Flu Word Soup & Perspective

• Words and definitions from PandemicFlu.gov

• Perspective from CDC.gov• EMS Recommendations CDC.gov

Acute Febrile Respiratory Illness

• Fever, i.e. temp over 100.4, plus nasal congestion, runny nose, sore throat, or cough.

Influenza:

• A serious disease caused by viruses that infect the respiratory tract.

• i.e. An Acute Respiratory Infection

Seasonal flu:

• A respiratory illness that can be transmitted person to person. Most people have some immunity, and a vaccine is available. This is also known as the common flu or winter flu.

Epidemic: 

• A disease occurring suddenly in humans in a community, region or country in numbers clearly in excess of normal.

Pandemic:

• The worldwide outbreak of a disease in humans in numbers clearly in excess of normal.

Antiviral:

• Drug that is used to prevent or cure a disease caused by a virus, by interfering with the ability of the virus to multiply in number or spread from cell to cell.

Virulent:

• Highly lethal; causing severe illness or death.

Isolation:  

• A state of separation between persons or groups to prevent the spread of disease.

Quarantine:  

• The period of isolation decreed to control the spread of disease.

Antigen:

• Any foreign substance, usually a protein that stimulates the body's immune system to produce antibodies.

Antibody:

• A protein produced by the body's immune system in response to a foreign substance (antigen). Our bodies fight off an infection by producing antibodies. An antibody reacts specifically with the antigen that triggered its formation and its function is to inactivate the antigen.

Immune system:

• The cells, tissues and organs that help the body to resist infection and disease by producing antibodies and/or altered cells that inhibit the multiplication of the infectious agent.

Drift:

• One process in which influenza virus undergoes mutation. The change can be subtle or dramatic, but eventually as drift occurs, a new variant strain will become dominant. This process allows influenza viruses to change and re-infect people repeatedly through their lifetime and is the reason influenza virus strains in vaccine must be updated each year. See shift.

Antigenic Shift:• New influenza viruses emerge as a result

of a process called antigenic shift, which causes a sudden and major change in influenza A viruses. These changes occur when proteins on the surface of the virus combine in new ways as a result of mutation or exchange of genetic material between multiple influenza viruses. If such changes result in a new influenza A virus subtype that can infect humans and spread easily from person to person, an influenza pandemic can occur.

Vaccine:• A preparation consisting of antigens

of a disease-causing organism which, when introduced into the body, stimulates the production of specific antibodies or altered cells. This produces an immunity to the disease-causing organism. The antigen in the preparation can be whole disease-causing organisms (killed or weakened) or parts of these organisms.

What is an Influenza Pandemic?

• A pandemic is a global disease outbreak. An influenza pandemic occurs when a new influenza A virus emerges for which there is little or no immunity in the human population, begins to cause serious illness and then spreads easily person-to-person worldwide.

Historically, the 20th century saw 3 pandemics of influenza:

1918 influenza pandemic caused at least 675,000 U.S. deaths and up to 50 million

deaths worldwide

• This was called the Spanish Flu

1957 influenza pandemic caused at least 70,000 U.S.

deaths and 1-2 million deaths worldwide

• This was called the Asian Flu

1968 influenza pandemic caused about 34,000 U.S.

deaths and 700,000 deaths worldwide

• The was called the Hong Kong Flu

Seasonal versus Pandemic Flu

• A few statements from PandemicFlu.gov to help differentiate them in your mind.

Seasonal FluFlu

• Outbreaks follow seasonal patterns; occurs annually, usually in winter, in temperate climates

• Average U.S. deaths approximately 36,000/yr

• Usually some immunity built up from previous exposure

Pandemic Flu

• Occurs rarely (three times in 20th century - last in 1968)

• No previous exposure; little or no pre-existing immunity

• Number of deaths could be quite high; U.S. 1918 death toll approximately 675,000 or low as death toll from last Pandemic of 1968 was 34,000.

Seasonal Flu

• Healthy adults usually not at risk for serious complications; the very young, the elderly and those with certain underlying health conditions at increased risk for serious complications

Pandemic Flu

• Healthy people may be at increased risk for serious complications

Seasonal Flu

• Vaccine developed based on known flu strains and available for annual flu season

Pandemic Flu

• Vaccine probably would not be available in the early stages of a pandemic

Seasonal Flu

• Symptoms: fever, cough, runny nose, muscle pain. Deaths often caused by complications, such as pneumonia.

Pandemic Flu

• Same symptoms as seasonal flu, except:• Symptoms may be more severe and

complications more frequent

What antiviral drugs are available for treatment of

influenza in 2009?

• Tamiflu ® (oseltamivir) and • Relenza ® (zanamivir).• These antiviral drugs can reduce the

severity and duration of illness caused by influenza.

When should these drugs be taken to be effective?

• These drugs are most effective when they are taken shortly after the onset of illness (e.g., within 48 hours of symptom onset). Like all prescription medications, both Tamiflu® and Relenza® may cause side effects.

How would antivirals be used?

• Two ways:

• First Way: Antiviral drugs can treat influenza infection, shortening the length of illness and preventing complications.  When administered within a certain time frame before or after exposure to the influenza virus,

Second Way:

• Antivirals also can prevent influenza infection in people at risk or who have been in close contact with someone who is ill. Antiviral drug use is one important component of a multi-faceted response to an influenza pandemic.

What is swine flu?

• Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses. Outbreaks of swine flu happen regularly in pigs. People do not normally get swine flu, but human infections can and do happen. Most commonly, human cases of swine flu happen in people who are around pigs but it’s possible for swine flu viruses to spread from person to person also.

What are the signs and symptoms of swine flu in people?

• The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.

Are there medicines to treat swine flu?

• Yes. CDC recommends the use of oseltamivir (brand name Tamiflu ®) or zanamivir (brand name Relenza ®) for the treatment and/or prevention of infection with these swine influenza viruses.

 • If you get sick, antiviral drugs can

make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).

What should I do to keep from getting the flu?

• First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus.

Wash your hands

• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.

Avoid touching

• Avoid touching your eyes, nose or mouth. Germs spread this way.

What should I do if I get sick?

• If you live in areas that have reported cases and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider

In adults and children certain emergency warning

signs suggest that the patient needs urgent

medical attention.

Adult Warning Signs

• Difficulty breathing or shortness of breath

• Pain or pressure in the chest or abdomen

• Sudden dizziness• Confusion• Severe or persistent vomiting

In children emergency warning signs that the child

needs urgent medical attention include:

• Fast breathing or trouble breathing

Children’s Warning Signs

• Bluish skin color• Fast breathing or trouble breathing• Not drinking enough fluids• Not waking up or not interacting• Being so irritable that the child does

not want to be held• Flu-like symptoms improve but then

return with fever and worse cough• Fever with a rash

Other Information From the CDC

• How Long are People with the Flu Infectious, i.e. contagious?

• CDC says one day before and seven days after illness starts.

Other Information From the CDC

• EMS personnel should suspect Flu in all cases of acute febrile respiratory illness defined as:

• Fever plus one of the following:• Nasal congestion/runny nose/sore throat, or

cough• EMS personnel should use respiratory droplet

precautions and other PPE measures as instructed by State of Department of Health.

Other Information From the CDC

• The CDC recommends you assess all patients with an Acute Febrile Respiratory Infection for travel to Swine Flu area or exposure to sick persons who traveled to those areas.

• If Travel History to Swine Flu area is confirmed or Swine Flu is confirmed in your geographic area, the CDC recommends goggles, N-95 mask, disposable gloves and disposable gown during transport of suspected cases.