"Advisory on influenza- A H1N1"

Posted on August 12, 2009
1. What is Influenza – A (H1N1) and what is the current situation
• Influenza – A (H1N1) is an influenza virus causing illness in people. First detected in Mexico in April, 2009, it has spread more than 168 countries in the World
• World Health Organization (WHO) has given Influenza A – H1N1 virus a pandemic alert of Phase 6. At this time, WHO considers the overall severity of the influenza pandemic to be moderate. This is based on scientific evidence as well as input from WHO Member States on the pandemic’s impact on their health systems, and their social and economic functioning.
• The moderate assessment reflects that:
 Most people recover from infection without the need for hospitalization or medical care.
 Overall, hospitals and health care systems in most countries have been able to cope with the numbers of people seeking care, although some facilities and systems have been stressed in some localities.
• As of 31st July 2009, WHO has reported 1,62,000 laboratory confirmed cases of H1N1 across 168 countries. As of 4th August 2009, India has reported 558 laboratory confirmed cases of H1N1.
2. What are the signs and symptoms of influenza-A (H1N1)?
The symptoms of H1N1 in people are similar to the symptoms of regular seasonal flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with influenza-A (H1N1).
3. How does influenza-A (H1N1) spread?
Flu viruses are spread mainly from person to person through droplets created while coughing or sneezing by a person infected with the influenza-A (H1N1).
• Incubation period (period of time before symptoms appear) – 2-7 days depending on the immunity of the individual
• Infectious Period – Infected person may be able to infect others beginning one day before symptoms develop and up to seven or more days after becoming sick.
• Viruses can live for 2-8 hours or longer outside the body.
• Children, people above 65 years of age and people with pre-existing illnesses are more susceptible as their immunity level is lower.
• Pork products are absolutely safe if properly cooked.
4. What can I do to protect myself from getting sick?
• Maintain good immunity by getting enough sleep, drinking lots of water and eating nutritious food
• Avoid crowded places unless necessary
• 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 or mouth. Germs spread this way.
• Try to avoid close contact with people having respiratory illness.
• If you have to be in contact with people having respiratory illness, try to keep good distance (6 feet)
• Returning international travelers follow the screening procedures at the airport and self-monitor themselves and their families for any symptoms after return
5. What is the treatment for Influenza A (H1N1)
Anti viral drugs (Tamiflu) can be administered to reduce the illness and prevent serious flu complications. There is currently no vaccine available. Government of India has issued the following testing guidelines for H1N1:
• Testing for H1N1 will only be done in designated government health facilities. Private hospitals or labs cannot test patients for H1N1
• Any person with flu like symptoms such as fever, cough, sore throat, cold and running nose will have to go only to a designated government facility for testing.
• After clinical assessment, the designated medical officer will decide whether the symptoms require sample collection and testing. Once samples are collected, the patient will be allowed to go home.
• The sample of the suspect case will be sent to the notified laboratory for testing. If tested as positive for H1N1 and in case the symptoms are mild, the patient will be informed and given the option of admission to hospital or isolation and treatment in his/her own home.
• In case the patient opts for home isolation and treatment, he/she will be provided with detailed guidelines and safety measures that need to be strictly adhered to by the entire household of the patient.
• The family will then have to provide full contact details of the entire household. The household and social contacts of the infected patient will then be administered with a prophylaxis case of Tamiflu
• If the government designated doctor prescribes sample testing, please inform your PM and HR team immediately of the contacts made in office.
• Testing Centers in Bangalore
 Victoria Hospital – 26703284
 Lakeside Hospital – 25366725
 Rajiv Gandhi Institute of Chest Diseases – 26632634
• Testing Center in Hyderabad
 AP Chest Hospital – Dr Prasad – 9849902995
6. Monitoring the current situation
• http://www.mohfw.nic.in/SWINEFLU.htm – Ministry of Health website has information on daily press releases of confirmed H1N1 cases detected at international entry with flight details, list of isolation facilities and nodal officers in various cities.
• GoI Outbreak Monitoring Cell – 011-23921401
• http://www.who.int/csr/disease/swineflu/en/ – WHO website on the latest situation
• http://www.cdc.gov/h1n1flu/ – Center for Disease Control and Prevention (CDC) updates
• http://www.who.int/csr/don/h1n1_20090731_weekly.png – List of affected countries as of 31st July 2009