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Swine Flu :An Endemic and Pandemic Disease Review Article Kalavapudi.Vyshnavi et al. / Journal of Pharmacy Research 2010, 3(1),93-99 ISSN: 0974-6943 Available online through http://jprsolutions.info Swine Flu :an endemic and pandemic disease Kalavapudi.Vyshnavi*,Dr.I.Sudheer babu, Sriman.Tirumala.Gudimella.Raviteja*, palaniyappan.Venkatesh, Kothandam.Hariprasath. *Sir.C.R.Reddy College of Pharmaceutical Sciences, Eluru-534007, Andhra Pradesh, India. Received on: 20-09-2009; Revised on: 16-10-2009; Accepted on:15-12-2009 ABSTRACT Swine flu is a highly contagious disease of pigs and infection by any one of several types of swine influenza virus. Swine influenza virus is any strain of influenza family of viruses that is endemic in pigs. It is estimated that 50 to 100 million people were killed worldwide. The direct transfer of the virus probably occurs either by pigs (touching noses, or through dried mucus) and close contact with infected people. People who work with poultry and swine, especially people with intense exposures, are at increased risk of zoonotic infection with influenza virus endemic in these animals, and constitute a population of human hosts in which zoonosis and reassortment can co-occur. Symptoms of swine flu are similar to most influenza infections: running nose, body aches, chills, fever (100°F or greater), cough, fatigue, and headache, myalgia, dyspnea with fatigue being reported in most infected individuals. The two major tests that are being used are the nasopharyngeal (or back of the throat) swab for viral culture, the gold standard, and the indirect evidence test by detection of antibodies to novel H1N1 with polymerase chain reaction(PCR) studies. Antiviral treatment with either zanamivir alone or with a combination of oseltamivir and either amantadine or rimantadine should be initiated as soon as possible after the onset of symptoms. There are two kinds of 2009 H1N1 vaccines being produced:- A 2009 H1N1 “flu shot”, The 2009 H1N1 nasal spray flu vaccine. In our review paper, we have detailed the transmission, classification of influenza virus, replication, symptoms, treatment and its preventive measures. Keywords: Swine influenza virus, oseltamivir, amantadine. INTRODUCTION The Pandemic H1N1/09 virus is a swine-origin influenza A (H1N1) virus strain responsible for the 2009 flu pandemic. The ini- The word Influenza comes from the Italian language and re- tial outbreak was called the “H1N1 influenza.” In July 2009 WHO fers to the cause of the disease; initially, this ascribed illness to experts changed the name to “pandemic H1N1/09 virus” to distin- unfavorable astrological influences. Changes in medical thought led guish it from the current “seasonal H1N1 virus”. In the Netherlands it to its modification to influenza del freddo, meaning “influence of the was originally called “pig flu” but is now called “Mexican flu” by cold”. The word influenza was first used in English in 1743 when it the national health institute and in the media. Southwas adopted, with an anglicized pronunciation, during an outbreak of Korea and Israel briefly considered calling it the “Mexican virus”. the disease in Europe. The first convincing record of an influenza Later the South Korean press used “SI”, short for “swine pandemic was of an outbreak in 1580, which began in Russia and influenza”. Taiwan suggested the names “H1N1 flu” or “new flu”, spread to Europe via Africa. In Rome, over 8,000 people were killed, which most local media adopted. The World Organization for Animal and several Spanish cities were almost wiped out. Pandemics contin- Health proposed the name “North American influenza”. The European ued sporadically throughout the 17th and 18th centuries, with the Commission adopted the term “novel flu virus”. Swine flu is a highly pandemic of 1830–1833 being particularly widespread; it infected ap- contagious disease of pigs and infection by any one of several types proximately a quarter of the people exposed (Potter et al.,2001). The of swine influenza virus. Swine influenza virus is any strain of influ- most famous and lethal outbreak was the 1918 flu pandemic (Spanish enza family of viruses that is endemic in pigs flu pandemic) (type A influenza, H1N1 subtype), which lasted from 1918 to 1919. It is not known exactly how many it killed, but estimates HISTORY: range from 20 to 100 million people (Patterson et al., 1991). This pan- demic has been described as “the greatest medical holocaust in his- tory” and may have killed as many people as the Black Death. After *Corresponding author. 1930, for the following 60 years of swine influenza strains were Dr. Kalavapudi.Vyshnavi almost exclusively H1N1. Later flu pandemics were not so devastat- Sir.C.R.Reddy College of Pharmaceutical Sciences, Eluru-534007, Andhra ing. They included the 1957 Asian flu (type A, H2N2 strain) and the Pradesh, India. 1968 Hong Kong Flu (type A, H3N2 strain), but even these smaller Tel.: + 91-9441102235 outbreaks killed millions of people. In 1976, there was an outbreak of Telefax: +91- swine flu at Fort Dix. This virus is not the same as the 2009 outbreak, E-mail: [email protected];[email protected] but it was similar insofar as it was an influenza A virus that had simi- larities to the swine flu virus. There was one death at Fort Dix. The Journal of Pharmacy Research Vol.3.Issue 1.January 2010 93-99 Kalavapudi.Vyshnavi et al. / Journal of Pharmacy Research 2010, 3(1),93-99 government decided to produce a vaccine against this virus, but the virus can infect a pig respiratory cell at the same time as a swine vaccine was associated with neurological complications (Guillain-Barré influenza virus; some of the replicating RNA strands from the human syndrome) and was discontinued. Then between 1997 and 2002 new virus can get mistakenly enclosed inside the enveloped swine influ- strains of three different subtypes and five different enza virus. For example, one cell could contain eight swine flu and genotypes emerged as causes of influenza. During the mid-20th century, eight human flu RNA segments. The total number of RNA types in identification of influenza sub types became possible allowing accu- one cell would be 16; four swine and four human flu RNA segments rate diagnosis of transmission to humans. It is estimated could be incorporated into one particle, making a viable eight RNA that 500,000 people were killed worldwide. The etiological cause of segmented flu virus from the 16 available segment types. Various influenza, the Orthomyxoviridae family of viruses, was first discov- combinations of RNA segments can result in a new subtype of virus ered in pigs by Richard Shope in 1931. This discovery was shortly (known as antigenic shift) that may have the ability to preferentially followed by the isolation of the virus from humans by a group headed infect humans but still show characteristics unique to the swine influ- by Patrick Laidlaw at the Medical Research Council of the Unitedenza virus (Recker et al.,2007). It is even possible to include RNA Kingdom in 1933. strands from birds, swine, and human influenza viruses into one virus if a cell becomes infected with all three types of influenza (for example, TRANSMISSION: two bird flu, three swine flu, and three human flu RNA segments to produce a viable eight-segment new type of flu viral genome). Forma- Transmission between pigs tion of a new viral type is considered to be antigenic shift; small changes in an individual RNA segment in flu viruses are Influenza is quite common in pigs, with about half of breed- termed antigenic drift and result in minor changes in the virus. How- ing pigs having been exposed to the virus in the US. Antibodies to ever, these can accumulate over time to produce enough minor the virus are also common in pigs in other countries. The main route changes that cumulatively change the virus’ antigenic makeup over of transmission is through direct contact between infected and time (usually years). uninfected animals. These close contacts are particularly common during animal transport. Intensive farming may also increase the risk Second, pigs can play a unique role as an intermediary host of transmission, as the pigs are raised in very close proximity to each to new flu types because pig respiratory cells can be infected directly other. The direct transfer of the virus probably occurs either by pigs with bird, human, and other mammalian flu viruses. Consequently, pig touching noses, or through dried mucus. Airborne transmissions respiratory cells are able to be infected with many types of flu and can through the aerosols produced by pigs coughing or sneezing are also function as a “mixing pot” for flu RNA segments. Bird flu viruses, an important means of infection. The virus usually spreads quickly which usually infect the gastrointestinal cells of many bird species, through a herd, infecting all the pigs within just a few days. Transmis- are shed in bird feces. Pigs can pick these viruses up from the envi- sion may also occur through wild animals, such as wild boar, which ronment and seem to be the major way that bird flu virus RNA seg- can spread the disease between farms (Vicente et al., 2002). ments enter the mammalian flu virus population. Transmission to humans People who work with poultry and swine, especially people with intense exposures, are at increased risk of zoonotic infection with influenza virus endemic in these animals, and constitute a population of human hosts in which zoonosis and reassortment can co- occur (Gray et al., 2009). Vaccination of these workers against influ- enza and surveillance for new influenza strains among this popula- tion may therefore be an important public health measure. Transmis- sion of influenza from swine to humans who work with swine was documented in a small surveillance study performed in 2004 at the University of Iowa.
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