Inquiries about Swine Flu

Inquiries about Swine Flu
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In an interview with the "Raya" Qatari newspaper, Dr. Abu Bakr Ash-Shaafi'i, an advisor of otolaryngology at Al-‘Imaadi hospital in Qatar, said that swine flu is a severe, extremely infectious chest disease that infects pigs. It is produced from one of the A virus subtypes of swine flu. Although the rate of disease outbreak is high, the death rate because of it is low (1-4%).

Influenza spreads among pigs through direct contact or the aerosols produced by pigs (through coughing or sneezing), as well as through the disease-carrying pigs that do not show any indicative symptoms. Many countries routinely immunize pigs against swine flu.
Dr. Ash-Shaafi'i explains that the viruses of swine flu usually belong to the subtype H1N1. But other subtypes are widespread among pigs, such as H1N2, H3N1, H3N2. In addition to the viruses of swine flu, pigs might also be infected by the viruses of bird flu and seasonal flu that infects humans. It is thought that the virus H3N2 was first transmitted to pigs from humans. Pigs, according to Dr. Ash-Shaafi'i, are sometimes affected by more than one type of viruses simultaneously, causing their genes to reassort, which leads to the emergence of a flu virus containing genes of different sources. Although swine flu viruses usually belong to special types that affect pigs only, they go beyond the barrier of the species to cause disease to people.
Dr. Ash-Shaafi‘i stressed the importance of personal hygiene, pointing out that swine flu does not differ, in its symptoms, from common flu that causes a runny nose, aching bones and joints, in addition to vomiting, diarrhea, fever, shuddering and drowsiness. Thus, the symptoms of swine flu could be considered similar to those of ordinary flu, but more severe.
Dr. Ash-Shaafi'i advises the observance of the following hygienic practices as preventive precautions: wash your hands, do not kiss, use handkerchiefs when sneezing and throw them in the trash basket immediately after using them, do not scratch, and drink liquids more often once the disease symptoms emerge. Dr. Ash-Shaafi'i points out that death because of swine flu is connected with the weak immunity of the affected person.
Regarding the effects on the health of mankind, many cases of human infection by swine flu, individually or collectively, have been recorded. Its symptoms, in general, are similar to those of seasonal influenza. But the recorded clinical cases range between infection without symptoms and severe pneumonitis leading to death.
Because the typical clinical cases of swine flu are similar to seasonal flu and other severe infections of the upper part of the respiratory system, most cases have been detected by chance through seasonal surveillance of influenza. The light cases or those without symptoms could pass without being recognized. That is why the real extent to which the disease is widespread among people is unknown.
As regards the mechanism of human infection, people usually get the swine flu from infected pigs. Nevertheless, some infected people have never had any contact with pigs, nor have they been in environments where pigs exist. The transmission of the disease from man to man has been recorded in some cases where there was close contact or in cases where people have been in closed groups.
Swine flu is not among the diseases that were reported to the World Organization for Animal Health (www.oie.int), hence its spread among people is not sufficiently known.
Swine flu is an endemic disease in the USA, and it has occurred and spread among pigs in the North and South Americas, Europe (UK, Sweden and Italy), Africa (Kenya), and some parts of Eastern Asia (China and Japan).
As far as the risk of an epidemic outbreak of the disease is concerned, most people who are not in regular contact with pigs would probably have no immunity against the viruses that cause swine flu to protect them from being infected by it. If an efficient transmission of the swine flu virus takes place from man to man, it would lead to an outbreak of a flu epidemic, whose effects are hard to predict, as they depend on the virus's strength, immunity among people, and the protection caused by anti-bodies that are produced from seasonal influenza and its breeding factors.
There are no vaccines that contain the virus of the present swine flu that affects humans. It is also unknown whether or not the vaccines of the seasonal flu might provide protection in that respect. It is very important to invent a vaccine against the present type of swine flu virus, in order to provide the maximum degree of protection for people. That is why the World Health Organization (WHO) is in need to detect a large number of viruses to choose the most suitable one to use in manufacturing the desired vaccine.
Concerning the medicines available for treatment, the anti-virus medicines used to treat seasonal influenza are available in some countries, and they prevent and treat the disease effectively. There are two kinds of those medicines:
1. Adamantine, Amantadine, and Remantadine.
2. Oseltamivir and Zanamivir.
Most of the previously recorded cases of swine flu entirely recovered from the disease, without need for medical care or anti-virus medication.
Some influenza viruses have acquired immunity against anti-virus medicines, which restricts the effect of the chemical prophylaxes. The viruses that have been isolated from the present human cases of swine flu in the USA proved to be responsive to Oseltamivir and Zanamivir, and resistant to Amantadine and Remantadine.
But, unfortunately, there is not enough information to give advice about using anti-virus medicines to prevent and treat the virus of swine flu. Here, clinical physicians have to make their decisions depending upon the epidemic and clinical evaluation, and assessment of harm and benefit caused by using any of these to treat the diseased.
Concerning the current outbreak of the disease in the USA and Mexico, both local and national authorities recommend the use of Oseltamivir and Zanamivir in treatment, according to the virus's responsiveness.

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