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| It can be defined as a respiratory disease of pigs
caused by type A influenza viruses that causes
regular outbreaks in pigs’

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| m ine flu, Hog flu, and Pig flu


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|ear Designation Resulting Death Toll
Pandemic
3 H3N oderate Not
Available
33 H3N3 Devastating 50-300
mpanish) million
357 HN oderate 3-4 million
Asian)
3  H3N ild 3-4 million
Hong Kong)
  
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mm
| nasopharyngeal s ab
| nasal aspirate
| combined nasopharyngeal s ab ith
oropharyngeal s ab.
| nasal s ab
| oropharyngeal s ab
| Intubated patients - an endotracheal aspirate .
Bronchoalveolar lavage BAL) and sputum
specimens also acceptable’
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| moon after symptoms begin
| Before administration of antiviral medications
| Even if symptoms began more than one eek ago
| ultiple specimens on multiple days can be
collected
| m abs ith a synthetic tip eg, polyester or
Dacron) and an aluminium or plastic shaft
preferred
| m abs ith cotton tips and ooden shafts not
recommended.
| m abs made of calcium alginate not acceptable.
| Collection vial for s ab should contain 3 to 3 ml of
viral transport media.
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| Intensive Care Unit & Laboratory personnel :
)7+Y 
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| ortuary:
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| Insert a dry s ab into the nostril and take it back
to the nasopharynx
| Leave in place for a fe seconds
| mlo ly remove it hile slightly rotating it
| Ne s ab for other nostril
Nasal m ab
Collected from the anterior turbinate
  
  

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| Patientǯs mouth should be ide open
| Touch the s ab at the back of the throat near the
tonsils



 
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| Pre-printed barcode labels to be used
| n the specimen container
| n the field data collection form
| n the log book
m  m

| ithin 4 hours Ȃ store at 4° C before and after
transport
| Beyond 4 hours- -70 ° C
| Do not store in standard freezer- keep on ice or in
refrigerator



| All specimens should be
transported after packaging
using the H triple
packaging system.
| hile transportation cold
chain should be maintained.

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3) Primary receptacle: a labelled primary atertight,
leak-proof receptacle containing the specimen.

) mecondary receptacle: a second durable,


atertight, leak-proof receptacle to enclose and
protect the primary receptacles).

3) uter package: the package around the secondary


receptacle hich protects the receptacle and its
contents from outside influences such as physical
damage hile in transit.
  

Test ethod Infuenza Virus Time For Results
Types Detected
Virus Culture A and B 5 Ȃ 30 days

Fluorescent A and B  Ȃ 4 hrs


Immunoasssay
RT - PCR A and B 3 - days

merological Tests A and B >  eeks

Enzyme A and B  hours


Immunoassay EIA)
Rapid Antigen A ; A and B † 30 mins
Detection
| Diagnostic Tests
| Demonstration of virus antigen IF , PCR)
| Isolation of virus
| merology
| ther tests
  
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| done using fluorescent tagged influenza antiserum
| distinguishes bet een influenza A and B .
| positive for influenza A by immunofluorescence may
meet criteria for a suspected case.
| not possible to differentiate from seasonal influenza
A viruses
| A negative DFA or IFA does not exclude H3N3 influenza
A infection .
| should not be assumed a final diagnostic test for
novel influenza A H3N3) virus infection’


several PCR assays for detection of:

| highly conserved parts of the influenza genome


matrix Ǯǯ gene) to confirm the presence of influenza
A;
| detect current human influenza virus H3 and H3
genes;
| hen the result of PCR assay on Ǯǯ gene is Ǯnegativeǯ,
the diagnosis of Influenza could be ruled out. hen
the PCR Ǯǯ gene is positive together ith either PCR
H3H3 is positive, human influenza is diagnosed
| Real-time RT-PCR is the recommended test for
confirmation of novel influenza A H3N)3 cases.
| Currently, novel influenza A H3N3) virus ill test
positive for influenza A and negative for H3 and
H3 by real-time RT-PCR.
| If reactivity of real-time RT-PCR for influenza A is
strong it is more suggestive of a novel influenza A
H3N3) virus


| Done in monkey kidney cells or human embryo
kidney cells
| Isolation of H3N3 influenza A virus using culture
is diagnostic
| culture is usually too slo to help guide clinical
management.
| A negative viral culture does not exclude H3N3
influenza A infection.
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| Chilling, Harvesting of Amniotic and alllantoic fluid
separately
| Tested for haemaggglutination with guinea pig and
fowl RBCs in parallel, at room temperature & at 4[C
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| can distinguish bet een influenza A and B
viruses.
| Can detect the HmI Influenza A H3N3) virus
| not possible to differentiate from seasonal
influenza A viruses.
| suboptimal sensitivity to detect seasonal
influenza viruses
| negative rapid test could be a false negative
| should not be assumed a final diagnostic test for
novel influenza A H3N3) virus infection.
 

   

| There are several possibilities hen a patient tests
positive for influenza A by rapid antigen test:
| The patient might have novel H3N3 virus infection
| The patient might have seasonal influenza A virus
infection or
| The patient might have a false positive test result
| 
   

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| Paired mample for merology mtudy at an interval of
34 days
| To demonstrate a four-fold or more rise in HmI
influenza A H3N3) virus specific antibodies
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TREATENT
AND
PRPHLAXIm
| salicylateaspirin is strictly ci due to its potential
to cause reye s syndrome.
| seltamivir brand name Tamiflu ®)- to both treat
and prevent influenza A and B virus infection in
people one year of age and older.
| Zanamivir brand name Relenza ®)- to treat
influenza A and B virus infection in people 5 years
and older and to prevent influenza A and B virus
infection in people 5 years and older.
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