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What you should know about H1N1 Influenza A August 12, 2009

Posted by nikmj in General, Malaysian Mirror, National, news.
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It has come to a point where it has become difficult to know the exact number of people infected by – or had died due to –the dreaded Influenza A (H1N1) disease because many cases had not been reported.

The situation has become such either because families are reluctant to tell authorities about the sick people in their homes, indifferent to the severity of the pandemic or just plain ignorant about the disease.

Among the more concerned who are worried about the  increasing deaths  and number of cases reportedly warded in hospitals every day, tension and anxiety mounts in their households whenever someone coughs or has high fever,

Health scientists the world over are still looking for clues as to how this deadly disease can be stopped.

In Malaysia too, we  wait for signs of the dreaded disease subsiding.

For  answers to questions about what every concerned Malaysian should know about the pandemic and what they can do to prevent the virus from creeping into their homes, we provide this special Question and Answer article as  your personal guide on the disease. 

What is the A (H1N1) influenza? 

h1n1-virus.jpgOften misunderstood and underestimated,  it is not just “a bad cold”



It is a new strain influenza virus named the ‘new H1N1’ first identified in April 2009, and commonly called ‘swine flu’


It is thought to be a mutation four known strains of the influenza ‘A’

virus, subtype H1N1: one normally infecting humans; one in birds and two types connected to pigs.

Experts assume the virus ‘most likely’emerged from pigs in Asia and was carrie to North America by infected persons.

There is evidence that the new strain has been circulating among pigs in other continents for years before infecting humans. But transmission is human to human.

Differences between Allergy, Cold and Flu


Airborne allergy

Common Cold

Flu or Influenza Infection




Usual. High (100-102F)(37.8-38.9C) sometimes higher (especially in young children); last 3-5 days





General aches & pains



Usual; often severe

Fatigue, weakness



Usual, can last up to 3 weeks

Extreme exhaustion



Usual, at the beginning of the illness

Stuffy or runny










Sore throat





Sometimes. Dry (non-productive)

Common, hacking, often productive

Common, can become severe. Usually non-productive

Chest discomfort


Mild to moderate




Maybe sudden


Acute and sudden


Over a week

3-5 days

Over 5 days

Red eyes/ Conjunctivitis



Maybe prominent




How common is the A (H1N1) flu infection in humans?

As an example, in past reports, about one human A(H1N1) flu virus infection had been received every one to two years in the United States. From December 2005 till February 2009, 12 cases have been reported.

Has this strain of flu been seen before?

No. Flu mutates constantly, so it is common for new strains to emerge. Pigs can also be infected with both human and avian influenza, and the current circulating A (H1N1) flu strain appears to contain genetic elements from all three.

How did the 2009 pandemic of A (H1N1) start?h1n1-graphic.gif

First identified in April and commonly called ‘swine flu’

then, the spread started in Mexico, with evidence that that country was already in the midst of an epidemic for months before the outbreak was recognised.

Soon after, their government closed down most of Mexico City’

s public and private offices and facilities to help contain the spread.

In early June, as the virus spread globally, the World Health Organisation (WHO) declared the outbreak to be a pandemic but also noted that most illnesses were of ‘moderate severity.’

 The virus then spread to the Southern Hemisphere, entered its winter flu season, and to many less developed countries with limited healthcare systems.

Because the virus was spreading with ‘unprecedented speed’

and many clinics were overwhelmed testing and treating patients, WHO stopped requiring countries to report all cases, but is still monitoring unusually large outbreaks.

How does the virus spread?

The virus typically spreads from coughs and sneezes or by touching contaminated surfaces and then touching the nose or mouth., Influenza A (H1N1) viruses do not typically infect humans though they do occur through close proximity or contact with infected pigs or contaminated areas. More cases of human-to-human spread have been documented.


What are the possible symptoms?

Symptoms, which can last up to a week, are similar to those of seasonal flu and may include fever, sneezes, sore throat, coughs, headaches, lethargy, runny nose, lack of appetite, muscle or joint pains and, in some cases vomiting and diarrhoea. 

The United States’

 Centre for DiseaseControl and Prevention (CDC) notes that most cases worldwide have been so far mild and most  hospital admissions and deaths have been of persons who had underlying conditions such as asthma, diabetes, obesity, heart disease, or a weakened immune system.

What should people who get the flu do?

As the virus spreads easily between people, through the air or surface contact, those who get the flu are recommended to stay home from school or work and avoid crowds to avoid spreading the infection further.

In an attempt to slow the spread of the illness, a number of countries, especially in Asia, have quarantined airline passengers with flu symptoms, while some are also pre-screening passengers.

For how long is someone with the A (H1N1) flu considered contagious?

 People with the A (H1N1) influenza virus infection should be considered potentially contagious for as long as they are symptomatic; possibly for up to seven days following the onset of the illness. Children, especially younger children, might potentially be contagious for longer periods.

Is there any vaccine to contain the virus?

WHO does not expect to have a full vaccine before the end of 2009 and vaccines available sooner may be limited and given first to healthcare workers, pregnant women and other higher risk groups.

Two or three injections will be required for maximum immunity from both the swine flu and seasonal flu. There is also concern if the new virus mutates further, it could become more virulent and less susceptible to any new vaccine.

In Malaysia, all government hospitals, clinics and selected private hospitals will be stocked with Tamiflu, the anti-viral drug to treat influenza A (H1N1).

Private clinics would also be allowed to obtain stocks from relevant suppliers, However, medical practitioners are warned not to use anti-viral drugs as a preventive measure because this could result in the virus developing resistance to medication.

Pharmacists have also been told not to dispense Tamiflu without a prescription

Can the A (H1N1) flu be treated with antiviral drugs and flu vaccine? 

 The A (H1N1) flu is resistant to two common drugs –

 Amantadine and Rimantadine.

The A (H1N1) flu viruses are very different from human H1N1 viruses. Therefore, vaccines for     human seasonal flu would not provide protection. However, a ‘seed vaccine’

has been specifically tailored to this swine flu and will be manufactured if officials deem it necessary.

How does seasonal influenza vaccination help to prevent H1N1 infection?

 It DOES NOT protect against H1N1but such vaccination is recommended because of: personal           protection against human influenza; precaution against possible re-assortment and; it enables early diagnosis and isolation of true H1N1 influenza patients.

Who should be vaccinated?

 Generally, EVERYONE in the face of a pandemic threat. These are usually travelers, children (aged six months to five years), elderly people (especially those 65 years and above), residents of immunity, pregnant nursing homes, people with long-term illness (eg, heart and lungs), people with depressed women (in second to third trimester) and healthcare workers.

What precautions are in place in Malaysia?h1n1 3.jpg22

1.      Quarantine

2.      Health Ministry officials conduct health screenings on passengers arriving from the United States.

3.      Thermal scanners are placed at international airports to speed up the screening process

4.       Public and private medical practitioners have been instructed to report to the district health office on patients with influenza-like illnesses or severe pneumonia symptoms and who had travelled to affected countries after April 17.

5.      A temperature check on all students before classes start. All teachers given thermometers. All students who are unwell will be isolated and then sent home for a rest and asked to go for a medical checkup.

6.      Increasing anti-virus stocks from 10% to 20%

7.      Increasing beds at  intensive care unit (ICUs)  in hospitals that report on H1N1 cases.

8.      Hospitals are instructed to provide anti-virus vaccines immediately to six categories of high risk patients : i) pregnant women ii) obese patients iii) asthmatic patients  iv) chronic pneumonia patients v) diabetics and vi) individuals with low immunisation

How to prevent H1N1 spreading or contracting?

Everyone can help the spread of germs that cause respiratory illness like H1N1 and other influenza types by:

1. Practising good personal hygiene via

    a) covering the mouth with a tissue when coughing or sneezing and disposing it properly into the waste basket

   b) wearing surgical masks when not feeling well, and

  c)  washing the  hands often with soap and water (or alcohol-based hand cleaners), especially after a cough or a sneeze.

2. Caring about environmental hygiene; that is, ensuring regular cleaning and sterilising of work areas or equipment

3. Exercising social responsibility, such as

    a) avoiding close contact with sick people.

    b) staying at home and limiting your contacts with others, if you are sick with flu,and

    c)  putting on a surgical mask if you really need to go out.

3. Maintaining a healthy lifestyle by exercising and the following:

   a) consuming a balanced diet and adequate  amount of water daily

   b) taking essential supplements, such as vitamins A,C, E, and zinc, and

   c) having adequate rest

4. Monitoring temperature

    a) Your body temperature should be measured  twice a day (morning and afternoon). If te temperature is more than 37 degrees Celsius, immediately don a mask and visit the doctor.

    b)  Consult your nearest healthcare facility if you think you have any of the symptoms.

     c) Get a vaccination (see ‘Who should be vaccinated?’


 IMPORTANT: Heed the following advice

1.      Avoid crowded places and  unnecessary travel, especially to epicenters of the outbreak

2.      Spend more time in the outdoors or open spaces than in an enclosed air-con environment

3.      Be prepared by stocking up on masks, thermometers and Tamiflu

4.      Contact your nearest healthcare facility or the Health Minstry’

s 24-hour operations room in Putrajaya (03 8881 0200/300, if you

5.      i)    have travelled recently to Mexico, the US, Canada, Chile, Australia and Japan OR

6.      ii)   have contact with anyone who had traveled to these places, OR

7.      iii) have fever of more than 38 degrees Celsius, with our without  flu symptoms

Additional advice for travelersh1n1-1.png

1.      Prior to travel

 i) get the flu vaccination at least two weeks before traveling

 ii) carry along a  box of Tamiflu and some N95 masks and

 iii) bring along a travel medicine kit

2.      After travel

i) quarantine self and work from home, if traveling from epicenters, for seven days while monitoring temperature regularly and for symptoms

ii) keep self updated on the news in regards to possible contacts with confirmed cases while traveling and

iii) see a doctor immediately if symptoms developed after traveling to non-epicenters

 Where can I get more information?

For more information, go to the Health Ministry website (www.moh.gov.my) or call the Ministry’s hotline at 03 8881-0200/300.

Useful Links:
Ministry of Foreign Affairs: http://www.kln.gov.my/ 
World Health Organisation( WHO): www.who.int 
Centers for Disease Control and Prevention: www.cdc.gov 
Homeland Security Department: www.dhs.gov 
WHO A (H1N1) flu page: http://www.who.int/csr/disease/swineflu/en/index.html

Courtesy Of MalaysianMirror


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