Influenzae

Question 1

There are 3 main types of influenza

Answer 1

A, B, C

Question 2

Influenza A infects

Answer 2

humans and animals; pandemics

Question 3

Influenza B infects

Answer 3

infects human; no pandemics

Question 4

Influenza C results in

Answer 4

mild disease

Question 5

2 surface proteins of Influenza

Answer 5

Hemaglutinin and neuraminidase

Question 6

Serological types of hemaglutinin

Answer 6

H1-H15

Question 7

Serological types of neuraminidase

Answer 7

N1-N10

Question 8

Influenza nucleic acid

Answer 8

RNA

Question 9

Results of having RNA as nucleic acid

Answer 9

-higher mutation rate

Question 10

Definition of antigenic drift

Answer 10

Slow change of the presentation of H and N proteins of the surface

Question 11

Definition of antigenic shift

Answer 11

Sudden incorporation of new piece of RNA from different influenza viruses.

Question 12

One animal that is the true carrier of influenza

Answer 12

Ducks

Question 13

Transmission of influenza can occur among which species

Answer 13

ducks to humans, pigs, poultry, horses, whales/seals

Question 14

H1N1 colloquially known as

Answer 14

1918 spanish influenza

Question 15

1957 asian influenza a combination of

Answer 15

H2N2 avian virus + H1N1 human virus = H2N2

Question 16

1968 hong kong influenza

Answer 16

H3 avian virus + H2N2 human virus = H3N2

Question 17

Timeline of influenza

Answer 17

H1N1 => H2N2 => H3N2 and H1N1

-normally one major strain circulating at one time

Question 18

Transmission of influenza

Answer 18

• need large droplets from sneezing and coughing
• close contact
• contaminated surfaces not important for transmission
• no transmission through meat

Question 19

Clinical illness

Answer 19

• fever most common with headache, myalgia, fatigue
• URI symptoms follow; cough, sore throat, nasal drip
• fatigue and weakness may last for pure

Question 20

Symptoms that are misconstrued as classic influenza symptoms

Answer 20

nausea, vomiting, diarrhea

Question 21

Complications of influenza

Answer 21

• viral pneumonia
• bacterial pneumonia; Strep pneumoniae, S.aureus
• myositis and rhabdomylosis
• MI
• encephalitis, encephalopathy
• Reye’s syndrome(hepatic encephalopathy, necrosis)

Question 22

Unique to spanish flu

Answer 22

• infection started with typical symptoms, worsened
• bacterial pneumonia most common cause of death
• aspirin given high doses

Question 23

Unique to bird flu

Answer 23

• primarily children and young adults
• high mortality rates, 60%
• diarrhea and neurologic components

Question 24

Avian influenza H7N9

Answer 24

• primarily occurred in china 2013
• elderly more affected
• severe respiratory illness
• no evidence about human transmission

Question 25

Mortality of influenza

Answer 25

• 3000 deaths

- severe years or pandemics: 45k deaths

Question 26

Diagnosis of influenza

Answer 26

• rapid antigen test with moderate sensitivity
• viral culture
• serology not helpful
• PCR highly sensitive

Question 27

Treatment of influenza

Answer 27

• no antivirals work great
• Amantidine and Rimantadine; all current strains resistant
• Nueraminidase inhibitors; Oseltamivir and Zanamivir
• best reduce symptoms by 1-2 days if taken within 48hrs

Question 28

Zanamivir

Answer 28

• oral inhalation

- iv form possible

Question 29

Concept of influenza vaccine

Answer 29

• new vaccines every year due to antigenic drift
• educated guesses
• 9months to develop vaccine

Question 30

Production of vaccine

Answer 30

• grown in eggs
• 1 egg for every shot
• vaccine are purified and virus is inactivated with formaldehyde

Question 31

Current components of vaccines

Answer 31

• 2 A strains and 1 B strain, an H3N2 strain and an H1N1 strain
• 2 A and 2 B strains
• current contains H1N1 2009

Question 32

Side effects of vaccine

Answer 32

• not possible to get flu from vaccine

- Guillain barre syndrome

Question 33

Vaccine effectiveness

Answer 33

• vaccines most effective in children

- in those >65, vaccines not very effective