Infection Control Society Pakistan

KARACHI, May 9: Experts speaking at a seminar on Saturday said that swine flu (A H1N1) virus, if at all entered the city, would have little chance to survive or surge owing to the hot and humid environment here. However, they warned, health providers were required to remain alert till the advent of winter.

Dr Iftikhar Ahmed and Dr Rafique Khanani, both associated with the Dow University of Health Sciences (DUHS), were expressing their views at the seminar on “Swine Influenza”, a virus that has been declared a pandemic by the World Health Organisation (WHO). The virus, after its outbreak in Mexico, has infected more than 2,500 people in about 25 countries and already caused dozens of deaths.

Organised by the DUHS, the seminar was presided over by its Pro-Vice-Chancellor, Prof Salahuddin Afsar.

Dr. Iftikhar Ahmed, the head of infectious diseases department at the DUHS, observed that swine flu was a highly contagious, acute respiratory disease of pigs, caused by one of several swine influenza-A viruses that regularly caused outbreaks of influenza in pigs and occasionally caused human-to-human transmission.

He said that though the exact time and location of the outbreak of the latest swine influenza was unknown, it was believed to have been first detected when influenza-like illness was reported by the health agencies and local news media in Mexico. The virus responsible was clinically defined as a new strain of influenza on April 24, 2009.

He said that pigs were now considered as a mixing vessel since they could catch human and avian or pig flu. “When flu viruses from different species infect pigs, they can mix inside the animal and create new mixed viruses,” he added.

“Our best countermeasure – vaccine – will probably be unavailable during the first wave of pandemic while antiviral treatment may improve outcomes, though will have only modest effect on transmission,” he remarked. He said that in the given situation, prevention was the best measure and individuals should cover their nose and mouth with a tissue when they cough or sneeze and trash the tissue after the use.

Dr Ahmed said that the symptoms of H1N1 virus were similar to those of seasonal flu and included fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people infected with this virus also reported diarrhoea and vomiting, he added, observing that the virus had the same properties in terms of spread as seasonal flu viruses.

Elaborating, he said that with seasonal flu, studies had shown that people might be contagious from the day before they developed symptoms till up to seven days after they fell sick. Children, might potentially be contagious for longer periods.

About preventive measures, he said that people should often wash their hands with soap and water, especially after they cough or sneeze. Alcohol-based hand cleaners were also effective. They should also avoid touching their eyes, nose or mouth as germs spread this way. The infected people should stay indoors for a week or so and other people should not come in direct physical contact with them.

Dr Rafique Khanani was also of the view that there was little chance for H1N1 to survive in the weather conditions that prevailed currently in the southern parts of the country. Hot and humid conditions were less favourable for the virus to spread but at the same time it was necessary to continue with the vigilance exercises and remain prepared as the virus could hit with more intensity the countries already affected by it. The virus, he said, was very much fragile outside the animal or human bodies but could have an intensified transmission in winters.

He warned that the comforts like air-conditioning of houses, offices and vehicles could help the virus to spread although the outdoor climate was not favourable for its spread. A degree of caution should be observed in this regard.

Dr Khanani, who is also the president of Infection Control Society, Pakistan, said that the swine virus contained gene segments from different influenza types —North American swine, North American avian, North American human and Eurasian swine — and it had acquired two new tools/capabilities: 1) Human-to-human transmissibility and 2) Enhanced virulence.

He said that WHO had raised the alert level to Phase 5. Its alert system was revised after avian influenza began to spread in 2004, and April 27 this year was the day when it was raised above Phase 3. On April 29, it was raised to Phase 5, which was characterised by human-to-human spread of the virus into at least two countries in one WHO region.

While most countries are not likely to be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalise the organisation, communication and implementation of the planned mitigation measures is short.

Highlighting the transmission of influenza A (H1N1) to human, Dr Khanani said that it happened through contact with infected pigs and humans or the environments contaminated with swine flu viruses.

“A confirmed case of swine influenza-A (H1N1) virus infection is defined as a person with an acute febrile respiratory illness with laboratory-confirmed swine influenza-A (H1N1) virus infection by real-time RT-PCR or viral culture,” he concluded.

Source: Dawn.com