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Swine flu, caused by the H1N1 influenza virus, is a subtype of influenza A that affects both the upper and lower respiratory tracts. It is primarily found in pigs and can be transmitted to humans through genetic variations in the virus. The 1918 Spanish flu pandemic resulted in the deaths of 50 to 100 million individuals. In 2009, the pandemic affected 178 countries, resulting in an estimated 43 to 89 million cases and 1799 deaths. The pathophysiology of H1N1 involves inflammation of the respiratory tract, with an incubation period of 1 to 4 days and a contagious period lasting 5 to 7 days. The signs and symptoms of swine flu include cough, sore throat, fever, myalgia, congestion, headache, rhinorrhoea, dizziness, sneezing, loss of appetite, fatigue, abdominal pain, shortness of breath, and in rare cases, vomiting and diarrhoea. The most common cause of death is respiratory failure, and neurological symptoms can occur due to high fever. To diagnose swine flu, various tests such as haematological, biochemical, and microbiological tests are conducted, including the collection of nasal or oral swabs for reverse transcriptase polymerase chain reaction (RT-PCR). Prevention and control measures include managing swine flu in pigs through herd management, hygiene practices, and vaccination. Treatment options vary based on the severity of the case. Mild to moderate cases can be managed with rest, antipyretics, NSAIDs, antihistamines, and oral rehydration therapy. Severe cases may require intravenous hydration, antibiotics for bacterial infections, antiviral therapy, and respiratory support. [ABSTRACT FROM AUTHOR]

The swine flu is a viral disease that is transmitted to humans, the swine flu is also known as pork flu virus belonging to the family Orthomyxoviridae which is endemic in population of pigs. A study to assess the knowledge on swine flu among adults in Poonchery, Kanchipuram District,Tamilnadu, India. The study was conducted with the aim to assess the knowledge on swine flu among the adults and to associate knowledge on swine flu with selected demographic variables between the age group of (18 years to 60 years). A study was conducted and the sample was consisted of a total of 50 adults. The tool used for this study was structured questionnaire. It results that 52% of them having Inadequate knowledge,30% of them having moderate knowledge and 18% of them having Inadequate knowledge .The chi square value is 20.9862 (P>0.05) S*,There is significant association between demographic variables we have found that there is inadequate knowledge of adult population. [ABSTRACT FROM AUTHOR]

Influenza is a major health threat, and a broadly protective influenza vaccine would be a significant advance. Signal Minus FLU (S-FLU) is a candidate broadly protective influenza vaccine that is limited to a single cycle of replication, which induces a strong cross-reactive T cell response but a minimal Ab response to hemagglutinin after intranasal or aerosol administration. We tested whether an H3N2 S-FLU can protect pigs and ferrets from heterosubtypic H1N1 influenza challenge. Aerosol administration of S-FLU to pigs induced lung tissue-resident memory T cells and reduced lung pathology but not the viral load. In contrast, in ferrets, S-FLU reduced viral replication and aerosol transmission. Our data show that S-FLU has different protective efficacy in pigs and ferrets, and that in the absence of Ab, lung T cell immunity can reduce disease severity without reducing challenge viral replication. [ABSTRACT FROM AUTHOR]

Nine hundred students from Engineering and Pharmacy college of TalegaonDabhade were contacted in their college after taking permission of their Principal .The purpose was to study their knowledge and awareness about prevention of Swine flu Six hundred thirty males(70%) and 370females(30%)participated in the study. Six hundred eighty eight(76.4%)were aware that cough,cold,fever headache were the symptoms initially. For Seven hundred ninety five (88.33%) News paper,749 (83,2%)TV, 744(82,2% )Radio was the source of information. Five hundred six (56.1 ) thought that foreigners visiting India are responsible for transmission of Swine flu in India .Seven hundred ninety-five (88.5%) were aware of the fact that Medicine is available for treatment,580(64.4%)could tell the name of Tami flu three hundred thirty five(37.2%)were aware of the fact that the vaccine is available for prevention and 78(8.7%) could also mention that Serum Institute of India Pune had manufactured the vaccine The correct answers for medicine and vaccine were given by Pharmacy Students. Four seventy (52.3%)used scarf/mask/cloth to cover nose and 423(95%) of them agreed to wash everyday and change it from time to time About washing and disposal of mask nobody had clear idea so the explanation was given at the end to use soap or dettol for washing and mask should be burnt after repeated use to avoid spreading of infection. .During 2009 when initially cases were detected educational institutes were closed to prevent transmission of Swine flu .In the holidays 181(20.1%) students were playing on the ground,187(20.1%)travelled to other towns Eigty two (9%)went to theatre to see movie. Actually it was expected they will sit at home and do not mix in the crowd, to prevent spread of infection . Four hundred ninety six (56.22%)were aware about the importance of washing hands . Conclusions and recommendations of the study were communicated to the students, through their teachers, by writing a letter. [ABSTRACT FROM AUTHOR]

Influenza A virus (IAV) subtypes against which little or no pre-existing immunity exists in humans represent a serious threat to global public health. Monitoring of IAV in animal hosts is essential for early and rapid detection of potential pandemic IAV strains to prevent their spread. Recently, the increased pandemic potential of the avian-like swine H1N1 IAV A/swine/Guangdong/104/2013 has been suggested. The virus is infectious in humans and the general population seems to lack neutralizing antibodies against this virus. Here we present an in silico analysis that shows a strong human propensity of this swine virus further confirming its pandemic potential. We suggest mutations which would further enhance its human propensity. We also propose conserved antigenic determinants which could serve as a component of a prepandemic vaccine. The bioinformatics tool, which can be used to further monitor the evolution of swine influenza viruses towards a pandemic virus, are described here and are made publically available (; ). [ABSTRACT FROM AUTHOR]

To assess the behavior and precautions that swine workers take during suspected influenza outbreaks in swine, six commercial swine farms in the Midwest U.S. region were visited when influenza outbreaks were suspected in herds during the fall/winter of 2012-2013. Use of personal protective equipment (PPE) and type of task performed by swine workers were recorded based on farm representative reports. Between one to two workers were working on the day of each visit and spent approximately 25 minutes performing work-related tasks that placed them in close contact with the swine. The most common tasks reported were walking the aisles (27%), handling pigs (21%), and handling equipment (21%). The most common PPE were boots (100%), heavy rubber gloves (75%), and dedicated nondisposable clothing (74%). Use of N95 respirators was reported at three farms. Hand hygiene practices were common in most of the farms, but reportedly performed for only 20% to 25% of tasks. [ABSTRACT FROM AUTHOR]

In 2007, Mexico, the USA and Canada signed the North America Plan for Avian and Pandemic Influenza (NAPAPI). During the 2009 H1N1 pandemic, the plan was implemented for the first time. After the emergency, the three countries decided to review their response, and update the plan. This study analyses the trinational negotiations towards the amended NAPAPI of 2012. More specifically, it focuses on the intergovernmental synergies and intersectoral dynamics in Mexico's domestic policy-making process relevant to the negotiations. The general research questions guiding this analysis were: how do domestic intergovernmental processes and intersectoral dynamics in Mexico affect the crafting of foreign policy? And how does international cooperation affect the domestic public health agenda? The study seeks to answer these questions by examining the H1N1 pandemic, the challenges facing Mexico in the course of the pandemic, and its experience of NAPAPI. It also examines the domestic policy process in Mexico for revising this trinational plan. [ABSTRACT FROM AUTHOR]

In its strongest resurgence since the pandemic of 2009, the influenza type A virus, known as H1N1, has broken out in different parts of India with deaths surpassing 1000 mark and number of affected cases exceeding 18,000 by the end of February 2015. Swine influenza spreads from person to person, either by inhaling the virus or by touching surfaces contaminated with the virus, then touching the mouth or nose. Symptoms occurring in infected human by H1N1 are like any other flu symptoms. Treatment is largely supportive and consists of bed rest, increased fluid consumption, cough suppressants, antipyretics and analgesics for fever and myalgias. Management largely includes the potential use of antiviral agents for patients presenting with illness due to influenza virus infection. If the illness is known or suspected to be due to a zoonotic influenza A virus, oseltamivir or zanamivir are treatment options. For known or suspected infection with avian influenza H5N1 virus, antiviral treatment should follow the World Health Organization (WHO) rapid advice guidelines on pharmacological management of humans infected with highly pathogenic avian influenza A (H5N1) virus. WHO also recommends vaccination of the high-risk group with seasonal influenza vaccine. Vaccination is recommended for health care workers working in close proximity to influenza patients are at higher risk of acquiring the disease. Since swine flu can directly be transmitted from one person to another through air droplets, people who fail to follow proper hygiene, especially in crowded places are at a high risk of contracting the virus. Proper preventive and control measures thus must be ensured. We have only limited treatment options, so rational use of the antiviral agent is very essential to avoid resistance and future complications. Health education and awareness among citizens should be transferred by proper mechanism. [ABSTRACT FROM AUTHOR]

In 1947, a smallpox outbreak occurred in New York City with a total of twelve cases and two deaths. In order to contain this outbreak, the New York City Department of Health launched a mass immunization campaign that over a period of some 60 days vaccinated 6.35 million people. This article examines in detail the epidemiology of this outbreak and the measures employed to contain it. In 1976, a swine influenza strain was isolated among a few recruits at a US Army training camp at Fort Dix, New Jersey. It was concluded at the time that this virus possibly represented a re-appearance of the 1918 influenza pandemic influenza strain. As a result, a mass national immunization program was launched by the federal government. From its inception, the program encountered a myriad of challenges ranging from doubts that it was even necessary to the development of Guillain-Barré paralysis among some vaccine recipients. This paper examines the planning for and implementation of the swine flu immunization program in New York City. It also compares it to the smallpox vaccination program of 1947. Despite equivalent financial and personnel resources, leadership and organizational skills, the 1976 program only immunized approximately a tenth of the number of New York City residents vaccinated in 1947. The reasons for these marked differences in outcomes are discussed in detail. [ABSTRACT FROM AUTHOR]

During recent Influenza A H1N1(swine flu) outbreak the current study was undertaken to assess knowledge, attitude and practices (KAP) of rural population of Jammu region regarding swine flu. 270 participants were administered a pre-designed and pre-tested questionnaire consisting of 26 questions evaluating KAP. Overall knowledge score was 62.9%. More than 90% had heard of swine flu, knew prevalent season and had knowledge of disease symptoms. However, knowledge about preventing vaccine was low (27.7%). Overall attitude score was 79.5%. Higher number of the participants expressed willingness to seek more knowledge about disease prevention , though half of them were not satisfied with health authorities efforts. The total practice rate was 60%.Preference for nutritious diet and willingness to use tissue/handkerchief was over 80% ,but only 40% expressed willingness to use mask. On most of the parameters of KAP, there was no difference on gender basis except for swine flu treatment ,panic reaction and preference for herbal medication in females. The current study found good KAP regarding swine flu in the rural area of Jammu. However, unwillingness to use mask, dissatisfaction with health agencies and lack of knowledge about population at risk is a matter of concern. [ABSTRACT FROM AUTHOR]

Background: Medical and paramedical health workers are especially vulnerable to swine flu infection as they come in regular contact with patients. They can also serve as important channels for communication of swine flu awareness to the general population. This study was carried out to find out the knowledge, attitude and practices amongst the nursing students of a tertiary care centre. Methodology: A hospital based cross sectional study carried out in February 2015 amongst the students of nursing college affiliated to a tertiary care centre in Ahmedabad. A pretested questionnaire was given to the students with multiple choice questions regarding swine flu virus, its symptoms, prevention etc. Results: A total of 108 students responded to the questionnaire. Of these maximum 76% respondents had received information from hospital. Majority of respondents knew about causative organism. Cough(81%), cold(93%) and fever(77%) were believed to be the commonest symptoms of swine flu. Handwashing as a preventive measure was known to only 45% while use of mask was known to 90%. 43% knew about vaccine availability and 83% were scared of swine flu commonest reasons being fear of death and fast spread. Conclusion : In the present study hospital, TV and newspapers were the major sources of information. It is therefore essential that these media spread correct information amongst the general population as well as the paramedical workers who are at risk for swine flu. The paramedical staff's confidence and active participation thus remains critical in enforcing any prevention and control strategy against the disease. Paramedical workers had good knowledge, attitude and practice regarding swine flu in the current study. This should be utilized to spread knowledge and awareness amongst the general population.12 Focus on key areas like hand washing with soap and water and availability of vaccine, knowledge regarding which was lacking in the present study, should be immediately addressed. This represents the mass hysteria and panic amongst the general population regarding the disease and its prevention. It needs to be explained that swine flu, with proper precautions can be prevented and epidemic can be controlled through awareness and correct practices. [ABSTRACT FROM AUTHOR]

The article provides the highlights of a workshop on the threat of animal influenza viruses organized by the U.S. Agricultural Research Service (ARS). The workshop discussed the protection of animals and people from the threat of influenza viruses, particularly avian influenza and swine influenza. It presented results of research on animal influenza viruses conducted at the National Poultry Research Center in Athens, Georgia.

As one of the most significant swine diseases, in recent years, swine influenza (SI) has had an immense impact on public health and has raised extensive public concerns in China. Swine are predisposed to both avian and human influenza virus infections, between that and/or swine influenza viruses, genetic reassortment could occur. This analysis aims at introducing the history of swine influenza virus, the serological epidemiology of swine influenza virus infection, the clinical details of swine influenza, the development of vaccines against swine influenza and controlling the situation of swine influenza in China. Considering the elaborate nature of swine influenza, a more methodical surveillance should be further implemented. [ABSTRACT FROM AUTHOR]

Objectives An epidemiological survey was carried out in order to obtain a better understanding of the role of wild boars in the epidemiology of the influenza virus. Design The samples were submitted to Real-Time PCR testing for gene M of the swine influenza virus ( SIV), and virus isolation was performed from the positive PCR samples. Genome sequence analysis was performed on the isolates. Additionally, 1,977 boar sera samples were analyzed using ELISA and hemoagglutination inhibition. Setting Over recent years, the wild boar population has greatly increased in Italy, including in areas of high-density industrial pig farming, where the influenza virus is widespread. From July to December 2012, wild boar lung samples were collected in the Parma and Piacenza area, in the Emilia Romagna region. Sample 354 wild boar lung samples were collected. Main outcome measures Wild-boar influenza A virus infection should be studied more broadly in order to obtain a better understanding of the epidemiological role played by this species. Results Three SIV strains were isolated out of 12 samples that resulted positive using PCR analysis and they were identified as avian-like SIV subtype H1N1. Phylogenetic analysis of the sequences obtained from isolate A/wild boar/291320/2012 showed that it clustered with recent Italian avian-like H1N1 SIVs isolated from domestic pigs. Sixty-eight sera samples showed a positive titer to the isolate A/wild boar/291320/2012. Conclusions This study suggests that SIV actively circulates in the wild boar population in the investigated. area. [ABSTRACT FROM AUTHOR]

Background Understanding the ecology and evolution of influenza A viruses ( IAV) in mammalian hosts is critical to reduce disease burden in production animals and lower zoonotic infection risk in humans. Recent advances in influenza surveillance in US swine populations allow for timely epidemiological, phylogenetic, and virological analyses that monitor emergence of novel viruses and assess changes in viral population dynamics. Methods To better understand IAV in the North American swine population, we undertook a phylogenetic analysis of 1075 HA, 1049 NA, and 1040 M sequences of IAV isolated from US swine during 2009-2012 through voluntary and anonymous submissions to the US Department of Agriculture IAV swine surveillance system. Results Analyses revealed changes in population dynamics among multiple clades of A/H1N1, A/H3N2, and A/H1N2 cocirculating in US swine populations during 2009-2012. Viral isolates were categorized into one of seven genetically and antigenically distinct hemagglutinin lineages: H1α, H1β, H1γ, H1δ1, H1δ2, H1pdm09, and H3 cluster IV. There was an increase in occurrence of H1δ1 in samples submitted, with a concurrent decrease in H1pdm09. H3 cluster IV exhibited increasing diversification, warranting a re-evaluation of phylogenetic nomenclature criteria. Although H3N2 represented 25% of identified viruses, this subtype was reported in increasing proportion of sequenced isolates since late 2011. Conclusions Surveillance and reporting of IAV in US swine have increased since 2009, and we demonstrate a period of expanded viral diversity. These data may be used to inform intervention strategies of vaccine and diagnostic updates and changes in swine health management. [ABSTRACT FROM AUTHOR]

Background Influenza A viruses ( IAV) are important pathogens responsible for economic losses in the swine industry and represent a threat to public health. In Argentina, clinical, pathological, and virological findings suggest that IAV infection is widespread among pig farms. In addition, several subtypes of IAV, such as p H1 N1, H3 N2, δ1 H1 N1, and δ2 H1 N2, have been reported. Objectives To evaluate the infection patterns of influenza virus in nine pig farms in Argentina. Methods Clinical, serological, pathological, and virological cross-sectional studies were conducted. Results Clinical and pathological results were characteristic of endemic influenza infection in eight of the nine farms studied. By r RT- PCR, six of the nine farms were positive to influenza. Five IAV were obtained. Genome analysis determined that four of the isolations were p H1 N1 and that the remaining one was a reassortant human origin H3 N2 virus containing pandemic internal genes. Serological results showed that all farms were positive to influenza A antibodies. Moreover, the hemagglutination inhibition test showed that infection with viruses containing HA′s from different subtypes (p H1, δ1 H1, δ2 H1, and H3) is present among the farms studied and that coinfections with two or more subtypes were present in 80.5% of positive pigs. Conclusions Because vaccines against IAV are not licensed in Argentina, these results reflect the situation of IAV infection in non-vaccinated herds. This study provides more information about the circulation and characteristics of IAV in a poorly surveyed region. This study provides more data that will be used to evaluate the tools necessary to control this disease. [ABSTRACT FROM AUTHOR]

Background Swine influenza A virus ( IAV) reassortment with 2009 H1N1 pandemic (H1N1pdm09) virus has been documented, and new genotypes and subclusters of H3N2 have since expanded in the US swine population. An H3N2 variant (H3N2v) virus with the H1N1pdm09 matrix gene and the remaining genes of swine triple reassortant H3N2 caused outbreaks at agricultural fairs in 2011-2012. Methods To assess commercial swine IAV vaccines' efficacy against H3N2 viruses, including those similar to H3N2v, antisera to three vaccines were tested by hemagglutinin inhibition ( HI) assay against contemporary H3N2. Vaccine 1, with high HI cross-reactivity, was further investigated for efficacy against H3N2 virus infection in pigs with or without maternally derived antibodies ( MDA). In addition, efficacy of a vaccine derived from whole inactivated virus ( WIV) was compared with live attenuated influenza virus ( LAIV) against H3N2. Results Hemagglutinin inhibition cross-reactivity demonstrated that contemporary swine H3N2 viruses have drifted from viruses in current swine IAV vaccines. The vaccine with the highest level of HI cross-reactivity significantly protected pigs without MDA. However, the presence of MDA at vaccination blocked vaccine efficacy. The performance of WIV and LAIV was comparable in the absence of MDA. Conclusions Swine IAV in the United States is complex and dynamic. Vaccination to minimize virus shedding can help limit transmission of virus among pigs and people. However, vaccines must be updated. A critical review of the use of WIV in sows is required in the context of the current IAV ecology and vaccine application in pigs with MDA. [ABSTRACT FROM AUTHOR]

The recent emergence of the pandemic H1N1 (pH1N1) and H3N2 variant influenza A viruses (IAV) in 2009 and 2011-2012, respectively, highlight the zoonotic potential of influenza viruses and the need for vaccines capable of eliciting heterosubtypic protection. In these studies, single-cycle, propagation-defective replicon particle (RP) vaccines expressing IAV haemagglutinin (HA) and nucleoprotein (NP) genes were constructed and efficacy was evaluated in homologous and heterologous pig challenge studies with the pH1N1 2009 influenza virus (A/California/04/2009). Homologous HA RP vaccination eliminated virus shedding and decreased pulmonary pathology in pigs following pH1N1 2009 challenge. An RP vaccine expressing an H3N2-derived NP gene was able to decrease nasal shedding and viral load following heterosubtypic pH1N1 2009 challenge in pigs. These studies indicate that although homologous vaccination of swine remains the most effective means of preventing IAV infection, other vaccine alternatives do offer a level of heterosubtypic protection, and should continue to be evaluated for their ability to provide broader protection. [ABSTRACT FROM AUTHOR]

Public health debates in online forums allow the emergence of ordinary practical reasoning about 'official' health information. We used a Discursive Psychology approach to analyse postings in a forum devoted to the discussion of the H1N1 (Swine flu) virus. We identify the discursive practices that contributors use to valorize certain elements in the debate (what they cast as science, rationality and 'proper' scepticism) over others (especially commercial interests, 'charlatanism' and 'profiteering'). A forum participant can be disqualified on the basis of their alleged partiality and interest, if they can be accused of having a commercial stake in the matter. But no such opprobrium results if they have a 'scientific' interest. [ABSTRACT FROM AUTHOR]

WHO declares on June 11, 2009, that H1N1 (Swine-influenza A) is pandemic. There have been nearly 30,000 confirmed H1N1 cases across 74 countries. The reports have shown sharp increase in the number of infections reported in recent days from Chile, Japan, and the UK, and other parts of the world, with the most dramatic increase recorded in Australia where more than 1200 cases were reported in a very short duration. As per the latest report of the Ministry of Health and Family Welfare, death from swine flu has reached to 1235. Around 12,3397 people have been tested in India as on February 1, 2010. In India, 23.3% of people who have tested for swine flu are found suffering from swine flu. Also around 4% of people who have tested positive for swine flu have died and could not be saved in India. The New York Times has reported that this is the first flu for being pandemic in the last 41 years. This article enlightens the brief review about the swine influenza virus, its modes of spread, and prevention measures. The aim of this article is to bring awareness in general and know the consequences of the infection. [ABSTRACT FROM AUTHOR]

Preventing transmission of H1N1 and other infectious diseases can require individuals to change behaviors, but recommendations to change behavior can run counter to other powerful influences. For example, instructions to not shake hands or avoid certain public gatherings can run counter to substantial social pressures to shake hands or be in attendance. These behavioral conflicts are illustrated with an experience of the relative ineffectiveness of voluntary recommendations, which highlights the importance of considering these social pressures when determining what recommendations to make and how to make them. An analysis of how social pressures influence behaviors relevant to preventing disease transmission can aid public health officials in considering how to make effective recommendations concerning H1N1 and other infectious disease situations. [ABSTRACT FROM AUTHOR]

An essay is presented on the 2009 H1N1 pandemic and the implementation of initial responses to mitigate its effects. It says that the responses to H1N1, which is more widespread compared to SARS, went well including its early detection in North America, integration of clinical laboratory for disease severity, and nonpharmaceutical interventions. It adds that there are still lessons to be learned for future H1N1 planning and timely access to influenza vaccines and antivirals remains a challenge.

The article discusses the scheme for the outbreak of the swine flu virus in the U.S. It tackles the International Health Legal Regime and the International Health Regulations (IHR) of the World Health Organization (WHO) in 2005. It also explores the expansion of the class regulated disease and the entities capable of reporting outbreaks.

The article reviews several articles including "Muslim Women and Medical Students in the Clinical Encounter," by M. McLean and colleagues, which appeared in the 2010 issue of the periodical "Medical Education," "Why We Went Over the Top in the Swine Flu Battle," by N. Hawkes, which appeared in the 2010 issue of the periodical "British Medical Journal," and "The Torfaen Referral Evaluation Project," by E. Evans, which appeared in the 2009 issue of the periodical "Quality in Primary Care."

Patients with an acute respiratory illness may present for dental treatment at outpatient dental settings. The primary goal is to prevent transmission of disease. This article outlines the characteristics, transmission and prevention of the H1N1 influenza virus (swine flu). [ABSTRACT FROM AUTHOR]

Abstract: A swine influenza virus (SIV) vaccine-challenge pig model was used to study the potential of a conserved matrix 2 (M2) protein vaccine alone or in combination with an inactivated H1N1-vaccine to protect against H1N1 and H1N2 viruses. The H1N1-vaccine and heterologous H1N2-challenge virus model has previously been shown to prolong fever and increase SIV-associated pneumonic lesions. The M2 vaccine in combination with the H1N1-vaccine reduced the H1N2 induced fever but not virus shedding. The M2 vaccine alone reduced respiratory signs and pneumonic lesions to levels similar to the negative control pigs following H1N2 infection. This study found that the M2 protein has potential as a vaccine for SIV-associated disease prevention. However, development of an immune response towards the major envelope HA protein was required to reduce SIV shedding. [Copyright &y& Elsevier]

The authors reflect on Australian Health Management Plan for Pandemic Influenza (AHMPPI), a pandemic plan released by Australian government in 2008. They discuss the pandemic of swine flu and argue on its implication to the public health of the country. They reveal that the plan include the mobilization of neuraminidase inhibitors; however, travelers are not prioritize to receive it. They imply on the inappropriateness of the plan in responding to the pandemic case of swine flu in Australia.

Summary: In response to WHO raising the influenza pandemic alert level from phase five to phase six, health officials around the world are carefully reviewing pandemic mitigation protocols. School closure (also called class dismissal in North America) is a non-pharmaceutical intervention that is commonly suggested for mitigating influenza pandemics. Health officials taking the decision to close schools must weigh the potential health benefits of reducing transmission and thus case numbers against high economic and social costs, difficult ethical issues, and the possible disruption of key services such as health care. Also, if schools are expected to close as a deliberate policy option, or just because of high levels of staff absenteeism, it is important to plan to mitigate the negative features of closure. In this context, there is still debate about if, when, and how school closure policy should be used. In this Review, we take a multidisciplinary and holistic perspective and review the multiple aspects of school closure as a public health policy. Implications for the mitigation of the swine-origin influenza A H1N1 pandemic are also discussed. [Copyright &y& Elsevier]

The origin of the new A (H1N1) influenza virus recently emerging in North America is a hot controversial topic of significance in disease control and risk assessment. Some experts claimed that it was an unusually mongrelized mix of human, avian and swine influenza viruses, while some others concluded that it was totally a simple re-assortment hybrid of two lineages of swine influenza viruses. Here the phylogenetic diversity of the viral PB1, PA and PB2 gene sequences using online web servers, and the results suggest that all the 8 genetic segments of the new virus were possibly from two lineages of swine influenza viruses, and one of the lineage was a mongrelized mix of human, avian and swine influenza viruses emerging in the world approximately 10 years ago. Considering the recent epidemiological trends of the new virus, we believe it will spread more widely in the world and persist long in human populations. It also could spread among swine populations. The future wide spreading of the new virus may coincide the disappearance of a subtype of previous human influenza A virus. [ABSTRACT FROM AUTHOR]

The article offers suggestions for family physicians of the U.S. to prepare one's office for an infectious disease epidemic. As stated, one should have a detailed plan for responding to a complex medical emergency like the recent swineflu outbreak. The plan should address several issues including training for patients and staff, systems to diagnose and treat patients and recovery and reconstitution of the office practice. It is also suggested to coordinate with public health agencies.

The new strain of Swine influenza called H1N1 is responsible for the swine flu outbreak in 2009 in humans. The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can be contagious for up to ten days.3 In 2011, there were only 34 cases reported the entire year, compared to 1,405 in 2010 and 3,047 in 2009.2 Aim of the study was to assess the awareness of swine flu among general population at Sri Venkateshwaraa Medical College Hospital and Research Centre. Cross sectional survey design was adopted and was conducted at outpatient departments in Sri Venkateshwaraa Medical College Hospital and Research Centre. 1770 general population were selected for the study by convenient sampling technique. Questionnaire which was prepared based on general information about swine flu, cause, mode of transmission, and prevention of spread of infection and demographic variables was used to collect data from 1770 samples by face to face interview method. The study findings revealed that over all awareness on swine flu among general public were not fully satisfactory. Present study found that health care providers seem to play an insufficient role in the education of the public. People should be enlightened about early diagnoses and prevention of spread of infection. [ABSTRACT FROM AUTHOR]

The article examines the advantages and reliability of hand sanitizers in preventing the transfer of microbes from one person to another in the U.S. Parents demand the use of hand sanitizers in schools to ensure protection of their children from swine flu and Methicillin-resistant Staphylococcus aureus (MRSA). Schools also took the initiative to install alcohol-based hand sanitizing stations. Results of studies conducted by the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) found that alcohol-based sanitizers are more efficient but not all hand sanitizers are created equally. However, there are growing uncertainties on the efficacy of hand sanitizers.

The author looks at the responsibilities of the U.S. Food and Drug Administration (FDA) as a public health agency. She argues that the agency has been responsible for oversight of more than 2 trillion U.S. dollars in medical products and other consumer goods. She states that under U.S. President Barack Obama, the agency's purpose is to fulfill society's interest in assuring the conditions in which citizens can be healthy. She notes that the public health role of the agency is reflected in the urgent need to develop a vaccine against the H1N1 virus.

A letter to the editor is presented in response to the article "Pulmonary sequelae in a patient recovered from swine flu" by V. Singh, B. B. Sharma, and V. Patel in the 2012 issue.

The article reports the Food and Drug Administration (FDA) advisers' recommendation to retain the current influenza type A H3N2 and influenza B strains vaccine formulation for the 2011–12 flu season. The article discusses febrile seizures in children after vaccination, and features comments from Lisa Grohskopf, a Centers for Disease Control and Prevention (CDC) medical officer, and Navy Captain Kevin Russell of the Department of Defense (DoD), on influenza activity and vaccine effectiveness.

The article discusses the public health's efforts in the development and delivery of a novel influenza vaccine virus to prevent the outbreak of the H1N1 disease in 2009 and 2010. Problems which were encountered during the development of the vaccine such as lower-than-expected vaccine virus yields and shortage of sprayer devices to measure vaccine potency are cited. The article notes that H1N1 cases peaked in late October or early November and that the 50-millionth dose was not shipped until early December 2009.

The authors ponder on the controversy surrounding the administration of the heptavalent pneumococcalconjugate vaccine (PCV7) for H1N1 prevention in Mexico. They reflect on how the Mexican government should deliver the vaccine in order to provide much benefit. They discuss the implications of the PCV7 vaccination for the Mexican public health, along with the financial issues associated with the vaccination program. The authors also reflect on the ethical aspects of public health administration.

A quiz about environmental health is presented.

The article offers information on how to prepare children for possible swine flu (H1N1) outbreak. It discusses the need for the parents to remind their children that they are safe and healthy. It highlights the symptoms of the disease, which include fever, sore throat, and cough. It suggests that the virus of the disease is transmitted through the coughing or sneezing of people infected with the virus.

The article examines China as the first country to vaccinate its citizens against the H1N1 influenza virus, also known as the swine flu. China has taken strict measures, such as the use of a quarantine system, to ensure its residents do not develop swine flu which has become a pandemic. China's quarantine has been criticized as draconian, sparking scientific debate and diplomatic quarrels before it was scaled back and a mass vaccination program put in its place. Topics include the impetus for China's aggressive campaign against H1N1 outbreaks, which was partially due to an outbreak in Mexico, an overview of some of China's stringent methods, such as screening overseas passengers, and the debate among China's flu experts regarding the usefulness of only one shot.