OLFU MED

2012

Microbiology B
Dr. Santos
01.15.10

contents

Clinical signs and Symptoms

Hospitalization and deaths
Seasonal
INFLUENZA VIRUS TYPES
Influenza A virus divided into
subtypes based on HA and N
proteins on surface
Drift or shift
Influenza subtypes in humans
Current Flu Pandemic: novel A
(H1N1)
Avian Influenza
Treatment of Influenza
Treatment for current pandemic
flu
Target Groups for Vaccination
When should you give the flu
shot?
Vaccine dosage by age group

INFLUENZA
Commonly called the flu
A contagious respiratory illness caused by influenza viruses
Infection with influenza viruses can result in illness ranging
from mild to severe with life-threatening complications.

Clinical signs and Symptoms

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Incubation period for influenza is 1-4 days, with an average

of 2 days
Adults- infectious from the day before symptoms begin
through approximately 5 days after onset
Children- infectious for >/+ 10 days, and young children
can shed virus for </= 6 days before their illness onset
Immunocompromised persons can shed virus for weeks or
months

There is no growth without change, no change without fear or loss, and no loss without pain

***loveskeedoo ;-)

Resolves after a limited number of days for the majority of

persons, although cough and malaise can persist for >/= 2
weeks
Young children can have initial symptoms mimicking
bacterial sepsis with high fevers

</= 20 % of children hospitalized with influenza

can have febrile seizures
Influenza infection has also been associated with

Encephalopathy

Transverse myelitis

Reye syndrome

Myositis

Myocarditis

Pericarditis

Hospitalization and deaths

Population at risk for complications, hospitalizations &
deaths: >/= 65 years old

Young children

Persons of any age with certain underlying health

conditions: cardiovascular and pulmonary
9including asthma), metabolic e.g. DM,
Hgbpathies, immunosuppression

Receiving long term ASA

Seasonal
In colder countries flu is largely seen during colder months
and they vaccinate prior to this season 9e.g. October)
In tropical countries flu is seen all year round

INFLUENZA VIRUS TYPES

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Three: Infuenza A, B, and C

Influenza types A or B viruses cause epidemics; influenza
A may cause pandemics
Getting a flu shot can prevent illness from types A and B
influenza but not from type C
Influenza type c causes mild respiratory illness; not thought
to cause epidemics

There is no growth without change, no change without fear or loss, and no loss without pain

***loveskeedoo ;-)

Influenza A virus divided into subtypes based on HA and N

proteins on surface
-

15 HA, 9N
Nomenclature based on: site of orihin. Isolate number
Year of isolation, subtype
Example: influenza A/ Johannesburg/ 33/95 (H3n2)

Current Flu Pandemic: novel A (H1N1)

Quadruple reassortant: 2 NA bird flu genes, 1 swine flu,
human flu
Thrives in lower respiratory tract
More contagious
Is now more common than seasonal flu
Resistant to amantadie, rimantadine

Avian Influenza
Caused 15 subtypes of influenza A virus subtype of avian
influenza
Low pathogenicity avian influenza (LPAI)
Highly pathogenic avian influenza (HPAI)

First recognized in Italy in 1878

Exteremely contagious in birds

Rapidly fatal, high mortality (almost 100% in a

few days)

Most recent: H5N1

Drift or shift
Antigenic Drift small changes in the virus that happen
continually (influenza A and B)
Antigenic Shift abrupt, a major change in the influenza
A viruses, resulting in new H &/or new H and N proteins
that infect humans (influenza A only)
Influenza subtypes in humans
Current subtypes of influenza A viruses found in people are
A (H1N1) and A (H3N2)
Influenza B virus is not divided into subtypes
Influenza A (H1N1), A (H3N2), and influenza B strains are
included in each years influenza vaccine
Protection is serotype specific

Treatment of Influenza
Antiviral medications
Antiviral drugs:

Adamantanes: amantadine, rimantidine

Neuraminidase inhibitors: zanamivir, oseltamivir

-

Antiviral treatment lasts for 5 days and must be started

within the first 2 days of illness

Treatment for current pandemic flu

All hospitalized patients with confirmed, probable, or
suspected pandemic H1N1 influenza A virus infection
Patients at higher risk of complications. In addition to
patients with underlying illnesses, all children younger than
5 years of age, particularly those less than 2 years of age,
are at increased risk for complications of influenza

Target Groups for Vaccination

1. Those with increased risk of complications:
- persons age 50 yrs old and above
- Children from 6-23 months old
- Adults and children with the following risk factors:

Chronic cardiovascular disease (e.g. congestive

heart failure, hypertensive cardiovascular
disease, valvular heart disease, rheumatic heart
disease, stroke)

Chronic lung disease (e.g. COPD, asthma,

bronchiectasis, malignancies, chronic PTB)

Chronic metabolic disease (diabetes mellitus)

Chronic renal dysfunction

Hemoglobinopathies

Immunosuppressed (e.g. HIV, malignancies,

immunosuppressive drugs, radiation therapy,
transplant patients)

Children and adolescents who are receiving

long-term aspirin therapy

Residents of nursing homes and other chronic

care facilities

Preganant women on their 2nd and 3rd trimester

who have not received their flu vaccine within
the last 12 months.

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There is no growth without change, no change without fear or loss, and no loss without pain

***loveskeedoo ;-)

Those who can transmit the disease to others

health car workers and other personnel of out patient

care settings, hospitals, nursing homes, and chronic
cae facilities
Household contacts (including children) and
caregivers of person at high risk

When should you give the flu shot?

(highlights Influenza Consensus- Flu TWG Oct. 2004)
Data from the five-year epidemiologic data (February
1998- Sept 2003) shows increased influenza activity June
to November.
Vaccination should be given once a year preferably from
February to June
The Southern hemisphere vaccine which is made available
starting February of each year is recommended to cover the
expected increase in influenza activity from june to
November.

Vaccine dosage by age group

Age
Dose
No. doses
6-35 mos
0.25 ml
1 or 2*
3-8 yrs
0.5 ml
1 or 2*
= or > 9 yrs
0.5 ml
1

2 if receiving vaccine for 1sttime 1 month apart

Route
IM
IM
IM

Mga Pagbati at mensahe!!!

Hola! Mga mare kong hot hahaha!! Smile and wave naman
dyan: joza, Aja, Rhea, Ate Leng, Tine2 (ever hotness;-)), Love

Chika minute. ;-)

2.

(henyo), Abie (sweetheart). Rhan2 (hot from PBB), tepie, Seidz

and Papa Echs!!!
Xoxo-Elise

Gusto ko lang batiin mga followers ng trans (likod

agad ng trans binabasa bago ang lecture):
-

Kay nikku and mimay na ang hinahanaphanap

ang mga pagbati..;-)

Kashim, allan and john-em! Tnx sa tiratirang

pizzawag nyo ipagkalat ang d totoo baka
maniwala ang tao..hahaha
Kay marc and sly na lagging nagpapasaya sa
malungkot kong Saturday..hehehe

Joy and abhie, sana tuloy na tau sa movie trip

natin!! Excited na ako..

--------------------------------------------------------Birthday greetings!!!

Happy bday kay Jason..pasenxa na d ko kasi lam date ng

bday mo kaya d kita nainclude sa mga binate ko sa last
trans..peace

na

tau..gusto

mo

kantahan

pa

kita

eh..hehehe

Happy bday din sa isang boylet naming jan..wag ka kumain ng

damo..oat meal nalang..effective naman so far..hehehe

------------------------ end of lecture -------------------------------

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Tnx pala kay Giianina for providing me

a copy sa picture ng lecture..;-)

TONGUE TWISTER TIME!!!

If one doctor doctors another doctor, does the doctor
who doctors the doctor doctor the doctor the way the
doctor he is doctoring doctors? Or does he doctor the
doctor the way the doctor who doctors doctors?
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There is no growth without change, no change without fear or loss, and no loss without pain

***loveskeedoo ;-)