Influenza A (H1N1):

Pandemic Threat Level:

The World Health Organisation (WHO) raised the level of the Pandemic Threat Alert Phase 5 to 6 (widespread human infection). The Phase 6 pandemic alert level is a reflection of the spread of the virus, not the severity of illness caused by the virus. See the WHO website at http://www.who.int/mediacentre/news/statements/2009/h1n1_20090427/en/index.html for further details.

General information on the influenza A (H1N1) has been posted on the WHO website.

National Institute for Communicable Diseases (NICD):

Refer to the website (http://www.nicd.ac.za) of the National Institute for Communicable Diseases (NICD) for regular situation updates of the H1N1 virus within the Republic of South Africa. (Updates are issued every Monday, in line with WHO requests to maintain reporting by epidemiological week.)

International Travel:

The WHO does not recommend restriction on international travel. As usual it is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention.

As some countries are implementing certain control measures at short notice travellers are advised to contact the Embassy/ High Commission/ Consulate General of the country they intend visiting to ascertain whether there are any restrictions in place.

Travellers should consult a doctor immediately if they show signs of flu-like symptoms.

What to do when you get sick?

According to the NICD, if you live in areas where people have been identified with the H1N1 virus, and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, it is recommended you seek medical care.

For further information on emergency warning signs in children and adults, that need urgent medical attention, refer to the link to the NICD http://www.nicd.ac.za/pubs/communique/2009/sitrep/SwineFAQ.htm.

Increased risk of severe disease:

According to the WHO, the majority of patients infected with the H1N1 virus experience mild symptoms and recover fully within a week, even in the absence of any medical treatment.

In addition to the accumulating evidence suggesting pregnant women are at higher risk, groups at increased risk of severe or fatal illness include people with underlying medical conditions, most notably chronic lung disease (including asthma and other forms of respiratory disease), cardiovascular disease, diabetes, and immunosuppression (which involves an act that reduces the activation or efficacy of the immune system). Some preliminary studies suggest that obesity, and especially extreme obesity, may be a risk factor for more severe disease.

Within this largely reassuring picture, a small number of otherwise healthy people, usually under the age of 50 years, experience very rapid progression to severe and often fatal illness, characterised by severe pneumonia that destroys the lung tissue, and the failure of multiple organs. No factors that can predict this pattern of severe disease have yet been identified, though studies are under way.

Further information is available on http://www.who.int/csr/disease/swineflu/notes/h1n1_pregnancy_20090731/en/index.html.
Tests available in South Africa:

The National Influenza Centre at the National Health Laboratory service at the National Institute for Communicable Diseases and Virology Laboratory at the University of Stellenbosch are currently providing the testing for the virus. Additional laboratories will be providing testing in the coming weeks.

Suspected cases that will be tested:

Suspected cases will be tested, and a suspect case is currently defined as follows:

An individual with recent onset of influenza-like illness – fever of 38°C plus one or more of the following acute respiratory symptoms (sore throat, runny nose/nasal congestion, cough or muscle pains) and gives one of the following histories:

travel within 7 days prior to onset of symptoms to countries with confirmed community-wide outbreaks
close contact with an individual who is a suspected/confirmed case of H1N1 infection in the 7 days prior to onset of symptoms i.e. having cared for, lived in the same household with, or had direct contact within 2 meters of a suspected or confirmed case of H1N1 virus.

Further information is available on http://www.nicd.ac.za/pubs/communique/2009/sitrep/SwineFAQ.htm.

Effective treatment in South Africa:

Oseltamivir (Tami flu®) are drugs currently recommended in South Africa.

According to the NICD it is recommended that treatment be given only to suspected and confirmed cases showing severe symptoms as well as those at high risk of severe illness.

Information adapted from:

The World Health Organisation (WHO).
National Institute for Communicable Diseases (NICD).
Centers for Disease Control and Prevention (CDC).