Influenza

Question 1

Most common Influenza-Like Illness causes?

Answer 1

-Influenza A/B/C (A & B most common)
-Parainfluenza Virus
-RSV
-M. pnemoniae

Question 2

How does Influenza spread?

Answer 2

-Droplet Inhalation &/or direct / indirect contact with contaminated respiratory secretions.

Question 3

Influenza incubation period?

Answer 3

1.5-2d most commonly (ranges from 1-4d)

Question 4

When can adults spread Influenza virus?

Answer 4

1d before symptoms to ~5d after symptom onset

Question 5

When is the optimal time to vaccinate for Influenza?

Answer 5

October (prior to the beginning of the Nov-Apr surge)

Question 6

The negative stranded RNA Virus that’s responsible for Influenza is covered with a protective & antigenic envelope… What are the envelope’s sub-components?

Answer 6

-Haemagglutinin (HA)
-Neuraminidase (NA)
-Matrix 2 (M2) Ion Channels

Question 7

Steps 1-4 of Influenza Viral Invasion & Replication?

Answer 7

1) HA binds host cell receptors in the respiratory tract.

2) Viral RNA released into cytoplasm & is transported to nucleus.

3-4) Complementary vRNA transcribed & is either exported into cytoplasm or stays in nucleus.

Question 8

Steps 5-7 of Influenza Viral Invasion & Replication?

Answer 8

5) New viral proteins secreted through Golgi Apparatus onto cell surface or transported back to nucleus to form new viral genome particles.

6) vRNA & other proteins leave nucleus, bulge out of host cell membrane coated in viral surface proteins.

7) Mature virus buds off from cell & host cell dies.

Question 9

Through what mechanism do AV drugs work?

Answer 9

Inhibition of the budding stage (Step 7)

Question 10

Antigenic Shift / Drift refers to what process?

Answer 10

Appearance of Influenza Virus (usually Influenza A) with new HA or NA subtypes

Question 11

What epidemic was declared to be the world’s worst ever?

Answer 11

1918-19 Influenza Pandemic

-20% world’s population infected
-2.5% - 20% mortality
-Killed up to 50mil people

Question 12

Signs & Symptoms of Influenza infection?

Answer 12

-Sudden high fever (7-10d length ; preceded by chills)
-Cough (may persist for 2wks)
-Sore Throat
-Myalgia / Fatigue (can linger around for wks)
-Headache / Appetite Loss / Rhinitis / NVD (espec. kids)

Question 13

When do most people recover from Influenza infections?

Answer 13

7-10d

Question 14

What are some complications that may arise from Influenza infection?

Answer 14

-Viral / Secondary Bacterial Pneumonia
-Exacerbated Chronic Lung Disease
-Croup / Bronchiolitis (young kids)
-Otitis Media

Question 15

Death from Influenza infection most often arises due to what?

Answer 15

Exacerbated underlying Cardio-Pulmonary Disease

Question 16

What other co-morbid conditions may be exacerbated by Influenza infection?

Answer 16

-Febrile Seizures
-Reye’s Syndrome (Abnormal fat depositions & increased pressures on the brain)
-Encephalitis
-Guillain Barre Syndrome (Autoimmune attack on PNS)
-Myositis
-Myocarditis

Question 17

In what pregnancy trimester does Influenza demonstrate its highest mortality rates?

Answer 17

3rd trimester

Question 18

IIV3 & IIV4 stand for what?

Answer 18

Inactivated Influenza Vaccine Trivalent / Quadrivalent

Question 19

LAIV3 & LAIV4 stand for what?

Answer 19

Live Attenuated Influenza Vaccine Trivalent / Quadrivalent

Question 20

SD (as it pertains to vaccine terminology) refers to what?

Answer 20

Standard Dose, Unadjuvanted

Question 21

Adj (as it pertains to vaccine terminology) refers to what?

Answer 21

Adjuvanted

Question 22

HD (as it pertains to vaccine terminology) refers to what?

Answer 22

High Dose, Unadjuvanted

Question 23

cc (as it pertains to vaccine terminology) refers to what?

Answer 23

Cell Culture Based ; Is standard dose & unadjuvanted

Question 24

RIV4 (as it pertains to vaccine terminology) refers to what?

Answer 24

Recombinant Protein

Question 25

Cell Culture Based vaccines are typically grown in what culture types?

Answer 25

Avian Based (generally Duck)… IIV4-cc is unique, as it’s a mammalian based cell culture vaccine.

Question 26

Approved IIV4-SD Influenza Vaccines?

Answer 26

-Afluria Tetra (5yrs & up)

-Flulaval Tetra (6mo & older)

-Fluzone Quadrivalent (6mo & older)

-Influvac Tetra (6mo & older)

Question 27

Dosing parameters around IIV4-SD vaccines?

Answer 27

-Unadjuvanted

-15ug of HA / strain ; 0.5mL dose (IM Injection)

Question 28

Approved IIV4-HD Influenza Vaccines?

Answer 28

-Fluzone High Dose (65yrs & up)

Question 29

Dosing parameters around IIV4-HD vaccines?

Answer 29

-50ug of HA / 0.7mL dose

Question 30

IIV4-cc Influenza Vaccines?

Answer 30

-Flucelvax (6mo & older)

Question 31

Dosing parameters for IIV4-cc Influenza Vaccines?

Answer 31

-Unadjuvanted

-15ug of HA / strain ; 0.5mL dose (IM Injection)