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Infection > Influenza > Flashcards

Influenza Flashcards

1
Q

What type of virus is the influenza virus?

A

RNA virus

8 segment genome

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2
Q

What are the 3 main groups of influenza virus?

A

A, B, C

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3
Q

What type of influenza infects mammals and bird/?

A

IfA

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4
Q

What type of influenza infects only humans?

A

IfB and IfC

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5
Q

What are the main surface proteins on the influenza virus?

A

Haemagglutinin

Neuraminidase

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6
Q

What does the surface protein haemagglutinin do?

A

Facilitates viral attachment and entry to host cell

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7
Q

What does the surface protein neuraminidase do?

A

Enables new virion to be released from host cell

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8
Q

How many different known H antigens are there?

A

18 differed H antigens

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9
Q

How many different known N antigens are there?

A

11 different N antigens

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10
Q

What virus family is influenza part of?

A

Orthomyxoviridae

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11
Q

How does antigenic drift work?

A

Occurs continually over time, small on-going point mutations in the genes coding for antibody binding sites

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12
Q

Does antigenic drift or shift change the antigenic properties and eventually means the immune system can’t combat the virus as well?

A

Antigenic drift

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13
Q

Does antigenic drift or shift cause worse than normal epidemics and vaccine mismatch?

A

Antigenic drift

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14
Q

What is antigenic shift?

A

Abrupt major change in the virus, resulting in new H/N combinations

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15
Q

Each year, what does the flu vaccine contain?

A

Two A strains
One B strain
- can change year to year

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16
Q

What is the genetic change that enables a flu strain to jump from one animal species to another?

A

Antigenic shift

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17
Q

What is the process by which two or more different strains of a virus combine to form a new subtype, resulting in new H/N combinations?

A

Antigenic shift

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18
Q

What can lead to pandemics: antigenic drift or shift?

A

Antigenic shift

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19
Q

How is pandemic flu different to seasonal flu?

A

Occurs sporadically
Affects 25%+ of population
More serious, more complications

20
Q

How much of the population does seasonal flu usually affect?

A

10-15%

21
Q

What are pandemic requirements?

A

Human pathogenicity
‘New’ virus (antigenic shift)
Efficient person-to-person transmission

22
Q

Who is more susceptible to the flu?

A

Young and old

23
Q

How does avian flu spread?

A

Direct contact with infected birds: dead or alive
Occasional transmission via close human contact
Not food

24
Q

What are the clinical features of influenza?

A

Incubation period 2-4 days
Abrupt fever up to 41’ lasts 3 days
Plus 2 or more of: cough, sore throat, myalgia, headache, malaise
Predominance of systemic symptoms

25
Q

What are less common symptoms of influenza?

A

Nausea, vomiting, diarrhoea

26
Q

What is an ILI?

A

Influenza-like illness

27
Q

What is the WHO definition for an ILI?

A

Fever >38’ AND
cough
onset with last 10 days

28
Q

What are the symptoms of swine flu?

A

Sudden fever
Sudden cough
Tiredness, chills
Headache, sore throat, running nose, sneezine
Diarrhoea, stomach upset, loss of appetite
Aching muscles, limb or joint pain

29
Q

What is the transmission of influenza?

A

Airborne: Person -> person (droplets >5 microns)
Contact: direct, indirect

30
Q

What is the period of virus shedding?

A

First 4 days of illness

Longer children+immunocompromised

31
Q

What is the virus survival?

A

24-48hrs non-porous surfaces

8-12hrs porous surfaces (tissue)

32
Q

What are high risk groups for influenza?

A 
Chronic organ disease
DM
Immunosuppression
65+
Pregnancy
Children <6mo
Morbid obesity
33
Q

What are common respiratory complications of influenza?

A

Acute bronchitis

Secondary bacterial pneumonia

34
Q

What are less common complications of influenza?

A

Resp: primary viral pneumonia
Cardiac: myocarditis/pericarditis
CNS: transverse myelitis/Guillain-Barre

35
Q

How does encephalitis lethargica present?

A

Fever, headache
External ophthalmoplegia
Lethargy
Sleep reversal

36
Q

What are the investigations for influenza?

A 
Viral nose and throat swabs
Chest XR
Blood culture
Pulse oximetry
RR
U&amp;Es, FBC< CRP
37
Q

When are patients at risk of secondary bacterial pneumonia and should have urgent CXR?

A

Flu symptoms and fever for >4 days

38
Q

What does the CURB65 score stand for?

A 
Confusion
Urea >7mmol/l
RR
BP
>65
39
Q

What class of drugs are commonly used for influenza?

A

Neuraminidase inhibitors

antiviral therapy

40
Q

What are examples of neuraminidase inhibitors?

A

Zanamivir

Oseltamivir (Tamiflu)

41
Q

What is the common name for oseltamivir?

A

Tamiflu

42
Q

What is the management for influenza?

A

Antiviral therapy - Tamiflu or Relenza

43
Q

What are the common ADR for Tamiflu?

A

Nausea, vomiting, abode pain, diarrhoea

44
Q

What is the first line therapy in a pregnancy influenza?

A

Tamiflu

45
Q

When does an individual become non-infectious with influenza?

A

24hrs after last flu symptoms or when anti-viral therapy completed

Infection (13 decks)

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