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22 Cards in this Set
- Front
- Back
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Who can get Influenza?
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Healthy children and adults. Basically ANYONE. At-risk individuals do not have a high attack rate but do get a worse disease when infected. These individuals include immunocompromised people, COPD, smokers, asthma, CHF,chronic renal failure, chronic respiratory diseaese, chronic herat disease, hematologic cancers, pregnant individuals, really old or really young people, and obesity.
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What are antigenic shifts?
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They are MAJOR changes in an influenza strain that generates a new strain no one has any immunity against.
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What are antigenic drifts?
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They are small changes in a viral strain which slightly changes people's immunity to the virus. It is how new flu strains pop up each year.
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What is Influenza A H1N1v?
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This is an influenza virus that caused the 2009 influenza. It came from Mexico in the middle or our winter. Some elder individuals had immunity due to exposure to H1N1 early in their lives. Young people died from this virus.
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What is Influenza A H3N2v?
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This is a virus that caused the 2010 influenza. It was picked up from pigs and mainly affected children in contact with pigs.
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What type of disease does the Influenza virus cause?
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Respiratory disease NOT GI disease
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How is influenza virus transmitted?
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It can be transmitted between people. In the US it is a winter disease due to the crowding and traveling of individuals. Spread is rapid due to its short incubation period.
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Is Influenza an upper or lower respiratory tract infection?
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Influenza is a lower respiratory tract infection (it DOES NOT cause itchy eyes or a runny nose).
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What are the symptoms of Influenza A viral infection?
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Non-specific= fever, extreme malaise lasting several weeks, chills, aches, headache, no appetite.
Specific= dry and hacking cough and a scratchy throat. The onset of this disease is dramatic. IL-1 causes systemic symptoms and is what makes you feel so terrible. It is a form of tracheobronchitis. |
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What are the signs of Influenza A viral infection?
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Nonspecific signs= fever, tachycardia, look toxic
Specific signs= dry cough, tachypnea, lack of respiratory sounds, potential wheezing |
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What is primary influenza pneumonia?
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It is a progressive disease that occurs in high risk patients infected with Influenza A virus. These patients DO NOT just have tracheobronchitis. The disease goes through the typical flu progression but the patients get more dyspnic and have to go to the hospital. They have diffuse, bilateral infiltrates, hemorrhages in their lungs, and non-purulent, frothy, thin, blood-tinged sputum in their bronchioles and bronchi. This disease results in a high mortality rate.
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What is secondary bacterial pneumonia?
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This disease occurs following the flu (the flu puts you at risk for getting this). The patient has chest pain, purulent sputum, is febrile, and short of breath. It is usually caused by Streptococcus pneumonia, Group A streptococcus, Staphylococcus aureus (MRSA) or H. influenzae (encapsulated, upper respiratory organisms).
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How is Influenza A infection diagnosed?
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Usually a clinical diagnosis is made. While the virus is easy to grow, it is slow. Culture is not done routinely but is only done to determine the circulating strains of this virus in the population. Serology can be used to affirm the diagnosis but it is usually done after the initial diagnosis (it takes weeks for the body to form antibodies). An EIA for antigen can be done on a nasopharyngeal swab. This is known as the rapid flu test and is done on a dipstick, is quick and is 70% sensitive. The gold standard is PCR of a nasopharyngeal swab.
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How do you treat Influenza A viral infection?
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Amantidine and Rimantidine are ONLY good against Influenza A virus. There is a lot of resistance against these drugs. Oseltamivir and Zanamivir can also be used. These drugs are active against BOTH Influenza A and B viral strains with little resistance against them.
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How do you treat Influenza B viral infections?
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Oseltamivir and Zanamivir can be used. They treat against BOTH Influenza A and B. There is only some resistance against these drugs.
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How do you prevent Influenza infection?
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There are not great vaccines available.
There is a killed vaccine that is made in eggs and given via IM. It is trivalent and CANNOT give you the flu. Old peopel do not respond well to these vaccines though (only 40-50% effective vs. 70% effective in the rest of the population). There is also a cold-adapted live virus vaccine known as FluMist. It is ONLY recommended for adults up to 49 years old. It is made in eggs, trivalent and given intra-nasally. |
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What is Fluzone?
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This is a high titer viral vaccine that is trivalent and egg-based. It is used for older adults. It generates higher antibody titers in people who receive this vaccine but it is more expensive. There is no data showing it has better efficacy than other flu vaccines.
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What is FluBlock?
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This is a new non-egg based vaccine.
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What is Flu Cell Vax?
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This is a new vaccine made from viruses that were raised in canine kidney cultures.
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What forms of prophylaxis are available against influenza?
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Antivirals can be used as prophylaxis against viruses. Tamovir is used as prophylaxis. Prophylaxis shoul dbe given to high risk individuals if they are waiting for the vaccine to kick in (the flu vaccine take 2-3 weeks for the person to start generating their own antibodies) or if the vaccine is not effective in them.
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If someone comes into a nursing home with the flu, what should you do?
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Vaccinate the entire population with the flu vaccine and provide them with prophylaxis.
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What are 3 things you SHOULD consider prior to providing someone with flu prophylaxis?
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Make sure the person has the flu
Make sure you are using a drug the virus is susceptible to Only use it in high risk populations in which the flu is introduced |
