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ICM - Infectious Disease > Influenza > Flashcards

Influenza Flashcards

1
Q

Scariest side effect of 1976 Swine flu vaccine

A

guillon-barre

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2
Q

What is Influenza A

A

Infects humans and animals

causes pandemics

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3
Q

What is Influenza B

A

Infects only humans

NO pandemics

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4
Q

Two surface proteins and # of them

A

Hemaglutinin (H1-H15)

Neurominidase (N1-N10)

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5
Q

Influenza A flu types are further naems according to…

A

Where they were first ideantified, their lineage year isolated

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6
Q

Minor changes in Influenza antigen proteins

So what?

A

Drift

Keeps you susceptible from year to year

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7
Q

Major changes in Influenza antigen proteins

A

Shift

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8
Q

Unique setup of influenza genome

A

RNA

Each gene of influenza is encoded on a separate strand

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9
Q

When can antigen shift happen

A

Viruses of two kinds infect the same cell and pull the genetic switcharoo

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10
Q

Animal most responsible for the origin/spread of influenza in all other animals

A

Ducks

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11
Q

Fist major bird flu

A

Spanish Flu

1918

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12
Q

Asian Flu (1957) was comprised of….

A

H1N1 + H2N2

As time went on its new genes added on to the next big thing

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13
Q

Typically how many strains can cause pandemic at at a time

A

One

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14
Q

What’s the deal with H1N1 Russian Flu

A

Identical to Russian Flu

Possibly caused by a lab release

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15
Q

How is influenza transmitted?

A

Large droplets (sneezing/coughing)
Close contact
Not so commonly spread on contaminated surfaces
Not carried in pork/chicken meet

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16
Q

Clinical effects of influenza

A

Fever, Headache, Myalgia, and Fatigue
Cough, Sore Throat, Nasal Discharge to follow
Fatigue/Weakness may last for week

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17
Q

Symptoms that are mistakenly associated with flu

A

Nausea, Vomiting, Diarrhea

18
Q

Complications of Influenza

A 
Viral/Bacterial Pneumonias
Myositis and Rhabdomyolysis
MI
Encephalitis/Encephalopathy (Rare)
Reye's Syndrome (From taking too much Aspirin)
19
Q

Most common post-flu bacterial pneumonias

A

Strep pneumo

S. aureus

20
Q

Unique things about Spanish Flu (1918)

A
  • Started typical, then worsened several days later due to bacterial secondary infection.
  • High Dose Aspirin
21
Q

Things unique to Bird Flu (H5N1)

A

Mostly kids and adults
Very high mortality rates (60%)
Usually respiratory, but some diarrhea+neuro components

22
Q

Transmission risk of Bird Flu (H5N1)

A

Very low person to person transmission

23
Q

Things unique to H7N9

A

China 2013
Elderly severe respiratory stress
Pretty much gone now

24
Q

Things unique to Variant H3N2 influenza

A

Indiana
Close contact with pigs
H1N1 + and a pig H3N2 genes combined
No sustained transmission, mid disease

25
Q

Average Mortality. Mild Year? Severe year/pandemic?

A

Mild – 3,000 (mostly elderly)

Severe – 45,000 (children)

26
Q

How to diagnose influenza?

A

BEST TEST – PCR, sensitive and fast, but expensive
Rapid antigen tests
*Viral culture (gold standard, but takes time)
Serology is pretty useless

27
Q

Treatment for influenza?

A

None are very good
Old school – Amantadine + Rimantadine (useless now)
Now – Neuraminidase inhibitors

28
Q

Name two neurominidase inhibitors

A

Oseltamivir, Sanamivir

29
Q

When do you need to provide treatment to help flu?

A

Within 48 hours of symptom onset

Could reduce symptoms by 1-2 days

30
Q

MOA for Zanamivir?

A

Oral Inhalation

IV available

31
Q

Why new vaccines every year?

A

Antigenic drift in predominant circulating strain

32
Q

Why do they make the guess on the flu vaccine so early?

A

It takes 9 months to mass produce the vaccine

They are grown in eggs. One egg makes one shot.

33
Q

How does the making a vaccine in an egg thing work?

A

Eggs with virus are purified and virus is inactivated with formaldehyde
Currently further purified to have only HA and N antigens (split vaccine) to decrease side effects

34
Q

Side effects of Flu vaccine

A

Not Flu

Possibly Guillain-Barre

35
Q

How do you vaccine the egg-allergic

A

Cell culture based vaccine
Entirely recombinant vaccine
Live attenuated vaccine for those under 50

36
Q

Why get the live, attenuated virus vaccine?

A

May possibly give better protection

37
Q

Are vaccines very effective?

A

Mostly in kids

Not so much for those over 65

38
Q

Vaccines are thought to provide only _____ immunity

A

Non-sterilizing

39
Q

Contents of current vaccines

A

Either two A strains and 1 B strain or two of each

40
Q

Contents of 2015 vaccine

A

H3N2 strain plus 1-2 B strains

41
Q

Effectiveness of 2013-14 vaccine?

2014-2015?

A

51%

23%

ICM - Infectious Disease (11 decks)

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