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5 Major Phases of Pandemic Influenza: Swine Flu

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Since centuries, humans have confronted catastrophes, illnesses, and warfare that have destructed and adversely deteriorated human lives. However, since a few decades, medical science with the collaboration of healthcare organizations is playing an influential role in minimizing the effects of health-related illnesses and diseases. Despite rapid scientific and medical advancements, some health-related diseases have remained a notion of major concern for healthcare organizations, and pandemics is one of such issues that have continued to hoard thousands of people under its adverse effects. This paper would clearly try to speak about the pandemics, its past. It will endeavour to discuss one of the examples of pandemics that will enable a comprehensive understanding of this health-related issue.

5 Major Phases of Pandemic Influenza Swine Flu

This is an assumption that pandemic flu is not the common flu and occurs after decades of normal intervals, thus affecting a significant number of regions across the globe. Experts find it to be one of the most severe forms of influenza in terms of effects, though it can not be distinguished from ordinary flu based solely on symptoms. Throughout the history, pandemic flu viruses have continued to alter its specifications that are the major complexity of pandemics, as every time, pandemic flu comes in a new wardrobe that is its major tool to affect people due to absence of immunity against the new strain (Reeth, pp. 243-60, 2007). In specific, an animal flu virus plays a crucial role in spreading pandemics in humans, such as the case of the bird flu virus that affected thousands of people around the globe.

Due to innovative strains of pandemics every time, healthcare experts are usually incapable of creating its antiviral during initial stages, and only analysis of few patients allow experts to create its vaccines that also take few months, causing losses of hundreds of lives. Since the sixteenth century, pandemics have continued to deteriorate human lives with intervals of ten to forty years while altering its complexities, effects, as well as physiological characteristics.

Experts (Tognotti, pp. 31-34, 2009) Pandemics have been reported to endorse animal influenza viruses commonly found in mammals and birds. Although a majority of viruses from mammalian species does not affect humans directly, however, few can contaminate humans. Analysis of the material on pandemics identified that such animal virus looks for isolated regions to infect humans with zero immunity, and consequently, resulting in transmissions of viruses from infected individuals to other communities. Genetically, pandemics occur through two processes: reassortment or mutation. In the former process, genes of both human, as well as animal viruses, interact collectively to create a reasserted new virus. In the later process, genes of animal virus alter its attributes to adjust in the human body, and then, enabling human-to-human transmissions (Reeth, pp. 243-60, 2007).

Lastly, medical science does not call a disease as pandemic unless it is infectious regardless of its impact and symptoms that is another mandatory requisite of becoming a pandemic. For example, cancer has been affecting and killing thousands of people every year; however, it does not come under pandemics due to its inability to contagious. Before discussing one of the specific examples of pandemics, the paper will go through some of the pandemics cases that affected millions of people throughout human history (Fineberg, pp. 37-44, 2005):

  • Typhoid Plague of Athens – 430 BC. Killed 25% of the Athenian population
  • Antonine Plague, 165–180. Smallpox killed approximately five million people.
  • Plague of Justinian, 541-750, bubonic plague in Egypt killed ten thousand people every day.
  • Black Death, the 1300s, Killed 75 million people
  • Third Pandemic killed 10 million people in India.
  • Smallpox in 1520s killed 150,000 in Tenochtitlán.
  • During the 1770s, smallpox killed thirty per cent of the Native Americans.
  • During 1848–49, measles killed 40,000 people in Hawaii.
  • In the late 19th century, tuberculosis-infected a majority of urban European and North American inhabitants, killing forty per cent of them
  • Malaria has continued to affect and killed people throughout the world. Annually, it infects more than 400 million people globally in different parts, especially Africa, and Asia.

(WHO, 2009)

Swine Flu

Until now, the paper has attempted to provide a brief perspective of pandemics along with a timeline of its historical existence. Now it will endeavor to discuss and analyze some aspects of one of the major examples of pandemics: Swine Flu that will provide an extensive idea of deadly existence of pandemics globally. In specific, Swine flu relates to an animal influenza virus that has been able to infect humans in the form of respiratory illness. Although experts (Reeth, pp. 243-60, 2007) Pigs have been confirmed as the primary cause of Swine flu but they have not yet been able to trace the origin of the pigs that started this outbreak worldwide. Until now, it has resulted in the deaths of thousands of people and is still transmitting from one individual to another that is the major cause of its pandemic status.

Swine flu has been successful in altering its physiological attributes to distinguish itself from ordinary flu viruses, another requisite to become a pandemic flu. Moreover, healthcare experts (Maher, pp 154-57, 2009) have noticed that a majority of humans is not immune to this new pandemic flu. Thus, human society is confronting huge threats due to the worldwide spread of Swine flu. In response, several healthcare organizations, especially World Health Organization is putting efforts along with other national health-related organizations in creating mitigation strategies to eliminate this kind of pandemics that have continued to kill humans throughout the history.

In particular, minute particles are the major constituents of Swine flu virus that travel through drops of human cough or sneeze, and this is the major mode of transportation of Swine flu from one human to another (Maher, pp 154-57, 2009). Handshakes have become another crucial tool of transmittal of Swine flu due to lack of awareness, especially in rural regions where people do not use tissues while coughing and sneezing and use hands instead. In this regard, health awareness is an imperative methodology that can mitigate and eliminate threats of Swine flu on a global level. Although health experts (Murphy, pp. 336-40, 2009) have been able to create antiviral drugs, however, studies have indicated that it is not a cure but only temporary recovery method to reduce the speed of symptoms. Thus, precaution is the only cure in cases of pandemics, and especially Swine flu.

Although swine flu has continued to alter its physiological characteristics, however, several experts (Maher, pp 154-57, 2009) have attempted to relate it with avian influenza as well due to chances of infection in pigs through avian influenza. Moreover, swine flu has emerged in different ways that have resulted in its different types. For instance, over the years, swine flu has appeared by (Miller, pp. 19-22, 2006):

  • Only animal influenza virus (pig influenza)
  • By mixing animal influenza and human influenza virus
  • Mixing pig influenza and avian influenza

Currently, health experts have categorized the common swine influenza ‘A’ into four major types in the context of specifically pigs that are (Shinde et al., pp. 1-11, 2009):

  • H1N1
  • H1N2
  • H3N1
  • H3N2

where H1N1 subtype has remained the most common type of swine flu in humans. As earlier mentioned that one cannot distinguish pandemic flu from ordinary flu based on symptoms, thus, studies (Maher, pp 154-57, 2009) related to swine flu have indicated some of the common symptoms, such as breathlessness, cough, fever, sneeze, etc. that can be observable in ordinary flu as well. This is the major quality of swine flu as it acts as the ordinary flu in the initial stages; however, become deadly and hazardous in its later phases (Friedman, pp. 23-25, 2008). Some of the other indications of swine flu are body ache, headache, and loss of hunger.

Some recent investigations (Myers et al., pp. 1-5, 2007) regarding swine flu have specified that swine flu usually has not been the source of infectious diseases in humans. Thus, it has always been taking the support of other irregular human diseases to enter into the body. Moreover, experts have indicated that individuals working in the pig industry and people living near pig meat factory are some of the major vulnerable members of the society that can catch swine flu easily. Also, healthcare workers are at risk as well due to their exposure to patients confronting different illnesses. Thus, they must be alert to avoid the occurrence of swine flu in their body. Once a human is infected, it then acts as a transmitter to spread it in the environment as it happened during different swine flu outbreaks in 1918, 1976, 1988, 1998, 2007, and now in the year 2009 (Gojovic, pp. 673-80, 2009).

From 2005 to 2009, swine flu has infected approximately twelve people in the USA, whereas, WHO (pp. 20-28, 2009) has shown reports of infected cases of swine flu in Canada, Mexico, etc. In the past, a major misconception regarding swine influenza was that it could travel in food as well. However, recent experts have specified that eating pork meat or pork products cannot infect an individual with swine influenza; however, individuals cooking pork meat must cook it on at least 160°F temperature that is enough to kill swine flu viruses in the meat.

Besides prevention, experts (Sinha & Roy, pp. 349-51, 2009) have clarified that a respiratory sample is the most imperative requisite for diagnosing ‘A’ type of swine flu and that even during its first phase of 4-5 days. However, usually, adult patients are not aware of their state that is the major complication in the cases of swine flu, and adult patients usually confront losses consequently. On the other hand, swine flu in children takes ten days or more for its initial phase that gives more time to experts for its diagnosis. In the USA, the CDC has been able to create various antiviral drugs to reduce the acceleration level of swine influenza virus in the body. Some of these drugs are zanamivir, amantadine, oseltamivir, etc. (Nichol & Treanor, pp. 1-4, 2006). Although abovementioned antiviral drugs have been successful in affecting swine flu viruses, however, recent reports have indicated that some swine flu viruses have begun to alter their characteristics to become resistant against these drugs, especially amantadine.


Until now, the paper has discussed different aspects of Swine flu that has resulted in huge losses of human lives around the globe. Analysis (WHO, pp. 28-34, 2009) has indicated that treatment and diagnosis is the major complication in pandemic influenza cases. Thus, prevention and management strategies are playing a crucial and influential role in alleviating the risks and threats associated with pandemics. However, to create management strategies, World Health Organization (2009, pp. 28) has developed a series of phases regarding pandemic influenza that is very crucial for preventing and managing such cases globally. For swine flu, countries are planning and acting on the same guideline and thus, it is very imperative to discuss it in the paper that will provide a critical understanding of pandemics.

Experts (WHO, pp. 28-34, 2009) have indicated that influenza viruses continue to exist in animals and most specifically birds; however, such viruses rarely change into pandemic viruses. In phase one, influenza viruses remain in the animals, while humans do not catch them. However, in the second phase, a human incidentally confronts infection from pet or wild infected animals during his/her employment at a farm/zoo/meat factory, etc. End of phase two results in the major threat of pandemics globally.

In the third phase, influenza viruses begin to transmit from humans to humans, as well as from animals to humans in people of a specific and limited location and do not spread communally. WHO has termed this phase as limited transmittal phase of pandemics, as the spread of virus remains limited, indicating its incapability of becoming a pandemic. However, in the fourth phase, influenza viruses begin to infect people on the communal basis that is where national authorities must coordinate with the World Health Organization (2009) for effective assessment and investigation of virus specimens to avoid further outbreaks on a national and international level.

Some experts (Davies, pp. 449-51, 2009) have forbidden calling viruses a pandemic even during the fourth stage and clarified that efficient step can eliminate risks of occurrence of a pandemic. However, an influenza virus becomes pandemic influenza once it enters the fifth stage that involves the transmission of the virus from one country to another through human-to-human or human-to-animal transmits. According to WHO regulations, the occurrence of influenza virus in at least two countries of a single region is an indication of a confirmation of upcoming pandemic influenza globally. For such purpose, WHO (pp. 35, 2009) has categorized world map into different regions to determine the level and impact of pandemic influenza:

  • Africa Region
  • America Region
  • Eastern Mediterranean Region
  • European Region
  • South-East Region
  • West Pacific Region

The sixth phase is the pandemic phase that signifies the occurrence of pandemic influenza on a global level, and WHO confirms this phase when an influenza virus travels from one of the countries from a single region to a country of another region. During this phase, surveillance is at the highest peak that reduces to adequate level during the post-peak period that indicates lessening of pandemic influenza globally.

However, WHO has indicated that pandemics may occur in different waves, and thus, national authorities must stay alert to confront second or even third wave of the pandemics. Lastly, pandemics end with post-pandemic phase in which pandemic influenza changes back into ordinary or seasonal influenza. During this phase, countries must continue their recovery, as well as evaluation processes to eliminate any vulnerability left in the region.

Management Strategies

In this last section, the paper will endeavour to discuss some of the management strategies that can facilitate national authorities and healthcare organizations in managing different phases of pandemics (Baker, pp. 343-45, 2009).

  • Planning and Coordination

Involves deciding leadership in different regions on the national level along with the integration of pandemic-related preparatory regulations into emergency structures of national level

  • Situation Monitoring and Assessment

It involves the collection, analysis, and distribution of information regarding influenza before its occurrence to encourage awareness and prevention.It also includes an assessment of specimens to monitor influenza levels and impact on the regional level, as well as for the creation of vaccines.

  • Reducing the Spread of Disease

It involves strategies to discourage social gatherings and increase distances between individuals, especially in travelling at railway stations, airports, roads, etc.

  • Continuity of Health Care Provision

It includes campaigns to motivate personal hygiene on the individual, as well as a communal basis with the help of media.It also involves the utilization of pharmaceutical companies to help national authorities in mitigating the effects of pandemic influenza on a national level (WHO, pp. 34-35, 2009).


Conclusively, the paper has discussed some of the significant aspects of pandemics while analyzing one of the major examples of pandemic influenza: Swine Influenza. Experts have indicated that pandemics usually take the support of animal influenza viruses that exist in mammals and birds. Also, medical science does not call a disease as pandemic unless it is infectious regardless of its impact and symptoms that is another mandatory requisite of becoming pandemic influenza. In particular, minute particles are the major constituents of Swine flu virus that travel through drops of human cough or sneeze, and this is the major mode of transportation of Swine flu from one human to another.

Besides prevention, experts have clarified that a respiratory sample is the most imperative requisite for diagnosing ‘A’ type of swine flu and that even during its first phase of 4-5 days. However, usually, adult patients are not aware of their state that is the major complication in the cases of swine flu, and adult patients usually confront losses consequently. Consequently, the paper discussed five major phases of pandemic influenza and then, some of the management strategies. It is an expectation that the paper will be beneficial for students, teachers, and professionals in better understanding of the topic.

  • Baker, Maureen. (2009). “Pandemic Flu.” Education for Primary Care. Volume 20, Issue 5, pp. 343-45.
  • Davies, Justine. (2009). “Swine Flu Vaccines.” Journal of Cell. Volume 139, Issue 3, pp. 449-51.
  • Fineberg, Harvey V. (2005). The Swine Flu Affair. University Press of the Pacific.
  • Friedman, Lauri S. (2008). Pandemics. Greenhaven Press.
  • Gojovic, Marija. (2009). “Modeling Mitigation Strategies for Pandemic (H1N1) 2009.” Canadian Medical Association Journal. Volume 181, Issue 10, pp. 673-80.
  • Maher, Brendan & Butler, Declan. (2009). “Swine Flu.” Nature. Volume 462, Issue 7270, pp. 154-57.
  • Miller, Debra A. (2006). Pandemics. Lucent Books.
  • Murphy, Jeannette. (2009). “Global Health.” Health Information & Libraries Journal. Volume 26, Issue 4, pp. 336-40.
  • Myers, K. P, Olsen, C. W., Gray, G. C. (2007). “Cases of Swine Influenza in Humans.” Journal of Clinical Infectious Diseases. Issue of 2007, pp. 1-5.
  • Nichol, K. L., Treanor, J. J. (2006). “Vaccines for Seasonal and Pandemic Influenza.” Journal of Infectious Diseases. Issue of 2006, pp. 1-4.
  • Reeth, Kristen Van. (2007). “Avian and Swine Influenza Viruses.” Journal of Veterinary Research. Volume 38, Issue of 2007, pp. 243-260.
  • Shinde, Vivek, Bridges, Carolyn B, et al. (2009). “Triple-Reassortant Swine Influenza A (H1) in the United States.” The New England Journal of Medicine. Volume 10, Issue 2, pp. 1-11.
  • Sinha, Niladri Kumar & Roy, Ayan. (2009). “Evolutionary Complexities of Swine Flu H1N1 gene sequences of 2009.” Biochemical and Biophysical Research Communications. Volume 390, Issue 3, pp. 349-51.
  • Tognotti, Eugenia. (2009). “Influenza Pandemics.” Journal of Infection in Developing Countries. Volume 3, Issue 5, pp. 331-334.
  • WHO. (2009). “Pandemic Influenza Preparedness and Response.” Global Influenza Programme. Retrieved on November 20, 2009: www.who.int/csr/disease/influenza/PIPGuidance09.pdf

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