Microsoft word - swine flu qa250409 _2_.doc
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,
Q2) How common and serious is swine flu infection in general?
Like seasonal flu, swine flu in humans can vary in severity from mild to severe.
Between 2005 until Jan 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.
Q3) Is this particular swine flu virus contagious in HUMAN?
CDC has determined that this swine influenza A (H1N1) virus is a new virus subtype
containing a combination of gene segments that "previously has not been reported
among swine or human influenza viruses." It is contagious and can spread from
Q4) What is the current situation in US and Mexico?
As of 26 April 2009, the United States Government has reported 20 laboratory
confirmed human cases of swine influenza A/H1N1 (8 in New York, 7 in California,
2 in Texas, 2 in Kansas and 1 in Ohio). All 20 cases have had mild Influenza-Like
Illness with only one requiring brief hospitalization. No deaths have been reported.
All 20 viruses have the same genetic pattern based on preliminary testing. The virus is
being described as a new subtype of A/H1N1 not previously detected in swine or
The Government of Mexico has reported three separate events. In the Federal District
of Mexico, surveillance began picking up cases of ILI (influenza –like illness) starting
18 March. The number of cases has risen steadily through April and as of 23 April
there are now more than 854 cases of pneumonia from the capital. Of those, 59 have
died. In San Luis Potosi, in central Mexico, 24 cases of ILI, with three deaths, have
been reported. And from Mexicali, near the border with the United States, four cases
of ILI, with no deaths, have been reported. Investigation is continuing to clarify the
spread and severity of the disease in Mexico. Suspect clinical cases have been
reported in 19 of the country's 32 states. As of 26 April, the Government of Mexico
has reported 18 laboratory confirmed cases of swine influenza A/H1N1.
On Saturday, 25 April, upon the advice of the Emergency Committee called under the
rules of the International Health Regulations, the Director-General declared this event
a Public Health Emergency of International Concern
It is likely that most of people, especially those who do not have regular contact with
pigs, do not have immunity to swine influenza viruses that can prevent the virus
infection. If a swine virus establishes efficient human-to human transmission, it can
cause an influenza pandemic. The impact of a pandemic caused by such a virus is
difficult to predict: it depends on virulence of the virus, existing immunity among
people, cross protection by antibodies acquired from seasonal influenza infection and
Q6) 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.
Q7) How long can an infected person spread swine flu to others?
People with swine influenza virus infection should be considered potentially
contagious as from 1 day prior to the onset of symptoms to up to 7 days following
illness onset. Children, especially younger children, might potentially be contagious
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 and
the spread of this swine influenza A (H1N1) virus is thought to be happening in the
same way that seasonal flu spreads; that is, mainly through coughing or sneezing and
sometimes through touching something with flu viruses on it and then touching their
Q9) 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.
Q10) 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 hand-washing will help you reduce
the chance of getting contamination from these common surfaces.
Q11) What would the doctor consider when I attend the clinic?
Clinicians would consider the possibility of swine influenza virus infections in
patients presenting with febrile respiratory illness who
1. Live in an area where human cases of swine influenza A (H1N1) has been
2. Have traveled to an area where human cases of swine influenza A (H1N1) has
3. Have been in contact with ill persons from these areas in the 7 days prior to
Q12) 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 might
require sending the specimen to relevant local health authority for laboratory testing.
Q13) Are there medicines to treat swine flu?
For the ongoing outbreak of the swine influenza infection in the United States and
Mexico, the national and the local authorities are recommending to use Oseltamivir
(Tamiflu) or Zanamivir (Relenza) for treatment of the disease based on the virus’s
susceptibility profile. These 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).
Q14) 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
Avoid close contact with people who are sick. When you are sick, keep your
distance from others to protect them from getting sick too.
If possible, stay home from work, school, and errands when you are sick. You will
help prevent others from catching your illness.
Cover your mouth and nose with a tissue when coughing or sneezing. It may
prevent those around you from getting sick.
Washing your hands often will help protect you from germs.
Avoid touching your eyes, nose or mouth.
Germs are often spread when a person touches something that is contaminated with
germs and then touches his or her eyes, nose, or mouth.
If used correctly, surgical face masks and N95 face mask can help prevent some
exposures, but they should be always used along with other preventive measures,
such as avoiding close contact and maintaining good hand hygiene.
Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids,
Q15) 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 20 seconds. When soap
and water are not available, alcohol-based disposable hand wipes or gel sanitizers
(containing 70% alcohol) 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.
Q16) What is the interim recommendation for facemask and N 95 masks?
When crowded settings or close contact with others cannot be avoided, the use of
facemasks or N95 masks in areas where transmission of swine influenza A (H1N1)
virus has been confirmed should be considered as follows:
1. Whenever possible, rather than relying on the use of facemasks or respirators,
close contact with people who might be ill and being in crowded settings
2. Surgical facemasks should be considered for use by individuals who enter
crowded settings, both to protect their nose and mouth from other people's
coughs and to reduce the wearers' likelihood of coughing on others; the time
spent in crowded settings should be as short as possible.
3. N95 facemask should be considered for use by individuals for whom close
contact with an infectious person is unavoidable. This can include selected
individuals who must care for a sick person (e.g., family member with a
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
Q18) What are the warning signs that require urgent medical attention?
In children emergency warning signs that need urgent medical attention include:
Being so irritable that the child does not want to be held
Flu-like symptoms improve but then return with fever and worse cough
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
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 NOT
provide protection against the swine H1N1 viruses.
Q20) I have not had the flu shot for 2009, can I get the flu vaccination for
In general, the seasonal flu vaccination is recommended for the prophylaxis of human
flu (NOT swine flu), especially in the young and the elderly as well as people with
chronic medical conditions. Having the human flu vaccination in majority of the
population would also reduced the chance of having concurrent human and swine flu
in the same individual and thus reduced the risk of further cross matching and
mutation of the swine flu virus. Hence, it is still beneficial to have the current flu
vaccination. In northern hemisphere including Hong Kong, the new flu vaccine for
year 2010 would usually be available from September 2009. If one decides to have
the current vaccine, it would confer protection until September and should still have
the new vaccine in September 2009. Since the demand of the 2010 flu vaccines are
likely to be high and the supply is tight, one might need to consult the clinician for
reservation and pre-ordering of the flu vaccines.
Q21) 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/
70°C kills the swine flu virus as it does other bacteria and viruses.
Q22) What is the government doing for the border control?
Surveillance measures at boundary control points had been stepped up to detect
travellers with fever and respiratory symptoms and coming from places where cases
of human infection of Swine Influenza were reported. Airlines had been asked to
broadcast health advice messages on all direct flights coming from the affected places.
Passengers with respiratory symptoms are urged to approach Port Health officers at
the Airport for follow-up investigations
Q23) We are going to USA for business trip next week, what should we do?
The World Health Organization has not advised on any travel restriction yet. People
traveling to the affected places should take precautionary measures. These measures
include avoiding contact with sick people; avoiding touching one's eyes, nose or
mouth; wash hands frequently with soap and water or apply alcohol-based hand
cleaners. They should also bring along surgical masks for use whenever appropriate.
People who develop respiratory illness within 7 days after returning from the affected
places should put on a surgical mask and seek medical consultation from public
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