Swine flu: is your child safe?

As children across the country went back to school this week, concerns have been raised about the rapid transmission of the H1N1 virus and how fast it could spread through learners.

South Africa passed the 100 mark for recorded cases of swine flu last week, according to the National Institute for Communicable Diseases (NICD). This means that, in line with a World Health Organisation (WHO) recommendation, it will stop the routine testing of suspected cases as it has established that the pandemic has reached South Africa.

The NICD said they would continue to do laboratory testing for the H1N1 virus which causes the illness if it is warranted, and will continue to chart the behaviour of the virus and monitor any changes in its characteristics. Although they did admit they would be keep a close eye on any surge in numbers once schools went back.

Most cases have been reported through the private health system and there are no clear indications yet how it is affecting the wider community which relies on public hospitals.

Already some private schools, like St Stithians College in Johannesburg, have reported cases. School staff have consulted the health department for advice.

What to look out for:

• A recent onset of fever (¡Ã38¨¬C) with sore throat, runny nose/nasal congestion, cough, myalgia and/or gastrointestinal symptoms; and
• Recent travel or close contact with someone who is a suspected/confirmed case of swine flu in the seven days prior to the onset of symptoms.

What are the symptoms of swine flu in humans?
The symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhoea.

Can people catch swine flu from eating pork?
No. Swine influenza viruses are not transmitted by food. You can not get swine influenza from eating pork or pork products. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 71 degrees Celsius kills the swine flu virus as it does other bacteria and viruses.

How does swine flu spread?
Influenza viruses can be directly transmitted from pigs to people and from people to pigs. Human infection with flu viruses from pigs are most likely to occur when people are in close proximity to infected pigs, such as in pig barns and livestock exhibits housing pigs at fairs.

Human-to-human transmission of swine flu can also occur. This is thought to occur in the same way as seasonal flu occurs in people, which is mainly person-to-person transmission through coughing or sneezing of people infected with the influenza virus. People may become infected by touching something with flu viruses on it and then touching their mouth or nose.

What do we know about human-to-human spread of swine flu?
In September 1988, a previously healthy 32-year-old pregnant woman was hospitalised for pneumonia and died eight days later. A swine H1N1 flu virus was detected. Four days before getting sick, the patient visited a county fair swine exhibition where there was widespread influenza-like illness among the swine.

In follow-up studies, 76% of swine exhibitors tested had antibody evidence of swine flu infection, but no serious illnesses were detected among this group. Additional studies suggest that one to three health-care personnel who had contact with the patient developed mild influenza-like illnesses with antibody evidence of swine flu infection.

How can human infections with swine influenza be diagnosed?
To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first four to five days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 10 days or longer.

The WHO provides the following precautionary advice for individuals who are well:
Maintain a distance of at least 1m from any individual with influenza-like symptoms, and:

• Refrain from touching your mouth and nose;
• Perform hand hygiene frequently, by washing with soap and water or using an alcohol-based handrub, especially if touching your mouth and nose and surfaces that are potentially contaminated;
• Reduce as much as possible the time spent in close contact with people who might be ill;
• Reduce as much as possible the time spent in crowded settings;
• Improve airflow in your living space by opening your windows as much as possible.

For individuals with influenza-like symptoms:

• Stay at home if you feel unwell and follow the local public health recommendations;
• Keep distance from well individuals as much as possible (at least 1m);
• Cover your mouth and nose when you're coughing or sneezing, with tissues or other suitable materials, to contain respiratory secretions;
• Dispose of the material immediately after use, or wash it;
• Clean your hands immediately after contact with respiratory secretions; and
• Improve airflow in your living space by opening your windows as much as possible.

(Sapa, Health24, July 2009)

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