All You Need To Know About Swine Flu

Posted on: 27 April 2009 by Gareth Hargreaves

Infection control experts are scrambling to respond to outbreaks of swine flu in Mexico and the US, and suspected cases elsewhere.

A top European Union official has warned against travel to areas hit by a outbreak of swine flu, amid growing concern over the spread of the virus.

Experts suspect it has killed more than 100 people in Mexico. Cases have also been found in Canada, the US and on Monday in Spain.

At least five other nations are testing patients for possible swine flu.

What is swine flu?

Swine flu is a respiratory disease, caused by influenza type A which infects pigs.

There are many types, and the infection is constantly changing.

Until now it has not normally infected humans, but the latest form clearly does, and can be spread from person to person - probably through coughing and sneezing.

What is new about this type of swine flu?

Swine Flu

  • Symptoms usually similar to seasonal flu - but deaths recorded in Mexico It is a new version of the H1N1 strain which caused the 1918 flu pandemic.
  • Too early to say whether it will lead to a pandemic.
  • Current treatments do work, but there is no vaccine.
  • Good personal hygiene, such as washing hands, covering nose when sneezing advised.

The World Health Organization has confirmed that at least some of the human cases are a never-before-seen version of the H1N1 strain of influenza type A.

H1N1 is the same strain which causes seasonal outbreaks of flu in humans on a regular basis.

But this latest version of H1N1 is different: it contains genetic material that is typically found in strains of the virus that affect humans, birds and swine.

Flu viruses have the ability to swap genetic components with each other, and it seems likely that the new version of H1N1 resulted from a mixing of different versions of the virus, which may usually affect different species, in the same animal host.

Pigs provide an excellent 'melting pot' for these viruses to mix and match with each other.

How dangerous is it?

Symptoms of swine flu in humans appear to be similar to those produced by standard, seasonal flu.

These include fever, cough, sore throat, body aches, chills and fatigue.

Most cases so far reported around the world appear to be mild, but in Mexico lives have been lost.

How worried should people be?

Flu Pandemics

  • 1918: The Spanish flu pandemic remains the most devastating outbreak of modern times - infecting up to 40% of the world's population and killing more than 50m people, with young adults particularly badly affected.
  • 1957: Asian flu killed two million people. Caused by a human form of the virus, H2N2, combining with a mutated strain found in wild ducks. The elderly were particularly vulnerable.
  • 1968: An outbreak first detected in Hong Kong, and caused by a strain known as H3N2, killed up to one million people globally, with those over 65 most likely to die.

When any new strain of flu emerges that acquires the ability to pass from person to person, it is monitored very closely in case it has the potential to spark a global epidemic, or pandemic.

The World Health Organization has warned that taken together the Mexican and US cases could potentially trigger a global pandemic, and stress that the situation is serious.

However, experts say it is still too early to accurately assess the situation fully.

Currently, they say the world is closer to a flu pandemic than at any point since 1968 - rating the threat at three on a six-point scale.

Nobody knows the full potential impact of a pandemic, but experts have warned that it could cost millions of lives worldwide. The Spanish flu pandemic, which began in 1918, and was also caused by an H1N1 strain, killed millions of people.

The fact that all the cases in the US have so far produced mild symptoms is encouraging. It suggests that the severity of the Mexican outbreak may be due to an unusual geographically-specific factor - possibly a second unrelated virus circulating in the community - which would be unlikely to come into play in the rest of the world.

Alternatively, people infected in Mexico may have sought treatment at a much later stage than those in other countries.

It may also be the case that the form of the virus circulating in Mexico is subtly different to that elsewhere - although that will only be confirmed by laboratory analysis.

There is also hope that, as humans are often exposed to forms of H1N1 through seasonal flu, our immune systems may have something of a head start in fighting infection.

However, the fact that many of the victims are young does point to something unusual. Normal, seasonal flu tends to affect the elderly disproportionately.

Can the virus be contained?

The virus appears already to have started to spread around the world, and most experts believe that containment of the virus in the era of readily available air travel will be extremely difficult.

Can it be treated?

The US authorities say that two drugs commonly used to treat flu, Tamiflu and Relenza, seem to be effective at treating cases that have occurred there so far. However, the drugs must be administered at an early stage to be effective.

Use of these drugs may also make it less likely that infected people will pass the virus on to others.

The UK Government already has a stockpile of Tamiflu, ordered as a precaution against a pandemic.

It is unclear how effective currently available flu vaccines would be at offering protection against the new strain, as it is genetically distinct from other flu strains.

US scientists are already developing a bespoke new vaccine, but it may take some time to perfect it, and manufacture enough supplies to meet what could be huge demand.

A vaccine was used to protect humans from a version of swine flu in the US in 1976.

However, it caused serious side effects, including an estimated 500 cases of Guillain-Barré syndrome. There were more deaths from the vaccine than the outbreak.

What should I do to stay safe?

Anyone with flu-like symptoms who might have been in contact with the swine virus - such as those living or travelling in the areas of Mexico that have been affected - should seek medical advice.

But patients are being asked not to go into doctors surgeries in order to minimise the risk of spreading the disease to others. Instead, they should stay at home and call their healthcare provider for advice.

Although the Foreign and Commonwealth Office says people "should be aware" of the outbreak, it is not currently advising people against travelling to affected areas of Mexico and the US.

What measures can I take to prevent infection?

Avoid close contact with people who appear unwell and who have fever and cough.

General infection control practices and good respiratory hand hygiene can help to reduce transmission of all viruses, including the human swine influenza. This includes covering your nose and mouth when coughing or sneezing, using a tissue when possible and disposing of it promptly.

It is also important to maintain good basic hygiene, for example washing hands frequently with soap and water to reduce the spread of the virus from your hands to face or to other people and cleaning hard surfaces like door handles frequently using a normal cleaning product.

If caring for someone with a flu-like illness, a mask can be worn to cover the nose and mouth to reduce the risk of transmission.

Masks are probably most useful for people with symptoms to prevent them spreading infection and masks need to be changed daily to be effective.

Is it safe to eat pig meat?

Yes. There is no evidence that swine flu can be transmitted through eating meat from infected animals.

However, it is essential to cook meat properly. A temperature of 70C (158F) would be sure to kill the virus.

What about bird flu?

The strain of bird flu which has caused scores of human deaths in South East Asia in recent years is a different strain to that responsible for the current outbreak of swine flu.

The latest form of swine flu is a new type of the H1N1 strain, while bird, or avian flu, is H5N1.

Experts fear H5N1 hold the potential to trigger a pandemic because of its ability to mutate rapidly.

However, up until now it has remained very much a disease of birds.

Those humans who have been infected have, without exception, worked closely with birds, and cases of human-to-human transmission are extremely rare - there is no suggestion that H5N1 has gained the ability to pass easily from person to person.

Your View

The international community is better prepared than ever to deal with the threatened spread of a new swine flu virus, a top UN health chief has said.

Dr Keiji Fukuda said years of preparing for bird flu had led to improved stocks of anti-virals worldwide.

The World Health Organization (WHO) has warned the outbreak, which it says has killed up to 71 people in Mexico, could become a pandemic. In the US, about 20 people are infected, but none are seriously ill.

Schools in and around Mexico City have been closed until 6 May, and some 70% of bars and restaurants in the capital have been temporarily closed.

How concerned are you about the virus? What should governments do to attempt to prevent it from spreading? Are you in Mexico or the US? Do you know anyone who has been affected by the outbreak? 

Let us know by leaving a comment in the box below or share your thoughts with other readers in the 50connect forums.

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