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Influenza 1

Influenza is caused by influenza viruses type A, B, or C. It is transmitted through aerosol droplets and causes fever, cough, and other respiratory symptoms. Major pandemics in the 20th century were the 1918 Spanish Flu which killed 20 million people worldwide and the 1957 Asian Flu. Influenza can lead to complications like pneumonia, worsening of heart or lung disease, and Reye's syndrome in children. Vaccines containing inactivated virus are used each year to protect against the strains predicted to circulate. Treatment involves rest, fluids, and antiviral drugs though resistance to some has emerged.

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Angeli Jean Koreen Corpuz
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157 views5 pages

Influenza 1

Influenza is caused by influenza viruses type A, B, or C. It is transmitted through aerosol droplets and causes fever, cough, and other respiratory symptoms. Major pandemics in the 20th century were the 1918 Spanish Flu which killed 20 million people worldwide and the 1957 Asian Flu. Influenza can lead to complications like pneumonia, worsening of heart or lung disease, and Reye's syndrome in children. Vaccines containing inactivated virus are used each year to protect against the strains predicted to circulate. Treatment involves rest, fluids, and antiviral drugs though resistance to some has emerged.

Uploaded by

Angeli Jean Koreen Corpuz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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INFLUENZA

Called FLU
different from H. Influenzae
(bacteria)
True influenza
influenza virus A or
influenza virus B
(or influenza virus C
infections - much milder)
Febrile respiratory disease with
systemic symptoms(FEVER)
Rhinovirus,adenovirus,parainflue
nza virus----do not cause fever

TRANSMISSION

AEROSOL- 100,000 TO
1,000,000 VIRIONS PER
DROPLET
18-72 HR INCUBATION
SHEDDING

THE IMPACT OF INFLUENZA


PANDEMICS
Deaths:

1918-1919
o Spanish flu 500,000 US
20M worldwide
1957-58
o Asian flu 70,000 US
THE IMPACT OF INFLUENZA

recently some increase in


morbidity and mortality
possible factors
more elderly people
Chronic patients live longer
more high risk neonates
more immunosuppressed
patients
ORTHOMYXOVIRUSES
pleomorphic
influenza types A,B,C
febrile, respiratory illness with
systemic symptoms

RECOVERY

INTERFERON
o SIDE EFFECTS INCLUDE:
FEVER, MYALGIA, FATIGUE,
MALAISE
CELL-MEDIATED IMMUNE
RESPONSE
TISSUE REPAIR
o CAN TAKE SOME TIME

RHINITIS
OCULAR SYMPTOMS
CLINICAL FINDINGS

SEVERITY
o VERY YOUNG
o ELDERLY
o IMMUNOCOMPROMISED
o HEART OR LUNG
DISEASE

PROTECTION AGAINST REINFECTION

IgG and IgA


o IgG less efficient but lasts
longer
antibodies to both HA and NA
important
o antibody to HA more
important (can neutralize)

PULMONARY COMPLICATIONS

INDUCTION OF INTERFERON
interferon-alpha and interferonbeta
o induced by :
viral infection (especially
RNA viruses)
double stranded RNA
certain bacterial
components
o strong anti-viral properties
interferon-gamma
o antigens, mitogenic
stimulation of lymphocytes
SYMPTOMS OF INFLUENZA

FEVER
HEADACHE
MYALGIA
COUGH

CROUP (YOUNG CHILDREN)


PRIMARY INFLUENZA VIRUS
PNEUMONIA
SECONDARY BACTERIAL
INFECTION
o Streptococcus
pneumoniae
o Staphlyococcus aureus
o Hemophilus influenza

NON-PULMONARY COMPLICATIONS

myositis (rare, > in children, > with


type B)
cardiac complications
recent studies report
encephalopathy
o 2002/2003 season studies of
patients younger than 21 yrs in
Michigan
o 8 cases (2 deaths)
liver and CNS
o Reyes syndrome
peripheral nervous system
o Guillian-Barr syndrome

Reyes syndrome

liver
o fatty deposits
brain
o edema
vomiting, lethargy, coma
risk factors
o youth
o certain viral infections (influenza,
chicken pox)
o aspirin
Guillian-Barr syndrome

peripheral nervous system


involved
1976/77 swine flu vaccine
o 35,000,000 doses
354 cases of GBS
28 GBS-associated
deaths
recent vaccines much
lower risk
ANTIGENIC DRIFT

MORTALITY

MAJOR CAUSES OF
INFLUENZA VIRUSASSOCIATED DEATH
o BACTERIAL PNEUMONIA
o CARDIAC FAILURE
90% OF DEATHS IN THOSE
OVER 65 YEARS OF AGE
DIAGNOSIS

ISOLATION
o NOSE, THROAT SWAB
o GROW IN TISSUE
CULTURE OR EGGS
SEROLOGY
PCR
RAPID TESTS
provisional - clinical picture +
outbreak

HA and NA accumulate mutations


o RNA virus
immune response no longer
protects fully
sporadic outbreaks, limited
epidemics
ANTIGENIC SHIFT

new HA or NA proteins
pre-existing antibodies do not
protect
may get pandemics

Where do new HA and NA come


from?
~16 types HA
~9 types NA
o all circulate in birds
pigs
o can be infected by avian
and human influenza
viruses
H5N1 in birds
3

Avian H5N1 has spread to


humans
So far human cases in Asia and
Africa
o 387 cases
o 245 (63%) fatal
Have been a few instances
where may have spread humanto-human
So far no sustained spread in
humans

Why do we not have influenza B


pandemics?

so far no shifts have been


recorded
no animal reservoir known
VACCINE

Influenza
Precautions/CI

BEST GUESS OF MAIN


ANTIGENIC TYPES
o CURRENTLY TRIVALENT
type A - H1N1
type A - H3N2
type B
each year choose which strain of
each subtype is the best to use
for optimal protection
For 2016:
A/California/7/2009
(H1N1)
A/Texas/50/2012 (H3N2)
B/Massachusetts/2/2012
inactivated (trivalent inactivated
influenza vaccine, TIV)
o egg grown
o some formulations licensed
for children
reassortant, trivalent live vaccine
(live attenuated vaccine, LAIV)
o egg grown
o for healthy persons (those
not at risk for complications
from influenza infection)
ages 5-49 years
o also approved for healthy
children 24-59 months old
without a history of recurrent
wheezing

Severe allergic reaction to egg or


to a prior dose
Moderate to severe illness
History of GBS within 6 weeks
following a previous dose

Quadrivalent Influenza Vaccine

Designed to protect against 4


influenza viruses
2 influenza A and 2 influenza B
viruses

Quadrivalent inactivated

IM route
Southern Hemisphere strain
February to June, but maybe
given throughout the year.
(because it is before rainy
season)
Trivalent vaccines for use in the
2016 influenza season
A/California/7/2009
(H1N1)pdm09-like
virus;
4

A/Hong
Kong/4801/2014
(H3N2)-like virus;
B/Brisbane/60/2008
-like virus.
Quadrivalent vaccines: contain
the above three viruses and
B/Brisbane/60/2008- like virus.

o type A only
o 2005 to present
high levels of
resistance of
influenza A viruses to
amantidine and
rimantidine, so these
drugs are not
recommended until
resistance drops

Why is it important that an additional


B strain be added to trivalent
influenza vaccines?
Vaccine efficacy: similarity match
between the viruses or virus in the
vaccine and those in circulation

OTHER TREATMENT

REST, LIQUIDS, ANTI-FEBRILE


AGENTS (NO ASPIRIN FOR
AGES 6MTHS-18YRS)
BE AWARE OF
COMPLICATIONS AND TREAT
APPROPRIATELY

PREVENTION DRUGS

ZANAMIVIR (NA)
o types A and B
OSELTAMIVIR (NA)
o types A and B (some
resistance, but most strains
sensitive)
RIMANTADINE (M2)
o type A only
AMANTADINE (M2)

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