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Lecture+Influenza+A+ H1 N1
1. Influenza A (H1N1) ROMEO ALMAZAN BITUIN, MD, MHA Medical Specialist III HEMS Coordinator Dr. Jose Fabella Memorial Hospital Department of Health DISTRIBUTED BY www.medicalppt.blogspot.com National Center for Disease Prevention and Control, DOH
2. Influenza A (H1N1) Is PANDEMIC Imminent? National Center for Disease Prevention and Control, DOH
33. Influenza A (H1N1) Surveillance Reporting Flow Bureau of Quarantine Referral Hospitals Influenza-like Illness Surveillance Event-based Surveillance NEC/HOTLINE Surveillance Team Response needed? Yes Daily zero reporting No WHO Inform other offices, agencies, etc. involved in the response EXECOM Central Command Media End Cases under investigation Probable/ Confirmed Probable/ Confirmed National Center for Disease Prevention and Control, DOH
46. Thank you for listening and God Bless Us All ! DISTRIBUTED BY www.medicalppt.blogspot.com National Center for Disease Prevention and Control, DOH
Editor's Notes
Module 2: ABCs of Influenza and Pandemics - Influenza (commonly called “flu”) is a respiratory infection – the virus attacks the respiratory tract (upper airways and lungs) so it causes symptoms such as cough or sore throat - The influenza virus is contagious and can easily spread from person to person - Human influenza is a respiratory infection that is thought mostly to be spread through direct contact with respiratory secretions from an infected person who is sneezing and/or coughing. - Indirect transmission from objects (such as contact with “fomites” on contaminated surfaces or clothing) is also a possible means of transmission.
Module 2: ABCs of Influenza and Pandemics Little information is available on the modes of influenza transmission and the data from studies has been interpreted in various ways. Contact, droplet and droplet nuclei transmission all likely occur but the relative contribution of each is unclear. Droplet transmission is thought to be the most important mode of transmission with infectious particles generated by the coughing and sneezing of infected persons. Most studies of infection transmission are either artificial human or animal experiments or outbreak investigations. In outbreaks, influenza is often also circulating in the community so the source of infection is difficult to pinpoint. The lack of clarity over modes of influenza transmission has complicated the development of some control strategies for influenza.
Module 2: ABCs of Influenza and Pandemics Infected adults can shed virus and possible transmit influenza from 1 day before they have symptoms to 5-7 days after the onset of symptoms. Peak viral shedding (when infected persons are most likely to infect others) is during the first 3 days of symptoms. Infants, children and immunocompromised patients (such as people with AIDS, or cancer patients on chemotherapy) may shed the virus and be infectious for longer periods of time.
Module 2: ABCs of Influenza and Pandemics The incubation period, the time period from exposure to the onset of symptoms, for influenza is fairly short, between 1 and 4 days. The short incubation period makes influenza outbreaks difficult to control. Human influenza usually peaks in winter months (which are December – March in the Northern Hemisphere and May – September in the Southern Hemisphere) within temperate zones but can occur year-round in tropical zones. However because of limited influenza surveillance systems in many tropical and developing countries, less is known about the epidemiology and seasonality of influenza in these settings.
Module 2: ABCs of Influenza and Pandemics The hallmark of influenza is the sudden , rapid onset of symptoms. Influenza symptoms may include fever, chills, body aches, sore throat, non-productive cough, runny nose and headache. Gastrointestinal symptoms and myositis occur more often in young children, and infants can present with a sepsis-like syndrome. Complications include viral and bacterial pneumonia, febrile seizures, cardiomyopathy, encephalopathy/encephalitis, and worsening underlying chronic conditions.
Module 2: ABCs of Influenza and Pandemics Complications of Influenza infection include pneumonia, dehydration, or worsening of chronic lung and heart problems, and even death. Groups at high risk for influenza complications are: - Persons 65 and older - Persons with other chronic medical conditions, such as lung or heart disease, or diabetes - Infants less than 2 years of age - Pregnant women - Nursing home residents - Children on long-term aspirin therapy
Module 2: ABCs of Influenza and Pandemics The influenza vaccine is the main way of preventing seasonal influenza infection and its serious complications. Each year, 3 virus strains are selected for the vaccine based on information about circulating strains (usually, the vaccine includes 2 type A strains and 1 type B strain). Therefore, the vaccine can only protect us from the 3 influenza subtypes selected for inclusion in the vaccine and will provide no protection for any new pandemic subtype resulting from antigenic shift. More will be discussed about influenza subtypes and the phenomenon of antigenic drift/shift later in this presentation. Live, intranasal spray vaccine is approved for use in the United States by healthy non-pregnant persons 5-49 years old. Inactivated, injectable vaccine is approved for aged persons 6 months and older.
Module 2: ABCs of Influenza and Pandemics While there are three types of influenza viruses—A, B, and C—only two cause significant disease in humans (A and B). Type B influenza viruses are limited to humans, whereas Type A viruses can cause severe disease in humans and affect many other species. Influenza Type A Type A influenza is considered to cause the most serious disease among the influenza viruses. Influenza A can cause severe epidemics as well as pandemics. Influenza type A infects multiple species including people, birds, pigs, cats, dogs, horses, and other animals. Wild birds are the natural hosts for these viruses. Influenza Type B Influenza B viruses are usually found only in humans. Influenza B viruses can cause some morbidity and mortality among humans, but in general are associated with less severe epidemics (chiefly among children) than influenza A viruses. Although influenza type B viruses can cause human epidemics, they do not cause pandemics. Because avian influenza and all pandemic viruses are of the Type A variety, we will focus this session on Type A influenza viruses.
Module 2: ABCs of Influenza and Pandemics Influenza A viruses are further subtyped by two proteins on the viral surface, called hemagglutinin (or HA) and neuraminidase (or NA). Hemagglutinin allows the virus to attach to host cells, while neuraminidase allows the virus to escape infected cells, and then go on to infect more cells. There are 16 known hemagglutinin and 9 known neuraminidase subtypes for Influenza A. Each hemagglutinin subtype is named using an “H” plus a number, such as type H1, H2, and so on. In the same way, each neuraminidase subtype is named with an “N” plus a number, such as type N1, N2, and so on. Many different combinations of HA and NA proteins are possible.
Module 2: ABCs of Influenza and Pandemics Influenza A viruses are named based on the type and the place that the sample originally came from. They are also labeled with a strain number by a reference laboratory, the year the virus was isolated, and the subtype of the virus. Viruses from animals would also include the type of animal.
