Influenza, Herpes Simplex & RSV (Final Exam) Flashcards
what are the four influenza viruses
A, B, C and D
this type of influenza causes seasonal epidemic in humans (“flu season”) and may also cause global pandemic (e.g. with emergence of a new variant)
A
this type of influenza causes seasonal epidemics in humans (“flu season”)
B
this type of influenza does not cause disease in humans
D
this type of influenza causes mild disease and does not cause epidemics
C
H1N1 and H3N2 are sub-types of which influenza virus
A
Victoria and Yamagata are sub-types of which influenza virus
B
this is minor H or N gene mutations that cause changes in the viral protein antigenicity. this leads to seasonal epidemics thus requiring worldwide influenza surveillance and the need for annual updated vaccination
antigenic drift
true or false: influenza vaccines are currently formulated to protect against A(H1N1), A(H3N2), B/Yamagata, B/Victoria, C and D.
false - not against C or D
when does peak flu season occur in US and Canada
December and February
what are some common flu symptoms
- fever (not always seen), cough, sore throat, runny/stuffy nose
- muscle aches, body aches, headaches, malaise
- vomiting, diarrhea (more often seen in children)
true or false: flu symptoms usually appear gradually and usually resolve in 3-7 days although cough and malaise may remain for up to 2 weeks
false - flu symptoms usually appear suddenly/quickly
true or false: COVID-19 infections may have a longer incubation period than influenza and COVID-19 positive patients may be contagious for a longer period of time than patients with influenza
true
true or false: it is possible to be infected with COVID-19 or the flu and not show any symptoms
true
true or false: if a person has the flu, it could take them longer from the time of infection to experience symptoms than if they have COVID-19
false - other way around:
if a person has COVID-19, it could take them longer from the time of infection to experience symptoms than if they have the flu
does this describe the flu or COVID-19?:
typically a person may experience symptoms anywhere from one to four days after infection
flu
does this describe the flu or COVID-19?:
typically, a person may experience symptoms anywhere for two to five days and up to 14 days after infection
COVID-19
what are some further complications of the flu?
- PNEUMONIA
- sinus and ear infections
- myocarditis (inflammation of the heart in response to an infection or some other trigger)
- encephalitis (inflammation of the brain)
- myositis (nflamed muscles, which can cause prolonged muscle fatigue and weakness) or rhabdomyolysis (amaged muscle tissue releases its proteins and electrolytes into the blood - can cause permanent damage)
- sepsis
- multi-organ failure
- exacerbation of an underlying chronic condition (e.g. asthma)
what are some warning signs of flu COMPLICATIONS in children
- fast breathing/trouble breathing
- blue lips/face
- ribs pulling in with each breath
- chest pain
- severe muscle pain ( child refuses to walk)
- dehydration (no urine for 8 hours, dry mouth, no tears when crying)
- not alert to interacting when awake
- seizures
- fever above 104ºF (40ºC)
- in children younger than 12 week, any fever
- fever or cough that improve but then return or worsen
- worsening of chronic medical conditions
what are some warning signs of flu COMPLICATIONS in adults
- difficulty breathing or SOB
- persistent pain or pressure in the chest or abdomen
- persistent dizziness, confusion
- seizures
- not urinating
- severe muscle pain
- severe weakness or unsteadiness
- fever or cough that improve but then return or worsen
- worsening of chronic medical conditions
how is the flu infection transmitted
- viral shedding by infected person occurs
- virus is transmitted from one infection person to the next via inhalation of small aerosolized virus-containing respiratory secretions
what is the incubation period (the number of days between when you’re infected with something and when you might see symptoms) of the flu
1-7 days (average of 2 days, 7 days is less common)
what is the infectious/contagious period of the flu?
from within 1 day prior to first symptoms to 5-7 days after the onset of symptoms
how long does recovery from the flu usually occur
7-10 days
how can the flu be prevented?
- clean, cover & contain (clean hands, cover coughs & sneezes, contain illness by staying home to rest)
- vaccination
how long does it take for antibodies to develop in the body after a flu vaccination
~ 2 weeks
when is the ideal time for vaccination for the flu?
end of September to October
what ages is flu vaccination recommended for?
all ages 6 months and over
what flu vaccine should be given for ages 6 months - 65 y/o
any standard dose, age-appropriate vaccine
what flu vaccine should be given to people > 65 y/o
a high dose (Fluzone High-Dose Quadrivalent) or ajduvanated (Fluid) flu vaccine is recommended
what are the THREE types of flu vaccines
IIV (inactivated influenza vaccine)
- trivalent (IIV3)
- quadrivalent (IIV4)
RIV (recombinant influenza vaccine)
- trivalent (RIV4)
LAIV (live attenuated influenza vaccine)
- trivalent (LAIV3)
- quadrivalent (LAIV4)
these two types of flu vaccines are manufactured using virus grown in hen eggs
IIV & LAIV
adjuvants may be added to vaccines to increase effectiveness. what is the adjuvant authorized in Canada
MF59
what are some s/e seen with the flu vaccine
- usually temporary & mild *
LOCAL - pain, redness, swelling at the injection site
- systemic: headache, muscle ache, fatigue, etc
- typically resolve in 1-3 days *
this can occur after getting a vaccination; consists of one or more of the following: red eyes, acute respiratory symptoms (including respiratory distress, throat tightness and/or chest discomfort), and facial oedema. There may or may not be associated systemic symptoms, including high fever. Symptoms vary from mild to severe, resolving fully within 48 hours.
Characteristically, the onset of symptoms is 2-24 hours after immunization, more commonly in women than in men, and particularly in the age group 40-59 years.
Oculorespiratory Syndrome (ORS)
a rare disorder that can occur after vaccination where the body’s immune system damages nerve. The damage to the nerves causes muscle weakness and sometimes paralysis.
Guillian-Barre Syndrome
what can be used for symptom relief of the flu
- OTCs (acetaminophen, throat lozenges)
- Fluid & rest!!
these are most useful when started within 2 days of symptom onset; may reduce symptom duration by ~1 day; may prevent serious flu complications (e.g. pneumonia) especially in high risk patients
e.g. Oseltamivir (Tamiflu) PO (tab or liquid)
Zanamivir (Relenza) inhalation thus not rec for pts with asthma or COPD
Peramivir (Rapivab) - IV
Baloxavir carboxyl (Xofluza) - PO one dose
antiviral drugs
what are some of the common s/e for the antivirals
Oseltamivir - N/V, h/a, Pain
Zanamivir - sore throat, cough, abdominal pain
Peramivir - D/C/V, insomnia
Baloxavir marboxil - D/V (both seen in children)
true or false: the flu and COVID-19 vaccines can be given at the same time
true
this type of herpes-simplex virus causes cold sores (aka oral herpes, mouth herpes, herpes simplex labials)
HSV-1
this type of herpes-simplex virus mostly causes genital herpes
HSV-2
true or false: either HSV-1 or HSV-2 can cause a herpes sore on face or genitals
true
how is HSV-1 transmitted
- usually acquired as an infant or child, via skin to skin contact (e.g. from mother) usually from an adult carrying the virus - an adult doesn’t need to have sores present to spread the virus (symptomatic viral shedding can occur)
- kissing touching the person’s skin, sharing objects such as lip balm, razor or silverware
true or false: oral sex can spread HSV-1 to genitals
true
how is HSV-2 transmitted
- usually acquired via sexual contact
- does not need to have sores to spread the virus
- can also be transmitted by child birth
true or false: once infected, HSV migrates from skin cells to nerve cells and remains for life (dormant state)
true
what are some common triggers that can result in an outbreak of HSV
- stress
- illness
- fever
- sun exposure
- menstruation
- surgery
what are some signs/symptoms of a HSV outbreak
- tingling, itchy or burning 1-2 days prior to appearance of the lesion
- painful fluid filled blisters, which break open and result in crusting prior to healing
- sores take 2-20 days after being infected to appear
*could also be accompanied by flu-like symptoms (fever, muscle aches, swollen lymph nodes)
*genital herpes may be accompanied by difficulty with urinating or a burning sensation
this is a disseminated cutaneous infection in a patient with atopic dermatitis
herpes herpeticum
symptoms of this include pain, light sensitivity, discharge, gritty/dryness. scarring can occurring if not promptly treated (can lead to vision loss)
herpes keratitis
what are some options that are used for tx os HSV
- acyclovir, famciclovir & valacyclovir
- topical (primarily used to relieve symptoms)
- oral/IV to shorten the course of illness
- this is a common respiratory virus that causes mild, cold-like symptoms
- recovery usually occurs in 1-2 weeks
- people of any age can be infected
- may cause serious infections with complications in infants <1, young children and older adults
respiratory syncital virus (RSV)
how is RSV transmitted
- aerosolized droplets containing virus (from a cough or a sneeze) gets in eyes, nose or mouth
- direct contact with virus (kissing the face of a child with RSV)
- touching the surface with virus on it (e.g. door knob) and transferring it to eyes, face, mouth
how long is someone with RSV usually contagious for
3-8 days (may become contagious 1-2 days before showing signs of illness)
true or false: infant and adults with weakened immune systems may continue to spread RSV even after symptoms resolve (4 weeks)
true
what are some symptoms of RSV
- runny nose, loss of appetite, cough, sneeze, fever, wheeze
*in very young infants: the only symptoms may be irritability, reduced activity & breathing difficulties
what is used for tx of RSV
- symptom management: OTC’s (acetaminophen) to relieve fever and pain
- fluids (dehydration may happen quickly in an infant)
- rest
- no specific tx for RSV infection
- if hospitalized due to severe disease, oxygen and IV fluids may be required
who is at the highest risk for severe RSV infection
- premies!!
- young children with congenital heart or chronic lung disease
- young children with weakened immune systems (whether disease or tx related)
- children with neuromuscular disorders
- adults with compromised immune systems
- older adults, especially if there is underlying heart or lung conditions
