H1N1 Influenza (Swine Flu)

Symptoms Of Swine Flu (H1N1 Influenza)

The clinical manifestations of swine flu are similar to any other flu. The symptoms include:

• Fever ( (100 F or greater)

• Chills

• Runny or blocked nose

• Cough

• Sore throat

• Watery and redness of eyes 

• Fatigue

• Body aches

• Joint pains 

• Headache

• Shortness of breath 

• Rapid breaths

• Vomiting

• Diarrhea

Rare symptoms include:

• Conjunctivitis 

• Parotitis in toddlers (inflammation of the parotid salivary gland)

Note: The immuno-compromised patients and patients in extremes of age (infants and elderly) may show altered mental status and respiratory distress.

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Differences and similarities between swine flu and the common cold

Swine flu and the common cold are both contagious respiratory tract illnesses, but they are caused by different viruses. They have a lot of similarities and it becomes difficult to distinguish between them. Some of the most common similarities and differences include:

1. Symptoms

Similarity: The symptoms of cold and flu are very similar at the onset with a runny nose, headache, fatigue, and difficulty in breathing.

Difference: Cold symptoms are usually milder than the symptoms of swine flu and it generally does not result in serious health problems.

2. Cause

Similarity: Both cold and influenza are caused by viruses.

Difference: Swine flu is caused by the H1N1 influenza virus. Whereas the common cold can be caused by a number of other viruses, including rhinoviruses, parainfluenza, and seasonal coronaviruses.

3. Incubation period

Similarity: Both diseases are highly contagious and have an incubation period (the period between exposure to an infection and the appearance of the first symptoms) of a minimum of 1 day before the individual starts experiencing symptoms.

Difference: The incubation period for influenza is usually 1-4 days and 1-7 days for colds.

4. Duration of illness

Similarity: Swine flu and the common cold cause respiratory tract illnesses ranging from 4 days to two weeks.

Difference: A cold's duration (how long it lasts) is about 7 to 10 days; however, depending upon the viral strain, it can last up to two weeks. The swine flu's duration varies from about 5 days to two weeks with an average of 8 days.

5. Risk factors

Similarity: Both have similar risk factors i.e. younger children, old people, pregnant women, and immunocompromised individuals are at a higher risk.

Difference: Individuals who do not receive the swine flu vaccine are more likely to risk getting infected with the flu virus but there is no vaccination to prevent the common cold.

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Differences and similarities between swine flu and COVID-19

Swine flu and COVID-19 are both contagious respiratory infections of the respiratory system but are caused by different viruses. COVID-19 is caused by an infection with a coronavirus (first identified in 2019). And swine flu is caused by the H1N1 virus. They are both quite similar yet different, some of the common similarities and differences between them include:

1. Duration of illness

Similarity: It is two days on average before an infected person starts experiencing the symptoms of illness.

Difference: COVID-19 may take a longer duration for the symptoms to start whereas, in the case of flu, the symptoms begin between 1-4 days.

2. Mode of the spread

Similarity: Both COVID-19 and swine flu can spread from person to person between people who are in close contact with one another i.e. within about 6 feet through droplets from sneezing, coughing, or talking.

Difference: COVID-19 is generally more contagious than the swine flu virus.

3. Risk factors

Similarity: Older adults, individuals with certain underlying medical conditions, pregnant women, and children are at higher risk of getting both COVID-19 and swine flu.

Difference: COVID-19 seems to cause more serious illnesses in some people resulting in hospitalization and death can occur even in healthy people.

4. Complications

Similarity: Respiratory complications occur in patients infected with swine flu and COVID-19.

Difference: Most people with swine flu can recover on their own in a few days to two weeks whereas COVID-19 complications can happen even after the recovery (long covid syndrome).

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Differences and similarities between swine flu and seasonal influenza

Regular flu or influenza may be caused by RNA viruses belonging to the family Orthomxoviridae. Swine flu is caused by a family of viruses that affects pigs. Some of the similarities and differences between them include: 

1. Cause

Similarity: Both swine flu and influenza are caused by viruses.

Difference: The strains that cause Influenza viruses A, B, and C. The known strains that cause swine flu include subtypes of influenza also known as H1N1.

2. Symptoms

Similarity: Both present with similar symptoms that include fever, chills, sore throat, body ache, headache, coughing, and fatigue. 

Difference: In swine flu, some people may experience gastrointestinal symptoms, such as nausea or diarrhea. This is thought to be one of the ways it differs from seasonal flu.

3. Incubation period

Similarity: Symptoms for both begin after about two days from the contraction of the virus.

Difference: The known incubation period for H1N1 swine flu ranges from 1 to 4 days, but for some individuals, it may be as long as 7 days. In the case of seasonal flu, symptoms typically begin about two days but can range from 1-4, after flu viruses infect the respiratory tract.

4. Mode of transmission

Similarity: Both spread through droplets of nuclei from an infected person.

Difference: The virus is transmitted through larger droplets in the case of swine flu, and infection can spread from an infected animal to humans.

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Causes Of Swine Flu (H1N1 Influenza)

H1N1 swine influenza is a common respiratory infection in pigs worldwide, and hence the name, swine flu. Sometimes, people who are in the close proximity of pigs develop swine flu (zoonotic swine flu). The H1N1 swine influenza viruses can potentially cause infections in humans if the capability of stimulating an immune response of the virus changes.

Influenza A pandemics such as the one in 2009 occurred due to person-to-person transmission through airborne droplets, and potentially, through human contact with inanimate objects contaminated with the virus which got transferred to the eyes or nose.

Risk Factors For Swine Flu (H1N1 Influenza)

There are a number of factors that can increase your risk of contracting swine flu. They include:

• Individuals above 65 years of age 

• Children below 5 years of age

• People with chronic diseases like

  • Diabetes

  • Chronic pulmonary conditions including asthma

  • Congestive cardiac failure

  • Kidney failure

  • Liver failure

  • Blood abnormalities including sickle cell disease

  • Neurologic conditions

  • Neuromuscular disorders

• Pregnant women

• Teens receiving long- time period aspirin therapy

• Immunocompromised individuals

• People on medications for HIV.

Diagnosis Of Swine Flu (H1N1 Influenza)

A physical exam is done to look for symptoms of H1N1. There are many tests used to diagnose influenza. But not everyone who has the flu needs to be tested. A diagnosis of confirmed swine flu requires laboratory testing of a respiratory sample (a simple nose and throat swab). The tests include:

1. Real-time PCR

This test is used to detect seasonal influenza A, B, H1, H3, and avian H5 serotypes. The test is done by collecting samples from the throat and nose of the suspected individual. It provides an accurate and rapid diagnosis of swine flu.

2. Nucleotide sequencing

It refers to the general laboratory technique for determining the exact sequence of nucleotides, or bases, in a DNA molecule. It is helpful in determining the H1N1 strain.

3. Phylogenetic analysis

It is done to isolate the gene from the pigs. This test is indicated to determine the exact strain of swine flu.

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Prevention Of Swine Flu (H1N1 Influenza)

Prevention and control measures for swine influenza are based on understanding how the disease is transmitted. Preventive measures include

1. Prevention of pig-to-human transmission

The transmission between pigs and humans mainly occurs in swine farms where farmers are in close contact with live pigs. Measures to prevent it include vaccines for swine to prevent their infection. Avoiding smoking near the infected animal, and wearing gloves while handling them can decrease infections to a larger extent.

2. Prevention of human-to-human transmission

This virus is not transmitted through food. In humans, it is most contagious during the first 5 days of the illness. However, children can remain contagious for up to 10 days. Recommendations to prevent the spread of the virus among humans include:

a. Take quarantine seriously: The close contacts of the suspected, probable, and confirmed swine cases are advised to remain at home and avoid traveling for at least 7 days. In case of any symptoms, the contacts should undergo a prompt test for H1N1 influenza and consult a physician. 

b. Follow cough and hand hygiene: 

• Hands must be frequently washed with soap and water or alcohol-based or antiseptic handwash or hand rub.
• The infected persons should cover their nose and mouth with a single-use tissue while coughing or sneezing
• The used tissue must be disposed of immediately
• The healthcare workers who are involved in the direct care of patients with confirmed or suspected swine should use gowns, eye protection, gloves, and disposable N95 respirators.

c. Give importance to chemo-prophylaxis: Antiviral medicines can be used for prophylaxis (to prevent) contact with the patient with a high risk for complications and the healthcare personnel. Oseltamivir is given once a day until 10 days after the individual’s last contact with the patient and can be given for a maximum of 6 weeks.

d. Get vaccinated: WHO recommends vaccination of all the healthcare staff coming in contact with the suspected or confirmed cases of swine flu (physicians, nurses, paramedical, and ambulance staff). This vaccine against influenza A/H1N1 can be taken yearly. The immune response of the body takes about 2-3 weeks to develop after vaccination.

e. Other general measures

• Early self-isolation of those feeling unwell or have symptoms
• Avoid close contact with sick people
• Avoid touching your eyes, nose, or mouth
• Disinfect surfaces that have come in contact with the infected person
• Cook red meat at 1600F (700C) to kill the virus.
• Disinfect used tissues before discarding them.

Keep this in mind!

Children and teenagers recovering from flu-like symptoms should never take aspirin. This is due to the risk of Reye syndrome, a rare but potentially life-threatening condition.

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Doctor To Visit

People who have the swine flu with a fever above 100 F (38 C), cough, or sore throat might need medical interventions from:

• General Physician

• Emergency medicine doctor 

• Internal Medicine specialist

• Pediatrician 

• Pulmonologist 

An emergency medicine doctor is a specialist who treats patients in the emergency department. An internal medicine specialist specializes in the internal organs and systems of the body. A pediatrician is a doctor who deals with the diseases of children whereas a pulmonologist is a doctor who specializes in the respiratory system. 

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Treatment Of Swine Flu (H1N1 Influenza)

The treatment is basically supportive care in mild to moderate cases. Depending on the severity, the treatment options include the following:

1. Supportive measures

Swine flu requires supportive management, with or without antiviral medications. These include: 

• Bed rest

• Staying hydrated

• Electrolytes

• Administration of intravenous fluids in severe cases

• Painkillers and antipyretics (like paracetamol and ibuprofen) to manage pain and fever

• Broad-spectrum antibiotics (like cefuroxime, cefotaxime, clarithromycin, and erythromycin) to treat or prevent secondary bacterial pneumonia 

• Oxygen therapy or in severe persistent hypoxia (decreased oxygen)

Note: Corticosteroids may be used in case of management of septic shock.

2. Antiviral therapy

Your doctor may prescribe antiviral drugs to reduce the severity of symptoms and lower the risk of complications. Examples of antiviral medications used to treat swine flu include:

• Oseltamivir

• Zanamivir

• Peramivir

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3. Management in Pigs

Though swine influenza isn’t deadly to pigs, little treatment beyond rest and supportive care may be required. Vaccination and animal management techniques with antibiotics are used to prevent bacterial pneumonia and different secondary infections in animals weakened by the influenza virus.

Home Care For Swine Flu (H1N1 Influenza)

Like any other flu, even swine flu can be managed at home by taking adequate rest, getting enough sleep, being well hydrated, and managing fever and body aches with painkillers and antipyretics. Along with these, there are certain home remedies that can help get rid of the symptoms soon. They include:

• Turmeric (Haldi): Turmeric is known for its anti-inflammatory properties. Add a pinch of turmeric to a glass of warm milk and drink it every night to help your body fight the swine flu infection.
  
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• Garlic (Lahsun): Studies show that garlic has anti-viral properties. It also improves your body's immunity and is loaded with antioxidants. Swallow 2 garlic pods with warm water on an empty stomach every morning to reap the benefits. People on blood thinners should avoid too much consumption of garlic. 

• Basil (Tulsi): Research suggests that tulsi is one of the major herbs used for influenza-like disease treatment. Eating tulsi leaves can clear up infections in your throat and lungs, along with building immunity.

• Indian gooseberry (Amla): It is rich in vitamin C, and research suggests that it is blessed with immune-boosting properties. You can eat the whole fruit or drink its juice to keep your body infections at bay.

• Ginseng: Studies demonstrate that oral administration of ginseng extract can protect against the H1N1 influenza virus. Drinking a cup of ginseng tea every day can prove to be beneficial for individuals with swine flu. People on blood thinners should avoid Ginseng as it can cause a risk of bleeding. 

• Olive (Zaitoon) leaves: Studies indicate that these are rich in properties that can help your body fight the symptoms of swine flu like nausea, chills, fever, and headaches effectively. Give your body the extracts of this herb regularly to keep swine flu at bay.

• Tulsi: Consuming tulsi leaves can aid in clearing the infection in your throat and lungs, while also strengthening your immune system to combat swine flu infection.
  
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• Aloe vera: Aloe vera is not just an immune system enhancer, it also possesses anti-inflammatory properties. It can be beneficial in fighting infections and alleviating swine flu symptoms such as joint pain.
  
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• Giloy: It is a herbaceous plant that has been used in Ayurveda to treat various disorders. Giloy juice helps in reducing high fever.

Complications Of Swine Flu (H1N1 Influenza)

Swine flu is a respiratory tract illness that can cause mild to moderate symptoms. However, in some cases, it can lead to complications like:

1. Pneumonia: This is due to a secondary bacterial infection. Swine flu can lead to more serious problems like lung infection and other breathing problems. 

2. Respiratory failure: Studies suggest that the infection causes severe hypoxemic respiratory failure or acute respiratory distress syndrome (ARDS, fluid build-up in lungs) with multi-organ involvement.

3. Seizures: these are generally seen in children along with encephalopathy (disease of the brain). 

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Alternative Therapies For Swine Flu (H1N1 Influenza)

Flu symptoms can be managed with complementary therapies along with supportive treatment. Even the cases that require antiviral therapy can benefit from the following alternative therapies:

1. Homeopathy

Studies suggest that Oscillococcinum is a highly diluted homeopathic preparation that some people take regularly over the winter months either to prevent flu or as a treatment for flu symptoms.

2. Traditional Chinese medicine

Research suggests that some plants that are extensively used in traditional Chinese medicine could prove useful for the management of swine flu. The herbal blend used in this therapy can be the most effective formula, especially if started within the first 24 hours of symptoms.

Living With Swine Flu (H1N1 Influenza)

Swine flu is an upper respiratory tract infection that generally clears up within a week or so. Both adults and children can get affected by it, however, it is more common among teenagers and severe in some of the very young. 

Tips for Parents

In kids, diarrhea and vomiting are more common than in adults. Infants may present with fever and lethargy without respiratory symptoms. Managing kids while they are sick can be quite a task. Here are a few things to keep in mind:

• Be vigilant, and watch your kids closely

• Make sure you wash your hands while handling the kids

• Wash their hands frequently

• Avoid crowded areas

• Avoid direct contact with sick individuals

• If your kid is sick, do not send them to school

• Get them vaccinated.

Here are 10 more tips to follow if your child has a fever.