More Flu Info

Here's the latest info on the flu that I have received:

Swine Flu

What you should do:
1. Stay home if you are sick.
2. Don’t get on an airplane if you are sick with respiratory symptoms.
3. Wash your hands regularly.
4. If your child is sick, don’t send him/her to school.
Information and Resources:
Outbreak Information
For complete information: CDC Swine Flu Investigation site
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April 27, 2009

Swine Flu Update:

The following states have confirmed cases of H1 swine flu: Ohio – 1 case with history of travel to Mexico, California – 7 cases, no hx of travel; Texas-2 cases, no hx of travel, Kansas-2 cases with a travel hx; and NYC – 8 cases with hx of travel. The age range is 7 yrs -54 yrs of age. The incubation period is 2-5 days (primarily 4-5 days). The attack rate for acute respiratory illness is 27% and the attack rate for ILI (influenza like illness) is 13%. It appears to be a mild illness and only one case has been admitted to the hospital. This is just the opposite of Mexico who is seeing a large number of deaths. CDC is trying to determine why our cases are mild and Mexico is so severe. They do expect it to spread throughout the U.S. and current recommendations are to treat it like our usual seasonal flu.
There are everyday actions people can take to stay healthy.
Cover your nose and mouth with a tissue 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 hands cleaners are also effective.
Avoid touching your eyes, nose or mouth. Germs spread that way.
Try to avoid close contact with sick people.
Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
New Zealand has reported several possible cases as well as Canada and Israel .



Definitions of Respiratory Illness
Influenza-like Illness
Fever or feverishness (fever >37.8°C (100°F)
Plus one or two of the following: Rhinorrhea or nasal congestion
Sore throat
Cough
Myalgias

Case Definitions for Infection with Swine Influenza A (H1N1) Virus
A Confirmed case of swine influenza A (H1N1) virus infection is defined as a person with an acute respiratory illness with laboratory confirmed swine influenza A (H1N1) virus infection at CDC by one or more of the following tests:
1. real-time RT-PCR
2. viral culture

A Probable case of swine influenza A (H1N1) virus infection is defined as a person with an acute respiratory illness with an influenza test that is positive for influenza A, but H1 and H3 negative.
A Suspected case of swine influenza A (H1N1) virus infection is defined as:
1. A person with an acute respiratory illness who was a close contact to a confirmed case of swine influenza A (H1N1) virus infection while the case was ill OR
2. A person with an acute respiratory illness who has traveled to an area where there are confirmed cases of swine influenza A (H1N1) within 7 days of suspect case's illness onset.

Infectious period for confirmed cases = 1 day before onset to 7 days after onset of illnessDay before onset = Day -1Onset day = Day 0Days after onset = Days 1-7
Close contact is defined as: within about 6 feet of an ill person who is a confirmed or suspected case of swine influenza A (H1N1) virus infection during the case’s infectious period.

Antiviral Treatment (guidelines from CDC)

Suspected Cases
Empiric antiviral treatment is recommended for any ill person suspected to have swine influenza A (H1N1) virus infection. Antiviral treatment with either zanamivir alone or with a combination of oseltamivir and either amantadine or rimantadine should be initiated as soon as possible after the onset of symptoms. Recommended duration of treatment is five days. Recommendations for use of antivirals may change as data on antiviral susceptibilities become available. Antiviral doses and schedules recommended for treatment of swine influenza A (H1N1) virus infection are the same as those recommended for seasonal influenza: http://www.cdc.gov/flu/professionals/antivirals/dosagetable.htm#table

Confirmed Cases
For antiviral treatment of a confirmed case of swine influenza A (H1N1) virus infection, either oseltamivir or zanamivir may be administered. Recommended duration of treatment is five days. These same antivirals should be considered for treatment of cases that test positive for influenza A but test negative for seasonal influenza viruses H3 and H1 by PCR.

Pregnant Women
Oseltamivir, zanamivir, amantadine, and rimantadine are all “Pregnancy Category C" medications, indicating that no clinical studies have been conducted to assess the safety of these medications for pregnant women. Only two cases of amantadine use for severe influenza illness during the third trimester have been reported. However, both amantadine and rimantadine have been demonstrated in animal studies to be teratogenic and embryotoxic when administered at substantially high doses. Because of the unknown effects of influenza antiviral drugs on pregnant women and their fetuses, these four drugs should be used during pregnancy only if the potential benefit justifies the potential risk to the embryo or fetus; the manufacturers' package inserts should be consulted. However, no adverse effects have been reported among women who received oseltamivir or zanamivir during pregnancy or among infants born to such women.

Antiviral Chemoprophylaxis
For antiviral chemoprophylaxis of swine influenza A (H1N1) virus infection, either oseltamivir or zanamivir are recommended. Duration of antiviral chemoprophylaxis is 7 days after the last known exposure to an ill confirmed case of swine influenza A (H1N1) virus infection. Antiviral dosing and schedules recommended for chemoprophylaxis of swine influenza A (H1N1) virus infection are the same as those recommended for seasonal influenza: http://www.cdc.gov/flu/professionals/antivirals/dosagetable.htm#table
Antiviral chemoprophylaxis (pre-exposure or post-exposure) with either oseltamivir or zanamivir is recommended for the following individuals:
Household close contacts who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) of a confirmed or suspected case.
School children who are at high-risk for complications of influenza (persons with certain chronic medical conditions) who had close contact (face-to-face) with a confirmed or suspected case.
Travelers to Mexico who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).
Border workers ( Mexico ) who are at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly).
Health care workers or public health workers who had unprotected close contact with an ill confirmed case of swine influenza A (H1N1) virus infection during the case’s infectious period.
Antiviral chemoprophylaxis (pre-exposure or post-exposure) with either oseltamivir or zanamivir can be considered for the following:
Any health care worker who is at high-risk for complications of influenza (persons with certain chronic medical conditions, elderly) who is working in an area with confirmed swine influenza A (H1N1) cases, and who is caring for patients with any acute febrile respiratory illness.
Non-high risk persons who are travelers to Mexico , first responders, or border workers who are working in areas with confirmed cases of swine influenza A (H1N1) virus infection.