War on swine flu around the world
As Wales prepares for a winter wave of the virus, Health Editor Madeleine Brindley examines how swine flu is affecting the rest of the world
IN FRANCE the practice of greeting someone with a kiss could be at risk, while the thousands of pilgrims who make the Hajj to Mecca this year are being told to take precautions against swine flu.
The French health ministry recommends avoiding direct contact with people, including not kissing, shaking hands or caressing the face of others especially sick people.
It also advises maintaining a one-metre buffer zone from other people and although it does not specifically mention la bise, some children are being told not to kiss their teachers or other students.
In one town in western Brittany so-called bise boxes have been set up to allow pupils to put heart-shaped greetings into before they are exchanged in class.
The Foreign and Commonwealth Office has advised the elderly, pregnant women, the chronically ill and children not to take part in the Hajj this year.
Pilgrims will also need to be able to prove that they have been vaccinated against seasonal flu before applying for a visa to travel to Mecca. All passengers arriving in Saudi Arabia will be screened.
Elsewhere in the world both Angola and Lesotho have recorded their first cases of swine flu, while in China more than 9,000 people have already been confirmed with swine flu, as rates begin to spike.
More than 200 people have died in India after contracting swine flu. Schools, colleges and even cinemas have been closed temporarily in a bid to control the virus.
Passenger screening has been introduced at Indias 22 international airports because it is thought that a large number of cases have been in people returning from overseas travel.
In the southern hemisphere there is evidence that the flu season is coming to an end.
At its peak in Australia, more than 90 people a day were being admitted to hospital with swine flu, that figure had fallen to about 70 at the end of last month.
In neighbouring New Zealand a country with many similarities to Wales restrictions put in place by the Catholic Church to prevent the spread of infection have been lifted as the spring starts. More than 3,000 cases of swine flu were confirmed by laboratory tests and 17 deaths have been linked to the virus.
Dr Roland Salmon, director of the communicable disease surveillance centre at the National Public Health Service for Wales, said: New Zealand has had an epidemic but it has been modest and that gives an indication of what we may expect.
In the four months since the World Health Organisation (WHO) declared a pandemic, swine flu cases have been reported on every populated continent. The latest figures reveal there have been more than 277,000 confirmed cases the actual total is considerably higher as most countries no longer test every person with symptoms and at least 3,205 deaths.As the southern hemisphere moves into spring, rates of swine flu are declining but WHO said there is still active transmission in the tropical regions of the Americas and Asia.
Swine flu activity in the northern hemisphere, however, is variable. In the United States, regional increases in influenza activity are being reported, most notably in the south eastern states. Most of Europe is reporting low or moderate respiratory diseases activity Wales continues to see low level activity but WHO said some parts of Eastern Europe are beginning to report increases in activity.
Experts are continuing to warn that although the majority of people infected with the H1N1 virus will experience a mild illness, there is a risk of severe respiratory illness in at-risk groups, including pregnant women and those with asthma, cardiovascular disease and diabetes and people who are immuno- suppressed.
The WHO added: Current evidence points to some important differences between patterns of illness reported during the pandemic and those seen during seasonal epidemics of influenza.
The age groups affected by the pandemic are generally younger. This is true for those most frequently infected, and especially so for those experiencing severe or fatal illness. To date, most severe cases and deaths have occurred in adults under the age of 50 years, with deaths in the elderly comparatively rare. This age distribution is in stark contrast with seasonal influenza, where around 90% of severe and fatal cases occur in people 65 years of age or older.
THE Nursing and Midwifery Council is writing to unregistered nurses and midwives in a bid to ensure the NHS is adequately staffed to deal with a winter of swine flu.
The NMC hopes that by contacting more than 90,000 nurses and midwives whose registration has lapsed in the last four years, will help to offset any NHS staff shortages.
All nurses and midwives must be registered with the NMC to be eligible to work in the UK.
Those with lapsed registration are eligible for re-admission if they have worked as a nurse or a midwife during the previous five years, for a minimum of 750 hours.
Kathy George, chief executive and registrar of the NMC, said: The NMC is already working to support services to address any potential staffing shortages which may occur in the event of a surge in the swine flu pandemic.
We are doing this by writing to over 90,000 nurses and midwives whose registration has lapsed within the last four years and encouraging them to consider applying for re-admission to the register.
IN FRANCE the practice of greeting someone with a kiss could be at risk, while the thousands of pilgrims who make the Hajj to Mecca this year are being told to take precautions against swine flu.
The French health ministry recommends avoiding direct contact with people, including not kissing, shaking hands or caressing the face of others especially sick people.
It also advises maintaining a one-metre buffer zone from other people and although it does not specifically mention la bise, some children are being told not to kiss their teachers or other students.
In one town in western Brittany so-called bise boxes have been set up to allow pupils to put heart-shaped greetings into before they are exchanged in class.
The Foreign and Commonwealth Office has advised the elderly, pregnant women, the chronically ill and children not to take part in the Hajj this year.
Pilgrims will also need to be able to prove that they have been vaccinated against seasonal flu before applying for a visa to travel to Mecca. All passengers arriving in Saudi Arabia will be screened.
Elsewhere in the world both Angola and Lesotho have recorded their first cases of swine flu, while in China more than 9,000 people have already been confirmed with swine flu, as rates begin to spike.
More than 200 people have died in India after contracting swine flu. Schools, colleges and even cinemas have been closed temporarily in a bid to control the virus.
Passenger screening has been introduced at Indias 22 international airports because it is thought that a large number of cases have been in people returning from overseas travel.
In the southern hemisphere there is evidence that the flu season is coming to an end.
At its peak in Australia, more than 90 people a day were being admitted to hospital with swine flu, that figure had fallen to about 70 at the end of last month.
In neighbouring New Zealand a country with many similarities to Wales restrictions put in place by the Catholic Church to prevent the spread of infection have been lifted as the spring starts. More than 3,000 cases of swine flu were confirmed by laboratory tests and 17 deaths have been linked to the virus.
Dr Roland Salmon, director of the communicable disease surveillance centre at the National Public Health Service for Wales, said: New Zealand has had an epidemic but it has been modest and that gives an indication of what we may expect.
In the four months since the World Health Organisation (WHO) declared a pandemic, swine flu cases have been reported on every populated continent. The latest figures reveal there have been more than 277,000 confirmed cases the actual total is considerably higher as most countries no longer test every person with symptoms and at least 3,205 deaths.As the southern hemisphere moves into spring, rates of swine flu are declining but WHO said there is still active transmission in the tropical regions of the Americas and Asia.
Swine flu activity in the northern hemisphere, however, is variable. In the United States, regional increases in influenza activity are being reported, most notably in the south eastern states. Most of Europe is reporting low or moderate respiratory diseases activity Wales continues to see low level activity but WHO said some parts of Eastern Europe are beginning to report increases in activity.
Experts are continuing to warn that although the majority of people infected with the H1N1 virus will experience a mild illness, there is a risk of severe respiratory illness in at-risk groups, including pregnant women and those with asthma, cardiovascular disease and diabetes and people who are immuno- suppressed.
The WHO added: Current evidence points to some important differences between patterns of illness reported during the pandemic and those seen during seasonal epidemics of influenza.
The age groups affected by the pandemic are generally younger. This is true for those most frequently infected, and especially so for those experiencing severe or fatal illness. To date, most severe cases and deaths have occurred in adults under the age of 50 years, with deaths in the elderly comparatively rare. This age distribution is in stark contrast with seasonal influenza, where around 90% of severe and fatal cases occur in people 65 years of age or older.
THE Nursing and Midwifery Council is writing to unregistered nurses and midwives in a bid to ensure the NHS is adequately staffed to deal with a winter of swine flu.
The NMC hopes that by contacting more than 90,000 nurses and midwives whose registration has lapsed in the last four years, will help to offset any NHS staff shortages.
All nurses and midwives must be registered with the NMC to be eligible to work in the UK.
Those with lapsed registration are eligible for re-admission if they have worked as a nurse or a midwife during the previous five years, for a minimum of 750 hours.
Kathy George, chief executive and registrar of the NMC, said: The NMC is already working to support services to address any potential staffing shortages which may occur in the event of a surge in the swine flu pandemic.
We are doing this by writing to over 90,000 nurses and midwives whose registration has lapsed within the last four years and encouraging them to consider applying for re-admission to the register.
Experts meet to review H1N1 Swine Flu Pandemic affecting the world
Ranbaxy Science Foundation (RSF), a non-profit organization set-up by Ranbaxy Laboratories Limited (RLL), organized its XXIII Round Table Conference on the “Pandemic Influenza Update” on September 19, 2009 in New Delhi. The programme was moderated by Shobha Broor, All India Institute of Medical Sciences, New Delhi and Prof. T. Jacob John, Formerly Professor and Head, Departments of Clinical Microbiology and Virology, Christian Medical College, Vellore. Jai P. Narain Director, Dept. of Communicable Diseases, WHO-SEARO, New Delhi, delivered the keynote address on the topic “Global Scenario of H1N1 Pandemic Influenza”
This was the first open forum of scientists and public health experts on the pandemic in India. The main objective of this Round Table Conference was to review the progression of the pandemic as it affects the world in general and India in particular, successes and failures, the lessons learnt so far and to redefine our preparedness plan for such pandemics in future. The scientific sessions on various aspects of influenza were followed by a panel discussion. The conclusions drawn out of the day long conference are as follows :
1. H1 N1 Swine Flu is highly contagious and has spread very fast to 191 countries starting from America, to Europe, Asia & Africa
No. of confirmed cases & deaths as on 18th Sept, 2009
* Number of confirmed cases in India : 7374
* Number of deaths in India : 225
* Number of confirmed cases globally : 296471
* Number of deaths globally : 3486
H1 N1 will probably continue to spread for some time – the more the number of cases – the faster the rate of spread
2. H1N1 is generally not a very serious disease
3. Both - the pandemic and seasonal flu strains are currently in circulation
4. Signs & symptoms of H1N1 and seasonal flu are very similar and like common seasonal flu most persons with H1 N1 Swine Flu also soon get better without any specific treatment
5. Transmission of the virus can not be stopped. Current focus is on reducing the impact of pandemic by diagnosing the cases on the basis of case definition and treatment of severe cases thereby saving lives and contributing to the prevention of further spread
6. No need to test each and everybody having flu like symptoms. Only cases with an index of suspicion should be tested. Early treatment is recommended to such cases without waiting for the lab report which takes about 48 hours.
7. Persons having underlying co-morbid conditions like diabetes, cancer, liver disease or any other chronic disease including pregnant women and children are at high risk.
8. Chemoprophylaxis should be given to the close contacts if necessary
9. Screening of cases at the airports is not recommended
10. Closure of schools & public places like cinema halls and malls can only delay but cannot stop the spread of H1 N1. Decision to do so is however to be taken by the respective State Govt.
11. Need to enroll private laboratories and hospitals to meet the need due to the increasing number of cases
12. Vaccine is the most effective tool to control the spread of H1 N1
13. Only 21 cases of drug resistance to Tamiflu have been reported globally
14. Public health measures taken by individuals and communities such as social distancing, respiratory etiquette and hand hygiene etc. are at present the most feasible measures available to reduce or delay the disease caused by pandemic influenza
Ranbaxy Science Foundation, chaired by Dr. Nityanand, is a non profit organization, set up by Ranbaxy Laboratories Limited, which promotes scientific endeavour in the country by encouraging and rewarding excellence in medical and pharmaceutical research and channeling national and international knowledge and expertise. Among the prime activities it undertakes every year are, holding of Scientific Symposia in front line areas of research, inviting Foreign Scientists as visiting Professors and holding of Round Table Conferences on subjects of public health concerns. The Foundation also gives annually four Research Awards in different areas of Biomedical
This was the first open forum of scientists and public health experts on the pandemic in India. The main objective of this Round Table Conference was to review the progression of the pandemic as it affects the world in general and India in particular, successes and failures, the lessons learnt so far and to redefine our preparedness plan for such pandemics in future. The scientific sessions on various aspects of influenza were followed by a panel discussion. The conclusions drawn out of the day long conference are as follows :
1. H1 N1 Swine Flu is highly contagious and has spread very fast to 191 countries starting from America, to Europe, Asia & Africa
No. of confirmed cases & deaths as on 18th Sept, 2009
* Number of confirmed cases in India : 7374
* Number of deaths in India : 225
* Number of confirmed cases globally : 296471
* Number of deaths globally : 3486
H1 N1 will probably continue to spread for some time – the more the number of cases – the faster the rate of spread
2. H1N1 is generally not a very serious disease
3. Both - the pandemic and seasonal flu strains are currently in circulation
4. Signs & symptoms of H1N1 and seasonal flu are very similar and like common seasonal flu most persons with H1 N1 Swine Flu also soon get better without any specific treatment
5. Transmission of the virus can not be stopped. Current focus is on reducing the impact of pandemic by diagnosing the cases on the basis of case definition and treatment of severe cases thereby saving lives and contributing to the prevention of further spread
6. No need to test each and everybody having flu like symptoms. Only cases with an index of suspicion should be tested. Early treatment is recommended to such cases without waiting for the lab report which takes about 48 hours.
7. Persons having underlying co-morbid conditions like diabetes, cancer, liver disease or any other chronic disease including pregnant women and children are at high risk.
8. Chemoprophylaxis should be given to the close contacts if necessary
9. Screening of cases at the airports is not recommended
10. Closure of schools & public places like cinema halls and malls can only delay but cannot stop the spread of H1 N1. Decision to do so is however to be taken by the respective State Govt.
11. Need to enroll private laboratories and hospitals to meet the need due to the increasing number of cases
12. Vaccine is the most effective tool to control the spread of H1 N1
13. Only 21 cases of drug resistance to Tamiflu have been reported globally
14. Public health measures taken by individuals and communities such as social distancing, respiratory etiquette and hand hygiene etc. are at present the most feasible measures available to reduce or delay the disease caused by pandemic influenza
Ranbaxy Science Foundation, chaired by Dr. Nityanand, is a non profit organization, set up by Ranbaxy Laboratories Limited, which promotes scientific endeavour in the country by encouraging and rewarding excellence in medical and pharmaceutical research and channeling national and international knowledge and expertise. Among the prime activities it undertakes every year are, holding of Scientific Symposia in front line areas of research, inviting Foreign Scientists as visiting Professors and holding of Round Table Conferences on subjects of public health concerns. The Foundation also gives annually four Research Awards in different areas of Biomedical
H1N1 influenza (swine flu)
H1N1 influenza, also known as "swine flu," is a newly identified virus that can spread from people who are infected to others through coughs and sneezes. When people cough or sneeze, they spread germs through the air or onto surfaces that other people may touch. H1N1 influenza is not transmitted from pigs to humans or from eating pork products. H1N1 influenza is a new virus to human populations, so people's bodies have little ability to fight H1N1 infection. To avoid spreading illness to others, people with symptoms of the flu should stay at home until any fever has been gone for at least 24 hours without the use of fever-reducing medicines.
Flu Symptoms
Influenza, commonly shortened to “flu,” is a respiratory illness caused by influenza A or B viruses. It is extremely contagious and usually spread by the coughs and sneezes of a person who is infected. It appears most frequently in winter and early spring which is the time for viruses to breed. The virus attacks the body by spreading through the upper and/or lower respiratory tract.
Symptoms of flu may be same as other viral infections or cold but it varies in intensity. A person attacked by flu may experience more intense symptoms than normal cold and may linger for about a week. The feeling of tiredness and gloom can continue for several weeks.
Here are few symptoms of flu:
* Runny/blocked nose
* Sore Throat
* Dry cough
* High temperature
* Cold sweats, shivers
* Headache
* Muscle aches and pains
* Weakness and tiredness
* Aching joints, aching limbs
* Fatigue, feeling utterly exhausted
* Gastro-intestinal symptoms, such as nausea, vomiting, and diarrhoea
Usually these symptoms appear 1 to 4 days later after the infection of virus. Flu is very contagious and it can spread to others before and after the symptoms of flu appear in the body.
Symptoms of flu may be same as other viral infections or cold but it varies in intensity. A person attacked by flu may experience more intense symptoms than normal cold and may linger for about a week. The feeling of tiredness and gloom can continue for several weeks.
Here are few symptoms of flu:
* Runny/blocked nose
* Sore Throat
* Dry cough
* High temperature
* Cold sweats, shivers
* Headache
* Muscle aches and pains
* Weakness and tiredness
* Aching joints, aching limbs
* Fatigue, feeling utterly exhausted
* Gastro-intestinal symptoms, such as nausea, vomiting, and diarrhoea
Usually these symptoms appear 1 to 4 days later after the infection of virus. Flu is very contagious and it can spread to others before and after the symptoms of flu appear in the body.
Vaccine for H1N1 influenza?
A vaccine for H1N1 influenza is being developed, and vaccine manufacturers expect to have it ready in October 2009. Initial supplies of vaccines will go to those at highest risk, including:
* Pregnant women
* Children and young adults 6 months to 24 years of age
* Persons ages 25-64 years old with health conditions that could make them dangerously ill from the flu (such as those with heart disease, diabetes, asthma, or anyone with a lowered immunity)
* Household members and caregivers of children younger than 6 months in age; and
* Healthcare workers and emergency medical service providers.
* Pregnant women
* Children and young adults 6 months to 24 years of age
* Persons ages 25-64 years old with health conditions that could make them dangerously ill from the flu (such as those with heart disease, diabetes, asthma, or anyone with a lowered immunity)
* Household members and caregivers of children younger than 6 months in age; and
* Healthcare workers and emergency medical service providers.
When using facemasks:
* Change masks when they become moist
* Do not leave masks dangling around the neck
* Throw away used masks
* After touching or throwing away a used mask, wash hands or use alcohol sanitizer
Public Health does not recommend the use of masks except for the following people:
* Sick people if they must be near others at home, or if they must leave the home (such as for an appointment with a health care provider).
* Caregivers of a people ill with influenza – when the caregiver leaves their home. This is to prevent spreading flu to others in case the caregiver is in the early stages of infection.
Whenever possible, do not rely on the use of facemasks or respirators alone to provide respiratory protection against novel influenza virus infection. The best way to prevent exposure to influenza is to avoid contact with ill people. Other steps include avoiding crowded setting and washing your hands frequently.
* Do not leave masks dangling around the neck
* Throw away used masks
* After touching or throwing away a used mask, wash hands or use alcohol sanitizer
Public Health does not recommend the use of masks except for the following people:
* Sick people if they must be near others at home, or if they must leave the home (such as for an appointment with a health care provider).
* Caregivers of a people ill with influenza – when the caregiver leaves their home. This is to prevent spreading flu to others in case the caregiver is in the early stages of infection.
Whenever possible, do not rely on the use of facemasks or respirators alone to provide respiratory protection against novel influenza virus infection. The best way to prevent exposure to influenza is to avoid contact with ill people. Other steps include avoiding crowded setting and washing your hands frequently.
What can I do to protect myself and my family?
Take these everyday steps to protect your health:
* Cover your nose and mouth with a tissue or your sleeve when you cough or sneeze. Throw the tissue in the trash after you use it.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
* Avoid touching your eyes, nose or mouth. Germs spread this way.
* Try to avoid close contact with sick people.
* Get a H1N1 influenza vaccine. The H1N1 influenza vaccine is not available yet, but it may be available in mid-October. In King County H1N1 vaccine will be distributed using Public Health clinics, private providers and pharmacies. Individuals and families can get their H1N1 influenza vaccine at the same place they get the seasonal flu vaccine.
* Get your seasonal flu vaccine. The H1N1 influenza vaccine does not replace seasonal flu vaccine. It is important that people in high risk groups for seasonal flu get their seasonal influenza shot so that they are protected. Older individuals are at higher risk for seasonal flu and Public Health recommends they get the flu vaccine every years.
* If you don't have one yet, consider developing a family emergency plan as a precaution. This should include storing a supply of extra food, medicines, and other essential supplies. This is to avoid contact with other people as much as possible, including trips to the store. Prepare to get by for at least two weeks on what you have at home.
* Cover your nose and mouth with a tissue or your sleeve when you cough or sneeze. Throw the tissue in the trash after you use it.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
* Avoid touching your eyes, nose or mouth. Germs spread this way.
* Try to avoid close contact with sick people.
* Get a H1N1 influenza vaccine. The H1N1 influenza vaccine is not available yet, but it may be available in mid-October. In King County H1N1 vaccine will be distributed using Public Health clinics, private providers and pharmacies. Individuals and families can get their H1N1 influenza vaccine at the same place they get the seasonal flu vaccine.
* Get your seasonal flu vaccine. The H1N1 influenza vaccine does not replace seasonal flu vaccine. It is important that people in high risk groups for seasonal flu get their seasonal influenza shot so that they are protected. Older individuals are at higher risk for seasonal flu and Public Health recommends they get the flu vaccine every years.
* If you don't have one yet, consider developing a family emergency plan as a precaution. This should include storing a supply of extra food, medicines, and other essential supplies. This is to avoid contact with other people as much as possible, including trips to the store. Prepare to get by for at least two weeks on what you have at home.