Breast Infection Symptoms

Breast Infection Symptoms

•Infection: Breast infections may cause pain, redness, and warmth of the breast along with the following symptoms:

◦Tenderness and swelling

◦Body aches

◦Fatigue

◦Breast engorgement

◦Fever and chills

◦Rigor or shaking

•Abscess: Sometimes a breast abscess can complicate mastitis. Harmless, noncancerous masses such as abscesses are more often tender and frequently feel mobile beneath the skin. The edge of the mass is usually regular and well defined. Indications that this more serious infection has occurred include the following:

◦Tender lump in the breast that does not get smaller after breastfeeding a newborn (If the abscess is deep in the breast, you may not be able to feel it). The mass may be moveable and/or compressible.

◦Pus draining from the nipple

◦Persistent fever and no improvement of symptoms within 48-72 hours of treatment

Breast Infection Causes

Breast Infection Causes

Mastitis (inflammation of breast tissue) is a common benign cause of a breast mass. It is commonly seen in women after childbirth while breastfeeding. These masses are often quite painful. Women who are not breastfeeding can also develop mastitis. In healthy women, mastitis is rare. However, women with diabetes, chronic illness, AIDS, or an impaired immune system may be more susceptible to the development of mastitis.

•Bacteria normally found in a baby's mouth or on the nipple can enter the milk ducts through small cracks in the skin of the nipple and can multiply rapidly in the breast milk. This can lead to a superficial small area of inflammation (frequently from streptococcal bacteria) or a deeper walled-off infection or abscess (frequently from staphylococcal bacteria).

•Mild temperature elevations (previously termed milk fever) accompanied by some breast or nipple soreness is usually secondary to engorgement and dehydration immediately (24-72 hours) after delivery and is treated by improved breastfeeding technique. The body temperature should not be above 39°C (102.2°F), nor should the fever persist for longer than about 4-16 hours. This condition may also occur in women who are not breastfeeding and have not completely suppressed lactation yet.

•About one to three percent of breastfeeding mothers develop mastitis, usually within the first few weeks after delivery. Most breast infections occur within the first or second month after delivery or at the time of weaning. Typically, the infection is only in one breast. Engorgement and incomplete breast emptying can contribute to the problem and make the symptoms worse.

•Chronic mastitis occurs in women who are not breastfeeding. In postmenopausal women, breast infections may be associated with chronic inflammation of the ducts below the nipple. Hormonal changes in the body can cause the milk ducts to become clogged with dead skin cells and debris. These clogged ducts make the breast more prone to bacterial infection. This type of infection tends to come back after treatment with antibiotics.

Breast Infection Overview

Mastitis is an infection of the tissue of the breast that occurs most frequently during the time of breastfeeding. This infection causes pain, swelling, redness, and increased temperature of the breast. It can occur when bacteria, often from the baby's mouth, enter a milk duct through a crack in the nipple. This causes an infection and painful inflammation of the breast.

Breast infections most commonly occur one to three months after the delivery of a baby, but they can occur in women who have not recently delivered as well as in women after menopause. Other causes of infection include chronic mastitis and a rare form of cancer called inflammatory carcinoma.

•The breast is composed of several glands and ducts that lead to the nipple and the surrounding colored area called the areola. The milk-carrying ducts extend from the nipple into the underlying breast tissue like the spokes of a wheel. Under the areola are lactiferous ducts. These fill with milk during lactation after a woman has a baby. When a girl reaches puberty, changing hormones cause the ducts to grow and cause fat deposits in the breast tissue to increase. The glands that produce milk (mammary glands) that are connected to the surface of the breast by the lactiferous ducts may extend to the armpit area (axilla).

•A breast infection that leads to an abscess (a localized pocket or collection of pus) is a more serious type of infection. If mastitis is left untreated, an abscess can develop in the breast tissue. This type of infection may require surgical drainage.

How can I prevent swine flu infection?

How can I prevent swine flu infection?

The CDC recommends taking these steps:

Wash your hands regularly with soap and water, especially after coughing or sneezing. Or, use an alcohol-based hand cleaner.

Avoid close contact with sick people.

Avoid touching your mouth, nose, or eyes.

Got flu symptoms? Stay home, and when you cough or sneeze, cover your mouth and nose with a tissue. Afterward, throw the tissue in the trash and wash your hands.

Should I cancel my travel plans?

Only if you're already sick. The World Health Organization and CDC currently don't recommend any travel bans or travel restrictions for healthy people. An earlier U.S. advisory against travel to Mexico has been lifted. But if you're sick, health officials want you to stay home. If you have flu-like symptoms, the CDC says you should stay home and avoid travel for seven days after you get sick or for at least 24 hours after you stop having symptoms, whichever is longer.

What else should I be doing?

Keep informed of what's going on in your community. Your state and local health departments will have important information on how your area is handling swine flu and on the swine flu vaccine, when it becomes available. If you're a parent, you may also want to plan how you would handle your child's school being temporarily closed due to H1N1 swine flu.

Is there a swine flu vaccine for people?

Is there a swine flu vaccine for people?

Clinical trials of a swine flu vaccine are underway. Here, WebMD Senior Writer Daniel J. DeNoon gets his shot in a trial being conducted at Emory University in Atlanta. Depending on how long federal officials wait for the results of these tests, tens of millions of doses of swine flu vaccine could be ready as soon as September 2009, with more vaccine becoming available each month thereafter.

How severe is swine flu?

The severity of cases in the current swine flu pandemic has varied widely, from mild cases to fatalities. Most U.S. cases have been mild, but there have been a number of deaths and hundreds of hospitalizations. Flu viruses can change, and it's impossible to know whether the H1N1 swine flu virus will become more deadly. But so far, this particular virus hasn't changed much since it first appeared.

How many people have swine flu?

How many people have swine flu?

That's a hard question to answer, because the figure is changing so quickly and the H1N1 virus is has spread worldwide. The World Health Organization (WHO) is no longer keeping count of people sickened by H1N1 swine flu, and is concentrating instead on unusual cases that may arise. The CDC is also de-emphasizing case counts. Instead, it's reporting where and when there are unusually high numbers of flu cases.

How is swine flu treated?

The H1N1 swine flu virus is sensitive to the antiviral drugs Tamiflu and Relenza. The CDC recommends those drugs to prevent or treat swine flu; the drugs are most effective when taken within 48 hours of the start of flu symptoms. But not everyone needs those drugs. Most people who have come down with swine flu have recovered without treatment. The U.S. government has replenished state stockpiles of Tamiflu and Relenza in preparation for the fall flu season. Health officials have asked people not to hoard Tamiflu or Relenza.

When is swine flu an emergency?

When is swine flu an emergency?

Children should get urgent medical attention if they have fast breathing or trouble breathing, have bluish or gray skin color, are not drinking enough fluid, are not waking up or not interacting, have severe or persistent vomiting, are so irritable that the child doesn't want to be held, have flu-like symptoms that improve but then return with fever and a worse cough, have fever with a rash, or have fever and then have a seizure or sudden mental or behavioral change. Adults should seek urgent medical attention if they have trouble breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting, or flu-like symptoms that improve, but then come back with worsening fever or cough

How does swine flu spread?

The new swine flu virus apparently spreads just like regular flu. You could pick up germs directly from an infected person, or by touching an object they recently touched, and then touching your eyes, mouth, or nose, delivering their germs for your own infection. That's why you should make a habit of washing your hands, even when you're not ill. Flu germs can start spreading up to a day before symptoms start, and for up to seven days after getting sick, according to the CDC.

What are swine flu symptoms?

What are swine flu symptoms?

Symptoms of swine flu are like regular flu symptoms and include fever, cough, sore throat, body aches, headache, chills, and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. Those symptoms can also be caused by many other conditions, and that means that you and your doctor can't know, just based on your symptoms, if you've got swine flu. It takes a lab test to tell whether it's swine flu or some other condition.

When should I see my doctor?

If you only have mild flu symptoms and you're not at high risk of severe disease, you don't need medical attention unless your illness worsens. If you are at high risk (pregnant women, young children, people with chronic medical conditions, and elderly people), call or email your doctor at the first sign of flu-like symptoms.

What is swine flu?

What is swine flu?

Like people, pigs can get influenza (flu), but swine flu viruses aren't the same as human flu viruses. Swine flu doesn't often infect people, and the rare human cases that have occurred in the past have mainly affected people who had direct contact with pigs. But the current swine flu outbreak is different. It's caused by a new swine flu virus that has spread from person to person — and it's happening among people who haven't had any contact with pigs.

How is the current swine flu different?

The current swine flu outbreak is caused by a new swine flu virus that has spread from person to person -- and it's happening among people who haven't had any contact with pigs. Here is a picture of the new swine flu virus, colorized and magnified.


more about swine flu

What are the complications of mono?

What are the complications of mono?

A common, but usually not serious, complication of mono is a mild inflammation of the liver or hepatitis. This form of hepatitis is rarely serious and rarely requires treatment. The enlargement of the spleen that occurs with mono makes traumatic rupture of the spleen a possible complication. Fortunately, the more severe complications of mono are quite rare, and mono is very rarely fatal in healthy people. The rare severe complications include destruction of red blood cells (hemolytic anemia) and inflammation of the sac surrounding the heart (pericarditis), the heart muscle itself (myocarditis), and the brain (encephalitis). Mono tends to be more aggressive in patients with abnormal immune systems, such as people with AIDS or those who are taking medications that suppress immune function. The EBV has been associated with some types of cancers, most commonly lymphomas. As well, some studies have linked EBV to the development of at least one subtype of Hodgkin's disease.

Infectious Mononucleosis At A Glance

Infectious mononucleosis is a contagious illness caused by the Epstein-Barr virus (EBV).

The infection can be spread by saliva, and the incubation period for mono is four to six weeks.

Most adults have laboratory evidence (antibodies against the EBV) indicative of a previous infection with EBV and are immune to further infection.

Symptoms include fever, fatigue, sore throat, and swollen lymph nodes.

Diagnosis is confirmed by blood tests.

Mono can cause liver inflammation (hepatitis) and enlargement of the spleen.

People who have had mono can continue to shed virus particles in their saliva during reactivations of the viral infection throughout their lifetime.

Vigorous contact sports should be avoided in the illness and recovery phase to prevent rupture of the spleen.

How is mono diagnosed?

How is mono diagnosed?

A diagnosis of mono is suspected by the doctor based on the patient's symptoms and signs. Mono is confirmed by blood tests that may also include tests to exclude other possible causes of the symptoms, such as tests to rule out Strep throat. Early in the course of mono, blood tests may show an increase in one type of white blood cell (lymphocyte). Some of these increased lymphocytes have an unusual or "atypical" appearance when viewed under a microscope, which suggests mono.

More specific blood tests, such as the monospot and heterophile antibody tests, can confirm the diagnosis of mono. These tests rely on the body's immune system to make measurable antibodies against the EBV. Unfortunately, the antibodies may not become detectable until the second or third week of the illness. A blood chemistry test may reveal abnormalities in liver function.

What is the usual course and treatment of mono?

In most cases of mono, no specific treatment is necessary. The illness is usually self-limited and resolves in much the same way as other common viral illnesses. Treatment is directed toward the relief of symptoms. Available antiviral drugs have no significant effect on the overall outcome of mono and may actually prolong the course of the illness. For the most part, supportive or comfort measures are all that is necessary. Acetaminophen can be given for fever and any body- or headaches. A sufficient amount of sleep and rest is important. The throat soreness is worst during the first five to seven days of illness and then subsides over the next seven to 10 days.

Are there any long-term effects of mono?

A feeling of fatigue or tiredness may persist for months following the acute phase of the illness. It is recommended that patients with mono avoid participation in any contact sports during the first six to eight weeks following the onset to prevent trauma to the enlarged spleen. Patients can continue to have virus particles present in their saliva for as long as 18 months after the initial infection. When symptoms persist for more than six months, the condition is frequently called "chronic" EBV infection.

Approximately 20%-80% of people who have had mono will continue to secrete the EBV in their saliva for years due to periodic "reactivations."

What is infectious mononucleosis ("mono")?

Infectious mononucleosis, "mono," "kissing disease," and glandular fever are all terms popularly used for the very common illness caused by the Epstein-Barr virus (EBV). This common viral infection causes fever, sore throat, and enlarged lymph nodes. The illness generally goes away without medical help. However, it may last from weeks to months. Treatment is mainly to ease symptoms, usually at home, with plenty of rest and fluids.

What is the Epstein-Barr virus?

EBV is a member of the herpesvirus family and causes more than 90% of cases of mononucleosis. EBV is a double-stranded DNA virus named for the English virologists professor Sir Anthony Epstein and Yvonne M. Barr. The designation "mononucleosis" refers to an increase in a special type of white blood cells (lymphocytes) in the bloodstream relative to the other blood components as a result of the EBV infection.

What is the cause of mono?

The EBV that causes mono is found throughout the world. By the time most people reach adulthood, an antibody against EBV can be detected in their blood. In the U.S., up to 95% of adults 35-40 years of age have antibodies directed against EBV. This means that most people, sometime in their lives, have been infected with EBV. While there are other illnesses falling under the broad classification of mononucleosis that cause similar symptoms and an increase in blood lymphocytes, the form caused by the EBV is by far the most common.

What are the risk factors for mono?

The EBV can infect anyone. By adulthood, 90%-95% of men and women have been infected with EBV; infections most often occur in people 5-25 years of age. Not surprisingly, 1%-3% of college students contract mono each year, as it is most often transmitted via saliva (hence the name “kissing disease”). However, mono can also be spread through blood and genital secretions.

How is mono spread?

Mono is usually spread by person-to-person contact. Saliva is the primary method of transmitting mono. Infectious mononucleosis developed its common name of "kissing disease" from this prevalent form of transmission among teenagers. A person with mono can also pass on the disease by coughing or sneezing, causing small droplets of infected saliva and/or mucus to be suspended in the air and inhaled by others. Sharing food or beverages from the same container or utensil can also transfer the virus from one person to another, since contact with infected saliva may result.

How long is mono contagious?

Most people have been exposed to the virus as children, and as a result of the exposure, they have developed immunity to the virus. It is of note that most people who are exposed to the EBV don't ever develop mononucleosis. The incubation period for mono, meaning the time from the initial viral infection until the appearance of symptoms, is between four and six weeks. During an infection, a person is likely able to transmit the virus to others for at least a few weeks.

Reactivations of mono

Research has shown that, depending on the method used to detect the virus, anywhere from 20% to 80% of people who have had mononucleosis and have recovered will continue to secrete the EBV in their saliva for years due to periodic "reactivations" of the viral infection. Since healthy people without symptoms also secrete the virus during reactivation episodes throughout their lifetime, isolation of people infected with EBV is not necessary. It is currently believed that these healthy people, who nevertheless secrete EBV particles, are the primary reservoir for

What are the symptoms of mono?

The initial symptoms of mono are a general lack of energy (malaise), loss of appetite, and chills. These initial symptoms can last from one to three days before the more intense symptoms of the illness begin. The more common intense symptoms include a severe sore throat, fever, and swollen glands (lymph nodes) in the neck area. It is typically the severe sore throat that prompts people to contact their doctor.

What are the signs of mono?

In addition to a fever from 102 F-104 F, the most common signs of mono are a very reddened throat and tonsils and swollen lymph glands (nodes) in the neck. The tonsils have a whitish coating in at least one-third of the cases. The spleen (sometimes referred to as the body's biggest lymph node), an organ found in the left upper abdomen underneath the rib cage, becomes enlarged or swollen in about 50% of patients with mono. An enlarged liver may also occur. About 5% of patients have a splotchy red rash over the body, which has a similar appearance to the rash of measles.

HIV - AIDS

Acquired immune deficiency syndrome

Acquired immune deficiency syndrome or acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV).
This condition progressively reduces the effectiveness of the immune system and leaves individuals susceptible to opportunistic infections and tumors. HIV is transmitted through direct contact of a mucous membrane or the bloodstream with a bodily fluid containing HIV, such as blood, semen, vaginal fluid, preseminal fluid, and breast milk.
This transmission can involve anal, vaginal or oral sex, blood transfusion, contaminated hypodermic needles, exchange between mother and baby during pregnancy, childbirth, breastfeeding or other exposure to one of the above bodily fluids.

AIDS is now a pandemic. In 2007, it was estimated that 33.2 million people lived with the disease worldwide, and that AIDS had killed an estimated 2.1 million people, including 330,000 children. Over three-quarters of these deaths occurred in sub-Saharan Africa, retarding economic growth and destroying human capital.

Genetic research indicates that HIV originated in west-central Africa during the late nineteenth or early twentieth century. AIDS was first recognized by the U.S. Centers for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s.

Although treatments for AIDS and HIV can slow the course of the disease, there is currently no vaccine or cure. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but these drugs are expensive and routine access to antiretroviral medication is not available in all countries. Due to the difficulty in treating HIV infection, preventing infection is a key aim in controlling the AIDS pandemic, with health organizations promoting safe sex and needle-exchange programmes in attempts to slow the spread of the virus.

Symptoms

The symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals with healthy immune systems. Most of these conditions are infections caused by bacteria, viruses, fungi and parasites that are normally controlled by the elements of the immune system that HIV damages.

Opportunistic infections are common in people with AIDS. HIV affects nearly every organ system.

People with AIDS also have an increased risk of developing various cancers such as Kaposi's sarcoma, cervical cancer and cancers of the immune system known as lymphomas. Additionally, people with AIDS often have systemic symptoms of infection like fevers, sweats (particularly at night), swollen glands, chills, weakness, and weight loss. The specific opportunistic infections that AIDS patients develop depend in part on the prevalence of these infections in the geographic area in which the patient lives.

Courtesy: Wikipedia

Joint FAO/WHO/OIE Statement on influenza A(H1N1) and the safety of pork

Joint FAO/WHO/OIE Statement on influenza A(H1N1) and the safety of pork

In the ongoing spread of influenza A(H1N1), concerns about the possibility of this virus being found in pigs and the safety of pork and pork products have been raised.

Influenza viruses are not known to be transmissible to people through eating processed pork or other food products derived from pigs.

Heat treatments commonly used in cooking meat (e.g. 70°C/160°F core temperature) will readily inactivate any viruses potentially present in raw meat products.

Pork and pork products, handled in accordance with good hygienic practices recommended by the WHO , Codex Alimentarius Commission and the OIE, will not be a source of infection

Authorities and consumers should ensure that meat from sick pigs or pigs found dead are not processed or used for human consumption under any circumstances.

Assessing the severity of an influenza pandemic

Assessing the severity of an influenza pandemic
The major determinant of the severity of an influenza pandemic, as measured by the number of cases of severe illness and deaths it causes, is the inherent virulence of the virus. However, many other factors influence the overall severity of a pandemic’s impact.

Even a pandemic virus that initially causes mild symptoms in otherwise healthy people can be disruptive, especially under the conditions of today’s highly mobile and closely interdependent societies. Moreover, the same virus that causes mild illness in one country can result in much higher morbidity and mortality in another. In addition, the inherent virulence of the virus can change over time as the pandemic goes through subsequent waves of national and international spread.

Properties of the virus
An influenza pandemic is caused by a virus that is either entirely new or has not circulated recently and widely in the human population. This creates an almost universal vulnerability to infection. While not all people ever become infected during a pandemic, nearly all people are susceptible to infection.

The occurrence of large numbers of people falling ill at or around the same time is one reason why pandemics are socially and economically disruptive, with a potential to temporarily overburden health services.

The contagiousness of the virus also influences the severity of a pandemic’s impact, as it can increase the number of people falling ill and needing care within a short timeframe in a given geographical area. On the positive side, not all parts of the world, or all parts of a country, are affected at the same time.

The contagiousness of the virus will influence the speed of spread, both within countries and internationally. This, too, can influence severity, as very rapid spread can undermine the capacity of governments and health services to cope.

Pandemics usually have a concentrated adverse impact in specific age groups. Concentrated illnesses and deaths in a young, economically productive age group will be more disruptive to societies and economies than when the very young or very old are most severely affected, as seen during epidemics of seasonal influenza.

Population vulnerability
The overall vulnerability of the population can play a major role. For example, people with underlying chronic conditions, such as cardiovascular disease, hypertension, asthma, diabetes, rheumatoid arthritis, and several others, are more likely to experience severe or lethal infections. The prevalence of these conditions, combined with other factors such as nutritional status, can influence the severity of a pandemic in a significant way.

Subsequent waves of spread
The overall severity of a pandemic is further influenced by the tendency of pandemics to encircle the globe in at least two, sometimes three, waves. For many reasons, the severity of subsequent waves can differ dramatically in some or even most countries.

A distinctive feature of influenza viruses is that mutations occur frequently and unpredictably in the eight gene segments, and especially in the haemagglutinin gene. The emergence of an inherently more virulent virus during the course of a pandemic can never be ruled out.

Different patterns of spread can also influence the severity of subsequent waves. For example, if schoolchildren are mainly affected in the first wave, the elderly can bear the brunt of illness during the second wave, with higher mortality seen because of the greater vulnerability of elderly people.

During the previous century, the 1918 pandemic began mild and returned, within six months, in a much more lethal form. The pandemic that began in 1957 started mild, and returned in a somewhat more severe form, though significantly less devastating than seen in 1918. The 1968 pandemic began relatively mild, with sporadic cases prior to the first wave, and remained mild in its second wave in most, but not all, countries.

Capacity to respond
Finally, the quality of health services influences the impact of any pandemic. The same virus that causes only mild symptoms in countries with strong health systems can be devastating in other countries where health systems are weak, supplies of medicines, including antibiotics, are limited or frequently interrupted, and hospitals are crowded, poorly equipped, and under-staffed.

Assessment of the current situation
To date, the following observations can be made, specifically about the H1N1 virus, and more generally about the vulnerability of the world population. Observations specific to H1N1 are preliminary, based on limited data in only a few countries.

The H1N1 virus strain causing the current outbreaks is a new virus that has not been seen previously in either humans or animals. Although firm conclusions cannot be reached at present, scientists anticipate that pre-existing immunity to the virus will be low or non-existent, or largely confined to older population groups.

H1N1 appears to be more contagious than seasonal influenza. The secondary attack rate of seasonal influenza ranges from 5% to 15%. Current estimates of the secondary attack rate of H1N1 range from 22% to 33%.

With the exception of the outbreak in Mexico, which is still not fully understood, the H1N1 virus tends to cause very mild illness in otherwise healthy people. Outside Mexico, nearly all cases of illness, and all deaths, have been detected in people with underlying chronic conditions.

In the two largest and best documented outbreaks to date, in Mexico and the United States of America, a younger age group has been affected than seen during seasonal epidemics of influenza. Though cases have been confirmed in all age groups, from infants to the elderly, the youth of patients with severe or lethal infections is a striking feature of these early outbreaks.

In terms of population vulnerability, the tendency of the H1N1 virus to cause more severe and lethal infections in people with underlying conditions is of particular concern.

For several reasons, the prevalence of chronic diseases has risen dramatically since 1968, when the last pandemic of the previous century occurred. The geographical distribution of these diseases, once considered the close companions of affluent societies, has likewise shifted dramatically. Today, WHO estimates that 85% of the burden of chronic diseases is now concentrated in low- and middle-income countries. In these countries, chronic diseases show an earlier average age of onset than seen in more affluent parts of the world.

In these early days of the outbreaks, some scientists speculate that the full clinical spectrum of disease caused by H1N1 will not become apparent until the virus is more widespread. This, too, could alter the current disease picture, which is overwhelmingly mild outside Mexico.

Apart from the intrinsic mutability of influenza viruses, other factors could alter the severity of current disease patterns, though in completely unknowable ways, if the virus continues to spread.

Scientists are concerned about possible changes that could take place as the virus spreads to the southern hemisphere and encounters currently circulating human viruses as the normal influenza season in that hemisphere begins.

The fact that the H5N1 avian influenza virus is firmly established in poultry in some parts of the world is another cause for concern. No one can predict how the H5N1 virus will behave under the pressure of a pandemic. At present, H5N1 is an animal virus that does not spread easily to humans and only very rarely transmits directly from one person to another.

The current WHO phase of pandemic alert is 6.

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.The current WHO phase of pandemic alert is 6.

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.

H1N1 swine flu (Influenza A)

What is swine flu?

Like people, pigs can get influenza (flu), but swine flu viruses aren't the same as human flu viruses. Swine flu doesn't often infect people, and the rare human cases that have occurred in the past have mainly affected people who had direct contact with pigs. But the current swine flu outbreak is different. It's caused by a new swine flu virus that has spread from person to person — and it's happening among people who haven't had any contact with pigs.

H1N1 swine flu (Influenza A)

What is influenza A(H1N1 swine flu)?

How do people become infected with influenza A(H1N1)?

Outbreaks in humans are now occurring from human-to-human transmission. When infected people cough or sneeze, infected droplets get on their hands, drop onto surfaces, or are dispersed into the air. Another person can breathe in contaminated air, or touch infected hands or surfaces, and be exposed. To prevent spread, people should cover their mouth and nose with a tissue when coughing, and wash their hands regularly.

What are the signs and symptoms of infection?

Early signs of influenza A(H1N1) are flu-like, including fever, cough, headache, muscle and joint pain, sore throat and runny nose, and sometimes vomiting or diarrhoea.

What can I do to protect myself from catching influenza A(H1N1)?

The main route of transmission of the new influenza A(H1N1) virus seems to be similar to seasonal influenza, via droplets that are expelled by speaking, sneezing or coughing. You can prevent getting infected by avoiding close contact with people who show influenza-like symptoms (trying to maintain a distance of about 1 metre if possible) and taking the following measures:

•avoid touching your mouth and nose;

•clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated);

•avoid close contact with people who might be ill;

•reduce the time spent in crowded settings if possible;

•improve airflow in your living space by opening windows;

•practise good health habits including adequate sleep, eating nutritious food, and keeping physically active.

What about using a mask? What does WHO recommend?

If you are not sick you do not have to wear a mask.

If you are caring for a sick person, you can wear a mask when you are in close contact with the ill person and dispose of it immediately after contact, and cleanse your hands thoroughly afterwards.

If you are sick and must travel or be around others, cover your mouth and nose.

Using a mask correctly in all situations is essential. Incorrect use actually increases the chance of spreading infection.

How do I know if I have influenza A(H1N1)?

You will not be able to tell the difference between seasonal flu and influenza A(H1N1) without medical help. Typical symptoms to watch for are similar to seasonal viruses and include fever, cough, headache, body aches, sore throat and runny nose. Only your medical practitioner and local health authority can confirm a case of influenza A(H1N1).

What should I do if I think I have the illness?

If you feel unwell, have high fever, cough or sore throat:

•stay at home and keep away from work, school or crowds;

•rest and take plenty of fluids;

•cover your nose and mouth when coughing and sneezing and, if using tissues, make sure you dispose of them carefully. Clean your hands immediately after with soap and water or cleanse them with an alcohol-based hand rub;

•if you do not have a tissue close by when you cough or sneeze, cover your mouth as much as possible with the crook of your elbow;

•use a mask to help you contain the spread of droplets when you are around others, but be sure to do so correctly;

•inform family and friends about your illness and try to avoid contact with other people;

•If possible, contact a health professional before traveling to a health facility to discuss whether a medical examination is necessary.

Should I take an antiviral now just in case I catch the new virus?

No. You should only take an antiviral, such as oseltamivir or zanamivir, if your health care provider advises you to do so. Individuals should not buy medicines to prevent or fight this new influenza without a prescription, and they should exercise caution in buying antivirals over the Internet.

What about breastfeeding? Should I stop if I am ill?

No, not unless your health care provider advises it. Studies on other influenza infections show that breastfeeding is most likely protective for babies - it passes on helpful maternal immunities and lowers the risk of respiratory disease. Breastfeeding provides the best overall nutrition for babies and increases their defense factors to fight illness.

What should I do if I need medical attention?

•If possible, contact your health care provider before traveling to a health facility, and report your symptoms. Explain why you think you have influenza A (H1N1) (e.g. if you have recently traveled to a country where there is an outbreak in people). Follow the advice given to you.

•If you cannot contact your health care provider before traveling to a health facility, tell a health care worker of your suspicion of infection immediately after arrival at the clinic or hospital.

•Cover your nose and mouth during travel.

Should I go to work if I have the flu but am feeling OK?

No. Whether you have influenza A(H1N1) or a seasonal influenza, you should stay home and away from work through the duration of your symptoms. This is a precaution that can protect your work colleagues and others.

Can I travel?

If you are feeling unwell or have symptoms of influenza, you should not travel. If you have any doubts about your health, you should check with your health care provider.

Are some people more at risk?

More study is needed to determine if some populations (i.e. younger or older people, or people with other medical conditions) could be affected by the outbreak, of if they are at higher risk for severe illness. WHO recommends that everyone take precautions to prevent the spread of infection.

Are there any special recommendations for pregnant women?

Yes, they are vulnerable. Like everyone, they should take all the necessary precautions.