are typically administered in clinics, hospitals, or doctor's offices. Many people of lower socioeconomic status are less likely to receive vaccinations because they do not have health insurance. Surveillance Although there is no formal national surveillance system in the United States to determine what viruses are circulating in pigs, an informal surveillance network in the United States is part of a world surveillance network. Treatment Swine As swine influenza is rarely fatal to pigs, little treatment beyond rest and supportive care is required. Instead, veterinary efforts are focused on preventing the spread of the virus throughout the farm or to other farms. Vaccination and animal management techniques are most important in these efforts. Antibiotics are also used to treat the disease, which, although they have no effect against the influenza virus, do help prevent bacterial pneumonia and other secondary infections in influenza-weakened herds. In Europe the avian-like H1N1 and the human-like H3N2 and H1N2 are the most common influenza subtypes in swine, of which avian-like H1N1 is the most frequent. Since 2009 another subtype, pdmH1N1(2009), emerged globally and also in European pig population. The prevalence varies from country to country but all of the subtypes are continuously circulating in swine herds. In the EU region whole-virus vaccines are available which are inactivated and adjuvanted. Vaccination of sows is common practice and reveals also a benefit to young pigs by prolonging the maternally level of antibodies. Several commercial vaccines are available including a trivalent one being used in sow vaccination and a vaccine against pdmH1N1(2009). In vaccinated sows multiplication of viruses and virus shedding are significantly reduced. Humans If a human becomes sick with swine flu, antiviral drugs can make the illness milder and make the patient feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within two days of symptoms). Beside antivirals, supportive care at home or in a hospital focuses on controlling fevers, relieving pain and maintaining fluid balance, as well as identifying and treating any secondary infections or other medical problems. The U.S. Centers for Disease Control and Prevention recommends the use of oseltamivir (Tamiflu) or zanamivir (Relenza) for the treatment and/or prevention of infection with swine influenza viruses; however, the majority of people infected with the virus make a full recovery without requiring medical attention or antiviral drugs. The virus isolated in the 2009