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The Truth About Pandemics

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We are reeling under a surfeit of breaking news and scientific expert opinions about the swine flu pandemic. However, we need to remain focused and evaluate the statistics. The World Health Organization (WHO) says that there are approximately 1.2 million cases worldwide and around 1,000 deaths. In India, the fatalities are still in the double digits.

In contrast, tuberculosis (TB) causes 4,00,000 deaths in India annually. In fact, it is the leading cause of death in the economically productive 15 to 45 age group. However, TB can be easily diagnosed and cured with proper medication.

Around 450 out of 1,00,000 healthy young women die during childbirth. This is in contrast to China where the figure has fallen to 50. The WHO report states that the problem is magnified because the poor get inadequate care, while the rich demand and pay for caesarians and other non essential interventions.

Nineteen-year-old Saina Nehwal made headlines when she developed chicken pox a couple of weeks before the August 10 world badminton finals. She is part of the 95 per cent of the world population that develops chicken pox at some time in the course of their lives. It is an extremely contagious infection which is not taken seriously, as it usually results in innocuous disease. It can, however, turn dangerous and cause complications like brain fever, blindness, pneumonia and sterility in 10 per cent of those affected. If it occurs in childhood, it usually passes off with about a month’s absence from school. But if it occurs at a crucial stage in life like during your college finals or a public exam, it can cause much misery. The fact is such harassment is totally avoidable. The disease is preventable with a single dose of Varicella vaccine, which has to be administered after the age of one.

Pneumococcal disease causes pneumonia, brain fever, ear infection, sinusitis and bronchitis. The infection is common and results in 1.6 million deaths every year. Of this, one million are children. The death toll can be eliminated with timely immunisation in childhood. Infective jaundice because of hepatitis A and B can also be prevented with immunisation. Hepatitis A is considered harmless and exposure inevitable in India. Although the number of fatalities is negligible, it causes morbidity, with a feeling of “weakness”, lack of energy and ill health that persists for months. Hepatitis B is more dangerous. It can result in liver damage, chronic disease, cancer and even death. Again, both infections are preventable with immunisation.

Rubella or German measles is another disease that is preventable through vaccination. If acquired during pregnancy, the affliction can result in a stillbirth or a mentally retarded child with multiple defects requiring a lifetime of care. There are more vaccine preventable diseases such as measles, brain fever (caused by H. Influenzae or the meningococcal bacteria), typhoid, rotor virus diarrhoea, polio and even cervical cancer (caused by the Human Papillovirus infection).

Why then are we so focused on the swine flu epidemic? Flu has been around for centuries. Confirmed pandemics have been occurring with devastating regularity after 1918. The viruses responsible have a reservoir in birds and animals from where they mutate and transmigrate into humans. Since pigs share many genes with humans, the transition is this particular pandemic is very efficient. The rapid spread of the virus is helped by the lack of sunshine during the monsoon and in winter. It cannot survive long when exposed to our tropical sun, so in India the pandemic may be time bound.

It is difficult to differentiate the symptoms of regular flu from that of swine flu. Both start with fever, body ache, headache, sore throat, nasal stuffiness and cough. There may be diarrhoea or vomiting. The symptoms are more severe with swine flu. Most healthy people recover spontaneously from either. Those at risk are children under five, old people above 65, pregnant women and those with underlying medical conditions such as cancer, diabetes or heart disease.

Vaccines are available, but they have to be “upgraded” and “restructured” each time there is a new epidemic, as the genetic nature of the virus changes. The WHO anticipates that a vaccine to protect us against this pandemic will be available by October or November. But will there be enough vaccine to cover the entire world (or even Indian) population at risk?

The diagnosis is confirmed by tests done on nasal and throat swabs or nasal aspirates. Blood tests can be done but they take five days and involve taking two different samples. Treatment too is available in government hospitals. The drug Tamiflu (oseltamivir) is administered once diagnosis is confirmed.

The likelihood of infection is reduced by:

• Washing hands with soap several times a day, especially after handling money

• Cleaning surfaces like doorknobs with disinfectant

• Using a face mask

• Covering the face while coughing or sneezing

• Not spitting.

Source: The Terlegraph (Kolkata, India)

 
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How WHO Measures a Pandemic

The World Health Organization has six phases of pandemic alert to assess the potential for a new global flu outbreak. Swine flu has raised the level to phase 5.

— Phase 1. There are no viruses circulating in animals that have been reported to cause infections in humans.

— Phase 2. An animal flu virus has caused infections in humans in the past and is considered to be a potential pandemic threat.

Phase 3. An animal or mixed animal-human virus has caused occasional cases or small clusters of disease, but the virus does not spread easily. The world is currently in phase 4, with H5N1 bird flu viruses sporadically infecting humans and occasionally spreading from human to human.

— Phase 4. The new virus can cause sustained outbreaks and is adapting itself to human spread.

— Phase 5. The virus has spread into at least two countries and is causing even bigger outbreaks.

— Phase 6. More outbreaks in at least two regions of the world; the pandemic is under way.

The World Health Organization raised its pandemic alert level to 5, signaling that the swine flu virus is becoming increasingly adept at spreading between humans. That signals governments they should ready their pandemic preparedness plans and increase detection systems for potential cases.

Phase 6 means there is transmission in at least two regions of the world and that a pandemic is under way.

With an elevated pandemic alert level, WHO might also issue travel advisories, warning against nonessential travel to regions battling outbreaks, trade restrictions, the cancellation of public events or border closures.

During the SARS outbreak in 2003, WHO travel advisories drastically slashed travel to affected regions, curtailing the outbreak

Sources
: Los Angeles Times

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Flu- Influenza

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Alternative Names:
Flu; Influenza A; Influenza B

Etymology:
The term influenza has its origins in 15th-century Italy, where the cause of the disease was ascribed to unfavourable astrological influences. Evolution in medical thought led to its modification to influenza del freddo, meaning “influence of the cold.” The word “influenza” was first attested in English in 1743 when it was borrowed during an outbreak of the disease in Europe. Archaic terms for influenza include epidemic catarrh, grippe (from the French grippe, meaning flu; sometimes spelled “grip” or “gripe”), sweating sickness, and Spanish fever (particularly for the 1918 pandemic strain).

Description:
It is an infectious disease of birds and mammals caused by RNA viruses of the family Orthomyxoviridae (the influenza viruses). In humans, common symptoms of influenza infection are fever, sore throat, muscle pains, severe headache, coughing, weakness and general discomfort. In more serious cases, influenza causes pneumonia, which can be fatal, particularly in young children and the elderly. Sometimes confused with the common cold, influenza is a much more severe disease and is caused by a different type of virus. Although nausea and vomiting can be produced, especially in children, these symptoms are more characteristic of the unrelated gastroenteritis, which is sometimes called “stomach flu” or “24-hour flu.”

Typically, influenza is transmitted from infected mammals through the air by coughs or sneezes, creating aerosols containing the virus, and from infected birds through their droppings. Influenza can also be transmitted by saliva, nasal secretions, feces and blood. Infections also occur through contact with these body fluids or with contaminated surfaces.

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Flu viruses can remain infectious for about one week at human body temperature, over 30 days at 0 °C (32 °F), and indefinitely at very low temperatures (such as lakes in northeast Siberia). Most influenza strains can be inactivated easily by disinfectants and detergents.

Flu spreads around the world in seasonal epidemics, killing millions of people in pandemic years and hundreds of thousands in non-pandemic years. Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans. Often, these new strains result from the spread of an existing flu virus to humans from other animal species.

Since it first killed humans in Asia in the 1990s, a deadly avian strain named H5N1 has posed the greatest risk for a new influenza pandemic; fortunately, this virus has not mutated to a form that spreads easily between people.

Vaccinations against influenza are most commonly given to high-risk humans in industrialized countries and to farmed poultry. The most common human vaccine is the trivalent flu vaccine that contains purified and inactivated material from three viral strains. Typically this vaccine includes material from two influenza A virus subtypes and one influenza B virus strain. A vaccine formulated for one year may be ineffective in the following year, since the influenza virus changes rapidly over time and different strains become dominant. Antiviral drugs can be used to treat influenza, with neuraminidase inhibitors being particularly effective.

Causes

The flu usually begins abruptly, with a fever between 102 to 106°F. (An adult typically has a lower fever than a child.) Other common symptoms include a flushed face, body aches, and lack of energy. Some people have dizziness or vomiting. The fever usually lasts for a day or two, but can last 5 days.

Somewhere between day 2 and day 4 of the illness, the “whole body” symptoms begin to subside, and respiratory symptoms begin to increase. The flu virus can settle anywhere in the respiratory tract, producing symptoms of a cold, croup, sore throat, bronchiolitis, ear infection, or pneumonia.

The most prominent of the respiratory symptoms is usually a dry, hacking cough. Most people also develop a sore throat and headache. Nasal discharge (runny nose) and sneezing are common. These symptoms (except the cough) usually disappear within 4-7 days. Sometimes, the fever returns. Cough and tiredness usually last for weeks after the rest of the illness is over.

The flu usually arrives in the winter months. The most common way to catch the flu is by breathing in droplets from coughs or sneezes. Less often, it is spread when you touch a surface such as a faucet handle or phone that has the virus on it, and then touch your own mouth, nose, or eyes.

Symptoms appear 1-7 days later (usually within 2-3 days). Because the flu spreads through the air and is very contagious, it often strikes a community all at once. This creates a cluster of school and work absences. Many students become sick within 2 or 3 weeks of the flu’s arrival in a school.

Tens of millions of people in the United States get the flu each year. Most get better within a week or two, but thousands become sick enough to be hospitalized. About 36,000 people died each year from complications of the flu.

Anyone at any age can have serious complications from the flu, but those at highest risk include:

People over 50

Children between 6 months and 2 years

Women more than 3 months pregnant during the flu season

Anyone living in a long-term care facility

Anyone with chronic heart, lung, or kidney conditions, diabetes, or weakened immune system

Sometimes people confuse cold and flu, which share some of the same symptoms and typically occur at the same time of the year. However, the two diseases are very different. Most people get a cold several times each year, and the flu only once every several years.

People often use the term “stomach flu” to describe a viral illness where vomiting or diarrhea are the main symptoms. This is incorrect, as the stomach symptoms are not caused by the flu virus. Flu infections are primarily respiratory infections.

Diagnosis
In humans, influenza’s effects are much more severe than those of the common cold, and last longer. Recovery takes about one to two weeks. Influenza, however, can be deadly, especially for the weak, old or chronically ill.

Symptoms

Fever – may be high

Headache

Tiredness

Dry cough

Sore throat

Stuffy, congested nose

Muscle aches and stiffness

Other symptoms may include:

Nasal discharge

Shortness of breath

Wheezing

Croupy cough

Chills

Fatigue

Malaise

Sweating

Loss of appetite

Vomiting

Dizziness

Worsening of underlying illnagnosis:ess, such as asthma or heart failure.

Diagnosis:
Most people who get influenza will recover in one to two weeks, but others will develop life-threatening complications (such as pneumonia). According to the World Health Organization: “Every winter, tens of millions of people get the flu. Most are home, sick and miserable, for about a week. Some ”mostly the elderly  die. We know the world-wide death toll exceeds a few hundred thousand people a year, but even in developed countries the numbers are uncertain, because medical authorities don’t usually verify who actually died of influenza and who died of a flu-like illness.” Even healthy people can be affected, and serious problems from influenza can happen at any age. People over 50 years old, very young children and people of any age with chronic medical conditions, are more likely to get complications from influenza: such as pneumonia, bronchitis, sinus, and ear infections.

The flu can worsen chronic health problems. People with emphysema, chronic bronchitis or asthma may experience shortness of breath while they have the flu, and influenza may cause worsening of coronary heart disease or congestive heart failure.[56] Smoking is another risk factor associated with more serious disease and increased mortality from influenza

The evaluation of an individual with flu symptoms should include a thorough physical exam and, in cases where pneumonia is suspected, a chest x-ray.

Additional blood work may be needed. They may include a complete blood count, blood cultures, and sputum cultures.

The most common method for diagnosing the flu is an antigen detection test, which is done by swabbing the nose and throat, then sending a sample to the laboratory for testing.

The results of these tests can be available rapidly, and can help decide if specific treatment is appropriate. However, the diagnosis can often be made by simply identifying symptoms without further testing.

Treatment:

If you have mild illness and are not at high-risk, take these steps:

Rest
Take medicines that relieve symptoms and help you rest
Drink plenty of liquids
Avoid aspirin (especially teens and children)
Avoid alcohol and tobacco
Avoid antibiotics (unless necessary for another illness)
If the flu is diagnosed within 48 hours of when symptoms begin, especially if you are high risk for complications, antiviral medications may help shorten the length of symptoms by approximately a day.

In the past, doctors commonly prescribed the antiviral medications amantadine and rimantadine to treat type A influenza. The U.S. Centers for Disease Control and Prevention now recommends that neither drug be used for such treatment because of growing resistance to the drugs. Instead, the agency recommends using oseltamivir (Tamiflu) or zanamivir (Relenza), which are active against both influenza A and B. Each of these medicines has different side effects and affects different viruses. Your doctor will determine which one is best for you.

Treatment is usually not necessary for children, but if the illness is diagnosed early and the patient is at risk of developing a severe case, it can be started. Oseltamivir (Tamiflu) is the best choice for children age 12 and older. It is available in as a liquid, which may make it easier to give to the child than zanamivir (Relenza), which comes in an inhaler.

Treatment will only help if started early and only if the illness is actually influenza. It will not help treat a regular cold.

Ayurvedic Treatment of Influenza.………………………...(1).…………...(2)

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Prognosis:In most individuals who are otherwise healthy, the flu goes away within 7 to 10 days.

Possible Complications :

Possible complications, especially for those at high risk, include:

Pneumonia
Encephalitis (infection of the brain)
Bronchitis
Sinus infections
Ear infections

Prevention :

A yearly vaccine is recommended for infants, the elderly, women who may be pregnant during flu season, and those with certain chronic health conditions. The vaccine is also recommended for people who work or live with others at high risk.

A flu shot can help lower one’s chances of getting the flu. A flu shot is generally available to people who:

Are over 6 months old
Don’t have a serious allergy to eggs
Haven’t had a serious reaction to flu shots in the past
Are not pregnant
A new nasal spray-type flu vaccine called FluMist is available to people aged 2 to 49 years old. FluMist uses a live, weakened virus instead of a dead one like the flu shot. In one study, the nasal spray provided protection against the flu in up to 93% of children.

Homeopathic Prevention of Influenza

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Influenza
http://www.nlm.nih.gov/medlineplus/ency/article/000080.htm