In February an outbreak of influenza occurred among military recruits at Fort Dix, N.J. The virus identified as the cause of the outbreak was swine influenza virus, the same strain thought to have produced the pandemic of 1918-1919, which caused over half a million deaths in the United States alone. U.S. public health officials feared that a major outbreak of swine flu in the winter of 1976-1977 was probable. As a result, President Ford announced this March a nationwide swine-flu vaccination campaign aimed at countering the expected epidemic. The president requested and received an appropriation of $135 million from the Congress, $100 million of which was to be used to purchase 200 million doses of vaccine from four pharmaceutical companies.
The original plan was to provide protection for essentially everyone in the population. However, as the months went by, difficulties were encountered in producing a vaccine that could be given to children without causing substantial reactions. There was also considerable opposition to providing immunization for everyone, rather than for certain high-risk groups. Finally, the whole program was placed in jeopardy when pharmaceutical companies scheduled to produce and sell the vaccine were denied coverage by their insurance companies. After prolonged debate this summer, Congress passed a liability program in August, under which the federal government assumed the cost of malpractice suits arising from the mass inoculations.
The first swine flu shots were administered on October 1. But during early October a total of over 35 persons died within 48 hours of inoculation. Some states suspended the program, but when no evidence linking the deaths with the vaccine was found, they resumed it.
WHAT IS SWINE INFLUENZA ?
Swine flu (swine influenza) is a respiratory disease caused by viruses (influenza viruses) that infect the respiratory tract of pigs, resulting in nasal secretions, a barking cough, decreased appetite, and listless behavior. Swine flu produces most of the same symptoms in pigs as human flu produces in people. Swine flu can last about one to two weeks in pigs that survive. Swine influenza virus was first isolated from pigs in 1930 in the U.S. and has been recognized by pork producers and veterinarians to cause infections in pigs worldwide. In a number of instances, people have developed the swine flu infection when they are closely associated with pigs (for example, farmers, pork processors), and likewise, pig populations have occasionally been infected with the human flu infection. In most instances, the cross-species infections (swine virus to man; human flu virus to pigs) have remained in local areas and have not caused national or worldwide infections in either pigs or humans. Unfortunately, this cross-species situation with influenza viruses has had the potential to change. Investigators decided the 2009 so-called “swine flu” strain, first seen in Mexico, should be termed novel H1N1 flu since it was mainly found infecting people and exhibits two main surface antigens, H1 (hemagglutinin type 1) and N1 (neuraminidase type1). The eight RNA strands from novel H1N1 flu have one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains.
Swine flu is transmitted from person to person by inhalation or ingestion of droplets containing virus from people sneezing or coughing; it is not transmitted by eating cooked pork products. The newest swine flu virus that has caused swine flu is influenza A H3N2v (commonly termed H3N2v) that began as an outbreak in 2011. The “v” in the name means the virus is a variant that normally infects only pigs but has begun to infect humans. There have been small outbreaks of H1N1 since the pandemic; a recent one is in India where at least three people have died.
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 season.
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 pregnant.
These measures also help prevent swine flu (H1N1 flu) and limit its spread:
- 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.
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