Influenza: Clinical Background Information

Influenza: Clinical Background Information

Prepared By : Admiral Retired Dr. Adel Abd El Wahhab Consultant of Occupational Health & Safety

Types Of Influenza Viruses

There are three types of influenza viruses: types A, B, and C. Seasonal influenza outbreaks can be caused by either type A or type B Influenza viruses. Only type A influenza viruses cause pandemic.

Influenza type C viruses cause mild illness in humans but do not cause epidemics or pandemics.

Subtypes Of Influenza Viruses

.Only type A is divided into subtypes Subtype designations are based on the presence of two viral surface proteins (: (antigens (. hemagglutinin (H( and neuraminidase (N( To date, 16 different hemagglutinin and 9 different neuraminidase surface proteins have been identified in influenza A viruses. The H protein type (116( followed by the N (. protein type (19( (e.g., H5N1

History Of Influenza Pandemics

Historically, influenza has caused outbreaks of respiratory illness for centuries, including three pandemics Worldwide outbreaks of disease( in the( 20th century. Three different subtypes (i.e., H1N1, H2N2, and H3N2( have .caused pandemics in the 20th century

Prior Influenza Pandemics

The 1918 influenza pandemic, caused by subtype H1N1 viruses, resulted in death for an estimated 500,000 U.S. citizens and as many as 40 million people worldwide. The 1957 (caused by subtype H2N2 viruses( killed an estimated 70,000 . 1968 (caused by subtype H3N2 viruses( killed an estimated 34,000 U.S.

Seasonal influenza
Seasonal influenza or flu refers to periodic outbreaks of acute onset viral respiratory infection caused by circulating strains of human influenza A and B viruses. It occurs most frequently during the winter months when the humidity and outdoor temperatures are low (generally from .December until April

Prevalence Of Seasonal Flu

Between 520 percent of the population may be infected annually. Most people have some immunity to the currently circulating strains of influenza virus and, as a result, the severity and impact of seasonal Influenza is substantially less than during pandemics. Seasonal influenza is responsible for approximately 36,000 deaths and 226,000 .hospitalizations annually in the United States , The risk of death is highest among the elderly the very young, and patients with cardiopulmonary .and other chronic conditions

Clinical Presentation of Seasonal Influenza

Seasonal influenza typically has an abrupt onset, with symptoms of fever, chills, fatigue, muscle aches, headache, dry cough, upper respiratory congestion and sore throat. The time from exposure to disease onset is usually 1 to 4 days, with an average of 2 days. Most patients recover within 3 to 7 days. In adults, fever usually last for 2 to 3 days, but may last longer in children. Cough and weakness can persist for up to 2 weeks.

Vaccination Against Seasonal Flu

Every year, a trivalent influenza vaccine is prepared in advance of the anticipated seasonal outbreak and it includes those strains (two type A and one type B( that are expected to be the most likely to circulate in the upcoming flu season.

Pandemic Influenza
A pandemic is a global disease outbreak. A flu pandemic occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no available vaccine. The disease spreads easily person-toperson, causes serious illness, and can sweep across the country and around the world in a very short time.

WHO Pandemic Alert System

WHO Plan describes six phases of increasing public health risk associated with the emergence of a new influenza virus subtype that may pose a pandemic threat

WHO Pandemic Alert System

Phases 1 and 2( there is a novel influenza A virus in animals, but( .no human cases have been observed Phases 35( a novel influenza virus causes human infection with( a new subtype, but does not exhibit efficient and sustained .human to- human transmission Once a new influenza A virus develops the capacity for efficient and sustained human-to-human transmission in the general population Phase 6( the WHO declares that an influenza pandemic is in( (.progress (this is known as the Pandemic Period

Swine influenza H1N1is a respiratory disease of pigs caused by type A influenza viruses and has a major economic impact on the swine .industry

Signs of swine flu in pigs

S.Flu outbreaks in pigs are common, especially during winter months. In pigs influenza infection produces fever, lethargy, sneezing, coughing, difficulity breathing and decreased appetite. In some cases the infection can cause abortion. Although mortality is usually low (around 1-4%(, the virus can produce weight loss and poor growth, causing economic loss to farmers.

Can people catch swine flu from ?pork

The 1918 flu pandemic in humans was associated with H1N1 and influenza appearing in pigs. This may reflect a zoonosis either from swine to humans or from humans to swine. Although it is not certain in which direction the virus was transferred, some evidence suggests that, in this case, pigs caught the disease from humans. Direct transmission of a swine flu virus from pigs to humans is occasionally possible In all, 50 cases are known to have occurred since the first report in medical literature in 1958, which have resulted in a total of six deaths.

pandemic in humans 2009

The H1N1 viral strain implicated in the 2009 flu pandemic among humans is called Swine Flu" because the initial testing showed many of the genes in the virus were similar to influenza viruses normally occurring in North American swine. Further research has shown that the outbreak is due to a new strain of H1N1 not previously reported in pigs.

"symptoms of 2009 Swine Flu

According to the Centers for Disease Control and Prevention (CDC(, in humans the symptoms of the 2009 "swine flu" H1N1 virus are similar to those of influenza and of influenza-like illness in general. Symptoms include fever, cough, sore throat, body aches, headache, chills and fatigue. The 2009 outbreak has shown an increased percentage of patients reporting diarrhea and vomiting. The 2009 H1N1 virus is not zoonotic swine flu, as it is not transmitted from pigs to humans, but from person to person.

The H1N1 flu virus can spread :from person to person when
Someone with the flu coughs or sneezes into air that others breathe in. Someone touches a door knob, desk, computer, or counter with the H1N1 germs on it and then touches their mouth, eyes, or nose. Someone touches mucus of a child or others while taking care of them when they are ill with the H1N1 flu virus You CANNOT get H1N1 flu virus from eating pork or any other food, drinking water, swimming in pools, or using a hot tubs or saunas

How is swine flu (H1N1( ?diagnosed

Swine flu is diagnosed clinically by the patient's history of association with people known to have the disease and their symptoms listed above. nasopharyngeal swab sample( is done to see if the patient is infected with influenza A or B virus. Most of the tests can distinguish between A and B types. The test can be negative (no flu infection( or positive for type A and B. If the test is positive for type B, the flu is not likely to be swine flu (H1N1(. If it is positive for type A, the person could have a conventional flu strain or swine flu (H1N1(. Swine flu (H1N1( is definitively diagnosed by identifying the particular antigens associated with the virus type.

Treatment
Most people who get H1N1 flu will likely recover without needing medical care or special antiviral medications. Check with your health care provider about whether you should take antiviral .medications to treat the H1N1 flu

Antiviral Drugs
Doctors may prescribe antiviral drugs to treat people who become very sick with the flu or are at high risk for flu complications. The following people may be at :high risk Children younger than 5 years old, especially those younger than age 2 Adults 65 years of age and older : People with
Chronic lung (including asthma( or heart conditions (except high blood pressure( Kidney, liver, neurologic, and neuromuscular conditions Blood disorders (including sickle cell disease( Diabetes and other metabolic disorders An immune system that does not work well, such as AIDS patients or cancer patients receiving chemotherapy

Prevention of human to human transmission

Everyone should take these steps to prevent the flu from :spreading Cover your nose and mouth with a tissue when you cough or . sneeze. Throw the tissue away after using it Wash your hands often with soap and water for 15 - 20 seconds, especially after you cough or sneeze. You may also use . alcohol-based hand cleaners Avoid touching your eyes, nose, or mouth, to avoid getting . infected by germs . Avoid close contact with sick people If you do get sick, consider staying home from work or school for 7 days after your symptoms begin, or until you have been . symptom-free for 24 hours, whichever is longer Wear a facemask , if possible, when sharing common spaces with other household members

H1N1 influenza vaccine 2009

Vaccines are available to protect against 2009 H1N1 influenza. These vaccines are made just like seasonal flu vaccines. They are expected to be as safe and effective as seasonal flu vaccines. They will not prevent influenza-like illnesses caused by other viruses. They will not prevent seasonal flu. You should also get seasonal influenza vaccine, if you want to be protected against seasonal . flu

Who should get 2009 H1N1 ?Flu Shots and when

Groups recommended to receive 2009 H1N1 vaccine first are: Pregnant women People who live with or care for infants younger than 6 months of age Health care and emergency medical personnel Anyone from 6 months through 24 years of age Anyone from 25 through 64 years of age with certain chronic medical conditions or a weakened immune system As more vaccine becomes available, these groups should also be vaccinated: Healthy 25 through 64 year olds Adults 65 years and older

(The nasal mist vaccine (LAIV

A non-shot option, the nasal mist vaccine, is now available, but because it contains weakened live flu viruses it is not for people with weakened immune systems or certain health conditions. The nasal mist vaccine is only for healthy, non-pregnant people between the ages of 2 and 49 years. Check with your doctor to see if your child can or .should get this type of flu vaccine

Some people should not get the vaccine or should wait

You should not get 2009 H1N1 flu vaccine if you have a severe (life-threatening( allergy to eggs, or to any other substance in the vaccine. Also if you have ever had: a life-threatening allergic reaction after a dose of seasonal flu vaccine, Guillain Barr Syndrome (a severe paralytic illness also called GBS(. These may not be reasons to avoid the vaccine, but the medical staff can help you decide. If you are moderately or severely ill, you might be advised to wait until you recover before getting the vaccine. If you have a mild cold or other illness, there is usually no need to wait. Pregnant or breastfeeding women can get inactivated 2009 H1N1 fl u vaccine. Inactivated 2009 H1N1 vaccine may be given at the same time . as other vaccines, including seasonal influenza vaccine

Mild problems: soreness, redness, tenderness, or swelling where the shot was given fainting (mainly adolescents( headache, muscle aches fever nausea If these problems occur, they usually begin soon after the shot and last 1-2 days. Sever problems: Lifethreatening allergic reactions to vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the shot. In 1976, an earlier type of swine flu vaccine was associated with cases of Guillain-Barr Syndrome (GBS(. Since then, flu vaccines have not been clearly . linked to GBS

What are the risks from2009 ?H1N1 influenza vaccine

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