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Swine influenza

infection caused by any one of several types of swine influenza viruses

Swine influenza virus is a virus that is common in pigs. This type of influenza virus can also infect humans and birds. Swine influenza virus is sometimes called SIV or swine flu.

Pigs can have more than one type of flu at the same time. This means that viruses can mix genes and become a type of flu that could cause a pandemic.

Swine flu is common in pigs. Normally, it only infects people who have been in close contact with pigs. However, the disease can spread from one person to another.[1] Swine flu can cause fever, disorientation (not being clear-headed), stiffness of the joints, vomiting, and loss of consciousness. Sometimes this ends in death.[2] There are different types, or strains, of swine flu. They are called H1N1,[3] H1N2,[3] H3N1,[4] H3N2,[3] and H2N3.[5]

Background

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Military hospital during Spanish flu pandemic in 1918.

H1N1 came from the Spanish flu, which caused a pandemic in humans in 1918 and 1919.[6][7] New viruses came from the Spanish flu. These viruses became common in pigs. Every once in a while, the viruses spread from pigs to humans. This has happened during the 20th century. (However, they happened at the same time as the flu epidemics that happen every year. Because of this, it is hard to tell the difference between 'normal' influenza and swine influenza.)[6] Infections that spread from pigs to humans are rare. Scientists only know of 12 known cases in the United States since 2005.[8]

It is very difficult to prevent the flu virus. This is because the virus changes all the time. If a person gets the flu, his body forms antibodies to fight that virus off if it happens again. But since the flu virus changes all the time, a person's antibodies may not recognize the virus the next time it happens, because it is different. The same thing happens with vaccines.

The changes in the flu virus can cause a flu pandemic. For example, the virus might only change a little bit in about two to three years. After about ten years, most people will have developed antibodies to fight these small changes. But if the virus then changes a lot, there can be a pandemic. Hundreds of millions of people suddenly realize that the antibodies they developed are useless.[9] Even during the Spanish flu pandemic, the first wave of the disease was relatively mild, while the second wave was very deadly.[7]

In 1957, an Asian flu pandemic infected about 45 million Americans and killed 70,000. Eleven years later, from 1968 to 1969, the Hong Kong flu pandemic infected 50 million Americans and caused 33,000 deaths. It also cost about $3.9 billion. In 1976, about 500 soldiers became infected with swine flu over a few weeks. However, by the end of the month, investigators found that the virus had "mysteriously disappeared", and there were no more signs of swine flu.[7] There were a small number of isolated (far-apart) cases around the U.S. These were in people who were thought to have caught the virus from pigs.

Scientists fear the swine flu virus might mutate, or change, into a pandemic as deadly as the 1918/1919 pandemic. They watched the outbreak in 2009, and made plans about what to do if a global pandemic breaks out.

Symptoms

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The main symptoms of the swine influenza is much the same as regular influenza. Symptoms include vomiting, nausea, runny nose, loss of appetite, lethargy (feeling tired), chills, fever, body aches, sore throat, coughing, diarrhea, and stomach ache.

Where swine influenza is found

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The bird flu virus H3N2 is endemic in pigs in China. It has been found in pigs in Vietnam. Specialists also think that this might lead to new variations of the influenza virus.[10] Pigs can carry human influenza viruses. These viruses can combine in new ways, and exchange certain genes with H5N1. Through mutation, this would create a form of the virus that can pass easily among humans.[11] H3N2 evolved from H2N2 by antigenic shift.[12] In August 2004, researchers in China found H5N1 in pigs.[13]

In 2005 it was discovered that H5N1 could be infecting up to half of the pig population in some areas of Indonesia, but without showing symptoms. Chairul Nidom, a virologist at Airlangga University's tropical disease center in Surabaya, East Java, did some independent research: he tested the blood of 10 apparently healthy pigs housed near poultry farms in West Java where avian flu had broken out, Nature reported. Five of the pig samples contained the H5N1 virus. The Indonesian government has since found similar results in the same region. Additional tests of 150 pigs outside the area were negative.[14][15]

Swine Flu in Humans

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Electron microscope image of the N1H1 virus. The viruses are 80–120 nanometres in diameter.[16]

The Centers for Disease Control and Prevention (CDC), a United States government agency, reports that the symptoms and transmission of the swine flu from human to human is much like seasonal flu. Usually, the symptoms are fever, lethargy (feeling tired), lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhoea.[17] It is believed to be spread between humans when an infected person coughs or sneezes and then touches something. Another person then might touch the same thing with the virus on it and then touch their own nose or mouth.[18] The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can be contagious for up to ten days. Diagnosis can be made by sending a specimen (sample), collected during the first five days, for analysis.[19]

The Swine Flu is susceptible to four licensed drugs in the United States, amantadine, rimantadine, oseltamivir and zanamivir. However, for the 2009 outbreak, it was recommended it be treated with oseltamivir and zanamivir.[20] The vaccine for the human seasonal flu does not protect against the swine flu.

Veterinary swine flu vaccine

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The virus has evolved. This has made Swine influenza a bigger problem, mainly because traditional vaccines against influenza do not always work against Swine influenza. There are special vaccines against Swine influenza, but they only work if the virus strain is similar to some extent. In the cases more difficult to treat, special vaccines are produced. These are very similar, as they are made to match the specific virus strain.[21][22]

Present vaccination strategies for SIV control and prevention in swine farms use vaccines commercially available in the United States. The protective ability of influenza vaccines depends primarily on the closeness of the match between the vaccine virus and the epidemic virus.[23][24] The current vaccine against the seasonal influenza strain H1N1 is thought unlikely to provide protection.[25] The director of CDC's National Center for Immunization and Respiratory Diseases said that the United States' cases were found to be made up of genetic elements from four different flu viruses—North American swine influenza, North American avian influenza, human influenza A virus subtype H1N1, and swine influenza virus typically found in Asia and Europe. On two cases, a complete genome sequence had been obtained. She said that the virus is resistant to amantadine and rimantadine, but susceptible to oseltamivir (Tamiflu) and zanamivir (Relenza).[26][27][28]

2009 outbreak (Swine flu)

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Map of the swine flu deaths
  Confirmed cases, people died
  Confirmed cases, no deaths
  Unconfirmed or suspected cases
  No cases or no data

A new strain of swine influenza A called H1N1 was responsible for the swine flu outbreak in 2009 in humans. It came from a combination of several strains of influenza in humans and influenza in birds and swine influenza. Tests were done. Testers found that the hemagglutinin gene was similar to that of swine flu viruses that had already been found in pigs in the United States since 1999, but the neuraminidase and matrix protein genes resembled versions in European swine. Viruses like this had not been found in humans or pigs before. There is no program to monitor what viruses are circulating in pigs in the United States, however it began in Mexico, North America.[29]

Legacy in WHO guidelines

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In 2009, the government of Egypt ordered over 300,000 pigs killed to prevent the spread of H1N1, even though experts said the pigs were not going to spread H1N1 anyway. Most of the pigs' owners were not paid for their dead pigs.[30][31]

In 2015, the World Health Organization made itself some rules for naming viruses: No official name is allowed to refer to a place, person or animal. This is to prevent stigma, or blame. The WHO rules list "swine flu" as an example of what not to do when naming a virus or disease.[32][33]

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References

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  1. ↑ Cuevas Mayra; Curley Ann; Hellerman Caleb; Quijano Elaine; Candiotti Susan (25 April 2009). "More cases of swine flu reported; WHO warns of health emergency".
  2. ↑ "World Health Organization: Swine flu could spread globally". CNN.com. Retrieved 2009-04-25.
  3. ↑ 3.0 3.1 3.2 "Swine Influenza". Swine Diseases (Chest). Iowa State University College of Veterinary Medicine.
  4. ↑ eurekalert Archived 2017-09-15 at the Wayback Machine Tips from the Journals of the American Society for Microbiology - Novel H3N1 Swine Influenza Virus Identified in Pigs in Korea
  5. ↑ PNAS Archived 2009-08-12 at the Wayback Machine Published online before print December 18, 2007, doi: 10.1073/pnas.0710286104 PNAS December 26, 2007 vol. 104 no. 52 20949-20954
  6. ↑ 6.0 6.1 Taubenberger JK, Morens DM (2006). "1918 Influenza: the mother of all pandemics". Emerg Infect Dis. 12 (1): 15–22. doi:10.3201/eid1201.050979. PMC 3291398. PMID 16494711.
  7. ↑ 7.0 7.1 7.2 "Soft evidence and hard sell". New York Times. 5 September 1976.
  8. ↑ "U.S. pork groups urge hog farmers to reduce flu risk". Reuters. 26 April 2009.
  9. ↑ "The Last Great Swine Flu Epidemic" Archived 2009-11-03 at the Wayback Machine, Salon.com, April 28, 2009
  10. ↑ Yu, H. (March 2008). "Genetic evolution of swine influenza A (H3N2) viruses in China from 1970 to 2006". Journal of Clinical Microbiology. 46 (3): 1067–1075. doi:10.1128/JCM.01257-07. PMC 2268354. PMID 18199784. Archived from the original on 2009-04-29. Retrieved 2009-04-26.
  11. ↑ "Bird flu and pandemic influenza: what are the risks?". UK Department of Health. Archived from the original on 2009-07-09. Retrieved 2009-04-26.
  12. ↑ "Genetic analysis of human H2N2 and early H3N2 influenza viruses, 1957–1972: evidence for genetic divergence and multiple reassortment events". ScienceDirect.[permanent dead link]
  13. ↑ World Health Organization (October 28, 2005). "H5N1 avian influenza: timeline" (PDF). Archived from the original (PDF) on November 4, 2005. Retrieved April 26, 2009.
  14. ↑ "Indonesian pigs have avian flu virus; bird cases double in China". CIDRAP. 27 May 2005. Archived from the original on 7 October 2009. Retrieved 26 April 2009.
  15. ↑ Roos Robert, ed. (31 March 2009). "H5N1 virus may be adapting to pigs in Indonesia". University of Minnesota: Center for Infectious Disease Research & Policy. Archived from the original on 2009-10-07. Retrieved 2009-04-26.
  16. ↑ International Committee on Taxonomy of Viruses. "The Universal Virus Database, version 4: Influenza A".
  17. ↑ "Q & A: Key Facts about Swine Influenza (Swine Flu) - Symptoms". Centers for Disease Control and Prevention. 24 April 2009. Retrieved 2009-04-26.
  18. ↑ "Q & A: Key Facts about Swine Influenza (Swine Flu) – Spread of Swine Flu". Centers for Disease Control and Prevention. 24 April 2009. Retrieved 2009-04-26.
  19. ↑ "Q & A: Key Facts about Swine Influenza (Swine Flu) – Diagnosis". Centers for Disease Control and Prevention. 24 April 2009. Retrieved 2009-04-26.
  20. ↑ "Q & A: Key Facts about Swine Influenza (Swine Flu) – Treatment". Centers for Disease Control and Prevention. 2009-04-24. Retrieved 2009-04-26.
  21. ↑ "Swine flu virus turns endemic". National Hog Farmer. 15 September 2007.
  22. ↑ "Swine". Custom Vaccines. Novartis. Archived from the original on 2009-04-30. Retrieved 2009-04-26.
  23. ↑ Gramer Marie René; Lee Jee Hoon; Choi Young Ki; Goyal Sagar M; Joo Han Soo (July 2007). "Serologic and genetic characterization of North American H3N2 swine influenza A viruses". Canadian Journal of Veterinary Research. 71 (3): 201–206. PMC 1899866. PMID 1899866.
  24. ↑ Myers KP; Olsen CW; Gray GC (April 2007). "Cases of swine influenza in humans: a review of the literature". Clin Infect Dis. 44 (8): 1084–8. doi:10.1086/512813. PMC 1973337. PMID 17366454.
  25. ↑ "Update: Swine Influenza A (H1N1) Infections --- California and Texas, April 2009". MMWR. Centrers for Disease Control. 24 April 2009.
  26. ↑ Steven Reinberg (24 April 2009). "Swine Flu Cases Now Total 7: CDC". ABC News.
  27. ↑ Rob Stein (23 April 2009). "In California and Texas, 5 New Swine Flu Cases". Washington Post.
  28. ↑ "CDC Briefing on Public Health Investigation of Human Cases of Swine Influenza". CDC online newsroom. 23 April 2009.
  29. ↑ "Swine influenza A (H1N1) infection in two children --- Southern California, March--April 2009". Morbidity and Mortality Weekly Report. Centers for Disease Control. 2009.
  30. ↑ Brian Whitaker (April 30, 2009). "Pigs to the slaughter in Egypt". The Guardian. Retrieved February 12, 2020.
  31. ↑ Ashraf Badr (April 30, 2009). "Egypt starts pig slaughter, some farmers resist". Reuters. Retrieved February 12, 2020.
  32. ↑ Sanya Mansoor (February 11, 2020). "What's in a Name? Why WHO's Formal Name for the New Coronavirus Disease Matters". Time. Retrieved February 13, 2020.
  33. ↑ Brett Dahlberg and Elena Renken (February 11, 2020). "New Coronavirus Disease Officially Named COVID-19 By The World Health Organization". NPR. Retrieved February 12, 2020.

Further reading

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Swine Flu h1n1

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