Pandamic H1N1
Current Disease Situation
In general, H1N1 flu virus appears to be a mild strain similar to seasonal influenza.
TRANSMISSION
This current H1N1 flu strain has demonstrated easy person-to-person transmission primarily via droplets produced when an infected person coughs or sneezes. These droplets do not remain aerosolized for extended periods or distances (typically less than 4 to 6 feet) but do settle on surfaces. Infected individuals may also contaminate surfaces with their own secretions via soiled hands. Surfaces can harbor infectious virus particles for minutes to hours.
Infected individuals can transmit the virus from 1 day before they develop symptoms and can continue to be infectious for 4 to 7 days after initial symptoms begin (typically until all symptoms and fever have resolved). Young children can excrete seasonal influenza virus for up to 3 weeks, but the most significant transmissibility is within the first 10 to 14 days.
Symptoms and Clinical Course
H1N1 flu is initially indistinguishable from seasonal influenza, presenting with fever and typical influenza-like symptoms, e.g., cough, rhinitis, muscle aches, headaches, chills, sore throat, and fatigue. Some persons have reported diarrhea and vomiting, not usually found with seasonal influenza. Mild or symptom-free disease can also occur.
H1N1 flu has caused a greater burden of disease among persons < 25 years of age than in older people. There are relatively fewer cases and deaths reported in persons > 65 years of age, which is unusual when compared with seasonal influenza; this low attack rate in older persons suggests that repeated previous exposure to H1N1 viruses that have circulated worldwide since 1964 offer some protective effect, though laboratory testing has not yet corroborated this.
Pregnancy, asthma, and other high risk medical conditions are associated with increased risk of complications from H1N1 virus.
Warning signs of possible severe disease
In persons with confirmed or suspected H1N1 flu infection, signs that can signal a progression to severe disease include:
o shortness of breath during physical activity or while resting
o difficulty breathing
o turning blue
o bloody or colored sputum
o chest pain
o altered mental status
o high fever that persists beyond 3 days
o low blood pressure
o flu-like symptoms that improve but then return with fever and worse cough
o severe dehydration manifested by decreased activity, dizziness, decreased urine output, and lethargy
In children with confirmed or suspected H1N1 flu infection, danger signs include:
o fast or difficult breathing
o lack of alertness
o difficulty in waking up
o little or no desire to play
o extreme irritability
Because a patient's condition can worsen very quickly, medical attention should be sought when any of these warning signs appear. Most patients continue to have mild symptoms and recover fully within a week, but a few people, usually younger than 50, rapidly progress to severe and often fatal illness.
Vaccines
The (H1N1) component of current human seasonal influenza vaccines does not include swine strains. Currently available data show that sera of individuals vaccinated with 2007/08 or 2008/09 seasonal influenza vaccines do not neutralize the currently circulating H1N1 flu virus. These results indicate that immunization with seasonal vaccine is unlikely to provide protection against H1N1 flu virus.
Several H1N1 flu vaccines have been approved in the U.S. The first doses became available in early October. Production of the vaccine has been slower than anticipated, and the vaccine is in short supply in most areas. It is not currently available in Tashkent, and most of the embassies don't anticipate having a supply for a month or more.
In the meantime, we would like to advise all foreign nationals traveling back to their country of origin to take the opportunity, if possible, to be vaccinated against H1N1.
INFECTION CONTROL
Those who work outside of home should act responsibly by not coming to work or send children to school when ill with flu symptoms:
Persons with influenza-like illness who are not health care workers should stay home for at least 24 hours after cessation of fever (> 100° F). Health care workers with influenza-like illness should stay home for 7 days after illness onset or for 24 hours after resolution of symptoms, whichever is greater.
In addition, the following guidelines can help minimize spread of the virus:
1. Avoid close contact. Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
2. Stay home when you are sick. If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
3. Cover your mouth and nose. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
4. Clean your hands. Washing your hands often will help protect you from germs.
5. Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
6. Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.
For more information, go to:
This is to remind you about preventive measures to be
undertaken regarding H1N1 flu virus as well as to provide
you with some updates on this subject.
Street Address: 38, Sarikul street, Tashkent, 100105, Uzbekistan
Tel.: +(998-71) 291 0142, 291 0726, 120 1120, 120 1144
Fax:+(998-71) 291 2246