What are the non-pulmonary complications of influenza?
liver and central nervous system complications
peripheral nervous system complications
What kind of people usually encounter the non pulmonary complications?
most people with compromised or not fully developed immune systems such as babies and the elderly
What is myositis?
inflammation of your muscles
rare, more common in children
comes with type B flu which is rare
What are the cardiac complications
heart problems, heart disease, etc
What is encephalopathy?
bad brain disease
recent studies report that it is a non pulmonary complication
studies of patients under 21 years in Michigan- 8 cases seen last season
What are the liver and central nervous system complications
What are the peripheral nervous system complications
Guillian Barre syndrome
What is Reye Syndrome?
liver has fatty deposits
brain edema (swelling)
vomiting, lethargy, coma
What are the risk factors of Reye Syndrome?
youth (adults usually don't get it)
certian viral infections (influenza, chicken pox)
giving kids asprin can cause it
What is the method of infection and replication, the way the virus works?
1. The flu virus attaches to the carbohydrates or sugars on your cell's surface (epithelial cells) such as nose, throat and lungs of mammals and intestines of birds (these are the places where epithelial cells are located)
2. The virus gets into the cell. Hemagglutinin allows it to do this
3. In influenza A, m2 allows hydrogen into the cell, lowering the pH and making it more acidic
4. The acid allows the virus to uncoat itself and reveal the RNA
5. The RNA can then go through protien synthesis and make more viruses inside the cell
6. Then the viruses leave the cell with the help of Neuraminidase and attack new cells and the process starts over
What is the flu vaccine?
contains a "Best Guess" of main antigenic types (Each year we choose which variant of each suptype is the best to use for optimal protection)
currently the vaccine has...
---> Type A H1N2
---> Type A H3N2
---> Type B
vaccine is inactivated
sub-unit vaccine for children
Where is the flu vaccine grown?
in an egg... like a chicken egg
What was approved in 2003?
reassortant live vaccine: for healthy people (those not at risk of complications from influenza injections) age 5-49 years because they have strong immune systems
When is the time to get the flu shot?
When is the height of the flu season?
What is the incubation period of a typical case of influenza?
incubation period is the time between exposure and symptoms
short 1-3 days
In a typical case of Influenza when might the person shed the virus?
infected person may shed (or spread) the virus for 12-24 hours before they get symptoms
viral shedding peoaks on day 2 or 3 then declines
How long may the virus be present in a normal case of influenza?
virus may be present as long as there are symptoms
usually 5-10 days
How is influenza spread?
nearly all is spread by person to person (sneezing, coughing on someone)
spread by droplets (as from a cough or sneeze) inhaled by a suceptable person
inanimate objects (doorknobs, towels) and physical contact (handshaking) may contribute to spread, but their role is minor
What are the signs/symptoms of influenza
abrupt onset of symptoms
fever, usually over 100 degrees F
cough with little or no sputum
potentially severe, persistant malaise (sleepiness, youre out of it)
chest sores, light sensitivity, eye pain
Implications of H5N1 infection?
only animals have had it, no previous human exposure
morbidity and mortality in both young and old
potential for pandemic infection by little known pathogen
What do we need to do to be ready for H5N1?
pandemic readiness plan
rapid detection and diagnosis of new viral strains
continuing research for new antiviral agents
What are the differences between H5N1 and current strains of flu?
Typical influenza involves only the upper respiratory tract (bronchus and bronchioles but not lungs while H5N1 has the ability to infect the upper and lower respiratory tract (including the lungs
People with underlying medical problems such as lung or heart disease or cancer, or the elderly are at increased risk of secondary bacterial pneoumonia while anyone who is susceptable to H5N1 can get pneumonia caused by the influenza virus
In regular influenza the influenza viral pneumonia is rare and in H5N1's resulting pneumonia is severe and may be fatal
What are the economic costs of Influenza outbreak?
total annual costs of influenza are estimated at $14.6 billion in the US
10% of cost is direct costs of increased medical care
90% of cost is indirect costs like lost productivity, people are out sick and don't go to work, money is lost
Explain the inactivated Influenza virus vaccine
History: First developed in the 1940s
Content: updated yearly to protect against strains that doctors think will come up. consists of 2 versions of type A and one version of Type B
Process: Grown in emryonated chicken eggs and formalin inactivated
Influenza vaccine is most effective in...
young healthy people
Influenza vaccine often prevents...
infection, usually prevents serious disease
Flu shot is less effective in
--->many develop infection, but vaccine reduces the frequency of serious disease and death
--->elderly's response is directly related to their overall state of health
What is currently available right now?
Selective Neuraminidase inhabitors (that stop the virus from getting out of the cell)
What are the selective neuraminidase inhibitors available?
What is the indication, spectrum, and administration of relenza?
Indication: Treatment (may be given before you get sick)
Spectrum: Type A and Type B
Administration: Inhaled- 2 puffs a day for 5 days
What is the indication, spectrum, and administration of tamiflu?
Indication: Treatment Prophylaxis (meaning you get treated after you get sick)