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Pathik Parikh
Pathik Parikh
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SWINE FLU PANDEMIC (H1N1)
NOMENCLATURE - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NOMENCLATURE - ,[object Object],[object Object],[object Object]
Historical context - ,[object Object],[object Object],[object Object],[object Object]
Historical context - Pandemic Year Influenza A virus subtype People infected (approx) Deaths (est.) Case fatality rate Seasonal flu Every year mainly A/H3N2, A/H1N1, and B 5–15% (340 million – 1 billion) 250,000–500,000 per year <0.05%
20th century flu pandemics - Pandemic Year Influenza A virus subtype People infected (approx) Deaths (est.) Case fatality rate 1918 flu pandemic 1918–19 H1N1 0.5 to 1 billion (near 50%) 20 to 100 million [ >2.5% Asian flu 1956–58 H2N2 2 million <0.1% ? Hong Kong flu 1968–69 H3N2 1 million <0.1%
1918 - 1919 Pandemic - ,[object Object],[object Object],[object Object],[object Object],[object Object]
1918 - 1919 Pandemic - ,[object Object],[object Object],[object Object],[object Object]
1918 - 1919 Pandemic -
Pandemic H1N1/09 virus - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Virus source and name - ,[object Object],[object Object],[object Object],[object Object]
Virus origins - ,[object Object],[object Object],[object Object],[object Object]
Virus origins - ,[object Object],[object Object],[object Object]
Virulence - ,[object Object],[object Object],[object Object]
Mutation potential - ,[object Object],[object Object],[object Object],[object Object]
Initial outbreaks - ,[object Object],[object Object]
Role Of Mexico - ,[object Object],[object Object],[object Object]
Spread - ,[object Object],[object Object]
Spread - ,[object Object],[object Object]
India - ,[object Object],[object Object],[object Object]
India -
Gujarat - ,[object Object],[object Object],[object Object]
Pandemic declared - ,[object Object],[object Object],[object Object]
By July 2009 - ,[object Object],[object Object],[object Object],[object Object]
By August 2009 - ,[object Object],[object Object],[object Object]
Epidemiological factors - ,[object Object],[object Object]
Epidemiological factors - ,[object Object],[object Object],[object Object],[object Object],[object Object]
Immunity - ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features – ,[object Object]
Clinical Features – Uncomplicated influenza ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features – Uncomplicated influenza ,[object Object],[object Object],[object Object],[object Object]
Clinical Features – Complicated or Severe Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features – Complicated or Severe Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features – Complicated or Severe Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features – Complicated or Severe Influenza ,[object Object]
Clinical Features - Progressive disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features - Progressive disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features - Progressive disease ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Features - Progressive disease ,[object Object],[object Object],[object Object]
Pneumonia - ,[object Object],[object Object],[object Object],[object Object]
Deaths – India ,[object Object],[object Object],[object Object],[object Object]
Cases As of August 21 – Gujarat ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cases As of August 24 – Gujarat ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Infection among animals - ,[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory Diagnosis – ,[object Object]
Laboratory Diagnosis – ,[object Object],[object Object],[object Object]
Specimens - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Specimens - ,[object Object],[object Object]
Molecular diagnostics - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Molecular diagnostics - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Molecular diagnostics - ,[object Object],[object Object]
Virus isolation - ,[object Object]
Rapid tests or immunofluorescence - ,[object Object],[object Object]
Serology - ,[object Object],[object Object],[object Object],[object Object]
Biosafety - ,[object Object],[object Object]
Case Definitions - ,[object Object],[object Object],[object Object],[object Object]
Case Definition – suspected case ,[object Object],[object Object],[object Object],[object Object]
Case Definition – probable case ,[object Object],[object Object],[object Object],[object Object]
Case Definition – confirmed case ,[object Object],[object Object],[object Object],[object Object]
Stratification of patients - ,[object Object]
Stratification of patients - (Ministry of H&FW 14 th August 2009) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stratification of patients - (Ministry of H&FW 14 th August 2009) ,[object Object],[object Object],[object Object]
Stratification of patients - (Ministry of H&FW 14 th August 2009) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stratification of patients - (Ministry of H&FW 14 th August 2009) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Stratification of patients - (Ministry of H&FW 14 th August 2009) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Stratification of patients - (Ministry of H&FW 14 th August 2009) ,[object Object],[object Object],[object Object]
Management of H1N1 – (Ministry of H&FW guidelines) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pharmacological Management – ,[object Object]
Pharmacological Management – (WHO guidelines 20 August 2009) ,[object Object],[object Object],[object Object]
Pharmacological Management – (WHO guidelines 20 August 2009) ,[object Object],[object Object]
Antiviral susceptibilities of circulating  viruses ( June 2009 ) Oseltamivir  Zanamivir   M2 inhibitors Pandemic A(H1N1) 2009  S S R Seasonal A (H1N1)  R S S Seasonal A (H3N2)  S S R Influenza B  S S R Avian influenza (H5N1)  S S Variably resistant
Severe or Progressive symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Uncomplicated - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Uncomplicated - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Oseltamivir - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Oseltamivir - ,[object Object],[object Object],[object Object]
Oseltamivir - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Oseltamivir - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Zanamivir – (VIRENZA, Cipla) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Zanamivir – (VIRENZA, Cipla) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Zanamivir – (VIRENZA, Cipla) ,[object Object],[object Object],[object Object]
Supportive therapy - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Discharge Policy - ,[object Object],[object Object],[object Object],[object Object]
Oseltamivir resistant virus - ,[object Object],[object Object],[object Object],[object Object]
Prevention – Personal Protection Equipment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Respiratory Hygiene/Cough Etiquette - ,[object Object],[object Object],[object Object]
Hand Hygiene - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ Close Contact&quot; ,[object Object],[object Object],[object Object],[object Object],[object Object]
Containment - ,[object Object],[object Object],[object Object]
Quarantines - ,[object Object],[object Object],[object Object],[object Object]
Pre-screening advisories by some governments ,[object Object],[object Object],[object Object]
Other measures - ,[object Object],[object Object],[object Object]
Chemo Prophylaxis - ,[object Object]
Chemo Prophylaxis - Indications ,[object Object],[object Object],[object Object]
Chemo Prophylaxis - Oseltamivir ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chemo Prophylaxis - Zanamivir ,[object Object],[object Object],[object Object],[object Object]
Chemo Prophylaxis - ContraIndications ,[object Object],[object Object],[object Object],[object Object]
Vaccine - ,[object Object],[object Object],[object Object],[object Object]
Vaccine - ,[object Object],[object Object],[object Object],[object Object]
Vaccine - ,[object Object],[object Object]
Vaccine – safety?? ,[object Object],[object Object],[object Object]
Vaccine - ,[object Object],[object Object]
Global surveillance of pandemic – ( WHO guidelines) ,[object Object],[object Object],[object Object],[object Object]
Estimates of total cases - ,[object Object],[object Object],[object Object]
THANK YOU

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swine flu

  • 1. SWINE FLU PANDEMIC (H1N1)
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  • 5. Historical context - Pandemic Year Influenza A virus subtype People infected (approx) Deaths (est.) Case fatality rate Seasonal flu Every year mainly A/H3N2, A/H1N1, and B 5–15% (340 million – 1 billion) 250,000–500,000 per year <0.05%
  • 6. 20th century flu pandemics - Pandemic Year Influenza A virus subtype People infected (approx) Deaths (est.) Case fatality rate 1918 flu pandemic 1918–19 H1N1 0.5 to 1 billion (near 50%) 20 to 100 million [ >2.5% Asian flu 1956–58 H2N2 2 million <0.1% ? Hong Kong flu 1968–69 H3N2 1 million <0.1%
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  • 9. 1918 - 1919 Pandemic -
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  • 79. Antiviral susceptibilities of circulating  viruses ( June 2009 ) Oseltamivir  Zanamivir   M2 inhibitors Pandemic A(H1N1) 2009  S S R Seasonal A (H1N1)  R S S Seasonal A (H3N2)  S S R Influenza B  S S R Avian influenza (H5N1)  S S Variably resistant
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