Guidelines for treating A(H1N1)The Union Minis¬try for Health and Family Welfare has issued fresh gui¬delines to prevent and con¬tain the outbreak of Influenza A(H1N1).All the individuals seeking consultations for flu-like symptoms should be screened at both government
and private health care facilities. Patients with mild fever, cough/sore throat with or without body ache, headache, diarrhea and vomiting.
Patients categorised into three groups categorised as Category A. They do not require Tamiflu tablets.Such patients should be monitored and reassessed be¬tween 24 and 48 hours. They should be confined at homes and should avoid mixing with public. No testing of patient for A(H1N1) required.
Those having high fever and severe throat infection should be categorized as
Cat¬egory B and they may require Tamiflu tablets and home iso¬lation. Here too tests for the A(H1N1) are not required.
Category C are those hav¬ing breathlessness, chest pain, drowsiness, fall in blood pressure, sputum mixed with blood, bluish discolouration of nails, irritability among small children and refusal to accept feed and worsening of underlying chronic condi¬tions. All these patients re¬quire testing, immediate hospitalisation and treat¬ment.
mazharmhm on 2009-08-17
♡ PANKAJ VARMA last decade
H1N1 is now a household name. The 4th pandem¬ic flu is making headlines. The flu phobia is visible and mask mania is disturbing.
Obviously this is due to the horrific memory of millions of deaths within months dur¬ing previous pandemics in¬cluding the first one in 1918 caused by HIM. What really are H1 and NI and why are they important to flu virus and our understanding?
Like viruses in general, HIN1 depends on its outer surface proteins to infect host cells.
In swine flu virus these are Haemagglutinin (H) and Neuraminidase (N). To sur¬vive the host pro¬duces antibodies to these two proteins and inactivates them.
The virus, however, mod¬ifies the protein surfaces sub¬tly by genetic mutations and escapes the antibodies. The
new strain can therefore cause disease even in survi¬vors of previous attacks.
The numbers denote vari¬ous forms of these two pro¬teins.
In the case of H1 and N1, the numbers refer to the first type of Haemagglutinin and Neuraminidases identified in the isolates of the virus from the first pandemic.
Since the isolates from dif¬ferent geographical regions or at different times or from animals either did not react with the antibodies to H1 and N1 or reacted only to either one, the new ones were de¬noted chronologically as H1N2, H2N1, H2N2 (caused Asian flu, 1956-58), H3N2 (caused Hong Kong flu 1968¬69), H3N3 etc. There are 16 different H types and 9 differ¬ent N types known currently.
As the name suggests, Hae¬magglutinin agglutinates haemoglobin-containing red blood cells by binding to a sugar compound on its sur¬face. The sugar, called Sialic acid, is common and abun¬dant in many cell types, al¬lowing the virus to cause wide-spread damage.
The largest surface area makes respiratory system the most vulnerable. Upon bind¬ing to Silaic acid, Haemagglu¬tinin changes shape and mediates viral entry by bring¬ing about fusion of the viral and host surfaces.
Neuraminic acid is another name for Sialic acid. Neurami¬nidase breaks down Sialic acid, the very compound that Haemagglutinin binds to. Though this appears counter¬ productive, it actually prevents the newly released viruses binding to dead cells causing non-productive infection. Though Neuraminidase is not essential for viral infection, its combination with Haemagglutinin is lethal. Since both vary in their structure and effectiveness, the number associated with the two letters (H and N) has special significance to virulence.
mazharmhm last decade
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