Influenza H1N1

Author and editor: Alida Fernandes

Overview  

H1N1, also commonly known as the swine flu, is a subtype of the influenza A virus (Jilani, Jamil & Siddiqui, 2020). The swine flu virus causes complications in the respiratory system and in serious cases may be fatal (Jilani, Jamil & Siddiqui, 2020). As the name suggests, swine flu is commonly found in pigs and can be a risk for swine and humans (Jilani, Jamil & Siddiqui, 2020). On June 11th, 2009 the severity of swine flu caused the declaration of an H1N1 pandemic by the World Health Organization due to the high volume of infected individuals in over 30 countries (Jilani, Jamil & Siddiqui, 2020).

 

Etiology

The H1N1 virus is an extremely contagious infection that attacks the respiratory system of pigs and is caused by one of many subtypes of influenza A (Dandagi & Byahatti, 2011). Through aerosols, direct and indirect contact with an infected individual, and asymptomatic infected pigs, the virus is quickly spread (Dandagi & Byahatti, 2011). The swine flu is either spread between pigs and humans or between one infected human to another healthy individual (Dandagi & Byahatti, 2011).

 

Symptoms 

Symptoms of H1N1 may include:

  • Fever and Chills 
  • Cough
  • Sore throat
  • Congested eyes
  • Shortness of breath
  • Headache
  • Abdominal pain or Diarrhea 
  • Vomiting
  • Decreased appetite 
  • Fatigue (Jilani, Jamil & Siddiqui, 2020) (Dotis & Roilides, 2009)

 

Risk Factors 

Risk factors of contracting H1N1 may include:

  • Young children under the age of 5
  • Elderly adults over the age of 65 
  • Pregnant women (Jilani, Jamil & Siddiqui, 2020)
  • Individuals with lung disorders including COPD, Bronchial asthma or pneumonia 
  • Obesity 
  • Individuals with cancer or autoimmune diseases (Jilani, Jamil & Siddiqui, 2020)

 

Diagnosis 

Individuals suffering from flu-like symptoms including fever, cough or sore throat or battling acute pneumonia, especially those residing in a place where a swine flu outbreak is prevalent, should be tested for carrying the swine flu virus (Jilani, Jamil & Siddiqui, 2020; Soleimani & Akbarpour, 2011).

Individuals can get tested for the H1N1 virus using a nasal or throat swab that uses the sample to detect the presence of the virus  (Jilani, Jamil & Siddiqui, 2020).

 

Treatment

Pharmaceutical Treatment & Vaccines

In order to refrain from getting the H1N1, it is highly recommended to receive 1 dose of the FDA-approved swine flu vaccine (Jilani, Jamil & Siddiqui, 2020). The vaccine creates immunity from the H1N1 virus to protect individuals from infection (Jilani, Jamil & Siddiqui, 2020). If diagnosed with the H1N1 flu, antiviral drugs such as Oseltamivir and Zanamivir may ease symptoms of the swine flu (Rewar, Mirdha & Rewar, 2016). Medication is most effective when taken 48 hours after initial symptoms are presented (Rewar, Mirdha & Rewar, 2016). 

Caution should be taken in order to maintain safe conditions and prevent the spread of the swine flu in places where the virus is prevalent (Jilani, Jamil & Siddiqui, 2020). Good preventative methods include vaccinating pigs and ensuring those who work closely with swine wear gloves and face masks as well as properly disinfect all areas  (Jilani, Jamil & Siddiqui, 2020). Frequent hand washing and sterilization of work areas should be practiced, especially where the swine flu is known to be active (Jilani, Jamil & Siddiqui, 2020).

Non-Pharmaceutical Treatment – Reduction of Influenza Spread

Non-pharmaceutical methods available to reduce influenza virus infection include community health education about the importance of social distance, and personal hygiene ( Sharma et al.2019). Biosecurity measures, regular disease surveillance and monitoring program, farm management practice including washing hands (Khanna et al. 2012, Itolikar et al. 2015, Singh et al. 2011, Scolaro et al .2017), follow the disinfection and sanitary practices, isolating people with flu from the public places.

Follow biosafety standards: use the face mask, covering nostrils and mouth while sneezing or coughing (Dhama et al. 2012). Follow the infection control practices, create a separate isolation ward, distribution of the information, Education and Communication (IEC) material in hospitals and schools (Mahesh et al. 2014).

 

Misdiagnosis Articles

Aucott, J. N., & Seifter, A. (2011). Misdiagnosis of early Lyme disease as the summer flu. Orthopedic Reviews, 3(2), e14. https://doi.org/10.4081/or.2011.e14

Zou, B., Ma, D., Li, Y., Qiu, L., Chen, Y., Hao, Y., Luo, X., & Shu, S. (2020). Are They Just Two Children COVID-19 Cases Confused With Flu? Frontiers in Pediatrics, 0. https://doi.org/10.3389/fped.2020.00341

References 

Biswas, D. K., Kaur, P., Murhekar, M., & Bhunia, R. (2012). An outbreak of pandemic influenza A (H1N1) in Kolkata, West Bengal, India, 2010. The Indian journal of medical research, 135(4), 529–533.

Dandagi, G. L., & Byahatti, S. M. (2011). An insight into the swine-influenza A (H1N1) virus infection in humans. Lung India : official organ of Indian Chest Society, 28(1), 34–38. https://doi.org/10.4103/0970-2113.76299

Dhama K, Verma AK, Rajagunalan S, Deb R, Karthik K, Kapoor S, Mahima, Tiwari R, Panwar PK, Chakraborty S. Swine flu is back again: a review. Pak J Biol Sci. 2012 Nov 1;15(21):1001-9. doi: 10.3923/pjbs.2012.1001.1009. PMID: 24163942.

Dotis, J., & Roilides, E. (2009). H1N1 influenza A infection. Hippokratia, 13(3), 135–138.

Itolikar S, Nadkar M.Y., H1N1 revisited after six years: then and now. The J Assoc Physicians India. 2015;63(4):41–43. 

Jilani, T. N., Jamil, R. T., & Siddiqui, A. H. (2020). H1N1 Influenza (Swine Flu). Stat Pearls.

Khanna M, Kumar B, Gupta A, Kumar P. Pandemic influenza A H1N1 (2009) virus: lessons from the past and implications for the future. Indian J Virol. 2012;23(1):12–17. 

Mahesh S.H. , Kushwaha A.S. , Kotwal A, Pandemic influenza: Experience in a flu OPD of a tertiary care hospital, Medical Journal Armed Forces India, Volume 70, Issue 1,2014,Pages 39-42,ISSN 0377-1237, https://doi.org/10.1016/j.mjafi.2012.06.018.

Rewar, S., Mirdha, D., & Rewar, P. (2016). Treatment and Prevention of Pandemic H1N1 Influenza. Annals of Global Health, 81(5), 645. doi:10.1016/j.aogh.2015.08.014

Scolaro K.L., Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care, 19th Edition. November 2017

Sheikh Taslim Ali, A.S. Kadi, Neil M. Ferguson, Transmission dynamics of the 2009 influenza A (H1N1) pandemic in India: The impact of holiday-related school closure, Epidemics, Volume 5, Issue 4,2013, 5(4):157-163

Sharma J, Bhattacharyya D, Poddar K, Pavithran T.C., Thakur H, Scoping review of non-pharmacological interventions to control H1N1 in India, Clinical Epidemiology and Global Health, Volume 7, Issue 3,2019,Pages 504-508,ISSN 2213-3984,https://doi.org/10.1016/j.cegh.2018.12.001.

Soleimani, G., & Akbarpour, M. (2011). Clinical presentation of novel influenza a (h(1)n(1)) in hospitalized children. Iranian journal of pediatrics, 21(2), 215–219.

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