INFLUENZA A H1N1 - The facts #2

High risk groups:

· Less than 5 years old
· More than 65 years old
· Pregnant
· Obese with chronic illnesses such as asthma, chronic lung disease, heart disease, diabetes or kidney disease
· On long term aspirin therapy
· On drugs that will suppress your immune system eg. steroids, oral chemotherapeutic drugs, azathioprine, cyclophosphamide
· Undergoing cancer treatment


Treatment of H1N1:

Vaccines

Vaccines are usually given to prevent infections. Influenza vaccines are made from either pieces of the killed influenza virus or weakened versions of the live virus that will not lead to disease. When vaccinated, the body’s immune system makes antibodies which will fight off infection if exposure to the virus occurs. However, the influenza virus has the ability to mutate. The latest strain is H1N1. So we will have to wait for the specific vaccine to be available.

Antivirals [Tamiflu (Oseltamivir), Relenza (Zanamivir)]

Antivirals are drugs that can treat people who have already been infected by a virus. Currently, two anti-virals are available which are Tamiflu and Relenza. These drugs are able to stop the virus from replicating in the body and has to be taken within two days after symptoms appear. However, it is not indicated for everybody with flu as the disease is mostly self-limiting. People who are in the high-risk group should be given the anti-virals if they have flu-like illness.
Tamiflu is a neuraminidase inhibitor. It is effective against both type A and B strains of flu.There is no generic version of Tamiflu available. 10 capsules (minimum amount) can cost around RM80 – RM100. Tamiflu helps to reduce your time with flu symptoms by about 1.3 days.

Dosage of Tamiflu:
Oseltamivir is marketed by Roche under the trade name Tamiflu, as capsules (containing oseltamivir phosphate 98.5 mg equivalent to oseltamivir 75 mg). Adults take 75mg twice a day for 5 days.

Side Effects:
The most common side effects of Tamiflu are nausea, vomiting, diarrhea, and conjunctivitis (pinkeye). Sometimes people report getting headaches after taking Tamiflu. There are concerns that oseltamivir may cause dangerous psychological, neuropsychiatric side effects including self harm in some users. These dangerous side effects occur more commonly in children than in adults.


Prevention

The main route of transmission of the new influenza A(H1N1) virus seems to be similar to seasonal influenza, via droplets that are expelled by speaking, sneezing or coughing. You can prevent getting infected by avoiding close contact with people who show influenza-like symptoms (trying to maintain a distance of about 1 metre if possible) and taking the following measures:
- avoid touching your mouth and nose;
- clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated);
- avoid close contact with people who might be ill;
- reduce the time spent in crowded settings if possible;
- improve airflow in your living space by opening windows;
- practise good health habits including adequate sleep, eating nutritious food, and keeping physically active.


The status of H1N1 now:

The WHO considers the overall severity of the influenza pandemic to be moderate. This assessment is based on scientific evidence available to WHO, as well as input from its Member States on the pandemic's impact on their health systems, and their social and economic functioning.

The moderate assessment reflects that:
- Most people recover from infection without the need for hospitalization or medical care.
- Overall, national levels of severe illness from influenza A(H1N1) appear similar to levels seen during local seasonal influenza periods, although high levels of disease have occurred in some local areas and institutions.
- Overall, hospitals and health care systems in most countries have been able to cope with the numbers of people seeking care, although some facilities and systems have been stressed in some localities.

WHO is concerned about current patterns of serious cases and deaths that are occurring primarily among young persons, including the previously healthy and those with pre-existing medical conditions or pregnancy.
Large outbreaks of disease have not yet been reported in many countries, and the full clinical spectrum of disease is not yet known.

For more info:
Malaysia: http://h1n1.moh.gov.my/
USA: http://flu.gov/
WHO: http://www.who.int/csr/disease/swineflu/en/index.html