As flu season approaches, health units across Northern Ontario are planning for the onset of the H1N1 virus, also known as the pandemic human swine influenza.
The pH1N1 flu virus is a respiratory infection known to afflict pigs. This current virus was thought to have originated from swine in Mexico, causing human infection from direct exposure. However, the virus is now being transmitted by people throughout the world and has been classified as a phase-six pandemic by the World Health Organization.
A flu pandemic is declared when the emergence of a new strain of influenza A virus occurs in which people have little or no immunity, and is spread easily from person to person, resulting in many illnesses and possible deaths. The declaration is based on the spread of the virus, not the severity. SYMPTOMS AND CASES
The symptoms mimic the seasonal flu, causing headache, chills and cough, followed by fever, loss of appetite, muscle aches and fatigue, runny nose, sneezing, watery eyes and throat irritation, according to the Ministry of Health and Long-Term Care's website. Other symptoms like nausea, vomiting and diarrhea may occur in adults and children. Pneumonia may develop in people with chronic conditions.
Currently, the virus is spreading easily from person to person and from one country to another. As of August 21, there have been more than 182,000 laboratory confirmed cases of pH1N1 across the globe, and 1,799 deaths in 177 countries and territories, according to WHO update No. 62.
In Ontario, there have been 339 pH1N1 hospitalizations and 21 deaths as of August 14. Half of those hospitalized were 20 or younger, which appears to be the target group. Based on historical flu viruses, those born before the 1957 Asian flu outbreak and 1968 Hong Kong flu may have more immunity.
Dr. Jim Chirico, acting medical officer of health for the North Bay Parry Sound District Health Unit, said the mortality rate is actually less than what is seen with seasonal flu.
"There is a population mortality rate of 1.6 per million," he said. "So, out of one million people, we would expect 1.6 pH1N1 deaths. Every year, seasonal flu will kill about 300 people in Ontario and about 3,000 in Canada - more than what we are seeing with the pH1N1."
As of mid-August, the virus had been described as mild. Of the 21 fatal cases in Ontario, 18 were older than 40 with underlying medical conditions, according to Chirico.
The Public Health Agency of Canada's weekly Flu Watch bulletin ending August 8, 2009 suggested the overall pH1N1 flu activity has decreased across Canada, with its peak period between June 14 and July 25, 2009.
But as the fall approaches, health units across Northern Ontario are preparing for an increase in seasonal influenza types A and B, and the circulating pH1N1 virus.
The Northern Ontario Medical Journal spoke with representatives from the Thunder Bay, Porcupine, Sudbury, and North Bay and Parry Sound District Health Units, all of which have their own pandemic plan as required by the province since the SARS outbreak. Health units are monitoring the epidemiology of the virus and are in a heightened surveillance mode.
Surveillance
"We are trying to monitor the southern hemisphere because they are in their seasonal flu period," Chirico said. "They are seeing predominantly pH1N1, but are not seeing a severe form yet."
National and world reporting organizations are monitoring and updating information weekly. Physicians report the number of influenza-like illnesses in patients from 170 sentinel positions throughout Ontario. Each health unit is mandated to report respiratory infection outbreaks in hospitals, long-term care facilities, and absentee rates in schools and workplaces. Telehealth calls are also analyzed. Immunizations and the use and distribution of antivirals are also monitored. Chirico said they have both passive and active surveillance.
Education
Another key component of pandemic preparation is education and communication with the public and health unit part
