travelling to affected areas, do the same things you would normally do to protect yourself and others during normal flu season. Wash your hands, cover coughs and sneezes, stay in if you are sick and get an annual influenza immunization (flu shot).

Even though the annual flu shot many not protect against the human swine influenza, there is still seasonal influenza circulating in Mexico and the flu shot will help protect you from contracting the seasonal human flu.

If I have travelled to Mexico and/or California or Texas and I’m feeling sick, what should I do?
If you have travelled to Mexico, California or Texas and you become sick with flu-like symptoms - especially respiratory symptoms such as, fever and cough or difficulty breathing - see your doctor and tell him or her that you have recently travelled to those areas.

What should I do if I get sick while I am travelling?
If you develop symptoms while you are travelling, seek care from local health care professionals.

What should I do if I feel sick when I am supposed to fly or travel by train or bus?
If you have symptoms of illness, see a doctor before boarding an airplane or other forms of public transportation. If you become sick while at the airport, consult airport officials before boarding the airplane.

Are all the influenza-like-illnesses reported in Mexico linked to the human swine influenza?
No. Mexico’s flu season is peaking later than usual this year. Seasonal Influenza A and B are still being reported in Mexico.

What is being done to make sure that people who are travelling do not spread the virus?
Federal Quarantine officers are stationed in airports, at the Halifax, Montreal and Vancouver Ports, and at borders and will detain individuals with symptoms of illness when departing or arriving in Canada so that they can be assessed.

However, people may not have symptoms until later. If this happens, they should contact their health care professional to discuss their symptoms and travel history.

Can I catch swine influenza from eating pork?
No. Proper cooking of pork products would kill any viruses. Make sure pork is cooked through, not pink in the middle. Use a food thermometer to confirm pork has been heated through to 71 degrees Celsius (160 degrees Fahrenheit).

 

[Jackie]

I heard it may be in the U.K. to, not sure there was something on the news. Anyway good post, loads of information. Thanks NicnaK.

 

[suewatters1]

I hope I won't have to take a vaccination for the Swine flu

A vaccine is any preparation intended to produce immunity to a disease by stimulating the production of antibodies. Vaccines are the primary means to prevent illness and death from influenza. They stimulate the production of antibodies against the flu virus components included in the vaccine, providing immunity against the virus.

Because of the flu shot and how it's stimulates the antibodies is why I got CIDP Chronic Inflammatory Demyelinating Polyneuropathy.

So hopefully the swine flu will not spread to much.

Sue

 

[texasgirl]

I read this morning that they have closed 14 schools in Texas this past week.
Tamiflu does work apparently if caught early enough. The U.S. has released its stockpile as well. FYI.

TG

 

[David Baxter PhD]

I hope I won't have to take a vaccination for the Swine flu

Because of the flu shot and how it's stimulates the antibodies is why I got CIDP Chronic Inflammatory Demyelinating Polyneuropathy.

Making a statement like that is at best premature.

1. The cause of CIDP is currently unknown.

2. There have been suggestions anectdotally of a link between certain vaccines and CIDP but this has never been established or confirmed.

3. The progression of CIDP is that an autoimmune response (which is necessary to fight of infection) goes awry and begins to attack the myelin sheath, the fatty insulating substance that surrounds and protects nerve cells.

4. There doesn't seem to be anything specific or unusual about flu vaccines in general or the swine flu vaccine in particular that is likely to make them "the cause" of CIDP.

You're not the first person to make this claim, of course, but my concern is that spreading an unsubstantiated claim like this (similar to the claim that certain vaccinations cause autism, which has been repeatedly shown to be false but doesn't stop people from freamongering by making that claim) may deter people from obtaining vaccinations that may save their lives.

Even if it were proven that swine flu causes CIDP (which is not the case and is unlikely to ever be the case), the condition is very rare and most people recover from the condition, while on the other hand death from various types of influenza is not rare at all. That's why flu vaccinations are so important and why these unsubstantiated rumors about links to other diseases or conditions are so dangerous.

 

[suewatters1]

I understand DR Baxter. Nobody is really 100% sure why people get CIDP

The reason I felt the flu shot gave me the Disease because there is a small risk of getting Guillian Barre syndrome from a flu shot and that is posted on the manufactures website. Since CIDP is the Chronic version of it and my symptoms started after receiving the flu shot well I assume it was the flu shot that gave it to me. Now my Neurologist doesn't want me getting any vaccination whatsoever.

I don't want to spread any rumors for sure. They told me the odds of getting it is 1 in 100,000. so very rare chance.
You are right I don't want to spread rumors just what I learn from other people and myself doing research on it.

Here is a part on the topic on a Canadian Government website.
STATEMENT ON INFLUENZA VACCINATION FOR THE 2003-2004 SEASON - CCDR Vol.29 ACS-4 - Public Health Agency of Canada

Guillain-Barr? syndrome (GBS) associated with influenza vaccination has been observed in a minority of influenza seasons over the last two decades. Apart from the 1976-1977 swine ?flu season, the risk of GBS associated with influenza vaccination is small. In a retrospective study of the 1992-93 and 1993-94 seasons in four U.S. states(48), the relative risk of GBS occurring within 6 weeks after influenza vaccination, adjusted for age and sex, was 1.7 (95% confidence intervals 1.0, 2.8; p = 0.04), suggesting slightly more than one additional case of GBS per million people vaccinated against influenza. In comparison, the morbidity and mortality associated with influenza are much greater.

In Canada the background incidence of GBS was estimated at just over 20 cases per million population in a study done in Ontario and Quebec(49). A variety of infectious agents, such as Campylobacter jejuni, have been associated with GBS. It is not known whether influenza virus infection itself is associated with GBS, or whether influenza vaccination is causally associated with increased risk of recurrent GBS in people with a previous history of GBS. Avoiding subsequent influenza vaccination of people known to have developed GBS within 6 to 8 weeks of a previous influenza vaccination appears prudent at this time.

 

[David Baxter PhD]

Again, with Guillain-Barr? Syndrome as with Chronic Inflammatory Demyelinating Polyneuropathy, the claimed link is anectdotal and correlational only.

To date, there is no evidence that a vaccination causes either condition. It is purely correlational and therefore speculative.

If I were to get hit by a car 3 weeks after getting a flu shot, would anyone be claiming that flu shots cause car accidents? Of course not.

That's both the weakness and the danger with drawing conclusions from such anectdotal correlational "links".

Note: I am not suggesting that you should not listen to and comply with advice given to you personally by your physicians. I am merely clarifying that the claims made to date about such hypothesized links are not (to date at least) supported by evidence and that they should not be a reason for other people failing to be vaccinated.

 

[Retired]

the morbidity and mortality associated with influenza are much greater

It is a matter of benefits vs risks, and the protective benefits against regular flu along with the risks associated with regular flu, based on available scientific evidence, outweigh the possible risks associated with the flu shots themselves.

In addition, as has been stated, practicing good hand hygiene, which means frequent hand washing for at least 20 seconds with warm water, soap and agitation, or the use of hand sanitizers after contact with public facilities prior to handling food or eating increases our protection against person to person transmission of viruses.

 

[Jackie]

There are now two confirmed cases in Scotland, its all over the national news.

 

[Retired]

US Declares Swine Flu Emergency

from WebMD ?

April 26, 2009 ? The U.S. government today declared the swine flu outbreak a public health emergency. Swine flu has sickened at least 20 people in the U.S., by the CDC's latest count.

"We are declaring today a public health emergency," Secretary of Homeland Security Janet Napolitano said today at a White House news briefing. That declaration is "standard operating procedure," Napolitano said. "It is similar to what we do when we see a hurricane approaching a site. The hurricane might not actually hit but allows you to take a number of preparatory steps. We really don't know ultimately what the size or seriousness of this outbreak is going to be."

As part of the emergency, the Department of Homeland Security is releasing 25% of stockpiled antivirals -- Tamiflu and Relenza -- to the states.
Here's what officials want you to do: Stay home if you're sick, avoid close contact with people who are sick, wash your hands often, avoid touching your eyes, nose, and mouth, cover your mouth or nose with a tissue when coughing or sneezing, and keep up with health information in your own community.

The CDC has gotten reports of lab-confirmed swine flu cases in eight people in New York City, seven people in California, two in Texas, two in Kansas, and one in Ohio.
All of those swine flu cases have been relatively mild, although one person was briefly hospitalized, according to Keiji Fukuda, MD, assistant director-general for health security and environment at the World Health Organization.

The eight swine flu cases in New York City involved students at Saint Francis Preparatory School in Queens. All have recovered fully, according to a news release from the New York City Department of Health and Mental Hygiene.

So far, U.S. cases of swine flu have been milder than those seen in Mexico, where the World Health Organization has confirmed that at least 20 people have died from swine flu; health officials are investigating dozens more deaths in Mexico.

More swine flu cases are likely in the U.S. as public health officials heighten their hunt for the new strain of swine flu virus, notes Anne Schuchat, MD, the CDC's interim deputy director for science and public health program. Her advice: Be prepared for the possibility that there may be severe cases, and even fatalities, in the U.S.

"I do fear that we will have deaths here," Schuchat said today at a news conference.

Countries around the world are watching for the virus, and scientists are scrambling to learn more about the virus and stop it before it becomes a pandemic.
Fukuda says the global health community is taking the swine flu threat "very seriously" but wants more information before deciding whether to raise the WHO's pandemic alert level from phase 3 to phase 4.
An influenza pandemic occurs when a new influenza type A virus emerges for which there is little or no immunity in the human population, begins to cause serious illness, and then spreads easily from person to person worldwide, according to background information from the U.S. Department of Health and Human Services.

The WHO has a scale ranging from phase 1 (low risk of a flu pandemic) to phase 6 (a full-blown pandemic is under way).

Swine Flu Symptoms
Symptoms of swine flu seen in U.S. patients so far have been "relatively nonspecific -- high fever, cough, sore throat, muscle aches, possibly vomiting and diarrhea in some numbers," says Schuchat.

The problem is, those symptoms aren't unique to swine flu.

They "can be caused by so many different things," Schuchat says, which makes it "impossible" for a patient to tell if they have swine flu, as opposed to another flu virus or a different illness.

"This is a dilemma, a challenge, we're wrestling with," says Schuchat. She encourages patients to use their judgment about whether they're sick enough to see a doctor, and to definitely do so if they've recently been to a high-risk area, such as Mexico.

Schuchat also notes that there have been cases of the virus spreading from person to person in the U.S. The two confirmed cases in Kansas are a husband and wife, one of whom traveled to Mexico. Two days after returning home, the spouse became ill, says Schuchat.

 

[SoSo]

There are now 4 confirmed cases in Ontario, Durham and York region. I was watching the news concerning the flu shots and they said it would do no good to get the flu shots now. I haven't had a flu shot since my cancer and the radiation treatment because the specialist advised against them at the time until my own immune system kicked in. I haven't had the flu in years. I get my final full body scan next Jan. As soon as I hear those wonderful words I have waited so long for, that there is no hurthle cell cancer left in my body, I am getting the shots again. I would not hesitate to get the flu shot unless advised by a fully qualified doctor not to. Good post and replies. We will all be wanting to get informed concerning this flu.
SoSo

 

[Retired]

Phases Of A Pandemic

The World Health Organization (WHO) has developed a global influenza preparedness plan that includes a classification system for guiding planning and response activities for an influenza pandemic.

This classification system is comprised of six phases of increasing public health risk associated with the emergence and spread of a new influenza virus subtype that may lead to a pandemic.

The Director General of WHO formally declares the current global pandemic phase and adjusts the phase level to correspond with pandemic conditions around the world.

For each phase, the global influenza preparedness plan identifies response measures WHO will take, and recommends actions that countries around the world should implement

See attachment

 

[Retired]

WHO raises pandemic flu alert level to phase 5

GENEVA (AP) ? The World Health Organization has raised its pandemic alert for swine flu to the second highest level, meaning that it believes a global outbreak of the disease is imminent.

WHO says the phase 5 alert means there is sustained human to human spread in at least two countries. It also signals that efforts to produce a vaccine will be ramped up.

WHO has confirmed human cases of swine flu in Mexico, the United States, Canada, Britain, Israel, New Zealand and Spain. Mexico and the U.S. have reported deaths.

WHO Director-General Margaret Chan made the decision Wednesday to raise the alert level from phase 4 ? signifying transmission in only one country ? after reviewing the latest scientific evidence on the outbreak.

THIS IS A BREAKING NEWS UPDATE. Check back soon for further information. AP's earlier story is below.

BERLIN (AP) ? The World Health Organization warned Wednesday that the swine flu outbreak is moving closer to becoming a pandemic, as the United States reported the first swine flu death outside of Mexico, and Germany and Austria became latest European nations hit by the disease.

In Geneva, WHO flu chief Dr. Keiji Fukuda told reporters that there was no evidence the virus was slowing down, moving the agency closer to raising its pandemic alert to phase 5, indicating widespread human-to-human transmission.

But he said the health body not yet ready to move the pandemic alert level up from its current level of 4, which means the virus is being passed among people. Phase 6 ? the highest in the scale ? is for a full-scale pandemic.

As fear and uncertainty about the disease ricocheted around the globe, nations took all sorts of precautions, some more useful than others.

Britain closed a school after a 12-year-old girl was found to have the disease. Egypt slaughtered all its pigs and the central African nation of Gabon became the latest nation to ban pork imports, despite assurances that swine flu was not related to eating pork.

Cuba eased its flight ban, deciding just to block flights coming in from Mexico. And Asian nations greeted returning airport travelers with teams of medical workers and carts of disinfectants, eager to keep swine flu from infecting their continent.

In Mexico City, the epicenter of the epidemic, the mayor said Wednesday the outbreak seemed to be stabilizing and he was considering easing the citywide shutdown that closed schools, restaurants, concert halls and sports arenas.

Swine flu is suspected of killing more than 150 people in Mexico and sickening over 2,400 there.

Dr. Richard Besser, the acting chief of the U.S. Centers for Disease Control and Prevention, said 91 cases have now been confirmed in 10 states, and health officials there reported Wednesday that a 23-month-old Mexican boy had died in Texas from the disease.

Across Europe, Germany confirmed three swine flu cases and Austria one, while the number of confirmed cases rose to five in Britain and ten in Spain.

WHO conducted a scientific review Wednesday to determine exactly what is known about how the disease spreads, how it affects human health and how it can be treated.

Dr. Nikki Shindo, a WHO flu expert, said the review would focus on the large trove of data coming from Mexico and from a school in New York City that has been hard-hit by the outbreak.

Germany's national disease control center, the Robert Koch Institute, said the country's three cases include a 22-year-old woman hospitalized in Hamburg, a man in his late 30s at a hospital in Regensburg, north of Munich, and a 37-year-old woman from another Bavarian town. All three had recently returned from Mexico.

Austria's health ministry said a 28-year-old woman who recently returned from a monthlong trip to Guatemala via Mexico City and Miami has the virus but is recovering.

British Prime Minister Gordon Brown said health officials were ordering extra medicine and "several million more" face masks to deal with the virus.

British media reports, citing an unidentified European surgical mask manufacturer, said the U.K. was seeking 32 million masks to protect its health workers from a possible pandemic.

"We've decided to build stocks of anti-virals, from 35 million to 50 million," Brown said, adding that the government had put in enhanced airport checks and was going to mail swine flu information leaflets to every household in Britain.

In addition to a couple in Scotland who got swine flu on their Mexican honeymoon, new British cases included a 12-year-old girl in the southwest English town of Torbay. Brown said her school had been closed as a precaution.

He said the other two cases were adults in London and in Birmingham. All three had visited Mexico, were receiving anti-viral drugs and were responding well to treatment, Brown said.

French President Nicolas Sarkozy met with Cabinet ministers to discuss swine flu and his health minister said France will ask the European Union to suspend flights to Mexico.

The U.S., the European Union and other countries have discouraged nonessential travel to Mexico. Cuba suspended all regular and charter flights from Mexico to the island but was still allowing airlines to return travelers to Mexico.

New Zealand's number of swine flu cases rose to 14, 13 of them among a school group that recently returned from Mexico. Officials say the swine flu strain infecting the students is the same as that in Mexico. All were responding well to antiviral drugs and in voluntary quarantine at home.

New Zealand has 44 other possible cases, with tests under way.

Mexico was taking drastic measures to fight the outbreak. It closed all archaeological sites and allowed restaurants in the capital to only serve takeout food in an aggressive bid to stop gatherings where the virus can spread. Schools remained closed until at least May 6.

A regional beach soccer championship in Mexico was postponed and all Mexican first-division soccer games this weekend will be played with no audiences. Cruise lines were avoiding Mexican ports and holiday tour groups are canceling holiday charter flights there.

The Philippine health chief appealed to dozens of Filipino legislators to abandon plans to visit Las Vegas to cheer for boxing idol Manny Pacquiao ? even though Las Vegas is more than 300 miles (480 kilometers) from the Mexican border.

Egypt's government ordered the slaughter of all pigs in the country as a precaution, though no swine flu cases have been reported there. Egypt's overwhelmingly Muslim population does not eat pork, but farmers raise up to 350,000 pigs for its Christian minority.

In Australia, officials were testing more than 100 people with flu symptoms for the virus and the government gave health authorities wide powers to contain contagious diseases.

"(We can make) sure that people are isolated and perhaps detained if they don't cooperate and are showing symptoms," said Health Minister Nicola Roxon.

 

[Retired]

Your swine flu questions answered

An epidemic of swine flu has recently developed in Mexico and the United States, says the CDC. Swine flu has killed many people in Mexico, and the outbreak has features that suggest it could become a global pandemic. A pandemic is an epidemic that spreads around the whole world. Pandemics also often cause more severe disease than epidemics.

As of Sunday, April 26, 2009 the United States has declared a public health emergency, and suspect or confirmed cases are being reported from many parts of the world. If a pandemic happens, it could be very serious for human health and the global economy (which definitely does not need any more bad news right now).

Q: What are ?swine flu? and ?bird flu??
A: Flu is a disease caused by the influenza virus. Humans, pigs, birds, and other animals all can be infected by influenza viruses. Typically, influenza viruses can infect only one species, so the influenza viruses of humans are different from those of pigs and birds. However, sometimes a virus can infect more than one species. For example, pigs sometimes can be infected not only with pig influenza viruses, but also with human and bird influenza viruses. Then these viruses can sidle up to one another and swap genes, creating new viruses that have a mix of genes?from human, pig, and bird viruses. That is what has happened with this new swine flu virus.
Sometimes this swapping of genes allows a virus that was originally able to infect only pigs or only birds to also infect humans. When that happens, we refer to the illness as ?swine flu? or ?bird flu.? This current virus could actually be called ?swine/bird flu,? since it has some genes from pig flu viruses and other genes from bird flu viruses. However, for simplicity's sake, it is just being referred to as ?swine flu.?

Q: Are swine flu or bird flu viruses dangerous?
A: Most viruses that cause swine flu or bird flu are very hard to pass from one human to another: they don?t cause epidemics. Sometimes, however, further changes in genes create a virus that can spread rapidly among humans, and can produce a more severe illness. One reason this illness is more severe is that the virus is so new. The regular flu that comes each year is caused by a regular human influenza virus that often has similarities to the viruses that have caused the flu in years past, so people have some degree of immunity to the latest virus. The unusual swine flu or bird flu viruses that develop the ability for person-to-person spread are so different that people have little or no immunity to them. That is what some experts worry may be happening with swine flu.

Q: How bad can a global pandemic be?
A: The worst global pandemic in modern times was the influenza pandemic of 1918 to 1919. It affected about a third of the human race, and killed at least 40 million people in less than a year?more than have been killed by AIDS in three decades. The world economy went into a deep recession. The average length of life dropped for 10 years. In other words, global pandemics can be a really big deal. On the other hand, other pandemics have been considerably less serious than the 1918 to 1919 influenza pandemic.

Q: Can this new swine flu virus be easily transmitted from person to person?
A: Unfortunately, the new swine flu virus can be transmitted between humans. It is not clear yet how easily it is transmitted, nor how it is transmitted. Almost surely it is transmitted by sneezing and coughing, and by skin-to-skin contact (like shaking hands or kissing) with an infected person.

Q: How sick do people get from this virus?
A: Most people infected with the virus have recovered from the illness. In fact, all of the people in the U.S. have recovered.
However, in Mexico, some people have kept getting sicker, and eventually died. The regular flu viruses that come each winter can occasionally cause severe illness and death. Most often, this happens in very young children or frail elderly people. What worries some experts is that many of the deaths in Mexico have been in young, healthy adults. In past pandemics, like the influenza pandemic of 1918 to 1919, it was also young, healthy people who were most likely to die. Experts are puzzled as to why the infection currently appears to be worse in Mexico than in the U.S.

Q: Are there treatments?
A: As of now, the new virus is killed by two antiviral medicines?oseltamivir and zanamivir. Based on experience with other flu viruses, treatment would be most effective if given within 2 days of the onset of symptoms. As long as this current swine flu virus is infecting people, it is likely that health authorities will recommend that people with more severe illness take these medicines.
On the other hand, there is no proven benefit from using the medicines before symptoms develop, and there is proven harm: unnecessary widespread use of these drugs could produce drug-resistant viruses.
There is no vaccine yet for the new virus, and the Centers for Disease Control and Prevention (CDC) has expressed doubt that this year?s regular flu vaccine will offer protection.

Q: How do I know if I?ve caught swine flu?
A: The initial symptoms of this flu virus are like those of the regular, annual flu viruses: fever, muscle aches, runny nose, and sore throat. Nausea, vomiting, and diarrhea may be more common with this swine flu than with the regular flu. If this epidemic hits your community and you develop flu-like symptoms, it is likely your doctor will take samples from your throat or material you cough up and send them to the state public health laboratory for testing.

Q: How do I protect myself?

A: To protect yourself from catching swine flu, take the same steps you would to prevent getting any cold or flu:

• Wash your hands or use alcohol-based hand cleaners frequently.
• When you greet people, don?t shake hands or exchange kisses.
• Avoid contact with people with flu symptoms.
• And to protect others, if you develop sneezing and coughing, be sure to use tissues to wipe your nose and cover your mouth, and to throw the tissues in the trash or toilet bowl.

Q: How long are people contagious?
A: Adults should be considered contagious until at least 7 days after the start of symptoms; with children, it may be 10 to 14 days.

Q: Can you get swine flu from eating pork?
A: Absolutely not. But, as you probably know, you need to cook pork thoroughly to avoid getting other illnesses that can be spread by undercooked meat.

Q: Will there be unusual restrictions on our lives if there is a global pandemic?
A: If there is a global pandemic, for some period of time governments may well restrict travel (indeed, some governments already have). Governments also may close schools and public places, require as many people as possible to work from home, tell any people who develop symptoms to isolate themselves at home, and tell people to seek medical attention immediately if more serious symptoms develop.
What are those symptoms?


For adults, teens, and kids aged 3 to 12, the most worrisome symptoms are:

• Shortness of breath
• Persistent vomiting
• Confusion
• Dizziness

For children younger than 2, the most worrisome symptoms are:

• Very rapid breathing
• Not interacting normally, not eating or drinking normally, being unusually irritable, or appearing unusually sleepy
• High fever and rash
• A bluish color of the lips and skin

Q: Where can I get more information?
A: For updated information from the CDC, go to: http://www.cdc.gov/swineflu or visit Harvard Health Publications? Flu Resource Center.

 

[David Baxter PhD]

I was actually listening to a discussion on the radio yesterday about exactly how WHO defines a pandemic. It sounds scarier than it really is, although that's partly because the potential range of seriousness is pretty large.

To be classifed as a pandemic, all you need to have is identified victims who contracted the disease from two or more geographical locations. We know of a number who contracted the disease in Mexico. If even a single case is identified where the victim contracted the disease from somewhere other than Mexico, we will have a pandemic by definition.

What does the WHO's pandemic scale mean? And why is anyone worried about this? : Aetiology

Does 7 deaths REALLY constitute a pandemic? Are we that wussy and panic-prone as a society that the WHO freaks out over a couple deaths from the freakin' flu?

This is what I was getting at with my comment on pandemic phases. The number of deaths don't matter--it's the transmission in the human population that's key. Let's look at their scale:

Phase 1-3 go from no animal viruses reported causing infections to humans up to the presence of a new animal or human-animal reassortant that's caused sporadic cases or small clusters of disease in people, but no sustained human-to-human transmission or community-level outbreaks.

Phase 4 signifies a new virus capable of causing community-level outbreaks. "Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion." This is where we were with the beginning of the outbreak in Mexico.

Phase 5 (and I'll quote directly from WHO here): characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short. This is the key--Phase 5 is a signal to governments to get their act together, because the **** is about to hit the fan.

Phase 6, then, is the full-blown pandemic phase. This has not been declared yet. Maybe we won't get to this, the individual outbreaks will burn themselves out, and we'll head back down to a 4 or even 3. But for now, we're still seeing cases increase, and the prudent thing to do is be careful and prepared. Weren't any of these nay-sayers ever Boy Scouts?

 

[SoSo]

This may seem like a dumb question, have tried to find the answer on the net, but here goes...does anyone know how safe is it to eat mushrooms right now as they are grown in pig manure, my parents used to live across the road from the mushroom farm, just wondered. I know mushrooms are suppose to be a good way to boost the immune system so have been eating a lot of them but stopped as soon as the swine flu story started. Wild mushrooms would be safe, if one knows what to pick but just wondering about farmed ones we buy at the grocery store.
SoSo:think:

 

[David Baxter PhD]

You can eat mushrooms and you can eat pork. You won't get the swine flu from either.

 

[suewatters1]

CTV.ca | H1N1 may have infected pigs on Alberta farm

CTV.ca News Staff

Health authorities say the H1N1 flu may have jumped from a farm worker to pigs in Alberta, in what could be the first case of human-to-animal transmission of the virus.

CTV News has confirmed that authorities believe the worker had returned to the farm from Mexico after contracting the disease, which was then passed on to the animals.

Dr. Neil Rau, an infectious diseases specialist, said the latest twist -- if true -- may not signal any added danger to humans.

"We know that eating pork is not the way in which we get this virus," he told CTV Newsnet. "All of the cases have been person-to-person transmissions, so even if this virus is in pigs, in terms of an immediate risk we have nothing to worry about."

But he urged long-term surveillance of pigs and other livestock, "to make sure something different isn't going on."

Scientists believe the H1N1 virus, or so-called "swine flu," has been passed from human to human for some time. But even though the virus contains swine flu genes, the World Health Organization says there is no evidence pigs are passing the disease to humans.

Canadian health authorities say the virus found in the Alberta pigs is the same strain of H1N1 found in human cases around the world.

Developing story...