1. Mini Medical School
NJMS

2.  Understand the clinical aspects of the
influenza virus
 Explore methods of influenza prevention
 Learn the causes and symptoms of
pneumonia
 Understand the types of vaccines available
 List the recommendations for vaccination in
the US
 Apply knowledge to a case study

3.  Influenza, commonly known as “the flu”, is
caused by an RNA virus that infects the
respiratory tracts of many animals, including
humans

4.  Influenza viruses are divided into three types:
A, B, and C
 Type A is responsible for the annual flu
outbreaks, as well as major pandemics
 On the outer surface of the virus particles are
small molecules called Hemagglutinins (H)
and Neuraminidases (N)
 This allows a specific subtype to be classified, i.e.
H1N1

5.  There are many different subtypes of the
influenza A virus, but there are only three that
are known to be circulating among humans:
H1N1, H1N2, and H3N2
 Each subtype of influenza virus has many
different strains, many of which vary by
geographic location
 As a result, the particular strain that is
responsible for the winter “flu season” changes
annually

6.  The influenza virus is spread by coughing, sneezing, talking, or
touching surfaces that have the flu virus on them
 Prevention is key!
 WASH YOUR HANDS!
 Symptoms:
 Fever (usually 100 F-103 F in adults and often even higher in children)
 Respiratory symptoms such as cough, sore throat, runny or stuffy
nose
 Headache
 Muscle aches
 Fatigue
 Symptoms can last 1-2 weeks
 These symptoms are worse in elderly and people with chronic
health problems

7.  Treatment:
 Rest!
 Drink plenty of fluids
 Antiviral Medications
▪ Only effective if taken within the first 2 days of getting
sick
 Antibiotics WILL NOT help!

8.  The changing strains of influenza viruses pose a
challenge for developing a vaccine against the flu
 Each year, the prominent strains that cause infection
vary
 As a result, a flu shot is only effective for that
particular season, and must be repeated annually
 Who is at risk?
 Senior citizens
 Children, especially those under age 2
 People with chronic health conditions

9.  A 67-year-old man comes into the ER complaining of
difficulty breathing, fatigue, and a cough that
produces “yellow stuff”. He had the flu last week, and
states that he did not get the flu shot this season
because he “never gets sick”. He also reports smoking
a pack of cigarettes a day, and has been for the last 50
years.
 Vital signs:
 BP: 168/92
 Pulse: 128 bpm
 Respirations: 32, shallow
 Temperature: 101.3 °F
 Are these vital signs normal?

10.  BP: 168/92 – high
 Pulse: 128 – high
 Respirations: 32, shallow – high, seems
labored
 Temperature: 101.3 °F – high (fever)
 What aspects of this patient’s history stand
out?
 What do you suspect might be going on with
this patient?

11.  Pneumonia is a respiratory condition in which
there is an infection of the lung
 The lungs can be infected with viruses,
bacteria, or fungi
 There are many bacteria living in your nose,
mouth, and throat
 These bacteria are called the “normal flora” – they
are supposed to be there, and often serve a
protective role
 Some bacteria may end up in places where they
should not be, such as the lungs, especially when
the body’s defenses are weakened

12.  Bacteria colonize the lungs
and cause the production of
pus (“yellow stuff”), which
can irritate the lungs and
make it difficult to breathe
 The body tries to fight off
the infection, leading to
fever, chills, and fatigue

13.  The patient was given
oxygen, and a chest x-
ray was ordered.
 A sputum sample
(“yellow stuff”) was
collected and cultured.
 What do you notice
about the patient’s
chest x-ray?

14.  Chest X-ray: congestion
in the right upper lobe
 Healthy lungs are clear,
and appear black on an
X-ray

15.  The patient’s sputum culture came back
positive for Streptococcus pneumoniae
 Is this patient’s pneumonia due to a virus,
bacteria, or fungus?

16.  The cause of 50% of all bacterial pneumonia
 Elderly individuals are at high risk for S.
pneumoniae infection
 A vaccine is available,
and is recommended for
individuals age 65+

17.  Individuals at risk:
 Elderly
 Smokers
 Alcoholics
 Young children
 Those with a recent viral infection
 Those who live in a nursing home
 Treatment:
 Antibiotics

18.  The patient was given antibiotics and was
able to return home after 3 days in the
hospital. The doctors advised the patient to
quit smoking, and gave him the number of a
local pharmacy that offers vaccinations

19.  A vaccine is a biological preparation that
improves immunity to a particular disease
 A vaccine typically contains an agent that
resembles a disease-causing microorganism,
which stimulates the immune system to
recognize it as foreign and destroy it
 The immune system is capable of
“remembering” the agent, and is thus able to
recognize and destroy any of these
microorganisms that it later encounters

20.  There are 4 types of vaccines:
 Killed: Contain killed, but previously virulent, micro-
organisms that have been destroyed with chemicals,
heat, radioactivity or antibiotics (i.e. the influenza
vaccine)
 Attenuated: Contain live, attenuated microorganisms
that have been cultivated under conditions that
disable their virulent properties (i.e. the measles
vaccine)
 Toxoid: made from inactivated toxic compounds that
cause illness (i.e. the tetanus toxoid)
 Subunit: made from a protein subunit from part of
the microorganism (i.e. the hepatitis B vaccine)