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28 Cards in this Set
- Front
- Back
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What is influenza? What pathogens is it caused by? |
Contagious Viral Respiratory Illness Influenza A (H1N1, H3N2) Influenza B (Yamagata/Victoria - lineages) |
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Influenza A is found in what? When what the first global pandemic in more than 40 years? |
Found in animals ducks, chickens, pigs, whales, horses, seals |
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What is peak influenza season? |
October thru March - per notes (feb-may - here) |
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Small changes in genes of influenza viruses that happen continually over time as the virus replicates are know as what? |
Antigenic drift |
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What does antigenic drift produce? How does the immune system respond to this? |
Produces viruses that are closely related to each other/share same antigenic properties Immune system, when exposed to a similar virus, will usually recognize it and respond - called cross-protection |
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An abrupt, major change in the influenza A viruses is called what? What does this usually result from and cause? What is one example of this? |
Antigenic shift - only occur is influenza A viruses!!! Usually emerges from animals, and the shift is so different that most people don't have immunity (even to the subtype) 2009 H1N1 virus |
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Show is influenza spread? When is it contagious? |
Droplets - cough - sneeze - talk - contaminated surfaces Contagious one day before sx start and 5-7 days after becoming sick - can be asymptomatic and spread the virus both before and after symptoms |
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Influenza - symptoms? |
Fever (but not a requirement) Cough Odynophagia Rhinorrhea or nasal congestion Myalgias/body aches Headache Fatigue Occasional vomiting/diarrhea - more common in kids that adults |
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Influenza - duration? |
Few days to less than two weeks - depends on complications - can exacerbate chronic health problems |
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What complications may be associated with influenza? |
Pneumonia Bronchitis Sinus infection Ear infection Exacerbation of chronic health problems - asthma - CHF |
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Who is at most risk of developing complications with influenza? |
>65 years and older People with chronic medical conditions Pregnant women Young children |
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What vaccines are available for influenza? |
IIV - inactivated influenza vaccine - contains non-replicating virus LAIV - Live-attenuated influenza virus - contains the live virus LAIV "nasal spray flu vaccine"
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Who should the LAIV nasal spray vaccine not be given to? |
children <2 years old adults 50 years and older pregnant women immunocompromised |
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Children should get how many doses the first season they are vaccinated? When should they get vaccinated? Which vaccination shows superior efficacy? |
studies how 2 vaccines provide better protection 1st dose as soon as its available; 2nd dose 4 weeks later LAIV> IIV |
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What is available for influenza vaccine to people > 65 years old and why? |
Fulzone High-Dose available - contains higher doses of the antigen to give older people a better immune response - better protection against the flu >65 have decreased immunity |
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Who gets the influenza vaccine? |
EVERYONE > 6 months old - unless contraindicated |
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Who is the IIV influenza vaccine contraindicated in? |
Severe allergic reaction to any component of the vaccine - including egg protein - or documented reaction after previous dose of any influenza vaccine Precaution in: - moderate to severe illness w/or w/o fever - hx of Guillain-Barre syndrome within 6 weeks of receipt of influenza vaccine |
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In addition to the IIV vaccine contraindications and precautions; what additional precautions are there with the LAIV vaccine? |
- no concomitant use of aspirin or aspirin-containing meds in children/adolescents - not recommended in: - pregnant women - immunocompromised persons - egg allergies - children aged 2-4 w/ asthma or wheezing episode in past 12 months
Should not be given to persons who: - had influenza antiviral meds in last 48 hours (will decrease response to the vaccine) - care for severely immunocompromised persons requiring protective environment (or avoid contact w/ those persons for 7 days after receipt) |
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Who decides what the formulation of the influenza vaccine will be each year? |
WHO collaborating centers - reviews the results of surveillance, lab, and clinical studies, then make recommendations about the upcoming flu season strains |
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When are the flu vaccines produced? |
Started as early as January for the following years flu season
Takes six months to produce large quantities of the vaccine. |
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How long does protection from the flu vaccine extend? |
6-8 months (up to 3 years) |
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What is used to test for influenza? |
RIDTs Rapid influenza diagnostic tests - produce quick results (15 minutes or less) - simple to perform - office/beside use available - sub-optimal test sensitivity |
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RIDTs - results may be what when flu activity is high? - results may be what when flu activity is low? |
High - false negatives are common Low - false positives are common |
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Do the RIDTs distinguish between Influenza A and B? Do they provide the subtype or specific strain information? |
Some distinguish between A and B Do not provide subtype/specific strain information |
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What two types of tests can be performed and give results in 1-6 hours? What is a more accurate test,but takes longer for results? What do these tests allow for? |
Direct Fluorescence Antibody (DFA) Reverse Transcriptase-Polymerase Chain Reaction - RT-PCR Viral culture is more accurate but can take 3-10 days for results Can be orders so that therapy can be more specific. |
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How is a viral culture obtained for an influenza culture? |
Oral or nasal swab Sputum sample |
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What do you do when you suspect a patient has the flu? |
Initiate prompt treatment - do not wait for testing to even do testing Clinical benefit is greatest when antiviral treatment is initiated within the first 48 hours of symptoms/onset of illness. However, benefits can still be obtained if treatment is given after the initial 48 hour window. |
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In what situations should medications always be prescribed outside of the 48 hour window with influenza? |
Chonic conditions Immunocompromised Elderly |
