Influenza Flashcards

1
Q

When does seasonal influenza occur?

A

During the winter months (December-February in northern hemisphere)

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2
Q

What type of virus is influenza?

A

RNA virus

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3
Q

What are the three groups of influenza and what species does each affect?

A

Influenza A- birds and mammals

Influenza B and C- humans exclusively

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4
Q

What are the implications of antigenic drift with influenza?

A

Occurs within the virus over time and results in genetic variation
Implications- immune system won’t respond as well and issues with vaccinations cause worse than normal epidemics

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5
Q

What is antigenic shift and what are the implications of it?

A

Abrupt major change in the virus
Allows flu strains to jump species
Involves two or more strains combining to form a new subtype
New antigenic properties so population at risk and pandemics can occur

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6
Q

How does pandemic flu vary from seasonal flu?

A

Seasonal flu occurs every winter, pandemic flu occurs sporadically
Seasonal flu affects 10-15% of the population, pandemic flu affects 25%+ of the population
Seasonal flu is not usually life threatening, but pandemic flu can be

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7
Q

What properties are required for a pandemic to occur?

A

Human pathogenicity
Antigenic shift (susceptible population)
Efficient person-person transmission

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8
Q

What are the clinical features of influenza?

A

Incubation period of 2-4 days
Abrupt fever up to 41°C which lasts 3 days
Plus 2 or more of: Cough, myalgia, headache, malaise.
Predominance of systemic symptoms
Less common symptoms: Nausea, vomiting, diarrhoea

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9
Q

What are the characteristics of influenza-like illness?

A

Fever >38 degrees
Cough
Onset within last ten days

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10
Q

When does influenza-like illness change names and what is it called?

A

When admission to hospital is required it is referred to as severe acute respiratory infection

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11
Q

What are the symptoms of swine flu?

A
Main symptoms:
Sudden fever
Sudden cough
Other symptoms:
Tiredness
Chills
Headache
Sore throat
Runny nose
Sneezing
Diarrhoea
Loss of appetite
Aching muscles
Joint/limb pain
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12
Q

How can influenza be transmitted?

A

Airborne- only direct person-person
Contact- direct or indirect
Virus can survive for 24-48 hrs on non-porous surface or 8-12 hrs on porous surface

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13
Q

What are the risk factors for complicated influenza?

A

Neurological, hepatic, renal, pulmonary and chronic cardiac disease
Diabetes mellitus
Severe immunosuppression
Age over 65 years
Pregnancy (including up to two weeks post partum)
Children under 6 months of age
Morbid obesity (BMI ≥40)

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14
Q

What are the common complications of influenza?

A

Acute bronchitis

Secondary bacterial pneumonia

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15
Q

What are the less common complications of influenza?

A
Primary viral pneumonia
Myocarditis
Pericarditis
Transverse myelitis
Myositis/myoglobinuria
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16
Q

What are the symptoms of encephalitis lethargica?

A
Fever
Headache
External opthalmoplegia
Lethargy 
Sleep reversal
17
Q

What investigations can be done for encephalitis lethargica?

A
Viral nose and throat swabs
Chest x-ray
Blood culture
Pulse oximetry
Respiratory rate
Blood tests- U&Es, FBC, CRP
18
Q

What antimicrobials should be given for influenza?

A

Antiviral therapy started ASAP- ideally within 48hrs of onset of symptoms
First line treatment is oseltamivir or zanamivir
If pregnant- oseltamivir
Immunocompromised adults vary

19
Q

When is a patient with influenza deemed non-infectious?

A

24hrs after last flu symptoms or when antiviral therapy is completed, whichever is longer

20
Q

What protective measures for healthcare staff should be used in influenza?

A

Surgical face mask
Plastic apron
Gloves
Hand washing