H1N1 Virus Description - Research Paper Example

 H1N1 Contents Contents 1 Outline 3 Abstract 4 Introduction 5 History 5 Statistics and Epidemiology 6 Risk Factors and Groups 7 Clinical Picture 7 Affect on animals 8 Current Situation 8 References 10 Outline  H1N1 virus is a RNA enveloped virus which is mainly known to be found in birds and then affects the pigs from where the virus is transmitted to humans.  The first outbreak due to this virus was in the year 1919 and led to 50 million deaths.  Since there have been outbreaks until a major pandemic hit the world in the year 2009.  The first case of this pandemic were reported in California and then a chain started with the global spread of the disease  The disease presents with respiratory symptoms including flu and in severe cases it can result in pneumonia.  It is also associated with hospitalizations and mortality.  Pregnant women, young children, aged people along with smokers, alcohols and diabetics have a very high risk of being infected by the virus.  The world right now is the post pandemic state as declared by the World Health Organization and the pandemic is over. Abstract H1N1 has been associated with many outbreaks across the world. Its history dates back to 1918 when the first outbreak took place and it resulted in the death of 50 million people. The disease reemerged many time but the second sever pandemic occurred in 2009 which also resulted in affecting many people and was responsible for many deaths as well. It is considered to be transmitted from pigs to humans. The pigs also develop respiratory symptoms due to it. There are many risk groups and factors associated with this condition. It can also result in long term effects. The pandemic is over now and right now the world is in the post pandemic period for the disease. Introduction H1N1 virus belongs to the family of orthomyxoviruses. It is an enveloped RNA virus consisting of a genetic structure of a single stranded RNA. It has a helical capsid and it also has surface spikes on two different locations which are hemagglutinin and neuraminidase (Levinsion 2008). This virus is classified as an avian virus and the virus is believed to be first found in birds, mainly the ducks from which it is transmitted to the pigs and then it finally infects humans. This virus needs to be understood because it has been associated with many outbreaks throughout the world and it is also believed that such outbreaks serve to be an economic burden and a reason for morbidity and mortality (Brooks et al 2004). History The history of H1N1 virus dates to the beginning of the twentieth century and there have been many outbreaks due to this virus along with a very high rate of fatalities. The first outbreak due to this virus was reported in the year 1918. It was a pandemic and the estimated number of deaths was so high that it was said that the deaths due to this outbreak were more than the total number of people who died in World War 1 and 2, the Korean War as well as the War of Vietnam (Levinson 2008). It was analyzed that approximately 50 million people died due to this outbreak and at the same time an illness among pigs assisted the scientists to reach to a decision that this illness had been contracted from the pigs (Zimmer and Burke 2009). In 1930, the virus was found in pigs in the United States and occurrence of disease in the animals was reported. In particular the season of winter is optimum for the occurrence of this virus (CIDRAP). Ever since then, there were cases of influenza due to this virus but no significant outbreaks. In 1957, the virus got completely eradicated and it was in 1970s that this virus reemerged. In 1976 there was an outbreak at an army base in New Jersey and many soldiers were affected. In the year 1977, a global pattern was reported with Soviet Union, China and Hong Kong. The international movement of pigs led to the spread of disease among them and it was also confirmed that pigs got affected by the virus through ducks (Zimmer and Burke 2009). Statistics and Epidemiology The major pandemic of the virus broke out recently in the 2009. It took a global pattern and affected many countries around the globe. It was declared in the phase 5 -6 according to the World Health Organization representing the fact that the disease had been widespread. There were a few differences noted in the molecular pattern of the virus of the 2009 pandemic. The hemagglutinin and neuraminidase was different from the H1N1 virus of the year 2008 by 27.2% and 18.2 % respectively (Gallher 2009). The pandemic of 2009 affected many countries around the globe. The first two cases to be reported with the pandemic were two children in California in close proximity to the border of Mexico in April (Zimmer & Burke 2009). By July in the East Mediterranean Region 1028 cases and 1 death was reported. The maximum numbers of cases were reported from Saudi Arabia and 232 was the exact figure (Regional Office for the East Mediterranean WHO). The CDC reported the number of cases, hospital admissions and the number of deaths in the United States from April 2009 till April 2010. According to the report approximately 61 million cases were reported from the United States, on an average 274,000 of the cases were admitted to the hospital and the number of patients who died due to the pandemic were on an average 12,740 (CDC, 2010). According to the South East Asia Regional Office of WHO, 76,302 cases of the disease were reported along with the number of deaths being 2054. Some of the countries in this region include India, Bhutan and Bangladesh (Regional Office for South East Asia, WHO). Risk Factors and Groups There are many risk factors and risk groups who have a higher susceptibility of being infected by the virus and have severe manifestations. Pregnancy serves as a very important risk factor as pregnant women present with serious manifestations of the disease and they accounted for 10 percent of the patients who died in pandemic of the year 2009. Suppressed immunity due to underlying pathologies also led to increased susceptibility of being infected. Increased body weight and obese individuals were also more prone to contract disease. Children below the age of 5 years and adults above the age of 65 years also had a greater risk. Lifestyle choices also added to risks which included higher susceptibility amongst smokers as well as alcoholics. Other factors included clotting disorders, diseases of the nervous system and the cardiovascular system as well as diabetes (Bautista et al 2010). Clinical Picture The time for the appearance of the disease after the virus has entered the body ranges from 1.5 days till 3days. As the name of the disease is swine flu, it can be analyzed that flu is one of clinical presentation of the disease. The respiratory system is mostly affected and the respiratory disease may range from mild disease to very sever pneumonia. It may also be accompanied with raised body temperature and cough. Sore throat is also one of the symptoms. Patients could also present with dehydration and they might not be very alert. The gastrointestinal system may also be affected and the patient may have vomiting, diarrhea or nausea. Patients can even develop serious complications which necessitate admissions in the hospitals and in severe cases the ICU. Pneumonia, Acute Respiratory Distress Syndrome as well as loss of function of the kidneys can lead to the patients being admitted and are counted as the serious presentations. Pulmonary thromboembolism has also been reported in severe cases. Superimposed bacterial infections have also been reported in the cases and it has been seen that respiratory pathological conditions might result owing to the virus. These include Chronic Obstructive Pulmonary Disease as well as asthma. The disease manifestations were so severe that some patients succumbed to the infection with 3 days and died. The nervous system can also be affected with the patients experiencing seizures, loss of consciousness as well as inflammation (Bautista et al 2010; Jain 2009; Cao 2009). Affect on animals An interesting aspect with regard to this virus is that though it does infect the pigs and they develop respiratory problems and there is a tendency of the spread of disease amongst them, the virus does not lead to the death of the animals. The transmission between the pigs occurs when they are close to each other and mainly respiratory secretions are considered to be involved in the spread (Kothalawala et al 2006). Current Situation The disease is no longer considered a pandemic and the Director General of the World Health Organization declared that H1N1 was not a pandemic based on the different reports and surveys reported from differing areas of the world. It was also no longer in the phase 6 that is a phase of high infectivity. But he also declared the fact that this period now was a post pandemic period (Director-General WHO 2010). The World Health Organization also made it clear that the pandemic was over but seasonal occurrences of influenza would be occurring according to their patterns. It was also reported that proper care was to be taken and vaccination was an important aspect that needed to be followed. The impact on the respiratory system of the individuals highly affected might persist. It was also indicated that there were still areas in the world where the disease was present. The WHO also declared this time a period of surveillance and asked for proper monitoring and reporting of any deviations and alterations resulting from the disease which were not seen during the pandemic. Also it was finally recommended that the people who were suffering for the disease should be properly treated according to the recommendations of the WHO (World Health Organization 2010). References Top of Form Top of Form Bautista, E., Chotpitayasunondh, T., Gao, Z., Harper, S. A., Shaw, M., Uyeki, T. M., Zaki, S. R., ... Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza. (January 01, 2010). Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. The New England Journal of Medicine, 362, 18, 1708-19. Bottom of Form Bottom of Form Top of Form Top of Form Brooks, G. F., Butel, J. S., Morse, S. A., & Jawetz, E. (2004). Jawetz, Melnick, & Adelberg's medical microbiology. Lange medical book. New York, N.Y: Lange Medical Books/McGraw-Hill, Medical Pub. Division. Bottom of Form Centers for Disease Control and Prevention.(May 14, 2010). Updated CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States, April 2009 – April 10, 2010. Retrieved from: http://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm Top of Form CIDRAP : Center for Infectious Disease Research and Policy. Pandemic Influenza 2010 Retrieved from: http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/biofacts/panflu.html#_Swine_Influenza_H1N1 Bottom of Form Director-General World Health Organization.(2010) “H1N1 in post-pandemic period.” World Health Organization. Retrieved from: http://www.who.int/mediacentre/news/statements/2010/h1n1_vpc_20100810/en/index.html Top of Form Top of Form Gallaher, W. R. (January 01, 2009). Towards a sane and rational approach to management of Influenza H1N1 2009.Virology Journal, 6. Bottom of Form Top of Form Top of Form Jain, S. (January 01, 2009). Hospitalized Patients with 2009 H1N1 Influenza in the United States, April-June 2009. The New England Journal of Medicine, 361, 20, 1935. Bottom of Form Bottom of Form Top of Form Top of Form Kothalawala, H., Toussaint, M. J. M., & Gruys, E. (January 01, 2006). An overview of swine influenza. The Veterinary Quarterly, 28, 2, 45. Bottom of Form Bottom of Form Bottom of Form Bottom of Form Top of Form Top of Form Levinson, W. (2008). Review of medical microbiology and immunology. New York: McGraw-Hill Medical. Bottom of Form Regional Office for the East Mediterranean. World Health Organization. (July 26, 2010) Pandemic (H1N1) 2009: WHO Eastern Mediterranean Region. Retrieved from: http://www.emro.who.int/csr/h1n1/pdf/sitrep_5.pdf Regional Office for South East Asia. World Health Organization. (2010) Pandemic (H1N1) 2009: WHO South East Asia. Retrieved from: http://www.searo.who.int/EN/Section10/Section2562.html World Health Organization (August 10, 2010).WHO recommendations for the post-pandemic period. Retrieved from: http://www.who.int/csr/disease/swineflu/notes/briefing_20100810/en/index.html Top of Form Top of Form Zimmer, S. M., & Burke, D. S. (January 01, 2009). Historical perspective--Emergence of influenza A (H1N1) viruses. The New England Journal of Medicine, 361, 3, 279-85. Bottom of Form Bottom of Form Bottom of Form Read More