Those with HIV may experience more severe illness, complications. The Center for Disease Control (CDC) has issued "interim guidance" for clinicians treating patients with swine flu who are also HIV-positive. The full publication is available here.The document notes that people with compromised immune systems, including people with HIV, are more at risk for seasonal flu, and thus are more likely to be at risk for H1N1, or swine-origin, flu as well.
There are insufficient data available at this point to determine who is at higher risk for complications of swine-origin influenza A (H1N1) virus infection. However, adults and adolescents with HIV infection, especially persons with low CD4 cell counts, are known to be at higher risk for viral and bacterial lower respiratory tract infections and for recurrent pneumonias.
Evidence that influenza can be more severe for HIV-infected adults and adolescents comes from studies among HIV-infected persons who had seasonal influenza; these data are limited. However, several studies have reported higher hospitalization rates, prolonged illness and increased mortality, especially among persons with AIDS. Thus, immune compromised persons, including HIV-infected adults and adolescents and especially persons with low CD4 cell counts or AIDS can experience more severe complications of seasonal influenza and it is possible that HIV-infected adults and adolescents are also at higher risk for swine-origin influenza complications.
People with HIV who contract swine flu should be treated with antiviral medications zanamivir or oseltamivir, the two drugs to which the virus is not resistant. "No adverse effects" have been reported in people with HIV who have received the two flu medications and "there are no known absolute contraindications" for people receiving the drugs when they are also taking antiretroviral drugs to treat HIV, according to the CDC.People with HIV should take the same precautions as the general population to avoid contracting swine flu:
The risk for swine-origin influenza A (H1N1) might be reduced by taking steps to limit possible exposures to persons with respiratory infections. These actions include frequent handwashing, covering coughs, and having ill persons stay home, except to seek medical care, and minimize contact with others in the household who may be ill with swine-origin influenza virus.
Additional measures that can limit transmission of a new influenza strain include voluntary home quarantine of members of households with confirmed or probable swine influenza cases, reduction of unnecessary social contacts, and avoidance whenever possible of crowded settings. If used correctly, facemasks and respirators may help reduce the risk of getting influenza, but they should be used along with other preventive measures, such as avoiding close contact and maintaining good hand hygiene.
A respirator that fits snugly on the face can filter out small particles that can be inhaled around the edges of a facemask, but compared with a facemask it is harder to breathe through a respirator for long periods of time.
In addition, people with HIV should be vigilant about their health by making sure they adhere to their HIV treatments, the agency said.
President Barack Obama appealed for calm as officials confirmed 44 mild cases of deadly swine flu across the United States and warned against tourist travel to neighboring Mexico.
The President of the United States, Barack Obama issued this statement today, "The Department of Health and Human Services has declared a Public Health Emergency as a precautionary tool to ensure that we have the resources we need at our disposal to respond quickly and effectively,"
The World Health Organization raised its global alert level for the swine flu on Monday, as Mexican officials reported that the death toll from the outbreak had reached 149. In the United States, the number of people sickened by the virus reached 44 (with 28 in one New York City school), though officials said that none of the cases were serious.Amid travel advisories and health warnings, how worried should Americans be that the disease might turn into a far more serious epidemic?
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Swine flu and humans
Swine flu viruses can be passed between pigs and humans, but human infections are not common. Most infections occur among people with direct pig contact. Sometimes a flu virus can mutate to be more transmissible to humans. An outbreak occurred among soldiers in Fort Dix, N.J., in 1976, resulting in 200 infections, several serious illnesses and one death.Human symptoms
All flus are passed by coughs and sneezes. Symptoms can include fever, fatigue, coughing, vomiting and diarrhea. Seasonal flus typically kill the old and young. New flus like this one can kill healthy people whose own immune reactions overwhelm them.Vaccine and treatments
Officials do not know if the seasonal flu vaccine will protect against the A(H1N1) swine flu virus. In the laboratory, the antiviral drugs Tamiflu and Relenza are effective against this new flu; amantadine and rimantadine are not.