Swine Flu FAQ

1. What Is Swine Flu?
   Like humans, pigs get the flu. Four different type A swine flu strains commonly circulate among pigs. Most recent swine flu viruses have belonged to the H1N1 and H3N2 subtypes. Pigs typically get sick but usually don't die from swine flu. The new swine flu virus infecting humans is very unusual. It's somehow acquired genes from swine, bird, and human flu bugs. And it's also got genes from Eurasian swine flu viruses that aren't supposed to be in North America.

2. Do Humans Get Swine Flu?
   Normally, swine flu bugs don't infect people. Historically, there's a case every year or two in the U.S. among people who have contact with live pigs. But from December 2005 to January 2009 there was an uptick in swine flu cases. There were 12 human swine flu infections during this time. Eleven of these people had direct or indirect contact with pigs; in the twelfth case it was not known whether there was pig contact.
   
   It's possible this uptick was due to improved reporting systems, but the CDC says "genetic changes in swine flu viruses and other factors might also be a factor." The new swine flu virus is different. It's not yet clear that it's here to stay. But it is infecting humans, and that has world health officials keeping a close eye on it.

3. What Are the Symptoms of Swine Flu?
   Swine flu symptoms are similar to regular flu symptoms and include cough, sore throat, fever, chills, headache, and fatigue. Some patients have also reported nausea and diarrhea. There is no easy way to distinguish swine flu from other types of flu or other germs. It takes a lab test to tell whether it's swine flu.

4. Can Swine Flu Spread From Person to Person?
   The U.S. residents infected with swine flu virus had no direct contact with pigs. The CDC says it's likely that the infections represent widely separated cycles of human-to-human infections.

5. Have There Been Previous Swine Flu Outbreaks?
   If swine flu sounds familiar to you, it's probably because you remember or have read about the 1976 swine flu outbreak at Fort Dix, N.J., among military recruits. It lasted about a month and then went away as mysteriously as it appeared. As many as 240 people were infected; one died. The swine flu that spread at Fort Dix was the H1N1 strain. That's the same flu strain that caused the disastrous flu pandemic of 1918-1919, resulting in tens of millions of deaths. Concern that a new H1N1 pandemic might return with winter led to a crash program to create a vaccine and vaccinate all Americans against swine flu. That vaccine program ran into all kinds of problems -- not the least of which was public perception that the vaccine caused excessive rates of dangerous reactions. After more than 40 million people were vaccinated, the effort was abandoned. As it turned out, there was no swine flu epidemic.

6. I Got a Flu Shot. Am I Protected Against Swine Flu?
   No. There is currently no swine flu vaccine. It's possible that the seasonal flu vaccine might provide partial protection against H3N2 swine flu bugs. But the strain that appeared in California is the H1N1 swine flu strain. It is very different from the H1N1 human flu strain included in the seasonal flu vaccine. It's not known whether previous infection with human type A H1N1 flu might provide partial protection against the type A H1N1 swine flu in the current outbreak. However, the CDC has made a "vaccine seed" from swine flu isolated from an infected person, and has begun the process of developing a vaccine should the need arise. Whether a vaccine could be produced in quantity by next flu season is a huge question.

7. How Serious Is the Public Health Threat of a Swine Flu Epidemic?
   Any flu epidemic is worrisome, especially when a new strain of flu bug is involved. "Influenza A viruses new to the human population that are able to efficiently transmit from person to person and cause illness may represent a pandemic threat," the CDC warns. It's worrisome that, unlike seasonal flu, the swine flu outbreak in Mexico is attacking healthy young people. That's a hallmark of pandemic flu bugs.
   
   But it takes more than a new virus spreading among humans to make a pandemic. The virus has to be able to spread efficiently from one person to another, and transmission has to be sustained over time. In addition, the virus has to spread geographically.

8. Is There a Treatment for Swine Flu?
   Yes. While the swine flu bug is resistant to older flu medicines, it remains sensitive to Tamiflu and to Relenza.

9. Can You Get Swine Flu by Eating Pork?
   No. You can only catch swine flu from being around an infected pig -- or, if it's the new swine flu virus, from an infected person.

In Sickness and in Health
http://www.newsweek.com/id/195788/output/print
Matthew Philips | NEWSWEEK |From the magazine issue dated May 18, 2009
http://www.newsweek.com/id/195788

History repeats itself, but not without wrinkles. We pick apart the connections:

• The Comparison
  With the world in a panic over swine flu, it's starting to feel like 2003, when SARS was the raging contagion flooding the news, threatening to wipe out mankind and sending people racing to their local drugstores for cheap masks. Remember: most such masks stop germs only from infecting others; they won't keep you from getting sick.

• Why It Works
  Both are viruses with respiratory symptoms that humans spread by coughing. In nine months, SARS spread to 29 countries and killed 810 people out of about 8,000 cases. At press time, there were already 615 cases of swine flu in 15 countries and 13 confirmed deaths, with both figures expected to rise fast.

• Why It Doesn't
  Swine flu looks to be more contagious and threatens to be deadlier than SARS. While both were classified as "epidemics," experts believe swine flu will likely climb to "pandemic" status. Here in the U.S., swine flu has already caused more havoc: more cases in more states, plus 300 school closures to date.

Exercise Calms Agitation Associated With Dementia
http://www.leaderpost.com/health/Exercise+calms+agitation+associated+with+dementia
By Megan Rauscher, Reuters

Agitation and functioning improved in a group of elderly nursing home residents suffering from severe dementia when they engaged in just 30 minutes of supervised exercise three times a week.

NEW YORK (Reuters Health) - In a pilot study, agitation and functioning improved in a group of elderly nursing home residents suffering from severe dementia when they engaged in just 30 minutes of supervised exercise three times a week.

Edris Aman, a second-year medical student at Saint Louis University School of Medicine in Missouri, who conducted the study, told Reuters Health: "Lots of people just assume that people with this kind of (severe) dementia cannot follow exercise instructions, but they can. It just takes more patience on the part of the exercise coordinator -- me in this case."

Aman said his study is unique because it involved people suffering from severe dementia who were living in the "special needs" units of two nursing homes. The 50 study participants, whose average age was 79, performed 15 minutes of aerobic exercise and 15 minutes of weight lifting three times a week.

"Before and after" tests revealed that patients were far less agitated after completing the 3-week exercise program. They also showed significant improvement in their functional status -- specifically, the distance they could walk in six minutes.

Aman, who presented his research today at the annual meeting of the American Geriatrics Society, said there didn't seem to be an improvement in depression with exercise; however, this was a "very low dose of exercise," he said, and "there are a lot of studies that are emerging" that do show a benefit of exercise on depression. The take-home message, Aman said, is that "exercise benefits all; even those with severe dementia can reap the benefits of exercise if people are patient enough."

Aman's study is currently "in press" at the Journal of the American Medical Directors Association.

Filling Prescriptions To Get Easier
Ontario Government Supports Innovative Models For Drug Dispensing

TORONTO, May 6 /CNW/ - Ontario is proposing to make it more convenient for patients to get their drug prescriptions filled by allowing remote dispensing across the province. Legislation to be introduced in the coming days would, if passed, amend the Drug and Pharmacies Regulations Act (DPRA) and the Ontario Drug Benefit Act (ODBA) to allow prescriptions to be filled without the pharmacist being physically present. This remote dispensing could be done by:

• Patients using a dispensing machine to fill a prescription while speaking to the pharmacist through built-in video conferencing

• Pharmacy technicians dispensing drugs under the supervision of a pharmacist who is connected by a video link-up

• Mail order where medications for chronic conditions are dispensed and delivered regularly to patients' homes.

Some of the benefits associated with remote dispensing would include:

• Increasing access to medication and improving convenience for patients (especially those in remote areas of the province)

• Supporting new business development and made-in-Ontario technologies

• Potentially reducing the cost of drug distribution

To help ensure patient safety, the Ontario College of Pharmacists would be responsible for accrediting, monitoring and enforcing the regulatory requirements for these new types of drug dispensing systems.

QUOTES

"Remote drug dispensing is beginning to emerge as a viable alternative to the traditional pharmacy. We want to make it easier for patients to get the medications they need, and we want to do it in a way that ensures patient safety and is cost effective."

• David Caplan, Minister of Health and Long-Term Care

QUICK FACTS

• As a pilot project that began in June 2008, Sunnybrook Health Sciences Centre has two dispensing machines in use - one for outpatients and one for inpatients.

• Made-in-Ontario technology is being used in the pilot

• Narcotics will not be available through remote dispensing capabilities

LEARN MORE

Find out more about Ontario Public Drug Programs
(http://www.health.gov.on.ca/english/public/program/drugs/drugs_ep.html).

New President of Ontario Medical Association says Every Ontarian Should Have a Doctor

TORONTO, May 3 /CNW/ - The Ontario Medical Association's (OMA) 128th President, Dr. Suzanne Strasberg, says that while Ontario's health care system has made some good strides to improve patient access to services, there is more work to be done. Dr. Strasberg put forward a number solutions that she will focus on during her term as President that she believes are critical to a sustainable health care system including:

• Ensuring that every person in Ontario has access to a family physician;

• Advocating for adequate physician input into local health care decision making;

• Promoting a healthy lifestyle for all Ontarians; and

• Expansion of the use of IT and eHealth.

"In the face of some challenging economic circumstances it is more important than ever that programs and services which have demonstrated their value and proven to benefit patients should be a priority," Dr. Strasberg said.

Dr. Strasberg pointed to a number of initiatives, including collaborative care models, which have helped over 630,000 patients that didn't have a family physician, find one; and Electronic Medical Records, which have enhanced patient safety and improved the quality and continuity of care, as examples of where further expansions should be made immediately. With the creation of Local Health Integration Networks, Dr. Strasberg suggested that one of the most effective ways to improve patient access would be to consult physicians when decisions regarding local health services are being considered.

"Doctors are on the frontlines everyday, which provides them with a unique perspective on what types of services are required to meet the needs of patients," said Dr. Strasberg. "I look forward to collaborating with my fellow physicians and working with the government to continue to implement strategies that benefit patients in Ontario."

Dr. Strasberg also committed to promoting healthier lifestyles, continuing to protect Ontario's children, and helping make communities safer. Last year, physicians played an integral role in the introduction and passage of provincial legislation that bans smoking in cars with kids and using a hand held cell phone while driving. More recently, Ontario's doctors called for calorie counts to be prominently displayed on menu boards in chain restaurants and school cafeterias.