INTRODUCTION:

Infectious diseases have not only become the world’s leading cause of premature death, but they also threaten to cripple the society, social and economic development in third world countries. New epidemics of infectious diseases continue to hit the deck and H1N1 flu or Influenza A is one of them. H1N1 flu (Swine flu, Hog flu, or Pig flu) is an infection by any one of several types of Swine influenza virus (SIV). SIV is any strain of the influenza family of viruses that is endemic in pigs ¹. The common clinical features are fever, common cold and cough with muscle ache. These symptoms are similar to seasonal flu but due to havoc created by H1N1 flu every case of fever with cough and cold is being considered as H1N1 flu by general public ².

WHAT IS INFLUENZA?

Influenza (the flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death_3.

SYMPTOMS OF INFLUENZA ARE AS FOLLOWING:

§ Fever* or feeling feverish/chills

§ Cough

§ Sore throat

§ Runny or stuffy nose

§ Muscle or body aches

§ Headaches

§ Fatigue (tiredness)

§ Some people may have vomiting and diarrhea, though this is more common in children than adults.

*It's important to note that not everyone with flu will have a fever

HOW INFLUENZA SPREADS:

§ People with flu can spread it to others up to about 6 feet away

§ Most experts think that flu viruses are spread mainly by droplets made when people with flu cough, sneeze or talk

§ These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. (large droplet transmission, small particle droplet nuclei)

§ Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose (contact transmission)₅.

PREVENTION AND CONTROL OF H1N1:

The Centers for Disease Control and Prevention recommends flu vaccination for all people older than 6 months of age. An H1N1 virus is one component of the seasonal flu shot for 2013-2014. The flu shot also protects against two or three other influenza viruses that are expected to be the most common during the 2013-2014 flu season₇. The vaccine will be available as an injection or a nasal spray. The nasal spray is approved for use in healthy people 2 through 49 years of age who are not pregnant₇. These measures also help prevent swine flu (H1N1 flu) and limit its spread₇:

· Stay home if you're sick. If you do have swine flu (H1N1 flu), you can give it to others starting about 24 hours before you develop symptoms and ending about seven days later.

· Wash your hands thoroughly and frequently. Use soap and water, or if they're unavailable, use an alcohol-based hand sanitizer. Flu viruses can survive for two hours or longer on surfaces, such as doorknobs and countertops.

· Contain your coughs and sneezes. Cover your mouth and nose when you sneeze or cough. To avoid contaminating your hands, cough or sneeze into a tissue or the inner crook of your elbow.

· Avoid contact. Stay away from crowds if possible. And if you're at high risk of complications from the flu — for example, you're younger than 5 or you're 65 or older, you're pregnant, or you have a chronic medical condition such as asthma — consider avoiding swine barns at seasonal fairs and elsewhere.

· Reduce exposure within your household. If a member of your household has swine flu, designate only one household member to be responsible for the ill person's personal care.

· Most cases of flu, including H1N1 flu, require only symptom relief. If you have a chronic respiratory disease, your doctor may prescribe additional medication to help relieve your symptoms.

· The antiviral drugs Oseltamivir (Tamiflu) and Zanamivir (Relenza) are sometimes prescribed to reduce the severity of symptoms, but flu viruses can develop resistance to them. Some researchers recommend further study on both of these drugs due to uncertainty about their effects beyond the initial reduction in symptoms.

COMPLICATIONS:

· Worsening of chronic conditions, such as heart disease, diabetes and asthma_4.

· Pneumonia_4.

· Neurological signs and symptoms, ranging from confusion to seizures_4.

· Respiratory failure_4.

GLOBAL IMPACT:

1 More than 214 countries and overseas territories or communities had reported laboratory confirmed cases of pandemic influenza H1N1 2009, including at least 18,449 deaths (World Health Organization, August 6, 2010)_5.

2 Reported cases and deaths are likely a substantial under-estimate of true impact of 2009 H1N1_5.

3 Estimating the true number of individual flu cases and deaths is very challenging_5.

4 Many people with flu don’t seek medical care_5.

5 Only a small number of those that do seek care are tested_5.

6 More people who are hospitalized or die of flu-related causes are tested and reported, but under- reporting of hospitalizations and deaths occurs as well_5.

DOMESTIC IMPACT

CURRENT STATISTICAL INFORMATION REGARDING H1N1IN INDIA

TABLE 1 SHOWS THAT NUMBER OF SWINE FLU DEATHS IN INDIA₄

YEAR	CASES	DEATH	DEATH RATE
2015 (TILL FEB 2015)	8423	585	6.9%
2014	937	218	23.3%
2013	5253	699	13.3%
2012	5044	405	8%
2011	603	75	12.4%
2010	20604	1763	8.6%
2009 (MAY TO DEC )	27236	981	3.6%

TABLE 2 SHOWED THAT TEN STATES WITH MORE THAN 100 CASES REPORTED IN INDIA₆

STATE	CASES	DEATH
Rajastan	2568	165
Gujarat	1674	144
Delhi	1477	06
Telengana	1068	46
Maharastra	442	58
Tamilnadu	198	08
Madyapradesh	298	76
Karnataka	259	17
Haryana	106	16
Utterpradesh	105	05

CONCLUSION:

Although there is an appropriate knowledge and awareness regarding various aspects of H1N1 flu among urban adult population still, active interventions are required in all areas of H1N1 flu pandemic not only to improve their knowledge and awareness regarding H1N1 flu of urban adults but also for rural adults and avoid exposure to over crowed area and travelling.

REFERENCES:

1. Scalera NM, Mossad MB. The first pandemic of the 21st century: a review of the 2009 pandemic variant influenza A (H1N!) virus. Postgrad Med. 2009;121(5):43-47.

2. Singh B. Combating the H1N1 influenza (swine flu) Epidemic: What should India do? Indian Journal of Public Health 2009; 53(3):190-91.

3. www.cdc.gov/h1n1flu

4. Sanchita Sharma, Hindustan Times, New Delhi | Updated: Feb 18, 2015 07:56 IST

5. Michaelis M, Doerr HW, Cinatl J Jr. An influenza A H1N1 virus revival-pandemic H1N1/09 virus. Infections 2009;37(5):381-89.

6. News paper THE TRIBUNE 18 march 2015 news paper h1n1 virus: prime concern 7 Thorner AR. Epidemiology of pandemic H1N1 influenza ('swine influenza'). http://www.uptodate. com/index. Accessed Dec. 2, 2013

Received on 01.10.2015 Modified on 17.10.2015

Int. J. Nur. Edu. and Research 4(1): Jan.-Mar., 2016; Page 64-66

DOI: 10.5958/2454-2660.2016.00012.0