Influenza is caused by RNA viruses of the Orthomyxoviridae family. There are three main types - A, B, and C. Type A is the most common and can infect both humans and animals, potentially causing pandemics. It has multiple subtypes defined by two surface proteins, hemagglutinin and neuraminidase. Type A viruses found in birds can mutate and infect humans. Human infection can range from asymptomatic to severe pneumonia and ARDS. Treatment involves antivirals, antibiotics, and supportive care. Early identification and isolation of cases is important to control spread.
Influenza is caused by RNA viruses of the Orthomyxoviridae family. There are three main types - A, B, and C. Type A is the most common and can infect both humans and animals, potentially causing pandemics. It has multiple subtypes defined by two surface proteins, hemagglutinin and neuraminidase. Type A viruses found in birds can mutate and infect humans. Human infection can range from asymptomatic to severe pneumonia and ARDS. Treatment involves antivirals, antibiotics, and supportive care. Early identification and isolation of cases is important to control spread.
Influenza is caused by RNA viruses of the Orthomyxoviridae family. There are three main types - A, B, and C. Type A is the most common and can infect both humans and animals, potentially causing pandemics. It has multiple subtypes defined by two surface proteins, hemagglutinin and neuraminidase. Type A viruses found in birds can mutate and infect humans. Human infection can range from asymptomatic to severe pneumonia and ARDS. Treatment involves antivirals, antibiotics, and supportive care. Early identification and isolation of cases is important to control spread.
Influenza is caused by RNA viruses of the Orthomyxoviridae family. There are three main types - A, B, and C. Type A is the most common and can infect both humans and animals, potentially causing pandemics. It has multiple subtypes defined by two surface proteins, hemagglutinin and neuraminidase. Type A viruses found in birds can mutate and infect humans. Human infection can range from asymptomatic to severe pneumonia and ARDS. Treatment involves antivirals, antibiotics, and supportive care. Early identification and isolation of cases is important to control spread.
Download as PPT, PDF, TXT or read online from Scribd
Download as ppt, pdf, or txt
You are on page 1/ 36
Dr Rahmini Shabariah SpA
family Orthomyxoviridae large, single-stranded RNA virus 2 major surface glikoprotein serotype 1/. hemagglutinin (H) & 2/. neuromidase (N) project as spikes through the envelope H1-15 and N1-9
human primary pathogen mild - moderate AURI, epidemic
human sporadic cases mild AURI, no epidemic th ed, Nelson 17th 2004
animal host, mainly aves reservoir for
diverse strain potential for infecting human any of 15H & 9H in animal may be introduced into humans many serotypes, potential changes
antigenic drift: minor changes within a serotype
antigenic shift: major changes within a serotype
migratory avian host spread of disease
th ed, Nelson 17th 2004
live in the water: 4 days in 220C, and
>30 days in 00C live in avian feces up to 32 days very labile, mutate easily: LPAI HPAI
in chicken carcasses, die in 800C for 1
and 600C for 30 in chicken egg, die in 640C for 5 die in: alcohol 70%, formalin 2-5%, chlorine, iodine, fenol, Na/K hypochloride
Avian influenza H5N1 in poultry
confirmed in Asia South Korea, Vietnam, Japan, Thailand, Cambodia, Taiwan, Laos, China, Indonesia, Pakistan, Malaysia possible virus sources:
birds migration transportation of infected poultry
1997: Hong Kong (H5N1) 18 cases, 6 died
1999: China & Hong Kong (H9N2) 2 cases 2002: Virginia (H7N2);1 seropositive case 2003: Fujian, Hong Kong (H5N1) 2 cases, 1 died 2003: Netherlands (H7N7); 89 cases, 1 died 2003: Hong Kong (H9N2); 1 case 2004-2005: Canada (H7N3); Vietnam (H5N1) 87 cases; Thailand (H5N1) 17 cases; Cambodia (H5N1) 4 cases; Indonesia (H5N1) 1 case
Spanish flu 1918 virus H1N1 40-50 million death 50% victim young healthy people die in a few days
Asian flu 1957 virus H2N2 China, Feb 1957 spread to USA in 4 months 1 million death
Hong Kong flu 1968 virus H3N2 Hongkong, early 1968 spread quickly to USA still circulate today
Age Onse Clinical Lab Duratio t n 8 y 24.06.0 fever,cough, positiv 20 5 diarrhea,RDS e days serolog y 1y
29.06.0 5
38 y
02.07.0 5
fever,cough, diarrhea,RDS fever,cough, positiv cold,diarrhea e , RDS PCR
10 days 10 days
limited cases, only 109 confirmed cases up
to July 2005 vary clinical features, usually with respiratory symptoms, but one cases without respiratory symptoms at all progressive clinical process leading to death despite aggressive treatment retrospective analysis
incubation period for human influenza: 23 days (range 1-7 days )
incubation period for avian influenza: 3 days (2-4) clinical features: vary, from asymptomatic, mild ILI (Influenza like illness) to severe ARDS (Acute respiratory distress syndrome)
fever >380C cough, coryza, sore throat AND, 1 of the following: in the last week, visiting a farm with an AI outbreak in the poultry OR history of contact with a confirmed AI case OR working in the lab which processing AI virus specimen
suspect case AND
progressive clinical features, leading to pneumonia / respiratory failure / death OR laboratory test positive for H5N1 Ag OR no other proven etiology
a person with acute respiratory febrile
illness, with >1 of the following: positive viral culture for influenza A/H5 positive PCR for influenza A/H5 positive IFA (Immuno-fluorescent antibody) test to H5 antigen using monoclonal antibodies 4-fold rise in H5 specific antibody titre in paired serum sample
the disease will have bad prognosis if:
late hospitalized older age pneumonia leucopenia lymphopenia
non specific extensive bilateral infiltrates diffuse, multifocal, or patchy infiltrates lobar collapse focal consolidation air bronchogram
early implementation of infection control
precautions to minimize nosocomial spread of disease proper case management to prevent severe illness and death early identification and follow up of persons at risk of infection to facilitate early intervention with antiviral therapy to reduce morbidity an mortality an limit further spread of the disease
WHO Guidelines Feb
2004
use high efficiency mask
a negative pressure room if available is recommended isolate the patient to a single room, if not available bed should be placed >1m apart, preferably separated by a physical barrier (curtain, partition) appropriate Personal Protective Equipment (PPE)
WHO Guidelines Feb
2004
limit the number of Health Care Workers
(HCWs) who have direct contact with the patient(s), restrict the number of visitors and provide them with appropriate PPE dispose of waste properly linen and reusable materials should be handled separately and disinfected
WHO Guidelines Feb
2004
if not requiring hospitalization, educate
patient and family on personal hygiene and infection control if clinically indicated, hospitalize patients take respiratory & blood specimens for lab testing for influenza and other infections treat with neuromidase inhibitor, such as oseltamivir provide supportive care, monitor oxygen saturation and treat desaturation with supplemental oxygen as required
WHO Guidelines Feb
2004
take respiratory and blood specimens serially to
check for possible bacterial infection consider IV antibiotic therapy to control secondary bacterial infections as required steroids should be used only in the context of clinical trial avoid salicylates in children<18 years because the risk of Reye syndrome, instead use paracetamol or ibuprofen
WHO Guidelines Feb
2004
Isolation room
beware of airborne transmission
infectious period, the first 7 days of symptoms
Moved to ward
PCR or culture of nasopharyngeal swab is
negative for several times no fever for 7 days
rest body defense mechanism improvement antiviral therapy antibiotic respiratory care anti-inflammation : steroid (prednisolone 2mg/kg/hari), if needed immuno-modulator
should be given in the first 48 hours
two kinds: M2 protein inhibitor: amantadine (Symmetrel, Symadine) rimantadine (Flumadine)
after resolution of fever children patients remain in hospital for 21 days after resolution of fever
human to human transmission is very rare
clinical features of AI are not specific, and vary from asymptomatic to severe ARDS the severe form, progress rapidly and usually fatal acute respiratory febrile illness with progressive clinical features should be suspected as an AI oseltamivir is an important drug for treatment and prevention of AI AI has a potential to become a new pandemic increase awareness of this potential threat
