Acute infectious disease caused by toxigenic strains of Corynebacterium diphtheriae 3 major clinical types anterior nasal, faucial, laryngeal Skin,conjunctiva, vulva and other parts may be affected

1. INFLUENZA AND
DIPTHERIA
Dr. Krishna Smirthi C V
1st MPH

2. INFLUENZA

3. Influenza is a
communicable viral
disease that affects
the respiratory tract
Head and body aches,
sore throat, fever and
respiratory
symptoms, which can
be severe
WHO estimates that
seasonal influenza
may result in 290
000-650 000 deaths
each year due
to respiratory
diseases alone
INFLUENZA

4. HISTORY

5. Epidemiology determinants

6. SL.No Basis Type A Type B Type C
1 Symptoms Moderate to severe Mild Mild
2 Age Group All Primarily
children
All
3 Affect Humans and animal Affect human
only
Affects human
only
4 Divided Subdivided based on
antigenic differences
Not divided
into sub types
Not divided
into sub types
5 Epidemics Widespread Regional Don’t cause
6 Experienced Mostly Less comman
than type A
Rarely
reported
AGENT
 Family Orthomyxoviridae
 There are 3 viral subtypes, namely influenza type A, type B, and type C

7. RESERVOIR OF INFECTION
 It has become increasingly
evident that a major
reservoir of the influenza
virus exists in animals and
birds
SOURCE OF INFECTION
 Case or subclinical case.
PERIOD OF INFECTIVITY
 Virus is present in the
nasopharynx from 1 to 2
days before and 1 to 2 days
after onset of symptoms.

8. HOST FACTOR
AGE AND GENDER:
Influenza affects all ages and both
sexes.
HUMAN MOBILITY :
Is considered as an important
factor in the spread of infection.
IMMUNITY :
Antibodies appear in about 7 days
after the attack and reach a
maximum level in about 2 weeks.
After 8 to 12 months, the antibody
level drops to a pre-infection level

9. Mode of transmission
Person to person by droplet infection
created by sneezing, coughing, or
talking. The portal of entry of the virus
is the respiratory tract.
Incubation period
18 to 72 hours.
 Season
 Winter months or rainy season
 Overcrowding
ENVIRONMENTAL FACTORS

10. Virus
The respiratory
tract
inflammation and
necrosis of
superficial
epithelium of the
tracheal and
bronchial mucosa
PATHOGENESIS
INFLUENZA

11. PANDEMIC INFLUENZA A (H1N1) 2009 (SWINE FLU)

12.  Good ventilation of public buildings
 Avoidance of crowded places
 Cover their face
 Isolation
 Vaccination
PREVENTION OF INFLUENZA
LABORATORY DIAGNOSIS
*Virus isolation *Serology *Elisa

13. As of 2016, the World Health Organization (WHO) recommends seasonal influenza vaccination for:
First priority:
•Pregnant women
Second priority (in no particular order):
•Children aged 6–59 months
•Elderly
•Individuals with specific chronic medical conditions
•Health-care workers
Trivalent vaccine
The trivalent vaccine protects against three strains of the flu; these include two strains of influenza A
and one of influenza B
INFLUENZA VACCINE

14. New versions of the vaccines are developed twice a year, as the influenza virus rapidly changes
Killed vaccines
 Most influenza vaccination programs make use of inactivated vaccines
 Subcutaneous route . Dose of 0.5 ml for adults and children over 3 years.
 0.25 ml for children from 6 months to 36 months of age
Live attenuated vaccines
The live, weakened vaccine is generally not recommended in pregnant women, children less
than two years old, adults older than 50, or people with a weakened immune system.
Depending on the type they can be injected into a muscle, sprayed into the nose, or injected into
the middle layer of the skin (intradermal)
INFLUENZA VACCINE

15. Treatment
 Symptomatic care
 Antiviral Therapy : Oseltamivir phosphate,Zanamivir
 Chemoprophylaxis

16. GISRS
In 1947, WHO’s Interim Committee recognized the importance of Influenza and started a globally-
coordinated effort for its surveillance, study and control. This led to the beginning of the Global
Influenza Programme (GIP) and the Global Influenza Surveillance and Response System (GISRS)

17. Acute infectious
disease caused by
toxigenic strains of
Corynebacterium
diphtheriae
3 major clinical
types anterior nasal,
faucial, laryngeal
Skin,conjunctiva, vulva
and other parts may
be affected
DIPTHERIA

18. HISTORY

20. Epidemiology determinants

21. Agent factors
AGENT: Corynebacterium diphtheriae
SOURCE OF INFECTION: The source of infection may be a case or carrier
INFECTIVE MATERIAL: Nasopharyngeal secretions, discharges from skin lesions, and possibly infected
dust.
PERIOD OF INFECTIVITY: Unless treated, the period of infectivity may vary from 14 to 28 days from
the onset of the disease, but carriers may remain infective for much longer periods
AGE : 1 to 5
SEX : Both sexes are affected.
IMMUNITY : Infants born of immune mothers are relatively immune during the first few weeks
or months of life
Host factors

22. Cases of diphtheria occur in all seasons, although winter months favour its spread.
Environmental factors
Mode of transmission
 Droplets infections
 Infected cutaneous lesions
 Contaminated object
 Respiratory route
 Non-respiratory routes
Portal of entry
Incubation period 2 to 6 days, occasionally longer.
Incubation period

23. Anterior nasal
A white
membrane
usually forms on
the nasal septum
Laryngeal diphtheria
can be either an
extension of the
pharyngeal form or can
involve only this site.
Faucial diphtheria
The infection is
limited mostly to
the tonsillar region;
Cutaneous diphtheria
Skin infections may be
manifested by a scaling
rash or by ulcers
Diphtheria Clinical type

24. •A thick, gray
membrane covering
the throat and tonsils
A sore
throat&
hoarseness
Swollen glands
in the neck
(Bull’s neck)
Difficulty
breathing
Fever and chills Difficulty
swallow
Diagnosis
 Clinical feature with detection of pseudo membrane
 Albert staining for oropharynx and larynx
Sign and Symptoms

25. Antitoxins-
Neutralising
circulating
Toxins
Antibiotics-
Eradicate
Bacteria
Supportive
treatment
Manage
Complications
Treatment - principal

26. Prevention
 Early detection
 Isolation
 Imminization

27. Immunization
Combined or mixed vaccine:
 Pentavalent vaccine
 DPT (Diptheria-pertussis-tetanus)
 DT (Diphtheria-tetanus toxoid)
 DT (Diptheria-tetanus, adult type)
Single vaccines:
 FT (formal-toxoid).
 APT (alum-precipitated toxoid)
 PTAP (purified toxoid aluminium
phosphate)
 PTAH (purified toxoid aluminium
hydroxide)
 TAF (toxoid-antitoxin floccules)
Antisera:1. Diphtheria anti-toxin
Diphtheria vaccine

28. DPT Vaccine
Content- Diptheria, Pertussis and
Tetanus toxoid
Route – Deep intramuscular part
of thigh
Dose – 0.5ml
Recommended site –
Anterolateral part of thigh
DTP vaccine – Schedule
1. 1st dose - 6th week.
2. 2nd dose – 10th week.
3. 3rd dose – 14th week.—4.
4. 1st booster – 18-24 months.
5. 2nd booster – 4-5 years.
Diphtheria vaccine