1. Facts About
Novel H1N1 Influenza
[Swine Flu]

2. Novel H1N1 Influenza
Novel H1N1 (referred to a swine flu early on) is a new influenza virus
It is spreading from person-to-person.
Piramal Healthcare goals are to:
Provide information to help to our field executives and health care providers address the challenges posed by this emergency.
Help reduce transmission and illness severity

3. Swine Flu & H1N1
H1N1 (referred to as “swine flu” early on) is a new influenza virus
This new virus was first detected in people in the United States in April 2009.
Other countries, including Mexico and Canada, have reported people sick with this new virus.
This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.

4. Swine Flu & H1N1
Swine Influenza (swine flu) orignally is a respiratory disease of pigs caused by Type A influenza viruses that causes regular outbreaks in pigs.
Novel H1N1 Influenza [Swine Flu] outbreak certainly poses the potential to be at least as serious as seasonal flu.
Especially given the fact that there currently is no vaccine against this virus.
Because this is a new virus, most people will not have immunity to it, and illness may be more severe and widespread as a result.

5. How many H1N1 (swine) flu viruses are there?
Like all influenza viruses, swine flu viruses change constantly.
Pigs can be infected by avian influenza and human influenza viruses as well as swine influenza viruses.
When influenza viruses from different species infect pigs, the viruses can reassort (i.e. swap genes) and new viruses that are a mix of swine, human and/or avian influenza viruses can emerge.
Over the years, different variations of swine flu viruses have emerged.
At this time, there are four main influenza type A virus subtypes that have been isolated in pigs: H1N1, H1N2, H3N2, and H3N1. However, most of the recently isolated influenza viruses from pigs have been H1N1 viruses.

6. How severe is illness associated with this new H1N1 virus?
It’s not known at this time how severe this virus will be in the general population.
In seasonal flu, there are certain people that are at higher risk of serious flu-related complications.
This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with chronic medical conditions.
It’s unknown at this time whether certain groups of people are at greater risk of serious flu-related complications from infection with this new virus.

7. How does novel H1N1 Influenza spread?
This virus is thought to spread the same way seasonal flu spreads
Primarily through respiratory droplets
Coughing
Sneezing
Touching respiratory droplets on yourself, another person, or an object, then touching mucus membranes (e.g., mouth, nose, eyes) without washing hands

8. How long can viruses live outside the body?
We know that some viruses and bacteria can live two hours or longer on surfaces like cafeteria tables, doorknobs, and desks.
Frequent hand washing will help you reduce the chance of getting contamination from these common surfaces.

9. How can someone with the flu infect someone else?
Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick.
That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

10. Can you get novel H1N1 Influenza from eating pork?
The novel H1N1 influenza virus (formerly referred to as swine flu) virus is not spread by food.
You cannot get novel H1N1 flu from eating pork or pork products. Eating properly handled and cooked pork products is safe.

11. What are the signs and symptoms of H1N1 (swine) flu in people?
The symptoms are similar to the symptoms of regular human flu include fever, cough, sore throat, body aches, headache, chills and fatigue.
Some people have reported diarrhea and vomiting associated with H1N1 (swine) flu.
In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with H1N1 (swine) flu infection in people.
Like seasonal flu, H1N1 (swine) flu may cause a worsening of underlying chronic medical conditions.

12. In children emergency warning signs that need urgent medical attention include:
Fast breathing or trouble breathing
Bluish or gray skin color
Not drinking enough fluids
Severe or persistent vomiting
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms improve but then return with fever and worse cough

13. In adults, emergency warning signs that need urgent medical attention include:
Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting
Flu-like symptoms improve but then return with fever and worse cough

14. How long can an infected person spread swine flu to others?
People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset.
Children, especially younger children, might potentially be contagious for longer periods.

15. Are there medicines to treat swine flu?
Yes. Oseltamivir (Tamiflu®) or zanamivir (Relenza®) are recommended for the treatment and/or prevention of infection with these swine influenza viruses.
[Note: It is decided by the healthcare provider whether to prescribe these medications seeing the medical condition of patients]
Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body.
If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications.

16. What can you do to protect yourself from getting sick?
There is no vaccine right now to protect against this new H1N1 virus.
However, everyday actions can help prevent spread of germs that cause respiratory illnesses like influenza.

17. What can I do to protect myself from getting sick?
Currently available seasonal influenza vaccine does not protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.
Take these everyday steps to protect your health:
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 one gets sick with influenza, one must stay at home, away from work or school and limit contact with others to keep from infecting them. However, if one is having any respiratory distress, one should report to a nearby hospital.

18. Infection control measures at Individual level
Hand Hygiene
Hand hygiene is the single most important measure to reduce the risk of transmitting infectious organism from one person to other.
Hands should be washed frequently with soap and water / alcohol based hand rubs/ antiseptic hand wash and thoroughly dried preferably using disposable tissue/ paper/ towel.
After contact with respiratory secretions or such contaminated surfaces.
Any activity that involves hand to face contact such as eating/ normal grooming / smoking etc.

20. Respiratory Hygiene/Cough Etiquette
The following measures to contain respiratory secretions are recommended for all individuals with signs and symptoms of a respiratory infection.
Cover the nose/mouth with a handkerchief/ tissue paper when coughing or sneezing;
Use tissues to contain respiratory secretions and dispose of them in the nearest waste receptacle after use;
Perform hand hygiene (e.g., hand washing with non- antimicrobial soap and water, alcohol-based hand rub, or antiseptic hand wash) after having contact with respiratory secretions and contaminated objects/materials

21. Staying away
Stay away from infected cases. If contact is inevitable, maintain at least arms length.
Avoid hand shake
Wash hands if in contact with a suspect case.

22. Use of mask
Three layered surgical mask is recommended for all cases and immediate family and social contacts.
If masks are worn, proper use and disposal is essential to ensure they are potentially effective and to avoid any increase in risk of transmission associated with the incorrect use of masks.

23. Correct use of masks
• Place mask carefully to cover mouth and nose and tie securely to minimise any gaps between the face and the mask
• While in use, avoid touching the mask − whenever you touch a used mask, for example when removing or washing, clean hands by washing with soap and water or using an alcohol-based handrub
• Replace masks with a new clean, dry mask as soon as they become damp/humid
• Do not re-use single-use masks, discard single-use masks after each use and dispose of them immediately upon removing.

24. Although some alternative barriers to standard medical masks are frequently used (e.g. cloth mask, scarf, paper masks, rags tied over the nose and mouth), there is insufficient information available on their effectiveness.
If such alternative barriers are used, they should only be used once or, in the case of cloth masks, should be cleaned thoroughly between each use (i.e. wash with normal household detergent at normal temperature).
They should be removed immediately after caring for the ill.
Hands should be washed immediately after removal of the mask.

26. How to dispose of the masks?
Disposing of masks can be done in a number of ways but
·       dip it in phenyl or any other disinfectant solution before disposing it off in a dustbin
·       burning it

27. Ninety five laboratory confirmed cases have been reported today.
Government of India Ministry of Health and Family Welfare Influenza A [H1N1]
As on 31st July 2009 WHO has reported laboratory confirmed cases of influenza A/H1N1 and 1154 deaths. No further update is available.
Ninety five laboratory confirmed cases have been reported today.
Pune (47), Mumbai (22), Panchgani (6), Delhi (14), Noida (1), Ajmer (1) Gurgaon (1) and Mangalore (3),
Status as on: Dated 10th August, 2009

31. Pandemic Influenza Phases

32. Phase 6 pandemic

33. Remember