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Minimizing Swine flu risk and treatment options

Minimising risk of acquiring swine flu:

Awareness of the mode of spread of the infection is fundamental in understanding what you need to do to minimise the risk of the infection:

§ Hygiene: Wash hands thoroughly and frequently particularly after using a toilet at home or in a public place. Soap does render the virus inactive. Alcohol-based hand wipes or lotions/gel are also useful after touching potentially contaminated surfaces.

§ Masks: The use of masks is controversial. It is acknowledged that no mask can completely eliminate the risk. However, it is recommended that health care workers wear N95 masks and individuals may consider wearing surgical masks especially if they are sneezing themselves.

§ Social engagement: It might be prudent to avoid unnecessary prolonged exposure to large crowds.

§ If symptomatic, stay at home.

If suspecting that you may have swine flu:

Most countries have put measures and specific advice in place for what you need to do if you think you might have the infection. However, the general measures are uniform.

§ Stay at home

§ Take medication to bring the temperature down. Paracetamol (Acetaminophen) is the drug of choice. If a child or teenager is affected do not give them Aspirin. This increases the risk of a potentially lethal complication called Reye’s syndrome.

§ Take plenty of fluids and definitely avoid dehydration

§ Contact your health care provider (doctor or midwife) by phone. This is to help decide whether the diagnosis is correct and whether further measures such as anti-viral medication or even hospital admission are required.

§ If you are in the UK, you can contact the National Pandemic Flu service or NHS Direct. The contact details are given below.

England:              Tel: 0800 15 13 100

Scotland:             Tel: 08454 24 24 24 Tamiflu for swine flu

Wales:                 Tel: 0845 46 47

Northern Ireland: Tel: 0800 051 41 42

Anti-viral medication for swine flu

There is no such thing as a cure for swine flu. Like all variants of this viral infection, it is a self-limited disease. The course of the disease may vary from person to person and the severity differs but each episode has a limited duration span. The aim of giving antivirals is to shorten the course of the disease, reduce severity and, in the process, reduce the chances of the patient from spreading it to others.

There are two types of anti-viral medications approved for use with swine flu. Both act against an essential viral enzyme. They are called Neuraminidase inhibitors. The two are Tamiflu (Oseltamivir) available in oral tablet form and Relenza (Zanamivir) which is inhaled. For maximum benefit, these need to be started as early asRelenza used in pregnancy possible in the course of the infection, preferably within 48 hours of onset of symptoms.

If you are pregnant...

It is recommended that the inhalational Relenza (Zanamivir) is used if you are pregnant. Since respiratory complications are the most feared, the logic is that it will be delivered directly to where it is required most. In addition, this method of delivery of the drug minimises the amount that gets into the circulation and therefore to the baby. Pregnancy has been classified as a potential risk state for swine flu (see previous page). It is also important to be aware of the limited effect of any anti-viral medication. It is not a cure.

Because severe systemic disease increases the risk of spontaneous miscarriage and preterm labour with all the potential consequences of this, the recommendation is for active management of confirmed or strongly suspected disease. Medication needs to be taken for 5 days.

If a pregnant woman has been in close contact with a confirmed case of swine flu, chemoprophylaxis (preventative medication) could be considered especially if she has other risk factors mentioned above. If preventative medication is taken, the course should last 10 days.

Swine flu and new mothers

It is an established fact that breastfeeding protects against respiratory diseases for newborns and infants. Bottle-fed babies are at a significantly higher risk of these conditions and that would include swine flu. At this time  of the pandemic, this is another reason for mothers to consider breast-feeding, among other things, as a proven preventative measure for the baby. If you happen to acquire the infection and you are breastfeeding, there is no need to stop. You can breast-feed whilst taking the antiviral drugs.

Vaccination against swine flu

There is a number of swine flu vaccines. The vaccines have been available since late October 2009. In many countries including the UK, administration of the vaccine started with those identified to be ‘at risk’ groups. These include:

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Anti-virals Tamiflu in pill form (above) and relenza which is inhaled are the two forms of treatment available. They help moderate the disease both in severity and duration.