Swine Flu is back but no panic

Dr KK Aggarwal, Padma Shri and Dr B C Roy National Awardee

57 cases of Swine Flu have been recorded in Delhi with four deaths. No panic as this does not mean that for every 57 cases, four will die. It only means 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 having pregnancy, underlying heart disease or other organ damage disease or who are < 5 or > 65 years of age. 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 case is confirmed with a lab test using rRT/PCR technique.

Types of swine flu

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 less than 60, involvement of the heart muscle. These patients will have persistent high fever and other symptoms lasting more than three days.

Can swine flu come without symptoms?

Most patients will remain without symptoms with illness lasting 3-7 days.

The other characteristic features are presence of chills, muscle pain and joint pain.

Who is at risk of flu?

In pregnant lady, flu can have higher 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.

How to treat swine flu

Tamiflu is the treatment of choice but should be taken under medical supervision. But it has to be given in the first 48 hours. It is given in severely sick patients, pregnant ladies, 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.

How does swine flu spread?

The virus spreads through droplet infection through a person who coughs, sneezes, sings or speaks. The virus can cover only a distance of 3 to 6 feet.

How to prevent swine flu

1.   Stay 3 feet away from the person who is coughing.

2.   The standard prevention is respiratory hygiene, cough etiquette and hand hygiene.

3.   Hand washing should be performed before and after every patient contact or infectious material and before putting and after taking off the surgical things like gloves.

4.   Hand hygiene can be performed by washing with soap, water and with alcohol based hand drops.

5.   If hands are visibly soiled, they should be washed with soap and water.

6.   Patients should be placed in a private room or area. The health care staff should wear 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.

7.   Patients should wear a surgical mask and should be aware of respiratory hygiene, cough etiquette and hand hygiene.

8.   Droplet precaution should be taken for seven days after illness onset or 24 hours after resolutions of fever and respiratory syndrome.

9.   One should not cough in the hands, handkerchief but cough either in the tissue paper and dispose it off or in the side of the arm.