SWINE FLU

What is swine flu?

Like people, pigs can get influenza (flu), but swine flu viruses aren't the same as human flu viruses. Swine flu doesn't often infect people, and the rare human cases that have occurred in the past have mainly affected people who had direct contact with pigs.

But the current "swine flu" outbreak is different. It's caused by a new swine flu virus that has changed in ways that allow it to spread from person to person -- and it's happening among people who haven't had any contact with pigs.

That makes it a human flu virus. To distinguish it both from flu viruses that infect mainly pigs and from the seasonal influenza A H1N1 viruses that have been in circulation for many years, the CDC calls the virus "novel influenza A (H1N1) virus" and the World Health Organization calls it "pandemic (H1N1) 2009."

The CDC calls swine flu illness "H1N1 flu" and the World Health Organization calls it "pandemic influenza A (H1N1)."

What are swine flu symptoms?

Symptoms of swine flu are like regular flu symptoms and include - fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue. Many people with swine flu have had diarrhea and vomiting. Nearly everyone with flu has at least two of these symptoms. But these symptoms can also be caused by many other conditions. That means that you and your doctor can't know, just based on your symptoms, if you've got swine flu. Health care professionals may offer a rapid flu test, although a negative result doesn't necessarily mean you don't have the flu.

Like seasonal flu, pandemic swine flu can cause neurologic symptoms in children. These events are rare, but, as cases associated with seasonal flu have shown, they can be very severe and often fatal. Symptoms include seizures or changes in mental status (confusion or sudden cognitive or behavioral changes). It's not clear why these symptoms occur, although they may be caused by Reye's syndrome. Reye's syndrome usually occurs in children with a viral illness who have taken aspirin -- something that should always be avoided.

Only lab tests can definitively show whether you've got swine flu. State health departments can do these tests.

Who is at highest risk from H1N1 swine flu?

Most U.S. cases of H1N1 swine flu have been in older children and young adults. It's not clear why, and it's not clear whether this will change.

But certain groups are at particularly high risk of severe disease or bad outcomes if they get the flu:

• Young children, especially those under 12 months of age
• Elderly people are at high risk of severe flu disease. But relatively few swine flu cases    have been seen in people over age 65.
• People with cardiovascular conditions (except high blood pressure)
• People with liver problems
• People with kidney problems
• People with blood disorders, including sickle cell disease
• People with neurologic disorders
• People with neuromuscular disorders
• People with metabolic disorders, including diabetes
• People with immune suppression, including HIV infection and medications that suppress the immune system,
  such as cancer chemotherapy or anti-rejection drugs for transplants
• Residents of a nursing home or other chronic-care facility

People in these groups should seek medical care as soon as they get flu symptoms.
A striking number of adults who developed severe swine flu complications have been morbidly obese. However, obesity itself does not seem to be the issue. The vast majority of extremely obese people suffer respiratory problems and/or diabetes, which seem to be the underlying reason for their severe flu complications.

How does swine flu spread? Is it airborne?

The new swine flu virus apparently spreads just like regular flu. You could pick up germs directly from droplets from the cough or sneeze of an infected person, or by touching an object they recently touched, and then touching your eyes, mouth, or nose, delivering their germs for your own infection. That's why you should make washing your hands a habit, even when you're not ill. Infected people can start spreading flu germs up to a day before symptoms start, and for up to seven days after getting sick, according to the CDC.
The new swine flu virus is a human virus spread by people and not by pigs. The only way to get the new swine flu is from another person.

How severe is swine flu?

The severity of cases in the current swine flu outbreak has varied widely, from mild cases to fatalities. Most U.S. cases have been mild, but there have been a number of deaths and hundreds of hospitalizations -- mostly in young people aged 5 to 24.
Like seasonal flu, children who get swine flu can have serious neurological complications such as seizures and Reye's syndrome. But as with seasonal flu, these complications fortunately are rare.

Studies of the swine flu virus show that it is more infectious to lung cells than are seasonal flu viruses. But studies also suggest that the swine flu virus is less well adapted to humans and may be harder to inhale deep into the lungs.

Flu viruses change all the time, and the way the pandemic swine flu virus evolved suggests that it is particularly liable to swap gene segments with other flu viruses. But so far the swine flu virus hasn't changed much. That's good news, as the vast majority of swine flu cases have been mild. And it's also good news for the swine flu vaccine, which is based on swine flu strains isolated early in the pandemic.

It's impossible to know whether the virus will become more deadly. Scientists are watching closely to see which way the new swine flu virus is heading -- but health experts warn that flu viruses are notoriously hard to predict.

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