Influenza Pathophysiology 2012 (1)

Until nasopharynx is reached rotate swab gently for 5

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until nasopharynx is reached Rotate swab gently for 5-10 seconds Remove swab and place in viral transport media Transport specimen to microbiology laboratory
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Key Steps in the Evaluation and Management of Influenza 1. Consider clinical presentation 1. Evaluate diagnostic tests and lab values 3. Consider antiviral therapy 4. Provide appropriate monitoring of therapeutic interventions
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Questions ???
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Epidemic and Pandemic Influenza Epidemic An unexpected increase in the incidence of influenza cases But confined to a given community (city, country) Antigenic drift Minor point mutations within HA and/or NA Occur every year or every few years Antibodies are less effective due to these mutations, but may confer some benefit Definitions and Terminology
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Epidemic and Pandemic Influenza Pandemic Outbreaks of influenza that: Rapidly progress to involve all parts of the world Are easily transmitted between species and from human to human Are associated with the emergence of a new virus to which humans possess no immunity Antigenic shift Virus acquires a new HA or NA May result in pandemic disease Must have human-to-human spread capability (H5N1) Definitions and Terminology
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Influenza Pandemic Diseases Years Flu Virus Mortality 1918-19 “Spanish” Type A (H1N1) 40-100 million total 550,000 US 1957-58 “Asian” Type A (H2N2) 70,000 US 1968-69 “Hong Kong” Type A (H3N2) 34,000 US 2009-10 “Swine Flu” Type A (H1N1) 12,500 US 1990s Seasonal Flu Type A and B ~ 36,000 US / year ~ 250,000 worldwide A Historical Perspective
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The “Spanish Flu” of 1918 25% of the world’s population was ill 40-100 million deaths worldwide in 9 months! 550,000 in the US Decreased average life expectancy by 13 years ~ 4% of the infected died The Great Influenza”
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1900 1918 1930 1942 1954 40 50 55 65 The “Spanish Flu” of 1918 Life expectancy in the United States, 1900-1960 Date Age The Threat of Pandemic Influenza: Are We Ready? A Workshop Summary, pp. 1-23.
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Spanish Flu” of 1918
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Questions??? What does the “Spanish flu” of 1918 have to do with the seasonal flu today? What does the “Spanish flu” of 1918 have to do with the H1N1 pandemic from 2009?
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Avian, Swine and Human Influenza Wild birds are the natural hosts for ALL known subtypes of influenza A What’s the Connection? Genetic parts of currently circulating human influenza strains came from birds
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Avian, Swine and Human Influenza Typically wild birds don’t get sick from influenza Virus is carried in their intestines Transmission to other animals or humans occurs via contaminated saliva, nasal secretions and feces What’s the Connection?
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Avian, Swine and Human Influenza What’s the Connection?
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