Influenza

Question 1

What makes up Influenza virus?

Answer 1

Different segments of RNA

Question 2

How many main types of influenza are there?

Answer 2

3 (A,B,C)

Question 3

What does influenza A act on?

Answer 3

Humans and animals, causes pandemics

Question 4

What does influenza B act on?

Answer 4

Human, doesn’t cause pandemics

Question 5

What does influenza C do?

Answer 5

Mild disease

Question 6

What are the 2 surface proteins that are targets for neutralization?

Answer 6

Hemaglutinin

Neuraminidase

Question 7

How many hemaglutinins are there?

Answer 7

15

Question 8

How many neuraminindases are there?

Answer 8

10

Question 9

Why does Influenza have a high mutation rate?

Answer 9

They are RNA viruses

Question 10

What changes in Influenza from year to year?

Answer 10

Sequence of H1 and N1 proteins

Question 11

Changing surface proteins from year to year is called what?

Answer 11

Antigenic drift

Question 12

How many genes are encoded on one strand of RNA

Answer 12

1

Question 13

How do viruses gain new genes?

Answer 13

During virus envelope formation gene segments from other viruses can incorporate themselves.

Question 14

What is it called when new hemagglutinin or neuraminidase genes are obtained?

Answer 14

Antigenic shift

Question 15

Animal responsible for origin and spread of influenza to other animals?

Answer 15

Duck

Question 16

Where did spanish flu come from?

Answer 16

Bird to human

Question 17

Next anticipated pandemic?

Answer 17

Novel H1N1

Question 18

How long will a strain of influenza circulate?

Answer 18

Unpredicatable

Question 19

How is influenza transmitted?

Answer 19

Large droplets like sneezes and coughs

Question 20

Limiting factor of transmission?

Answer 20

Large droplets don’t stay in air so close contact needed

Question 21

Does it remain on surfaces?

Answer 21

Not important for transmission

Question 22

Can you get influenza from pork or chicken meat?

Answer 22

No

Question 23

How does influenza present?

Answer 23

Fever, headache, myalgia, and fatigue

Question 24

What are not typical features of influenza?

Answer 24

Nausea, vomiting, and diarrhea

Question 25

What causes Reye's syndrome?

Answer 25

Giving aspirin to kids

Question 26

Most common causes for secondary bacterial infection pneumonia?

Answer 26

Step pneumonia and staph aureus

Question 27

Most common cause of death in Spanish Flu?

Answer 27

Bacterial pneumonia

Question 28

What happened with vaccines made from killed bacteria used on Spanish Flu?

Answer 28

it helped (improved mortality rates)

Question 29

Who does the "Bird Flu"/H5N1 affect?

Answer 29

Children and young adults

Question 30

Presentation of H5N1?

Answer 30

Respiratory illness, but also diarrhea and neurologic problems

Question 31

Who was affected by Avian Influenza H7N9 in 2013?

Answer 31

Elderly

Question 32

How do you diagnose Influenza?

Answer 32

Rapid antigen tests

Question 33

Gold standard for diagnosis?

Answer 33

Viral culture, but takes days

Question 34

What is the best diagnostic test?

Answer 34

RT-PCR, expensive

Question 35

Which antiviral is used for treatment?

Answer 35

None of them work great

Question 36

Why aren't Amantadine or Rimantadine used anymore?

Answer 36

All strains are resistant to it

Question 37

New treatments?

Answer 37

Neuraminidase inhibitors Oseltamivir and Zanamivir

Question 38

When do these neuraminidase inhibitors need to be given by?

Answer 38

within 48 hours of symptom onset, reduces symptoms by 1-2 days

Question 39

How is Zanamivir given?

Answer 39

Oral inhalation, but IV available

Question 40

How is it determined which strains will be predominant in upcoming flu year?

Answer 40

Educated guesses

Question 41

How long does it take to make vaccines?

Answer 41

9 months

Question 42

Where are vaccines grown?

Answer 42

Eggs

Question 43

What is done with egg containing virus?

Answer 43

Purified and virus inactivated with formaldehyde

Question 44

What constitutes a "split" vaccine?

Answer 44

Vaccine that separates Hemagglutinin and neuraminidase surface proteins in vaccine for less side effects

Question 45

What is a trivalent vaccine?

Answer 45

Vaccine with two A strains and 1 B strain

Question 46

Quadrivalent strain?

Answer 46

Vaccine with two A strains and 2 B strains

Question 47

What complication was noticed with vaccines in 1976?

Answer 47

Guillain-Barre

Question 48

What do you give for people allergic to eggs?

Answer 48

Cell culture based vaccine

Question 49

Does live attenuated vaccine give better protection?

Answer 49

Not proven

Question 50

Who are vaccines most effective for? | Least effective?

Answer 50

Children | >65 elders