Prevention and treatment

(source: wikipedia.org)

Personal hygiene

Recommendations to prevent infection by the virus consist of the standard personal precautions against influenza. This includes frequent washing of hands with soap and water or with alcohol-based hand sanitizers, especially after being out in public. The CDC advises not touching the mouth, nose or eyes, as these are primary modes of transmission. When coughing, they recommend coughing into a tissue and disposing of the tissue, then immediately washing the hands. Chance of transmission is also reduced by disinfecting household surfaces, which can be done effectively with a diluted chlorine bleach solution.

Home treatment remedies

The Mayo Clinic has suggested a number of measures to help ease symptoms:

* Drink plenty of liquids, especially water, juice and warm soups to prevent dehydration. Drink enough so that your urine is clear or pale yellow.
* Rest and sleep to help your immune system fight the infection.
* Chicken soup: "It's not just good for your soul — it really can help relieve flu symptoms by breaking up congestion."
* Over-the-counter pain relievers, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) cautiously, as needed. Note that while pain relievers may make you more comfortable by relieving symptoms, they won't make the flu go away any faster and may have side effects. For instance, Ibuprofen may cause stomach pain, bleeding and ulcers if taken for a long period or in higher than recommended doses. Acetaminophen can be toxic to your liver. Mayo suggests you talk to your doctor before giving acetaminophen to children, and not to give aspirin to children or teens because of the risk of Reye's syndrome, a rare but potentially fatal disease.

Fever relief

According to Medline Encyclopedia, aspirin is very effective for treating fever in adults but is not recommended for children unless directed by a doctor. Other medications, such as acetaminophen and ibuprofen will help reduce fever in children and adults, and acetaminophen can be taken every 4 - 6 hours. It works by turning down the brain's thermostat. Ibuprofen can be taken every 6 - 8 hours. Like aspirin, it helps fight inflammation at the source of the fever. Sometimes doctors advise you to use both types of medicine, although ibuprofen is not approved for use in children younger than 6 months old.  According to the CDC, it is expected that most people will recover without needing medical care. However, they recommend that anyone with severe illness or at high risk of flu complications, to contact their health care provider or seek medical care. The health care provider will determine whether flu testing or treatment is needed. The CDC also notes that should the flu become widespread, there will be little need to continue testing people, and they may decide not to test for the flu virus.

 

Transmission

Air

There is so far little data available on the risk of airborne transmission of this particular virus. Mexican authorities are distributing surgical masks to the general public.
The UK Health Protection Agency considers facial masks unnecessary for the general public. Many authorities recommend the use of respirators by health-care workers in the vicinity of pandemic flu patients, in particular during aerosol generating procedures (e.g. intubation, chest physiotherapy, bronchoscopy).

Pork products

Although some pigs in Canada were recently found to be infected with the new strain of H1N1, the leading international health agencies have stressed that the "influenza viruses are not known to be transmissible to people through eating processed pork or other food products derived from pigs." In mid-May, Mexico's Agriculture Department began a publicity campaign to convince Mexicans that it was safe to eat the meat despite swine flu fears, since plummeting sales have cost the pork industry 2.5 billion pesos ($188 million) since the outbreak. Mexico's Labor Secretary said the "pig-out" was held to demonstrate to "Mexico and the world that it is perfectly safe and very delicious and nutritious to eat pork."  Several countries including China, Russia and Ukraine have already banned Mexican pork products after the swine flu outbreak.

Antiviral drugs

According to the CDC, antiviral drugs can be given to treat those who become severely ill, however these antiviral drugs are prescription medicines (pills, liquid or an inhaler) and act against influenza viruses, including H1N1 flu virus. There are two influenza antiviral medications that are recommended for use against H1N1 flu. The drugs that are used for treating H1N1 flu are called oseltamivir (trade name Tamiflu ®) and zanamivir (Relenza ®). The CDC notes that as the H1N1 flu spreads, these antiviral drugs may become in short supply. Therefore, the drugs will be given first to those people who have been hospitalized or are at high risk of complications. The drugs work best if given within 2 days of becoming ill, but may be given later if illness is severe or for those at a high risk for complications. When buying these medications, some agencies such as the MHRA in the UK have recommended not using online sources, as the WHO estimates that half the drugs sold by online pharmacies without a physical address are counterfeit.  Medical experts are also concerned that people "racing to grab up antiviral drugs just to feel safe" may eventually lead to the virus developing drug resistance. Partly as a result, experts suggest the medications should be reserved for only the very ill or people with severe immune deficiencies.

Vaccines

Influenza vaccines are typically developed to cope with seasonal flu to minimize infection rates, yet it still kills around 500,000 people a year around the world. Currently, most of the world's flu vaccines use an injection of "killed virus," a vaccine method made famous by Jonas Salk when he developed the first vaccine against the polio virus in 1955. As The Economist magazine summarizes the problem today, however, "if a global pandemic is declared and manufacturers are asked to produce a vaccine for H1N1, they are unlikely to be able to respond quickly enough." Furthermore, vaccine producers can produce about a billion doses of any one vaccine each year, so that even if all the capacity was switched to fight the a pandemic flu, as opposed to a seasonal flu, "there would still be a huge global shortfall." Keiji Fukuda of the WHO said, "There’s much greater vaccine capacity than there was a few years ago, but there is not enough vaccine capacity to instantly make vaccines for the entire world’s population for influenza."  The seasonal flu vaccine is not believed to protect against the new strain, therefore any existing stock would not be useful.There is also concern that should a second, deadlier wave of a new H1N1 strain reappear during the Northern autumn of 2009, producing pandemic vaccines now as a precaution may turn out to be a huge waste of resources with serious results, as the vaccine may not be as effective, and there would also be a shortage of seasonal flu vaccine available. William Schaffner, an infectious disease researcher at Vanderbilt University in Tennessee, USA, stated, referring to Northern hemisphere seasons, that "for now, there is no way to tell whether the swine flu will die out this spring, or tarry through the summer and reappear as a stronger, meaner virus in the fall." The costs of producing a vaccine have also become an issue, with some U.S. lawmakers questioning whether a vaccine is worth the unknown benefits. Representatives Phil Gingrey and Paul Broun, for instance, are not convinced that the U.S. should spend up to $2 billion to produce one, with Gingrey stating "We can’t let all of our spending and our reaction be media-driven in responding to a panic so that we don’t get Katrina-ed. ... It’s important because what we are talking about as we discuss the appropriateness of spending $2 billion to produce a vaccine that may never be used — that is a very important decision that our country has to make." Moreover, should a pandemic be declared and a vaccine produced, the WHO will attempt to make sure that a substantial amount is available for the benefit of developing countries. Vaccine makers and countries with standing orders, such as the U.S. and a number of European countries, will be asked, according to WHO officials, "to share with developing countries from the moment the first batches are ready if an H1N1 vaccine is made."  The global body stated that it wants companies to donate at least 10 percent of their production or offer reduced prices for poor countries that could otherwise be left without vaccines if there is a sudden surge in demand.

Production decisions

After a meeting with the WHO on May 14, 2009, pharmaceutical companies said they were ready to begin making a swine flu vaccine. However, important questions remained: "what happens if the virus mutates when the vaccine is ready? how much should be produced? how will it be distributed? who should get it?" According to news reports, the WHO's experts will present recommendations to WHO Director-General Margaret Chan, who is expected to issue advice to vaccine manufacturers and the World Health Assembly next week. WHO's Keiji Fukuda told reporters "These are enormously complicated questions, and they are not something that anyone can make in a single meeting." Most flu vaccine companies can only make one vaccine at a time: seasonal flu vaccine or pandemic vaccine. Production takes months and it is impossible to switch halfway through if health officials make a mistake. . . . if the swine flu mutates, scientists aren't sure how effective a vaccine made now from the current strain will remain." Rather than wait on the WHO decision, however, some countries in Europe have decided to go ahead with early vaccine orders. A May 20th AP article reported: “Manufacturers won't be able to start making the vaccine until mid-July at the earliest, weeks later than previous predictions, according to an expert panel convened by WHO. It will then take months to produce the vaccine in large quantities. The swine flu virus is not growing very fast in laboratories, making it difficult for scientists to get the key ingredient they need for a vaccine, the "seed stock" from the virus, WHO said. . . . In any case, mass producing a pandemic vaccine would be a gamble, as it would take away manufacturing capacity for the seasonal flu vaccine that kills up to 500,000 people each year. Some experts have wondered whether the world really needs a vaccine for an illness that so far appears mild.”  Another option proposed by the CDC is an "earlier rollout of seasonal vaccine," according to the CDCs Dr. Daniel Jernigan. He said the CDC would work with vaccine manufacturers and experts to see if that would be possible and desirable. Flu vaccination usually starts in September in the United States and peaks in November. Some vaccine experts agree it would be better to launch a second round of vaccinations against the new H1N1 strain instead of trying to add it to the seasonal flu vaccine or replacing one of its three components with the new H1N1 virus.

Containment

On April 28, WHO's Dr. Keiji Fukuda pointed out that it is too late to contain the swine flu. "Containment is not a feasible operation. Countries should now focus on mitigating the effect of the virus," he said. He therefore did not recommend closing borders or restricting travel, stating that "with the virus being widespread... closing borders or restricting travel really has very little effects in stopping the movement of this virus." However, on April 28, the U.S. CDC began "recommending that people avoid non-essential travel to Mexico." Many other countries confirmed that inbound international passengers will be screened. Typical airport health screening involves asking passengers which countries they have visited and checking whether they feel or appear particularly unwell. Thermographic equipment was put into use at a number of airports to screen passengers.  A number of countries also advised against travel to known affected regions while experts have suggested that if those infected stay at home or seek medical care, public meeting places are closed, and anti-flu medications are made widely available, then in simulations the sickness is reduced by nearly two-thirds.