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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What do we do? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CHALLENGES WE FACE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Scenario ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Enigmatic questions ,[object Object],[object Object],[object Object]
Subsequent challenges ,[object Object],[object Object],[object Object],[object Object]
Influenza At A Glance ,[object Object],[object Object]
INFLUENZA VIRUS
ELECTRON MICROSCOPY
TYPES
PIG  THE CREATOR
VIRAL VARIANTS ,[object Object],[object Object],[object Object],[object Object],[object Object]
QUADRUPLE REASSORTMENT GENETICS  ,[object Object],[object Object],H1N1
EARTH  LIVING SPACE FOR ALL ,[object Object],[object Object],[object Object]
HISTORY ,[object Object]
Emergency hospital, Camp Funston, Kansas 1918
WHO ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Global pandemic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Global pandemic
EPIDEMIOLOGY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Transmission
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Can I get infected with this new H1N1 virus from eating or preparing pork? ,[object Object]
Is there a risk from drinking water? ,[object Object]
What kills influenza virus? ,[object Object]
Risk factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DEFINITIONS  ,[object Object]
Case Definitions By CDC ,[object Object],[object Object]
[object Object],[object Object],[object Object]
Close contacts ,[object Object],[object Object],[object Object]
Mexican data ,[object Object],[object Object],[object Object],nejm.org august 13, 2009
Preventive measures taken in Mexican hospitals ,[object Object],[object Object],nejm.org august 13, 2009
COMPARISION SEASONAL INFLUENZA H1N1 INFLUENZA AGE <5  YRS  >60 YRS YOUNG & MIDDLE AGE SEVERITY LESS SEVERE PNEUMONIA  ARDS MORBIDITY LESS MORE  BUT >60 YRS LESS LIKELY TO HAVE SEVERE PNEUMONIA
contd SEASONAL INFLUENZA H1N1 INFLUENZA SYMPTOMS RESPIRATORY RESPIRATORY  & GASTROINTESTINAL SECONDARY  ATTACK  RATE 5-15 % 22-33 % VACCINE PROTECTIVE UNDER DEVELOPMENT
AGE SHIFTS IN MORTALITY ,[object Object],[object Object]
[object Object],[object Object]
Specimens  ,[object Object],[object Object],[object Object]
[object Object],[object Object]
DIAGNOSTIC TESTS RT PCR QUIDEL CULTURE DFA/IFA
LAB TESTS ,[object Object],[object Object],[object Object]
[object Object]
Whom to test ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
CLINICAL FEATURES Vomiting or diarrhea (not typical for influenza but reported by recent cases of swine influenza infection)
Mexican data in MV patients
Mexican data in MV patients
Younger people at risk
10-50 yrs Severe Respiratory Disease Concurrent with the Circulation of H1N1 Influenza Gerardo Chowell, Ph.D., Stefano M. Bertozzi, M.D., Ph.D., NEJM August 2009
Can we make a broad clinical check list ,[object Object],[object Object],[object Object],[object Object],[object Object]
Other Manifestations: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Children Clinical Presentation ,[object Object],[object Object]
Children Emergency Warning Signs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
In adults, emergency warning signs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why Complications In young (Cytokine storm) ,[object Object],[object Object],[object Object],[object Object]
SYMPTOMS OF THE CYTOKINE STORM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cytokine Storm Treatment  ,[object Object],[object Object],[object Object],[object Object]
HISTOPATHOLOGY ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LABORATORY FINDINGS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
H1 N1 Pneumonia
COMPLICATIONS ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
DD H1N1 PNEUMONIA  ,[object Object],[object Object],[object Object]
TREATMENT ,[object Object],[object Object],[object Object]
Tamiflu ( Oseltamivir ) ,[object Object],[object Object]
 
Tamiflu
Tamiflu
Tamiflu(contd) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tamiflu (Contd) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Zanamivir ( Relenza) ,[object Object],[object Object],[object Object]
Mild Cases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hospitalized pts: ,[object Object],[object Object],[object Object],[object Object]
Supportive care ,[object Object],[object Object],[object Object],[object Object],[object Object]
It is highly contagious! ,[object Object],[object Object],[object Object],[object Object]
prevention
 
N95 Mask
What should I do to keep from getting the flu? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Avoid close contact ,[object Object],[object Object]
 
Prevention ,[object Object],[object Object],[object Object],[object Object],[object Object]
Is Negative Pressure Room Must ? Place patients in a single-patient room with the door kept closed & droplet and contact isolation
Is BIA ready?
Why do we need vaccine COST EFFECTIVE TARGET AT RISK PEOPLE VACCINE WINTER SEASON TO COME(LOW  HUMIDITY,TEMP) RAPID GLOBAL SPREAD SEASONAL VACCINE PROTECTION?
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dealing with the Deceased
Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object]
THANK YOU Department of critical care medicine

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