SWINE FLU

NEED FOR STUDY The recent outbreak of swine flu within the human population has caused a great deal of concern for health officials in India and has become a much publicized disease; Swine flu is a highly contagious acute respiratory disease of pigs caused by one of the several swine influenza viruses commonly H1N1 viruses. (Type an influenza virus) An average of 2, 00,000 Americans are hospitalized due to seasonal flu annually. Between 1976 and 2006, the fewest Americans who died from the flu were 3,000 in one year. The most deaths from flu in that same time period were 49,000 in one year. Most of those who died were either infants, elderly, or people who had compromised immune systems due to another medical problems. In US 1,192 specimens were tested by WHO and NREVSS ( National Respiratory And Enteric Virus Surveillance System) collaborating laboratories and reported to CDC/ Influenza Division and 9 (0.8%) were found positive for influenza. 105 Laboratory in US Confirmed influenza associated pediatric deaths which have been reported to CDC. The proportion of outpatient visits for influenza like illness (ICI) was 0.9%. New York City and 49 states experienced minimal ICI activity geographic spread of influenza in Duerto Rico and 21 states was reported as sporadic and the District of Columbia, US Virgin Island, Guam and 29 states reported no influenza activity US VIROLOGIC Surveillance IN NATIONAL LEVEL Swine flu has unfortunately now reached India. Out of the 1,121 specimens tested in India 837 specimens are confirmed positive. Proportion of outpatient visit for influenza like illness (ICI) was 2.5%. As we had witnessed, the outbreak of this drastic and dreadful disease, swine flu Spreading among human population and endangering the lives of many within the recent Past, so we have taken up this study for our project work in order to create an awareness about the prevention and treatment of swine flu.

REVIEW OF LITERATURE

REVIEW OF LITERATURE
Literature related to origin of swine flu. Literature related to transmission of swine flu. Literature related to prevention and treatment of swine flu. Literature related to role of research for swine flu.

LITERATURE RELATED TO ORIGIN OF SWINE FLU

A study conducted on an update of swine flu origin influenza virus A /H1N1 by Schnitzler S .V, Etal in 2009, Hygienic Institute. In this review, specific makers for virulence can be evaluated in the viral genome. There are concerns that this virus may mutate or rearrolt with existing influenza viruses giving rise to more transmissible or more pathogenic viruses. This summarizes the current informations on the new pandemic swine flu origin influenza virus A/ H1N1. A study conducted on novel swine origin influenza virus by michdelism Etal in 2009, In this review, we sum up the current situation and put it into the current state of knowledge of influenza pandemics some indications suggests that a pandemic may be mild but even mild pandemic can result in millions of deaths. However no reasonable fore lasts, now this pandemic may develop can be made at this time. A study conducted on origin and evolution of highly pathogenic avian influenza by Sims L.D,etal in 2005. Out breaks of highly pathogenic avian influenza caused by H5N1 viruses were reported. In eight neighboring Asian countries between December 2003 and January 2004, with a 9th reporting in August 2004, suggesting that the virus had spread recently and rapidly. There in some evidence that the excretion of the virus by domestic ducks had increased by early 2004, and there is circumstantial evidence that they can be transmitted by wild birds. Asian H5N1 viruses were first detected in domestic geese in southern china in 1996.BY 2000 there host range had extended to domestic ducks, which played a key role in the genesis of the 2003/04 out breaks. A study conducted on origin of pandemic (avian) influenza by Rajagopals Treanur in 2005, in department of medicine, University of Rochester School of medicine, New York. The review discussed regarding the epidemiology and genetics of avian influenza viruses, the potential for transmission of disease to humans. The global efforts for disease prevention via a host of programmes including intensified. Surveillance cutting infected birds, education of medical personnels and the public production of vaccines and use of specific antiviral agents. Eg: adementane, neuraminidase inhibitors.

LTERATURE RELATED TO TRANSMISSION OF SWINE FLU

A study conducted on swine outbreak of pandemic influenza A, virus in 12, June through 4, July 2009. The study investigates a PH1N1 out breaks occurring on a swine research from with 37 human and 1300 and 1300 swine in Alberts Canada from 12, June through 4, July 2009. Human serological testing and performance of the human influenza like illness (I L I), case definition were also done. Seven of 37 human developed 14 and 2 were positive for PH1N1 by revase transcriptase polymerase chain reaction (RT-PCR). A Study conducted on focal on 2009 H1N1 influenza (swine flu) in infectious disease group of Italian society. At the moment of the onset of the pandemic there was few data about the transmission of the 2009 H1N1 virus infection from the mother to the newborn. Nevertheless neonates born to an ill mother from 2 days before through 7 days after illness onset in the mother were thought to be exposed and potentially infected. Rigorous attention to standard precaution and droplet precaution is required to reduce the Trans mission of the infection in the health care setting. A study conducted on transmission of influenza A virus between pigs and people in 2002-2004 by carter H in kings college London. The respiratory samples was collected and tested for influenza viruses from swine worker (SW) and from pigs.senal blood samples from study participants were tested by hemaggultination inhibition. During the first year 15 of 88 swine flu (SW) had ILI and were sampled all was culture negative for influenza. During the second year 11 of 76 of SW had ILI and were sample one was culture positive for human seasonal H3N2 virus.

LITERATURE RELATED TO PANDEMIC SWINE INFLUENZA VIRUS

A study conducted on influenza type A (H1N1) virus infection by Engin A comhursitesi Tip fakuters, Enfeksiyon Hastaliklan etal. In 1997, in Hongkong, since avaian influenza virus from bird to human infection with high morbidity and mortality rate the probability of human to human transmission. The diagnosis is confirmed by viral isolation, detection of H5 Specific RNA.The transmission of H5N1 virus to human is by direct contact with infected birds and paultry, close contact with their secretions or contaminated fomites. After a mean incubation period of 2-5 days, infection onsets with high fever, lower respiratory tract infection and diarrhoea. In severe cases death occur due to acute respiratory distress syndrome and multiple organ involvement. In this review articles influenza virus A (H5N1) infections, epidemiology and protection have been discussed. A study conducted on Avian influenza by Thomas J.k etal university of Maryland Baltimore USA by Sept 2006. The world health organization considers the avian influenza A H5N1 virus a public health risk with pandemic potential, WHO has documented 258 confirmed human infections with a mortality rate effective defense against an influenza pandemic, would be a directed vaccine to elicit specific immune response towards the strain or strain of the influenza virus. Avian influenza virus A1H5N1 is a public health threat that has the potential to cause serious illness and death in human. A study conducted on the spread of avian influenza H5N1 virus by Chutinimitkul. S etal university Bangkok Thailand Jan 2006. The study reveals influenza A H5N1 virus infection presences a major health problems Asian and Eurasian countries. In1997, an outbreak of highly pathogenic H5N1 virus emerged and caused severe systemic disease. Moreover, laboratory diagnostic

techniques vaccination strategies and antiviral therapies must be aimed at outbreak control and management aspects.

LITERATURE RELATED TO EFFECT OF COMMUNICATION SWINE FLU

A study conducted on reassuring and managing patients with concerns about swine flu by Rubin GJ etal. They used qualitative interview to identify the main reason why people approach NHS direct with concern about swine flu and to identify aspects of their contact which were reassuring, resign a frame work approach.33 patients participated in semi structured interview. The study recommend future major incidents involving other forms of chemical, biological or radiological hazards may also cause large number of unexposed people to seek health advices our data suggest the providing telephone triage and information is such instance, particularly where advice can be given via trusted pre-existing service. A study conducted on the impact of communication about swine flu on public response to the outbreak by Rubin G.J etal in kings college, London. Thirty six surveys were run, at an average weekly, interval across the UK between 1st May 2009 and 10th January 2010. All participants were asked to state how worried they were about the possibilities of personally catching swine flu. In total 56.1% of respondents were very or fairly. A study conducted on the impact of communication about swine flu on public response to the outbreak by Rubin G.J etal in kings college, London. Thirty six surveys were run, at an average weekly, interval across the UK between 1st May 2009 and 10th January 2010. All participants were asked to state how worried they were about the possibilities of personally catching swine flu. In total 56.1% of respondents were very or fairly likely to accept the swine flu vaccine. The strongest predictors were being very worried about the possibility of one self (adjusted odds ratio {AOR} 4.7, 95% confidence interval {CI} 3.2-7.0) or ones child AOR, 95%, CI 4.6- 13.9 catching swine flu overall

33.1% of participants reporting carrying tissue with them 95% had bought sanitizing gel 2.0% had avoided public transport and 1.6% had sought medical advice.

LITERATURE RELATED TO SURVEY ON NEEDS, CONCERN IF BEHAVIOUR OF THE PEOPLE AFFECTED WITH SWINE FLU. A study conducted on exploring the need, concerns and behavior of people with existing respiratory condition in relation to the H1N1 swine influenza pandemic, a multicenter survey and qualitative study by Luker K.A University of Manchester UK. The method used is mixed method study cross sectional survey (253 patient, 101 family members) ; one to one interview(13 patient, 7 family members) and focus group ( n = 3 groups, 30 participants). Most had already received information about swine flu (n = 187, 73.9%, p; n = 78, 77.2% FM). Mainly via a leaflet delivered to their home (n =125, 49.4%, p; n= 55, 54.5% FM). More patient were worried (n=147, 58.31) than not worried (n=99, 39.3%) about swine flu. Commonly adopted preventive measure were more frequent hand washing (107, 42.8%, p; 38, 37.6% FM) and greater use of sanitizing hand gel (n= 100, 40.5%, p; 37, 36.6% FM) in total 212 patient (83.8%) and 69 family members (68.3%) were very fairly likely to take up swine flu vaccination. Participants were not highly anxious about swine flu, but did recognize risk for patients.

LITERATURE RELATED TO PRECAUTIONS TAKEN DURING SWINE FLU WHILE TRAVELING

A Study conducted on level of concern and precautions taking among Australians regarding travel during pandemic (H1N1) 2009. There was 1292 respondents (45% response rate) .About half (53.2%) of respondent indicates some level of concern about pandemic (H1N1) 2009 when travelling and just over one third (35.5%) indicated they would likely cancelled. None the less, the majority of Queenslanders would have not postponed their own travel, if they exhibited symptoms consistent with pandemic (H1N1)2009. A Study conducted on new influenza A/H1N1 (swine flu) information needs of airport passengers and staff. At the start of the influenza A/H1N1 epidemic (29-30) April 2009 qualitative semistructured interviews (n=101) were conducted at frank furt internal airport with passengers who were either returning from going to Mexico and with airport staff, who had close contact

with these passengers. The results showed that a desire for more information was associated with higher concern-the least concern participants did not want any additional information, while the most participants reported a range of information needs. Airport staffs in contact with passengers travelling from the epicenter of the outbreak showed the highest level of fear or concern coupled with a desire to be adequately briefed by their employees. A Study conducted on a pandemic influenza H1N1 live vaccine based modified vaccines Ankara by Garica.etal in university of hongkong by June 2010. The MVA-H1-Ca and MVA-NI-Ca live vaccines together with an activated whole virus vaccines were assessed in using immune competent Balb/c mice and was founded that non replicating MVA based H1N1 live vaccines induced a broad protective immune response and are promising vaccine candidates for pandemic influenza.

LITERATURE RELATED TO ROLE OF RESEARCH FOR SWINE FLU VIRUS.

A Study conducted on perspectives on influenza on evolution and the role research by Forrest HL, Webster RG in Department of infectious disease St. Jude children Research hospital, Memphis TN 3810 2794 USA. By this study the researcher identify the gap in their knowledge of H5N1 and pandemic H1N1 influenza viruses. There gap include
1) An understanding of the molecular determinants of influenza virus and the host that

permit efficient bansmissibility and pandemic potential 2) The urgent need for prospective surveillance in apparently healthy swine
3) The molecular determinants of high pathogenicity in poultry,pigs,and people

4) The genetic basis as the reservoir of highly pathogenicity in poultry, pigs and people 5) The problem with vaccines 6) Seasonality 7) Co-infections and 8) Anti-influenza drug resistance

METHODOLOGY

METHODOLOGY
This chapter deals with the methodology adopted for the proposed study and different steps undertaken after gathering and orienting data for investigation. It includes research approach, research design, the setting, the population sample technique, the induction and exclusion criteria, development and description of the tool, pilot study, and method of data collection and plan for data analysis

RESEARCH APPROACH
A research approaches tells the researcher what data and how to analyze it also suggest possible conclusion to be drawn from the data. It view the nature of the problem selected for the study and objective to be accomplished. The pre-experimental design was considered an appropriate research design to describe the awareness of the swine flu among the group. So we have selected this approach for our study.

RESEARCH DESIGN
The research design selected for the present study was pre-experimental study with one group pre test and post test design. Here the pre test is conducted followed by structured teaching programme and then conducting post test for the same group after 4 days. Pre test Assessment of awareness on prevention and treatment of swine flu.
O1

Treatment Structured teaching programme

Post test Assessment of awareness on prevention and treatment of swine flu.

O2

O1 O2: Awareness on swine flu

X: Structured teaching programme

SYSYTEMATIC REPRESENTATION OF RESEARCH STUDY

SETTING OF THE STUDY

Setting refers to the area where the study is covered. It may be natural setting depending upon the study topic and researchers The study has been conducted in the 1st year BSC nursing, R.R college of nusing, Chikkabanavarn, Bangalore which comprises about 40 students

POPULATION
Population is a group whose numbers possessnspecific attributes that a researcher interested to study.

SAMPLE AND SAMPLING TECHNIQUES

Sample refers to a subset of population, selected to participate in research study. Sampling is the processes of selecting a group of people, event, behaviour or other elements with which to conduct a study. The sample for the present study was 40 students in R.R college of nursing. The sample were selected by using purposive sampling techique out of 46 samples who attented the structured teaching programme, who were selected depending upon the selecting criteria.

SAMPLING CRITERIA
I. Inclusion Criteria a) Students who were willing to participate. b) Students who were read and write English. I. Exclusion Criteria a) Students who were not available at the time of study.

SELECTION AND DEVELOPMENT OF TOOL

Tools were prepared on the basis of objective of the study. A self administered questionnaire selected to assess the knowledge of students regarding prevention and treatment measures. It was considered to be the most appropriate instrument to elicit the response from the students who are able to understand read and write English The following steps were carried out in preparing the tools:
Review of literature: - Books, Journals, newspaper, articles, published and

unpublished research studies and internet research were used to develop the tool.
Preparation of the blue print: - a blue print was prepared to aid in the construction

of the tool. 10 components were considered for the preparation of the tool and questions for the tool were distributed under these components.

DESCRIPTION OF THE TOOL

The interview schedule was designed into two parts. Part 1:- Consisting of items pertaining to the demographic variables of the respondents such as age, sex, previous knowledge and source of information. Part2:- It consists of items, prevention and treatment of swine flu. The items are distributed under the following components. 1. Definition 2. Classification 3. Incidence and prevalence 4. Incubation period 5. Source of transmission / Mode of transmission 6. Signs and symptoms 7. Diagnosis 8. Treatment 9. Nurses responsibility 10. Prevention Each correct response was assigned of score of one and wrong response was assigned a score of zero

SCORING PROCEDURE
Each item carries 1 mark for the correct answer and 0 mark for the wrong answer. The total score was which is classified as follows in this study Adequate knowledge > 75% Moderately adequate knowledge 51-75% Inadequate knowledge <50%

VALIDATION OF THE TOOL

1. In quantitative research, the ability of a data gathering instrument to what it purposes to measure. 2. In qualitative research, the extent to which research findings represent reality

RELIABILITY OF THE TOOL

Reliability of an instrument is the degree of consistency with which it measures the attribute its supposed to measure.

DEVELOPMENT OF THE STRUCTURED TECHINIQUE PROGRAMME

The STP was developed based on the review of the related research and non-research literature and the objectives stated in the teaching plan. The following steps were adopted to develop the STP
Preparation of the 1st draft of STP

Content validity of STP Preparation of final draft of STP Description of the STP

PREPERATION OF THE 1ST DRAFT OF STP

A 1st draft of STP was developed keeping in mind the objective, criteria, literature reviewed and opinion of experts. The main factors that were kept in mind which preparing STP were the level of understanding 1st year students simplicity of language and relevant audio visual aids.

CONTENT VALIDITY OF STP

The initial draft of structured teaching programme was given to experts in the field along with the tool. The suggestions were incorporated in the structured teaching programme.

PREPERATION OF FINAL DRAFT OF STP

Suggestions from experts were taken into consideration and modification of the tools was made. The final draft of STP was prepared after incorporating experts suggestions.

DESCRIPTION OF STRUCTURED TECHNIQUE PROGRAMME

The STP was titled PREVENTION AND TREATMENT OF SWINE FLU. The STP was prepared to enhance the knowledge of students regarding prevention and treatment measures. It consists the following contents 1. Definition of swine flu 2. Classification 3. Incidence and prevalence 4. Incubation period 5. Source of transmission and mode of transmission 6. Sign and symptoms 7. Diagnosis 8. Treatment 9. Nurses responsibility 10. Prevention

PROCEDURE FOR DATA COLLECTION

PERMISSION FROM THE CONCERNED AUTHORITY. Formal permission was obtained from principal of R.R College of nursing, Bangalore.

PROCEDURE FOR DATA COLLECTION

The data was collected on the meeting day where the 40 students gathered. Total data was collected from 40 samples which were selected by using purposive sampling by meeting the sampling criteria.

PRE-TEST
The investigation conducted on questionnaire method of evaluation techniques to each samples on swine flu. The time for the test was from 30 mts.

IMPELEMENTATION OF STP
After the pretest, on the next day the structured teaching programme was administrated using the 4 days. Post test was conducted using the same self administrated questionnaire after the structured teaching programme.

PLAN FOR DATA ANALYSIS

The data obtained was analyzed in teams of achieving the objective of the study using descriptive and inferential statistics.

STATISTICAL ANALYSIS OF DATA

Frequencies and percentages to be used for analysis of demographic characteristics Calculation of mean, mean deviation, mean percentage of pretest and posttest scores

RESULTS PRETEST
Classification of respondents (pretest level) on prevention and treatment of swine flu. AWARENESS LEVEL INADEQUATE MODERATE ADEQUATE 12.5% 12.5-18% >18% TOTAL CATEGORY RESPONDENTS NUMBER 16 24 0 40 PERCENTAGE 40% 60% 0% 100%

The finding revealed that 60% as moderate awareness level and 40% as inadequate awareness level.

POST TEST
Classification of respondents (post test level) on prevention and treatment of swine flu. AWARENESS LEVEL INADEQUATE MODERATE ADEQUATE 12.5% 12.5-18% >18% CATEGORY NUMBER 0 14 26 RESPONDENTS PERCENTAGE 0% 35% 65%

TOTAL

40

100%

The findings revealed that 65% have adequate awareness and 35% have acquired moderate awareness.

Classification of mean value and mean percentage of pretest and post test. TOPIC TEST Max. Score Prevention & treatment of swine flu. Pretest posttest 25 25 Mean RESPONDANTS Mean Percentage 12.5 19 50% 76%

CLASSIFICATION OF RESPONDENTS BY PERSONAL CHARECTERISTICS CHARACTERISTICS CATEGORY RESPONDENTS NUMBER AGE GROUP (YEARS) 17 years 18 years 17 23 PERCENTAGE 42.5% 57.5%

Above table reveals the classification of respondents by age majority of the respondents (23) followed by 17 in age group of 17 years.

CLASSSIFACTION OF RESPONDENTS BY FAMILY RELACTED CHARACTERISTICS CHARACTERISTICS CATEGORY RESPONDENTS NUMBER RELIGION HINDU CHRISTIAN MUSLIM 19 20 1 PERCENTAGE 47.5% 50% 2.5%

The above table reveals respondents by religion. In the present study it has evident that 20 of respondents where Christian followed by 19 Hindus and remaining 1 was Muslim.

T-Test

t =dnSD
Where d = dn S.D = (d-d)2n-1
d

= dn = 2 = 120440-1 = 120439 = 30.87 = 5.55

S.D = (d-d)2n-1

t = 2405.55
= 26.325.55

= 12.645.55 = 2.27

SUMMARY

SUMMARY
This chapter deals with the summary of the study and its major findings. The present study was conducted to assess the effectiveness of structured teaching program on prevention and treatment of swine flu among. The objectives of the study were:
To assess the present knowledge scores of 1st year BSc (N) students on prevention and

treatment of swine flu. To evaluate the effectiveness of STP on awareness of prevention and treatment of swine flu. Hypothesis formulated in this study were: H0 - There is significant difference between pretest and posttest knowledge, score regarding swine flu. H1 There is significant association between pretest and posttest knowledge score regarding swine flue Findings of the study It was found that 23 students were of age 18 years It was found that the remaining 17 students were of age 17 years. It was found that 28 students are heard about swine flu It was reveal that most students have heard about swine flu from mass media
After STP, we have ruled out that the post test knowledge score was more compared

to pretest knowledge score. By this we came to conclusion that the STP was effective The pretest knowledge score was the post test score was

IMPLICATIONS OF THE STUDY The findings of the study can be used in the following areas: 1. NURSING SURVICES The nurse plays a great in role prevention of communicable disease like swine flu. She has to follow standard precautions thereby preventing the transmission of infections among patients and herself by educating themselves and their communities about disease and prevention. Isolate the suspected cases and confirmed cases. Instruct the client who are coughing or sneezing to wear a mask, wiping down surfaces and chairs, frequent hand washing. Nurses should protect themselves by personal protective equipment like gown, gloves, eye protection glasses, while attending client .Nurse should update their by getting or knowing latest information about disease and prevention.
2. NURSING EDUCATION

The nurse educator should periodically conduct special awareness to the students in colleges and schools for enhancing like knowledge about swine flu and its prevention. The curriculum should emphasis on the importance of swine flu and its prevention in colleges, schools, and they should conduct health camps and give awareness for public regarding prevention and treatment of swine flu 3. NURSING ADMINISTRATION The nurse administrator should part in formulation of health policy, the element of protocols and standing order with respect to swine flu and its prevention. The nurse administrator should concentrate on the proper selection, placement and effective utilization of the nurse in all the areas giving opportunity creativity, interest and entrance the ability in educating the nursing students. Nursing administrator should organize the health education and in-service education programme. 4. NURSING RESEARCH The study helps the nurse researcher to develop insight into the development of teaching module and materials for nursing students regarding swine flu and its prevention. Nurse should come forward to take up unsolved questions in the field of awareness of prevention and treatment of swine flu to carry out studies and publish

them for the benefit of adolescents. Nursing personnels should be motivated to involve in research in the prevention and treatment of swine flu. RECOMMENDATIONS The study can be conducted on every aspect of prevention. The can be conducted by increasing the sample size. A comparative study can be conducted to assess the knowledge before and after giving information regarding swine flu and its prevention.

EVALUATION TOOL
SWINE FLU Date: 25 Time: 30 min. 1. What is swine flu? a) Viral disease b) Bacterial disease c) Fungal disease 1. Swine flu is a a) Non-communicable disease b) Communicable disease
c) Endemic disease

Max. Mark:

1. Swine flu is a type of a) Fatal disease b) Preventable disease c) Incurable disease 1. First outbreak of swine flu was in a) 1980 b) 1918 c) 1915 1. Incidence and prevalence of swine flu is common in a) South Africa b) Mexico c) India 1. Incubation period of swine flu is a) 1 month b) 28 days

c) 1-7 days 1. Common mode of transmission of swine flu is a) Indirect contact b) Direct contact with pigs, coughing, sneezing c) Parental transfusion 1. Swine flu get transmitted from, a) Man Man Pig b) Pig Man Man c) Man Pig Man 1. Which human body system is affected by swine flu a) Circulatory system b) Respiratory system c) Musculoskeletal system 1. The number of times can the man be affected by swine flu in his/her life span are, a) One time b) Two time c) More than two time 1. Source transmission of swine flu, a) Sweat b) Droplet c) Blood 1. The high risk group of swine flu are a) Pregnant women, children and adults with obesity, chronic medical problem b) Pregnant women and children c) Under five children 1. Swine flu symptoms in children are, a) Fast breathing, bluish skin color and fever with rash. b) Hormonal imbalance, fever without rashes c) Proteinuria, hypervolemia 1. In adult which system is having symptoms of swine flu? a) Musculoskeletal system b) Nervous system

c) Respiratory system 1. The investigation of conformation of swine flu is a) X Ray b) Real time RTPCR c) CT Scan 1. The clinical specimens used for the diagnosis of swine flu are,
a) Naso phasyngeal swab, Throat swab

b) Blood examination c) Urine examination 1. The drug recommended both for prophylaxis and treatment are,
a) Oseltamiver (Tamiflu)

b) Isoniazid c) Atanalol 1. The side effect of aspirin by using in the time of flu is
a) Rett syndrome

b) Down syndrome c) Reyes syndrome

1. The side effect of H1N1 vaccine at the location where the vaccine have been

administered are; a) Abdominal pain and discomfort b) Tenderness, pain, redness, swelling c) Shock, coma and death 1. The duration of prophylaxis is; a) 7 days after last exposure b) 5 days after last exposure c) 10 days after last exposure 1. The most important component of prevention of swine flu is; a) Prevention in swine b) Prevention of transmission to humans c) Prevention of its spread among humans 1. The commonly used aseptic technique for inactivating the flu virus is; a) Disinfection followed by cleaning

b) Drying c) Fumigation 1. The disinfectant ethanol used for inactivating flu virus is used in percentage of; a) 25% b) 50% c) 70% 1. The important measure to prevent swine flu is; a) Isolation b) Keeping hands clean c) Notification and screening 1. Swine flu spread through eating pork a) Yes b) No c) None of the above