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Swine Flu Update. Rich Feifer, MD, MPH, FACP April 27, 2009. What is “Swine Flu”?. Swine Flu is a type of influenza Usually infects pigs Human transmission from pigs has regularly but infrequently occurred over the years Human-to-human has previously been rare What is happening now?
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Swine Flu Update Rich Feifer, MD, MPH, FACP April 27, 2009
What is “Swine Flu”? • Swine Flu is a type of influenza • Usually infects pigs • Human transmission from pigs has regularly but infrequently occurred over the years • Human-to-human has previously been rare • What is happening now? • One type of swine flu, H1N1, has undergone a change into a new virus subtype: Now has the ability to more easily spread from human to human • To avoid confusion: Swine Flu H1N1 is different from Human Flu H1N1
World Health Organization (WHO) Pandemic Phases • Phase 1: No cases of animal influenza virus in humans • Phase 2: Human infection by animal influenza virus • Phase 3: Sporadic cases or small clusters, but no sustained human-to-human spread (Current Level) • Phase 4: Sustained human-to-human spread in communities • Media frenzy • Minimal disruptions to business or clinical care • Phase 5: Sustained human-to-human spread in multiple countries within a global region • Localized disruptions • Fear • Phase 6: Full Pandemic (eg, world) • Multiple “waves” • Healthcare system completely overwhelmed • Social isolation strategies adopted and enforced • Pharmacy supply chain disruptions • Pharmacy and medical regulations liberalized • Government use of emergency powers Timing ? Weeks to Months
Current Status • We are not currently in a pandemic, but we are closer to one than we were last week…. • A US “Public Health Emergency” was declared on 4/26 • This is just a preparedness step, not a description of current pandemic epidemiology or severity • Involves deployment of Federal stockpile of medications to regional sites
When is “the flu” NOT the flu? • Symptoms of influenza are severe • High fever • Cough • Sore throat • Body aches • Headache • Extreme fatigue • Occasional diarrhea or vomiting • Most respiratory infections are not the influenza (the flu), they are a cold • Symptoms may be similar to above, but are milder • More likely to have a runny or stuffy nose
Protection Measures • Contact avoidance • Hand washing and hand sanitizers • Antiviral medications • Tamiflu and Relenza – YES • Treatment (suspected vs confirmed H1N1 swine flu) • Pre-exposure prophylaxis • Post-exposure prophylaxis • Amantadine and Rimantadine – NO • Vaccines – NOT YET
Important Resources • Primary CDC website for influenza • http://www.pandemicflu.gov/ • Link to state-level pandemic preparedness and response • http://www.pandemicflu.gov/whereyoulive/index.html • http://www.pandemicflu.gov/plan/states/stateplans.html • http://pandemicflu.gov/plan/states/antivirals.html (dated 9-08) • Checklist for corporate pandemic preparedness • http://www.pandemicflu.gov/plan/pdf/businesschecklist.pdf • Interim guidance on antiviral drugs for swine flu • http://www.cdc.gov/swineflu/recommendations.htm • http://www.cdc.gov/flu/professionals/antivirals/dosagetable.htm#table