Influenza

Question 1

Scariest side effect of 1976 Swine flu vaccine

Answer 1

guillon-barre

Question 2

What is Influenza A

Answer 2

Infects humans and animals

causes pandemics

Question 3

What is Influenza B

Answer 3

Infects only humans

NO pandemics

Question 4

Two surface proteins and # of them

Answer 4

Hemaglutinin (H1-H15)

Neurominidase (N1-N10)

Question 5

Influenza A flu types are further naems according to…

Answer 5

Where they were first ideantified, their lineage year isolated

Question 6

Minor changes in Influenza antigen proteins

So what?

Answer 6

Drift

Keeps you susceptible from year to year

Question 7

Major changes in Influenza antigen proteins

Answer 7

Shift

Question 8

Unique setup of influenza genome

Answer 8

RNA

Each gene of influenza is encoded on a separate strand

Question 9

When can antigen shift happen

Answer 9

Viruses of two kinds infect the same cell and pull the genetic switcharoo

Question 10

Animal most responsible for the origin/spread of influenza in all other animals

Answer 10

Ducks

Question 11

Fist major bird flu

Answer 11

Spanish Flu

1918

Question 12

Asian Flu (1957) was comprised of….

Answer 12

H1N1 + H2N2

As time went on its new genes added on to the next big thing

Question 13

Typically how many strains can cause pandemic at at a time

Answer 13

One

Question 14

What’s the deal with H1N1 Russian Flu

Answer 14

Identical to Russian Flu

Possibly caused by a lab release

Question 15

How is influenza transmitted?

Answer 15

Large droplets (sneezing/coughing)
Close contact
Not so commonly spread on contaminated surfaces
Not carried in pork/chicken meet

Question 16

Clinical effects of influenza

Answer 16

Fever, Headache, Myalgia, and Fatigue
Cough, Sore Throat, Nasal Discharge to follow
Fatigue/Weakness may last for week

Question 17

Symptoms that are mistakenly associated with flu

Answer 17

Nausea, Vomiting, Diarrhea

Question 18

Complications of Influenza

Answer 18

Viral/Bacterial Pneumonias
Myositis and Rhabdomyolysis
MI
Encephalitis/Encephalopathy (Rare)
Reye's Syndrome (From taking too much Aspirin)

Question 19

Most common post-flu bacterial pneumonias

Answer 19

Strep pneumo

S. aureus

Question 20

Unique things about Spanish Flu (1918)

Answer 20

• Started typical, then worsened several days later due to bacterial secondary infection.
• High Dose Aspirin

Question 21

Things unique to Bird Flu (H5N1)

Answer 21

Mostly kids and adults
Very high mortality rates (60%)
Usually respiratory, but some diarrhea+neuro components

Question 22

Transmission risk of Bird Flu (H5N1)

Answer 22

Very low person to person transmission

Question 23

Things unique to H7N9

Answer 23

China 2013
Elderly severe respiratory stress
Pretty much gone now

Question 24

Things unique to Variant H3N2 influenza

Answer 24

Indiana
Close contact with pigs
H1N1 + and a pig H3N2 genes combined
No sustained transmission, mid disease

Question 25

Average Mortality. Mild Year? Severe year/pandemic?

Answer 25

Mild -- 3,000 (mostly elderly) | Severe -- 45,000 (children)

Question 26

How to diagnose influenza?

Answer 26

BEST TEST -- PCR, sensitive and fast, but expensive Rapid antigen tests *Viral culture (gold standard, but takes time) Serology is pretty useless

Question 27

Treatment for influenza?

Answer 27

None are very good Old school -- Amantadine + Rimantadine (useless now) Now -- Neuraminidase inhibitors

Question 28

Name two neurominidase inhibitors

Answer 28

Oseltamivir, Sanamivir

Question 29

When do you need to provide treatment to help flu?

Answer 29

Within 48 hours of symptom onset | Could reduce symptoms by 1-2 days

Question 30

MOA for Zanamivir?

Answer 30

Oral Inhalation | IV available

Question 31

Why new vaccines every year?

Answer 31

Antigenic drift in predominant circulating strain

Question 32

Why do they make the guess on the flu vaccine so early?

Answer 32

It takes 9 months to mass produce the vaccine | They are grown in eggs. One egg makes one shot.

Question 33

How does the making a vaccine in an egg thing work?

Answer 33

Eggs with virus are purified and virus is inactivated with formaldehyde Currently further purified to have only HA and N antigens (split vaccine) to decrease side effects

Question 34

Side effects of Flu vaccine

Answer 34

Not Flu | Possibly Guillain-Barre

Question 35

How do you vaccine the egg-allergic

Answer 35

Cell culture based vaccine Entirely recombinant vaccine Live attenuated vaccine for those under 50

Question 36

Why get the live, attenuated virus vaccine?

Answer 36

May possibly give better protection

Question 37

Are vaccines very effective?

Answer 37

Mostly in kids | Not so much for those over 65

Question 38

Vaccines are thought to provide only _____ immunity

Answer 38

Non-sterilizing

Question 39

Contents of current vaccines

Answer 39

Either two A strains and 1 B strain or two of each

Question 40

Contents of 2015 vaccine

Answer 40

H3N2 strain plus 1-2 B strains

Question 41

Effectiveness of 2013-14 vaccine? | 2014-2015?

Answer 41

51% | 23%