This simple presentation is just a brain storming one to shed light on the influenza infection & its management

1. INFLUENZA INFECTION
By M Osama Hussein. MD

2. Credit: L. Stammard, 1995
• RNA, enveloped
• Viral family:
Orthomyxoviridae
• Size:
80-200nm or .08 – 0.12 μm
(micron) in diameter
• Three types
• A, B, C
• Surface antigens
• H (haemaglutinin)
• N (neuraminidase)
Influenza Virus

3. H1 N1
H2 N2
H3 N3
H4 N4
H5 N5
H6 N6
H7 N7
H8 N8
H9 N9
H10
H11
H12
H13
H14
H15
H16
Haemagglutinin subtype Neuraminidase subtype

5.  Epidemic – a located cluster of cases
 Pandemic – worldwide epidemic
 Antigenic drift
◦ Changes in proteins by genetic point mutation &
selection
◦ Ongoing and basis for change in vaccine each year
 Antigenic shift
◦ Changes in proteins through genetic reassortment
◦ Produces different viruses not covered by annual
vaccine
Definitions

6. Influenza
The Normal Burden of Disease
 Seasonal Influenza
◦ Globally: 250,000 to 500,000 deaths per
year
◦ In the US (per year)
 ~35,000 deaths
 >200,000 Hospitalizations
 $37.5 billion in economic cost (influenza
& pneumonia)
 >$10 billion in lost productivity
 Pandemic Influenza
◦ An ever present threat

7. Reassortment in Pigs
Swine Influenza A(H1N1)
Transmission Through Species

8. Swine Influenza A(H1N1)
Global Response
Source: WHO

9. Source: WHO

11.  Influenza Symptoms
 Influenza (also known as the flu) is a
contagious respiratory illness caused by flu
viruses. It can cause mild to severe illness, and
at times can lead to death. The flu is different
from a cold. The flu usually comes on suddenly.

12. Influenza Symptoms
 Fever* or feeling feverish/chills
 Cough
 Sore throat
 Runny or stuffy nose
 Muscle or body aches
 Headaches
 Fatigue (tiredness)
 Vomiting and diarrhea, children

15. Swine Influenza A(H1N1)
Guidelines for General Population
 Covering nose and mouth with a
tissue when coughing or sneezing
◦ Dispose the tissue in the trash
after use.
 Handwashing with soap and water
◦ Especially after coughing or
sneezing.
 Cleaning hands with alcohol-based
hand cleaners
 Avoiding close contact with sick
people
 Avoiding touching eyes, nose or
mouth with unwashed hands
 If sick with influenza, staying
home from work or school and
limit contact with others to keep
from infecting them

16. Recommendations for Prevention and Control
of Influenza in Children, 2016–2017
COMMITTEE ON INFECTIOUS DISEASES
Pediatrics
September 2016
From the
American
Academy of
Pediatrics
Policy Statement

17. 1. Annual universal influenza immunization is
indicated with either a trivalent or quadrivalent
(no preference) inactivated vaccine.

18. 2. The 2016–2017 influenza A (H3N2) vaccine
strain differs from that contained in the 2015–
2016 seasonal vaccines. The 2016–2017 influenza
B vaccine strain (Victoria lineage) included in the
trivalent vaccine differs from that contained in the
2015–2016 seasonal trivalent vaccines (Yamagata
lineage).

19. 3. Quadrivalent live attenuated influenza vaccine
(LAIV4) should not be used in any setting during
the 2016–2017 influenza season in light of the
evidence for poor effectiveness of LAIV4 in
recent seasons, particularly against influenza A
(H1N1)pdm09 viruses.

20. 4. All children with egg allergy can receive
influenza vaccine with no additional precautions
from those of routine vaccinations.

21. 5. All HCP should receive an annual influenza
vaccine, a crucial step in preventing influenza
and reducing health care–associated influenza
infections. Because HCP may care for or live with
people at high risk of influenza-related
complications, it is especially important for them
to get vaccinated annually.

22. 6. Pediatricians should attempt to promptly
identify children suspected of having influenza
for rapid antiviral treatment, when indicated, to
reduce morbidity and mortality.

25.  Prevention and Control of Seasonal Influenza
with Vaccines
 Recommendations of the Advisory Committee
on Immunization Practices — United States,
2016–17 Influenza Season
 August 26, 2016 / Grohskopf, et al
 Routine annual influenza vaccination is
recommended for all persons aged ≥6 months
who do not have contraindications.

26.  live attenuated influenza vaccine (LAIV4)
should not be used.
 No preferential recommendation is made for
one influenza vaccine product over another for
persons for whom more than one licensed,
recommended product is otherwise
appropriate.