Case Management of Suspect Influenza A (H5N1) Infection in Humans. Part 1: Background information on clinical features of avian influenza H5N1. Learning Objectives. Recognize clinical features of H5N1 influenza in humans
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Part 1: Background information on clinical features of avian influenza H5N1
Question: Is avian influenza the most likely cause of Alex’s symptoms?
Commonly associated with avian influenza H5N1:
Ear infection, sinusitis
viral or secondary bacterial
Exacerbation of chronic conditions
Influenza A (H5N1) in Humans
Almost all develop pneumonia
Acute Respiratory Distress Syndrome (ARDS)
Do you think Alex has signs and symptoms of avian influenza H5N1? Why or why not?
Cultural context can produce unique exposures
Do you think Alex may have been exposed to avian influenza H5N1?
Would you suspect avian influenza H5N1 infection? Why or why not?
Part 2: Case Management of Suspected Avian Influenza H5N1 Cases
Detects viral RNA
Diagnose H5N1 in humans
Results within hours
Only in BSL-3 conditions with enhancements
Results in 2 – 10 days
Rise in H5N1 specific antibodies
Antigen testing only in USDA-approved BSL-3 containment facilityAvian Influenza H5N1
* Preferred specimens
X-ray changes are common in the lungs of avian influenza H5N1 patients
BBC News. http://bbb.co.uk
Saturday, 3 December 2005
Chest x-ray of an avian influenza H5N1 patient, shown by day of illness
Tran Tinh Hien, Nguyen Thanh Liem, Nguyen Thi Dung, et al. New England Journal of Medicine. 18 March, 2004. vol. 350 no. 12. pp 1179-1188.
Dosage for seasonal influenza
75 mg twice a day for 5 days
<1 year, not recommended
< 15 kg - 30 mg twice a day for 5 day
>15 kg to <23 kg - 45 mg twice a day for 5 days
>23 kg to <40 kg - 60 mg twice a day for 5 days
>40 kg - 75 mg twice a day for 5 days
Dosage for avian influenza H5N1
Hospital care for suspected or confirmed avian influenza cases should include:
Part 3: Public Health Action
Name and contact Information Infection
Close contactsCase Information
Report through normal channels Infection
Information shared with WHO
Help determine pandemic phase in USReporting
No symptoms (continued)
A subspecies of the influenza A virus that causes influenza among fowl and poultry.
A specific circumstance when the use of a certain treatment could be harmful.
Expected rise in influenza occurrence among humans living in temperate climates; occurs during the winter season with strains of influenza that have minor changes from season to season.