c




  

Noahdel Hallel C. Francisco

BS Biology
Major in Zoology
 OUTLINE

I. What is influenza virus?

II. Clinical presentation of the influenza

pandemic

III. Treatment of influenza

IV. Current updates on A(H1N1) Cases

 OBJECTIVES

1. To discuss about human swine influenza

virus or A(H1
A(H1N1) and its history,
evolution and diagnostic trail
trail;;

2. To elaborate on the clinical presentation

of the pandemic influenza
influenza;;
 OBJECTIVES

3. To discuss how influenza is being managed

through self
self--care treatment procedures
and recommended medications;
medications; and

4. To give the current updates regarding

influenza cases.
cases.
 v
vv 

Table 1. Genera-associated species and serotypes of v
 


[
     
   

nfluenzavirus nfluenza virus 1N1, 1N2, 2N2, uman, pig,
3N1, 3N2, 3N8, bird, horse
N1, N2, N3,
N8, N9, N1,
N2, N3, N4,
N, 9N2, 10N
nfluenzavirus B nfluenza B virus uman, seal
nfluenzavirus C nfluenza C virus uman, pig
savirus nfectious salmon tlantic salmon
anemia virus

hogotovirus
hogoto virus Batken virus,
ick, mosquito,
hori virus hori virus mammal (inc.
human)
 [
     
   

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INFLUENZA A VIRUS

VVV.Vikipedia.org
 SWINE INFLUENZA VIRUS

  any strain of the influenza family of

viruses that is endemic in pigs

  due to reassortment, there have been

transfers of genes among strains
crossing swine, avian, and human
species boundaries
 HISTORY OF PANDEMIC
INFLUENZA

  Spanish Flu
- earliest known pandemic
- 1918 to 1920
- killed 40 million people
- major cause: troop movements
during World War 1
 HISTORY OF PANDEMIC
INFLUENZA

  Asian Flu
- 1. M fatalities
- 19 to 198

  Hongkong Flu
- 1 M fatalities
- 1968 to 1969
 HISTORY OF PANDEMIC
INFLUENZA

  196 US outbreak
  1988 zoonosis
  1998 US outbreak in swine
  200 Philippine outbreak in swine
  2009 outbreak in human
 EVOLUTION OF HUMAN
SWINE INFLUENZA VIRUS

  (swine) proposed as a Ơmixing vesselơ for

the generation of pandemic viruses through
reassortment

  permissive to both avian and human

influenza viruses
 oto courtesy of: National Institute
of Allergy and Infectious Diseases
(NIAID)
 DIAGNOSTIC TRAIL

Novel strain of human Confirmed A(H1N1) in

H1N1 influenza A virus two children in San
Diego, California
Ơmysteriousơ influenza-
like illness in the town 642 confirmed cases in USA
of La Gloria

WHO alert due to Virus also reached

further cases in Mexico Canada and Europe

First reports in English Remote countries were

language media ƛ April also afflicted, including
21st Australia
 CASE DEFINITIONS

  vary between countries with few cases of

swine flu compared to those with many
cases

e.g. Australia (only 400 cases)

1. acute febrile respiratory illness
2. acute respiratory illness
 CASE DEFINITIONS

CDCƞs case definition:

?



 
? ?

- fever and cough and/or a sore throat in
the absence of a known cause other than
the influenza
 CASE DEFINITIONS

CDCƞs case definition:

1. Confirmed case
2. Probable case
3. Suspected case
 SYMPTOMS

  Sudden fever of 38 °C or higher

  Headache
  Dry cough
  Extreme weakness and exhaustion

Other symptoms may include:

Chills, loss of appetite, sore throat and
runny or stuffy nose
 CONFIRMING DIAGNOSIS

  rapid diagnosis of human swine

influenza infection is essential to:

- minimise spread of condition

- protect patients from developing
complications
- inform public health response
CONFIRMING DIAGNOSIS
Does illness in the patient meet the current case
definition for possible swine influenza?

Patient is isolated
Throat and nasal swab for viral PCR
testing and viral culture is collected

Testing involves health care worker

Patient sent home for isolation,

wait for pending result of the test

Use of antiviral will be recommended

when diagnosis is confirmed positive
 MODE OF TRANSMISSION

  Droplets of moisture
from an infected
person through
sneezing, coughing
or talking
MODE OF TRANSMISSION

  Touching infected
hard surfaces and
touching the mouth
or nose afterwards,
without washing the
hands first.
 STANDARD PROCEDURES TO
PREVENT SPREADING THE VIRUS

1. Get a flu shot.

2. Clean your hands.

3. Cover your cough.

4. Stay at home.

. Call your doctor.

 PERSONAL CARE OF AN
INFLUENZA--INFECTED PATIENT
INFLUENZA

1. Rest and get lots of sleep.

2. Try to stay away from
people for  days after
first symptom occurs.
3. Drink lots of fluids.
4. Gargle with warm salt
water.
 PERSONAL CARE OF AN
INFLUENZA--INFECTED PATIENT
INFLUENZA

. Use saline nose drops or

spray.
6. Do not smoke. Avoid
second hand smoke.
. Take recommended over-
over-
the--counter medications.
the
 POTENTIALLY RECOMMENDED
ANTI--VIRALS
ANTI

1. Oseltamivir [Tamiflu®]
2. Zanamivir [Relenza ®]
3. Amantidine
4. Rimantidine
 POTENTIALLY RECOMMENDED
ANTI--VIRALS
ANTI

Table 2. Treatment doses of oseltamivir [Tamiflu®] for infants aut orized by

t e FDA on April 27t 2009
M    


   

< 3 months 12 mg twice daily

3- months 20 mg twice daily

6-11 months 2 mg twice daily

 POTENTIALLY RECOMMENDED
ANTI--VIRALS
ANTI
Table 3. Treatment doses of oseltamivir [Tamiflu®] for • 1 year of age aut orized
by t e FDA on April 27t 2009
M    M   M         
   
 

 
   
  
  


  
   
1-2 < 1 30 mg twice daily 1 10 capsules
[30 mg]
3- 1-23 4 mg twice daily 2 10 capsules
[4 mg]
6-9 23-40 60 mg twice daily 2 20 capsules
[30 mg]
> 10 > 40  mg twice daily 3 10 capsules
[ mg]
 VACCINES

  approximately  to 6 months for

the first supplies of approved
vaccine to become available

  process of producing a new

vaccine involves many sequential
steps
 VACCINES

Ê



 Ê


 
 
 
 


Identification of a new virus Optimization of virus growth

conditions
Preparation of vaccine strain
Vaccine bulk manufacture

Verification of vaccine Quality control

strain
Vaccine filling and release
Preparation of reagents to
test the vaccine Clinical studies
 ACROSS THE GLOBE

  Food and Drug Administration (FDA)

issued V 
 ! 
 


to make available Relenza and Tamiflu
antiviral drugs

  Legal immunity set for swine flu vaccine

makers
 ACROSS THE GLOBE

  WHO issued guidelines for the use of

antivirals in the management of patients
infected with the H1N1 pandemic virus

  Monitoring of outbreaks

  Preparation for a second wave of

pandemic spread (northern hemisphere)
 PHILIPPINE SETTING

  July 1, 2009: 1 new death confirmed in

the Philippines

  Policy of mitigation

  Government is preparing for possible

second pandemic spread by continuously
monitoring the situation (DOH)
 PHILIPPINE SETTING

Current Philippine response alert level is:

 "

  Confirmed case(s) and/or death related to

Influenza A(H1
A(H1N1) virus in the Philippines.
Philippines.
  Confirmed case(s) in school(s).
school(s).
  Confirmed human-
human-to
to--human transmission(s)
transmission(s)..
  Declared community outbreak(s).
outbreak(s).
m 

 

   

  

   ! "
#
" Ê
$" $%

÷onfirmed cases folloVed by deat

÷onfirmed community outbreak of
H1N1
÷onfirmed cases by t e DOH
Unconfirmed or suspected cases
INTERNATIONAL RESPONSE
TO INFLUENZAƞS THREAT

  Internet

  Authoritative websites

  Medical journals
 SUMMARY AND
CONCLUSION
  Influenza A is currently the greatest
pandemic threat to humankind.
humankind.

  A new strain of swine influenza virus began

its outbreak in Mexico and has taken its toll
until now, declaring a huge threat among
the humankind.
humankind.
 SUMMARY AND
CONCLUSION
  Preventive measures have been promoted
such as self-
self-care treatment procedures and
taking in of recommended medications, e.g.
oseltamivir and zanamivir
zanamivir..

  Clinical cases have been rapidly increasing,

thus internet has been a major source of
spreading and accessing information online.
online.
 SUMMARY AND
CONCLUSION
  Being aware and informed of the human
swine influenza virus and its pandemic
effect can lead to concerned people with
established hygienic practices to minimize
spreading of the virus.
virus.

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