Professor Dr Jamal R Al-Rawi INFLEUNZA Professor Professor Dr Jamal R Al-Rawi MBChB, MSc, FICMS PROFESSOR of Community Medicine & , Dermatovenereology College of Medicine, Al-Mustansiryia University Jamal R Al-Rawi MBChB, MSc, FICMS

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 OBJECTIVE(s) Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 VIROLOGY Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 DISCOVERY OF VIRUS Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 VIROLOGY-Continued. Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 THE VIRUS Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013 CLASSIFCATION OF THE VIRUS Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 Nomenclature Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 ANTIGENIC SHIFT Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 ANTIGENIC DRIFT Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 RESORTMENT Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 RESERVOIRS Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013 Resevoir & Transmission Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 CLINICAL MANIFESTATIONS Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Differences between Seasonal and H1N1 Flu Symptoms Seasonal Flu Novel H1N1 Flu Fever Fever is rare with a cold. Fever is usually present with the flu in up to 80% of all flu cases. A temperature of 100°F or higher for 3 to 4 days is associated with the flu. Coughing A hacking, productive (mucus- producing) cough is often present with a cold. A non-productive (non-mucus producing) cough is usually present with the flu (sometimes referred to as dry cough). Aches Slight body aches and pains can be part of a cold. Severe aches and pains are common with the flu. Stuffy Nose Stuffy nose is commonly present with a cold and typically resolves spontaneously within a week. Stuffy nose is not commonly present with the flu. Chills Chills are uncommon with a cold. 60% of people who have the flu experience chills. Tiredness Tiredness is fairly mild with a cold. Tiredness is moderate to severe with the flu. Sneezing Sneezing is commonly present with a cold. Sneezing is not common with the flu. Sudden Symptoms Cold symptoms tend to develop over a few days. The flu has a rapid onset within 3-6 hours. The flu hits hard and includes sudden symptoms like high fever, aches and pains. Headache A headache is fairly uncommon with a cold. A headache is very common with the flu, present in 80% of flu cases. Sore Throat Sore throat is commonly present with a cold. Sore throat is not commonly present with the flu. Chest Discomfort Chest discomfort is mild to moderate with a cold. Chest discomfort is often severe with the flu. Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 CLINICAL DIAGNOSIS Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 LABORATORY DIAGNOSIS Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 HISTORICAL BACKGROUND OF PANDEMICS Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 INFLEUNZA A (H3N2) VARIENT PANDEMICS Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 PANDEMICS & THEIR MORTLITIES Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 CONTROL MEASURES Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 SUMMARY 1 Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 SUMMARY 2 Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 Therapeutic Measures TWO groups of Antiviral effective in Treatment & Prevention of Infleunza virus: Adamananes: THEY ARE CHEAPER & LESS EFFECTIVE Amantadine Remantadine • Inhibitors of Infleunza Neuraminidazs Oseltamivir Zanamivir Authorities Prefer the SECOND GROUP Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Antiviral Medications specially for high risk are effective Antiviral Medications: consult your doctors before leaving to suspected areas . High risk travelers going to infected areas (e.g. persons with diabetes, lung disease, heart disease, and the elderly) are recommended to take antiviral medications for prevention of swine influenza during travel. The recommended antiviral drug is Tamiflu®). It keep flu viruses from reproducing in your body. This drug can prevent infection if taken as a preventative. Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Practice healthy habits Wash your hands often with soap and water. Use waterless alcohol-based hand gels (containing at least 60% alcohol) when soap is not available and hands are not visibly dirty. Cover your mouth and nose with a tissue when you cough or sneeze and put your used tissue in a wastebasket. Professor Abdul H M Al-Hadi, MBChB, MSc, PhD, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 Healthy habits If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands. Wash your hands after coughing or sneezing, using soap and water or an alcohol-based hand gel. Wear a surgical mask if you are in contact with other people. Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Other Normal Precautions Pack a travel health kit that contains basic first aid and medical supplies. Identify the health-care resources in the area(s) you will be visiting. Check if your health insurance plan will cover you abroad. Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 ANTIGENIC VARIABILITY Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 TYPES OF VACCINE Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 CANDIDATE FOR VACCINATION Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 Vaccine Effectiveness • Influenza vaccine changing so matching for an effective vaccine is difficult Because WHO needs to select the virus TWICE/year Northern & Southern hemisphere. • The WHO recommended vaccine contains no swine virus therefore it is not effective in preventing swine flu since there is no cross antigenicity between swine & human infleunza virus Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016 flucounting.org Country No of cases No of death Case Fatality rate Iraq 223 2 0.009 Jordan 405 Kuwait 2881 9 0.003 Lebanon 761 0.0026 Egypt 1211 3 0.0024 Bahrain 450 6 0.13 UK 14114 85 0.006 Australia 36927 185 0.005 Yemen 210 0.0285 Saudi Arabia 4119 35 0.008 Malaysia 7066 77 0.0108 Total World cases 458014 5190 1.13% This Site Renew the world cases every 4 hours Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2016

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013 SWINE FLU Highly Contagious ARD of the pigs Pigs Morbidity High, Mortality Low 1-4% Droplet Spread asymptomatic carriers pigs exist Epidemics among Pigs happen yearly therefore vaccination is routine Swine virus killed by 70 °C 15 minutes Droplet Spread asymptomatic carriers pigs exist Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013

Professor Abdul H M Al-Hadi, MBChB, MSc, PhD, 2009 General Rules Most of the previously reported swine influenza cases recovered fully from the disease without requiring medical attention and without antiviral medicines. Professor Abdul H M Al-Hadi, MBChB, MSc, PhD, 2009

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013 References This research is based mainly on the following sites www.cdc.gov/travel. www.who.int www,mayoclinic.com Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013

Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013 THANK YOU THANK YOU Professor Jamal R Al-Rawi MBChB, MSc, FICMS, 2013