Swine Flu and ME/CFS
The following general information on Swine flu is from the World Health Organization.
Specific information for Swine Flu and people with ME/CFS have been released by both the MEA and AfME. Please click on links below.
Swine influenza frequently asked questions
What is swine influenza?
Swine influenza, or “swine flu”, is a highly contagious acute respiratory disease of pigs, caused by one of several swine influenza A viruses. Morbidity tends to be high and mortality low (1-4%). The virus is spread among pigs by aerosols, direct and indirect contact, and asymptomatic carrier pigs. Outbreaks in pigs occur year round, with an increased incidence in the fall and winter in temperate zones. Many countries routinely vaccinate swine populations against swine influenza.
Swine influenza viruses are most commonly of the H1N1 subtype, but other subtypes are also circulating in pigs (e.g., H1N2, H3N1, H3N2). Pigs can also be infected with avian influenza viruses and human seasonal influenza viruses as well as swine influenza viruses.
The H3N2 swine virus was thought to have been originally introduced into pigs by humans. Sometimes pigs can be infected with more than one virus type at a time, which can allow the genes from these viruses to mix. This can result in an influenza virus containing genes from a number of sources, called a "reassortant" virus. Although swine influenza viruses are normally species specific and only infect pigs, they do sometimes cross the species barrier to cause disease in humans.
What are the implications for human health?
Generally clinical symptoms are similar to seasonal influenza but reported clinical presentation ranges broadly from asymptomatic infection to severe pneumonia resulting in death.
Since typical clinical presentation of swine influenza infection in humans resembles seasonal influenza and other acute upper respiratory tract infections, most of the cases have been detected by chance through seasonal influenza surveillance. Mild or asymptomatic cases may have escaped from recognition; therefore the true extent of this disease among humans is unknown.
How do people become infected?
People usually get swine influenza from infected pigs, however, some human cases lack contact history with pigs or environments where pigs have been located. Human-to-human transmission has occurred in some instances but was limited to close contacts and closed groups of people.
Is it safe to eat pork and pork products?
Yes. Swine influenza has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. The swine influenza virus is killed by cooking temperatures of 160F/70C, corresponding to the general guidance for the preparation of pork and other meat.
What drugs are available for treatment?
There are two classes of such medicines, 1) adamantanes (amantadine and remantadine), and 2) inhibitors of influenza neuraminidase (oseltamivir and zanamivir). Most of the previously reported swine influenza cases recovered fully from the disease without requiring medical attention and without antiviral medicines.
Some influenza viruses develop resistance to the antiviral medicines, limiting the effectiveness of treatment. The viruses obtained from the recent human cases with swine influenza in the United States are sensitive to oselatmivir and zanamivir but resistant to amantadine and remantadine.
Information is insufficient to make recommendation on the use of the antivirals in treatment of swine influenza virus infection. Clinicians have to make decisions based on the clinical and epidemiological assessment and harms and benefit of the treatment of the patient2. For the ongoing outbreak of the swine influenza infection in the United States and Mexico, the national and the local authorities are recommending to use oseltamivir or zanamivir for treatment of the disease based on the virus’s susceptibility profile.
The Irish Position
One million people in Ireland could get swine flu this autumn and winter, the Department of Health has warned in a letter to doctors.
The swine flu is a new virus to which most people have little or no immunity and could therefore cause more infections than are seen with the seasonal flu, the department’s chief medical officer, Dr Tony Holohan, warned in the letter.
Studies of previous pandemics suggest a much larger wave of infection with more illness and death in the autumn or winter of this year, the letter said.
“Most planning scenarios have focussed on a clinical attack rate of 25%, which would equate to approximately one million clinical cases in Ireland,” it said.
The letter also pointed out that it is possible that the virus could increase its virulence, possibly as a result of interaction with avian influenza virus. Furthermore, when schools return in the autumn conditions for transmission will be more favourable.
The department pointed out that the vast majority of people in Europe who have contracted the virus have been under the age of 30. Some 77% of cases were reported in children and young adults under 30, a feature which distinguishes it from seasonal flu.
In developed countries, 98 to 99% of cases have been mild, in that cases have not required admission to hospital and have made a full recovery. However, there have been some hospitalisations and deaths, albeit in relatively small numbers, among those who do not belong in ‘high risk groups’. High risk groups include people with asthma, diabetes, chronic respiratory, heart, kidney, liver, or neurological disease, immunosuppression, and severely obese people.
Pregnant women, children under the age of five and people over the age of 65 are also at increased risk.
The department stressed that in spite of containment strategies in most developed countries, the virus spread around the world faster than any previous influenza pandemics. Only six weeks elapsed between the initial cases being identified in Mexico and the declaration of a global pandemic, it said.
It is expected that an increase in cases in Ireland will take place, continuing into the autumn and winter when an acceleration in cases similar to that currently taking place in the UK is very likely. The UK’s health secretary has said that he expects 100,000 new cases to be diagnosed there every day by the autumn.
Recently, the Department of Health made the decision to stop virus containment efforts and focus instead on treatment. This means that routine laboratory testing of suspect cases will cease and clinical diagnosis of influenza-like illness will be used instead.
A vaccine to immunise against the swine flu virus is currently being developed and 7.7 million vaccinations have been ordered. It is hoped that they will arrive in the autumn.
“We face a major increase in cases of A(H1N1) infection. We cannot prevent this from happening but we can mitigate its impact. We must now focus our energy and resources on preparing to treat increasing numbers of cases and preparing for mass immunisation with the pandemic vaccine,” the letter said.
Some 144 people have been confirmed as having swine flu in Ireland.
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