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Infection > Influenza > Flashcards

Influenza Flashcards

1
Q

Describe the influenza virus structure and groups

A
  • RNA virus - 8 segment genome
  • Orthomyxoviridae family
  • Three main groups: A, B and C
  • IfA infects mammals and birds
  • IfB and IfC only affects humans
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2
Q

What are the surface proteins found on influenza?

A
  • 18 different H antigens and 11 different N antigens
  • Haemagglutinin (H): facilitates viral attachment and entry into host cell
  • Neuraminidase (N): enables new virion to be released from host cell
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3
Q

How is the flu strain able to jump from one animal species to another?

A

Antigenic shift

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4
Q

Describe the features of avian flu

A
  • H5N1 and H7N9 affect humans
  • Spreads through direct contact with infected birds, dead or alive
  • Occasional transmission via close human contact
  • High case fatality rate (60%)
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5
Q

What are the clinical features of flu?

A
  • Incubation period 2-4 days
  • Fever (approx. 3 days)
  • Plus 2 or more of: cough, sore throat, rhinorrhoea, myalgia, headache and malaise
  • Less common symptoms: nausea, vomiting and diarrhoea
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6
Q

What is the WHO definition of Influenza like illness?

A
  • Fever (>38)
  • Cough
  • Onset within the last few days
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7
Q

What are the symptoms of swine flu?

A
  • Sudden fever and cough
  • Tiredness and chills
  • Headache, sore throat, runny nose and sneezing
  • Diarrhoea, stomach upset and loss of appetite
  • Aching muscles, limb or joint pain
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8
Q

How long can the flu virus survive outwith an organism?

A
  • Non-porous surfaces: 24-48 hrs

- Porous surfaces (e.g. tissue): 8-12

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9
Q

What are the high risk groups?

A
  • Neurological, hepatic, renal, pulmonary and chronic cardiac disease
  • Diabetes
  • Severe immunosuppression
  • Age > 65yrs
  • Pregnancy (including 2wks post partum)
  • Children < 6 months
  • BMI > 40
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10
Q

What are the common complications of flu?

A
  • Acute bronchitis

- Secondary bacterial pneumonia

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11
Q

What are the common organisms responsible for secondary bacterial pneumonia?

A

S. pneumoniae, S. aureus and H. influenzae

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12
Q

What are the less common complications of flu?

A
  • Primary viral pneumonia
  • Rapid resp. failure
  • Myocarditis/pericarditis
  • Transverse myelitis/Guillian-Barre
  • Myositis and myoglobinuria
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13
Q

What investigations can be done?

A
  • Viral nose and throat swabs
  • CXR
  • Blood culture
  • Pulse oximetry
  • RR
  • U&Es, FBC and CRP
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14
Q

When should patients with flu have an urgent CXR?

A

Flu symptoms and a fever for >4 days

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15
Q

What is Oseltamivir (Tamiflu) and what are the potential adverse effects?

A
  • Oral Antiviral therapy
  • Common S/E: Nausea, vomiting, abdo pain and diarrhoea
  • Less Common S/E: headache, hallucinations, insomnia and rash
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16
Q

What is Zanamivir (Relenza), how is it administered and what is the potential adverse effects?

A
  • Antiviral therapy
  • Dry powder inhaler
  • Rare S/E: occasional bronchospasm
17
Q

When should antivirals be used to treat influenza?

A
  • Uncomplicated patients who are severely immunocompromised or at serious risk of developing complications
  • All complicated patients
18
Q

Name other antiviral medications

A
  • Peramivir: IV
  • Favipiravir: Oral
  • Baloxavir Marboxil
19
Q

What is the guidance for the use of antivirals during pregnancy and breastfeeding?

A
  • Recommended in pregnancy due to adverse outcomes
  • Oseltamivir is first line in both pregnancy and breastfeeding
  • Zanamivir can also be used during pregnancy
20
Q

When does an individual become non-infectious?

A

24hrs after last flu symptoms or when anti-viral therapy is completed (whichever is longer)

21
Q

What protection should healthcare staff use when a patient is suspected to have flu?

A
  • Surgical face mask
  • Plastic apron
  • Gloves
  • Hand hygiene
  • FFP3 Respirator mask if the patient is on a nebuliser, NIV etc.
22
Q

Which types of flu are normally found in the flu vaccine?

A

2 Type A and 1 Type B subtype viruses

Infection (15 decks)

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