Swine flu

General

Swine flu, also known as the "new flu", describes an infection with an influenza A (H1N1) virus, which can infect humans as well as animals. The term "swine flu" is somewhat misleading, as the virus itself was never isolated from a pig, but it is a mixed variant of viruses that could each be isolated from infected pigs. Swine flu last made headlines in the 2009/10 season when a pandemic broke out, that is, the virus spread around the world and there were 226,000 confirmed cases in Germany alone.
Variants of swine flu had already been documented twice before. The first outbreak of the virus in humans was the "Spanish flu" of 1918. At that time, around 50 million people died from the disease. Around 700,000 people fell victim to the "Russian flu", which can also be traced back to a variant of the swine flu. The 2009 pandemic death toll was estimated at around 18,400 by the World Health Organization (WHO).

Although the pandemic of the 2009/10 season has now been declared over, the swine flu virus continues to occur in Germany. Any illness, suspicion or death related to the virus must be reported in Germany.

Symptoms

According to current knowledge, the symptoms of swine flu are not of the symptoms of seasonal flu to distinguish. In most cases the disease is relative mild, though too severe disease courses were documented. In some cases the infection with the virus was even a Incidental finding and proceeded accordingly symptomless. The exact differentiation between the different types of the flu virus cannot only be made by observing the symptoms, but only by detecting the virus in a laboratory.

The typical symptoms of swine flu are sudden onset feverwhich occurs in spurts, dry cough, Sneeze, Body aches, a headache, extreme malaise, fatigue, and a pronounced Feeling weak. Symptoms that are in contact with the respiratory system dry nasal mucous membranes or Difficulty breathing. In some cases this occurs too Symptoms of the gastrointestinal tract which are in nausea, Vomit and Diarrhea be able to show. In particular, the frequency of gastrointestinal problems can be an indication that there is an infection with the swine flu virus, since such symptoms are rather rare with an infection with the "normal" flu.

Characteristic for the illness, as with all illnesses with flu viruses, is sudden onset of illnesswhich is dominated by high fever. This is one of the key differentiators that the swine flu from one cold, also called flu-like infection.

diagnosis

Detecting the DNA of the virus is central to diagnosing an infection with the swine flu virus. Nevertheless, it is important to take a thorough medical history in a doctor-patient conversation. In this conversation, the suspicion of the presence of flu is usually confirmed. In this conversation, the attending physician is interested in the main symptoms, the duration and intensity of these complaints, as well as the presence of other risk factors that represent a risk in the case of illness with the swine flu virus. People with previous illnesses and immunodeficiency in particular are at greater risk of complications when infected with the virus, which is why this information is particularly important for the attending physician. Everyday life and daily dealings with other sick people in the immediate vicinity of the person concerned can also be important for the treating doctor in order to assess the likelihood of the presence of swine flu.

The patient's medical history is usually followed by a physical examination. The doctor uses a stethoscope to listen to the lungs to detect a manifestation of the virus in the airways and / or lungs. Palpation of the abdomen can also be helpful for the attending physician in order to assess the involvement of the gastrointestinal tract, which is typical for swine flu.

Since neither the medical history nor the physical examination can prove the presence of a swine flu infection, a different method must be used for this. The diagnosis of an infection with the virus can be made by taking sample material, which with great certainty contains a relevant amount of viruses. For this purpose, a swab is taken in the left and right nostril as well as in the throat using a cotton swab. These three samples are then sent to a laboratory, which evaluates the material. Alternatively, the attending physician can also take nasal rinsing fluid and send it in. In this case, saline fluid is flushed into the nose and removed again, which ensures that the fluid is sufficiently infected with viruses.

There is also a rapid test that can be used to diagnose swine flu in the doctor's office. Since this rapid test is not particularly accurate, it is nevertheless necessary to send in a sample taken from the person concerned after a positive or negative rapid test. However, it can be helpful for an initial assessment and, if the test result is positive, it can be the basis for starting therapy.

Learn more at: Rapid flu test

The laboratory, which receives the sample, uses the so-called "polymerase chain reaction" to duplicate the DNA material. If the laboratory also detects the genome of the swine flu in addition to the DNA of the person affected, the infection with the virus is considered confirmed. However, it usually takes one to two days to carry out these laboratory tests, which is why an initial assessment by the attending physician cannot and should not be replaced, especially for people with risk factors.

infection

Generally there is the possibility of infection with the swine flu between infected animals and humans as well as between Man and man. The swine flu virus is infected by two main routes. For one, the virus can be caused by the so-called Droplet infection be transmitted. This happens, for example, through the to cough or Sneeze from those affected who transmit the virus from themselves to healthy people, packed in droplets. Even with Speak microscopic droplets can pass onto another person, which is why the close contact to people who are sick with swine flu should be strictly avoided.

The second major route of transmission of the virus is that of Smear infection. Virus particles can appear here Doorknobs or the like can be transmitted by infected people and then picked up by other people who touch the object. For this reason, large crowds of people and your own should be avoided in confined spaces during the main flu infections Hand hygiene be carried out attentively and regularly. Since the virus itself 2 hours is still intact after touching the surface (at 22 ° C room temperature), surfaces that are often touched by many people (e.g. on public transport) should be handled with particular care and caution.

During the pandemic in the 2009/10 season, regions were particularly affected Mouthguard distributed so that the infection rate in the population can be kept low.

Overall, the swine flu is considered more contagious as one seasonal "winter flu" which is why infected people should be treated more carefully. It is assumed that a person is usually around 24 hours after the onset of the disease (i.e. the beginning of the symptoms), is contagious for the environment. The time of potential contagion can then be up to 7 days last for. In exceptional cases it is even possible that infection is still possible during the incubation period of the disease, i.e. after infection but before the symptoms appear. The incubation period of swine flu is about 2-3 Days.

therapy

Because the flu may be especially useful for those with risk factors life threatening a visit to the doctor should not be postponed if an infection with the virus is suspected. This is especially true for elderly people such as pregnant women.

Swine flu therapy should be given in all cases, even if only the strong suspicion an infection has been pronounced by the treating doctor. The therapy can be discontinued in these cases after the infection has been ruled out by a laboratory. Swine flu therapy can turn into a medicinal and a non-drug therapy be subdivided.

The medical therapy relies on the gift of anti-viral drugs. Drug therapy for swine flu is no different from therapy for seasonal flu. Medicines are used to remove the virus in the Multiplication and Spread in the body. Nowadays there are almost exclusively so-called Neuraminidase inhibitors for use in therapy against the Flu viruses, including the Swine flu. This drug works by blocking a protein in the virus Neuraminidase. This protein is responsible for the release of the virus from the body cells. This mechanism is blocked by the drugs, which is why the virus no longer replicates. The drugs used almost exclusively in this group are Oseltamivir and Zanamivir. That is beneficial when using these drugs Resistances the viruses against the active ingredients of the medication occur very rarely. However, one occurred during the 2009 pandemic Formation of resistance of the swine flu virus against the drug oseltamivir. This means that this drug was no longer effective against certain strains of the virus. Fortunately, resistance to zanamivir could not spread at that time.

Relevant Side effects the drugs mainly occur in connection with the Gastrointestinal tract on. So can nausea and Vomit, such as Diarrhea be triggered from taking these drugs. From one inhalative intake the medication will Asthmatics discouraged as this one Asthma attack can trigger. It should also be noted that in patients with severe renal failure the dose needs to be adjusted.

In addition to causal therapy for swine flu, a symptomatic therapy respectively. Symptoms like high feverthat occurs in bouts of fever as well as body aches sPain and fever lowering drugs how Ibuprofen and Paracetamol be treated.

Since the body is heavily stressed by the stress on the immune system, it can lead to so-called Superinfections come. This results in an infection of the body with bacteria, as the cells of the immune system can no longer fight them off. For example, it can be too Myocarditis, Pneumonia or Meningitis come with antibacterial therapy Antibiotics need. These superinfections are particularly dangerous for people with a weakened immune system Complications infection with the swine flu virus.

The non-drug therapy of swine flu is primarily one Protection of the body bed rest and sleep as well as a adequate hydration represent.

vaccination

since 2009 There is a vaccine against the swine flu virus that is in everyone nowadays seasonal Flu vaccination is integrated. The vaccine is a so-called Dead vaccinewhich contains killed viruses that can no longer infect the organism. However, they are sufficient to do that body's immune system to stimulate the production of antibodies which, if infected with live viruses, prevent disease.

As with the swine flu virus, as with all flu viruses, it is common Mutations arise, the vaccine has to be reassembled every year and you have to yearly Get vaccinated so that there is sufficient protection for the season.