Friday April 19, 2019

Common cold and swine flu: Some common tips

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By Dr JK Bhutani

Our respiratory system is formed by the airways or air passages and the lungs. The airways play an important role in the conditioning of air to the appropriate healthy temperature in a variety of environments. The airways also humidify, filter and remove various particulate pollutants and pollen present in the air. The lungs work best when the airways are able to provide a clean, conditioned, warm and humid air for them.

COMMON COLD – Every year before the onset of winter, the human body prepares itself for the harsh ‘cold-dry-wintry’ air by shedding the old respiratory airway mucosa and other defense cells and getting a new set. The nature perhaps helps, by sending some common viruses, (Rhino and Adeno Viruses) to hasten this process of changeover. This intervention by the nature sometimes leads to issues like sneezing, running-stuffy nose (rhinorrhoea), sore throat, cough, low-grade fever, headache and body aches. The term ‘common cold’ refers to such mild upper respiratory viral infections which, in a way, are the nature’s way of shedding the old cells and rejuvenating the respiratory airways with the new army of defence cells to last for adverse onslaughts of winter weather. Such ‘non-Influenza’ viral respiratory infections are innocuous and require simple common-sense tips on the part of the patient to manage the same.

1. Symptomatic treatment remains the mainstay of common cold treatment. In the absence of convincing evidence of a secondary bacterial infection, antibiotics are not effective in the treatment of the common cold and should be avoided. Even analgesics (pain-killers) and anti-pyretic (fever medicine) can be avoided and adequate rest, hot-fluids, steam and good

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nutrition must be the preferred way to go. Most patients do not require any intervention as the illness is brief (3-5 days) and self-limiting. The role of the medical personnel / help should be of a facilitator of the natural healing and s/he must ensure renewal of ability of the human organism in such settings.

2. The common over-the-counter available ‘decongestants-anti-histamine’ combinations (Vikoryl, Recofast, Coldrin etc.) generally hamper the clearance of secretions and nasal debris of cells and should be best avoided. They may block or thicken the secretions, thus predisposing to super-added bacterial infections of throat, sinuses and the ear.

3. PREVENTION of common cold – No vitamin, nutritional supplements, probiotics, Face-masks or herbal product have been shown to impact the incidence or the outcomes of common cold. Additionally, Adenovirus vaccines have not been found effective in protecting against the common cold. Hygienic measures such as hand washing and clean unclogged airways can hasten recovery and prevent the spread of respiratory viruses in closed environs.

SWINE-FLU

Swine-Flu or H1N1 influenza (‘swine influenza’) is another respiratory viral infection which strikes like a ‘common-cold’ infection but is more sinister in symptoms and the outcomes. The influenza virus mutates extremely fast and is highly infectious. The typical symptoms of Swine-flu are cough, sore-throat, fever, headache chills and fatigue. The severe infections, especially in patients who have co-morbid conditions like Diabetes, Heart disease, Asthma/COPD, compromised immune system and old age, may also include blue lips, blood in sputum, difficulty in breathing, pneumonia and respiratory failure.

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The spread of Swine-Flu is very rapid and epidemic. The people having flu infection, on move or at home, often cough or sneeze, thus spraying tiny drops of the virus into the air. When a person comes in contact with these drops or touches a surface (such as a wall, door, tap, sink or any articles like phone/keyboard etc) that an infected person has recently touched, the infection spreads.

Despite the name, one cannot catch swine flu from eating bacon, ham, or any other pork product.

The diagnosis of swine flu is often on strong suspicion, after contact with a proved patient and when the severity of cold symptoms is turning worse and ominous. The H1N1 influenza virus detection by polymerase chain reaction (rRT-PCR) or culture is the only proven method used by the government approved labs. Certain rapid influenza antigen tests are also commercially available which can give result in 4hrs.

Treatment – The milder infections in apparently healthy individuals can be managed with bed rest, warm fluids, proper nutrition and symptomatic treatment with analgesics (pain-killers) and anti-pyretic (fever) drugs. The mainstay is to isolate the patient at home for mild cases and in hospital for the serious cases, to halt the spread of disease. Proper hand-nose hygiene and the disposal of wipes containing nasal secretions are equally important. The use of the antiviral drugs like Oseltamivir (Tamiflu) is avoided in milder cases and should be best guided by the medical personnel’s advice. The close contacts of the proved Swine flu cases and the vulnerable exposed people can have prophylactic treatment in up to 48 hrs of exposure, after medical advice. Excessive use of such drugs when not required is already causing drug resistance and should be best avoided. The serious patients having pneumonia or other complications are best managed in hospital setting.

Prevention – The best treatment for Swine-flu is to have the vaccine before the onset of the winter season. The CDC and other national bodies recommend the vaccine for use in ages 6 months to the elderly (65 plus) including pregnant woman. High-risk individuals, their close contacts, and healthcare workers should remain high-priority populations in vaccination campaigns. The vaccine is safe, effective and has minimal side effects at the time of delivery. The vaccine can be administered in the muscle (intra-muscular injection), skin (intra-dermal injection) or the nasal inhalation route. The popular vaccines available in India are Fluair, Nasovac, Fluarix, Influvac  and Vaxigrip. The choice of vaccine formulation depends upon several factors, including age, comorbidities, pregnancy and risk of adverse reactions and the options should be discussed with the physician.

H1N1 influenza vaccine is already popular as FLU-SHOT in the west and shall soon have universal acceptance in India too. The governments are trying to bring down the costs (from Rs 600 to 100), to make it affordable for all. The Flu-shot needs to be given annually as the virus of swine-flu is quick to ‘shift and drift’ its structure, necessitating the new vaccine which is made available to the world every year around August-Sept.

Last year’s Swine flu outbreak in India showed inadequate preparedness, poor testing facilities and non-availability of drugs and vaccines. The number of deaths was 2123 out of the total number of 34656 cases reported by the health ministry. This year, the government is geared up and the Delhi government has already provisioned for isolation beds in hospitals (both govt and private), adequate Tamiflu and vaccines stocks and use of media for education/prevention. The government is using media for awareness of hand-hygiene and plans a sanitation awareness drive for a month starting from Oct-15 to Nov-14. The burden of the morbidity and mortality of the Swine flu can be negligible if all the citizens practice good hand-nose hygiene and implement other common sense measures of sanitation. It is not too much to ask for, at least from the Delhi residents who have one of the highest literacy rates in India.

Dr J.K. Bhutani MD is a protagonist of preventive and promotive health care based on austere biology and facilitating self healing powers of human organism.
You can follow him at https://twitter.com/drjkbhutani

 

Next Story

African Swine Fever Affects China’s Pork Industry

China Faces Challenges in Containing Swine Flu Infection.

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FILE - Workers disinfect passing vehicles in an area having the latest incident of African swine flu outbreak on the outskirts of Beijing, China, Nov. 23, 2018. VOA

The Year of the Pig is getting off to a rough start in China as the world’s largest consumer of pork and home to half the world’s pigs struggles to contain the spread of the African swine fever (ASF) virus.

Recent incidents, where traces of the virus were found in samples of frozen pork dumplings, suggest the outbreak is more widespread than has been reported, analysts said.

They add that the disease could have devastating socioeconomic consequences for both Chinese consumers and the global pig industry.

Latest outbreaks

Over the weekend, food safety regulators in southern Hunan and northwest Gansu provinces identified traces of the virus in pork products, including frozen dumplings.

The first outbreaks of African swine flu showed up in the northeastern province of Liaoning in August of last year.

Since then, China has reported more than 100 outbreaks from 25 of the country’s 34 provincial-level administrative units, according to the Food and Agricultural Organization under the United Nations.

Of China’s population of 430 million pigs, nearly one million have been culled because there’s not yet a vaccine to prevent and halt the spread of the virus.

 

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Slaughtered pigs are on display at a heaviest pig contest on the eighth day of the Chinese Lunar New Year of the pig, in Taizhou, Zhejiang province, China, Feb. 12, 2019. VOA

The losses have added pressure to local pig farmers, who are already be set with rising feed costs brought on by U.S.-China trade frictions.

Food scare

Chinese authorities have worked with food manufacturers to address the latest outbreaks, but it remains unclear if all contaminated frozen pork products have been located and destroyed.

Although the virus poses no risk to human health, people are likely to be one of the carriers of the disease and can spread the virus through contaminated water or waste food.

The disease is highly contagious among domestic and wild pigs and the virus is very difficult to eradicate. It can survive for an hour at boiling temperatures, days in the environment, weeks in meat or even months in frozen meat products.

It has taken some European countries more than a decade to eradicate the virus after it was first introduced to Georgia in 2007.

Under control?

Prior to recent outbreaks, Chinese authorities claimed the country’s infection had been brought under control an assertion analysts find unlikely.

“This is not impossible, but unlikely given the enormously high density of domestic pigs in China over a geographical space larger than France, Germany, Belgium and the Netherlands combined,” Dirk Pfeiffer, the chair professor of One Health from the City University of Hong Kong’s college of veterinary medicine and life sciences, said in an email to VOA.

Another challenge is China’s “high proportion of small to medium size pig farms with low biosecurity which don’t have the financial means to invest into better facilities,” he added.

The professor expressed concern over the possibility of under-reporting by Chinese farmers as they may not be provided an adequate level of compensation when pigs are culled.

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FILE – Workers in protective clothing operate heavy machinery at a sealed-off pig farm after the latest incident of African swine flu outbreak on the outskirts of Beijing, China, Nov. 23, 2018. VOA

China offers $179 (1,200 yuan) for each culled pig.

The dilemma lies in the balance, he said. If the compensation is too low, farmers are less likely to report. But too high, some may be incentivized to introduce the disease themselves and collect the fee.

Chinese officials have called on all stakeholders in the industry to cooperate with its efforts in stopping the virus’ spread.

Although few of its neighbors, such as Hong Kong, Macau and Mongolia, import pork from China, the epidemic still puts many other Asian countries at high risk. Vietnam, in particular, is one of the 10 largest pork producers in the world and shares a border with China.

Cross-border transmission

On Tuesday,the Animal Health Department of Vietnam, confirmed the country’s first outbreaks of the infection on three farms located in Hung Yen and Thai Binh provinces, southeast of the capital, Hanoi, claiming that all pigs had been culled.

Analysts said the epidemic will change the landscape of pig industries in China and globally.

“There will be a shift towards larger farms which can afford better facilities and that also means they are able to implement better biosecurity,” professor Pfeiffer said.

The feeding of waste food to pigs will decline because the practice is a common mechanism for spreading this virus, he added.

Deng Jinping, an animal science professor at South China Agricultural University, said he’s confident China has taken all necessary steps, including a ban on kitchen waste to pigs.

Enforcement, however, is always key for a sprawling country like China.

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But the crisis, he added, will present opportunities for the country’s massive pork industry to foster a better future.

“The butchery industry may be forced to seek a better development. Many would hope that the [long distance] transport of live pigs will be replaced by the use of refrigerated transportation. That will better manage risks for the third parties or across different regions. So, big changes to the industry can be expected,” Deng said. (VOA)