Power point presentation on influenza uploaded by manish singh sr.rsm lupin respira -upload on 14 august'15

1. INFLUENZA AND INFLUENZA
VACCINE
PREPARED BY-MANISH KUMAR SINGH[SR.RSM]
LUPIN RESPIRA

2. WHAT IS INFLUENZA?
 Influenza, commonly known as “the flu”, is a
highly contagious infection of the airways
caused by influenza viruses.
 It is often referred to as “seasonal” influenza
because these viruses circulate annually in the
winter season in the northern hemisphere.
 The timing and duration of influenza season
varies -outbreaks can happen as early as
October but most often activity peaks in
January or later.
 Late season outbreaks occurring in April and
even May have also been reported.

3. WHAT IS INFLUENZA?
 Influenza, commonly called "the flu," is
an illness caused by RNA viruses of
the family Orthomyxoviridae the
influenza viruses that infect the
respiratory tract of many animals, birds,
and humans.

4. A, B AND C INFLUENZA VIRUSES
 Influenza A and B viruses cause seasonal
epidemics, while type C viruses cause mild
respiratory illness
 Influenza A viruses are classified into different strains
or subtypes based on two proteins or antigens on the
virus surface: hemagglutinin (H) and neuraminidase (N)
e.g., H1N1 and H3N2
 Influenza B viruses can be classified into two
antigenically distinct lineages, Yamagata and Victoria
like viruses
 Influenza A and B strains are included in each year's
influenza vaccine
 The vaccine does not protect against influenza C viruses

5. SIGNS AND SYMPTOMS OF
INFLUENZA
 Sudden onset
 Typically starts with a headache, chills and cough,
followed rapidly by fever, loss of appetite, muscle
aches and fatigue, runny nose, sneezing, watery eyes
and throat irritation
 Nausea, vomiting and diarrhea may also occur,
especially in children

6. SIGNS AND SYMPTOMS
 Fever (usually 100 F-103 F
in adults and often even
higher in children)
 Cough,
 Sore throat,
 Runny or stuffy nose,
 Headache,
 Muscle aches,
 Extreme fatigue

7. HOW IS INFLUENZA SPREAD?
 The virus is spread mainly
from person to person when
those with influenza cough or
sneeze (droplet spread)
 The droplets are propelled
about 3 feet through the air
 People may also become
infected by touching an object
or a surface that has the
influenza virus on it and then
touching their mouth, eyes or
nose

8. INFLUENZA VACCINE DEVELOPMENT
 Each February, the World Health Organization (WHO)
provides a recommendation on the strains to be included
in the influenza vaccine for the northern hemisphere
 Two influenza "A" viruses and one influenza "B" virus
are selected based on the characteristics of the current
circulating influenza virus strains (two "B" viruses are
selected for quadrivalent vaccines)
 A new vaccine is reformulated each year to protect
against new influenza infections
 Each vaccine lot is tested on healthy individuals to
ensure the vaccine is safe and effective

9. INFLUENZA VACCINE DEVELOPMENT
(CONT’D)
 There are currently eight trivalent influenza vaccines
licensed for use in Canada
 Seven are trivalent inactivated influenza vaccine (TIV)
 One is a live attenuated influenza vaccine (LAIV)
 There are currently three quadrivalent influenza
vaccines licensed for use in Canada
 Two are quadrivalent inactivated influenza vaccine
(QIV)
 One is a live attenuated influenza vaccine (QLAIV)
 For the 2014–2015 influenza immunization program,
Alberta will be using three TIV products and one
QLAIV product

10. HOW DOES INACTIVATED INFLUENZA
VACCINE WORK?
 Both humoral and cell-mediated responses play a role in
immunity
 Administration of inactivated influenza vaccine results
in the production of circulating IgG antibodies to the
viral haemagglutinin as well as a cytotoxic T
lymphocyte response
 Humoral antibody levels, which correlate with vaccine
protection, are generally achieved 2 weeks after
immunization and immunity usually lasts less than 1
year
 Initial antibody response may be lower in the elderly
and immune.

11. HOW DOES LIVE ATTENUATED
INFLUENZA VACCINE WORK?
 Immune mechanisms conferring immunity following
administration of live attenuated vaccine are not fully
understood
 Administered by the intranasal route, QLAIV is
thought to result in an immune response that mimics
that induced by natural infection with wild-type virus,
developing both mucosal and systemic immunity
 Serum antibodies, mucosal antibodies and influenza-
specific T cells may play a role
 The viral strains in QLAIV are engineered to be cold
adapted (can only replicate in the nasopharynx),
temperature sensitive (cannot replicate in the warm
temperatures of the lower airways and lungs) and
attenuated (unable to cause clinical disease)

12. EFFECTIVENESS OF INFLUENZA
VACCINE
 Vaccine effectiveness depends on the similarity between vaccine
strains and the strains in circulation during influenza season
 With a good "match," influenza immunization prevents disease in
70 to 90% of healthy individuals
 This drops to 30 to 40% in the frail and elderly
 It does, however, prevent death in 85% of the frail and elderly
 It prevents hospitalization in 50 to 60% of individuals immunized
 Even with an imperfect match, Canadian studies show the vaccine
still reduces the overall risk of infection by about 40-60%
 A vaccine that is not perfectly matched can still offer protection
against related viruses making illness milder and preventing
complications
 QLAIV has generally shown to be equally or more immunogenic
than TIV in children and adolescents 2 to 17 years of age

13. VACCINE STRAINS FOR 2014-2015
 The strains that will be included in the 2014-2015
influenza vaccine for the Northern hemisphere are:
 A/California/7/2009 (H1N1)pdm09-like virus
 A/Texas/50/2012 (H3N2)-like virus
 B/Massachusetts/2/2012-like virus
 B/Brisbane/60/2008-like virus (B/Victoria lineage)
(Quadrivalent QLAIV only)

14. FACTS ABOUT TRIVALENT INACTIVATED
INFLUENZA VACCINE (TIV)
 Is an inactivated (killed) vaccine –cannot cause
influenza disease in the vaccine recipient
 The virus is grown in hens’ eggs, inactivated, broken
apart and highly purified
 In addition to the antigen, the vaccine may contain:
 Thimerosal (preservative in multidose vials)
 Trace residual amounts of egg proteins, formaldehyde,
kanamycin, neomycin, cetyl trimethyl ammonium
bromide (CTAB), polysorbate 80, sodium deoxycholate
and sucrose
 Check the product monograph as ingredients vary with
specific inactivated influenza vaccines

15. FACTS ABOUT LIVE ATTENUATED
INFLUENZA VACCINE (QLAIV)
 Is a live vaccine –cannot cause influenza disease in
the vaccine recipient because the virus is attenuated
or weakened (however is contraindicated in immuno
compromised individuals)
 The virus is grown in specific pathogen-free eggs from
specific pathogen-free chicken flocks
 In addition to the antigen, the vaccine may contain:
 Trace residual amount of arginine, gelatin
hydrolysate (porcine type A), gentamicin,
monosodium glutamate, ovalbumin and sucrose
 Check the product monograph for other product
excipients

16. INFLUENZA VACCINE DOSING FOR
SPECIFIC AGES
 6 months up to & including 8 years of age
 2 doses
 * if never been previously immunized with seasonal
influenza vaccine (spaced 4 weeks apart –minimum interval)
 1 dose only if previously immunized with seasonal influenza
vaccine
 9 years of age and older
 1 dose
 *This recommendation applies whether or not the child
received monovalent pH1N1 vaccine in 2009-2010.

17. REACTIONS TO INACTIVATED INFLUENZA
VACCINE
 The majority of people do not have a reaction to TIV;
however some reactions that may occur are outlined
below. These reactions generally start 6 to 12 hours
after immunization and can last for 1 to 2 days
 Common Reactions
 Injection site redness, swelling, pain
 Fatigue, headache, myalgia
 Arthralgia, fever, chills, malaise

18. REACTIONS TO LIVE ATTENUATED
INFLUENZA VACCINE
 Most people have no reaction to QLAIV. If reactions
occur they tend to be mild and last for 1-3 days, peaking
2 days following immunization.
 Common Reactions
 Runny, stuffy nose in children and adults
 Children –decreased appetite, headache, weakness and
fever
 Adults –sore throat, headache, cough and weakness
 For children requiring two doses of vaccine, the
symptoms tend to be less frequent following the second
dose.

19. THANKS & REGARDS !!