Monday, August 10, 2009


H1N1 virus is a new type of Influenza virus affecting pigs, humans and
maybe some other animals. Humans do not yet have herd immunity to it
as they do to other types of flu viruses. Hence, it is spreading like
wildfire and at a rate faster than any other virus epidemic we can
recall. By itself and at present, it is a very low mortality viral
infection and the risk of death (in kids who have low immunity, and
adults at old age especially when weakened by diabetes or other
debilitating disorders) is pale in comparison to childhood diarrhea,
typhoid, bronchopneumonia at extremes of age, and many other diseases
that we are used to.
The main worry is that the next mutated form of this virus, expected
within a year, may acquire higher levels of virulence to cause death
and or severe complications. To preempt that state of risk, we have to
build the overall level of immunity in the general population (herd
immunity) either by infection or with the help of a vaccine.

To reduce risks of vaccine-mediated injury, the R & D of Panacea
Biotec has been on the forefront in India in developing vaccines
without the use of adjuvants and preservatives which are theoretically
suspected in some quarters to be potentially toxic especially to
infants. In a pandemic of this nature, there is neither time nor
requirement to do large safety studies that are mandatory to get any
new vaccine approved.

Computational Models show Spanish HINI with no drugs bound, Avian H5NI
with Tamiflu bound and Swine A/HINI with Relenza bound


Just like any another flu, predominantly upper respiratory symptoms
like cough, cold accompanied by the usual fever, headache, body ache,
loss of appetite, sore throat, weakness, and sometimes uneasy stomach
has been reported in many cases. Mild respiratory illness (nasal
congestion, rhinorrhea - runny nose) without fever and occasional
severe disease also has been reported. Other symptoms reported with
swine influenza A virus infection include vomiting, diarrhea, myalgia,
headache, chills, fatigue, and dyspnea. Conjunctivitis is rare, but
has been reported. Severe disease (pneumonia, respiratory failure) and
fatal outcomes have been reported with swine influenza A virus
infection. The potential for exacerbation of underlying chronic
medical conditions or invasive bacterial infection with swine
influenza A virus infection should be considered. People at higher
risk of serious complications from seasonal flu include people age 65
years and older, younger than 18 years, pregnant women, people of any
age with chronic medical conditions (such as asthma, diabetes, or
heart disease), and people who are immuno-compromised (e.g., taking
immunosuppressive medications, infected with HIV).Mortality rate due
to the infection is about half of one percent, which is much lower
compared to many infective diseases common in day to day life.

Whenever any of above symptoms start, go to nearest Government
approved laboratories for checkup and testing for H1N1 infection. Most
private laboratories check for influenza A and B virus infection. Such
test kits are not highly specific or sensitive to catch H1N1 virus
infection in time.
The antiviral drugs (oseltamivir and zanamivir) which are highly
effective against H1N1 infection are available from Government sources
and must not be used indiscriminately as it may cause resistance
against virus.

If any person tests positive, all household members and close contacts
should to be treated simultaneously and kept under watch for seven
days, the time taken to build up body immunity.

For symptomatic relief:
For relief of fever, anti-pyretic medications such as acetaminophen or
non steroidal anti-inflammatory drugs including Nimesulide are
recommended. Aspirin or aspirin-containing products should not be
administered to any confirmed or suspected case of influenza A (H1N1)
virus infection in subjects aged 18 years or younger due to the risk
of Reye's syndrome.

Emergency Warning Signs
If you become ill and experience any of the warning signs, seek
emergency medical care at nearest government hospital.

In children, emergency warning signs that need urgent medical attention include:

Fast breathing or trouble breathing

Bluish or gray skin color

Not drinking enough fluids

Severe or persistent vomiting

Not waking up or not interacting

Being so irritable that the child does not want to be held

Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

Difficulty breathing or shortness of breath

Pain or pressure in the chest or abdomen

Sudden dizziness


Severe or persistent vomiting

Flu-like symptoms improve but then return with fever and worse cough

Protect Yourself, Your Family, and Community

Stay informed.

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 hand cleaners are also effective.

Avoid touching your eyes, nose and mouth. Germs spread this way.

Try to avoid close contact with sick people.

If you are sick, you may be ill for a week or longer. You should stay
home and keep away from others as much as possible. Stay home for at
least 24 hours after your fever is gone except to get medical care or
for other necessities. (Your fever should be gone without the use of
fever-reducing medicine.) Keep away from others as much as possible.
This is to keep from making others sick.

If you are sick and sharing a common space with other household
members in your home, wear a facemask, if available and tolerable, to
help prevent spreading the virus to others.

With seasonal flu, people may be contagious from one day before they
develop symptoms to up to 7 days after they get sick. Children,
especially younger children, might potentially be contagious for
longer periods.

If you are in a high risk group for complications from influenza, you
should attempt to avoid close contact (within 6 feet) with household
members who are sick with influenza. If close contact with a sick
individual is unavoidable, consider wearing a facemask or respirator,
if available and tolerable.  Infants and pregnant women should not be
cared for by sick family members.

Follow public health advice regarding school closures, avoiding
crowds, and other social distancing measures.

Monitor yourself and household members for flu symptoms and contact a
health care provider if symptoms occur.

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