The new strain of influenza H1N1 2009

Cause:

The cause is a new strain of the influenza A virus, H1N1, which has never been seen before in humans or pigs. It is the result of a genetic mixture of the influenza virus of humans, pigs, and birds. The virus in the nasal droplets and saliva of patients can survive on hands for about 5 minutes but it can live on surfaces for at least 2 to 8 hours depending on the environmental conditions; low humidity, dry and cold air are favorable for the survival of this virus.

Transmission:

The new strain of influenza A virus, H1N1, is found in the droplets of mucus and phlegm of infected patients. When patients cough or sneeze, the virus can spread to people within a range of 1 meter or about one arm's length. If patients use their hands to cover their nose and mouth when they cough or sneeze, the virus can remain on their hands and spread to objects, such as handkerchiefs, handrails, elevator buttons, telephones, computer keyboards, or when they touch their nose, eyes, or drink from the same glass as others. Patients can spread the virus most within the first 3 days of illness, and the risk of transmission decreases as symptoms improve. In most cases, the virus can be transmitted for no longer than 7 days.

Practicing behaviors to prevent infection:

• Stay at least one arm's length away from the patient to avoid direct exposure to coughing or sneezing, or inhaling infectious particles.
• Do not share personal items, especially with the patient, such as hand towels, drinking glasses, straws, and use a communal spoon when eating with others.
• Frequently wash hands, particularly after touching surfaces or items that may be contaminated with pathogens, such as doorknobs, handrails, elevator buttons, telephones, and computer keyboards.
• Develop a habit of not touching the nose, mouth, eyes, or face if hands are not clean. If necessary, use a tissue rather than the hands to prevent transmission.
• Avoid crowded places, particularly during high transmission periods. If required, individuals at high risk of severe illness should take extra precautions, such as wearing a face mask and frequently using hand sanitizer.
• Maintain a healthy and robust immune system.
• Exercise regularly and get exposure to sunlight in the morning to obtain adequate vitamin D.
• Consume nutritious food, such as eggs, milk, vegetables, fruits high in vitamin C, such as guava.
• Drink sufficient clean water.
• Get adequate rest and sleep.
• Do not smoke, drink alcohol, or travel to crowded places or areas with poor air circulation.

Symptoms:

After being infected for 1 to 4 days (average of 2 days), patients will begin to have a fever, headache, chills, body aches, cough, sore throat, stuffy nose, runny nose, fatigue, loss of appetite, and may experience nausea, vomiting, or diarrhea. The majority of patients (95%) have mild symptoms similar to seasonal influenza, but because this virus can cause pneumonia more than the seasonal strains, some patients (5%) may have severe symptoms.

The minority are severe cases:

Patients with severe symptoms are mostly (70%) those with underlying medical conditions (such as lung disease, asthma, heart disease, kidney disease, diabetes, neurological and intellectual disabilities, etc.), pregnant women (who are at four times higher risk of severe illness than the general population), obese individuals, those with weakened immune systems (such as those with blood disorders, cancer, AIDS, immunosuppressive drug recipients, etc.), young children under 2 years old, and elderly individuals over 65 years old. However, there are still a small number (30%) of individuals who were previously healthy and have no clear risk factors that have died. The World Health Organization and many countries are accelerating research to find the cause.

Dangerous signs

Danger signs include having a high fever that does not subside within 2 days (children may have seizures), coughing until chest pain, coughing up blood, or breathing rapidly, being short of breath, tired, not eating, not drinking, being very weak, sleeping excessively, vomiting or having severe diarrhea, showing signs of dehydration, and having a purplish skin color.

Patients with these symptoms, especially those at high risk of severe illness, should go to the hospital immediately for treatment and anti-viral medication as soon as possible.

Treatment

Patients in the high-risk group for severe illness include those with chronic diseases (such as lung disease, asthma, heart disease, kidney disease, diabetes, etc.), pregnant women, obese individuals, those with weakened immune systems (blood disorders, cancer, AIDS, patients taking immunosuppressant drugs, etc.), children under 2 years of age, and elderly individuals over 65 years of age. When they get sick with severe influenza, they may become seriously ill, so they should go to the hospital immediately for treatment when they begin to feel sick. The doctor will consider giving antiviral drugs as soon as possible, which will have a good treatment outcome.

Home care for non-severe illness

If the patient has mild symptoms such as a low-grade fever, not very hot, not too tired or weak, and can eat normally, they can be taken care of at home by following these guidelines:

• The patient should stop going to school or work and stay at home for about 7 days after the onset of symptoms, or may be earlier, but must be at least 1 day after recovery to avoid the spread of the infection.
• The patient should take fever-reducing medication such as paracetamol (not aspirin) and symptom-relieving medication such as decongestants and mucus thinners as directed by a doctor or pharmacist.
• Influenza is caused by a virus and does not require antibiotics, except when bacterial infections occur, which require medication as prescribed by a doctor.
• Wipe the body with lukewarm clean water or plain water for a period of time, wiping the arms and legs backward to the torso. Emphasize wiping to reduce fever on the forehead, cheekbones, cramped legs, and joints. If the patient feels cold or shivers, stop wiping and cover them with a warm blanket immediately.
• Drink plenty of clean water and fruit juices, avoiding very cold water.
• Try to eat soft, mild-tasting food such as porridge, boiled rice, eggs, vegetables, and fruits enough.
• Rest a lot in a room with not too cold air and good ventilation.

Preventing the spread of infection to others in the household:

• The patient should stay in a separate room and not leave the house until they have fully recovered for at least one day, in order to avoid spreading the infection.
• Food should be eaten separately from others. If symptoms have subsided, the patient can eat with others but should use a shared spoon each time.
• Personal items such as face towels, body towels, drinking glasses, and straws should not be shared with others.
• Cover mouth and nose with a tissue when coughing or sneezing, and then dispose of the tissue in a trash bin. Immediately clean hands with hand sanitizer or soap and water.
• When in close proximity to others, wear a mask and stay at least 1-2 meters away from others in the house.
• Caregivers of the patient should wear a mask when caring for the patient, and dispose of the mask in a trash bin after use. Immediately clean hands with hand sanitizer or soap and water.

Recommendations:

There are recommendations for relatives or visitors of patients who have contracted the 2009 influenza A (H1N1) virus, as well as recommendations for patients when they return home. Additionally, there are recommendations for the general public on how to cope with the 2009 influenza A (H1N1) virus. These can be found here.

Recommendations for family members/visitors regarding the flu:

• Limit visits to only necessary ones. Keep a record of the names of family members who visit and the date and time of their visit.
• People who have symptoms similar to the flu, sudden or chronic respiratory illnesses, heart disease, are pregnant, have weakened immune systems, or are over 65 years old are not allowed to visit patients in the Influenza Ward.
• Visitors must wear protective gear, such as a medical/surgical mask or a respirator mask, and gloves if they need to touch the patient's secretions.
• There are guidelines for practicing hand hygiene and personal hygiene strictly.
• For the Non-Influenza Ward, visitations should also be limited, and people with flu-like symptoms should not visit at all.
•  

Recommendations for patients when returning home are as follows:

• Practice good hand hygiene, especially during the disease's contact period.
• Always wear a mask covering your mouth and nose, except when eating or performing personal hygiene.
• Cover your mouth and nose when coughing or sneezing with tissue paper and then wash your hands.
• Avoid close contact with family members and refrain from going to crowded places. Stop working and studying until after the disease's contact period has passed, which is seven days after the onset of fever in adults or at least one day after fever subsides and 14 days in children from the onset of symptoms.
• If symptoms worsen, such as high fever lasting over 48 hours, severe coughing, chest pain, rapid breathing, fatigue, inability to eat, vomiting, or frequent bowel movements, seek medical attention immediately.

General Recommendations for the Public:

1. Cover your mouth and nose with a tissue or your own shirt sleeve when coughing or sneezing, and wear a face mask when you have a cold to prevent the spread of germs.

2. Wash your hands frequently with soap and water, or use hand sanitizer gel to clean your hands. Also, clean frequently touched surfaces and objects.

3. Avoid going to places where there is a high risk of getting infected, such as crowded places with poor ventilation, and if it is necessary to go to such places, take good precautions, especially by wearing a face mask.

4. Avoid traveling, going to school or work when you have a cold or fever, at least for one day until you recover completely, and during that time, avoid close contact or sharing personal items with others.

We sincerely hope this advice is helpful. - Vibhavadi Hospital.