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Swine flu symptoms test: Diagnosis of Swine Flu


Diagnosis of Swine Flu

Swine flu, caused by the influenza virus h2N1 2009 strain, is usually a mild illness. Diagnosis may be made based on the signs and symptoms of the disease. Swine flu manifests in most people as a usual flu infection with similar symptoms and thus may be confused with other viral illnesses.

Image Credit: Tashatuvango / Shutterstock.com

Features of swine flu

According to the Centers for Disease Prevention and Control (CDC) guidelines, swine flu is diagnosed in presence of the following features:

  • Acute fever and airways infection within 7 days of close contact with a person who has been confirmed to be a case of h2N1 influenza A infection
  • Acute fever and airways infection within 7 days of travel to a community (within or outside the country) where there have been one or more confirmed cases of h2N1 influenza A infection
  • Acute fever and airways infection seen in a person living in a community where there is at least one confirmed case of h2N1 influenza A infection

Confirmation of the diagnosis

To confirm the diagnosis, specific laboratory tests are needed that can also detect the strain causing the condition.

Laboratory tests include blood tests, chest X-rays and so forth.

Routine blood tests

Viral infections usually do not cause many changes in the routine blood picture.

A bacterial infection leading to flu-like features may be ruled out using a routine blood test with hemoglobin, complete blood counts including white blood cells, red blood cells and platelet counts.

Chest X-ray

Chest X-rays and other imaging tests are suggested in individuals at risk of complications like pneumonia.

Nose or throat swab

To test for swine flu a nose or throat swab is taken. Within 15 minutes, the laboratory may tell if influenza type A or B is present.

The specimen of the infected material from the patient’s throat or nose is collected within the first 4 to 5 days of illness. This is the most infectious period of the disease and the infected person is most likely to be shedding the virus. Children, however, may shed the virus for 10 days or longer. Further details of the exact strain may take a few days to detect and report.

If there is a wide-spread infection, there may be no need for testing. Treatment is based on the symptoms alone.

Most state health departments, after the pandemic, are now equipped with tests for non-human influenza virus strains. However, if a variant influenza virus is suspected, it is sent to CDC for further testing.

Kit to diagnose influenza

The CDC developed a new kit to diagnose seasonal flu as well as the flu viruses that could become pandemic. This was approved by the FDA (Food and Drugs Administration, USA) in September 2011.

It is called the Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel (rRT-PCR Flu Panel) and gives results in 4 hours.

The kit can identify and differentiate between influenza A and B viruses, further classify influenza A viruses by subtype, and also detect highly infectious avian or bird influenza A (H5N1) virus infection in human samples.


Further Reading

h2N1 flu (swine flu) – Diagnosis and treatment


Your doctor will conduct a physical exam, look for signs and symptoms of influenza, including h2N1 flu (swine flu), and possibly order a test that detects influenza viruses such as h2N1.

There are several tests used to diagnose influenza, but not everyone who has the flu needs to be tested. Your doctor may diagnose you with influenza based on your signs and symptoms. In most cases, knowing that someone has the flu doesn’t change the treatment plan. Doctors are more likely to use a test to diagnose flu if:

  • You’re already in the hospital
  • You’re at high risk of complications from the flu
  • You live with someone who is at greater risk of flu complications

Your doctor may also use a test to determine whether a flu virus is the cause of your symptoms, or if you have or are showing signs of another problem besides the flu, such as:

  • Heart problems, such as heart failure or an infection of the heart muscle
  • Lung and breathing problems, such as asthma or pneumonia
  • Brain and nervous system problems, such as encephalopathy or encephalitis
  • Septic shock or organ failure

In some cases, your doctor may suggest that you be tested for influenza. He or she may use various tests to diagnose influenza. Polymerase chain reaction (PCR) testing is becoming more common in many hospitals and labs. This test may be done while you’re in your doctor’s office or in the hospital. PCR testing is more sensitive than other tests and may be able to identify the influenza strain.

During the COVID-19 pandemic, it’s possible to have a test to diagnose both influenza and COVID-19. It’s possible to have both COVID-19 and influenza at the same time.


Most people with flu, including h2N1 flu (swine flu), require only symptom relief. Supportive care such as drinking liquids, taking pain relievers for fever and headache, and resting may be helpful. If you have a chronic respiratory disease, your doctor may prescribe additional medications to help relieve your symptoms.

Antiviral drugs are sometimes prescribed within the first day or two of symptoms. They can reduce the severity of symptoms and possibly the risk of complications. The U.S. Food and Drug Administration has approved these four drugs:

  • Oseltamivir (Tamiflu)
  • Zanamivir (Relenza)
  • Peramivir (Rapivab)
  • Baloxavir (Xofluza)

But flu viruses can develop resistance to these drugs.

To make development of resistance less likely and maintain supplies of these drugs for those who need them most, doctors reserve antivirals for people at high risk of complications and those who are in close contact with people who have high risk of complications.

People at higher risk of flu complications include people who:

  • Are in a hospital, nursing home or other long-term care facility.
  • Are younger than 5 years of age, particularly children younger than 2 years.
  • Are 65 years old or older.
  • Are pregnant or within two weeks of delivery, including women who have had pregnancy loss.
  • Are younger than 19 years of age and are receiving long-term aspirin therapy. Using aspirin during a viral illness increases the risk of developing Reye’s syndrome, a rare but potentially life-threatening condition, in these individuals.
  • Have a body mass index above 40, which is defined as morbid obesity.
  • Have certain chronic medical conditions, such as asthma, emphysema, heart disease, diabetes, neuromuscular disease, or kidney, liver or blood disease.
  • Are immunosuppressed due to certain medications or HIV.
  • Are of American Indian or Alaska Native heritage.

Lifestyle and home remedies

If you develop any type of flu, these measures may help ease your symptoms:

  • Drink plenty of liquids. Choose water, juice and warm soups to prevent dehydration.
  • Rest. Get more sleep to help your immune system fight infection.
  • Consider pain relievers. Use an over-the-counter pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

    Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye’s syndrome, a rare but potentially life-threatening condition, in such children.

If you have the flu, you can give it to others. Stay home for at least 24 hours after your fever is gone.

Feb. 24, 2021

CDC h2N1 Flu | Influenza Diagnostic Testing During the 2009-2010 Flu Season

Content on this page was developed during the 2009-2010 h2N1 pandemic and has not been updated.

  • The h2N1 virus that caused that pandemic is now a regular human flu virus and continues to circulate seasonally worldwide.
  • The English language content on this website is being archived for historic and reference purposes only.
  • For current, updated information on seasonal flu, including information about h2N1, see the CDC Seasonal Flu website.


September 29, 2009, 6:00 PM ET

For the Public

How will I know if I have the flu this season?

You may have the flu if you have one or more of these symptoms: fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue and sometimes, diarrhea and vomiting. Most people with 2009 h2N1 have had mild illness and have not needed medical care or antiviral drugs, and the same is true of seasonal flu. (More information is available on What To Do If You Get Sick this flu season.) Most people with flu symptoms do not need a test for 2009 h2N1 because the test results usually do not change how you are treated.  

How can I know for certain if I have the flu this season?

To know for certain, a test specific for flu would need to be performed.  But most people with flu symptoms do not need a test for 2009 h2N1 flu because the test results usually does not change how you are treated.

What kinds of flu tests are there?

A number of flu tests are available to detect influenza viruses. The most common are called “rapid influenza diagnostic tests” that can be used in outpatient settings. These tests can provide results in 30 minutes or less. Unfortunately, the ability of these tests to detect the flu can vary greatly. Therefore, you could still have the flu, even though your rapid test result is negative. In addition to rapid tests, there are several more accurate and sensitive flu tests available that must be performed in specialized laboratories, such as those found in hospitals or state public health laboratories. All of these tests are performed by a health care provider using a swab to swipe the inside of your nose or the back of your throat. These tests do not require a blood sample. For more information, see Seasonal Influenza Testing.

How well can these tests detect the flu?

Rapid tests vary in their ability to detect flu viruses. Depending on the test used, their ability to detect 2009 h2N1 flu can range from 10% to 70%. This means that some people with a 2009 h2N1 flu infection have had a negative rapid test result. (This situation is called a false negative test result.) Rapid tests appear to be better at detecting flu in children than adults. None of the rapid tests currently approved by the Food and Drug Administration (FDA) are able to distinguish 2009 h2N1 flu from other flu viruses. 

Will my health care provider test me for flu if I have flu-like symptoms?

Not necessarily. Your health care provider may diagnose you with flu based on your symptoms and their clinical judgment or they may choose to use an influenza diagnostic test. Depending on their clinical judgment and your symptoms, your healthcare provider will decide whether testing is needed and what type of test to perform. CDC has provided recommendations for clinicians this season to help with testing decisions. This season, most testing will be done in people who are seriously ill (hospitalized patients) and patients where testing may impact treatment decisions. In most cases, if a healthcare provider suspects you have the flu, the test results will not change their treatment decisions. 

Who is being tested for flu this season?

This season CDC has provided Interim Recommendations for Clinical Use of Influenza Diagnostic Tests During the 2009-10 Influenza Season which recommends that the following people receive influenza diagnostic testing: 1) people who are hospitalized with suspected flu and 2) people such as pregnant women or people with weakened immune systems, for whom a diagnosis of flu will help their doctor make decisions about their care. CDC expects that most people with flu symptoms this season will not require testing for 2009 h2N1 because the test results usually do not change how you are treated. Additional people may be recommended for testing based on the clinical judgment of their health care provider.

How will I know what strain of flu I have or if it’s 2009 h2N1 (formerly known as Swine Flu)?

You may not be able to find out definitively what flu virus you have. Currently available rapid influenza diagnostic tests cannot distinguish between 2009 h2N1 and seasonal influenza A viruses. Most people with flu symptoms this season will not require testing for 2009 h2N1 because the test results usually do not change how you are treated.  As of September 2009, more than 99% of circulating influenza viruses in the United States are 2009 h2N1. Therefore, at this time, if your health care provider determines that you have the flu, you most likely have 2009 h2N1. As the season progresses, different influenza viruses may circulate and updated national information on circulating influenza viruses is available in the FluView U.S. Weekly Influenza Surveillance Report.

There are laboratory tests available that can tell the difference between 2009 h2N1 and other strains of flu, but these can take one to several days to provide results and this season, CDC has recommended that this testing be focused on 1) people who are hospitalized with suspected flu; 2) people such as pregnant women or people with weakened immune systems, for whom a diagnosis of flu will help their doctor make decisions about their care.

Why can’t I get a more accurate laboratory test to find out if I had flu or what kind of flu I had?

The most accurate laboratory tests, such as real-time reverse transcriptase polymerase chain reaction (rRT-PCR) are only available in certain laboratories, and these tests can take several days to obtain results. This season, CDC is focusing use of these tests on people who are hospitalized or for other reasons explained in the question “Who is being tested for flu this season?”

Swine Flu Test | h2N1 Blood Test

what is swine flu?

Commonly referred to as the swine flu, the h2N1 is a subtype of the orthomyxovirus that causes influenza A in humans. Despite being informally called “swine flu”, the h2N1 flu virus cannot be spread by eating pork (pig meat) or pork products.

It is typically contracted by person to person transmission through respiratory droplets through coughing or sneezing by people with influenza.

Sometimes people may become infected by touching a surface or an object with flu viruses on it and then touching their face. h2N1 symptoms are marked especially by fever, sore throat, cough, lethargy, chills, body aches, fatigue and sometimes diarrhoea and vomiting similar to other influenza viruses. Swine flu symptoms usually last 4–6 days.

What Is Swine Flu (h2N1) Test?

The swine flu (h2N1) is a mild illness that stems from the influenza virus h2N1 2009 strain. The test affects healthy people and is known to be contracted at hospitals, affected communities and infected people.

The Swine Flu (h2N1) Test is a medical diagnosis which makes use of Chest X-rays, routine blood tests, and the CBC test to identify any signs of this infection and prevent any pandemic through early and effective treatment or prevention.

why do i need swine flu test?

Swine flu symptoms resemble those found in the regular and elderly people or people with other illnesses have a chance of dying from this infection. Reports from the U.S Center of Disease Control And Prevention (CDC) reveal that 556 deaths and 8,843 hospitalisations have occurred in the U.S. alone due to this disease. 

Even children are susceptible to this and suffer from respiratory diseases like asthma and COPD, and anyone with immunocompromised systems are at risk of several complications.

People who are in the advanced stages of swine flu virus infection may not be protected despite receiving immediate vaccinations. This is why you need this test to receive appropriate vaccinations on-time or early on before it becomes too late.


Like other influenzas, the symptoms of h2N1 too are similar which include Body aches, chills, cough, fatigue, fever, headache, loss of appetite, sore throat. 

Patients with h2N1 flu virus have also reported vomiting and diarrhoea. 

The source of infection of the virus is from consuming infected pig meat or coming in direct contact with infected swine. It is transferred when the virus enters the body, whether through the eyes, nose or mouth. It is contagious and spreads through the air and also by utilising belongings of an infected person.

Other Swine flu causes are linked to moving into communities with known incidences of h2N1 Influenza A infections. 

what other tests might i have along with this test?

Rapid tests using PCR technology may be recommended to you alongside your regular quick test which is done with a nasopharyngeal swab sample to check whether you are infected with influenza A or B virus.

You will have to go through routine bloodwork tests like platelet count, Complete Blood Cell Count (CBC) and Red Blood Cell Count with Hemoglobin tests for analysis of samples. 

Women who are pregnant will be suggested to go for limited testing and bronchoscopy may be required. These are the common tests involved, and it is best to consult with your doctor to identify which test is appropriate for you based on symptoms exhibited. 

does swine flu test pose any risk?

You may be at risk of infections, pain, and a bit of bruising when you go to the hospital to give your blood sample for analysis. 

The test is done to check for antibodies to the virus. Getting tested is an important part of swine flu prevention and treatment. Furthermore, you’ll likely increase your chances of survival and treatment if you get tested early.

Since the swine flu test cost is affordable at government hospitals and private clinics, it is recommended you get tested to be safe. 

what might affect my test results?

Your test results may be affected if you are on any existing drugs or medications which influence the outcome of the diagnosis. Depending on the medications or drugs you take, your swine flu virus infection may worsen, and results may get affected accordingly.

Swine flu vaccine cost is very affordable at government hospitals around the world. 

when do you expect results?

You can expect your h2N1 test report within 24 to 36 Hours from the time of your collecting your blood sample. 

how do i prepare for swine flu test?

Preparatory instructions before the test * 

There may be a feeling of choking or another discomfort.

One must sit with their head against a wall to reduce the tendency of pulling away during the procedure.

how is swine flu test done?

Specimen type: nasopharyngeal swab

Specimen collection procedure 

A dry swab would be inserted through one nostril straight back (not upwards), along the floor of the nasal passage until it reaches the wall of the nasopharynx. The distance from the nose to the ear would give an estimate of the distance the swab should be inserted.

The swab is gently rotated and left in its place for up to 10 seconds.

The swab is placed immediately into the transport container.

what do my test results mean?

Your test results will indicate whether you’ve been clinically diagnosed as positive for swine flu or negative. 

If all four targets are negative in your lab report, then a repeat sample analysis will be recommended. 3 out of 4 positive targets is considered inconclusive evidence and requires repeat testing.

Understanding results ofSwine Flu (h2N1) test

‘*A Reference range is a set of values which helps the healthcare professional to interpret a medical test. It may vary with age, gender, and other factors. Reference ranges may also vary between labs, in value & units depending on instruments used and method of establishment of reference ranges’


If you’re thinking of doing your swine flu test at home, you can book our services and have our healthcare specialists visit you. Your swine flu test report will be delivered to your doorstep 24- 36 hours from the moment you apply for a lab test for swine flu through us. 

Swine flu: Causes, symptoms, and treatment

Swine flu can affect both pigs and humans. It is a respiratory disease that results from an influenza A virus.

The influenza A variant subtype h2N1 is commonly the cause of swine flu in humans. It has similar genetic features to the h2N1 subtype of influenza virus that causes influenza in pigs.

Other main subtypes known to occur and cause influenza in pigs include h2N2 and h4N2. There have been infections in humans with these two variant subtypes as well.

In 2009, the h2N1 variant became widespread in humans for the first time.

Since 2009, the h2N1 virus has become one of the common viruses that circulate each flu season. Many people now have some immunity to the virus. As a result, experts are now less concerned about this type of swine flu than they were in 2009.

However, any time a virus affects humans from a different source, it is a concern. Scientists cannot always tell how a new virus will affect people, or how it will change over time.

Share on PinterestA person can help prevent the spread of swine flu by washing their hands regularly with soap and water.

The symptoms of swine flu are similar to those of regular flu.

They include:

In severe cases, there may be respiratory failure and death, but this is rare. Most people’s symptoms are relatively mild.

However, young children, older people, pregnant women, and those with a compromised immune system may have a higher risk.

Find out more about flu here.

Scientists developed a vaccine to protect humans from h2N1 after the 2009 outbreak. Since then, protection against h2N1 has become part of the regular seasonal flu shot.

Every year, experts try to predict which flu virus strains are likely to circulate during the flu season, which usually peaks in winter. They prepare vaccines according to the types that are most likely to occur.

If experts predict that a certain strain of h2N1 could cause a pandemic, health authorities will recommend including a change to this component in the annual flu shot.

TheCenters for Disease Control and Prevention (CDC) recommend an annual flu shot for everyone aged 6 months or older, barring certain rare exceptions. A doctor can advise on individual needs.

Most people recover from h2N1 without extensive medical intervention.

In some cases, however, a doctor may prescribe an antiviral medication. These drugs can shorten the duration of symptoms and reduce their severity.

People may need these drugs urgently if they:

  • have severe symptoms or complications
  • are in the hospital
  • have a high risk of complications

Steps for managing swine flu symptoms and preventing further infection include:

  • using over-the-counter remedies
  • washing hands regularly with soap and water
  • getting plenty of sleep
  • exercising often
  • managing stress
  • drinking liquids
  • eating a balanced diet
  • avoiding being close to someone with flu symptoms
  • not touching surfaces that may have the virus

Anyone who has flu should stay home from work or school while symptoms last.

Doctors now consider h2N1 to be a flu strain that can occur in people and spread alongside seasonal flu viruses. A person can catch it if they are in close contact with someone who has h2N1.

People who work with swine may have a risk of contracting new types of flu or other diseases from animals. These are known as zoonotic diseases.

Risk factors

Some people have a higher risk of flu, including h2N1, or having severe symptoms or complications.

These individuals include:

  • people aged over 65 years
  • children under 5 years
  • people with conditions, such as diabetes, HIV, or cancer
  • pregnant women
  • people with chronic lung disease, such as asthma
  • people with chronic heart disease, such as heart failure
  • anyone with a compromised immune system
  • children with neurologic conditions

If a doctor suspects that a person may have h2N1 or another type of flu, they may recommend a test to confirm the diagnosis.

The rapid influenza diagnostic test can help identify swine flu. However, this test can vary in effectiveness and may show a negative result when a certain influenza virus strain is present.

More accurate tests are available in specialist laboratories.

Most people do not need more than a rapid flu test, as treatment will be the same, regardless of the test outcome.

If a person has flu, the following tips can help prevent further spread:

  • Limit your contact with other people.
  • Do not go to work or school while experiencing flu symptoms.
  • Cover the mouth with a tissue when coughing or sneezing. If no tissue is handy, cover the mouth and nose with your hand or crooked arm.
  • Put your used tissues in a trash can.
  • Wash your hands and face regularly.
  • Keep all surfaces that you touch clean.
  • Follow all doctors’ instructions.

The annual flu shot can offer protection from various types of flu.

Those whose work or lifestyle brings them into contact with swine and other animals should:

  • follow all health and safety precautions when handling animals
  • ensure that swine have their relevant vaccinations
  • call a vet if an animal appears sick
  • avoid contact with pigs if they or other animals appear ill

Here are some more facts about swine flu:

Can I catch swine flu from pork?

Swine flu is a respiratory disease that transmits through droplets in the air and on surfaces. It is not possible to catch if from eating properly cooked pork.

Could there be another pandemic?

Another pandemic of h2N1 swine flu is much less likely now, as people have developed some degree of immunity. Before the 2009–2010 pandemic, there was no evidence that h2N1 had infected humans.

Under the right conditions, however, a pandemic can occur if any novel virus moves from animals to humans.

The SARS-CoV-19 virus that causes COVID-19, the infection that first appeared in December 2019, is currently being monitored by the World Health Organization (WHO).

What does swine flu look like in pigs?

Symptoms in pigs include:

  • fever
  • depression
  • coughing (barking)
  • runny nose
  • red and runny eyes
  • breathing difficulty
  • low appetite

Swine flu is common in pigs in the United States, but vaccines are available.

Swine Flu (h2N1, h4N2v) Symptoms, Vaccination, Treatment, Causes

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Influenza Tests | Lab Tests Online

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(Updated 2009 December 24). h2N1 Flu: Diagnosis and Lab Testing. Centers for Disease Control and Prevention, [On-line information]. Available online at http://www.cdc.gov/h2n1flu/diagnosis/. Accessed March 2010.

Chang, H. (2009 November 4). Influenza. JAMA. 2009;302(17):1926 On-line information]. Available online at http://jama.ama-assn.org/cgi/reprint/302/17/1926.pdf. Accessed March 2010.

(Updated 2009 December 7). Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season. Centers for Disease Control and Prevention, [On-line information]. Available online at http://www.cdc.gov/h2n1flu/recommendations.htm. Accessed March 2010.

(2009 September 29). Questions & Answers, Influenza Diagnostic Testing During the 2009-2010 Flu Season. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/h2n1flu/diagnostic_testing_public_qa.htm. Accessed March 2010.

(2010 February 10). Questions & Answers, 2009 h2N1 Flu (“Swine Flu”) and You. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov. Accessed March 2010.

Derlet, R. et. al. (Updated 2009 December 8). Influenza. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/219557-overview. Accessed March 2010.

Bronze, M. S. (Updated 2010 January 27). h2N1 Influenza (Swine Flu) eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/1807048-overview. Accessed March 2010.

Katz, M. et. al. (2009 March 13). Use of Rapid Tests and Antiviral Medications for Influenza Among Primary Care Providers in the United States. Medscape Today from Influenza Resp Viruses. 2009;3(1):29-35 [On-line information]. Available online at http://www.medscape.com/viewarticle/588778. Accessed March 2010.

(2009 November 13). Fact Sheet for Healthcare Providers: Interpreting ELITech Molecular Diagnostics 2009-h2N1 Influenza A virus Real-Time RT-PCR Test Results ARUP Laboratories [On-line information]. PDF available for download at http://www.arup-lab.com/Testing-Information/resources/HotLines/h2N1-HealthcareProviders-InterpretingTestResults.pdf. Accessed March 2010.

Hillyard, D. et. al. (Updated 2010 February). Influenza Virus. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/InfluenzaVirus.html?client_ID=LTD. Accessed March 2010.

Mayo Clinic Staff (2009 September 30). h2N1 flu (swine flu). MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/health/swine-flu/DS01144. Accessed March 2010.

Mayo Clinic Staff (2009 September 11). Influenza (flu). MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/health/influenza/DS00081. Accessed March 2010.

(2009 August 10). Interim Guidance for the Detection of Novel Influenza A Virus Using Rapid Influenza Diagnostic Tests. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/h2n1flu/guidance/rapid_testing.htm. Accessed March 2010.

(Updated 2010 March 8). CDC Estimates of 2009 h2N1 Influenza Cases, Hospitalizations and Deaths in the United States, April 2009 – February 13, 2010. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/h2n1flu/estimates_2009_h2n1.htm. Accessed March 2010.

Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 1225, 1578.

Forbes, B. et. al. (© 2007). Bailey & Scott’s Diagnostic Microbiology, 12th Edition: Mosby Elsevier Press, St. Louis, MO. Pp 729.

Reviewed March 2013. Influenza Virus. Arup Consult. Available online at http://www.arupconsult.com/Topics/InfluenzaVirus.html. Accessed November 2013.

Reviewed December 2012. Laboratory Support for Surveillance of Vaccine-Preventable Diseases. Centers for Disease Control and Prevention. Available online at http://www.cdc.gov/vaccines/pubs/surv-manual/chpt22-lab-support.html. Accessed November 2013.

Reviewed March 2012. Guidance for Clinicians on the Use of RT-PCR and Other Molecular Assays for Diagnosis of Influenza Virus Infection. Centers for Disease Control and Prevention. Available online at http://www.cdc.gov/flu/professionals/diagnosis/molecular-assays.htm. Accessed November 2013.

Reviewed December 2011. Influenza Symptoms and the Role of Laboratory Diagnostics. Centers for Disease Control and Prevention. Available online at http://www.cdc.gov/flu/professionals/diagnosis/labrolesprocedures.htm. Accessed November 2013.

Reviewed October 2013. Overview of Influenza Surveillance in the United States. Centers for Disease Control and Prevention. Available online at http://www.cdc.gov/flu/weekly/overview.htm. Accessed November 2013.

Updated February 2012. Diagnostic Influenza Tests. Medscape. Available online at http://emedicine.medscape.com/article/2053517-overview. Accessed November 2013.

90,000 Frequently asked questions about influenza A (h2N1)

What is influenza A (h2N1)?

Influenza A (h2N1), formerly known as “swine flu”, is an extremely infectious acute respiratory disease of pigs caused by one of several swine influenza A viruses. Typically, it is characterized by high morbidity and low mortality (1-4%). The virus spreads among pigs by airborne droplets, through direct and indirect contact and by carrier pigs that do not show symptoms of the disease.Outbreaks occur in pigs all year round, and in temperate climates are most common in autumn and winter. In many countries, pig populations are routinely vaccinated against swine flu.

Most commonly, swine influenza viruses belong to the h2N1 subtype, but other subtypes (such as h2N2, h4N1 and h4N2) circulate among pigs. In addition to swine flu viruses, pigs can also be infected with avian influenza viruses and seasonal human influenza viruses.The h4N2 porcine virus is thought to have been introduced into swine populations by humans. Sometimes pigs can be infected with more than one virus at the same time, which allows the genes of these viruses to mix. This can lead to the emergence of an influenza virus containing genes from different sources – the so-called “reassortant” virus. Although swine flu viruses are usually species-specific and only infect pigs, they sometimes cross the species barrier and cause disease in humans.

What are its consequences for human health?

From time to time, there are reports of outbreaks and isolated cases of human infection with influenza A (h2N1). Typically, its clinical symptoms are similar to those of seasonal flu, but the reported clinical picture varies widely, from asymptomatic infection to severe fatal pneumonia.

Because the typical clinical picture of influenza A (h2N1) infection in humans is similar to seasonal influenza and other acute upper respiratory tract infections, most cases are detected incidentally as part of seasonal influenza surveillance.Mild and asymptomatic cases may go undetected; therefore, the real extent of the prevalence of this disease in humans is unknown.

Where did the human cases occur?

Since the IHR (2005) 1 became applicable in 2007, WHO has received notifications of influenza A (h2N1) cases from the United States of America and Spain.

How do people get infected?

Humans usually contract influenza A (h2N1) from infected pigs, but in some cases, people have had no previous contact with pigs or the environment where the pigs were.In some cases, human-to-human transmission has occurred, but it has been limited to individuals and groups of people who have had close contact with sick people.

Is it safe to eat pork and pork products?

Yes. There is no evidence of transmission of influenza A (h2N1) to humans through the consumption of properly processed and cooked pork (pig) or pork offal. The virus is killed during cooking at 70 ° C (160 ° F), following the general guidelines for pork and other meats.

In which countries have outbreaks occurred in pigs?

Swine influenza is not subject to notification to international animal health authorities (OIE – International Bureau of Epizootics, www.oie.int), so the extent of its international spread among animals is not well known. The disease is considered endemic in the United States of America. Outbreaks in pigs are also known to have occurred in North America, South America, Europe (including the United Kingdom of Great Britain and Northern Ireland, Sweden and Italy), Africa (Kenya) and parts of East Asia including China and Japan.

What is the risk of a pandemic?

In all likelihood, most people, especially those who do not have regular contact with pigs, do not have an immunity to swine flu viruses that can prevent viral infection. If effective human-to-human transmission of influenza A (h2N1) virus is established, an influenza pandemic could occur. The consequences of a pandemic caused by such a virus are difficult to predict: it depends on the virulence of the virus, existing immunity in humans, cross-immunity from antibodies acquired as a result of seasonal influenza infection, and body factors.

Is there a vaccine to protect people against influenza A (h2N1)?

There are no vaccines containing the current influenza A (h2N1) virus that causes human disease. It is not known if current human seasonal influenza vaccines provide any protection. Influenza viruses change very quickly. To ensure maximum protection for humans, it is important to develop a vaccine against the currently circulating strain of the virus. Therefore, WHO needs access to as many viruses as possible – this will allow choosing the most suitable virus for the vaccine.

What medicines are available for treatment?

In some countries, antiviral medicines for seasonal flu are available that are effective in preventing and treating illness. There are two classes of such drugs: 1) adamantanes (amantadine and rimantadine) and 2) influenza neuraminidase inhibitors (oseltamivir and zanamivir).

Most of the patients with previously reported cases of influenza A (h2N1) have completely recovered from the disease without any medical care or antiviral drugs.

Some influenza viruses develop resistance to antiviral drugs, which limits the effectiveness of chemoprophylaxis and treatment. Viruses from patients in recent cases of swine flu in the United States of America have been shown to be susceptible to oseltamivir and zanamivir, but resistant to amantadine and rimantadine.

There is insufficient information available to recommend the use of antiviral drugs for the prevention and treatment of influenza A (h2N1) viral infection.Clinicians must make decisions based on clinical and epidemiological judgment and on the harms and benefits of preventing / treating the patient. For the current influenza A (h2N1) outbreak in the United States of America and Mexico, national and local health authorities recommend the use of oseltamivir and zanamivir for the treatment and prevention of disease based on the sensitivity of the virus.

What should those who have regular contact with pigs do?

While there is no clear evidence that current human cases of swine flu are associated with recent or ongoing swine flu-like illness in pigs, it is advisable to minimize contact with sick pigs and report these animals to the appropriate animal health authority.

Most people are infected through long-term close contact with infected pigs. To prevent exposure to pathogens, good hygiene must be maintained at all contact with animals and especially during slaughter and subsequent handling. Sick animals or animals that have died from the disease should not undergo primary processing. The recommendations of the relevant national authorities should be followed.

There is no evidence that influenza A (h2N1) is transmitted to humans through the consumption of properly processed and cooked pork (pig) or pork offal.The influenza virus is killed by cooking at 70 ° C (160 ° F), according to the general guidelines for the preparation of pork and other meats.

How to protect yourself from getting influenza A (h2N1) from infected people?

In the past, people who were infected with swine flu were usually mild, but could lead to severe pneumonia. However, current outbreaks in the United States of America and Mexico have different clinical presentations.None of the confirmed cases in the United States of America had severe illness, and patients recovered without any medical attention. In Mexico, some patients reportedly had severe illness.

Take general preventive measures against influenza to protect yourself:

  • Avoid close contact with people who seem unhealthy and who have a fever and cough.
  • Wash your hands frequently and thoroughly with soap and water.
  • Live healthy lives, including getting enough sleep, eating nutritious foods, and staying physically active.

If there is a sick person in the house:

  • Try to give the sick person a separate room in the house. If this is not possible, ensure that the patient is at least one meter away from other people.
  • Cover your mouth and nose when caring for a sick person. You can buy masks that are commercially available, or make them from scrap materials, provided they are disposed of or washed properly.
  • Wash hands thoroughly with soap and water after every contact with a sick person.
  • Try to improve the supply of fresh air to the patient. In fresh wind, open doors and windows.
  • Keep the room clean using available household detergents and cleaning agents.

If you live in a country where people have influenza A (h2N1), follow additional advice from your national and local health authorities.

What if I think I have influenza A (h2N1)?

If you feel unwell, have a fever, cough and / or sore throat:

  • Stay home and, if possible, avoid going to work, school, or crowded places.
  • Rest and drink plenty of fluids.
  • Cover your mouth and nose with disposable handkerchiefs when coughing or sneezing and dispose of them properly.
  • Wash your hands thoroughly and often with soap and water, especially after coughing and sneezing.
  • Inform family and friends about your illness and ask them for help with household chores that require contact with others, such as shopping.

If you need medical attention:

  • Contact your doctor or healthcare provider before visiting and report your symptoms.
  • Explain why you think you have swine flu (for example, if you have recently traveled to a country where there is an outbreak of swine flu in humans). Follow the advice given to you.
  • If it is not possible to contact your healthcare provider in advance, please report your suspected swine flu as soon as you arrive at the healthcare facility.
  • Be sure to cover your nose and mouth with something while driving.

90,000 Swine flu virus identified as threat of new pandemic

Honglei Sun et al./ Proceedings of the National Academy of Sciences, 2020

Since 2016, domestic pigs in China have been dominated by the influenza virus, the genome of which combines traits of the h2N1 swine flu virus strains that caused the 2009 pandemic and the North American reassortant (combining genes of several virus varieties) strain, reported in Proceedings of the National Academy of Sciences .Laboratory studies have shown that it very easily colonizes the epithelial cells of the human respiratory tract, and more than 10 percent of pig farm workers have antibodies to it. All this indicates that a new swine flu virus (its strain is called G4 EA h2N1) may cause a new pandemic.

In 2009–2010, there was an influenza pandemic caused by the A / h2N1 virus, h2N1pdm2009 strain. The first cases of the disease were recorded in the United States and Mexico in April 2009, and then within a few months the infection spread throughout the world.The US Centers for Disease Control and Prevention estimates that 151,700-575,400 people died in the first year of the virus’s circulation.

A / h2N1 turned out to be especially infectious and dangerous, since it appeared as a result of reassortment – the mixing of the genetic material of several viruses. A / h2N1 is a cross between influenza viruses that infect pigs (hence the name swine flu), birds and humans. When this happens, a new virus often gains the ability to infect species that were previously immune to it.Therefore, it is worth studying what viruses infect animals with which a person is often in contact – agricultural, domestic pets, those who often become prey of hunters, and so on. It is their pathogens that are most likely to become human due to reassortment.

Therefore, researchers from several scientific institutions in China, led by Jinhua Liu from the China Agricultural University, checked which influenza viruses circulated among pigs on Chinese farms in the 10 most “pig” provinces in 2011-2018, and determined how it changed from their occurrence over the years.To do this, scientists took nasal swabs from animals killed for meat (29918 samples), and also made a homogenate from the lungs of pigs with pronounced signs of respiratory infection (1016 samples). Viruses were detected by polymerase chain reaction: they looked primarily at the genes of hemagglutinins (H in the name of the influenza virus) and neuraminidases (N in the name of the influenza virus). Their sequences were compared with those already known for other strains.

The genome of one of the 179 found virus varieties, the closest in the structure of the H and N genes to the h2N1pdm2009 strain, was sequenced in full.On cultures of human tracheal epithelium cells, it was tested how easily it binds to various versions of the sialoglycoprotein SAα2,6Gal, one of the key molecules for infection with influenza viruses. In addition, the authors analyzed data from immunological tests of 338 workers from 15 pig farms, during which in 2016–2018 the presence of antibodies to certain strains of influenza viruses was detected. They were compared with the results of similar tests of 230 people not involved in animal husbandry.

It turned out that in 2016, a new strain of the h2N1 influenza virus began to spread rapidly among Chinese pigs, which the authors called G4 EA h2N1, and since then it has been the most common.Apparently, G4 EA h2N1 appeared as a result of reassortment of the Eurasian and American A / h2N1 strains. In experiments with cell cultures, it preferentially binds to the “human” version of the sialoglycoprotein SAα2,6Gal. An additional series of experiments on ferrets (these animals are very often used to evaluate vaccines and drugs against influenza) showed that G4 EA h2N1 is easily transmitted from one animal to another.

In workers of pig farms, antibodies to the virus were detected in 10.4 percent of cases, in people not related to agriculture, in 4.4 percent of cases.The effect persisted after taking into account the possible cross-reactivity with h2N1pdm2009 (that is, the variant when antibodies were to the strain that caused the pandemic in 2009, and not to the new virus). All this (closeness to humans, a large proportion of people with antibodies to the strain, the ease of its binding to the desired glycoprotein and transmission from one individual to another) indicates that G4 EA h2N1 may cause a new pandemic in the coming years. Therefore, the authors point out the need to begin as soon as possible periodic screening of workers in pig farms, as well as the pigs themselves, for infections associated with influenza viruses.

In 2016, American scientists found that the severity of the flu caused by a particular strain of the virus can be estimated by the patient’s year of birth. It depends on what types of the virus a person encountered in childhood, and such information can be obtained by knowing their prevalence in a particular season. Influenza viruses within the same group have similar glycoproteins for neuraminidases, and if the immune system has once encountered neuraminidases of a particular group, it will most likely be easier to fight off viruses with glycoproteins from the same group.

Svetlana Yastrebova

90,000 Swine flu diagnostics (A / h2N1 influenza virus RNA)! – News – About us

RNA of influenza A / h2N1 virus (swine flu)

Service code: 13.30.A2.900

Biomaterial: oropharyngeal swab, nasopharyngeal swab.

Preparation of the patient: on an empty stomach, or 2 hours after a meal, do not use antiseptic and antiviral substances for mucous membranes (ointments, irrigation, sprays, drops) within 12 hours before the study.

Influenza A (h2N1), called “swine flu”, synonymous with California strain, A / H1N1 / CA / 2009 is an acute respiratory infection. The first massive outbreak of influenza A / h2N1 infection was in 2009.

Signs of swine flu are similar to the usual manifestations of influenza infection with any strain of the virus: fever, discomfort, cough, headache, muscle and joint pain, possible sore throat and runny nose, rarely nausea and upset stools.

Most people get mild to moderate swine flu A (h2N1) and recover completely without specific treatment, but they can be a source of swine flu infection to others. Pregnant women, young children, and anyone of any age with chronic pulmonary or other medical conditions are at risk of more complex or severe disease. Severe cases are attributed to viral pneumonia, which is more difficult to treat than the bacterial pneumonia usually associated with seasonal flu.

Analysis for the detection of RNA of the type A (h2N1) swine influenza virus allows timely diagnosis of an infection provoked by this virus strain and prevents the development of complications.

PCR testing for the presence of swine influenza virus in patients with mild to moderate disease helps to take measures to reduce the spread of the virus.

To take an analysis for the detection of RNA of the influenza A / h2N1 (swine flu) virus, you can order a nurse call at home.

Take general preventive measures against influenza to protect yourself:

  • Avoid close contact with people who seem unhealthy and have fever and cough

  • Wash your hands frequently and thoroughly with soap and water.

  • Lead a healthy lifestyle, including getting enough sleep, eating well, and staying physically active.

If there is a sick person in the house:

  • Try to give the sick person a separate room in the house. If this is not possible, ensure that the patient is at least one meter away from other people.

  • Cover your mouth and nose when caring for a sick person.You can buy masks that are commercially available, or make them from scrap materials, subject to their subsequent disposal or proper washing (masks must be changed every 2 hours).

  • Wash your hands thoroughly with soap and water after every contact with a sick person.

  • Try to improve the supply of fresh air to the patient. Ventilate regularly.

  • Keep the room clean using available household detergents and cleaning agents.

You can find out more information by calling 8 (800) 700-60-40 (call within Russia is free).

90,000 Important Facts About Swine Flu – Questions and Answers

Swine Flu What is Swine Flu?

Swine flu is a swine respiratory disease caused by the influenza A virus and occasionally provoking outbreaks in animals. Swine influenza viruses cause high morbidity, with reasonably low mortality, in pigs.They can spread among animals throughout the year, but more often outbreaks occur in late autumn and winter, similar to epidemics in humans. The classic swine flu virus (H1M1 influenza A virus) was first detected in a pig in 1930.


Can a person get swine flu?

Swine flu viruses are not normally transmitted to humans. However, there have been isolated cases of human infection with swine flu. Most often, the infection took place among people who had direct contact with animals (for example, children who were near pigs in the market, or workers on pig farms).In addition, there have been cases of human-to-human transmission of swine flu. For example, an outbreak of swine flu in animals in Wisconsin in 1988 caused numerous human diseases, but it did not cause an epidemic in the general population. However, the transmission of the virus from the patient to doctors who had close contact with him was confirmed by the presence of antibodies.

What are the symptoms of swine flu in humans?

Human symptoms of swine flu are thought to be the same as those of regular seasonal flu, and include fever, lethargy, lack of appetite, and cough.Some swine flu patients have reported runny nose, sore throat, nausea, vomiting, and diarrhea.

Can I get swine flu from pork?

No. The swine flu virus is not transmitted through food. You cannot get this virus by eating pork products. Properly processed and cooked pork products are safe. Cooking pork at an internal temperature of 7 ° C will kill the swine flu virus as well as other germs and viruses.

How is swine flu transmitted?

Viruses of this disease can be transmitted directly from animals to humans and vice versa. People are most likely to become infected with swine flu when there is close contact with sick animals, for example, in a pig pen and at livestock shows for domestic pigs. Human-to-human transmission is also possible.

Presumably, the mode of infection is similar to the seasonal flu infection in humans, which is mainly carried out through coughing or sneezing of patients.A person can also become infected after touching an object on the surface of which there is respiratory secretions with the influenza virus, and then to their mouth or nose.

What medications are available to treat swine flu in humans?

According to WHO, there are four groups of antiviral drugs for the treatment of influenza: amantadine, rimantadine, oseltamivir and zanamivir. Although most swine influenza viruses are susceptible to all four drugs, recent WHO data suggest that the virus is resistant to amantadine and riman-tadine.

Swine flu in pigs How does swine flu spread among pigs?

Influenza viruses are believed to be transmitted through close contact between animals and, possibly, from infected objects that move between sick and uninfected pigs. Infected herds and herds vaccinated against influenza may experience occasional illness, moderate illness, or be asymptomatic.

What are the signs of swine flu in pigs?

Signs of swine flu in pigs include sudden onset of fever, depression, coughing (barking sounds), nasal and eye discharge, sneezing, difficulty breathing, eye redness or irritation, and refusal to eat.

Is there a vaccine for swine flu?

Vaccines are available to prevent swine influenza. But there are no vaccines to protect humans from swine flu.The seasonal flu vaccine is likely to help protect some of the H3N2 swine virus, but not H1N1.

A. OHANYAN, chief physician of Bagaevskiy region

90,000 BBC Russian – Worldwide

Epidemiologists are looking for ways to contain the spread of swine flu.

What is swine flu?

Swine flu is a respiratory illness caused by influenza type A, which usually affects pigs.

There are many varieties of this infection and it is constantly changing.

Until now, it has not passed to humans, but its last form has overcome the interspecies barrier and can spread from person to person, possibly by airborne droplets.

What’s new in this type of swine flu?

The World Health Organization (WHO) has confirmed that at least a few human cases have been caused by a h2N1 strain of influenza A, which is still unknown.

h2N1 is the same virus strain that causes regular seasonal outbreaks of influenza in humans.

However, the current variant of the h2N1 strain is different. It contains genetic material commonly found in viruses that infect humans, birds and pigs.

Influenza viruses are capable of exchanging genetic components. It seems that the new h2N1 variety appeared as a result of mixing different variants of viruses in the body of one animal, usually infecting representatives of different species.

Pigs are the ideal melting pot in which viruses can mix.

How dangerous is this disease?

Human symptoms of swine flu appear to be similar to those of normal flu.

These are, in particular, fever, cough, sore throat, aches, chills and fatigue.

Of all the registered cases of the disease in the world, the majority of those infected have a mild form.However, in Mexico, several people have died.

How seriously should you take swine flu?

When a new strain of virus appears that can be transmitted from person to person, experts are watching it very closely, as it could potentially cause a global epidemic or pandemic.

WHO warned that cases of the disease in Mexico and the United States could cause a global pandemic, and indicates that the situation is very serious.

However, according to experts, it is too early to draw conclusions.

The world is now closer to an influenza pandemic, they point out, than at any time since 1968. Therefore, after an emergency meeting on Monday, the threat from the disease was raised from three to four on a six-point scale.

No one knows what the consequences of the pandemic may be, but experts have warned of the possibility of the death of millions of people. The Spanish flu pandemic, or “Spanish flu”, which began in 1918 and was caused by the h2N1 virus strain, has claimed millions of lives.

The fact that the disease in those infected in the United States and in other countries has so far been mild is encouraging. It can be assumed that the severe course of the disease in Mexico may be caused by a specific geographic factor – possibly the presence of another virus in the population, which may not be present in other areas.

Another explanation may be the fact that people who fell ill in Mexico sought help at a later stage of the disease than those who fell ill in other countries.

It is also possible that the form of the virus found in Mexico is slightly different from that found elsewhere. But this can only be confirmed by laboratory analysis.

It is also hoped that because humans are often exposed to forms of the h2N1 virus during seasonal outbreaks of influenza, our immune systems can fight this infection more effectively.

However, it is very unusual that among those who died from the disease there are many young people.Influenza usually affects the elderly the most.

Can this virus be contained?

This virus, apparently, has already begun to spread around the world, and most experts believe that it is extremely difficult to stop its spread in an environment where people can travel freely around the world.

WHO officials argue that flight restrictions will not have the desired effect. Checking passengers arriving at airports, in their opinion, is also ineffective, since many infected people may not yet show symptoms.

Is swine flu treatable?

US authorities reported that two flu medications, Tamiflu and Relenza, appear to be effective in treatment. But you need to start using them at an early stage.

The use of these drugs reduces the likelihood of transmission of the virus from sick people to others.

The British government has already stockpiled large quantities of Tamiflu in case of a pandemic.

It is not yet clear how effective influenza vaccines will be in protecting against this new strain, as it is genetically different from other influenza strains.

American scientists are developing a completely new vaccine, but it will take time to develop and produce it in quantities that can meet the huge demand.

A vaccine was used in the United States in 1976 to protect humans against a type of swine flu.

However, she had serious side effects, including Guillain-Barré syndrome (in 500 cases). The vaccine has killed more people than the flu itself.

What to do to avoid getting sick?

People with flu symptoms who may have contracted the swine flu virus, such as those living in areas of Mexico experiencing an outbreak, should seek medical attention.

But the sick are asked not to go to the clinic in order to reduce the risk of the spread of the disease.They should stay at home and ask their doctor for advice over the phone.

After WHO raised the threat of swine flu, the British Foreign Office issued a recommendation not to travel to Mexico if it can be done without it.

What measures can be taken to avoid getting infected?

Avoid contact with people who look sick and who are coughing.

Generally accepted rules of behavior and hygiene can help reduce the spread of infection.So, you need to cover your mouth and nose when coughing and sneezing with a disposable napkin, which must then be thrown away.

It is also important to wash your hands with soap and water as often as possible and frequently wipe common items such as doorknobs and telephone handsets with a damp cloth.

Those caring for people with flu symptoms should cover their mouth and nose with a mask. In Britain, the authorities are planning to purchase more of these protective masks for health workers.

But experts say there is no scientific evidence that wearing masks for prevention protects against infection.

Can I eat pork?

Yes. There is no evidence that a person can get swine flu if they eat meat from an infected animal.

However, it is very important to cook the meat thoroughly. The virus dies at 70C (158F).

Avian influenza

The strain of avian influenza that has claimed dozens of lives in Southeast Asia in the past few years is different from the strain that caused the current outbreak of swine flu.

This is a new type of h2N1 strain, while avian influenza is caused by the H5N1 strain.

Experts believe H5N1 has the potential to cause a pandemic as it mutates rapidly.

However, until now, this disease remains mainly avian.

Without exception, all infected people have worked in close contact with birds, and cases of human-to-human transmission of the virus are extremely rare.There is no evidence that H5N1 has acquired the ability to pass easily from person to person.

Where can I get more information?

Information about swine flu and tips on how to protect yourself from it can be found on the websites of the world’s leading medical and research organizations.

90,000 “If you have not been abroad, there is no need to run to take the test”

Chief epidemiologist of Tatarstan on why quarantine measures are needed and how many patients the healthcare system is able to “digest”

In 2010, against the background of the swine flu epidemic in Tatarstan, a forecast was developed, according to which, within two months, 10% of the population in the republic should be infected.For this scenario, the necessary reserves of medicines and equipment were determined, and methodological instructions were prescribed. Today, as the chief freelance epidemiologist of the Republic of Tatarstan Dmitry Lopushov said in an interview with BUSINESS Online, this plan is again relevant. “For us, this is a very common and predictable situation. We know what to do and how to do it, ”he assures.

Dmitry Lopushov (center): “At the moment we are on the rise in the incidence rate, then there will be a stage of stabilization, and then a decline” Photo: minzdrav.tatarstan.ru


– Dmitry Vladimirovich, as of Sunday, five infected with the new coronavirus were identified in the republic. And, most likely, this will not end there. Indeed, in order for the coronavirus worldwide to infect the first hundred thousand people, it took three months. The second one took 12 days, and the third hundred took only three days. Is the health care system of Tatarstan ready for a new challenge?

– It should be noted that the new coronavirus SARS-CoV-2, which causes the disease called by the World Health Organization COVID-19, is a typical representative of the group of respiratory viral infections.And it, as an infectious disease, has all the patterns according to which the infection develops. At the moment we are on the rise in morbidity, then there will be a stage of stabilization, and then a recession.

Several cases of infection with the new coronavirus have now been identified in Tatarstan. All of them are imported. Now we are making every effort to prevent local spread, which will entail a significant increase in the number of infected. At the moment, isolation measures are being actively carried out in relation to citizens of the Republic of Tatarstan arriving from abroad, restrictive measures are being introduced for mass events.I cannot talk about any shortcomings in their implementation – they are carried out strictly in accordance with the current regulatory documents.

– Is the task now to prevent a sharp increase in infection?

– Yes, the protracted rise in the incidence of the population plays into our hands. When the number of infected gradually increases, say, for two or three months, then a small plateau of disease stabilization and then a decrease. In this case, the health care system can provide quality care to all patients in a relaxed manner.And if there is a sharp jump in the disease, the daily admission of hundreds and thousands of sick people to hospitals, it will be quite difficult to provide assistance to everyone in full. Now we see this in the example of Italy.

“There are two main hospitals in Tatarstan specialized in dealing with infectious diseases”
Photo: “BUSINESS Online”


– Currently, two hospitals have been identified for receiving patients with coronavirus in Kazan – RCIB and City Hospital No. 2.Together, this is approximately 440 beds. Are they enough?

– There are two main hospitals in Tatarstan specialized in dealing with infectious diseases – the RCIB in Kazan and the infectious diseases hospital in Naberezhnye Chelny, as well as infectious diseases departments in the central regional hospitals. But we must understand that now there is a traditional spring peak in the incidence of influenza, it has not yet been passed. Therefore, in order to facilitate the work of the main infectious diseases hospitals, we decided to re-profile the departments in other hospitals.

Note that the branch conversion plan is not extraordinary. In every region of Russia, including in Tatarstan, in case of an outbreak of any especially dangerous infectious disease, a so-called plan of sanitary protection of the territory and a plan for re-profiling bed capacity have long been prepared. It defines reserve hospitals that are fully equipped with all the necessary equipment and are on standby for four hours to transport “regular” patients to other hospitals and to deploy additional beds to receive critically ill patients.

– How much can the health care system of Tatarstan “digest” such seriously ill patients – 200, 300, 500, 1000?

– We can “digest” any quantity. The experience of both ours and China suggests that if there is equipment and medicines (and we have them in reserve in the required amount), then, in principle, patients can be treated in adapted premises of non-medical organizations, so-called observators, for example , to deploy beds in gymnasiums of schools, children’s camps, sanatoriums and dispensaries.

– But what about “ordinary” patients? Where will they be treated?

– It is clear that strokes and heart attacks, from which many more people die than from coronavirus, will not go anywhere. The same surgical pathology, the same appendicitis in any case will not disappear anywhere. Therefore, we, of course, will not redesign some of the hospitals, they will begin to provide assistance, work according to their own schedule and, perhaps, will take on the burden from those medical institutions that will be redesigned.

– Do I understand correctly that a plan is being implemented in Tatarstan, which was created long ago to respond to any dangerous infectious disease?

– A hypothetical scenario was developed in 2010 when we encountered swine flu, the so-called highly pathogenic influenza A / California / 4/2009. After analyzing the data on the development of the disease around the world, we made our prognosis for the development of a contagious (highly contagious) infection in Tatarstan. According to our forecast, the epidemic was supposed to last two months, and during this time the number of victims could be 10 percent of the population of the republic.For this scenario, an assessment of the readiness of medical organizations was carried out, the necessary reserves of medicines and equipment were determined, and methodological instructions were prescribed.

“We know that the coronavirus mainly affects the elderly or adults with chronic diseases”
Photo: Alexey Belkin


– Is the coronavirus less dangerous than the flu?

– The coronavirus is less contagious and has fewer complications.We know that the coronavirus mainly affects the elderly or adults with chronic diseases. Children rarely get sick. This is very encouraging, because the same flu in our country always begins with children whose bodies are not yet fully formed. This often leads to serious complications and death … This is not the case here.

– Why is there such a difference between the effect of coronavirus and influenza?

– Most likely, in some peculiarity of the structure of the virus. But there is not much reliable data, so it is rather difficult to answer this question …

– Children can become infected with the coronavirus, infect others with it, but the disease itself is asymptomatic?

– We do not yet have complete data on how much the child population is infected with the virus.We now have no facts of the illness of children, there are no suspicious cases either. Why? This is the puzzle we need to solve.

– But they say that children can infect adults. Some even advise to temporarily exclude communication between the elderly and grandchildren.

– The key word here is “they say.” Although it is not necessary to assert 100 percent, since the virus is being actively studied so far.

– So you don’t confirm this theory?

– There is currently no scientific evidence that children are carriers of the coronavirus.There is such a theory, some hypotheses exist, but at the moment they require confirmation. In the world and in the Russian Federation, isolated cases of the disease in children have been registered. Given that the virus is poorly understood, we are taking quarantine measures against all residents, without exception.

“Laboratory diagnostics should be carried out in the presence of clinical symptoms, certain epidemiological signs and as prescribed by a doctor.”
Photo: © Ilya Pitalev, RIA Novosti


– How many are in self-isolation in Tatarstan now?

– As of Friday, we have about 1.5 thousand people are on self-isolation at home.That is, these are those who arrived from foreign countries without symptoms.

– And those for which there are suspicions, symptoms of SARS?

– There are about 40 of them so far (data as of Friday). They are under medical supervision at the infectious diseases hospital. They were all tested for the presence of coronavirus. While the results are negative, they should still remain under observation for 14 days until the incubation period ends. These are the rules. After three negative tests and at the end of the 14-day quarantine, they will be discharged.

– How sensitive are the tests we use?

– These test systems are certified and approved for use, we tested them back in Tyumen, when the first imported case from Wuhan was registered. Also, these tests were tested on the Russians, who came from the Diamond Princess liner. We have no complaints about the test systems.

– How many tests have been delivered to Tatarstan now?

– I know about the uninterrupted supply of test systems at the request of the Kazan Center for Hygiene and Epidemiology.The laboratory runs smoothly. And I don’t know by the number …

– Is the testing directed by a doctor?

– Yes. This is a scientifically based, generally accepted position. Laboratory diagnostics should be carried out in the presence of clinical symptoms, certain epidemiological signs and as prescribed by a doctor. If you have not been abroad, there is no need to run to take the coronavirus test.

– Why not give people the opportunity to get tested for coronavirus and calm down?

– Now this issue is being worked out.There is information that tests will soon appear on a commercial basis in paid clinics … But here’s what I want to note. For some reason, no one has a desire to be tested for HIV, although it is also quite dangerous, to be tested for syphilis … We have atherosclerosis, strokes, heart attacks, which have a much higher mortality rate than coronavirus infection. And the main preventive measures are regular monitoring of the state of glucose, cholesterol … Why not go to a colonoscopy or pass an analysis for occult blood in the feces in order to recognize rectal cancer in time? This will be much more useful than thinking about the coronavirus, although he himself has not traveled anywhere.It is understandable when you are told from the TV every five minutes that here is another case, one more, one more, an element of panic arises, although it is not substantiated by anything.

– For people who go into quarantine, for voluntary self-isolation, how is the issue of buying food resolved? They still need to go outside …

– They can order via the Internet, the delivery of goods is well developed with us. There are no special questions here.

– Does anyone monitor whether this regime is being violated or not?

– A decree was issued to ensure control over persons who must comply with quarantine measures.

– How? Will there be someone assigned to everyone?

– Most likely, this will be entrusted to the police, who will periodically check the fact of finding the house. Either a health worker comes to the house, we inform Rospotrebnadzor, which already includes administrative measures – the imposition of penalties.

– How are the police and health workers protected from infection?

– We have repeatedly conducted exercises, including on especially dangerous infections, when quarantine measures are turned on, when the hospital is cordoned off by the police.Accordingly, the police are at risk. It is clear that she is also equipped with personal protective equipment. According to my information, there is such a reserve. The other day the resolution of the chief sanitary doctor of Russia №7 was issued. And there an instruction is given, including to the internal affairs bodies, to get involved in this work.

– The Governor of the Moscow Region proposed to close the shopping and entertainment centers. Is this also planned in Kazan?

– A complete ban has not yet been introduced. If the situation develops according to the worst-case scenario, the measures will certainly be toughened up, including restricting visits to shopping centers.

“Taking into account the fact that the virus has not yet been fully studied, the measures that are used are justified.”
Photo: Alexey Belkin

“There are no superfluous methods here”

– It is known that the risk group is 65 plus and people with chronic diseases. Maybe you shouldn’t introduce some tough measures that destroy the economy, but simply single out this category of risk and isolate it, and let the rest get sick and get immunity?

– Russia has tremendous experience in combating various infectious diseases, starting with plague, cholera, and so on.Let me remind you that in 1977 there was an outbreak of smallpox in Moscow. And it is thanks to systematic quarantine measures that we have prevented the spread of smallpox, which is much more infectious than coronavirus.

– Here’s a different story. We say that people under 60 practically endure it like a mild cold, like ARVI, but you have to really destroy the economy. Still, it closes: shops, travel companies, transport, business goes bankrupt … Treatment will be more devastating in its consequences than the disease itself.

– Given that the virus has not yet been fully understood, the measures that are used are justified. There are no unnecessary methods here, everything is done exactly in accordance with the development of the infectious process.

– It is known that the main complication from the disease COVID -19 is SARS. Patients require mechanical ventilation devices. Are there enough of them in Tatarstan?

– We have calculated equipment with ventilators.In addition, funds have now been allocated from the federal budget for the additional purchase of devices. They will arrive at the end of this – the beginning of next week.

“We always, from year to year, prepare for a meeting with viruses”
Photo: tatarstan.ru

– Can you give any recommendations on how to treat the symptoms?

– Firstly, a volumetric lavage of the nose, that is, this is an ordinary saline solution, which purely mechanically flushes dust particles with a virus from the upper nasal passages.Secondly, it is to actively use the same oxolinic ointments or Viferon ointment, which, purely mechanically, makes it difficult for the virus to enter the human body.

– What about antiviral drugs?

– There is no clearly proven effectiveness for them. There are a number of drugs that are approved for use on the recommendation of the Ministry of Health of the Russian Federation, but they are taken only after medical supervision under the supervision and prescription of a doctor.

– Do you think this new coronavirus will disappear like the SARS that hit the planet in 2002, or will it become as seasonal as the flu?

– Both options are possible.To understand, you need to wait for the onset of the autumn season. By then, I hope we will have a working vaccine against the new coronavirus. Let me emphasize that we are always, from year to year, preparing for a meeting with viruses. We have a list of so-called classic infections, the same plague and cholera. There is such a thing as an “unknown pathogen”, with which we are now dealing. For us, this is a very common and predictable situation. We know what to do and how to do it.

90,000 h2N1 Q&A

Letter of Rospotrebnadzor dated 21.05.09 No. 01 / 6981-9-23

What is h2N1 (swine flu)?

h2N1 (known as “swine flu”) is a new influenza virus that causes illness in humans. This new virus was first detected in humans in the United States in April 2009. Other countries, including Mexico and Canada, are also reporting human cases of the new virus. This virus spreads from one person to another, probably in much the same way as regular seasonal flu.

Why is the new h2N1 virus sometimes called “swine flu”?

This virus was originally called “swine flu” because laboratory tests showed that many of the pathogens of this new virus were very similar to the influenza viruses commonly seen in pigs in North America. However, further research has shown that the identified virus differs in many ways from the one that is spreading among North American pigs. It contains two genes for influenza viruses commonly found in pigs in Europe and Asia, as well as avian genes.Scientists call this virus a “quadruple reassortant”.

How did the novel h2N1 influenza spread in humans in the United States?

The first confirmed human cases of h2N1 influenza in the United States were in Southern California and near Guadalupe County, Texas. Thereafter, the virus began to spread rapidly and infections are now being reported from an increasing number of states. The updated number of confirmed cases of h2N1 influenza infections in the United States is consistently reported on the Internet at http: // www.cdc.gov/h2n1flu/investigation.htm. The Centers for Disease Control and Prevention is working with local health and state agencies to study the situation.

Is this new h2N1 virus contagious?

Specialists at the Center for Disease Control have determined that the new h2N1 virus is contagious and is transmitted from one person to another. However, there is currently no information on how easily this virus spreads between people.

What are the main signs and symptoms of this virus in humans?

Symptoms of the new h2N1 flu virus are similar to those of seasonal flu. These include high fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and feeling tired.

Many of the infected patients also complained of diarrhea and vomiting. In addition, as with seasonal flu, serious and even fatal cases have been reported as a result of the disease caused by this virus.

How serious is the disease associated with the new h2N1 virus?

It is currently unknown how dangerous this virus will become to the general population. CDC staff are looking at the medical history of patients infected with the virus to determine if there are any groups of people who are at particular risk of infection, serious illness, or hospitalization associated with the virus. During seasonal flu, there are certain populations that are at greater risk of serious complications.Among them are people over the age of 65, children under five, pregnant women, as well as people of any age suffering from chronic diseases. It remains unclear at this time whether there are certain groups of people who are at serious risk of developing complications from contracting the new virus. The CDC also conducts laboratory tests to determine if people have natural immunity against this virus, depending on their age.

How is the new h2N1 virus transmitted?

The transmission of the new h2N1 virus is believed to be identical to the transmission of seasonal influenza.Influenza viruses are mainly spread from person to person when sick people cough or sneeze. Some people can get sick by touching objects that have influenza viruses and then touching their own mouth or nose.

How long does it take for this virus to pass from an infected person to other people?

The CDC currently believes this virus has the same spreading properties as seasonal influenza viruses.Seasonal influenza studies have shown that a person can be infected 1 day before symptoms appear and 7 days after the onset of illness. Children, especially young children, can be potential shedders of the virus for a longer period of time.

Can I get the new h2N1 virus if I eat or cook pork?

No. H2N1 viruses are not foodborne. Infection with the new HIN1 virus through pork or pork products is not possible.Properly processed and cooked pork is completely safe to eat.

Is there a risk of illness from drinking water?

Tap water treated with existing disinfection methods does not pose a particular risk of transmission of influenza viruses, while providing a high degree of protection against viruses. The susceptibility of the novel h2N1 influenza virus to accepted drinking water treatment processes has not been studied. However, recent research has shown that the level of free chlorine commonly used to treat drinking water is sufficient to inactivate the highly pathogenic H5N1 avian influenza.It is likely that other influenza viruses, such as new h2N1, will also be inactivated by chlorine treatment. To date, there are no documented cases of influenza caused by contaminated drinking water.

Can the novel h2N1 influenza virus spread through water in swimming pools, spas, water parks, fountains and other treated sources of bathing and swimming water?

Influenza viruses infect the upper respiratory tract of humans.There are no documented cases of waterborne influenza virus infection. The susceptibility of the h2N1 influenza virus to chlorine and other disinfectants used in swimming pools, spas, water parks, fountains and other treated sources of bathing and swimming water has not been studied. However, recent studies have shown that the free chlorine level recommended by the CDC (1-3 ppm [mg / L] for swimming pools and 2-5 ppm for spas) is sufficient to disinfect avian influenza A (H5N1).It is likely that other influenza viruses, such as the new h2N1, will also be disinfected with chlorine.

Can the h2N1 influenza virus be transmitted in places where bathing and swimming water accumulates outside of it?

Yes, the places where the water used for bathing and swimming is collected is no different from other public places. The transmission of the new h2N1 virus is believed to be identical to the transmission of seasonal flu. Influenza viruses are mainly spread from one person to another when sick people cough or sneeze.Some people get sick by first touching objects that have influenza viruses and then touching their own mouth or nose.

How can you protect yourself from infection?

The main and most effective means of preventing influenza is vaccination.

An influenza vaccine was used in the fall 2015 vaccination campaign, which includes the following strains:

– A / California / 7/2009 (h2N1) pdm09-like virus;

– A / Switzerland / 9715293/2013 (h4N2) -like virus;

– B / Phuket / 3073/2013-like virus

In addition, normal daily hygiene practices should be followed to prevent the spread of respiratory diseases such as influenza.

Use the following measures to protect your health:

• Cover your nose and mouth with a paper towel when you cough or sneeze. Dispose of the used tissue in the trash.

• Wash your hands thoroughly and often with soap and water, especially after coughing or sneezing. Alcohol-based hand cleaners are also effective.

• Do not touch your eyes, nose or mouth. The infection is transmitted in this way.

• Try to avoid close contact with sick people.

• If you are sick, stay at home for 7 days after symptoms are detected, or until symptoms appear within 24 hours, whichever lasts longer. This is to prevent infection of others and the further spread of the virus.

Other important measures you can take include:

• Follow health facility guidelines for school closures, crowding out, and other flu containment measures.

• Be prepared to stay home for about a week if you suddenly get sick; some stock of over-the-counter medicines, alcohol-based hand rub, tissues, and other related items may come in handy to help eliminate the need to go out in public while you are sick and sick

carrier of infection.

What is the best way to keep the virus from spreading through a cough or sneeze?

If you are sick, limit contact with other people as much as possible.If you get sick, stay at home for 7 days after showing symptoms or until symptoms appear within 24 hours, whichever lasts longer. Cover your mouth and nose with a paper towel when you cough or sneeze. Throw away used tissues in the trash can. After that, wash your hands, do this after every coughing or sneezing attack.

What is the best way to wash your hands to avoid getting the flu?

Frequent hand washing will protect you from germs.Use soap or an alcohol-based hand cleaner to wash your hands. It is recommended to wash your hands – with soap and warm water – for at least 15-20 seconds. If soap and water are not available, disposable wipes soaked in alcohol-based hand rub or sanitizing gels can be used. They can be found in most supermarkets and pharmacies. When using the gel, rub it into your hands until it dries completely. The gel does not require water to work; the alcohol it contains will kill germs on your hands.

What if you are sick?

If you have symptoms of an influenza-like illness, including fever, body aches, runny or stuffy nose, sore throat, nausea, vomiting, or diarrhea after returning from (or contact with someone with h2N1 influenza) influenza-affected countries , stay at home and avoid contact with other people, except when it is necessary to seek medical attention. If you are seriously ill or especially at risk of developing complications from the flu, contact your healthcare provider or seek medical attention.The health care provider will determine if flu tests are needed or if treatment should be started right away.

If you are sick and have any of the following signs that your condition is getting worse, call your doctor right away.

In children, among similar signs, in the presence of which urgent medical attention is required, the following may be:

• Rapid or labored breathing

• Cyanosis of the skin

• Refusal to drink enough

• Severe or persistent vomiting

• Non-awakening or no reaction

• So excited that the child resists being picked up

• Some relief of flu symptoms that then returned with fever and increased cough

In adults, among the signs in the presence of which urgent

medical assistance can be as follows:

• Difficulty breathing or shortness of breath

• Pain or pressure in the chest or abdomen

• Sudden dizziness

• Confusion of consciousness

• Severe or persistent vomiting

• Some relief of flu symptoms that then returned with fever and increased cough

Are there medications available to treat the new flu?

Yes.The CDC recommends the use of oseltamivir or zanamivir to treat and / or prevent infection with the new h2N1 influenza virus. Antiviral drugs are prescription drugs (tablets, solutions, or inhalers) that are used to treat the flu and prevent viruses from multiplying in your body. If you get sick, antiviral medications can help mitigate the progression of the disease and help you feel better faster. They can also prevent serious complications from the flu.During the current epidemic, the priority is the use of influenza antiviral drugs to treat serious influenza.

How long does the influenza virus remain active on objects (eg books and doorknobs)?

Studies have shown that the influenza virus is able to survive on surrounding objects with the possibility of human infection within 2-8 hours from the moment it hits the surface.

What causes the flu virus to die?

The influenza virus is destroyed by high temperatures (75-100 ° C).In addition, some chemical germicidal agents, including chlorine, hydrogen peroxide, detergents (soap), iodophores (iodine-based antiseptics), and alcohol solutions are effective against human influenza viruses when used in the appropriate concentration for a sufficient period of time. For example, rubbing alcohol and gels can be used to treat hands. Gels must be rubbed into hands until completely dry.

Which surfaces are more likely to be sources of contamination?

The spread of viruses is possible when a person touches the objects on which they are located, and then their eyes, nose or mouth.Viruses are transmitted through the air when sneezing or coughing in the saliva of an infected person.

How should household waste be handled to prevent the spread of the influenza virus?

To prevent the spread of the influenza virus, it is recommended to discard tissues and other disposable items used by an infected person in the trash bin.

After using the wipes, wash your hands with soap and water.

How to clean the house to prevent the spread of the flu virus?

To prevent the spread of the influenza virus, it is important to keep surfaces (especially bedside tables, bathrooms, kitchens and children’s toys) clean by wiping with household disinfectants according to label instructions.

How should we handle linen, cutlery and utensils used by people infected with the influenza virus?

It is not necessary to wash the linen and to wash the cutlery and dishes belonging to the patient separately, but it is important to remember that these items cannot be used by others without careful preliminary treatment. Laundry (such as sheets and towels) should be washed using regular laundry soap and dried in a hot dryer. You should not carry dirty laundry “in an armful” to the place of washing in order to prevent your own infection.After carrying dirty laundry, wash your hands with soap or rub with an alcohol-based hand cleaner. Feedback & Research

What epidemiological studies are conducted in response to

the current flu outbreak?

The daily monitoring of the epidemic situation in the world for h2N1 influenza is carried out. The airports carry out control (with thermometry) over the state of health of citizens entering Russia from countries unfavorable for h2N1 influenza.