Variant Influenza Virus (Swine Flu) Symptoms

Not infrequently, there is a news report of another outbreak of swine flu, where a type of influenza A that normally infects pigs crosses over and infects a human. Actually, however, "swine flu" no longer exists, since the infection is now called a "variant influenza virus" infection. The type of virus is often named based on its genetic makeup. People remember H1N1 from the news, but there are three different variants that have been recognized in recent years: H1N1, H1N2, and H3N2.

As a reminder, many types of viruses can cause very similar symptoms that are called influenza or the flu.

Variant influenza virus symptoms may include all those included in a regular influenza-like disease, including

• fever,
• cough,
• sore throat,
• chills,
• body aches, and
• fatigue.

However, with the variant virus, some patients may also experience more nausea, vomiting, and diarrhea than the seasonal flu, but this is not the case for every patient. Aside from the nausea, vomiting, diarrhea, and chills, these symptoms sound similar to the symptoms of a severe cold. Whether that's all there is or whether a person will become significantly ill is difficult to predict. However, individuals with poor or altered immune systems such as infants, pregnant women, the elderly, those undergoing chemotherapy treatment, or taking medications that impair immunity are at higher risk for more severe illness.

But even healthy people can become sick. The virus spreads by aerosol droplets, meaning that secretions from an infected person can be spread into the air by coughing or sneezing. It's the close contact with an ill person that causes the disease to spread. We live in a very social society. We ride public transportation, we attend school, and we work with many people. It's sometimes hard to know whom to avoid since a person may be contagious for 24 hours before their first symptoms occur.

Fortunately, we have learned how to limit the spread and the U.S. Centers for Disease Control and Prevention (CDC) has established monitoring programs looking for the first sign that an epidemic might be on the horizon. How a community, a hospital, or an individual deals with the potential for infection will help decide how fast and how far it will spread.
Preventing the spread of illness begins with decreasing contact with other people. For example, at the onset of the H1N1 flu outbreak in the spring of 2009, Mexico had soccer games played in empty stadiums, and public transportation was curtailed. Schools were closed in New York City, San Antonio, and San Diego after children who had traveled to Mexico on vacation returned with the swine flu infection. Travel advisories worldwide were posted to avoid not only Mexico, but also the U.S. and Canada.
Most schools, health care centers, and businesses have action plans in place for individuals who may have an infection, whether it is a cold, vomiting, diarrhea, or a skin infection. For people with upper respiratory tract infections like influenza, recommendations include staying home from work or school if you are ill and not returning to school or work until you have been free of fever (100 F or 37.7 C) for 24 hours without taking fever-reducing medication.
During flu season hospitals have plans developed to isolate patients who may be complaining of flu-like illnesses, whether the symptoms are due to "regular" or "variant" influenza. Patients may be placed in isolated rooms and made to wear surgical masks until they are examined and screened to make certain that influenza is not the cause of their illness. This might become a significant burden on hospitals and clinics if too many people show up to be seen. Imagine what would happen if waiting rooms were overwhelmed with coughing people. It would be difficult to isolate each one.

Influenza may cause some people to become very ill. Dehydration and pneumonia are major complications of influenza. Regardless of the altruism of not exposing other people to infection, sick people should seek medical care if it is needed. Guidelines have been spelled out clearly by the CDC and how they apply to various groups.

We've learned how to minimize the spread of influenza epidemics, but as the events of 2009 fade from our memory, we need to remember that influenza, both regular and variant, is not something to ignore.

People need to remain calm in the face of a constant barrage of press releases that act as a scoreboard for where and how many influenza cases have been found. Remember that the large majority of people infected with variant influenza virus infections around the world have done well without medication. Nonetheless, it pays to be prepared as follows:

• If there are cases of variant virus flu in the area, prevention starts with avoiding crowds of people.
• Other prevention issues are mostly common sense, such as good hand washing practices, avoid touching the face, mouth, nose, and eyes with your hands, and getting plenty of rest and fluids to maintain a strong immune system.
• If symptoms do begin, it is worthwhile contacting your family physician, health department, or local hospital to ask what to do.
• Staying at home and preventing disease spread to others is the first step.
• Advice about supportive care such as fluids and fever control measures may be given by phone.
• Prescription medication for oseltamivir (Tamiflu) or zanamivir (Relenza), antiviral medications that can treat variant virus and regular flu, may be also prescribed, but some health care practitioners may want to examine a patient before prescribing these drugs.