Swine Flu Trackers: Influenza A (H1N1) Infections Tracked on Google Maps

While it appears so far that the strain of the influenza virus is not a particularly virulent strain, it is important that the population is vigilant about the location of the occurrence of illness and any status change regarding the severity of the disease that could be caused by the notorious ability of the influenza virus to mutate into a more severe form. The 1918 Spanish flu first emerged in early summer, then went quiet, only to cause a severe pandemic in the fall. So far the Influenza A (H1N1) virus does not have the markers for virulence that were seen in the 1918 virus, which is estimated to have killed between 20 and 100 million people from March 1918 to June 1920. Recent reports of high mortality among healthy young adults in the 2009 Influenza A (H1N1) or swine flu outbreak has led to speculation that cytokine storms (suspected in the 1918 Spanish Flu) could be responsible for these deaths, but the CDC so far states that there is insufficient data to determine the virulence of the current strain of virus. Cytokine storms present high fever, swelling and redness, extreme fatigue, and nausea, when cytokines, immune system signaling molecules become highly elevated in a runaway positive feedback response of the immune system.

What’s important about a swine flu?
This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. Influenza A (H1N1) 2009 has two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes. Scientists call this a “quadruple reassortant” virus. Swine flu can be transmitted back and forth from pigs to humans. As of the date of this post, pigs are not known to be infected and special security efforts are being conducted to protect pigs from being infected by humans. Because of better understanding of the genetic makeup of the influenza virus, the 2009 outbreak from Mexico is now called Influenza A (H1N1).

What does the ‘H’ and ‘N’ stand for in Influenza A (H1N1)?
Influenza A virus strains are categorized according to two viral proteins, hemagglutinin (H) and neuraminidase (N). All influenza A viruses contain hemagglutinin and neuraminidase, but the structure of these proteins differs from strain to strain due to rapid genetic mutation in the viral genome. Influenza A virus strains are assigned an H number and an N number based on which forms of these two proteins the strain contains. Hemagglutin is an antigenic glycoprotein that functions to bind the virus to the cell that the virus is infecting. Something that is antigenic, stimulates a response from the immune system. Neuraminidase is an enzyme on the surface of influenza viruses that enables the virus to be released from the host cell. Drugs, such as Tamiflu, are antiviral drugs in that they inhibit neuraminidase in the effort to treat influenza.

How severe is influenza A (H1N1)? … does it kill? … does it make you miserable, and for how long?
Influenza A virus subtype H1N1, also known as A (H1N1), is a subtype of influenzavirus A and the most common cause of influenza (flu) in humans. Some strains of H1N1 are endemic in humans, including the strain(s) responsible for the 1918 flu pandemic which killed 50–100 million people worldwide.

Influenza produces widespread sporadic illness yearly during fall and winter in temperate climates. Epidemics in the US occur about every 2 to 3 yr, most often caused by influenza A viruses. Pandemics caused by new influenza A serotypes may cause particularly severe disease.

Symptoms and Signs
Influenza A (H1N1) is a sickness very similar to regular, seasonal influenza. The incubation period for Influenza A is about 1 to 4 days with an average of about 48 hours. In mild cases of Influenza A, symptoms are similar to those of a common cold (eg, sore throat, rhinorrhea); mild conjunctivitis (redness with eye infection) may also occur. In adults, the sudden onset of chills, fever, prostration, cough, and generalized aches and pains (especially in the back and legs) is common. Headache is prominent, often with photophobia and retrobulbar aching. Respiratory symptoms may be mild at first, with scratchy sore throat, substernal burning, nonproductive cough, and sometimes coryza. Later in the illness, lower respiratory tract illness becomes dominant; cough can be persistent, raspy, and productive. Children may also have prominent nausea, vomiting, or abdominal pain, and infants may present with a sepsis-like syndrome. A significant number of people who have been infected with this virus have reported diarrhea and vomiting. Acute symptoms subside after about 2 to 3 days, but fever may last up to 5 days. Cough, weakness, sweating, and fatigue may persist for several days or even weeks.

Pneumonia is suggested by a worsening cough, purulent or bloody sputum, dyspnea, and rales. Secondary bacterial pneumonia is suggested by persistence or recurrence of fever, cough, and other respiratory symptoms in the 2nd wk.

Encephalitis, myocarditis, and myoglobinuria develop infrequently, usually during recovery, and occur more frequently after influenza A pandemics.

How is it spreading and how contagious is Influenza A (H1N1)?
At the time of this writing, the CDC has declared that it does not know how easily the virus is transmitted from human to human, but the outbreak is intense, beginning in Mexico and first showing in the United States in Guadalupe County, Texas (Brownsville) from a visiting Mexican native and Southern California.

Influenza (Flu) viruses are spread mainly from person to person through coughing or sneezing by people already infected with influenza. People may become infected by touching something with flu viruses already settled on the object, and then touching their mouth, nose or eyes, where infection is likely to occur. Objects, such as clothing, blankets, door knobs, handrails, desktops, tabletops, and health club equipment that harbor infective viruses, are known as fomites.

The high humidity of summer typically leads to the end of the flu season as the virus becomes less likely to spread. In Mexico City and other northern hemisphere locations, the month of May marks the end of the dry season, and experts speculate that the spread of the swine flu or Influenza A (H1N1) may slow down in the northern hemisphere. Dry, heated air is usually associated with people in enclosed places, which are ideal for spreading the “swine flu” virus. Dry, heated air is also rough on membranes of the eyes, nose, mouth and respiratory tract, which makes it easier for the virus infect individuals. The 2009 outbreak comes at the beginning of the flu season for Southern Hemisphere countries such as New Zealand, Australia, South Africa, Argentina, Chile and other parts of South America.

Swine flu or Influenza A (H1N1) is not transmitted by eating pork or pork products. Besides the updated genetic information about the flu virus from the 2009 outbreak from Mexico, the name “Swine flu” is being de-emphasized to protect farmers and marketers of pork and pork products from undeserved ill reputation.

What should I do to keep from getting the flu?
First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not to touch surfaces that may be contaminated with the flu virus. Most likely, you will contact objects that harbor flu viruses or viruses of the common cold, so take very good care to wash your hands before you eat, or touch your eyes, mouth or nose. For best protection against colds and flu, never touch a public objects with your fingers and subsequently allow yourself to touch food, knives, forks, spoons and drinking glasses where these items, including your fingers, would eventually contact your mouth, eyes or nose. Avoid close contact with people who are sick.

Be careful to use lotion to protect your hands, which can become extra dry, raw and irritated from excessive washing, especially in winter conditions.

Thousands of people die from regular strains of influenza every year; therefore, many people feel that the news media is frightening the public for news sales or that the government is over-reacting (recalling a 1976 government reaction to the swine flu when more deaths were caused by the vaccination than the actual illness). Today’s sophisticated information gathering and reporting techniques need to be adapted to reduce risk and reduce fear. Getting out the proper and latest information about severity, transmission, treatment and the spread of the disease is the best way to maintain a healthy population and economy. Check the Centers for Disease Control and Prevention web page H1N1 Flu (Swine Flu) and You for the latest information on taking care of yourself and your family.

SOURCES:
Centers for Disease Control and Prevention — CDC.GOV
Merck Manuals Online Medical Library

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