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Swine Flu

Fwd Narotambhai Pattni, London

Please find below link for leaflet on Important Information about Swine Flu. Click here for more information Please read carefully.


Influenza  and  Avian Flu
Dr Bhiku Pattni. Birmingham. U.K.

Dear Community members


Influenza or “flu” has been in the news lately. Its not that flu is a new disease that is threatening the mankind. Indeed we have known the flu virus for many centuries!


This short article is an attempt to shed some light on the current worries about the so called bird or “Avian” flu. Importantly for most people the flu that they are most likely to come across is the seasonal flu that we see in this country in winter (namely October to March every year). We know a lot about the seasonal flu virus that affect us every year.


The following information will help to answer some of the questions you may have about flu.

Influenza is a virus which causes a severe form of respiratory tract infection with generalised bodily symptoms. It spreads around the world in epidemics and is responsible for much ill health as well as many deaths.

Symptoms of seasonal human Influenza

If you start to develop cold symptoms but starting more rapidly and rather more violently, with higher fever and severe aches and pains, often in the back and muscles, then you may well be developing influenza. This may be associated with severe headache, cough, and, as a result of the fever, intermittent sweating and shivering. Sometimes there is a gastrointestinal element, with vomiting and/or diarrhoea.

Many people think they have had "flu" when all that they have suffered is a bad cold. When you have influenza you will know the difference. Most people will find it impossible to leave their bed and feel terrible and feel very ill.

The worst symptoms usually last for three to five days, and then should begin to improve. It is common to need two to three weeks off work as there is considerable debility left after the feverish illness is over. Do not be surprised to be quite depressed, this is a natural after-effect of the condition.

Influenza makes everyone feel terrible, but most people recover. However it does have a small but significant mortality, especially in the very young, the very old, and those with poor immunity.


Influenza is caused by a virus which attacks our body's cells, resulting in various effects depending on the strain of the virus.

The virus mutates all the time and new variations (strains) arise. Unfortunately immunity against one strain (which is conferred by exposure or immunisation) does not protect against other strains. In the era of rapid air transport the worldwide spread of a new type of influenza can be extremely fast.


Diagnosis is largely based on the severity of the condition and the way in which it affects you (symptoms). It is possible to test body secretions for the influenza virus, but this is not usually of practical value as the test takes some time to show a result.


Until recently there was no specific treatment for influenza, and for most people it is still best to treat the symptoms in the old fashioned way:

  • Stay at home.
  • Drink plenty of fluids.
  • Take symptom relief with:

to help with fever and aches and pains. And:

    • decongestants
    • cough medicines
    • gargles, lozenges etc.,

to help with other symptoms.

  • If you are still hot, sponge down (or be sponged down!) with tepid water.
  • Await natural recovery.

New Developments

There are very few treatments that work on viruses. Those that do work on influenza need to be given within 48 hours of the onset of the attack, before it is possible to be absolutely sure of the diagnosis, and only shorten and reduce the severity of the condition.

The other aspect of this is that they are only available on prescription, and if everybody with influenza were to see their doctor within two days of developing symptoms the healthcare systems in most countries, already stretched by an epidemic, would probably grind to a complete halt. Prevention, with influenza vaccine, is a far better option.

When to call the doctor

You should consult your doctor if symptoms such as clouded/altered consciousness, breathlessness, or severe chest pain occur, and if you are concerned. Try not to call just because of the temperature, aches and pains, and cough, as there is nothing your doctor can do that you can not, and what is more, there are likely to be many other people with similar symptoms, stretching family doctor, nursing and hospital services to the limit.

If symptoms continue unabated for more than a week, or if you seem to be improving for a few days then get much worse again, it is worth asking your doctor's advice.

Sometimes, during 'flu, a secondary infection gets in while the body's defences are down. This is most commonly a chest infection and can be a pneumonia. The secondary infection is often caused by bacteria, and as a result is likely to respond to an antibiotic.


This is the current preferred defence against the influenza virus. There are many influenza viruses, often named after places where epidemics have occurred. There tend to be only one or two which reach epidemic proportions each year. By monitoring the progress of these worldwide, the World Health Organisation (WHO) each year decide on the best "cocktail" of influenza types to be included in that year's influenza vaccine.

It is advised that people belonging to the following risk categories consider annual influenza vaccination. In the UK this is available free of charge from your doctor from  October onwards.

High risk groups

There are various groups who are more at risk during influenza epidemics. These include:

  • people aged 65 or older
  • people who have poor immunity
  • people with conditions such as diabetes, lung disease (asthma, bronchitis), kidney disease, heart disease, or liver disease.

Other people who are not at such risk from influenza might choose to have the vaccination, but in the UK this is not routinely covered the National Health Service. Your employer may offer this as occupational health service or alternatively you can make a private arrangement with a doctor.

Avian Flu (H5N1 strain)


The link below lists the answers from the Chief Medical Officer of the department of health (DOH)  given to the BBC and I feel anwers most of the questions.




1)      Be aware of flu in general. Avian flu is not yet a worry in this country at present. Steps are being taken by the government and the health service to be prepared rather than take a wait and see attitude.

2)      If you are not at risk and get the seasonal flu treat it as described above with symptom control medications.

3)      If you belong to a group at risk make sure you have received your vaccination. If not get one as soon as you can.


By Dr Bhikhu L Pattni

General Medical Practitioner


Sadly we have had many deaths recently in our community. Our prayers and hearts go out for the departed souls and their loved ones and the family

When a young life is lost, the sadness and the intensity of loss are immeasurable and words cannot describe such catastrophe. With the deepest of sadness and greatest respect for the family that has suffered such a loss, we learned that a fine young man from our community was a victim of a disease that known as Meningitis.


So what is Meningitis? How do we recognise it? Is it preventable? Is there cure or treatment? How can we raise awareness both within our community and the wider world?


In a short article like this it is not possible to answer the above questions in details. I hope the following will help in understanding of the questions posed above.


Meningitis is usually (but not always) a sudden acute illness of a membranous lining that covers the brain and spinal cord called the meningeal membrane. When this lining gets infected or inflamed, it is referred to as meningitis. The lining is important for the proper functioning of the brain and spinal cord. There are many bugs that cause such infections. Some are common and others very rare (for example TB). Viruses can also give rise to meningitis though usually this is less severe.


Another form of meningitis is called septicaemia. Meningitis can occur with or without septicaemia.  This is a more severe form of the disease with high fatality rates. Essentially it means the bacteria has invaded the blood stream and spreads to all parts of the body. It makes the blood vessels very leaky so that blood and fluid leaks out from the vessels, leading to severe shock (rapid and extreme lowering of blood pressure) and multiple organ failure within minutes or hours.


There is no easy way of recognising the early symptoms of meningitis. In the early phases it can resemble flu like illness. It is also more common in winter months than summer months. Young children and young adults are more at risk but the disease can strike at any age. Some of the early symptoms are tiredness, headache, and body ache. Symptoms that are specific for meningitis are inability to withstand strong light, neck pain and stiffness. A specific rash may or may not develop. This is called a haemorrhagic rash (a purple bluish rash that does not disappear on pressure). The tumbler test is a useful tool to determine whether the rash fades or not. It is described in the link mentioned at the end of this article.


A full detailed explanation of the relevant symptoms is provided in the site maintained by the meningitis trust and I shan’t repeat them.


Although not all forms of meningitis are as yet preventable, vaccination is now available and routinely recommended for some forms of meningitis. This includes Haemophilus influenza bacteria (HiB vaccination routinely offered to all babies) MenC vaccination against meniningococcal C strain. There is no vaccination against the B strain as yet. Young adults going to University are particularly advised to be immunised against Men C and Hib form of meningitis.


Effective treatment depends on early diagnoses. If diagnosed early and appropriate antibiotics are administered as quickly as possible, outcome is better.


Help yourself and others by becoming meningitis aware. Do not hesitate to seek help and advise from a health professional if you have the slightest suspicion that you or other you know exhibits some symptoms of meningitis. Remember the earlier the detection or diagnosis the better the outcome. If you see a rash that is highly suggestive of meningitis (see the tumbler test in the link below) treat it as an emergency and call the emergency services for advice and response.


The following is an authoritative source of information for meningitis and I would highly recommend visiting the site for detailed information, help and advise on meningitis.


Dr Bhikhu L Pattni

General Medical Practitioner

Seven Indonesian Bird Flu Cases Linked to Patients (Update1)

2006-05-23 14:46 (New York)

By John Lauerman May 23 (Bloomberg)
Fwd by Pradip Pattni, London

All seven people infected with bird flu in a cluster of Indonesian cases can be linked to other patients, according to disease trackers investigating possible  human-to-human transmission of the H5N1 virus.

     A team of international experts has been unable to find animals that might have infected the people, the World Health Organization said in a statement today. In one case, a 10-year-old boy who caught the virus from his aunt may have passed it to his father, the first time officials have seen evidence of a

three-person chain of infection, an agency spokeswoman said. Six of the seven people have died.

     Almost all of the 218 cases of H5N1 infections confirmed by the WHO since late 2003 can be traced to direct contact with sick or dead birds. Strong evidence of human-to-human transmission may prompt the global health agency to convene a panel of experts and consider raising the pandemic alert level, said Maria Cheng, an agency spokeswoman.

    Considering the evidence and the size of the cluster, it's a possibility, Cheng said in a telephone interview. It depends on what we're dealing with in Indonesia. It's an evolving situation.

     The 32-year-old father in the cluster of cases on the island of Sumatra was ``closely involved in caring for his son, and this contact is considered a possible source of infection,'' The WHO said in its statement. Three others, including the sole survivor in the group, spent a night in a ``small'' room with the boy's aunt, who later died and was buried before health officials could conduct tests for the H5N1 virus.

 Directly Linked
“All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness,” the WHO said.

     While investigators have been unable to rule out human-to-human transmission in the Sumatran cluster, they continue to search for other explanations for how the infections arose, the

WHO statement said.

     Health experts are concerned that if H5N1 gains the ability to spread easily among people, it may set off a lethal global outbreak of flu. While some flu pandemics are relatively mild, the 1918 Spanish flu pandemic killed an estimated 50 million people worldwide.

     So far, studies of the Sumatran outbreak and genetic analyses of the virus don't indicate the virus has undergone major changes, Cheng said. Scientists at WHO-affiliated labs in the U.S. and Hong Kong found no evidence that the Indonesian strain of H5N1 has gained genes from pigs or humans that might change its power or spreading ability, WHO said.


These viruses mutate all the time and it's difficult to know what the mutations mean,'' Cheng said.

     Health officials earlier found strong evidence of direct human-to-human spread of H5N1 in Thailand in 2004. Scientists reported in the Jan. 27, 2005, issue of the New England Journal of Medicine that the H5N1 virus probably spread from an 11-year- old girl in Thailand to her aunt and mother, killing the mother and daughter. People who had more casual contact with the girl didn't become infected.

     In the Sumatran cluster, close, direct contact with a severely ill person was also needed for spread, Cheng said. Preliminary findings from the investigation indicate that the woman who died, considered to be the initial case, was coughing frequently while the three others spent the night in the same room. One of the three, a second brother, is the sole survivor. The other two, her sons, died. “It looks like the same behavior pattern'” of close contact and caretaking during illness with the bird flu virus, Cheng said. To raise the level of pandemic alert ``it would have to be transmissible from more casual contact.''

General Community
 The Indonesian Ministry of Health and international scientists are continuing their investigation to trace the  origins of the infections, the WHO said in its statement. Priority is now being given to the search for additional cases of influenza-like illness in other family members, close contacts, and the general community,'' the WHO said. ``To date, the investigation has found no evidence of spread within the

general community and no evidence that efficient human-to-human transmission has occurred.''

With reporting by Jason Gale in Singapore.

Editor: Gienger


Story illustration: For news related to bird flu,

For the World Organization for Animal Health's fact sheet on bird flu, see
For WHO's latest situation on bird flu, click on

To contact the reporter on this story: John Lauerman in Boston at (1) (617) 210-4630 or

To contact the editor responsible for this story: Robert Simison at (1) (202) 624-1812