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Infection > Influenza > Flashcards

Influenza Flashcards

1
Q

What kind of virus is influenza?

A

RNA virus

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2
Q

3 main groups of influenza

A

A
B
C

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3
Q

What does IfA affect?

A

Mammals

Birds

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4
Q

What do IfB and IfC affect?

A

only humans

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5
Q

Surface proteins of influenza

A

18 different H antigens (H1-3 in humans) = haemagglutinin (H)
11 different N antigens = Neuraminidase (N)

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6
Q

What does haemagglutinin allow?

A

Viral attachment and entry into the host cell

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7
Q

What do neuraminidases allow?

A

Enables new virion to be released from host cell

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8
Q

What is antigenic drift?

A

Mechanism of genetic variation within the virus

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9
Q

What can antigenic drift cause?

A

Worse than normal epidemics

Vaccine mismatch

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10
Q

Definition of pandemic

A

Virus spreads across the whole globe

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11
Q

When does pandemic flu occur?

A

Sporadically - not in usual influenza months

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12
Q

Mortality with pandemics increases with….

A

age

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13
Q

What strains of avian flu affect humans?

A

H5N1

H7N9

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14
Q

Transmission of avian flu

A

Spreads through direct contact with infected birds, dead or alive
Occassional transmission via close human to human contact (staff, caregivers)

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15
Q

Which avian flu strain has the highest mortality in humans?

A

H5N1

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16
Q

Investigations for influenza

A

Viral nose and throat swabs/VTs (molecular detection/PCR; using flocked swabs)
CXR; pneumonitis/pneumonia/ARDs
Blood culture
Pulse oximetry; SpO2 < 92% need ABG + oxygen
Respiratory rate
U and Es, FBC, CRP

17
Q

Incubation period of influenza

A

2-4 days (range 1-7 days)

18
Q

Presentation of influenza

A 
Abrupt fever up to 41C (commonly 38-41) which lasts 3 days (range 1-5 days)
2 or more of
- cough 
- sore throat, rhinorrhoea
- myalgia
- headache
- malaise 
Predominance of systemic symptoms
Less common symptoms
- nausea 
- vomiting
- diarrhoea
19
Q

Definition of influenza like illness (ILI)

A

Fever >38C AND cough with onset in last 10 days

20
Q

If influenza illness requires hospitalisation, what is it classed as?

A

Severe acute respiratory infection (SARI)

21
Q

Symptoms of swine flu

A 
Sudden fever (>38C)
Sudden cough 
tiredness
chills
headache
sore throat, runny nose, sneezing
Diarrhoea, loss of appetite
Aching muscles, joint or limb pain
22
Q

Transmission of influenza

A 
Airborne 
- person to person by large droplets
Contact
- direct (person to person)
- indirect (person to fomite to person)
23
Q

When does virus shedding of influenza occur?

A

First 4 days of illness (range 1-7 days)

24
Q

Viral survival of influenza

A

24-48 hours on non-porous surfaces

8-12 hours on porous surfaces e.g. tissue

25
Q

Risk factors for complicated influenza

A 
Neurological, hepatic, renal, pulmonary and chronic cardiac disease
Diabetes mellitus
Severe immunosuppression 
Age > 65
Pregnancy and up to 2 weeks post partum 
Children < 6 months old
Morbid obesity (BMI >_40)
26
Q

Complications of influenza

A 
Acute bronchitis
Secondary bacterial pneumonia (20%)
- 4-5 days before the start of the flu 
Community MRSA uncommon in US/Europe
less common 
- primary viral pneumonia
- myocarditis/pericarditis
- CNS e.g. Guillian barre
27
Q

Presentation of encephalitis lethargia

A 
fever
headache
external opthalmoplegia 
lethargy 
sleep reversal
28
Q

Mortality of encephalitis lethargia

A

25%

29
Q

Complications of encephalitis lethargia

A

Postencephalitic parkinsonism

30
Q

When does an individual become non-infectious in immunocompetent adults?

A

Whichever one of the below lasts longer
- 24 hrs after last flu symptoms (fever and cough)
OR
- When antiviral therapy is completed

31
Q

When should antiviral therapy be given in the treatment of influenza?

A

ASAP and within 48 hours of symptom onset

In complicated illness - should always be given, not matter how long after onset of illness

32
Q

Antivirals that can be used to treat influenza

A

Oseltamivir (Tamiflu) - FIRST LINE
Zanamivir (Relenza) - SECOND LINE
Peramivir
Favipiravir

33
Q

Can oseltamivir be used in pregnancy for the treatment of influenza?

A

Yes

34
Q

What must be worn by healthcare professionals if patient has proven or suspected flu?

A

Surgical face mask
Plastic apron
Gloves

35
Q

Who is the seasonal flu vaccine contraindicated to and why?

A

Those with an egg allergy as the vaccine is grown in the allantoic cavity of chick embryos

36
Q

What do seasonal flu vaccines contain?

A

They are trivalent

  • 2 type A subtype viruses
  • 1 type B subtype viruses
37
Q

Why should healthcare workers have the flu vaccine?

A

To protect themselves and their families
To reduce the risk to ‘at risk’ patients
To reduce absence from work during influenza ‘surge’ activity

Infection (16 decks)

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