1. Rich Feifer, MD, MPH, FACP April 27, 2009
Swine Flu Update
Rich Feifer, MD, MPH, FACP
April 27, 2009

2. What is “Swine Flu”? Swine Flu is a type of influenza
Usually infects pigs
Human transmission from pigs has regularly but infrequently occurred over the years
Human-to-human has previously been rare
What is happening now?
One type of swine flu, H1N1, has undergone a change into a new virus subtype: Now has the ability to more easily spread from human to human
To avoid confusion: Swine Flu H1N1 is different from Human Flu H1N1

3. World Health Organization (WHO) Pandemic Phases

4. World Health Organization (WHO) Pandemic Phases
Phase 1: No cases of animal influenza virus in humans
Phase 2: Human infection by animal influenza virus
Phase 3: Sporadic cases or small clusters, but no sustained human-to-human spread (Current Level)
Phase 4: Sustained human-to-human spread in communities
Media frenzy
Minimal disruptions to business or clinical care
Phase 5: Sustained human-to-human spread in multiple countries within a global region
Localized disruptions
Fear
Phase 6: Full Pandemic (eg, world)
Multiple “waves”
Healthcare system completely overwhelmed
Social isolation strategies adopted and enforced
Pharmacy supply chain disruptions
Pharmacy and medical regulations liberalized
Government use of emergency powers
Timing ?
Weeks to
Months

5. Current Status
We are not currently in a pandemic, but we are closer to one than we were last week….
A US “Public Health Emergency” was declared on 4/26
This is just a preparedness step, not a description of current pandemic epidemiology or severity
Involves deployment of Federal stockpile of medications to regional sites

6. When is “the flu” NOT the flu?
Symptoms of influenza are severe
High fever
Cough
Sore throat
Body aches
Headache
Extreme fatigue
Occasional diarrhea or vomiting
Most respiratory infections are not the influenza (the flu), they are a cold
Symptoms may be similar to above, but are milder
More likely to have a runny or stuffy nose

7. Protection Measures Contact avoidance Hand washing and hand sanitizers
Antiviral medications
Tamiflu and Relenza – YES
Treatment (suspected vs confirmed H1N1 swine flu)
Pre-exposure prophylaxis
Post-exposure prophylaxis
Amantadine and Rimantadine – NO
Vaccines – NOT YET

8. Important Resources Primary CDC website for influenza
Link to state-level pandemic preparedness and response
(dated 9-08)
Checklist for corporate pandemic preparedness
Interim guidance on antiviral drugs for swine flu

9. Q&A