general medicine

1. COMMON FLU &COVID -
19
DR KPR PETER

2. OBJECTIVES
At the end of the lesson you should be able to:
 Define common flu and covid-19
 Differentiate between the cold and flu
 Signs and symptoms of flu and covid-19
 Diagnosis of flu and covid-19
 Treatment of flu and covid-19

3. SEASONAL INFLUENZA
 Seasonal influenza is an acute respiratory infection caused
by influenza viruses which circulate in all parts of the
world.
 Flu (influenza) is an infection of the nose, throat and
lungs, which are part of the respiratory system.
 Influenza is commonly called the flu, but it's not the same
as stomach "flu" viruses that cause diarrhea and vomiting.

4. There are 4 types of influenza viruses, types A, B, C and D. Influenza A and B
viruses circulate and cause seasonal epidemics of disease.
 Influenza A viruses:
 Are further classified into subtypes according to the combinations of the
hemagglutinin (HA) and the neuraminidase (NA), the proteins on the surface of the
virus.
 Currently circulating in humans are subtype A(H1N1) and A(H3N2) influenza viruses.
 The A(H1N1) is also written as A(H1N1)pdm09 as it caused the pandemic in 2009
and subsequently replaced the seasonal influenza A(H1N1) virus which had
circulated prior to 2009.
 Only influenza type A viruses are known to have caused pandemics.

5.  Influenza B viruses
 These are not classified into subtypes, but can be broken down into
lineages.
 Currently circulating influenza type B viruses belong to either B/Yamagata
or B/Victoria lineage.
 Influenza C virus
 This one is detected less frequently and usually causes mild infections,
thus does not present public health importance.
 Influenza D viruses
 They primarily affect cattle and are not known to infect or cause illness in
people.

6. Flu (influenza)
 Most people with the flu get better on their own.
 But sometimes, influenza and its complications can
be deadly.
 People at higher risk of developing flu
complications include:
 Young children under age 2
 Adults older than age 65
 Residents of nursing homes and other long-term
care facilities

7.  People who are pregnant or plan to be pregnant
during flu season
 People with weakened immune systems
 American Indians or Alaska Natives
 People who have chronic illnesses, such as asthma,
heart disease, kidney disease, liver disease and
diabetes
 People with a body mass index (BMI) of 40 or higher

8. Signs & Symptoms
 At first, the flu may seem like a common cold with a runny nose, sneezing and
sore throat.
 Colds usually develop slowly. But the flu tends to come on suddenly.
 And while a cold can be miserable, you usually feel much worse with the flu.
 Common symptoms of the flu include:
 Fever
 Aching muscles
 Chills and sweats
 Headache
 more common in children than adults

9.  Dry, persistent cough
 Shortness of breath
 Tiredness and weakness
 Runny or stuffy nose
 Sore throat
 Eye pain
 Vomiting and diarrhea, but this is

10. DIAGNOSIS
Your health care provider will conduct a
physical exam, look for signs and
symptoms of flu, and possibly order a test
that detects influenza viruses.
During times when flu is widespread, you
may not need to be tested for it.
Your health care provider may diagnose
you based on your symptoms.

11.  In some cases, your health care provider may suggest
that you be tested for influenza.
 Your provider may use many tests to diagnose flu.
 Polymerase chain reaction (PCR) testing is
becoming more common in many hospitals and labs.
 This test may be done while you're in your health care
provider's office or in the hospital.
 PCR testing is more sensitive than other tests and
may be able to identify the influenza strain.

12. TREATMENT
Usually, you'll need nothing more than
rest and plenty of fluids to treat the
flu.
But if you have a severe infection or
are at higher risk of complications,
your health care provider may
prescribe an antiviral medication to
treat the flu.

13.  These drugs can include:
Oseltamivir (Tamiflu)-taken by mouth
(orally)
Zanamivir (Relenza)-inhaled through a
device similar to an asthma inhaler.
It shouldn’t be used by anyone with certain
chronic respiratory problems such as asthma
and lung disease.

14.  Peramivir (Rapivab)
 Baloxavir (Xofluza).
 These medications may shorten your illness by a
day or so and help prevent serious complications.
 Antiviral medication side effects may include
nausea and vomiting.
 These side effects may be lessened if the
medication is taken with food.

15. Flu symptoms
 Influenza (flu) can cause mild to severe illness, and
at times can lead to death.
 Flu symptoms usually come on suddenly.
 People who have flu often feel some or all of these
symptoms:
 fever* or feeling feverish/chills
 Cough
 Sore throat
 Runny or stuffy nose

16.  Muscle or body aches
 Headaches
 Fatigue (tiredness)
 Some people may have vomiting and diarrhea,
though this is more common in children than
adults.
*It’s important to note that not everyone with
flu will have a fever.

17. Complications
 Flu Complications
 Most people who get flu will recover in a few days to less than two weeks, but
some people will develop complications (such as pneumonia) as a result of
flu, some of which can be life-threatening and result in death.
 Sinus and ear infections
 These are examples of moderate complications from flu.
 Pneumonia
 This is a more serious flu complication that can result from either flu virus
infection alone or from co-infection of flu virus and bacteria.

18. Myocarditis-Inflammations of the heart
Encephalis-inflammation of the brain
Myocitis/rhabdomyolysis-inflammation of
muscle tissues
Multiple organ failure respiratory and
kidney failure

19.  Flu virus infection of the respiratory tract can trigger an
extreme inflammatory response in the body and can lead
to sepsis, the body’s life-threatening response to
infection.
 Flu also can make chronic medical problems worse.
 For example, people with asthma may experience asthma
attacks while they have flu, and people with chronic
heart disease may experience a worsening of this
condition triggered by flu.

20. COLD VS FLU
 Cold Versus Flu
 What is the difference between a cold and flu?
 Influenza (flu) and the common cold are both contagious
respiratory illnesses, but they are caused by different
viruses.
 Flu
 It is caused by influenza viruses ONLY, whereas the

21.  Common cold can be caused by a number
of different viruses,
Including rhinoviruses
Parainfluenza, and
Seasonal coronaviruses.

22.  Seasonal coronaviruses should not be confused with SARS-
CoV-2, the virus that causes COVID-19.
 Because flu and the common cold have similar symptoms,
it can be difficult to tell the difference between them
based on symptoms alone.
 In general, flu is worse than the common cold, and
symptoms are typically more intense and begin more
abruptly.
 Colds are usually milder than flu.

23.  People with colds are more likely to have a runny
or stuffy nose than people who have flu.
 Colds generally do not result in serious health
problems, such as pneumonia, bacterial
infections, or hospitalizations.
 Flu can have serious associated complications

24.  Because colds and flu share many symptoms, it can be difficult (or even
impossible) to tell the difference between them based on symptoms alone.
Special tests can tell if a person is sick with flu.
 What are the symptoms of flu versus the
symptoms of a cold?
 The symptoms of flu can include fever or feeling feverish/chills, cough, sore
throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue
(tiredness).
 Cold symptoms are usually milder than the symptoms of flu.
 People with colds are more likely to have a runny or stuffy nose. Colds
generally do not result in serious health problems.

26. Signs and Symptoms Cold Influenza (Flu)
Symptom onset Gradual Abrupt
Fever Rare Common; lasts 3-4 days
Aches Slight Common; often severe
Chills Uncommon Fairly common
Fatigue, weakness Sometimes Usual
Sneezing Common Sometimes
Chest discomfort, cough Mild to moderate; hacking
cough
Common; can be severe
Stuffy nose Common Sometimes
Sore throat Common Sometimes
Headache Rare Common

27. COVID-19
 Coronavirus disease 2019 (COVID-19) is
a contagious disease caused by a virus, the severe
acute respiratory syndrome coronavirus 2 (SARS-
CoV-2).
 The first known case was identified in Wuhan,
China, in December 2019.
 The disease quickly spread worldwide, resulting in
the COVID-19 pandemic.

28. Signs & Symptoms
 The symptoms of COVID-19 are variable but often include:
 Fever
 Cough
 Headache
 Fatigue
 Breathing difficulties
 Loss of smell
 And loss of taste.

29. Complications
 Complications may include:
 Pneumonia
 Acute respiratory distress syndrome (ARDS),
 multi-organ failure
 septic shock and
 death.

30. Complications
Cardiovascular complications may include:
 heart failure,
 Arrhythmias (including atrial fibrillation),
 Heart inflammation
 and thrombosis, particularly venous thromboembolism.
 Approximately 20–30% of people who present with
COVID-19 have elevated liver enzymes, reflecting liver
injury.

31. Complications
 Neurologic manifestations include:
 Seizure
 Stroke
 Encephalitis
 and Guillain–Barré syndrome (which includes loss of motor
functions).

32. Diagnosis
 COVID-19 can provisionally be diagnosed on the basis of symptoms and
confirmed using:
 Reverse transcription polymerase chain reaction (RT-PCR) or
other nucleic acid testing of infected secretions.
 Along with laboratory testing, chest CT scans may be helpful to
diagnose COVID-19 in individuals with a high clinical suspicion of
infection.
 Detection of a past infection is possible with serological tests, which
detect antibodies produced by the body in response to the infection.

33. Treatment
 Although several medications have been approved in
different countries as of April 2022, not all countries have
these medications.
 Patients with mild to moderate symptoms who are in the
risk groups can take
 Nirmatrelvir/ritonavir(marketed as) or
 Remdesivir, either of which reduces Paxlovidhe risk of
serious illness or hospitalization.

34.  Highly effective vaccines have reduced mortality
related to SARS-CoV-2.
 However, for those awaiting vaccination, as well
as for the estimated millions of
immunocompromised persons who are unlikely to
respond robustly to vaccination, treatment
remains important.

35.  The cornerstone of management of COVID-19 has
been supportive care, which includes:
 Treatment to relieve symptoms,
 Fluid therapy,
 Oxygen support and prone positioning as needed,
 And medications or
 Devices to support other affected vital organs

36.  Most cases of COVID-19 are mild.
 In these, supportive care includes medication
such as paracetamol or NSAIDs to relieve
symptoms (fever, body aches, cough), proper
intake of fluids, rest, and nasal breathing.
 Good personal hygiene and a healthy diet are also
recommended

37. Prevention
 Vaccine
 A COVID-19 vaccine is a vaccine intended to provide acquired immunity against
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that
causes coronavirus disease 2019 (COVID-19).
 Face masks and respiratory hygiene
 The WHO and the US CDC recommend individuals wear non-medical face coverings
in public settings where there is an increased risk of transmission and where social
distancing measures are difficult to maintain.
 This recommendation is meant to reduce the spread of the disease by
asymptomatic and pre-symptomatic individuals and is complementary to
established preventive measures such as social distancing.
 Face coverings limit the volume and travel distance of expiratory droplets
dispersed when talking, breathing, and coughing

39.  Indoor ventilation and avoiding crowded indoor spaces
 The CDC recommends that crowded indoor spaces
should be avoided.
 When indoors, increasing the rate of air change,
decreasing recirculation of air and increasing the use of
outdoor air can reduce transmission.
 The WHO recommends ventilation and air filtration in
public spaces to help clear out infectious aerosols.

40.  Hand-washing and hygiene
 Thorough hand hygiene after any cough or sneeze is
required.
 The WHO also recommends that individuals wash hands
often with soap and water for at least twenty seconds,
especially after going to the toilet or when hands are
visibly dirty, before eating and after blowing one's nose

42.  Social distancing
 Social distancing (also known as physical distancing)
includes infection control actions intended to slow the spread of
the disease by minimising close contact between individuals.
 Methods include:
 Quarantines
 Travel restrictions
 And the closing of schools, workplaces, stadiums, theatres, or
shopping centres.

43.  Individuals may apply social distancing methods by:
 Staying at home
 Limiting travel
 Avoiding crowded areas
 Using no-contact greetings
 And physically distancing themselves from others.
 Many governments are mandating or recommending
social distancing in regions affected by the outbreak

44.  Surface cleaning
After being expelled from the body,
coronaviruses can survive on surfaces for hours
to days.
If a person touches the dirty surface, they may
deposit the virus at the eyes, nose, or mouth
where it can enter the body and cause
infection.

45.  Self-isolation
 Self-isolation at home has been recommended for those
diagnosed with COVID-19 and those who suspect they
have been infected.
 Health agencies have issued detailed instructions for
proper self-isolation.
 Many governments have mandated or recommended
self-quarantine for entire populations.

46.  The strongest self-quarantine instructions have been
issued to those in high-risk groups.
 Those who may have been exposed to someone with
COVID-19 and those who have recently travelled to a
country or region with the widespread transmission
have been advised to self-quarantine for 14 days from
the time of last possible exposure.

47.  International travel-related control measures
 A 2021 Cochrane rapid review found that based upon
low-certainty evidence, international travel-related
control measures such as restricting cross-border travel
may help to contain the spread of COVID-19.
 Additionally, symptom/exposure-based screening
measures at borders may miss many positive cases.

48.  While test-based border screening measures may be more
effective, it could also miss many positive cases if only
conducted upon arrival without follow-up.
 The review concluded that a minimum 10-day quarantine
may be beneficial in preventing the spread of COVID-19
and may be more effective if combined with an additional
control measure like border screening.

49. COVID-19 VS FLU
 Difference Between Flu and COVID-19
 Influenza (Flu) and COVID-19 are both contagious
respiratory illnesses, but they are caused by different
viruses.
 COVID-19 is caused by infection with a coronavirus named
SARS-CoV-2, and flu is caused by infection with influenza
viruses.
 You cannot tell the difference between flu and COVID-19
by symptoms alone because some of the symptoms are the
same.

50.  Some PCR tests can differentiate between flu and
COVID-19 at the same time.
 If one of these tests is not available, many testing
locations provide flu and COVID-19 tests
separately.
 Talk to a healthcare provider about getting tested
for both flu and COVID-19 if you have symptoms

51. THANK YOU