Swine Influenza Virus (SI), Flu

Swine influenza is caused by a number of closely related influenza A viruses that are
noted for their ability to change their antigenic structure and create new strains. Each
serotype is identified by surface proteins referred to as "H" and "N". The three common
strains that affect the pig are described as H1 N1, H1 N2 and H3 N2. There are also
different strains within these serotypes with differing pathogenicity (capacity to produce
disease).
The incubation period of the disease is very short, as little as 12-48 hours and the onset
is usually rapid and dramatic. It is virtually impossible to maintain a population of pigs
that is influenza virus free. SI in large herds may become endemic with intermittent bouts
of disease and infertility and different strains may also sequentially infect the herd.
Immunity to influenza viruses is often short lived (6 months) and the immunity profile in
the breeding herd varies considerably with time.

Symptoms
Piglets
It would be unusual to see any signs of swine flu in the sucking pig unless disease
entered the herd for the first time.
Colostrum may prevent infection during the sucking period.
Coughing.
Pneumonia.
Fever.
Sows
High temperatures which cause abortions.
Widespread coughing.
Pneumonia
When the virus first enters the herd two or three animals may be observed sick for the
first two days, followed by:
A rapid explosive outbreak of inappetence and clinically very ill pigs.
The effects on the reproductive system follow the sudden onset of a rapid spreading
respiratory disease with coughing, pneumonia, fevers and inappetence.
Acute respiratory distress persists over a period of 7-10 days (depending on the amount
of contact between groups of sows).
At a herd level the following may also be seen:
A sudden and rapid onset of acute illness in sows.
Coughing and pneumonia spreading rapidly.
A return to clinical normality over 7-10 days.
Delayed returns to heat after weaning.
Increased repeats at 21 days.
Increased repeats outside the normal cycle.
Increased numbers of sows coming through not in-pig.
Increased numbers of abortions, particularly late term.
Increased numbers of stillbirth rates and slow farrowings.
Premature farrowings.
Occasionally an increase in mummified pigs.
During the phases of high temperatures other diseases present in the herd may be
triggered off. A typical example would be an increase in abortions associated with
leptospira infection.
Weaners & Growers
Acute disease:
Classically the pigs suddenly become prostrate.
Breathing heavily.
Severe coughing.
Most of them look as if they are going to die but most of them survive without treatment
unless the herd already has a respiratory disease problem.
SI causes severe pneumonia on its own but when it is combined with other infections
such as App, EP and PRRS an intractable chronic respiratory disease syndrome can
develop. Severely affected individuals or groups of pigs are therefore best given
antibiotic cover to prevent secondary pneumonias developing.

Endemic disease:
Here the virus remains in the herd, affecting small groups of pigs often weaners. It may
be responsible for continuing respiratory diseases with symptoms as in acute disease
but less dramatic.
Causes / Contributing factors
SI can be introduced by:
Infected animals including people, pigs and birds.
Carrier pigs.
Probably on the wind although this has not been proved.
Birds particularly water fowl, are reservoirs of infection.
Secondary bacterial infections.
Fluctuating temperatures.
Stress.
Wet bedding and floor surfaces.
Poor nutrition.
Diagnosis
This can often be made reliably on clinical grounds with acute disease because there
are no other diseases that are so dramatic in their onset and clinical effects. No other
disease affects so many pigs so quickly. Blood samples taken at the time of onset of
disease from affected sows and repeated 2-3 weeks later show rising levels of antibody
to the specific virus. SIV can be readily grown from nasal and throat swabs and identified
in the laboratory. This is often the best approach to confirm the diagnosis.
In acute disease the spread is so dramatic across all ages that little else can be
confused with it. In endemic disease however differentiation from other viral infections
can be difficult, but PRRS, PRCV, AD and also erysipelas should be considered.
Swine influenza is caused by a number of closely related influenza A viruses that are
noted for their ability to change their antigenic structure and create new strains. SI can
be introduced by infected people, carrier pigs and probably on the wind although this has
not been proved. Birds particularly water fowl, are reservoirs of infection.
Each serotype is identified by surface proteins referred to as "H" and "N". The three
common strains that affect the pig are described as H1 N1, H1 N2, and H3 N2. There
are also different strains within these serotypes with differing pathogenicity (capacity to
produce disease).
Clinical signs

The incubation period of the disease is very short, as little as 12-48 hours. When the
virus first enters the herd two or three animals may be observed sick for the first two
days, followed by a rapid explosive outbreak of inappetence and clinically very ill pigs.
The effects on the reproductive system follow the sudden onset of a rapid spreading
respiratory disease with coughing, pneumonia, fevers and inappetence. Acute
respiratory distress persists over a period of 7-10 days (depending on the amount of
contact between groups of sows). There are three important periods when infection
causes infertility. First, if sows are ill in the first 21 days post-service pregnancy their
developing embryos may not get established and an increase in 21 day returns results. If
pregnancy has been established 14-16 days after mating, and it then fails returns will be
delayed. Second if infection occurs in the first five weeks of pregnancy, there could be
total embryo mortality and absorption with sows becoming pseudo-pregnant and not in-
pig. Litter size may also be affected at this stage due to absorption of embryos. Towards
the end of the pregnancy period abortions or late mummified pigs at farrowing may also
be experienced. The third major effect is on the boar, where high body temperatures
affect semen and depress fertility for a 4 to 5 week period.
SI in large herds may become endemic with intermittent bouts of disease and infertility
and different strains may also sequentially infect the herd. Immunity to influenza viruses
is often short lived (6 months) and the immunity profile in the breeding herd varies
considerably with time.
At a herd level the following may also be seen:
A sudden and rapid onset of acute illness in sows.
Coughing and pneumonia spreading rapidly.
A return to clinical normality over 7-10 days.
Delayed returns to heat after post-weaning.
Increased repeats at 21 days.
Increased repeats outside the normal cycle.
Increased numbers of sows coming through not in-pig.
Increased numbers of abortions, particularly late term.
Increased numbers of stillbirth rates and slow farrowings.
Occasionally an increase in mummified pigs.
During the phases of high temperatures other diseases present in the herd may be
triggered off. A typical example would be an increase in abortions associated with
leptospira infection.

Diagnosis
This can often be made reliably on clinical grounds because there are no other diseases
that are so dramatic in their onset and clinical effects. Blood samples taken at the time of
onset of disease from affected sows and repeated 2-3 weeks later show rising levels of
antibody to the specific virus. SIV can be readily grown from nasal and throat swabs and
identified in the laboratory. This is often the best approach to confirm the diagnosis.

Similar diseases

In acute disease the spread is so dramatic across all ages that little else can be
confused with it. In endemic disease however differentiation from other viral infections
can be difficult, but PRRS, PRCV, AD and erysipelas should be considered
Treatment

Individual breeding females or boars showing acute illness, and raised temperatures,
particularly with increased respiratory rate should be treated with broad spectrum
antibiotics for three days.
Suitable medicines would include penicillin/streptomycin, long-acting OTC or synthetic
penicillins such as amoxycillin. If the illness is severe then medicate the drinking water
with either CTC or OTC at a level of 25g (100% pure) per 1000kg of live weight per day,
for five days.

Management control and prevention

It is important to prevent any secondary bacterial infections.

Keep sows within an environmental temperature of 20-23ºC (70-75ºF)
Reduce all possible stress, such as draughts.
Maintain dry bedding and floor surfaces.
Monitor boars carefully for evidence of illness
Identify boars that have been ill and cross-serve with another boar for the next four
weeks.
Serve sows by AI followed by a natural mating and consider a second dose of AI
(am/pm/am).
Medicate the water with soluble vitamins for seven days.
Medicate the feed as described above for 2 weeks.
If periods of inappetence occur in boars, blood test them twice two weeks apart to
establish a diagnosis.
Because of the possible ways by which the virus may enter the herd it is extremely
difficult to maintain populations free of infections. In some countries inactivated vaccines
are available and appear to be protective. In herds in which the virus periodically
circulates and causes disease this route should be explored.
If you believe your herd to be free (and this can be confirmed by serological tests,)
purchase breeding stock from herds that have a similar disease history and that are also
serologically negative. The practicality of this however is not easy.
This is caused by one of 4 or 5 different strains of influenza virus which cause
respiratory disease and infertility. If a new strain is introduced into the breeding herd and
there is no immunity, the respiratory disease that follows can be quite dramatic. Within 2
to 3 days up to 40 to 50% of animals may be off their feed looking very ill. This can be
quite alarming but the rapidity of the clinical signs are almost exclusively confined to this
disease. The major risk to the pregnant sows are the high temperatures which cause
abortions, embryo or foetal loss, or high stillbirth rates. Widespread coughing and
pneumonia may also be seen and individuals should be treated with broad spectrum
long-acting antibiotics.
To prevent secondary infections causing complications such as abortions and stillborn
piglets it is advisable to treat the breeding herd at the very onset with water soluble
antibiotics, OTC or CTC, for a period of 48 to 72 hours. The course of the disease in
individual sows is usually 4 to 7 days and within 14 days most animals in the herd have
returned to normal. In large herds SI can become endemic with disease appearing every
3 to 6 months. A vaccine is available in some countries.
Swine influenza is similar in most respects to human flu. In the pig there are at least four
different serotypes each stimulating immunity to itself but not to the other serotypes. It is
thus possible for the pigs to be infected by one virus and develop disease and then
some two to three months later be infected by a different serotype and develop disease
yet again. In large herds of over 300 sows the virus may circulate in young growing pigs,
disease becoming more active in the winter time associated with reduced ventilation
rates. In the growing and finishing pig disease is not seen until maternal antibody has
disappeared at sometime between 7 and 12 weeks of age. SI viruses can interchange
between man, pig and birds and the carrier state can exist in the pig for some two to four
weeks. They are also spread by birds, particularly ducks. It is also thought that the
viruses may spread on wind up to 3km (2miles) on wind but this has never been
demonstrated. Thus it is virtually impossible to guarantee or maintain a population of
pigs that is free of this disease.

Clinical signs

Acute disease

The incubation period is short, less than 48 hours. The onset can be extremely rapid and
dramatic. The classical picture is a house full of pigs that are normal on one day and
most of them are prostrate and breathing heavily by the following morning. Severe
coughing and laboured breathing will be observed. You may think most of the pigs are
going to die but rest assured most of them survive, and provided the herd does not have
a history of ongoing pneumonia the pigs will recover on their own, but it is always difficult
to predict the outcome. Severely affected individuals or groups of pigs are therefore best
given antibiotic cover.

Endemic Disease

This is where the virus continually circulates through the herd infecting individual pigs
within groups. SI causes severe pneumonia on its own but when it is combined with
other infections such as App, EP and PRRS a chronic respiratory disease syndrome can
develop.

Diagnosis
In acute disease the rapidity of development and spread, together with typical clinical
signs, are diagnostic. No other disease will affect so many pigs so quickly.
In the chronic respiratory disease syndrome it is necessary to carry out serological tests
and virus isolation to determine the presence and serotype of the virus.

Treatment
There is no treatment specifically for flu viruses. However secondary bacterial
pneumonia may be involved and in such cases antibiotic treatments by injection or in the
drinking water, would be advised.
In-feed medication in acute disease is a waste of time because pigs do not eat. Although
labour intensive, it is far more efficient to treat individual pigs that have secondary
pneumonia with long-acting antibiotics, such as oxytetracycline or amoxycillin.
Management control and prevention
Use the management procedures already outlined for the other respiratory diseases.
Reduce the weights of exposure to other organisms.
Vaccination is used in some countries with mixed results.
Avoid buying pigs from sources where SI is active.

Swine influenza frequently asked questions

What is swine influenza?

Swine influenza, or “swine flu”, is a highly contagious acute respiratory disease of pigs,
caused by one of several swine influenza A viruses. Morbidity tends to be high and
mortality low (1-4%). The virus is spread among pigs by aerosols, direct and indirect
contact, and asymptomatic carrier pigs. Outbreaks in pigs occur year round, with an
increased incidence in the fall and winter in temperate zones. Many countries routinely
vaccinate swine populations against swine influenza. Swine influenza viruses are most
commonly of the H1N1 subtype, but other subtypes are also circulating in pigs (e.g.,
H1N2, H3N1, H3N2). Pigs can also be infected with avian influenza viruses and human
seasonal influenza viruses as well as swine influenza viruses. The H3N2 swine virus
was thought to have been originally introduced into pigs by humans. Sometimes pigs
can be infected with more than one virus type at a time, which can allow the genes from
these viruses to mix. This can result in an influenza virus containing genes from a
number of sources, called a "reassortant" virus.
Although swine influenza viruses are normally species specific and only infect pigs, they
do sometimes cross the species barrier to cause disease in humans.

What are the implications for human health?

Outbreaks and sporadic human infection with swine influenza have been occasionally
reported. Generally clinical symptoms are similar to seasonal influenza but reported
clinical presentation ranges broadly from asymptomatic infection to severe pneumonia
resulting in death. Since typical clinical presentation of swine influenza infection in
humans resembles seasonal influenza and other acute upper respiratory tract infections,
most of the cases have been detected by chance through seasonal influenza
surveillance. Mild or asymptomatic cases may have escaped from recognition; therefore
the true extent of this disease among humans is unknown.

Where have human cases occurred?

Since the implementation of IHR(2005)1 in 2007, WHO has been notified of swine
influenza cases from the United States and Spain.

How do people become infected?

People usually get swine influenza from infected pigs, however, some human cases lack
contact history with pigs or environments where pigs have been located. Human-to-
human transmission has occurred in some instances but was limited to close contacts
and closed groups of people.
Is it safe to eat pork meat and pork products?
Yes. Swine influenza has not been shown to be transmissible to people through eating
properly handled and prepared pork (pig meat) or other products derived from pigs. The
swine influenza virus is killed by cooking temperatures of 160°F/70°C, corresponding to
the general guidance for the preparation of pork and other meat.

Which countries have been affected by outbreaks in pigs?

Swine influenza is not notifiable to international animal health authorities (OIE,
www.oie.int), therefore its international distribution in animals is not well known. The
disease is considered endemic in the United States. Outbreaks in pigs are also known to
have occurred in North America, South America, Europe (including the UK, Sweden, and
Italy), Africa (Kenya), and in parts of eastern Asia including China and Japan.

What about the pandemic risk?

It is likely that most of people, especially those who do not have regular contact with
pigs, do not have immunity to swine influenza viruses that can prevent the virus
infection. If a swine virus establishes efficient human-to human transmission, it can
cause an influenza pandemic. The impact of a pandemic caused by such a virus is
difficult to predict: it depends on virulence of the virus, existing immunity among people,
cross protection by antibodies acquired from seasonal influenza infection and host
factors.

Is there a human vaccine to protect from swine influenza?

There are no vaccines that contain the current swine influenza virus causing illness in
humans. It is not known whether current human seasonal influenza vaccines can provide
any protection. Influenza viruses change very quickly. It is important to develop a
vaccine against the currently circulating virus strain for it to provide maximum protection
to the vaccinated people. This is why WHO needs access to as many viruses as
possible in order to select the most appropriate candidate vaccine virus.

What drugs are available for treatment?

Antiviral drugs for seasonal influenza are available in some countries and effectively
prevent and treat the illness. There are two classes of such medicines, 1) adamantanes
(amantadine and remantadine), and 2) inhibitors of influenza neuraminidase (oseltamivir
and zanamivir). Most of the previously reported swine influenza cases recovered fully
from the disease without requiring medical attention and without antiviral medicines.
Some influenza viruses develop resistance to the antiviral medicines, limiting the
effectiveness of chemoprophylaxis and treatment. The viruses obtained from the recent
human cases with swine influenza in the United States were sensitive to oselatmivir and
zanamivir but resistant to amantadine and remantadine.

Information is insufficient to make recommendation on the use of the antivirals in

prevention and treatment of swine influenza virus infection. Clinicians have to make
decisions based on the clinical and epidemiological assessment and harms and benefit
of the prophylaxis/treatment of the patient2. For the ongoing outbreak of the swine
influenza infection in the United States and Mexico, the national and the local authorities
are recommending to use oseltamivir or zanamivir for treatment and prevention of the
disease based on the virus’s susceptibility profile

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