Treatment and Prevention of Swine Flu!!!!

Swine influenza (also called swine flu, hog flu, and pig flu) is an infection by any one of several types of swine influenza virus. Swine influenza virus (SIV) is any strain of the influenza family of viruses that is endemic in pigs. The known SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H3N1, H3N2, and H2N3

Clinical features Of Swine flu:

Important clinical features of swine influenza include fever, and upper respiratory symptoms such as cough and sore throat. Head ache, body ache, fatigue diarrhea and vomiting have also been observed.

Investigations:

Routine investigations required for evaluation and management of a patient with
symptoms as described above will be required. These may include
haematological, biochemical, radiological and microbiological tests as necessary.
Confirmation of influenza A(H1N1) swine origin infection is through:
-Real time RT PCR or
-Isolation of the virus in culture or
-Four-fold rise in virus specific neutralizing antibodies.

Treatment:

The guiding principles are:
-Early implementation of infection control precautions to minimize the spread of disease
-Prompt treatment to prevent severe illness & death.
-Early identification and follow up of persons at risk.

Anti-viral Medication:

Oseltamivir is the recommended drug both for prophylaxis and treatment. The other anti-viral drug is Zanamivir.

Dosage for treatment is as follows:

By Weight:
For weight less than 15kg, 30 mg twice a day (BD) for 5 days
For weight between 15-23kg, 45 mg BD for 5 days
For weight between 24-40kg, 60 mg BD for 5 days
For weight greater than 40kg, 75 mg BD for 5 days

For infants:
3 months -12 mg BD for 5 days
3-5 months- 20 mg BD for 5 days
6-11 months -25 mg BD for 5 days

If needed dose and the duration can be modified as per clinical condition.

Preventive treatment (prophylaxis) for swine flu:

Oseltamivir is the drug of choice. Prophylaxis should be provided till 10 days after last exposure.

By Weight:
For weight less than 15kg, 30 mg once daily (OD)
For 15-23kg, 45 mg OD
For 24-40kg, 60 mg OD
For weight greater than 40kg, 75 mg OD

For infants:
Less than 3 months not recommended unless situation judged critical due to limited data on use in this age group
3-5 months, 20 mg once daily (OD)
6-11 months, 25 mg OD

Supportive therapy:

-IV Fluids.
-Parentral nutrition.
-Oxygen therapy/ ventilatory support.
-Antibiotics for secondary infection.
-Vasopressors for shock.
-Paracetamol or ibuprofen is prescribed for fever, myalgia and headache. Patient is advised to drink plenty of fluids. Smokers should avoid smoking. For sore throat, short course of topical decongestants, saline nasal drops, throat lozenges and steam inhalation may be beneficial.
-Salicylate / aspirin is strictly contra-indicated in any influenza patient.
-Maintain airway, breathing and circulation (ABC);
-Maintain hydration, electrolyte balance and nutrition.
-If the laboratory reports are negative, the patient should be discharged after giving full course of oseltamivir.

Some DO's and DONT's
-Cover your nose and mouth with atissue when uou 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 and sneeze. Alcohol based hand cleaners are also effective.
-Avoid touching your eyes, nose or mouth. The virus can spread this way.
-Try to avoid close contact with sick people.
-If you get sick with influenza, stay at home and avoid contact with others to keep from infecting them.