Swine flu of spring 2009

The Swine Flu of Spring, 2009: Is it a problem for your family? This month, an unusual outbreak of influenza virus infection is occurring in severalnations, with Mexico having the largest to date. There are several features of thisoutbreak that are generating large media attention. But the real question for you and yourfamily is whether any harm threatens.
At this time, this infection looks no more harmful than the usual winter flu we see every
year. There has been only one death in the US from this infection (as of 4/29/09). But,
because this could change, we will keep this web page updated as new information
becomes available.
Meanwhile, here are a few things to keep in mind.
1. There is a difference between the illness we call flu, and the germ we call the
influenza virus
THE ILLNESS, FLU, is a slang term for a viral illness that makes you feel very lousy. It can be a stomach flu or a respiratory flu. It is very seldom fatal in generally healthy people of all ages.
THE INFLUENZA VIRUS is a particular species of virus that typically causes infection of the airways. This includes eyes, ears, nose, sinuses, throat, voice box, and lungs. It can cause troubles with which we are all familiar: pink eye, ear infections, earache, runny nose, blocked sinuses, croup, hoarse voice, sore throat, coughs, bronchitis, and pneumonias. The influenza virus causes about one third ofall respiratory flus and not many stomach flus. It can cause fatalities, mostly in aged or generally unhealthy people.
2. Being infected with a particular virus, such as the influenza virus, does not
determine how sick you are or will be
Any virus, including the influenza virus, can cause a wide range of illness, anything from a mild 12 hour illness to a two week illness of severe misery, or worse.
So is this swine flu epidemic more or less likely to cause bad illness? To answer that, let's look at some of its unusual features: 1. Influenza virus usually hits our communities in the winter, starting in December
and peaking in January and February. This swine flu virus began hitting the world in
April, very unusual.
2. All influenza viruses infect barnyard animals in the summer and humans in the
, but the virus does not typically cycle through pigs. Influenza virus that cycles
through pigs may occasionally cause a few cases, but not an epidemic. A famous case
occurred in 1975, prompting President Ford to rush to national immunization against the
possibility it might spread. It never spread, the immunization campaign was beset by
faulty vaccine, and many think this helped Ford lose to Carter in 1976.
3. The virus has led to some deaths in apparently healthy adults in Mexico, and as
noted in the New York Times this week, this is not how influenza usually works.
These features, singly and combined, raise worry that this is a bad, potentially hazardous,germ. But the fact is that we do not know that yet. Not a single US citizen has died fromthis virus, despite many cases. While some 200 people may have died from it worldwide,we do not know if that is out of 2 thousand or 2 million infected people.
Every year, influenza virus kills 30-40,000 Americans. That is out of millions of cases.
So, when our children get this infection (or we do), we are not overly worried. The SwineFlu epidemic may prove to be a very mild wave of flu from influenza virus in the spring.
That would be wonderful. Or it may reveal itself to be more dangerous. That would bevery upsetting. But as yet, neither has happened and we do not yet know the outcome.
Influenza viruses spread by sneezing and coughing. Influenza is not spread through skin-to-skin contact, per se. To become infected, the recipient must have the virus come incontact with their eyes, nose, or mouth. This can occur through breathing or touching aliving virus on a surface and transferring it to a moist, mucus part of the body.
As a point of information, every breath a person inhales contains billions of viruses.
Sneezing and coughing merely make them move quickly, rapidly, and in larger numbers.
Covering ones mouth during sneezing and coughing is always a good idea to minimize
the spread of viruses.
Masks are not particularly effective in prevention in the long run. At some point andoften, humans touch their eyes, nose, and mouth with their hands, thus bypassing themask. Taking off a mask after its use, results in touching it and the potential transfer ofthe virus it was intended to prevent! While washing your hands frequently is always a good idea, given the number of virusesand other germs in our world, it will not prevent their spread, merely delay it for sometime.
Keeping people home when they are sick, likewise, will not ultimately prevent the spreadof an illness, merely delay it. Epidemics are epidemics because they spread widely andwildly. Not much can prevent them entirely. Reasonable, hygienic behavior is a goodidea, but it never has prevented or stopped an epidemic.
The Swine Flu is not covered by the 2008 influenza vaccine. However, early indicatorssuggest that it is easily killed by two anti-viral antibiotics. The two drugs are Tamiflu andRelenza. Tamiflu comes in liquid and pill form and is available to be used for childrenolder than one. Relenza is an inhaled medication that is available to prevent the flu only ifa child is older than 5 years of age and to treat the flu only if a child is older than 7 yearsof age.
Both Tamiflu and Relenza have very limited benefits in the usual setting. They have noreal impact a child has been infected for more than 48 hours. (Most people with the fluare sick for at least that amount of time before they get sick enough to seek medicalattention.) Both drugs are associated with serious side effects. We do not recommendstockpiling these drugs, and in most instances these drugs will not help the colds and fluswe will see this spring. The main setting in which these drugs are used is when someonegets very seriously ill within the first 48 hours of illness, and tested positive for beinginfected with an influenza virus.
1. The swine flu epidemic of 2009 in the US appears to be causing mild
disease, very much like a mild flu or cold.

2. There appears to be no current danger of a hazardous epidemic.
3. We will post updates to this web page as information develops.
4. There is no reason for panic, or undue concern. If the situation fails to
worsen, all serious worry now will quickly appear needless.

Dr. Arthur Lavin is a pediatrician at Advanced Pediatrics in Beachwood OH. He isboard certified in Neonatal Care. He is the author of “Who’s The Boss? MovingFamilies from Conflict to Collaboration,” “Baby & Toddler Sleep Solutions forDummies,” and “Finding a Medical Home for Your Child.” www.advancedped.com

Source: http://www.advancedped.com/media/docs/Swine-Flu-2009.pdf

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