HeathWise June 2009
By Doctor Rik Heymans
Calle Angustias 24, NERJA
Telephone: 95 252 6775
Mobile : 619 50 21 51

Swine flu

Just when the world had about recovered from the dreaded bird flu, another animal flu is wreaking havoc on the human race. To make matters more confusing, this time it apparently originated in pigs, and not in birds. With the amount of animals still left on the planet, it seems that we could be in for an innumerable amount of diseases - all linked to some animal or other - to strike us.

Swine influenza is a highly contagious respiratory disease in pigs caused by one of several swine influenza (A) viruses. In addition, a different type of viruses, the influenza (C) viruses may also cause this sort of illness in swine. Current strategies to control swine influenza virus in animals typically include one of several commercially available swine influenza virus vaccines - just like for us, humans, for the annual flu campaign!

Transmission of swine influenza viruses to humans is uncommon. However, the swine influenza virus can be transmitted to humans via direct and close contact with infected pigs or such contact with environments, contaminated with swine influenza viruses. Once a human becomes infected, he or she can then spread the virus to other humans, presumably in the same way as seasonal influenza is spread (via coughing or sneezing).

The ability to trace outbreaks of similar swine flu outbreaks in humans dates back to investigation of the 1918 Spanish influenza pandemic, which infected one third of the world's population (an estimated 500 million people) and caused approximately 50 million deaths. In these days the relationship between these viruses and the illnesses was not as clearly understood as it is nowadays: the answers did not begin to emerge until the 1930s, when these related influenza viruses (now known as H1N1 viruses) were isolated from pigs and then humans.

In humans, the severity of swine influenza can vary from mild to severe. From 2005 until January 2009, 12 human cases of swine flu were reported in the United States. None were fatal. In 1988, however, a previously healthy 32-year-old pregnant woman in Wisconsin died of pneumonia as a complication of swine influenza.

Why is this one more dangerous?

Because this new variant contains genetic material from four other viruses, which makes it a dangerous cocktail, against which we humans have no immunity, no defence yet. Hence, it tends to cause high morbidity (this means illnesses associated with it), but only low mortality rates (1%-4%).

Can it cause an epidemic?

This is what is feared: since it is easily transmitted through the air, a cough or sneeze from an infected person is all that it takes to spread it ; or touching a contaminated object and afterwards touching one's own mouth or nose: wearing a mask makes sense!

Eating pork poses no risk whatsoever .

What are the symptoms?

They are very similar to those of the ‘normal', seasonal influenza. Patients present with symptoms of acute respiratory illness, with at least 2 of the following:

- Fever
- Cough
- Sore throat
- Body aches (‘wet rag')
- Headache
- Chills and fatigue
- Diarrhoea and vomiting ( sometimes).

The duration of illness is typically 4-6 days. The infectious period for a confirmed case is defined as 1 day prior to the onset of symptoms to 7 days after onset.

The main danger lies in the bacterial infections which tend to accompany (any) viral infection; of these a bacterial pneumonia is the most frequent, and the most feared.

Treatments consist of the so - called anti viral drugs, as well as quick action when a bacterial infection develops. No effective vaccine is available yet.

Which advice to follow?

Before the trip:

- WASH YOUR HANDS frequently with soap and water;
- COVER your face when sneezing, or coughing with a paper tissue, which should carefully be disposed of;
- AVOID TRAVELING to high risk areas, like Mexico.

On your return:

- Carefully monitor your health for about 10 days after your return;
- If any of the symptoms were to appear, do not delay in contacting your local health authority.

© Dr Rik HEYMANS.
Rik Heymans is a general medical practitioner in Nerja. He writes monthly for Streetwise on topics which a family doctor comes across regularly.