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What is flu?
   Flu refers to illnesses caused by a number of different influenza viruses. Flu can cause a range of symptoms and effects, from mild to lethal.

What are the types of flu ?

There are three types of flu viruses: A, B and C.   The A and B viruses cause epidemics (widespread outbreaks in a country) of infection in people every year in India.

  • Type C infections cause mild respiratory illness and are not thought to cause epidemics.
  • Type A viruses are divided into subtypes.  Subtypes of type A that have been found in people worldwide include H1N1H1N2, H5N1 and H3N2 viruses.
  • Flu viruses are constantly changing.  A global flu pandemic (worldwide outbreak) can happen if three conditions are met:
    • A new subtype of type A virus is introduced into the human population.
    • The virus causes serious illness in humans.
    • The virus can spread easily from person-to-person in a sustained manner.
  • The H1N1 Flu met all three conditions and caused a worldwide outbreak. In late spring, the WHO declared that a H1N1 flu pandemic is underway.

Seasonal flu:

   Influenza (the flu) is a contagious respiratory illness caused by influenza viruses. It spreads from person-to-person and can cause mild to severe illness; and in some cases, can lead to death.

Common symptoms occur during a seasonal flu are as follows-
  1. Fever (High)
  2. Tiredness (May be extreme)
  3. Headache
  4. Dry cough
  5. Sore throat
  6. Runny or stuffy nose
  7. Muscle ache
  8. Nausea ,vomitting and diarrhoea may occur but they are much common in adults than children .( These additional symptoms may be considered as of swine flu case )

How to distinguise if it is a cold or flu?

Flu and the common cold are both respiratory illnesses, but they are caused by different viruses.

  • Flu and the common cold have similar symptoms (e.g. fever, sore throat). It can be difficult to tell the difference between them.
  • Your doctor can give you a flu test within the first few days of your illness to determine whether you have the flu.
  • In general, the flu is worse than the common cold.
  • Symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense with the flu.
  • Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose.
  • Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.
H1N1 flu or swine flu :

Definition :
   H1N1 flu is a new influenza virus causing illness in people. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia, plus avian genes and human genes. Scientists call this a "quadruple reassortant” virus .

H1N1 flu is NOT caused by eating pork or pork products :
   H1N1 flu is not a foodborne disease, it is a respiratory disease. The Indian Ministry of Health and Family Welfare continues to remind consumers that all meat and poultry products are safe to eat when properly prepared and cooked.

Illness with the new H1N1 flu virus has ranged from mild to severe :
   While the vast majority of people who have contracted H1N1 flu have recovered without needing medical treatment, hospitalizations and deaths have occurred.

Symptoms of H1N1 flu :
   The symptoms of H1N1 flu are similar to seasonal flu, but may include additional symptoms such as vomiting and diarrhea.

Seasonal Flu

H1N1 Flu

All types of flu can cause:

  • Fever
  • Coughing and/or sore throat
  • Runny or stuffy nose
  • Headaches and/or body aches
  • Chills
  • Fatigue

Similar to seasonal flu, but symptoms may be more severe.

There may be additional symptoms. A significant number of H1N1 flu cases:

  • Vomiting
  • Diarrhea

   Emergency Warning Signs - If you become ill and experience any of the following warning signs, seek emergency medical care.

Emergency warning signs in children:

Emergency warning signs in adults:

  • 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
  • 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

Guidelines for taking care of yourself( who have diagnosed as having H1N1 flu) :
  1. Stay home & follow your doctor's orders.
  2. Avoid close contact with others especially those who might easily get flu .
  3. Wear a facemask if available and tolerable .
  4. Get plenty of rest .
  5. Drink clear fluids.
  6. Cover coughs and sneezes .
  7. Clean hands with soap and water .
Guidelines of taking care of others, who are having H1N1 flu :
  1. Avoid being face-to-face with the sick person. When holding a small child who is sick, place his/her chin on your shoulder so that he/she will not cough in your face.
  2. Make sure everyone in the household cleans their hands often, using soap and water or an alcohol-based hand rub.
  3. Remind the patient to cover coughs, and clean his/her hands with soap and water or an alcohol-based hand rub often, especially after coughing and/or sneezing.
  4. Speak with the person’s health care provider about any special care that might be needed, especially if the person is pregnant or has a health condition such as diabetes, heart disease, asthma, or emphysema.
  5. Talk to your health care provider about taking antiviral medication, such as oseltamivir (Tamiflu®) or zanamivir (Relenza®), to prevent getting the flu.
  6. Ask the patient’s health care provider whether the patient should take antiviral medications.
  7. Consider wearing a facemask or respirator, when close contact is unavoidable.
  8. Monitor yourself and household members for flu symptoms and contact a telephone hotline or health care provider if symptoms occur.
  9. Get medical care right away if the patient exhibits emergency warning signs .
H5N1 flu or bird flu :

Definition :
   H5N1 (Bird) flu virus is an influenza A virus subtype that is highly contagious among birds, and can be deadly to them. The H5N1 (Bird) flu virus does not usually infect people, but rare infections with these viruses have occurred in humans. Nearly all human cases have resulted from people having direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces.

Symptoms of bird flu :
   Symptoms of the H5N1 (Bird) flu virus in humans have ranged from typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of H5N1 (Bird) flu may depend on which virus caused the infection.

H5N1 or bird flu prevention and treatment :
  • Most cases of H5N1 (Bird) flu infection in humans have resulted from direct or close contact with infected poultry or surfaces contaminated with secretions and excretions from infected birds.

  • The Indian government carefully controls domestic and imported food products .

  • You cannot get H5N1 (Bird) flu from properly handled and cooked poultry and eggs.Even if poultry and eggs were to be contaminated with the virus, proper cooking would kill it.

    Follow the same advice you always would for properly cooking eggs and poultry:

    Wash your hands with soap and warm water for at least 20 seconds before and after handling raw poultry and eggs.

    Clean cutting boards and other utensils with soap and hot water to keep raw poultry from contaminating other foods.

    Use a food thermometer to make sure you cook poultry to a temperature of at least 165 degrees Fahrenheit. Consumers may wish to cook poultry to a higher temperature for personal preference.

    Cook eggs until whites and yolks are firm.

  • If you plan to visit any of the countries that have had confirmed human infection with H5N1 (Bird) flu, visit Avian Flu & Travelers from CDC for advice on travel preparation.

  • Some of the prescription medicines approved in the United States for human influenza viruses can be effective in treating H5N1 (Bird) flu in humans. H5N1 (Bird) flu is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, Oseltamivir (TAMIFLU®) and Zanamivir (RELENZA®) would likely be effective in treating H5N1 (Bird) flu, but additional studies still need to be completed to demonstrate their effectiveness. It is important to note that H5N1 (Bird) flu infection in humans is very rare.

  • The seasonal influenza vaccine does not provide protection against avian influenza.

  • The U.S. Food and Drug Administration (FDA) approved the first vaccine to prevent human infection with one strain of the H5N1 (Bird) flu virus in April of 2007. The H5N1 (Bird) flu virus is not a pandemic virus (because it does not transmit efficiently from person to person). As a result, the H5N1 (Bird) flu vaccine is being held in stockpiles rather than made commercially available to the public. Should circumstances change, it will be distributed if needed.
Global monitoring of H5N1 flu or bird flu :
   The World Health Organization (WHO) is coordinating the global response to human cases of H5N1 (Bird) flu and monitoring the threat of a H5N1 (Bird) flu pandemic. Epidemiologists use monitoring data to predict where and how disease might spread. It is important to know where disease outbreaks not only begin in the world, but also how and where they might spread in the United States. A primary goal of flu monitoring is to identify any outbreak of human-to-human transmission quickly so health officials can attempt to contain and control the outbreak.

References :
  1. Flu.gov (Flu database under the US department of Health and Human services) .
  2. The World Health Organisation .
  3. Cox, N.; Kawaoka (1998). "22". in Mahy B. and Collier L.. Topley and Wilson's Microbiology and Microbial Infections1 Virology. Y. (9 ed.). Arnold. pp. 415.
  4. Harrison's Principles of Internal Medicine,13th international edition .
  5. Essentials of Medical Pharmacology , K.D.Tripathi,6th edition .

© 2019 by Partha Sarathi(Director)