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Swine Flu in U.S. and Mexico: Symptoms, Treatment, Prevention and more…

04/25/2009 –  A type of swine flu that can be transmitted from person to person has emerged in parts of Mexico and the United States. No deaths have been reported in the U.S., where eight cases were identified in and around San Diego, California and San Antonio, Texas.  The situation is much worse in Mexico where approximately 60 people have died and over 1000 may be infected with the virus, prompting Mexican authorities to close schools and museums among other steps aimed at stopping the spread of the disease.

Two unusual and alarming features of this strain of flu are 1) It’s infecting young healthy people, who are usually the most resistant to flu, and 2) It is apparently being transmitted from person to person — swine flu is usually transmitted from swine to people only.

SYMPTOMS: Note, no severe illness or deaths have been reported in the United States as of this time.  According to the Centers for Disease Control and Prevention (CDC) the U.S. patients reported symptoms including “fever, aches and pains, sore throats, coughing, and trouble breathing. Some people have also reported diarrhea and vomiting.” However, early lab tests show that at least some of the cases in Mexico were caused by swine flu strains similar to the viruses isolated from U.S. patients.

TREATMENT:  Studies suggest that so far, the virus is sensitive to flu drugs oseltamivir (Tamiflu) and zanamivir (Releanza) but resistant to amantadine (Symmetrel) and rimanadine (Flumadine).

PREVENTION: No vaccine is yet available for this strain of flu.  Researchers have not yet determined exactly how the virus is being spread, however the CDC recommends the following precautions:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
• Try to avoid close contact with sick people.
• If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
• Avoid touching your eyes, nose or mouth. Germs spread that way.

These may sound like very basic, low-tech steps, but research shows they are extremely effective.  None of the people infected so far has had any obvious contact with swine, which is why authorities are so alarmed.

DIAGNOSIS:  Because it’s new, standard tests will not detect this virus.  The World Health Organization (WHO) reports that : “The only reliable means of confirming swine influenza A/H1N1 would require virus isolation (virus isolation should be done in a BSL-3 facility) and at least partial sequencing of the genome.”  This means that for now, most labs are unable to quickly confirm whether someone is infected with this particular flu.  The CDC is preparing a test kit tailored for this virus which the agency will distribute.  The gene targets for that kit will be “influenza A, universal swine NP and swine H1 HA,” according to WHO (See the guidance to laboratories at WHO).

TRAVEL PRECAUTIONS: As of this time, the CDC has not issued a travel advisory for Mexico, although the agency advises travelers to visit the agency’s travel site before they go to one of the affected areas.  In Mexico, those are greater Mexico City (the vast majority of flu-like cases and deaths have been there), San Luis Potosi in central Mexico (has had 24 cases of possible flu and three deaths), and  Mexicali, which is near the U.S. border (four possible cases and no deaths).

Given how respiratory diseases spread in confined settings like airplanes, travelers should definitely check the CDC’s travel site often for updates about this situation.  The airport in Sacramento is already taking extra precautions and poised to do more if necessary.

The outbreak in Mexico coincided with President Barack Obama’s recent trip there, and newspapers reported that a distinguished Mexican archeologist died days after meeting Obama in Mexico city, after experiencing symptoms similar to flu.

Other places to get news about the swine flu include the World Health Organization, Google’s Flutrends site, Google Maps for location of flu cases, MedPage, HumanSwinFlu on twitter,  and KevinMD’s blog post: How Do I Prevent and Treat Swine Flu, and is a Pandemic Imminent?