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Most Common Causative Agents of Respiratory Disease URI Parainfluenza, adenovirus, influenza, rhinovirus Pharyngitis Adenovirus, parainfluenza, coxsackie Croup Parainfluenza, respiratory syncytial Bronchitis Parainfluenza, respiratory syncytial

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slide1

Most Common Causative Agents of Respiratory Disease

URI Parainfluenza, adenovirus, influenza, rhinovirus

Pharyngitis Adenovirus, parainfluenza, coxsackie

Croup Parainfluenza, respiratory syncytial

Bronchitis Parainfluenza, respiratory syncytial

Bronchiolitis Respiratory syncytial, parainfluenza

Pneumonia Respiratory syncytial, parainfluenza, adenovirus,

influenza

slide5

The latest graph of virus activity in the Bay Area, as

of November 19, as measured by identifications in

the UCSF Clinical Virology Laboratory, is attached;

it can also be found at the following website:

http://labmed.ucsf.edu/images/graphs/viruses.gif

natural history of influenza viruses
Natural History of Influenza Viruses

Serum antibody prevalence

Virus isolation

B

H3N8

H3N2

H2N?

H2N2

H1N1

H1N1

1880

1890

1900

1910

1920

1930

1940

1950

1960

1970

1980

1990

2000

Topley and Wilson’s Microbiology and Microbial Infections. 9th ed, Vol 1, Virology. Mahy and Collier, eds, 1998, Arnold, page 387, with permission.

slide11

Direct FA for Respiratory Viruses

Virus # Sens %Spec %PPV NPV

RSV 86 97 94 93

Flu A 86 99 97 99

Flu B 65 98 90 89

Para 1 52 100 100 99

Para 3 85 99 79 99

slide12

Respiratory PCR Panel

Influenza A - H3 N2

H1 N1

B

RSV A

B

Para 1-4

Adeno

Metapneumo

Rhino

Entero

Corona

Sars

slide15

Antiviral Resistance in “Swine” Influenza H1N1

Adamantanes - Resistant

Oseltamivir - Susceptible (202/202, US, 3 resistant isolates

outside US)

Zanamivir - Susceptible (including 3 oseltamivir resistant)

Recommended Rx - oseltamivir or zanamivir

slide16

Isolates tested (n)

Resistant Viruses,Number (%)

Isolates tested (n)

Resistant Viruses, Number (%)

Oseltamivir

Zanamivir

Adamantanes

Influenza A (H1N1)

88

86 (98%)

0 (0)

88

0 (0%)

Influenza A (H3N2)

14

0 (0)

0 (0)

14

14 (100%)

Influenza B

40

0 (0)

0 (0)

N/A*

N/A*

*Data from CDC, last updated 1/3/09