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THE PHARMA REVIEW (JULY 2009)

What Pharmacists Should Know About Swine Flu

Rakesh Kumar Rishi

Abstracts: Swine Influenza (also called swine flu, hog flu and pig flu) is a respiratory disease of pigs caused by influenza virus (type A) responsible for outbreaks of influenza in pigs in the United States, Mexico, Canada, South America, Europe (including the United Kingdom, Sweden, and Italy), Kenya, Mainland China, Taiwan, Japan and other parts of Eastern Asia. Swine Influenza viruses cause high levels of illness and low death rates in pigs. Influenza viruses usually circulate among swine throughout the year, but most outbreaks occur during the late fall and winter similar to outbreaks in humans.

There are four main type A influenza virus subtypes that have been identified in pigs: H1N1, H1N2, H3N1 and H3N2. However, most of the recently isolated influenza viruses from pigs have been type A H1N1 viruses. The swine influenza virus (type A H1N1) was first isolated from a pig in 1930. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread. The H1N1 virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs.

Pigs can be infected by avian influenza, human influenza viruses as well as swine influenza viruses. The influenza virus has been known as a pathogen in the human population since at least the 16th century. It has got a unique ability to cause recurrent epidemics and global pandemics due to rapid genetic re-assortments that cause fast and unpredictable antigenic changes in important immune targets leading to recurrent epidemics of febrile respiratory disease every 1 to 3 years. Each century has witnessed some pandemics rapidly progressing to all parts of the world due to emergence of a novel virus to which the overall population holds no immunity. The influenza viruses can re-assort (i.e. swap genes) and new viruses, a mix of swine, human and/or avian influenza viruses can appear leading to development of new novel strain for which humans do not have the immunity. Like all other influenza viruses, swine influenza viruses also change constantly.

Recently, human cases of H1N1virus infection have been reported in several parts of the world and human-to-human transmission of the virus appears to be ongoing - representing a real pandemic threat. WHO has now upgraded the phasing of pandemic swine flu influenza from Phase - 3 to Phase - 5.

Transmission
Transmission of swine influenza virus from pigs to humans is not common and if at all the infection is passed on from pigs to humans, it is called zoonotic swine flu. People who work with pigs, especially people with intense exposures, are generally at increased risk of infection. Outbreaks of swine flu are now resulting due to human-to-human transmission. Infected person cough or sneeze and the infected droplets get onto their hands, drop onto surfaces, or are dispersed into the air. Other person can breathe such contaminated air, or touch infected hands or surfaces, and can be exposed. Therefore, to prevent spreading of swine flu, people should cover their mouth and nose with a tissue while coughing, and wash their hands regularly.

  

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