State of Indiana: 'Stay calm'

By DAVID A. MANN
David.Mann@newsandtribune.com

April 28, 2009 01:25 pm

— State officials are monitoring cases of swine flu identified in the United States.
The Indiana State Department of Health is intensifying surveillance among sentinel physicians, sending information out to public health workers and will share the interim guidance from the Centers for Disease Control and Prevention with physicians.
Additionally, The Indiana Department of Homeland Security is urging public safety professionals to take necessary precautions to safeguard their health.
“It’s too early to be classified as a pandemic,” said Joe Wainscott, executive director of the Indiana Department of Homeland Security, in a news release. “Each of us can make a difference. Limiting contact with others can help slow the spread of illness.
“We advise Hoosiers to stay calm and practice normal precautions to avoid influenza and other respiratory diseases,” said State Health Commissioner Dr. Judy Monroe in the release. “If you have milder symptoms of influenza, we advise you to stay home and contact your health care provider for advice.”
There is no vaccine to prevent the disease, according to Monroe. Those 65 and older — or sufferers of chronic diseases and immune deficiencies — are at higher risk for complications, such as pneumonia. If these individuals have not received the pneumococcal vaccine, they should discuss with their physician getting the vaccine.
Swine flu is not transmitted by food and persons cannot be infected by eating pork.
Planning for an outbreak such as this one is something local officials have been doing since the surge of bird flu in Asia a few years ago, said Dr. Tom Harris, Floyd County’s health officer. Essentially, officials have discussed when certain venues, schools or public places would be closed if the flu were to reach pandemic levels.
The good news so far is that medication, such as Tamiflu and Relenza, has been effective in fighting the disease. Those are available through a prescription.
The federal government has released stockpiles of flu drugs with an emergency declaration.
Harris said there are no reported cases in Indiana.
If someone comes down with flu symptoms, they should contact their primary physician, said Delynn Rutherford, the Clark County Health Department’s preparedness coordinator. Tests can be done to determine whether it is a case of swine flu and the information can be passed on to the state.
General precautions — hand washing and covering of the mouth when coughing or sneezing — are urged in order to prevent the spread, she said.
“The hand washing is very important — we can’t stress that enough,” she said.
On the federal level, President Barack Obama said Monday that the threat of swine flu spreading is a cause for concern but “not a cause for alarm,” according to the Associated Press.
The U.S. has declared a national health emergency in the midst of uncertainty about the mounting sick count. The declaration allowed Washington to ship roughly 12 million doses of flu-fighting medications from a federal stockpile to states in case they eventually need them.
About 2,000 cases have been reported in Mexico. Twenty-eight cases were confirmed at a New York City school. Thirteen cases were confirmed in California. And schools in California and Ohio were closing after students were found or suspected to have the flu.
Officials of Newberry Academy in South Carolina said Monday seniors from the school were in Mexico earlier this month and some had flu-like symptoms.
No one in the United States has died from the disease, but 152 deaths in Mexico are believed to be connected to swine flu.
— The Associated Press contributed to this story.

LA TIMES
Q: What is swine flu?
A: Swine flu is a general term for influenza viruses adapted to pigs, causing a respiratory disease in the animals. There are many different strains. Swine flu can infect humans and in such cases most often is transmitted from a pig to someone handling pigs. Swine flu can pass from human to human through coughing, sneezing or touching infected people or surfaces and then touching your mouth or nose. It is not contracted by eating thoroughly cooked pork.

Q: What are the symptoms of swine flu?
A: The symptoms are similar to regular types of flu seen every winter: fever, fatigue, sore throat, cough, poor appetite, body aches and chills. Some people also have nausea, vomiting and diarrhea. People who have other illnesses are at higher risk for developing complications from flu, such as pneumonia.

Q: Is it contagious?
A: The virus is contagious, but health officials cannot yet say how easily the current strain of swine flu spreads from person to person. People are usually contagious for as long as they are symptomatic, typically four to five days for adults and longer for children. Some children may be contagious for a few days even after recovering.

Q: How dangerous is this swine flu?
A: In Mexico, health officials have confirmed that 20 deaths were linked with swine flu; dozens more are suspected. But all known cases in the U.S. have been mild. Experts don't know how deadly swine flu is because they don't know how many people have been infected overall. The World Health Organization says that the mortality rate from swine flu is 1 percent to 4 percent.

Q: How is it diagnosed?
A: A respiratory specimen must be collected within the first four or five days of illness. The viral specimen is then sent to the U.S. Centers for Disease Control and Prevention for testing.

Q: What is the incubation period?
A: Only a day or two.

Q: How can flu be prevented?
A: Standard methods of prevention include covering your mouth when you cough and sneeze. Use tissues and throw them in the trash immediately. Wash your hands often with soap and water. Use alcohol-based hand sanitizers. Avoid sick people. If you become sick, stay home from work or school. People who know they have been exposed can obtain a prescription for the antiviral drugs oseltamivir (Tamiflu) or zanamivir (Relenza).

Q: Is there a vaccine?
A: The vaccine for seasonal flu that was available this past winter will not work against the swine flu. The CDC has not yet ordered production of a swine flu vaccine. Development of such a vaccine would take at least four months.

Q: What is the treatment?
A: Of the four antiviral drugs, only two — oseltamivir or zanamivir — are thought to work against swine flu. These drugs may make the illness milder and work best if started within two days of getting sick. There is no other treatment other than rest.

Q: I had the swine flu shot during the previous outbreak in 1976. Am I still immune to this form of flu, or has the shot’s effect worn off by now?
A: Probably yes, you do have some immunity, although it has been 30 years. There are two caveats — your immunity might be waning, and secondly, we do not know yet what the precise composition of the new virus is and how closely it matches the earlier swine flu outbreak.

Q: Should I avoid air travel to Mexico and other places where there are outbreaks?
A: Wait to see what authorities tell us. (The Department of Health and Human Services on Monday asked people to put off unnecessary travel to Mexico.) Curtailing air travel sounds good, but many people in the field actually believe this is not an effective way of quarantining an outbreak because the virus will still travel via cars, trucks, boats and other modes of transportation. Curtailing air travel, which can have very large costs, may only slow the arrival of a virus to a new location; it might not prevent it from arriving.

Q: How effective are hand sanitizers in preventing transmission of swine flu?
A: Hand sanitizers are effective if used correctly — they have alcohol in them. Hand washing helps, too, but there is also an aerosol component to the influenza virus. We can keep our hands in our pockets and still get influenza. At the same time, we should have hand hygiene as much as we can. Besides conferring some protection against swine flu, it helps against other problems such as common colds and intestinal bacteria.

Q: Are health recommendations for swine flu different for babies, toddlers, children or pregnant women?
A: No.

AVOID SPREADING
Follow basic precautionary measures to prevent the spread of a cold, influenza or any infectious disease, including:
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. Cough or sneeze into your sleeve, rather than your hands, if a tissue is not available.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners also are effective.
• Try to avoid close contact with sick people.
• If you get sick, stay home from work or school and limit contact with others to keep from infecting them.
• Avoid touching your eyes, nose or mouth, as germs spread that way.

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