Friday, February 08, 2013

Swine Flu is back in North India, but no need to panic

57 cases of Swine Flu have been recorded in Delhi with three deaths.
Do not panic as this does not mean that for every 57 cases, three will die. This only means that 57 laboratory confirmed cases have been reported. There will be a large number of who have not got tested.
Mortality is high in patients who are pregnant or have underlying heart disease or other organ damage disease. Routine people do not have to worry.
  • Swine flu presents with fever of more than 1000F with cough or sore throat in the absence of any other main cause.
  • The diagnosis is confirmed with a lab test using rRT/PCR technique.
  • Mild or uncomplicated flu or Swine Flu is characterized by fever, cough, sore throat, nasal discharge, muscle pain, headache, chills, malaise and sometimes diarrhea and vomiting. In mild cases, there is no shortness of breath.
  • Progressive swine flu is characterized by above symptoms along with chest pain, increased respiratory rate, decreased oxygen in the blood, labored breathing in children, low blood pressure, confusion, altered mental status, severe dehydration and exacerbation of underlying asthma, renal failure, diabetes, heart failure, angina or COPD.
  • Severe or complicated swine flu is characterized by respiratory failure, requirement of oxygen or ventilator, abnormal chest x-ray, inflammation of the brain, lowering of blood pressure to less than 60 and involvement of the heart muscle. These patients will have persistent high fever and other symptoms lasting more than three days.
  • Most patients will remain asthmatic with illness lasting 3-7 days.
  • The other characteristic features are presence of chills, muscle pain and joint pain.
  • In the pregnant women, flu can cause more serious complications including death of fetus.
  • Patients at extreme of ages are at risk. Mild cases do not require admission but progressive cases need to be admitted.
  • Older age, underlying, organ disease and requirement of mechanical ventilation is the indication for admission.
  • Tamiflu (oseltamivir phosphate) is the treatment of choice but it should be taken under medical supervision. But it has to be given in the first 48 hours. It is given in severely low patients, pregnant women, underlying organ disease or age less than 5 and more than 65 years.
  • Flu vaccine can be given to all. It should be given to all high-risk patients.
  • The virus spreads through droplet infection and spreads with a person coughs, sneezes, sings or speaks. The virus can cover only a distance of 3 to 6 feet.
  • Stay 3 feet away from the person who is coughing.
The standard prevention is respiratory hygiene, cough etiquette and hand hygiene.
  • Hand washing should be performed before and after every patient contact or infectious material and before putting and after removing gloves.
  • Hand hygiene can be performed by washing with soap, water and with alcohol based hand drops.
  • If hands are visibly soiled, they should be washed with soap and water.
  • Patients should be placed in a private room or area. The health care staff should wear a face mask while entering the patient’s room. When leaving the room, the health care workers should remove the face mask, dispose it off and then perform hand hygiene.
  • Patients should wear a surgical mask and should be aware of respiratory hygiene, cough etiquette and hand hygiene.
  • Droplet precaution should be taken for seven days after illness onset or 24 hours after resolutions of fever and respiratory syndrome.
  • One should not cough in the hands, handkerchief but instead cough either in the tissue paper and dispose it off or in the side of the arm.

Comments: I am again suggesting to all my patients & their parents to take the Influenza vaccine. It has been shown to prevent serious Flu disease in around 70 % of people who have taken the vaccine, and is well tolerated and safe. If you want to prevent yourself from catching this serious & life threatening condition, it is certainly important to consider taking this vaccine. Do remember, you need to take one dose every year to maintain the protection, though children (less than 9 years age) require two doses when they take it for the first time.

No comments: