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FLU. Orthomyxoviridae. Eight segmented pieces of RNA, a structure that permits the introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.

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  • Eight segmented pieces of RNA, a structure that permits the introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.

  • The hemagglutinin spikes which provide viral attachment to cell membranes. They are strain specific antigens that mutate frequently because of inefficient proofreading by RNA polymerase. This is called antigenic drift.

  • And ditto for the Neuraminidase spike, which provides release from cell membranes


Faq s
FAQ’s introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.

  • Type A: The Main Player

    • It causes annual outbreaks

    • It mutates easily. This is called antigenic drift and is why the vaccine changes every year, usually causing an epidemic affecting 10% to 20% of the population.

    • It is susceptible to RNA reassortment, where a portion of avian influenza RNA is inserted. This is called antigenic shift and is responsible for pandemics or infections occurring over a wide geographic area and affecting a high proportion of the population.

    • It is characterized by the H and N antigens.


Type b and type c
Type B and Type C introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.


Five pandemics
Five Pandemics introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.

  • 1918: Possibly an avian influenza strain that adapted to infect humans.

  • 1957 and 1968: A human/avian reassortment strain.

  • 2009: A human/swine/avian reassortment virus.


Swine flu what does this mean
SWINE FLU introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.What does this mean?


Transmission
Transmission introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.

  • Person to Person

  • Viral shedding—day prior to symptom onset—5-7 days after symptom onset

  • Can get from pigs not from eating pork


Vaccination
Vaccination introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.

  • EVERYONE >6months and older

  • IM (inactivated) Intranasal (live attenuated)

  • Intranasal NOT USED IN: chronic disease, immunsuppression, pregnancy, prior h/o GB from prior vaccinations

  • SMALL AMOUNTS of EGG in each

  • Anaphylaxis is rare

  • What do we carry?

  • Efficacy: 50%-80% rate of protection if closely matched


Vaccine
Vaccine introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.

Three strains: (always A-A-B) this year:

-A-California h1n1-”like” virus

-A-Perth h3n2 ”like” virus

-B Brisbane

Every year the strains are selected based on worldwide surveillance for most active strains– a little guess-work involved


I don t want it today doc
“I don’t want it today Doc…” introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.


Suspected cases
Suspected Cases introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.

  • Fevers, Myalgias

  • TEST—flu swab, nasal


Treatment ppx
Treatment & PPX introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.

  • Oseltamivir: TAMIFLU

  • Zanamavir: Ralenza

  • Rx for Type A &B

  • Low levels of resistance

  • In 48 hours TREAT (as per Dr. Chung)

  • PPX: NH Residents within 48 h, Case by case

    Babies, pregnant women


Practical concerns
PRACTICAL CONCERNS introduction of new RNA. This is called genetic reassortment. This is called antigenic shift.

  • HOW TO ORDER THE VACCINE

  • HOW TO BILL FOR IT

  • ALLERGIES: EGGS!!! Relative Contraindication

  • No inhaled form of vaccine here

  • Rapid antigen—Nasal swab in 6th floor Micro

  • ?????s


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