Swine Flu (H1N1) Prevention and Treatment: Vaccines, Antivirals, and Public Health Measures

Swine flu (influenza A H1N1pdm09) is a seasonal influenza strain. Prevention and treatment follow standard influenza guidelines.

1. Vaccination (Primary Prevention)

• Annual quadrivalent inactivated (IIV4) or recombinant (RIV4) vaccine includes H1N1pdm09 component.
• Recommended for all ≥6 months; priority: pregnant, chronic disease, immunocompromised, healthcare workers, ≥65 yrs.
• Effectiveness 40–60% when matched; reduces severity/hospitalization even if mismatched.
• Timing: September–October ideal; vaccinate through season.

2. Antiviral Treatment

• Neuraminidase inhibitors: Oseltamivir (Tamiflu®) 75 mg BID ×5 days; zanamivir (Relenza®) 10 mg BID inhaled ×5 days; peramivir (IV) single dose.
• Cap-dependent endonuclease inhibitor: Baloxavir marboxil (Xofluza®) single dose (40/80 mg by weight).
• Window: Start ≤48 hrs symptom onset for maximal benefit; still consider if high-risk/hospitalized later.
• Indications: Confirmed/suspected influenza in high-risk, severe/progressive, hospitalized.

3. Non-Pharmaceutical Interventions

• Stay home until afebrile ≥24 hrs without antipyretics.
• Respiratory hygiene: mask, tissue/elbow cough, hand hygiene (soap/water or ABHR ≥60% alcohol).
• Improve ventilation (HEPA, open windows).
• Clean high-touch surfaces (enveloped virus → susceptible to detergents).

4. High-Risk Groups

Pregnant, <5 yrs, ≥65 yrs, chronic pulmonary/cardiac/metabolic/renal/hepatic/neuro/immune conditions, BMI ≥40, long-term aspirin (<19 yrs).

5. Surveillance

CDC FluView, WHO GISRS track circulating strains, antiviral resistance, severity indicators.

Annual vaccination + early antiviral treatment for high-risk = best defense.