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Cross-Species Transmission of Avian Influenza (H5N1) to Humans

Cross-Species Transmission of Avian Influenza (H5N1) to Humans. Thomas Thacker, B.S., PA-S Frank Romanelli, Pharm. D., MPH, BCPS. Why did the chicken cross the road?. HOW did the chicken cross the road?. Why should we care?. 1918 “Spanish” Flu Pandemic 1957 “Asian” Flu Pandemic

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Cross-Species Transmission of Avian Influenza (H5N1) to Humans

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  1. Cross-Species Transmission of Avian Influenza (H5N1) to Humans Thomas Thacker, B.S., PA-S Frank Romanelli, Pharm. D., MPH, BCPS

  2. Why did the chicken cross the road?

  3. HOW did the chicken cross the road?

  4. Why should we care? • 1918 “Spanish” Flu Pandemic • 1957 “Asian” Flu Pandemic • 1958 “Hong Kong” Flu Pandemic • 1997 Avian Influenza (H5N1) in Humans • “Bird” Flu Pandemic? • > 50% Mortality

  5. Why should we care? • Avian influenza (H5N1) has caused more severe human infections than any other AIV • Avian Influenza (H5N1) Mutation? • Person-to-Person Transmission? • NO Human Immunity/NO Vaccine • High Rates of Dz & Mortality? • Resistance to Antivirals

  6. Epidemiology • Transmission: direct, close, or indirect contact with infected birds or their biological products

  7. Numerous Instances of Avian Influenza (H5N1) Infections in Humans

  8. Human Cases of Avian Influenza (H5N1)

  9. Pathophysiology

  10. Modalities of Cross-Species Transmission of Avian Influenza (H5N1):

  11. Antigenic Shift

  12. Antigenic Shift

  13. Leukopenia Lymphopenia Thrombocytopenia Elevated aminotransferases DIC Pancytopenia Hyperglycemia Elevated creatinine Infiltrates & consolidation on CXR Dx Findings Associated with Dz Caused by Avian Influenza (H5N1)

  14. Sxs of Dz Caused by Avian Influenza (H5N1): FLU-LIKE

  15. Management & Tx of Dz Caused by Avian Influenza (H5N1) • Mechanical ventilation • Intensive care • Corticosteroids • Empirical broad-spectrum antibiotics

  16. Management & Tx of Dz Caused by Avian Influenza (H5N1) • Tamiflu™ (oseltamivir) • Relenza™ (zanamivir)

  17. Prevention of Dz Caused by Avian Influenza (H5N1): GOOD HYGIENE

  18. Recipe for an Avian Influenza (H5N1) Pandemic in Humans • Infect humans and cause Dz • Evoke an ineffective immune response • Spread from human to human? I had a little bird, Its name was Enza, I opened the window, And in-flu-enza. -Children’s Rhyme, 1918 “Spanish” Flu Pandemic

  19. References

  20. References

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