An outbreak of severe pneumonia has been identified in Mexico and the south-western States of the USA. According to the World Health Organization (WHO) over 870 cases of pneumonia have occurred causing 62 deaths since March 2009. In 8 cases identified in the USA a new strain of H1N1 influenza has been isolated. The virus appears to be derived from a strain of swine influenza.
Usually infections between species happen independently of each other. For example, any infection in animals not not pose a threat to human until it jump species. This is what happened in SARS and bird flu, and now swine flu.
The majority of cases in Mexico have occurred in healthy young adults. The degree of infectivity of the virus is not known but close family contacts and health care workers may be at risk.
Antiviral sensitivity testing has indicated the virus is sensitive to oseltamivir (Tamiflu) and zanamivir, but is resistant to amantadine.
Clinical information is limited. Emergency Departments and ICU’s are asked to consider a traveller who presents with:
·
an Influenza Like Illness (ILI) (fever and cough and fatigue) and who has travelled to Mexico or California, Arizona, New Mexico or Texas in the past two weeks
or
· pneumonia and who has travelled to Mexico or California, Arizona, New Mexico or Texas in the past two weeks
as potentially infected with the new strain of influenza A. There is as yet not enough information about the new disease. Its symptoms of fever, cough and fatigue is vague enough to fit any type of infections.
Suspected cases should be managed in respiratory isolation until test results are available. All staff involved in managing the suspected case should implement protective measures including a P2 mask, suitable eye protection and gloves, with attention to frequent hand hygiene.
While staff should be vaccinated against seasonal influenza the current vaccine is unlikely to fully protect against the new strain.
Presently there is no suspected cases of swine fever in Malaysia.
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