Following cases of swine flu Influenza A (H1N1) in Canada, Mexico, and the United States, the World
Health Organization (WHO) has raised the level of influenza pandemic alert from phase 3 to phase 4. There are no confirmed cases reported in Toronto or Ontario at this time. Toronto Public Health is working
with the Ministry of Health and Long-Term Care and the Public Health Agency of Canada to monitor and investigate the illness.
The majority of people with swine flu in the United States and Canada have had mild illness.
What is swine flu?
Swine flu is a variant of normal seasonal influenza that contains bits of viruses from birds, pigs and humans. People with swine flu experience many of the same symptoms as with regular seasonal flu:
How is swine flu spread? We are still investigating how swine flu is transmitted but it is likely spread from person to person via the
respiratory route, the same as seasonal influenza. Coughs and sneezes release the germs into the air where they can be breathed in by others. Germs can also rest on hard surfaces like counters and
doorknobs, where they can be picked up on hands and transmitted to the respiratory system when someone touches their mouth and/or nose.
Influenza can be passed to others up to 24 hours before illness starts. It appears that swine flu can be
spread for up to 7 days after illness starts. Children may spread the virus for longer periods. Initial investigation shows that the incubation period of the human swine influenza is between two and seven
How can I avoid getting swine flu? You can decrease your risk of getting swine flu by washing your hands, coughing and sneezing into a
tissue, and staying home when you feel ill. If you do not have a tissue, sneeze or cough into your sleeve or arm.
How severe is the human swine flu?
The majority of cases of swine flu reported in Canada and the United States have been mild. Some of the cases reported in Mexico have been more severe, involving primarily healthy young people who rapidly
progressed from mild illness to severe respiratory distress. Some illnesses have resulted in death. The Public Health Agency of Canada has been working with the WHO, Mexican and American health officials to
determine why cases in Mexico appear to be more severe.
Visit our website at www.toronto.ca Is there a treatment for swine flu?
It appears that Tamiflu (oseltamivir) and Relenza (zanamavir) work to combat swine flu, so these drugs can be used to treat severe swine flu cases if treatment is started within two days of symptom onset. Mild
illness that appears to be going away on its own does not require treatment. Swine flu is resistant to amantadine.
Is there a vaccine for swine flu?
There is currently no vaccine available for swine flu. Canada has a contract with a vaccine manufacturer for vaccine production in the event of a pandemic. Once the pandemic strain has been confirmed, it may take
up to six months for an effective vaccine to be developed and tested. The contract covers the production of enough pandemic vaccine for all Canadians.
Can I get swine flu from eating pork?
No. Cooking destroys the virus. What should I do if I’ve been to an area where swine flu has been reported and I have symptoms of a respiratory illness?
If you have recently travelled to an area affected by swine flu and are feeling ill enough that you need to seek medical attention, be sure to call ahead to discuss your symptoms and travel history. If symptoms
require you to go to a hospital or urgent care clinic, tell the hospital or clinic immediately that you have travelled to an area where swine flu has been seen in the last 10 days. A travel history alone does not
warrant seeking medical care if you do not feel ill enough to require it. Should I travel to Mexico or one of the other affected areas? The Federal government through Public Health Agency of Canada and Foreign Affairs is responsible for
issuing travel advice to Canadians. Travel advisories can be found at http://www.phac-aspc.gc.ca/tmp- pmv/pub-eng.php and http://www.voyage.gc.ca/countries_pays/menu-eng.asp What should I do if someone I know is coming to Canada from an affected area?
There are no restrictions for individuals travelling from areas where swine flu has been detected. If someone coming from an affected area becomes ill in Canada with signs and symptoms of swine flu and
requires medical attention, be sure to call ahead to discuss their symptoms and travel history. If symptoms require them to go to a hospital or urgent care clinic, tell the hospital or clinic immediately that the person
has come from an area where swine flu has been seen in the last 10 days. Is this the next influenza pandemic? The WHO yesterday raised the pandemic influenza alert level from Phase 3 to Phase 4. According to the
WHO, Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” Phase 4 indicates a significant
increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion. Where can I get more information?
• Toronto Public Health is providing ongoing updates at www.toronto.ca/health.
• Ministry of Health and Long-Term Care http://www.health.gov.on.ca
• Public Health Agency of Canada http://www.phac-aspc.gc.ca/index-eng.php
PHAC’s toll-free information number: 1-800-454-8302
• World Health Organization http://www.who.int Visit our website at www.toronto.ca
PUBLIC HEALTH FACTS BY FAX April 30, 2009 Skagit County Health Department Howard L. Leibrand, M. D. Health Officer "Always working for a safer and healthier Skagit County" 336-9380 (voice) 336-9401 (fax) Please copy and distribute this fax to each provider served by this fax number. Number of pages:
For more information please contact: Dr Roley Davis, Business Development Director Case Study – Metabolites of Cyclosporin A Introduction: . Cyclosporin A (Csp A; Sandimmune®) is a natural product produced by the fermentation of the fungus Tolypocladium inflatum and is used extensively as an immunosuppressant. Its primary route of metabolism is via hepatic cytochrome P45