Influenza

Question 1

what is the difference b/w epidemic and pandemic?

Answer 1

• epidemic: more than what is normal to see with a particular dz
• pandemic: worldwide outbreak

Question 2

when was the last influenza pandemic?

Answer 2

• Spanish Influenza
• 1918-1919
• 40 million deaths
• most likely attributed to WWI

Question 3

flu virus

Answer 3

• can’t see w/o electron microscope
• don’t have cells, really just chains of genetic material lumped inside a protein coat
  
  • the proteins constantly change
• there are 2 proteins on flu virus:
  
  • hemagglutinin (H)
  • neuraminadase (N)
    
    • H & N mutate constantly, so have to keep getting immunized

Question 4

antigenic drift and shift

Answer 4

• drift: is a smaller/minor change in the structure of the H & N proteins
  
  • minor from year to year
• shift: large and major change in the structure of the H & N proteins

Question 5

transmission of the flu

Answer 5

• droplets
• respiratory
  
  • secretions
  • skin to skin
  • contact with particles
• can be passed by coughing, sneezing, talking
• can be contagious 48 hr before S/S start and 5 days after

Question 6

what is the difference b/w flu and common cold?

fever

headache

exhaustion

stuffy nose

cough

complications

Answer 6

• influenza: comes on sudden
  
  • fever: yes, usually high
  • headache: yes
  • exhaustion: early and sometimes severe
  • stuffy nose: sometimes
  • cough: yes
  • complications: bronchitis, pneumonia
• cold:
  
  • fever: unusual
  • headache: unusual
  • exhaustion: never
  • stuffy nose: common
  • cough: unusual
  • complications: sinus congestion

Question 7

treatment of influenza

Answer 7

• neuraminidase inhibitors:
  
  • Tamiflu (oseltajmivir)–have to start w/in 24-48 hours to shorten and limit the illness
    
    • SE: nausea (so may need Zofran)
    • don’t usually give to children unless hospitalized b/c causes severe nausea
• M2 ion channel inhibitors
• no aspirin for under 18 b/c of Reye’s Syndrome
• can give acetaminophen-ibuprofen
• abx tx should be reserved for the tx of secondary bacterial pneumonia

Question 8

influenza vaccine

Answer 8

• have to be developed yearly based on the strain that hit those ppl who had it the season before (so we go off of Australia)
• NOT a live vaccine–>so can’t get flu from vaccine
• takes 7-10 days to build up immunity to vaccine

Question 9

SEs of the influenza vaccine

Answer 9

• Guillain Barre Syndrome
• pain, redness, swelling at the injection site lasting 1-2 days
• systemic SEs

Question 10

groups to target with the flu vaccine

Answer 10

• F: facilities such as nursing homes or chronic care facilities
• L: likelihood of transmission to high risk persons (those over 65+, women who will be pregnant during flu season)
• U: underlying medical conditions

Question 11

contraindications to the flu vaccine

Answer 11

• egg allergy
• acute febrile illness
• previous Guillain Barre Syndrome

Question 12

if we have a pandemic tonight, how long would it take to develop a vaccine for the flu?

Answer 12

6 mos

Question 13

priorities during flu season

Answer 13

• assemble all available surveillance data
• inform public and health dept

Question 14

how to prevent the flu transmission

Answer 14

• cover cough: cover mouth and nose w tissue or cough/sneeze into upper sleeve, not hands
  
  • put used tissues in trash
• wash hands with soap and water
  
  • clean w/ alcohol based hand cleaner
  • wash stethoscope

Question 15

priorities for public health containment

Answer 15

• emphasize personal hygiene, cough etiquette
• close schools/public events
• isolate sick and quarantine those exposed
• promote social distancing
• discourage “absence penalties”

Question 16

priorities for public health control

Answer 16

• allocate and distribute antivirals and vaccines
• set priorities
• establish protocols for use