Pandemic flu

Question 1

Endemic

Answer 1

Regularly occurring in a given population

Question 2

Epidemic

Answer 2

More than the expected number of cases

Question 3

Pandemic

Answer 3

worldwide epidemic

Question 4

What is one illness that is endemic in montana?

Answer 4

West Nile Virus

Question 5

Influenza (general definition)

Answer 5

Viral respiratory tract infection, airborne transmission via direct contact with infected droplets
-Episodic in nature

Question 6

What are the three types of influenza?

Answer 6

A, B and C

Question 7

T/F Influenza is episodic in nature

Answer 7

True

Question 8

Type A Influenza

Answer 8

Most virulent, responsible for most large outbreaks

• Minor and MAJOR antigenic changes (antigenic shifts)
• Categorized based on two surface proteins and antigens
• Found in many wild birds, domestic chickens, pigs and humans

Question 9

Which type of influenza is the most virulent, responsible for most large outbreaks

Answer 9

Type A Influenza

Question 10

Mixing vessels

Answer 10

Strains are mixing b/n animals- creating new novel strains.

The reassortment of genetic material

Question 11

What allows for mixing vessels

Answer 11

Migration

Question 12

How Influenza A viruses are named

A/Hong Kong/156/97 (H2N1)

Answer 12

Type/Location isolation/lab/year (Hx/Nx)

Question 13

In nonhuman infections the naming includes the host

Answer 13

A/chicken/Hong Kong/G9/97 (H9N2)

Question 14

Complications of Influenza

Answer 14

Viral and bacterial pneumonia, death

Question 15

What are the 3 highest risk groups for influenza

Answer 15

Pregnancy, elderly, infants (babies <2mo)

Question 16

Efficacy of flu vaccine in elderly.

Answer 16

Decreases with age. Will increase doses; good vaccine only 40% effective in elderly. This is d/t poorer immune systems
-We will vaccinate those around them.

Question 17

Pandemic flu of 1918: Who did it hit the hardest? How did they grow this virus?

Answer 17

Hit young adults the worst; comes on suddenly

Grew vital cultures in chicken eggs

Question 18

3 conditions for an influenza pandemic

Answer 18

1. Novel virus emerges
2. Transmissible between species
3. Easily transmitted human-human

Question 19

Influenza pandemics occur roughly how often?

Answer 19

Roughly every 30-40 years

Question 20

Pandemic Flu stages: Current WHO pandemic stage for Avian flu H5N1*

Answer 20

Alert

Question 21

Pandemic Flu stages: WHO pandemic stage for novel H1N1

Answer 21

Post-pandemic

Question 22

What is your advice to a family that wants to keep backyard poultry?

Answer 22

• Great hand hygiene
• Recommend against direct handling of poultry
• What to do with a sick chicken

Question 23

5 Categories of surveillance

Answer 23

1) Viral surveillance- Keeping track of the +’s
2) Surveillance for Novel type A virus
3) Outpatient illness surveillance
4) Mortality surveillance
5) Hospitalization surveillance

Question 24

Can there be a novel type B influenza?

Answer 24

NO; only type A has the antigenic changes

Question 25

Clinical manifestations needed to dx Influenza

Answer 25

Fever > 100.0 and cough or sore throat- fever like illness

Question 26

What type of vaccine is the 2019-2020 influenza vaccine

Answer 26

Trivalent

Question 27

What strains do the trivalent influenza vaccine include

Answer 27

A, A & B A-Brisbane A-Kansas B- Colorado

Question 28

What strains will the quadrivalent vaccine include

Answer 28

AA, BB

Question 29

What is the recommended use for the population to receive the Influenza vaccine

Answer 29

EVERYONE >6 months without contraindications

Question 30

Contraindications to the Influenza vaccine

Answer 30

Previous SEVERE allergic rxn to INFLUENZA vaccine. Acute illness at time of illness History of egg allergy of any severity- may receive any licensed, recommended, and age appropriate influenza vaccine

Question 31

T/F Recombinant vaccines are grown in chicken eggs

Answer 31

False; they are not

Question 32

What are the four available influenza vaccines

Answer 32

Inactivated IIV- Trivalent or quadrivalent Recombinant influenza vaccine (RIV) (not in chicken) Live attenuated (LIV)- Flu mist spray High dose inactivated influenza vaccine (HD-IIV3) Elders, via an attempt to get a better immune response.

Question 33

Antiviral medications

Answer 33

Oseltamivir phosphate (Tamiflu) Zanamivir (Relenza) Peramivir & Baloxavir marboxil (Xofluza)

Question 34

Considerations for antiviral medication: Oseltamivir Phosphate (Tamiflu)

Answer 34

Must be at least 2 weeks old

Question 35

Considerations for antiviral medication: Zanamivir (Relenza)

Answer 35

Must be at least 8 years old

Question 36

Influenza and HP2020: Target

Answer 36

Targets INCREASED vaccination against influenza AND pneumococcal disease

Question 37

HP2020 call on nurses and influenza

Answer 37

Call on nurses to develop interventions that will increase vaccination RATES: Flu shots at polling places, churches, schools

Question 38

CDC pandemic mitigations recommendations

Answer 38

``` Immunization Antiviral medications Isolation and treatment Home quarantine Use of social distancing measures ```

Question 39

Ex: A 30 yr old school teacher suddenly gets sick with fever and resp. illness; pt. has wife and 2 babies at home. What does he do?

Answer 39

Offer Tamiflu | Give Tamiflu to 3 mo baby and wife