swine flu

NOMENCLATURE - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

NOMENCLATURE - ,[object Object],[object Object],[object Object]

Historical context - ,[object Object],[object Object],[object Object],[object Object]

Historical context - Pandemic Year Influenza A virus subtype People infected (approx) Deaths (est.) Case fatality rate Seasonal flu Every year mainly A/H3N2, A/H1N1, and B 5–15% (340 million – 1 billion) 250,000–500,000 per year <0.05%

20th century flu pandemics - Pandemic Year Influenza A virus subtype People infected (approx) Deaths (est.) Case fatality rate 1918 flu pandemic 1918–19 H1N1 0.5 to 1 billion (near 50%) 20 to 100 million [ >2.5% Asian flu 1956–58 H2N2 2 million <0.1% ? Hong Kong flu 1968–69 H3N2 1 million <0.1%

1918 - 1919 Pandemic - ,[object Object],[object Object],[object Object],[object Object],[object Object]

1918 - 1919 Pandemic - ,[object Object],[object Object],[object Object],[object Object]

Pandemic H1N1/09 virus - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Virus source and name - ,[object Object],[object Object],[object Object],[object Object]

Virus origins - ,[object Object],[object Object],[object Object],[object Object]

Virus origins - ,[object Object],[object Object],[object Object]

Virulence - ,[object Object],[object Object],[object Object]

Mutation potential - ,[object Object],[object Object],[object Object],[object Object]

Initial outbreaks - ,[object Object],[object Object]

Role Of Mexico - ,[object Object],[object Object],[object Object]

Spread - ,[object Object],[object Object]

India - ,[object Object],[object Object],[object Object]

Gujarat - ,[object Object],[object Object],[object Object]

Pandemic declared - ,[object Object],[object Object],[object Object]

By July 2009 - ,[object Object],[object Object],[object Object],[object Object]

By August 2009 - ,[object Object],[object Object],[object Object]

Epidemiological factors - ,[object Object],[object Object]

Epidemiological factors - ,[object Object],[object Object],[object Object],[object Object],[object Object]

Immunity - ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Features – ,[object Object]

Clinical Features – Uncomplicated influenza ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Features – Uncomplicated influenza ,[object Object],[object Object],[object Object],[object Object]

Clinical Features – Complicated or Severe Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Features – Complicated or Severe Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Features – Complicated or Severe Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Features – Complicated or Severe Influenza ,[object Object]

Clinical Features - Progressive disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Features - Progressive disease ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Features - Progressive disease ,[object Object],[object Object],[object Object]

Pneumonia - ,[object Object],[object Object],[object Object],[object Object]

Deaths – India ,[object Object],[object Object],[object Object],[object Object]

Cases As of August 21 – Gujarat ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cases As of August 24 – Gujarat ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Infection among animals - ,[object Object],[object Object],[object Object],[object Object],[object Object]

Laboratory Diagnosis – ,[object Object]

Laboratory Diagnosis – ,[object Object],[object Object],[object Object]

Specimens - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Specimens - ,[object Object],[object Object]

Molecular diagnostics - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Molecular diagnostics - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Molecular diagnostics - ,[object Object],[object Object]

Virus isolation - ,[object Object]

Rapid tests or immunofluorescence - ,[object Object],[object Object]

Serology - ,[object Object],[object Object],[object Object],[object Object]

Biosafety - ,[object Object],[object Object]

Case Definitions - ,[object Object],[object Object],[object Object],[object Object]

Case Definition – suspected case ,[object Object],[object Object],[object Object],[object Object]

Case Definition – probable case ,[object Object],[object Object],[object Object],[object Object]

Case Definition – confirmed case ,[object Object],[object Object],[object Object],[object Object]

Stratification of patients - ,[object Object]

Stratification of patients - (Ministry of H&FW 14 th August 2009) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Stratification of patients - (Ministry of H&FW 14 th August 2009) ,[object Object],[object Object],[object Object]

Stratification of patients - (Ministry of H&FW 14 th August 2009) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Stratification of patients - (Ministry of H&FW 14 th August 2009) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Management of H1N1 – (Ministry of H&FW guidelines) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pharmacological Management – ,[object Object]

Pharmacological Management – (WHO guidelines 20 August 2009) ,[object Object],[object Object],[object Object]

Pharmacological Management – (WHO guidelines 20 August 2009) ,[object Object],[object Object]

Antiviral susceptibilities of circulating viruses ( June 2009 ) Oseltamivir Zanamivir M2 inhibitors Pandemic A(H1N1) 2009 S S R Seasonal A (H1N1) R S S Seasonal A (H3N2) S S R Influenza B S S R Avian influenza (H5N1) S S Variably resistant

Severe or Progressive symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Uncomplicated - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Uncomplicated - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Oseltamivir - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Oseltamivir - ,[object Object],[object Object],[object Object]

Oseltamivir - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Zanamivir – (VIRENZA, Cipla) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Zanamivir – (VIRENZA, Cipla) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Zanamivir – (VIRENZA, Cipla) ,[object Object],[object Object],[object Object]

Supportive therapy - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Discharge Policy - ,[object Object],[object Object],[object Object],[object Object]

Oseltamivir resistant virus - ,[object Object],[object Object],[object Object],[object Object]

Prevention – Personal Protection Equipment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Respiratory Hygiene/Cough Etiquette - ,[object Object],[object Object],[object Object]

Hand Hygiene - ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

“ Close Contact" ,[object Object],[object Object],[object Object],[object Object],[object Object]

Containment - ,[object Object],[object Object],[object Object]

Quarantines - ,[object Object],[object Object],[object Object],[object Object]

Pre-screening advisories by some governments ,[object Object],[object Object],[object Object]

Other measures - ,[object Object],[object Object],[object Object]

Chemo Prophylaxis - ,[object Object]

Chemo Prophylaxis - Indications ,[object Object],[object Object],[object Object]

Chemo Prophylaxis - Oseltamivir ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Chemo Prophylaxis - Zanamivir ,[object Object],[object Object],[object Object],[object Object]

Chemo Prophylaxis - ContraIndications ,[object Object],[object Object],[object Object],[object Object]

Vaccine - ,[object Object],[object Object],[object Object],[object Object]

Vaccine - ,[object Object],[object Object]

Vaccine – safety?? ,[object Object],[object Object],[object Object]

Global surveillance of pandemic – ( WHO guidelines) ,[object Object],[object Object],[object Object],[object Object]

Estimates of total cases - ,[object Object],[object Object],[object Object]

swine flu

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swine flu