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mmmmm. Infectious Diseases. CHP400 COMMUNITY HEALTH PROGRAM-II. mmmmm. Emerging and Re-emerging Infectious Diseases. mmmmm. Novel H1N1 (Swine) Epidemiology & Control. Mohamed M. B. Alnoor. mmmmm. Swine Influenza A (H1N1). mmmmm. Content. mmmmm. Previous influenza pandemics.

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  1. mmmmm Infectious Diseases CHP400 COMMUNITY HEALTH PROGRAM-II mmmmm Emerging and Re-emergingInfectious Diseases mmmmm Novel H1N1 (Swine) Epidemiology & Control Mohamed M. B. Alnoor

  2. mmmmm Swine Influenza A (H1N1) mmmmm Content mmmmm • Previous influenza pandemics • Definitions • Transmission Through Species • Transmission to humans • Pandemic-Alert Levels and WHO Regions mmmmm mmmmm • The Global H1N1 Pandemic • Lessons Learned form Past Pandemics • Prevention of H1N1 infection • Who Should Be Vaccinated? • Antiviral Protection • Summary

  3. mmmmm mmmmm Previous influenza pandemics mmmmm mmmmm mmmmm

  4. mmmmm Swine Influenza A (H1N1) mmmmm Definition: mmmmm What is swine flu? Swine Influenza (swine flu) is a respiratory disease of pigs caused by Type A influenza viruses causing regular outbreaks in pigs. mmmmm mmmmm They do not normally infect humans

  5. mmmmm Swine Influenza A (H1N1) mmmmm Definition: mmmmm What is swine flu? 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. mmmmm mmmmm

  6. mmmmm Swine Influenza A (H1N1) mmmmm Definition: mmmmm What is swine flu? This swine influenza A (H1N1) virus is contagious and is spreading from human to human. mmmmm mmmmm

  7. mmmmm Human Virus Avian Virus Avian/Human Reassorted Virus Swine Virus Swine Influenza A (H1N1)Transmission Through Species mmmmm mmmmm North American swine North American avian North American human Eurasian swine mmmmm mmmmm Swine/ Reassortment in Pigs

  8. mmmmm Swine Influenza A (H1N1) mmmmm Transmission to humans: mmmmm How does swine flu spread? • Contact with: • - infected pigs • - contaminated environments mmmmm mmmmm - a person with swine flu • Airborne(from infected people) - coughing - sneezing

  9. mmmmm Swine Influenza A (H1N1)Pandemic-Alert Levels mmmmm mmmmm Phase 1: Animals viruses, no humans infections. Phase 2: Virus in domesticated/wild animals, caused infection in humans: a potential pandemic threat.” Phase 3: Reassortant v: sporadic cases or small clusters in humans. Phase 4: Reassortant v:community-level outbreaks. Phase 5: There is human-to-human spread of the virus into at least two countries in one WHO region. Phase 6: Phase 5 + community-level outbreaks in at least one other country in a different WHO region. A global pandemic is occurring. mmmmm mmmmm

  10. mmmmm WHO Regions mmmmm mmmmm South East Asia Region African Region East Mediterranean Region European Region Region of the Americas Western Pacific Region

  11. mmmmm Swine Influenza A (H1N1) mmmmm mmmmm mmmmm mmmmm

  12. mmmmm Lessons Learned formPast Pandemics mmmmm mmmmm • Pandemics are unpredictable: • -Mortality • -severity of illness • -pattern of spread • Capacity to cause severe disease in nontraditional groups is a major determinant of pandemic impact mmmmm mmmmm • Epidemiology reveals waves of infection:Ages/areas not initially infected likely vulnerable in future waves • Subsequent waves may be more severe

  13. mmmmm Lessons Learned formPast Pandemics mmmmm mmmmm Public health interventions delay, but do not stop pandemic spread • Quarantine, travel restriction show little effect • Temporary banning of public gatherings, • potentially effective mmmmm mmmmm • Delaying spread is desirable:

  14. mmmmm Swine Influenza A (H1N1) mmmmm Prevention of H1N1 INFECTION mmmmm General prevention and control measures • Tips to Reduce the Infection • Respiratory hygiene and cough etiquette mmmmm mmmmm • Social-Distancing

  15. mmmmm Swine Influenza A (H1N1) mmmmm Prevention of H1N1 INFECTION mmmmm • Tips to Reduce the H1N1 Influenza Infection • Use a tissue when coughing or sneezing. • Frequently wash hands with warm water and soap . • Try not to touch your eyes, nose or mouth . • Wipe down kitchen and bathroom countertops, home and office phones, keyboards , etc • If exhibiting symptoms, stay home. • If coworkers or family members become ill, consider taking anti-viral medication . mmmmm mmmmm

  16. mmmmm Swine Influenza A (H1N1) mmmmm Prevention of H1N1 INFECTION mmmmm Specific preventive measures vaccine mmmmm mmmmm The H1N1 Inactivated Vaccine (the shot) The H1N1 Live Attenuated Vaccine (the nasal spray)

  17. mmmmm Swine Influenza A (H1N1) mmmmm Who Should Be Vaccinated? mmmmm The groups recommended to receive the 2009 H1N1 influenza vaccine include: • Pregnant women • Contacts and caregivers <6 months • Healthcare and emergency personnel • All people from 6 mo - 24 years mmmmm mmmmm • Children from 6 mo - 18 years • Young adults 19 - 24 years • Persons 25 - 64 years • (higher risk of complications from influenza)

  18. mmmmm Swine Influenza A (H1N1) mmmmm Who Should NOT Be Vaccinated? mmmmm • People with allergy to chicken eggs or had a severe reaction to an influenza vaccination. • Children younger than 6 months of age • People who have a moderate-to-severe illness with a fever (delay vaccination.) • History of Guillain–Barré Syndrome. mmmmm mmmmm

  19. mmmmm Swine Influenza A(H1N1)Antiviral Protection mmmmm mmmmm Treatment (Antiviral drugs ) • Make illness milder and recovery faster • May prevent serious flu complications • Work best if started within 2 days of symptoms. • Warning! Do NOT give aspirin: Reye’s syndrome. mmmmm mmmmm

  20. mmmmm Importance of the Early Treatment mmmmm mmmmm Prognosis and days before treatment mmmmm mmmmm Recovered m Total number Dead >4 days 1 day 2 days 3 days Days from onset till initiation of treatment

  21. mmmmm Swine Influenza A(H1N1)Antiviral Protection mmmmm mmmmm Treatment (Antiviral drugs ) Who to treat Suspected or confirmed influenza with: • Illness requiring hospitalization • Progressive, severe, or complicated illness, regardless of previous status • Patients at risk for severe disease mmmmm mmmmm • Children <2, 2-4 • Adults > 65 • Pregnancy & 2wks postpartum • Persons with certain conditions:

  22. mmmmm Swine Influenza A(H1N1)Antiviral Protection mmmmm mmmmm Prophylaxis (Antiviral drugs ) Who may be considered: • Vaccine takes 10 – 14 days to act • Close contact of a person with H1N1 : • Persons at high risk for complications of influenza; • Health care workers and emergency medical personnel; • Pregnant women. mmmmm mmmmm • When the vaccine is not available

  23. mmmmm Swine Influenza A (H1N1) mmmmm The hajj Season mmmmm The health authorities of Saudi Arabia has advised certain populations against attending Hajj • Children younger than 10 • Adults older than 65 • Pregnant women • Those with chronic health conditions mmmmm mmmmm • That was the position of many countries • Vaccination against H1N1 required

  24. mmmmm Swine Influenza A (H1N1) mmmmm The hajj Season mmmmm To ensure pilgrim and resident safety, Saudi Arabia has set up: • Health screenings at all ports of entry • H1N1 vaccine secured • Antiviral medication is available mmmmm mmmmm • Meeting of Arab health ministers(In July) • working very closely with • World Health Organization • Other international experts • Schools started by mid-October

  25. mmmmm Swine Influenza A (H1N1) mmmmm Summary mmmmm • This is a NEWvirus • This virus is contagious and is spreading from human to human. mmmmm mmmmm • The disease has low fatality • This will not be the last pandemic

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