Swine flu cases spread around the world | World news | The Guardian Swine flu cases spread around the world Guardian correspondents report on how different countries are reacting to the swine flu outbreak Guardian reporters Tuesday 28 April 2009 08.19 EDT First published on Tuesday 28 April 2009 08.19 EDT Close Australia Authorities have imposed tough border-control measures, warning of a likely swine flu outbreak with 45 people being tested for the deadly virus. Emergency response teams and hotlines have been set up across the country and Tasmania, an island state in the south, has threatened to shut its borders in an attempt to keep the flu out. Airlines servicing Australia from the Americas are required to report any passengers with flu-like symptoms before being cleared to land at local airports. Nurses have been stationed at international airports to detect and treat anyone suspected of carrying the virus. The rapid spread across the world has forced Australian authorities to track down people who shared the Air New Zealand flight that carried an Auckland school group returning from an excursion to Mexico who have tested positive for the illness.

Suspected patients have been isolated at home and given the Tamiflu and Relenza vaccines which the federal government stockpiled in the wake of the Sars outbreak in 2002. The Australian prime minister, Kevin Rudd, says all available resources will be marshalled to fight the "evolving threat. This is a serious international concern for public health," he said. With almost 9m doses of medication at hand, Australia has one of the biggest per-capita vaccine reserves in the world. Yet many fear it may not be enough. Pharmacists say a growing number of people have been asking for the vaccine and purchasing surgical masks. Airline shares have tumbled amid fears that tourism would again be hit as it was during the Sars outbreak while pharmaceutical stocks have surged on the rising death toll. Toni O'Loughlin in Sydney Eleven New Zealand students who returned from an excursion to Mexico at the weekend have tested positive for swine flu while 18 people who shared the flight with the pupils are yet to be traced. New Zealand officials are investigating 45 other cases of suspected swine flu. . The government deployed a team of 25 to track the 364 passengers who shared the flight with the school party.

One of the pupils played football soon after landing, before the alarm was sounded, potentially infecting his teammates and those of the opposition. Fear of a pandemic is rising, fuelling criticism that New Zealand officials have been slow to act. One passenger who shared the flight with the Rangitoto College students, Ian Hooker, said he was contacted on Monday morning, more than 48 hours after the flight had landed. "We have been placed under quarantine as a result of today and I just can't help wondering whether that couldn't have been done on Sunday given that they knew about it on Saturday," Hooker said. Although he had no symptoms, he was given Tamiflu and told to stay indoors for up to seven days. Testing in New Zealand has taken longer as the samples needed to be sent to a WHO lab in Melbourne, Australia. Meanwhile, New Zealanders will have to wait till Friday for Tamiflu to be available over the counter at pharmacies. Toni O'Loughlin in Sydney Ireland The department of health in Dublin will release swine flu test results later today on four Irish people who have returned from abroad. The results will be released at a press conference after clinical tests lasting up to five hours.

Dr Kevin Kelleher, head of health protection at the Republic's health service executive, confirmed the suspected cases had recently returned from areas affected by the outbreak. He said further tests would be expected on the public in the coming week. Ireland's chief medical officer said the Republic was well prepared for an outbreak of swine flu. Dr Tony Holohan, from the department of heath, said the country had enough stocks of anti-viral drugs to cover up to half of its population. Ireland's health service executive is advising any Irish citizen who has returned from Mexico, California or Texas within the last seven days and developed an influenza-like illness to phone their family doctor for advice. The Irish government has so far declined to ban flights to affected countries or issue advice to travellers not to visit them. There was little sign of panic on the streets. The main talking point in Dublin today ‑ and the lead item in the first edition of the city's evening paper, the Evening Herald ‑ was the third day of an unofficial wildcat bus strike in the Irish capital. The department of foreign affairs has said about 300 Irish people live in Mexico and about 1,000 Irish people are currently on holiday there.

Henry McDonald in Ireland Israel Israeli health officials said today that they had found their first confirmed case of swine flu. Two Israelis have been in hospital quarantine with flu-like symptoms since Sunday after returning recently from Mexico. Doctors believe one, a man aged 26 who has been in hospital in Netanya, has swine flu although he is reported to be in good condition. Tests on the second patient in hospital in Kfar Sava continue. Health ministry officials said they were advising Israelis to put off any non-essential travel to Mexico and to stay alert about reports of swine flu in other countries. Israelis returning from Mexico were told to see a doctor if they developed flu symptoms within seven days and that they would be quarantined in hospital until the cause of their illness was determined. Warning signs have been put up at the country's main airport, Ben Gurion, near Tel Aviv. Until now there has been relatively little concern in Israel about the spread of the illness, except for the name it should be given. Yakov Litzman, Israel's deputy health minister and an ultra-Orthodox Jew, said the name "swine flu" was offensive to Jews who do not eat pork. "We will call it Mexico flu.

We won't call it swine flu," he said on Monday. Litzman said he was giving two daily briefings to the prime minister, Binyamin Netanyahu, about the illness. There were sufficient stocks of Tamifluto treat 18% of the population and a budget to buy enough drugs to treat a quarter of the population if necessary, he said. "If there's a catastrophe and the need arises to immediately increase the stock by several million pills this should not be a problem, thanks to various agreements we have," said Danny Laor, head of the health ministry's emergency unit. Rory McCarthy in Jerusalem Spain Spain's close ties with Mexico have made it the first country to import swine flu into Europe with a second case confirmed this morning in Valencia and a third expected later today in the north-eastern region of Catalonia. Groups of university students returning from spring breaks in Cancun and other Mexican resorts brought the virus into Spain last week. The announcement yesterday that Antonio Gil, a 23-year-old student in the eastern town of Almansa, had tested positive brought the now familiar blue face masks on to television screens while the government and doctors called for calm. Twenty-seven people are confined to hospitals and being tested for the virus.

Local health authorities said Gil was recovering well but would be held in observation for up to a week. Passengers on flights from Mexico are inspected on arrival and made to fill out forms detailing where they have been and how they can be contacted. The health minister, Soledad Jimenéz, said yesterday that the situation was "under control". There are, however, signs of confusion: Jimenéz contradicted health officials this morning by claiming Gil might be discharged today. It was reported that the patient in the second confirmed case of swine flu was discharged from hospital, only to be recalled hours later when a second set of tests showed positive. Spaniards have not panicked. Twenty blue plastic barrels of anti-viral medicine stored at a military base contain some 10m doses. The medicine was bought during the bird flu scare. Giles Tremlett in Madrid China China says it has no confirmed or probable cases. A school in Shaanxi, a northern province, has been closed as a precautionary measure after children developed flu-like symptoms, but it is thought unlikely that swine flu is responsible.

A Chinese health ministry spokesman, Mao Qun'an, told state media that the government had demanded that all medical bodies increase monitoring and immediately notify it of any suspected cases. Entry-exit and quarantine officials have also been told to strengthen inspections and disinfection procedures. Other precautions include banning pork imports from Mexico and affected American states, although experts say that consumption does not pose a transmission risk. Dr Hans Troedsson, the WHO representative in China, said the country had learned important lessons after officials were heavily criticised for covering up the Sars outbreak in 2002-03. The disease killed hundreds on the mainland and in Hong Kong. But he added: "The sheer number [of people here] makes it extremely difficult to have a perfect surveillance system.Other challenges [include] the migrant population. They are not always registered so they can seek healthcare ‑ and of course it is not good if people aren't getting at least medical advice if they have any symptoms." Chinese websites, news programmes and newspapers have led with news of the spread of swine flu, and official publications have underlined the need for openness in the wake of the Sars scandal.

The People's Daily, the mouthpiece of the Communist party, stressed the public's right to know about health issues, adding: "Disclosure of information will help to swiftly sever channels of infection." Tania Branigan in Beijing If swine flu isn’t kosher in Israel, is it halal in the Muslim world? If swine flu isn’t kosher in Israel, is it halal in the Muslim world? Our Jerusalem bureau had this interesting little story today about the swine flu outbreak: Swine flu not kosher in Israel JERUSALEM, April 27 (Reuters) – Swine flu? Not in the Jewish state. “We will call it Mexico flu. We won’t call it swine flu,” Deputy Health Minister Yakov Litzman, a black-garbed Orthodox Jew, told a news conference on Monday, assuring the Israeli public that authorities were prepared to handle any cases. Under Jewish dietary laws, pigs are considered unclean and pork is forbidden food — although non-kosher meat is available in some stores in Israel. If swine flu isn’t kosher, then it probably wouldn’t be halal either. So is swine flu being renamed anywhere in the Muslim world? NB: The U.S.

Centers for Disease Control and Prevention (CDC) website advises : “You can not get swine influenza from eating pork or pork products.” (Photo: Pigs at a farm outside Hanoi, 27 April 2009/Nguyen Huy Kham) « Previous Post Swine flu: Israel row over non-kosher virus name - Telegraph Swine Flu Swine flu: Israel row over non-kosher virus name Israel will continue to use the name Swine Flu for the deadly virus sweeping the world despite religious calls for it to be rebranded Mexican Flu. Deputy health minister Yakov Litzman said the authorities should call the virus sweeping the globe Mexican flu Photo: EPA 8:31AM BST 29 Apr 2009 Deputy health minister Yakov Litzman, a member of an ultra-religious party, said " swine flu " should not be used as it contains the name of the animal banned by Judaism. Instead he said the authorities should call the virus sweeping the globe "Mexican flu." That, however, did not sit well with either Mexico's ambassador to Israel nor the Jewish state's envoy to Mexico.

Mexico's ambassador Frederico Salas and the Israeli envoy to Mexico Yosef Livne both lodged official complaints at the foreign ministry on Tuesday protesting at the new term. "The ambassador (Salas) said he was offended when the deputy health minister's called it the Mexican flu," a foreign ministry official said. Related Articles 29 Apr 2009 "Israel has no intention of giving the flu any new names. " the official said. Eating pork is prohibited by Judaism, the religion practised by the majority of Israelis. Islam, adhered to by most of Israel's Arab minority, likewise bans consumption of pork. Israel confirmed that two nationals who recently returned from Mexico had contracted swine flu in the first such cases in the Middle East. US officials also said they were reviewing whether to change the name of the outbreak, complaining that a slew of countries were misguidedly banning pork exports from North America. "This is not a food-borne crisis. It's important to not refer to swine flu. It's important to convey the message that consuming pork will not cause this illness," Agriculture Secretary Tom Vilsack told reporters.

The World Organisation for Animal Health said on Monday that the name swine flu is a misnomer as the deadly virus has origins among birds and humans as well as pigs. Swine Flu (Influenza) SWINE FLU (INFLUENZA) Does the world face a deadly Pandemic? The head of the World Health Organization (WHO) says the swine flu outbreak in Mexico and the United States could develop into a pandemic. WHO Director-General Margaret Chan says the outbreak involves "an animal strain of the H1N1 virus, and it has pandemic potential." Fukuda, WHO assistant director-general for Health Security and Environment, said, the outbreak has spread widely enough that efforts must focus on mitigation, because containment of the virus is no longer feasible. A rising number of infections is causing concern across the globe. The flu has killed more than 150 people in Mexico. Nearly 100 people have been infected in other countries, including the United States, Canada, Spain and New Zealand. The number of infections is steadily rising around the globe. The Center for Disease Control officials have said they believe the virus is spreading person-to-person, but are unsure how quickly it spreads or how long it takes for the infection to appear.

What is the Swine flu? The Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses (H1N1) that causes regular outbreaks in pigs. People do not normally get swine flu, but human infections can and do happen as indicated with the current worldwide outbreak. This new strain of the swine flu virus actually has a mixture of swine and avian components (not to be confused with the deadly avian flu of Southeast Asia). Is this swine flu virus contagious? The Swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it not known how easily the virus spreads between people. Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. The incubation time is between 24 and 48 hours, however it can be as long as 5 days. Flu symptoms can last between 7 to 10 days How does swine flu spread?

Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sneezing can spread the virus to people up to 5 to 20 feet. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. How long can viruses live outside the body? We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Frequent hand washing will help you reduce the chance of getting contamination from these common surfaces. What can I do to protect myself 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. There is no vaccine available right now to protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.

Take these everyday steps to protect your health: ï¿½ Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. ï¿½ Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. ï¿½ Avoid touching your eyes, nose or mouth. Germs spread this way. ï¿½ Try to avoid close contact with sick people. ï¿½ If you get sick with influenza, it is recommended that you stay home from work or school and limit contact with others to keep from infecting them. Are there medicines to treat swine flu? Yes the use of oseltamivir or zanamivir (brand names Tamiflu and Relenza) for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications.

For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms). Is there a vaccine for Swine Flu? No, there is no current vaccine for the swine Flu. However the CDC and WHO has this current strain of virus and will consider whether to add it to next yearï¿½s flu vaccine as time goes on. Symptoms What should I do if I get sick? If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed. If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others. If you become ill and experience any of the following warning signs, seek emergency medical care.

In children emergency warning signs that need urgent medical attention include: ï¿½ Fast breathing or trouble breathing ï¿½ Bluish skin color ï¿½ Not drinking enough fluids ï¿½ Not waking up or not interacting ï¿½ Being so irritable that the child does not want to be held ï¿½ Flu-like symptoms improve but then return with fever and worse cough ï¿½ Fever with a rash In adults, emergency warning signs that need urgent medical attention include: ï¿½ Difficulty breathing or shortness of breath ï¿½ Pain or pressure in the chest or abdomen ï¿½ Sudden dizziness ï¿½ Severe or persistent vomiting Initial outbreak The earliest known case was at a Mexican pig farm nearby La Gloria whose nearby neighbors had been complaining about the smell and flies. The outbreak was first detected in Mexico City, where surveillance began picking up a surge in cases of Influenza like illness (ILI) starting March 18. The surge was assumed by Mexican authorities to be "late-season flu" (which usually coincides with a mild Influenzavirus B peak) until April 21, when a U.S.

Centers for Disease Control and Prevention alert concerning two isolated cases of a novel swine flu was reported in the media. The first two cases identified (and confirmed) as swine flu were two children living in the United States, in San Diego County and Imperial County, California, who became ill on March 28 and 30. This new strain was promptly confirmed in Mexico, connecting the new strain to the ongoing outbreak of ILI. The first deadly case seems to go back to April 13, where it is believed that the first case was in a woman from Oaxaca. Some samples were sent to the U.S.-based CDC on April 18. News of the connection was broadcast live in Mexico on April 23, 2009. In March and April 2009, over 1000 cases of suspected swine flu in humans were detected in Mexico and the southwestern United States. The strain appears to be unusually lethal in Mexico, causing 152 deaths (20 confirmed) so far, mostly in Mexico City.

There have also been cases reported in the states of San Luis Potosï¿½, Hidalgo, Querï¿½taro and Mexico State, all in central Mexico; Some cases in Mexico and the United States have been confirmed by the World Health Organization to be a never-before-seen strain of H1N1. The Mexican fatalities are mainly young adults of 25 to 45, a hallmark of pandemic flu. A new swine flu strain was confirmed in 16 of the deaths and at least 100 others were being tested as of April 24, 2009. Mexican Health Minister Josï¿½ ï¿½ngel Cï¿½rdova on April 24, said "Weï¿½re dealing with a new flu virus that constitutes a respiratory epidemic that so far is controllable." The origins of the new virus strain remain unknown. One theory is that Asian and European strains traveled to Mexico in migratory birds or in people, then combined with North American strains in Mexican pig factory farms before jumping over to farm workers.

The Mexican health agency acknowledged that the original disease vector of the virus may have been flies multiplying in manure lagoons of pig farms near Perote, Veracruz. Confirmed cases as of 04/27/2009 Canada: 6 cases Spain: 7 cases World Health Organization Pandemic Influenza Phases The World Health Organization raised the pandemic alert to phase 4 on Monday (April 27,2009) in reaction to the rapidly spreading swine flu. Phase 4 signifies a sharp increase in the risk of a global flu epidemic, but does not mean a pandemic is certain. Phase 6 is the alert for a full-blown pandemic. ï¿½Phase 1 no viruses circulating among animals have been reported to cause infections in humans. ï¿½Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat. ï¿½Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks.

Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic. ï¿½Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause ï¿½community-level outbreaks.ï¿½ The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion. ï¿½Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

ï¿½Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way. ï¿½ During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave. ï¿½ Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate ï¿½at-easeï¿½ signal may be premature. ï¿½ In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly.

An intensive phase of recovery and evaluation may be required. Worse case (using USA as an Example) A full-scale pandemic ï¿½ if it ever comes ï¿½ could be expected to claim the lives of about 2 percent of those infected, about 2 million Americans. The government estimates that a pandemic like the 1918 Spanish flu would sicken 90 million Americans, or about 30 percent of the population. Of those, nearly 10 million would have to be admitted to a hospital, and nearly 1.5 million would need intensive care. About 750,000 would need the help of mechanical ventilators to keep breathing. No one would be immune from the consequences, even those who don't get sick, according to worst-case exercises run by local and national agencies. ï¿½ Schools would be closed to try to block the spread of illness, for example, but school buses might be used to take flu victims to alternative clinics rather than overcrowded hospitals.

ï¿½ Businesses would be forced to use telecommuting to remain in business ï¿½ A 2006 report on the Washington region found both Maryland and Virginia would run out of hospital beds within two weeks of a moderate outbreak. ï¿½ People who got sick would be isolated, and their relatives could be quarantined. ï¿½ But even if families weren't required to stay home, many would do so to take care of sick relatives, or because they were afraid of getting sick themselves. ï¿½ Hotels, restaurants and airlines would face loss of business as business travel and meetings would be replaced by teleconferences. ï¿½ Families, businesses, churches and Governmental agencies would be vastly affected. Worldwide, The disease would skip from city to city over an 18-to-24 month period, infecting more than a third of the population. World health Organization officials believe as many as 1.5 billion people around the globe would seek medical care and nearly 30 million would seek hospitalization. Based on the last pandemic and current world population, as many as 7 million people could die, epidemiologists said.

Further Information CDC H1N1 Flu | H1N1 Flu and You 2009 H1N1 Flu What is 2009 H1N1 (swine flu)? 2009 H1N1 (sometimes called “swine flu”) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. This virus is spreading from person-to-person worldwide, probably in much the same way that regular seasonal influenza viruses spread. On June 11, 2009, the World Health Organization (WHO) declared that a pandemic of 2009 H1N1 flu was underway. Why is the 2009 H1N1 virus sometimes called “swine flu”? This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in the virus were very similar to influenza viruses that normally occur in pigs (swine) in North America. But further study has shown that the 2009 H1N1 is very different from what normally circulates in North American pigs.

It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and bird (avian) genes and human genes. Scientists call this a "quadruple reassortant" virus. 2009 H1N1 Flu in Humans Are there human infections with 2009 H1N1 virus in the U.S.? Yes. While 2009 H1N1 activity declined after later October, 2009 human illness with 2009 H1N1 is ongoing in the United States. In fact, the 2009 H1N1 virus is the predominant influenza virus in circulation so far during the 2009-2010 flu season. The United States experienced its first wave of 2009 H1N1 activity in the spring of 2009, followed by a second wave in the fall, with the number of people infected peaking at the end of October. There are still uncertainties surrounding the rest of this flu season, including the possibility that seasonal influenza viruses will spread during the winter as they usually do while 2009 H1N1 viruses continue to cause illness.

In past pandemics, flu activity has occurred in waves and it’s possible that the United States could experience another wave either later in the 2010 winter, or later. In the past, when new viruses have emerged to cause flu pandemics, the new virus has continued to spread among people. Experts believe it’s likely that the new 2009 H1N1 virus will continue to circulate among people for some time, perhaps as a typical winter flu. In fact, a 2009 H1N1 virus has been selected as the H1N1 vaccine component for the Southern Hemisphere’s upcoming seasonal flu vaccine. (More information about the selection of the viruses for the 2010-2011 Northern Hemisphere flu vaccine is available.). CDC routinely works with states to collect, compile and analyze information about influenza, and has done the same for the 2009 H1N1 virus since the beginning of the outbreak. This information is presented in a weekly report, called FluView . Is the 2009 H1N1 virus contagious? The 2009 H1N1 virus is contagious and is spreading from human to human.

How does the 2009 H1N1 virus spread? Spread of the 2009 H1N1 virus is thought to occur in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing, sneezing or talking by people with influenza. Sometimes people may become infected by touching something – such as a surface or object – with flu viruses on it and then touching their mouth or nose. Can I get 2009 H1N1 more than once? February 10, 2010 Getting infected with any influenza virus, including 2009 H1N1, should cause your body to develop immune resistance to that virus so it's not likely that a person would be infected with the identical influenza virus more than once. (However, people with weakened immune systems might not develop full immunity after infection and might be more likely to get infected with the same influenza virus more than once.) However, it's also possible that a person could have a positive test result for flu infection more than once in an influenza season.

This can occur for two reasons: A person may be infected with different influenza viruses (for example, the first time with 2009 H1N1 and the second time with a regular seasonal flu virus. Most rapid tests cannot distinguish which influenza virus is responsible for the illness. And, Influenza tests can occasionally give false positive and false negative results so it's possible that one of the test results were incorrect. This is more likely to happen when the diagnosis is made with the rapid flu tests. More information about flu diagnosis is available. Liver disorders Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders) Weakened immune system due to disease or medication (such as people with HIV or AIDS , or cancer , or those on chronic steroids) People younger than 19 years of age who are receiving long-term aspirin therapy In addition, some studies have shown that obese persons ( body mass index ≥30 ) and particularly morbidly obese persons (body mass index ≥40) are at higher risk, perhaps because they have one of the higher risk conditions above but do not realize it. How does 2009 H1N1 flu compare to seasonal flu in terms of its severity and infection rates?

Flu seasons vary in terms of timing, duration and severity. Seasonal influenza can cause mild to severe illness, and at times can lead to death. Each year, in the United States, on average 36,000 people die from flu-related complications and more than 200,000 people are hospitalized from flu-related causes. Of those hospitalized, 20,000 are children younger than 5 years old. More than 90% of deaths and about 60 percent of hospitalization occur in people older than 65. CDC estimates of the numbers of 2009 H1N1 cases, hospitalizations and deaths are that people younger than 65 years of age are more severely affected by 2009 H1N1 flu relative to people 65 and older compared with seasonal flu. CDC estimates that with 2009 H1N1, approximately 90% of hospitalizations and 88% of estimated deaths from April through December 12, 2009 occurred in people younger than 65 years old.

However, because severe illness and deaths have occurred among people 65 and older and because supplies of 2009 H1N1 vaccine have increased dramatically, CDC is now encouraging all people 6 months and older, including people older than 65, to get vaccinated against 2009 H1N1. How long can an infected person spread this virus to others? People infected with seasonal and 2009 H1N1 flu shed virus and may be able to infect others from 1 day before getting sick to 5 to 7 days after. This can be longer in some people, especially children and people with weakened immune systems and in people infected with 2009 H1N1 viruses. Prevention & Treatment Influenza Round Table: Antiviral Drugs Video Influenza Round Table: Antiviral Drugs Dr. Joe Bresee explains the nature of antiviral drugs and how they are used. Yes. There are drugs your doctor may prescribe for treating both seasonal and 2009 H1N1 called “ antiviral drugs .” These drugs can make you better faster and may also prevent serious complications.

It’s very important that antiviral drugs be used early to treat flu in people who are very sick (for example people who are in the hospital) and people who are sick with flu and have a greater chance of getting serious flu complications ( see box ). Other people may also be treated with antiviral drugs by their doctor this season. Most healthy people with flu, however, do not need to be treated with antiviral drugs. What is CDC’s recommendation regarding "swine flu parties"? "Swine flu parties" are gatherings during which people have close contact with a person who has 2009 H1N1 flu in order to become infected with the virus. The intent of these parties is for a person to become infected with what for many people has been a mild disease, in the hope of having natural immunity 2009 H1N1 flu virus that might circulate later and cause more severe disease. CDC does not recommend "swine flu parties" as a way to protect against 2009 H1N1 flu in the future. While the disease seen in the current 2009 H1N1 flu outbreak has been mild for many people, it has been severe and even fatal for others.

There is no way to predict with certainty what the outcome will be for an individual or, equally important, for others to whom the intentionally infected person may spread the virus. Vaccination against 2009 H1N1 with a 2009 H1N1 vaccine is the best way to protect against this virus. Supplies of 2009 H1N1 vaccine are ample and CDC is now recommending that everyone get vaccinated. CDC recommends that people with 2009 H1N1 flu avoid contact with others as much as possible. If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine. * ) Stay away from others as much as possible to keep from making others sick. Contamination & Cleaning How long can influenza virus remain viable on objects (such as books and doorknobs)? Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for 2 to 8 hours after being deposited on the surface. What kills influenza virus?

Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time. *What if soap and water are not available and alcohol-based products are not allowed in my facility? If soap and water are not available and alcohol-based products are not allowed, other hand sanitizers that do not contain alcohol may be useful. What surfaces are most likely to be sources of contamination? Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands. How should waste disposal be handled to prevent the spread of influenza virus?

To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste. What household cleaning should be done to prevent the spread of influenza virus? To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label. How should linens, eating utensils and dishes of persons infected with influenza virus be handled? Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first. Linens (such as bed sheets and towels) should be washed by using household laundry soap and tumbled dry on a hot setting. Individuals should avoid "hugging" laundry prior to washing it to prevent contaminating themselves. Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry. Eating utensils should be washed either in a dishwasher or by hand with water and soap.

Exposures Not Thought to Spread 2009 H1N1 Flu Can I get infected with 2009 H1N1 virus from eating or preparing pork? No. 2009 H1N1 viruses are not spread by food. You cannot get infected with 2009 HIN1 from eating pork or pork products. Eating properly handled and cooked pork products is safe. Is there a risk from drinking water? Tap water that has been treated by conventional disinfection processes does not likely pose a risk for transmission of influenza viruses. Current drinking water treatment regulations provide a high degree of protection from viruses. No research has been completed on the susceptibility of 2009 H1N1 flu virus to conventional drinking water treatment processes. However, recent studies have demonstrated that free chlorine levels typically used in drinking water treatment are adequate to inactivate highly pathogenic H5N1 avian influenza. It is likely that other influenza viruses such as 2009 H1N1 would also be similarly inactivated by chlorination. To date, there have been no documented human cases of influenza caused by exposure to influenza-contaminated drinking water.

Can 2009 H1N1 flu virus be spread through water in swimming pools, spas, water parks, interactive fountains, and other treated recreational water venues? Influenza viruses infect the human upper respiratory tract. There has never been a documented case of influenza virus infection associated with water exposure. Recreational water that has been treated at CDC recommended disinfectant levels does not likely pose a risk for transmission of influenza viruses. No research has been completed on the susceptibility of 2009 H1N1 influenza virus to chlorine and other disinfectants used in swimming pools, spas, water parks, interactive fountains, and other treated recreational venues. However, recent studies have demonstrated that free chlorine levels recommended by CDC (1–3 parts per million [ppm or mg/L] for pools and 2–5 ppm for spas) are adequate to disinfect avian influenza A (H5N1) virus. It is likely that other influenza viruses such as 2009 H1N1 virus would also be similarly disinfected by chlorine. Can 2009 H1N1 influenza virus be spread at recreational water venues outside of the water?

Yes, recreational water venues are no different than any other group setting. The spread of this 2009 H1N1 flu is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. 2009 H1N1 in Pets What animals can be infected with the 2009 H1N1 virus? In addition to humans, live swine and turkeys, a small number of ferrets (which are highly susceptible to influenza A viruses), domestic cats and dogs have been infected with 2009 H1N1 virus. In addition, 2009 H1N1 virus infection was reported in a cheetah in the United States. CDC is working closely with domestic and international public and animal health partners to continually monitor reports of 2009 H1N1 in animals and will provide additional information to the public as it becomes available. How do pets become infected with 2009 H1N1?

All available information suggests that the ferrets and domestic cats infected with 2009 H1N1 infections acquired the virus through close contact with ill humans. Can I get 2009 H1N1 influenza from my pet? Available evidence suggests that transmission has been from ill humans to their companion animals. No evidence is available to suggest that animals are infecting humans with 2009 H1N1 virus. What do I do if I am sick with flu-like symptoms and I have pets? If you are sick with influenza-like-illness, take the same precautions with your pets that you would to keep your family and friends healthy: Cover your coughs and sneezes Wash your hands frequently Minimize contact with your pets until 24 hours after your fever is gone without the use of fever reducing medication What should I do if I suspect my pet has 2009 H1N1 influenza virus? If members of your household have flu-like symptoms, and your pet exhibits respiratory illness, contact your veterinarian. Is there a vaccine available for my pet? Currently, there is not a licensed and approved 2009 H1N1 vaccine for pets.

(There is a canine influenza vaccine, which protects dogs from the H3N8 canine flu virus, but it will not protect pets against the 2009 H1N1 virus, and the H3N8 vaccine should not be used in any species other than dogs.) How serious is this disease in pets? Pet ferrets with naturally occurring 2009 H1N1 infection have exhibited illness similar in severity to that seen in ferrets exposed to seasonal influenza viruses and to 2009 H1N1 virus in laboratory settings. Clinical signs exhibited have included sneezing, inactivity, and weight loss. Of the reported cases, most of the pets have recovered fully with supportive care, although some have died. Additional Information Swine Flu Prompts A World Of Different Reactions : NPR Swine Flu Prompts A World Of Different Reactions April 29, 20092:01 PM ET Charles Holmes Get Outbreak Updates At The 'Flu Shots' Blog When three cases of swine flu emerged in Germany on Wednesday, the country's health minister, Ulla Schmidt, was blunt: "The development fills me with worry.

None of us knows how far this will extend." The World Health Organization on Wednesday raised its pandemic alert to Phase 5 — the second-highest level and a step away from a full-fledged pandemic. As the virus spread deeper into Europe, the first swine flu death in the U.S. was reported in Texas, and President Obama suggested that school closings may be a necessary precaution. Earlier this week, Obama reassured Americans that federal preparations were under way to deal with a possible epidemic, adding that there was "no cause for alarm." But alarm seemed to be the order of the day in Egypt. Authorities ordered the slaughter of 300,000 to 400,000 pigs in the country Wednesday to limit the spread of the disease, even though no cases have been reported there. In Spain, where a handful of cases have been confirmed, Prime Minister Jose Luis Rodriguez Zapatero urged people not to panic. "We have the scientific and the therapeutic means to respond to this situation," he said. Article continues after sponsorship Political leaders and public health authorities around the globe are grappling with a fundamental question as new swine flu cases are reported daily: how to address the problem but not exacerbate it.

Tone Should Be 'Scary But Tentative' "The way to sustain credibility is to be simultaneously scary but also tentative," says Peter Sandman, a Princeton, N.J.-based risk communication consultant who has advised the World Health Organization, the U.S. government and private companies. Jeffrey Koplan, a former director of the Centers for Disease Control and Prevention, now with Emory University, says much deliberation goes into crafting the public message during a crisis like the swine flu outbreak. "It is a constant balancing act in which you struggle to convey a sense of risk while not inducing a public panic," Koplan says. He says the CDC has been consistent in its language — calling it an "epidemic of concern" and stressing that it is likely to get worse. In Mexico, where the outbreak has hit hardest, schools and other public places have been ordered closed, and restaurants in the capital have been told to serve only takeout. The U.S. and scores of other governments have recommended to their citizens that they limit their travel to Mexico. Argentina and Cuba have banned flights to and from Mexico, though Cuba relaxed the prohibition Wednesday for flights taking people to Mexico.

Screening Travelers And Banning Pork Imports Officials at major airports worldwide are on the lookout for travelers with flu symptoms on flights from Mexico and the U.S. In Asia, authorities have dusted off thermal scanners used during the 2003 SARS outbreak to detect passengers who may have a fever. And Russian officials have ordered planes coming from affected countries to special zones where health officials can board the aircraft and screen passengers. Australia is requiring pilots of international flights to declare whether any passengers are displaying flu-like symptoms before the airport will grant permission to land. British officials are advising their citizens to curtail trips to Mexico. They have also recommended that British nationals in Mexico stay put rather than risk spreading an infection that they may already have. China and Russia, among other countries, have banned imports of pork and pork products from Mexico and U.S. states reporting cases of swine flu. Indonesia, which was hit hardest by bird flu several years ago, said it is banning all pork imports. The Centers for Disease Control and Prevention says there is no evidence to suggest that consuming pork can spread the swine flu virus.

The U.S., the European Union, China and other countries with sophisticated public health research agencies are better able to assess threats and react appropriately, Koplan says. "There is no interest to the public being served by telling people not to eat pork or killing pigs," Koplan says. In Israel, where two cases of the flu have been confirmed, officials were preparing to transfer control of emergency preparations from the government's health agency to the Israeli military, which has a long history of handling national crises. Prepare For Worst-Case Scenario The influenza coordinator at the European Center for Disease Prevention and Control, Angus Nicoll, said governments need to be prepared. "The pattern at the moment is that of a mild disease, but one of the things that you've got to always remember with flu and particularly potentially pandemic viruses is that they have a nasty habit of changing and even becoming nastier over time," Nicoll said. "That's why in the EU, we're working so hard to make sure that the countries are prepared if this is going to get bad." At least one high-ranking European Union official issued an advisory earlier this week warning against travel to the United States.

That prompted the State Department spokesman in Washington, D.C., to issue this tart response Tuesday: "As far as I know, there hasn't been any official notification coming from the European Union. As far as I know, that was just a personal view of the EU health commissioner." What To Call It? And what to call the disease? The United States began referring to the disease Wednesday by its scientific designation — H1N1. Israeli Deputy Health Minister Yakov Litzman, an ultra-Orthodox Jew, declared Monday that Israel would call the disease "Mexico flu" rather than swine flu, as pigs are not kosher. Mexico's ambassador to Israel formally protested Litzman's statement. Israel's Foreign Ministry later apologized, saying Litzman was "just kidding." In any event, Litzman's call has gone unheeded and the press and the public continue to call it swine flu. No one in Hong Kong is joking about the disease. Memories of the SARS crisis, which claimed more than 750 lives mostly in China and Hong Kong, are still fresh. Officials in Hong Kong are preparing camps to quarantine patients and have announced that all schools will be shut down if just one student falls ill with swine flu.

Residents have already been lining up at pharmacies to buy face masks and medical supplies. Chief executive Donald Tsang said Hong Kong would "rather take extra steps than lower its guard." NPR's Lourdes Garcia-Navarro in Jerusalem, Louisa Lim in Shanghai, Jerome Socolovsky in Madrid and Eric Westervelt in Berlin contributed to this report.

Question: In Israel in 2009, what did they call the world outbreak of swine flu?
Answer: Mexico flu