Project on H1N1
>> Tuesday, December 8, 2009
PROJECT I.T 2009-2010 PREPARED BY, JISNA MARY DEEPTHI.H.S.THALORE 2009-2010 SWINE FLU Through gods own country EPIDEMIC MORTALITY IN INDIA IT PROJECT 2009-2010 PREPARED BY, JISNA MARY STD:X.D, DEEPTHI.H.S.THALORE 2009-2010 DECLARATION I, guide of this project here by certify that all the steps taken during this project-its planning, hypothesis and execution are within my knowledge and the member of this project has worked so hard to achieve the goal. Name of the Guide: MOLY .K.D Signature: Address: H.S.A.BIOLOGY, DEEPTHI.H.S.THALORE Date: 19.11.2009 Place: Thrissur PUBLICATION DETAILS PROJECT INFORMATION TECHNOLOGY DEEPTHI.H.S.THALORE, THRISSUR 2009-2010 TYPE SETTING BY: DEEPTHI.H.S.THALORE IT LAB INDEX ACKNOWLEDGEMENT First of all I would like to thank my school authorities, especially our Headmaster Sri.C.D.Joseph Master who was very kind to provide the computer and printing facilities for me to do this project. Secondly I would like to thank my teacher, Smt.Moly.K.D for helping me to select this topic, in collecting information and also in every chores of my project. My computer teachers Sri.Philip.P.K and Sri.Babu Davis were indeed very co-operative and helpful for the complete success of this project. My friends – they were my strength to complete all the works within a very short period in spite of all the exams and other activities. I thank Smt.Beena Poulose who was a great help for me to do this project. Above all I thank the almighty God for providing such a good and rarest of the opportunities to me and that he could lead me through the best paths throughout the course of this project. INTRODUCTION Pandemics are rare events that occur every 10 to 50 years. They have been documented since the 16th century and in the last 400 years , at least 31 pandemics have been recorded. During the twentieth century, three influenza pandemics occurred. Influenza (Flu) pandemics are caused by new influenza viruses that have recently adapted to humans and resemble major natural disasters both in terms of recurrence and magnitude. The influenza virus, known to be circulating as pathogen in the human population since at least 16th century is notable for its unique ability to cause recurrent epidemics and global pandemics. Genetic re-assortments in the influenza virus cause fast and unpredictable antigenic changes in important immune targets leading to recurrent epidemics of febrile respiratory disease every 1 to 3 years, consistency necessitated the development of new vaccines. Each century has seen some pandemics rapidly progressing to all parts of the world due to the emergence of a novel virus to which the overall population holds no immunity. Swine influenza (A H1N1) or (Swine flue) is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of influenza in pigs. Swine flu viruses cause high levels of illness and low death rates in pigs. Swine influenza viruses usually circulate among swine throughout the year, but most outbreaks occur during the late fall and winter months similar to outbreaks in humans. The classical swine flu virus (an influenza type A H1N1 virus) was first isolated from a pig in 1930. H3N2 influenza viruses began circulating among pigs from 1998. The H3N2 viruses initially were introduced into the pig population from humans. Influenza A viruses are divided into subtypes based on two glycoprotein (haemagglutinin and neuraminidase antigens) present on the surface of the virus. Influenza A virus has been associated with most of the widespread epidemics and all the pandemics of the past. OBJECTIVES HYPOTHESIS PLANNING I first planned to do the project on the topic Swine Influenza. I decided to collect information about A H1N1 and related Topics from different medias like newspapers, televisions, computer, Internet, encyclopedias, Various action plans etc. I tried to refer different Books related to science, computer science, history etc. I planned to collect as much information from some health centers, nearby doctors, elders, neighbors, patients etc. I decided to seek for help from our science teachers, mathematics teachers, social science teachers, computer science teachers and other educated personalities. I also consulted with a few of the famous doctors and also approached help from health centers. TOOLS USED FOR DATA COLLECTION DATA COLLECTION SYMPTOMS The symptoms of Swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza like fever, lethargy, lack of appetite and cough. Some people have also reported runny nose, sire throat, nausea, vomiting and diarrhea. CATEGORISATION OF SYMPTOMS Category A Category B Category C In addition to the above signs and symptoms of Category A and Category B, if the patient has one or more of the following: All these patients mentioned above in Category C require testing, immediate hospitalization and treatment. DIAGNOSIS Though latest studies have found our effective vaccines for various epidemics. The currently available information suggests that seasonal influenza vaccine is found not effective against the re-assorted virus. It takes about six months to manufacture a vaccine against a novel virus. Hence, a vaccine may not be available during the first wave of the pandemic. For diagnosis of Swine influenza A infection, respiratory specimen would generally need to be collected within the first 4 to 5 days of illness ( when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 10 days or longer. Sample Collection & Laboratory Diagnosis CURRENT SITUATION Through global scenario As on 29 April 2009, nine countries have officially reported 148 confirmed cases of swine influenza A/H1N1 infection. Of these, Unites States has reported 91 laboratory confirmed human cases, including one death. Mexico has reported 26 confirmed human cases including seven deaths. The following countries have reported laboratory confirmed cases with no deaths – Australia (1), Canada (13), Germany (5), Israel (2), New Zealand (3), Spain (4) and the United Kingdom (5). All these cases have the history of travel of Mexico. CURRENT WHO PHASE OF PANDEMIC ALERT In the 2009 revision of the phase descriptions, WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans. The grouping and description of pandemic phases have been revised to make them easier to understand, more precise, and based upon observable phenomena. Phases 1–3 correlate with preparedness, including capacity development and response planning activities, while Phases 4–6 clearly signal the need for response and mitigation efforts. Furthermore, periods after the first pandemic wave are elaborated to facilitate post pandemic recovery activities. The current WHO phase of pandemic alert is 6. In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans. In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat. In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic. 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." The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion. Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short. Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way. During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave. Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate "at-ease" signal may be premature. In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required. SITUATION IN INDIA India's swine flu toll touches 550+ (2009-11-20) Nine swine flu deaths, including five in Rajasthan, were reported Thursday, taking the toll in India to 550+, health authorities said. Delhi recorded its highest number of cases on a single day with 176 people testing positive for the virus. Also, a record 252 new cases were reported in the country, taking the total number of people affected with the contagious virus to 18,872. With the new five deaths, the toll in Rajasthan has now touched 54. Two cases were also reported from Maharashtra, taking the total toll in the state, which reported the country's first death due to the flu in Aug 3, to 228. One death each was reported from Punjab and Uttarakhand. In the national capital, with 176 new cases the total number of people affected in Delhi has gone up to 5,417 - the highest in the country. So far, Delhi has reported 25 swine flu deaths. New cases were also reported from Haryana (34), Maharashtra (21), Uttar Pradesh (21), Rajasthan (14) and Tamil Nadu (12). AH1N1 IN MY DISTRICT – THRISSUR CMO is responsible for all health sector actions in the district. This includes essential components of the operation plan namely surveillance, early detection, containment operations (If recommended), hospital capacity, risk communication and maintaining health services during the period of the pandemic. The following information is collected as a part of data collection from DMO, Thrissur. ANALYSIS We collected information from DMO office (IDSP) Thrissur and surveyed 10 positive cases and also interviewed 4 doctors and 3 health inspectors and later we analysed the informations that we collected. Analysation based on interview: CHIKKUNGUNIA DENGUE FEVER SWINE FLU CARRIERS Mosquitoes Aedes egypti Influenza type A virus Main cause Of the Disease Virus Virus Spread through Animals Symptoms Fever Severe body pain Inflammations on the surface of the skin, joint pain, red colour in the eye, headache, vomiting Fever, body pain (especially on the muscles of legs), inflammation on the surface of the skin, red eye, headache, vomiting Fever, lethargy, body pain, lack of appetite, cough, runny nose, vomiting, diarrhea, respiratory infections Treatment Treatment according to the symptoms, antibodies, drips Treatment according to the symptoms, antibodies, platelet transfusion Oseltamivir Preventive Measures Prevention of mosquito breeding, don't allow the stale water in the surroundings, fogging, usage of nets, anti mosquito provisions. Prevention of mosquito breeding, don't allow the stale water in the surroundings, fogging, usage of nets 1) Avoid close contact with the infected. 2) Cover mouth with a mask 3) Wash hands regularly with soap 4) Use handkerchief NOTE: VARYING SYMPTOMS….D THE SYMPTOMS OF THIS DISEASE MAY NOT BE PERMANENT, SYMPTOMS ARE CHANGING DAY-BY-DAY, PERSON BY PERSON. NEW SYMPTOMS HAVE BEEN RECORDED! THE REASON IS THAT THE VIRUSES HAD UNDERGONE GENETIC CHANGES. Name Change The WHO has now changed the official name of the pandemic virus from Influenza A(H1N1) to Pandemic (H1N1) 2009.(information from:www.cdc.gov.org) SUGGESTIONS Let's wipe out Swine flu Here are some effective methods that can be used to wipe out Swine flu disease from our state. These details are collected from doctors PREVENTIVE MEASURES There is currently no vaccine available against human swine influenza; because the count of H and N may vary according to favourable situations. Ie; if the count of H is 16, then the count of N may be 12, if H is 1, N may vary from 1 to 12,..etc and so on. So it is very difficult to find out a vaccine against all the varying count of H and N. One has to follow proper hand hygiene and respiratory etiquettes. Do's and Don'ts:
Patients with mild fever plus cough / sore throat with or without body ache, headache, diarrhea and vomiting will be categorized as Category A. They do not require Oseltamivir and should be treated for the symptoms mentioned above. The patients should be monitored for their progress and reassessed at 24 to 48 hours by the doctor.
In addition to all the signs and symptoms mentioned under Category A, if the patient has high grade fever and severe sore throat, may require home isolation and Oseltamivir;
Children with mild illness but with predisposing risk factors.
Breathlessness, chest pain, drowsiness, fall in blood pressure, sputum mixed with blood, bluish discolouration of nails;
- Sick persons should keep distance from others for more than 5 days.
- If possible, stay at home, away from the work, school, and public places when you are sick.
- Cover you mouth and nose with a tissue or handkerchief when coughing or sneezing.
- If you have no tissue or handkerchief, you should not clean the nose with the hands but with the cut of your shirt or clothes.
- Washing your hands often with soap or alcohol based hand wash will help you protect from germs.
- Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids and eat nutritious food.
- Persons who develop influenza-like-illness(ILI) (fever with either cough or sore throat) should be strongly encouraged to self- isolate in their home for 7 days after the onset of illness or at least 24 hours after symptoms have resolved, whichever is longer.
Persons who experience ILI and wish to seek medical care should contact their health care providers to report illness (By telephone or other remote means) before seeking care at a clinic, physician's office, or hospital.
- Persons who have difficulty breathing or shortness or breath should seek immediate medical attention and report to the nearby hospital.
If ill persons must go into the community (e.g., to seek medical care) they should wear a face mask to reduce the risk of spreading the virus in the community.
If a face mask in unavailable, ill persons needing to go into the community should use a handkerchief or tissues to cover any coughing and sneezing.
Persons in the home isolation and their household members should be given infection control instructions like frequent hand washing with soap water, use of alcohol-based hand gels (containing at least 60% alcohol).
- When the ill person is within 6 feet of others at home, the ill person should wear a face mask, if available or handkerchief or tissues.
House hold contacts who are well should:-
- Remain home at the earliest sign of illness;
- Minimize contact in the community to the extent possible;
- Designate a single household family member as the ill person's caregiver to minimize interactions with asymptomatic persons.
Precautions for school children:-
- Schools with a confirmed or a suspected cause should be considered for closure.
- All school or childcare related gatherings should be cancelled and encourage parents and students to avoid congregating outside of the school.
- Schools and childcare facilities should bear students for a time period should be evaluated on an ongoing basis depending upon epidermal findings.
- Schools and childcare facilities should consult with their local or state health departments for guidance on reopening. If no additional confirmed or suspected cases are identified among students (or school-based personnel) for a period of 7 days, schools may consider opening.
- Schools and childcare facilities in unaffected areas should begin to prepare for the possibility of school or childcare facility closure.
Social Distancing Interventions:
- Large gatherings linked to settings or institutions with laboratory-confirmed cases should be cancelled, for example a school event linked to a school with cases, other large gatherings in the community may not need to be cancelled at this time.
- Additional social distancing measures are currently not recommended.
- Persons with underlying medical conditions who are high risk for complications of influenza may wish to consider avoiding large gatherings.
OPERATING PROCEEDERS FROM THE NATIONAL LEVEL TO DISTRICT LEVEL
India affected: Operational frame work for response.
Central Government:
The NDMA and NCMC would review the situation and give directions for the line ministries to role out the action plan. The Emergency Support Functions (ESF) plan the ministry of health and family welfare would be activated. MOHFW (Ministry of Health and Family Welfare) would provide the updated guidelines to the states.
The State Government:
The chief minister would convene a meeting of the state disaster management authority to review the response for the pandemic in health sector and sectors other than health. The action plan would be reviewed, gaps identified and filled. If the disease gets widespread, then mitigation measures including social distancing measures would be enforced. IEC campaign would focus on simple public health measures to prevent the disease. (Hand washing, cough etiquettes, staying away at least arms length from an affected person) and a flu wise campaign (report to authorities about illness and seek treatment)
District Administration:
District collector will hold meeting(s) in their respective districts with SP, CMO, Revenue, PWD, Forest, Education and Panchayati raj/local self governance departments where the district action would be reviewed and activated. The support required from the state government would be listed out.
Conclusion
From the above activities that I did during the various steps of this project-swine Flu Epidemic mortality in India, I was able to land at a perfect conclusion. The widely spread misunderstanding among the people that Swine Flue is spread through eating pork is absolutely wrong. The menace created by this disease could be controlled only by safety measures.
I found out that A H1N1 is the most dangerous compared to the other viral diseases spread in a state like Kerala. The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported 7 diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.
Recent studies have found out that there are new symptoms related to this disease due to the genetic change in the viruses.
Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
Frequent hand washing will help you reduce the chance of getting contamination from the common surfaces like cafeteria tables, Doorknobs and desks.
Currently available seasonal influenza vaccine does not protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.
Take these everyday steps to protect your health:
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially after you cough or sneeze.
- Alcohol based Hand cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs Spread this way.
- Try to avoid close contact with people having respiratory illness.
- If one gets sick with influenza, one must stay at home, away from work or school and limit contact with others to keep from infecting them. However, if one is having any respiratory distress, one should report to a nearby hospital.
Taking care in the cleanliness of our surroundings, and self precaution can control such a disease.
Let's hope that we can see a new dawn without swine Flue.
REFFERENCE
- Encyclopedia CD
- www.cdc.gov.org
APPENDIX
QUESTIONNAIRE FOR THE SURVEY
- Name:
- Age:
- Job:
- Address:
- What are the various symptoms that experienced?
- After how many days of symptoms, was the visit to the doctor?
- Were you admitted in the hospital? If yes, for how many days?
- What you think that how you got infected?
- U went to the checkup by your own will or by any body's guidance?
- What were the precautions that you took to keep others in your family not infected?
- Did you feel any problems when you had Tami flu?
- You had to be in ICU in any case?
- Do you have any difficulties related to this illness?
- From where, you seeked medical attention, from private hospital or from Govt. hospital?
QUESTIONAIRE
(TO INTERVIEW DOCTORS)
- What is Swine flu?
- Are there human infections with swine flu in India?
- Is this swine flu virus contagious?
- What are the bad signs and symptoms of swine flu in people?
- How does swine flu spread?
- How can someone with the flu infect someone else?
- What should I do keep from getting the flu?
- Are there medicines to treat swine flu?
- How long can an infected person spread swine flu to others?
- What surfaces are most likely to be sources of contamination?
- How long can viruses live outside the body?
- What can I do to protect myself from getting sick?
- Is there any vaccine for preventing this disease?
- As a part of our survey, a few patients reported some other symptoms that were not recorded earlier. Are there any new signs or symptoms in the present face of the disease?
- What are the differences between Chikunguniya- like diseases and H1N1?
The following are the contact details of the people from which we collected information.
Surveyed :
- Smt.Rosemol JoppanPerutty, Guruvayur House.ph.no:04872354256
- Smt.Sandhya.C,F,Chiriyankandath House, Peruvallur.Mobile No:9946897066
- Shri.Yadhukrishna.C.V,Chakkalath House, Kottappadi.9746357886
- Shri.Arun.K.S,Arrackal House,Ponnukkara.Mobile No:9656966996
- Mr.Joseph Seby,Neelankavil House,Konikkara.Mobile No:9995811159
- Smt.Poornima,Chandanaseri Madam,Ganesgiri(P.O)Mundaya,Shonur,Mobile No:919846590549
- Melvin Cherian,Pulikkottil House,Vadakkanchery,Mobile No:9846400554
- Smt.Pushpa Rajan.Padinjarekkara House,Ramavarmapuram,Thrissur
- Dr.Taj Paul,Assistant Surgeon,Thaluk Head Quarters Hospital,Kunnamkulam
- Dr.Ally Plackal.J,Assistant Surgeon,Pazhanji Social Welfare Centre.
Interviewed:
- Dr.Taj Paul,Assistant Surgeon,Thaluk Head Quarters Hospital,Kunnamkulam
- Dr.Ally Plackal.J,Assistant Surgeon,Pazhanji Social Welfare Centre.
- Dr.Balachandran, Nodel officer, Dist.hospital, Thrissur
- Dr.Alosius.P.J, Deputy DMO, Thrissur
- Mr.Binju, junior Health inspector, Taluk Head Quarters Hospital, Kunnamkulam
- Mr.Manoj.M, junior Health inspector, H1N1 special cell(IDSP), DMO, Thrissur
- Mr.Rajesh. junior Health inspector, Grade2, PHC, Nanmanikkara
- Mr.P.K.Raju, Technical Assistant, GR.I, DMO, Thrissur
MY BLOG
http://swineflualertjisnamary.blogspot.com
TO READ MY PROJECTON H1N1
http://projectonh1n1.blogspot.com
THANK YOU
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