Influenza

Presented by
Abhinay Sharma Bhugoo
Influenza
• Influenza is an acute viral infection that
spreads easily from person to person.
• It circulates worldwide causing epidemics,
• affect anybody in any age group.
• Each year, seasonal influenza affects 5-
15% of the population in the northern
hemisphere.
• While most infected people do not need
medical treatment, annually an estimated
3-5 million infections worldwide cause
severe disease resulting in hospitalization
or even death.
Influenza?
• Flu
• Spread by air or by direct contact
• Happen during every winter
• contagious one day before getting symptoms
and up to 7 days after becoming ill
• occur during epidemics or pandemic
 PATHOGEN’S FEATURES

• Orthomyxoviruses
• Influenza A and B
• Enveloped and Pleomorphic
• 8 gene segments code for 10 proteins
• Single-stranded RNA viruses
• RNA exhibits high mutation rates
Epidemia versus pandemia
 Seasonal influenza
• Influenza is an acute viral infection
• primarily attacks the upper respiratory
tract, including the nose, throat, bronchi
and, less frequently, the lungs.
• Seasonal influenza affects
approximately 5-15% of the population on
an annual basis.
• Most people recover without medical
treatment.
• is responsible for 250 000 - 500 000
deaths annually specially in group of high
risk
Pandemic influenza

• An influenza pandemic occurs when a new

influenza virus subtype emerges and
spreads easily among human beings.
Epidemics
• Involve 10% - 20% of world’s population.
• Kill 500,000 to 1,000,000 people yearly.
• Predictable, yearly.
• Driven by “drift” mutations.(Mutations can
cause small changes in the hemagglutinin
and neuraminidase antigens on the
surface of the virus)
• Changes confined to hemagglutinin (H)
and neuraminidase (N)
Pandemics
• Involve more than 25% of world’s
population.
• Number of deaths varies.
• Unpredictable, sporadic.
• Driven by “shift” mutations.(acquirement of
completely new antigens—for example by
reassortment between avian strains and
human strains)
• Adaptation of animal-like to human-like
strains.
• Adaptation involves all 8 gene segments
(polygenic selection)
Latest flu pandemics

Name of Subtype
Date Deaths
pandemic involved
possibly
Asiatic (Russi 1889–90 1 million
an) Flu H2N2
Spanish Flu 1918–20 50 million H1N1
1.5 to 2
Asian Flu 1957–58 H2N2
million
Hong Kong Fl 1968–69 1 million H3N2
u
As of June
Swine Flu over 18,209 [ novel H1N1
25, 2010
Example of drift
Antigenic drift creates influenza viruses with
slightly modified antigens,
A/Texas/1/77(H3N2) --->
A/Bangkok/1/79(H3N2)
Antigenic Shifts and Pandemic
Strains
• One cell infected with two different
influenza A strains
2 viruses x 8 gene segments
28 = 256 combinations

• A(H3N2) + A(H1N1) --->

• A(H3N2) ---> A(H3N2)
A(H1N1) ---> A(H1N1)
A(H1N2) ---> A(H1N2)
A(H3N1) ---> A(H3N1)* ---> pandemic
* adapted strain
Categories of Influenza

Influenza

Influenza Influenza Influenza

Type A Type B Type C
Influenza A

• infect people, birds, pigs, horses,

seals, whales, and other animals.
• Main host: bird
• divided into subtypes based on two
proteins on the surface of the virus
• hemagglutinin (HA) and
neuraminidase (NA)
• 16 different HA(H1-H16) subtypes
and 9 different NA (N1-N9)
subtypes
Influenza Type B
• Usually only found in humans
• not classified according to subtype
• cause human epidemics, but they have not caused
pandemics
Influenza Type C

• cause mild illness in humans

• do not cause epidemics or pandemics
• These viruses are not classified according to subtype.
Antigenic shift
Influenza transmission
• droplets from coughing and sneezing.
• the viruses fly into the air along with mucus, saliva
and other secretions
• infects the nose, throat or lungs
• ill in a short period of time
Avian influenza(bird flu)
• found chiefly in birds,
• but infections can occur in humans.
• Wild birds carry the viruses in their intestines,
• but usually do not get sick from them.
• Infected birds shed influenza virus in their saliva, nasal secretions,
and feces.
Swine Flu
• is a respiratory disease of pigs
caused by type A influenza virus
that regularly causes outbreaks
of influenza in pigs
• high levels of illness and low
death rates in pigs
• change constantly.
Is the H1N1 swine flu viruses the
same as human H1N1 viruses?
• the H1N1 swine flu viruses are
antigenically very different from human
H1N1 and therefore vaccines for human
seasonal flu offers no protection
EQUINE FLU
 Equine Flu

• Originally infected by wild aquatic birds

• Spread to another species
I got Dog
Flu…
Dog Flu
• is a contagious respiratory disease in dogs caused
by a specific Type A influenza virus
• referred to as a “canine influenza virus.”
• Involve dogs, not of humans.
• was originally an equine (horse) influenza virus
• now spread between dogs.
Risk Factor For Influenza

• 50 years of age and older

• Long-term heart or lung problems
• People that have kidney disease,
cystic fibrosis, anemia or immunology
disorders can also easily get Influenza
• Exposure to smoke, toxic fumes,
industrial smoke and other
environmental pollutants (injure
airways and damage the cilia)
• Travelling in Public Transport such as
Buses, and Trains
• Colds and flu's occur predominantly in
the winter (higher concentrations of
airborne viruses, Dry winter weather also
dries up nasal passages while making
them more susceptible to viruses)
Complications of Influenza
• Flu is usually limited and not so serious
• In United States, more than 200,000
people are hospitalized due to
complications of flu
• People which have higher risk of
getting serious complications are those
over 65 years old and those with
chronic medical conditions
• Example: Pneumonia
Symptoms of Influenza
• Depending the type of virus, age and
individual health problem
 Symptoms of 2 Types of Influenza
H5N1 ( Avian Influenza) H1N1 (Swine Influenza)
• Fever • Fever
• Cough • Cough
• Sore Throat • Sore Throat
• Muscle Aches • Body Aches
• Difficulty Breathing • Runny Nose
• Diarrheal • Extreme Fatigue
• Diarrheal
• Vomiting
 Diagnosis of Influenza
•Based on the types of symptoms
•Rapid (antigen detection) tests
•Fluorescent antibody tests
•Viral culture is able to differentiate between
strains of a specific virus
•Need Influenza treatment,
chemoprophylaxis to formulate vaccine
•for the coming year
The way that influenza to spread out

Influenza virus usually is passed through the air,

by coughing and by direct contact.

• Direct object here means that shaking hands or

kissing.
 To control or prevent
influenza
• The preferred treatment for influenza, and consequently most
viral infections is prevention.
• This prevention can be achieved through vaccinations such as
get vaccinated against the disease every year.
• Several antiviral drugs can be used to prevent infection with
influenza virus. For example, Amantadine and rimantadine
are older antiviral drugs that offer protection against
influenza type A but not influenza type B.
• Two new drugs, oseltamivir(Tamiflu) and
zanamivir(Relenza), (neuraminidase
inhibitors)can prevent infection with either
influenza virus type A or type B.
• These drugs produce minimal side effects.
 Treatment of Influenza
• Treatment include two parts: Home
treatment and Calling a health
professional.

• Home Treatment
1. Bed rest
2. At least one full glass of water or juice
every hour.
3. Acetaminophen (Tylenol), or Ibuprofen
can relieve head and muscle aches.
Aspirin should be avoided for children.
Treatment of Influenza

• antivirals better act if be taken within

48 hours of symptoms onset.
 Vaccine of influenza
• The best way to protect against the flu to get
vaccinated each year.

• There have two types of vaccines:

1. The “flu shot”
2. The nasal-spray flu vaccine

• Each vaccine contains three influenza viruses-one A

(H3N2) virus, one A (H1N1) virus, and one B virus.

• About 2 weeks after vaccination, antibodies that

provide protection against influenza virus infection
develop in the body.
Vaccine of influenza
• The "flu shot"— an inactivated vaccine
(containing killed virus) that is given with a needle,
usually in the arm. The flu shot is approved for use
in people older than 6 months, including healthy
people and people with chronic medical conditions.

• The nasal-spray flu vaccine — a vaccine made

with live, weakened flu viruses that do not cause
the flu (sometimes called LAIV for “live attenuated
influenza vaccine” or FluMist®). LAIV (FluMist®)
is approved for use in healthy* people 2-49 years
of age who are not pregnant.
Vaccine of influenza
• People who should get vaccinated each year
are:

1. Children aged 6 months up to their 19th

birthday
2. Pregnant women
3. People 50 years of age and older
4. People of any age with certain chronic
medical conditions
5. People who live in nursing homes and other
long-term care facilities
6. People who live with or care for those at
high risk for complications from flu
Vaccine of influenza
• There are some people who should not be
vaccinated without first consulting a physician.
These include

1. People who have a severe allergy to chicken

eggs.
2. People who have had a severe reaction to an
influenza vaccination.
3. People who developed Guillain-Barre syndrome
within 6 weeks of getting an influenza vaccine.
4. Children less than 6 months of age (influenza
vaccine is not approved for this age group)
5. People who have a moderate-to-severe illness
with a fever (they should wait until they recover
to get vaccinated.)
Vaccine of influenza
• Vaccine Effectiveness
The ability of flu vaccine to protect a person
depends on the age and health status of the
person getting the vaccine, and the similarity
or "match" between the virus strains in the
vaccine and those in circulation. Testing has
shown that both the flu shot and the nasal-
spray vaccine are effective at preventing the
flu.
Vaccine of influenza
• The flu shot, minor side effects that could
occur are

1. Soreness, redness, or swelling where the shot

was given
2. Fever (low grade)
3. Aches
Vaccine of influenza
• LAIV , In children, side effects from LAIV
(FluMist®) can include

1. runny nose
2. wheezing
3. headache
4. vomiting
5. muscle aches
6. fever
Vaccine of influenza
• LAIV, In adults, side effects from LAIV
(FluMist®) can include

1. runny nose
2. headache
3. sore throat
4. cough
Conclusion
• aware & take precautions
• reduce the risk of the spread of influenza
• Very dangerous
Thank you