Don’t want virus? Don’t share food!

I REFER to the report, "Singapore ready to tackle swine flu" (my paper, April 28).

The World Health Organization has described the swine-flu outbreak as "a public-health emergency of international concern".

It is a stark reminder of the Sars epidemic in 2003.

A pandemic on top of the global recession would batter the Singapore economy and lead to even more unemployment.

The Government has a duty to educate Singaporeans on tackling disease threats.

We must never be complacent, especially with respiratory diseases such as human flu, Sars, bird flu, swine flu and tuberculosis.

A normal person can survive without food or water for some time. But if he cannot breathe because his lungs are infected, he will die.

While many know that washing one's hands and not coughing openly are good hygiene habits, few pause to think about the consequences of sharing food, when individuals use their utensils to eat from common dishes.

A 1994 Ministry of Health (MOH) publication confirmed that through sharing food, "we are likely to share saliva as well, (along) with any bacteria or viruses (that are) in it".

Saliva can transmit many micro-organisms.

Among them are the viruses that cause hand, foot and mouth disease (HFMD), human flu, Sars, bird flu and swine flu, and those that are linked to liver cancer (hepatitis B virus) and nose cancer (Epstein-Barr virus).

The micro-organisms also include bacteria that cause tuberculosis and meningitis, and a bacterium that is linked to stomach cancer (Helicobacter pylori).

Few Singaporeans know that adults can also contract HFMD through close contact or the sharing of food.

The disease is then passed on to their children in the same manner.

Health risks aside, stop and think: How can you possibly enjoy your food when it contains others' saliva?

The MOH publication also had a simple recommendation: It suggested that serving spoons, separate soup bowls and sauce dishes be used both at home and in public eating places.

Regrettably, this important piece of public-health advice was never widely publicised.

Thus, many Singaporeans remain unaware of the health risks of sharing food.

A 2004 report in The Straits Times quoted Health Minister Khaw Boon Wan as saying: "There is nothing wrong with communal eating... But I think we can make it hygienic just by using serving spoons."

For years, Chinese restaurants in Australia have been routinely providing customers with serving spoons.

This is not so with most restaurants here, where it is a constant hassle to ask waiters to provide serving spoons for each dish.

These actions are urgently needed:

Public campaign

The Health Promotion Board should mount an "Eat the Hygienic Way" campaign to inform Singaporeans about hygienic eating habits, such as using serving spoons, to complement its "Eat the Healthy Way" campaign.

Make serving spoons compulsory

The National Environment Agency could issue a compulsory directive to hawkers and restaurants, requesting that they provide serving spoons to customers.

Mr See Leong Kit

From myPaper, My Say – Wednesday, 29-April-2009

Swine flu goes person-to-pig; What's next?

By MARGIE MASON,AP Medical Writer AP - 2 hours 44 minutes ago

MEXICO CITY - Now that the swine flu virus has passed from a farmworker to pigs, could it jump back to people? The question is important, because crossing species again could make it more deadly.

The never-before-seen virus was created when genes from pig, bird and human viruses mixed together inside a pig. Experts fear the virus that has gone from humans back into pigs in at least one case could mutate further before crossing back into humans again. But no one can predict what will happen.

"Could it gain virulence? Yes," Juan Lubroth, an animal health expert at the U.N. Food and Agriculture Organization in Rome, said Sunday. "It could also become milder. It could go in both directions."

Canadian officials announced Saturday that the virus had infected about 200 pigs on a farm _ the first evidence that it had jumped to another species. It was linked to a farmworker who recently returned from Mexico, where 19 people have died from the virus. The farmworker has recovered, and the mildly infected pigs have been quarantined.

Agriculture officials believe the worker may have sneezed or coughed near the pigs, possibly in a barn. About 10 percent of the herd experienced loss of appetite and fever, but all are recovering.

Experts say pork _ even from infected pigs _ is safe to eat.

Lubroth stressed that sick people should avoid contact with swine, but said healthy farmworkers don't need to take any extra precautions because the chance of catching flu from a pig is small.

Unlike the H5N1 bird flu virus, which infects the blood, organs and tissue of poultry, most swine flus are confined to the respiratory tract, meaning the risk of a human getting infected by a pig is "probably 10 or a 1,000 times less," Lubroth said.

But pigs are of special concern because they share some basic biological similarities with humans, and they have served as "mixing vessels" in which various flu strains have swapped genetic material. That's what happened to create the current swine flu strain.

Scientists are unsure when the virus leaped from pigs to humans _ possibly months or even a year ago _ but it was identified as a new strain about a week and a half ago. Since then, nearly 800 cases have been confirmed worldwide. The only death outside Mexico occurred when a Mexican toddler died in a Texas hospital.

There have been sporadic cases of pigs infecting humans with influenza in the past. Most cases resulted in mild symptoms, typically among people who were in close contact with sick pigs. A few deaths have been recorded, and limited human-to-human transmission also has been documented, but nothing sustained.

Dr. Tim Uyeki, an epidemiologist with the U.S. Centers for Disease Control and Prevention who has worked on SARS and bird flu outbreaks, said there may be more pig-to-human cases that have gone unnoticed because surveillance among swine populations tends to be weaker than among poultry stocks.

Given that the past three flu pandemics _ the 1918 Spanish flu, the 1957-58 Asian flu and the Hong Kong flu of 1968-69 _ were all linked to birds, much of the global pandemic preparedness has focused on avian flus.

"The world has been watching and preparing and trying to prevent a pandemic from an avian influenza reservoir," he said. "The focus has been on birds, and here is a virus that's coming from a swine reservoir. Now it's a human virus."

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From Yahoo! News; source article is here.

Khaw: Play safe, assume the worst

SWINE FLU ALERT
Neo Chai Chin, chaichin@mediacorp.com.sg

His ministry is working "round the clock" to stay abreast of swine flu developments around the world. And Health Minister Khaw Boon Wan yesterday sounded a reassuring note, saying the nation is in a better position to deal with a global pandemic compared to six years ago when Sars hit.

Back then, 33 people here died from the Severe Acute Respiratory Syndrome. Since then, progress has been made in laboratory capabilities and as well as alertness levels at hospitals and airports.

The Ministry of Health (MOH) is also looking at restricting the number of visitors for hospital patients — if developments over the next two days warrants it.
"As a general principal, if you don't have to visit hospitals, don't visit because it's not exactly a clean place. Why expose yourself unnecessarily?" said Mr Khaw.

Those who need to visit loved ones should maintain a high level of personal hygiene including frequent hand-washing.

Singapore also has a stockpile of Tamiflu — one of the antiviral drugs found to be effective against the swine flu virus — as well as personal protective equipment for hospital staff, he said.

MOH is likely to request hospital staff working in high-risk areas such as accident and emergency (A&E) wards and intensive care units to wear the personal protective equipment.

At least one hospital has already taken the initiative. Since Saturday, National University Hospital staff at the A&E temperature screening area have put on protective gowns in addition to the face mask routinely worn.

NUH and the Singapore General Hospital said patients are also asked about their travel histories. "Patients ... with travel history to Mexico, USA and Canada will be asked to alert our staff. Visitors with travel history and who are feeling unwell are advised not to visit patients, and to seek medical attention," said SGH chief executive Prof Ang Chong Lye.

Indeed, disclosure of travel history becomes "very important", said Mr Khaw, given how swine flu symptoms such as fever, cough and sore throat are similar to that of regular flu.

And while the swine flu outbreak could be "just a very localised" one that will "eventually burn itself out", Mr Khaw said Singapore will "play safe and assume the worst."

From TODAY, News – Monday, 27-April-2009

Swine Flu and You

Swine Influenza and You

What is swine flu?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs. People do not normally get swine flu, but human infections can and do happen. Swine flu viruses have been reported to spread from person-to-person, but in the past, this transmission was limited and not sustained beyond three people.

Are there human infections with swine flu in the U.S.?
In late March and early April 2009, cases of human infection with swine influenza A (H1N1) viruses were first reported in Southern California and near San Antonio, Texas. Other U.S. states have reported cases of swine flu infection in humans and cases have been reported internationally as well. An updated case count of confirmed swine flu infections in the United States is kept at http://www.cdc.gov/swineflu/investigation.htm. CDC and local and state health agencies are working together to investigate this situation.

Is this swine flu virus contagious?
CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

What are the signs and symptoms of swine flu in people?
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 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.

How does swine flu spread?
Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. 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.

How can someone with the flu infect someone else?
Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

What should I do to keep from getting the flu?
First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.

Are there medicines to treat swine flu?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).

How long can an infected person spread swine flu to others?
People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk and then touches their own eyes, mouth or nose before washing their hands.

How long can viruses live outside the body?
We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Frequent handwashing will help you reduce the chance of getting contamination from these common surfaces.

What can I do to protect myself from getting sick?
There is no vaccine available right now to 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 sick people.
• If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.

What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.

What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water. or clean with alcohol-based hand cleaner. we recommend that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.

What should I do if I get sick?
If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.
If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.
If you become ill and experience any of the following warning signs, seek emergency medical care.
In children emergency warning signs that need urgent medical attention include:

• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
• Fever with a rash

In adults, emergency warning signs that need urgent medical attention include:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting

How serious is swine flu infection?
Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Between 2005 until January 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring. However, swine flu infection can be serious. In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later. A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death.

Can I get swine influenza from eating or preparing pork?
No. Swine influenza viruses are not spread by food. You cannot get swine influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe.


Taken from CDCP site; the original article is here.