Swine Flu

The other day, I was discussing about Darwinism with a little boy next door. As I was educating him on this theory, I realized it is best understood with examples. As a doctor, microorganisms and infection are the first examples I could cite to explain to this boy about Darwin’s theory. The current swine flu pandemic best fits this example. A strong and healthy individual is more likely to recover from swine flu infection than compatriots who are not so medically fit.

Today as I begin writing this article about swine flu, I would like to enlighten you with some common facts about the swine flu virus.

• The virus that causes swine flu belongs to the family of influenza viruses. It causes endemic infection amongst pigs and rarely crosses over to affect humans. As of now, influenza subtype A strains which include H1N1 is the most common strain causing the current swine flu pandemic amongst humans.
• There are strains similar to H1N1 from subtype A and influenza subtype C categories which can affect humans.
• Being a flu virus, it also favors cold weather. Therefore, winter and rainy seasons are the times when this infection begins to affect one’s health.
• It presents as fever, running nose, sore throat, headaches, generalized body aches and generalized weakness within 2-4 days of exposure. Diarrhea and vomiting can occur in some individuals.
• Complications from initial infection include pneumonia, respiratory failure, dehydration, electrolyte disturbance and neuro disturbance which are seen in severe cases. The risks of complications have an increased probability in children below 5 years, elders above 65 years, pregnant ladies, postpartum women, asthmatic patients and those suffering from chronic medical diseases such as heart condition, kidney disorder and chronic infections such as HIV, tuberculosis and those who are immune-suppressed.
• Antiviral Oseltamivir (Tamiflu) and Zanamivir (Relenza) are two Food and Drug Administration (FDA) recommended agents that is known to control swine flu infection.
• The efficacy of antiviral agents against swine flu influenza strains is not clearly known. Furthermore, there are reports of drug resistance development. Therefore, antiviral agents are used selectively.
• Good personal hygiene and clean patient care are very effective tools to prevent the spread of swine flu.

Though the list of facts I wrote seems deadly in a practical setting, this virus hits most people in a mild manner. The general symptoms are usually subtle fever, cold and difficulty due to H1N1 or one can have all the listed severity but not caused by H1N1. I would say, thanks to all the information broadcasting and media, a lot of findings on this flu at every clinic has been hysterical and overblown. Therefore, I tell my patients not to overreact with every fever, cold and sore throat. Though the virus affects people with underlying medical risks in an alarming way, most people are able to go through influenza infection and are recovering well.

What you can do to treat it?

1. Stay indoors: Bed rest is the most important treatment. It helps the body to concentrate on fighting the virus. Staying at home also prevents you from infecting others, should the infection be from H1N1.
2. Drink plenty of fluids: Drink fluids and eat as much healthy food as possible.
3. Use over-the-counter medication if there is a need. Based on how the symptoms are, you can choose from a list of over-the-counter medications like Acetaminophen (Paracetamol), Ibuprofen, decongestants and expectorant brands.
4. Cover mouth and nose every time you cough and sneeze. It will be better if the patient is isolated from children and the elderly.
5. Plan a visit to the doctor. Unless the fever doesn’t come down in 2 days’ time or you have difficulty in breathing, you may not need to visit a doctor. You should call the doctor early if you:

• Are past your 65th birthday
• Have a history of chronic medical conditions such as tuberculosis, HIV, cancer, heart or kidney disease
• Have previous respiratory ailments including asthma, bronchitis or COPD
• Are on long term steroids / chemotherapy / immune-suppressants
• Your son / daughter is under 5 years and suffering with above mentioned symptoms

How to prevent swine flu?
From our past experience with H1N1 pandemic, we are able to formulate a vaccination against swine flu. FDA has thereby approved vaccine against various strains of swine flu.  Contact your healthcare provider to know about its availability in your community.

Those who haven’t received swine flu vaccine can still protect themselves against infection by maintaining good personal hygiene, keeping away from smoking and improving nutrition intake. It isn’t absolutely necessary to walk with a face mask; however, it becomes a necessity when you walk into a hospital / clinic that accept swine flu patients and when you are amongst a community who are infected.