Swine Flu and the Role Pharmacist to Prevent it
Prof. Dipti Phadtare1*, Rajashri Kulkarni2
1Department of Pharmaceutical Chemistry, R.G. Sapkal College of Pharmacy, Anjaneri, Nashik.
2Department of Quality Assurance Technology, R.G. Sapkal College of Pharmacy, Anjaneri, Nashik.
Swine flu is a disease of respiratory system, caused by the H1N1 virus or type A influenza virus, and has been declared as a pandemic by the World Health Organization. Initially swine flu was reported only in pigs, but of recent, a considerable number of cases of swine flu in humans too, have been reported all over the world. Cases of swine flu are rising on a daily basis and this calls for different treatment options that are effective in relieving swine flu symptoms. It also calls for more awareness on its causes, symptoms, diagnosis, prevention, treatments and the role of pharmacist of prevention of it.
Swine influenza is a respiratory disease of pigs caused by type A influenza viruses that regularly cause outbreaks of influenza in pigs. Influenza viruses that commonly circulate in swine are called “swine influenza viruses” or “swine flu viruses” the main swine influenza viruses circulating in U.S. pigs in recent years are:
· Swine triple reassortant H1N1 influenza virus
· tr H3N2 virus
· tr H1N2 virus1,2,3
Swine flu has been confirmed in a number of countries and it is spreading from human to human, which could lead to what is referred to as a pandemic flu outbreak4,5. Pandemic flu is different from ordinary flu because it’s a new flu virus that appears in humans and spreads very quickly from person to person worldwide. The World Health Organization is closely monitoring cases of swine flu globally to see whether this virus develops into a pandemic6,7. Because it’s a new virus, no one will have immunity to it and everyone could be at risk of catching it. This includes healthy adults as well as older people, young children and those with existing medical conditions6,7.
Swine flu viruses do not normally infect humans. However, sporadic human infections with swine influenza viruses have occurred. When this happens, these viruses are called “variant viruses”. They also can be denoted by adding the letter “V” to the end of the virus subtype designation8,9. Most commonly, human infections with variant viruses occur in people with exposure to infected pigs. There have been documented cases of multiple people becoming sick after exposure to one or more infected pigs and also cases of limited spread of variant influenza viruses from person to person1,3,5,7.
The influenza virion is roughly spherical. It is an enveloped virus; the outer layer is a lipid membrane which is taken from the host cell in which is taken from the host cell in which the virus multiplies. Inserted into the lipid membrane are ‘spikes’, which are proteins – actually glycoprotein’s, because they consist of protein linked to sugars- known as hem agglutinin and neuraminidase. There are the proteins that determine the subtype of influenza virus1,10,11.
There are three genera of influenza viruses that causes human flu, two also cause influenza in pigs, with influenza A being common in pigs and influenza C being rare. Swine influenza caused by influenza A subtypes H1N1, H1N2, H2N3, H3N1 and H3N212,13,14.
Signs and symptoms:
People who have swine flu can be contagious one day before they have any symptoms, and as many as 7 days after they get sick. Kids can be contagious for as long as 10 days. Most symptoms are the as seasonal flu. They can include:
· Systemic- Fever
· Nasopharynx- Runny nose and Sore throat
· Psychological- Lethargy and Lack of appetite
· Respiratory- Coughing
· Gastric- Nausea and Vomiting
· Intestinal- diarrhea12-14
Prevention of swine influenza has three components: prevention in swine, prevention of transmission to humans and prevention of its spread among humans. In swine methods of preventing the spread of influenza among swine include facility management, herd management, and vaccination. Because much of the illness and death associated with swine flu involves secondary infection by other pathogens, control strategies that rely on vaccination may be insufficient15,16. The transmission from swine to humans is believed to occur mainly in swine farms, where farmers are in close contact with live pigs. Although strains of swine influenza are usually not able to infect humans, this may occasionally happen, so farmers and veterinarians are encouraged to use face masks when dealing with infected animals. The use of vaccines on swine to prevent their infection is a major method of limiting swine to human transmission include smoking and, especially, not wearing gloves when working with sick animals, thereby increasing the likelihood of subsequent hand to eye, hand to nose or hand to mouth transmission.
Influenza spreads between humans when infected people cough or sneeze, then other people breath in the virus or touch something with the virus on it and then touch their own face.” Avoid touching your eyes, nose or mouth.” The standard infection control which includes frequent washing of hands with soap and water or with alcohol- based hand sanitizers, especially after being out in public. Chance of transmission is also reduced by disinfecting household surfaces, which can be done effectively with a diluted chlorine bleach solution. To protect our self and surrounding other people the best thing is to follow good hygiene practices. These will help to slow the spread of the virus and will be the single most effective thing that will protect from infection. When you cough or sneeze it is especially important to follow the rules of good hygiene to prevent the spread of germs:
· Always carry tissues.
· Use clean tissues to cover your mouth and nose when you cough and sneeze.
· Bin the tissues after one use.
· Wash your hands with soap and hot water or a sanitiser gel often15,16.
Vaccination and animal management techniques are most important in these efforts. Antibiotics are also used to treat this disease, which although they have no effect against the influenza virus, do help prevent bacterial pneumonia and other secondary infections in influenza weakened herds. in humans the antiviral drugs can make the better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick. Besides antivirals supportive care at home or in hospital focuses on controlling fevers, relieving pain and maintaining fluid balance, as well as identifying and treating any secondary infections or other medical problems. The U.S. Centers for Disease Control and Prevention recommends the use of Oseltamivir [Tamiflu] or Zanamivir [Relenza] for the treatment and prevention of infection with swine influenza viruses; however, the majority of people infected with the virus make a full recovery without requiring medical attention or antiviral drugs. The simplest method of preventing the disease is to take the smell of a mixture of camphor and cardamom1,4,7,15.
The role of pharmacist:
As the most accessible health care professional, pharmacists have an important role to play on planning communications to the public in the event of pandemic. It is important that the pharmacist convey concise and up- to- date information to the public. Pharmacists will also play a role in alerting public health officials of potential outbreaks.
Pharmacists will play an integral role in ensuring that the ‘sick’ stay away from the healthy in order to prevent the spread and transmission of the virus. One of the most important roles of pharmacist will be top manage patients with mild illness so that they do not need to access the overburdened acute care settings. Pharmacists will be required to counsel and educate on signs and symptoms their identification, supportive management and when and where to seek medical assistance. Pharmacists may be involved in conducting mass vaccination clinics and may be called upon to assist at non- traditional sites. Pharmacists may be asked to participate in the distribution and storage of vaccines and various other pharmaceuticals. Provide the leaflets or any sort of poster which will give information about the swine flu its occurrence, signs and symptoms and other related preventive parameters13,14,15.
1. International Committee on Onomy of Viruses “The Universal Virus Database Version 4 : Influenza A”
2. “Swine Influenza” the Merck veterinary manual 2008.
3. Centers for Disease Control and Prevention> key facts about swine flu influenza.
5. International Committee on Taxonomy of Viruses. "The Universal Virus Database, version 4: Influenza A".
7. Knobler S., Mack A., Mahmoud A. and Lemon S. (2005). The Threat of Pandemic Influenza: Are We
8. Ready, Washington, D.C., The National Academies Press.
9. Olsen C.W. (2002). The emergence of novel swine influenza viruses in North America. Virus Research,85(2): 199-210.
11. Taubenberger J.K. and Morens D.M. (2006). Influenza: the mother of all pandemics. Emerg Infect Dis.,12(1): 15-22.
16. A pharmacists guide to pandemic preparedness, pandemic influenza Canadian Pharmacists Association Updated: October 2009.
Received on 17.03.2016 Modified on 08.04.2016
Accepted on 25.04.2016 ©A&V Publications All right reserved