Influenza

Question 1

How is influenza spread?

Answer 1

Through respiratory droplets

Question 2

Which two glycoproteins are on the outside of the influenza virus?

Answer 2

HA and NA

Question 3

Does the virus or the host’s cytokine response cause most of the damage?

Answer 3

The host’s response

Question 4

Which symptoms are typically only present around the peak of the virus?

Answer 4

Headache, malaise, myalgia

Question 5

Which secondary infection is common with influenza?

Answer 5

Bacterial pneumonia
This is because influenza makes you more susceptible for certain pathogens

Question 6

Most common cause of CAP?

Answer 6

Influenza

Question 7

Compare antigenic drift and shift

Answer 7

Drift = small changes in genetic material. Prior infection should provide protection.
Shift = large change to virus - likely due to combination of multiple forms of the virus (e.g. human and non-human variations). Will express different surface proteins and therefore past infection will not provide protection and new vaccine will be needed

Question 8

List 4 methods of infection control

Answer 8

• isolating confirmed cases
• using PPE
• hand washing
• contact tracing

Question 9

Why do elderly patients need a higher dose of vaccine?

Answer 9

Because they have a weaker immune response. Need a higher dose to get the same effect. Given to over 60-65s

Question 10

Which class does oseltamivir belong to?

Answer 10

Neuramidinidase inhibitor

Question 11

Brand name of oseltamivir?

Answer 11

Tamiflu

Question 12

Treatment duration for antivirals?

Answer 12

5 days

Question 13

Which antiviral is given via inhalation?

Answer 13

Zanamivir

Question 14

What is the window during which antivirals are useful for influenza?

Answer 14

Within 48 hours of onset

Question 15

Desirable outcomes of using NI antivirals?

Answer 15

Reduced Sx duration, reduce need for antibiotics, reduce hospital admissions and reduce death

Question 16

Function of neuraminidase enzyme?

Answer 16

It cleaves the newly packaged virion from the infected cell so that it can go on and infect new cells

Question 17

Which patient groups might receive prophylactic treatment with an NI?

Answer 17

At risk groups. E.g. pregnant women, elderly, children, residents of long term care facility, immunocompromised, etc

Question 18

Is prophylactic treatment with NIs dangerous?

Answer 18

No. It is used in high-risk groups because the side effect profile is minimal and the drugs are mostly non-toxic

Question 19

Why might the drugs not be useful after 48 hours?

Answer 19

Because you are now dealing with the host cytokine response, not the replication and spread of the virus