‘Although we have seen fewer confirmed cases of swine flu in our country than most countries around the world the number of people infected with the virus is gaining momentum. For example, a number of school groups in the Western Cape that have travelled abroad during the July holidays have returned with the virus thereby introducing it into their communities. This is probably equally true elsewhere in the country where travellers continue to be the main carriers of the H1N1 virus,’ says Vincent.
The good news is that the more the virus spreads, the more our understanding of the disease evolves. Every time a new country is added to the list and as community level spread extends in impacted countries, this information is shared globally and we continue to learn more about this virus. The World Health Organisation is placing increasingly more emphasis on monitoring people with the H1N1 virus and is actively reporting trends in the activity of the disease.
According to the World Health Organisation (WHO), the average age of people who contract the H1N1 virus is also showing a slight increase. The average age of people reported is 12 to 17 years. However, there have been global reports that persons who require hospitalisation and patients, who do die from the virus, may be slightly older.
This differs from the usual seasonal influenza pattern, where fatal disease occurs most often in people older than 65 years. ‘We do however not have the final answers on this virus as it is still relatively early in its development,’ adds Vincent while pointing out that the risk factors for contracting a serious case of ‘swine flu’ have now definitely been determined by the WHO.
‘Illnesses such as existing cardiovascular disease, respiratory disease, diabetes and cancer are currently considered risk factors. Asthma and other forms of respiratory disease have been consistently reported as underlying conditions associated with an augmented risk of severe pandemic disease in several countries.’
According to the WHO, recent reports suggest obesity may be another risk factor for severe H1N1 infection. Pregnant women also seemed to be at higher risk for more severe disease. The more information the WHO accumulates on the disease, the better are their chances of developing an effective vaccine against the H1N1 virus. ‘Work has also commenced to manufacture a H1N1 vaccine which should be available overseas around September,’ says Vincent.
South Africans affected by the disease with severe symptoms have been treated with oseltamivir (brand name Tamiflu ® and Cipla Oseltamivir) and zanamivir (brand name Relenza ®) with great success. ‘If you have severe ‘flu-like symptoms, it is recommended you see your doctor as soon as possible. Depending on the severity of your symptoms, you should be tested for ‘swine flu’,’ he adds.
- How the H1N1 flu works
Influenza is an infectious disease caused by viruses which affect birds and mammals. (Common reservoirs of flu strains are ducks and pigs ‘ which is why some virulent strains have arisen in the Far East, where humans often live in close contact with their animals like ducks and pigs.) Flu is spread by contact with bodily fluids containing the virus (it spreads through the air when someone sneezes, or you can be infected by touching a surface someone with flu has touched, for instance in a bathroom or hand rail).
‘Strictly speaking we shouldn’t be calling this ‘swine’ flu at all,’ says Vincent. Because of the misguided threats to pigs it is officially been called Novel H1N1 flu virus. It’s a strain which appears to have human, avian and swine elements.’ New strains of flu are constantly evolving, and each year we are likely to encounter a strain that differs slightly from the one we had the previous year.
Medical scientists create flu vaccines using the strains which are prevalent in the opposite hemisphere: so, for instance, they assume that we in our South African winter will be infected by the same strain that the Europeans have just battled in their winter, and they create vaccines containing the European flu strains.
Scientists and epidemiologists have long known that flu can be a dangerous illness ‘ every year, it kills a number of people, usually the elderly, infants or people with compromised immune systems. History has shown that periodically a mutation will arise, making a flu strain more deadly. Such a mutation was responsible for the over 40 million deaths in the 1918/19 flu pandemic, and later for the killer 1957 Asian and 1968 Hong Kong flu pandemics.
- What to do
‘Our advice would be similar to that given by the WHO, Centre for Disease Control and the British authorities,’ says Vincent. ‘If you have to travel internationally, consult your doctor or Travel Clinic beforehand for an assessment of your risk factors. People with compromised immune systems, people who have recently had a serious illness or surgery, elderly people and the very young, and anyone with respiratory or other organ complications will likely be given a course of antiviral prophylaxis. Make sure you visit the clinic in good time, ideally four weeks before travelling. Update all the other medications and vaccinations that protect you while travelling ‘ if you fall ill with a different disease, your ability to fight the flu would be reduced.’
Vincent emphasises that this flu strain must be taken seriously: ‘Don’t take risks with your health while travelling. The normal, average winter flu has a mortality rate of about 0.1%. We have highly qualified and experienced medical scientists and good monitoring procedures in places and are able to react swiftly and effectively to assist those in need.’
In the meantime, says Vincent, both stay-at-homes and travellers should step up their own infection control. ‘It’s all the stuff your mother taught you: wash your hands (you might want to wash them more regularly in flu season, when you could be touching infected surfaces more often); cover your mouth when you sneeze to avoid spraying others if you’re infected. Pack a sanitiser spray containing alcohol in your bag or briefcase to spray surfaces ‘ alcohol does a good job of killing flu viruses. And see a doctor as soon as you start to experience symptoms such as an aching body, shivering and fever, sore throat, headache and watery, red eyes.’
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