What is influenza ,ethology ,types ,presentations signs and symptoms ,epidemic influenza ,laboratory investigations , management , the WHO guidelines in dealing with cases and contact
Measles is a highly contagious viral infection.
It is exanthematous disease with fewer, cough, coryza (rhinitis) and conjunctivitis.
Before the widespread use of measles vaccines, it was estimated that measles caused between 5 million and 8 million deaths worldwide each year.
Measles is a highly contagious viral infection.
It is exanthematous disease with fewer, cough, coryza (rhinitis) and conjunctivitis.
Before the widespread use of measles vaccines, it was estimated that measles caused between 5 million and 8 million deaths worldwide each year.
Polio: flaccid paralysis, major and minor
disease, fecal-oral
Coxsackievirus A: vesicular diseases,
meningitis; coxsackievirus B (body):
pleurodynia, myocarditis
Other echovirus and enteroviruses: like
coxsackievirus
Rhinoviruses: common cold, acid labile, does
not replicate above 33° C
Biology, Virulence, and Disease
• Small size, icosahedral capsid, positive RNA
genome with terminal protein
• Genome is sufficient for infection
• Encodes RNA-dependent RNA polymerase,
replicates in cytoplasm
Enteroviruses
• Capsid virus resistant to inactivation
• Disease due to lytic infection of important
target tissue
• Polio: cytolytic infection of motor neurons of
anterior horn and brainstem, paralysis
• Coxsackievirus A: herpangina, hand-foot-
and-mouth disease, common cold,
meningitis
• Coxsackievirus B: pleurodynia, neonatal
myocarditis, type 1 diabetes
Rhinoviruses
• Acid labile and cannot replicate at body
temperature
• Restricted to upper respiratory tract
• Common cold
Epidemiology
• Enteroviruses transmitted by fecal-oral route
and aerosols
• Rhinoviruses transmitted by aerosols and
contact
Diagnosis
• Immune assays (ELISA) or RT-PCR genome
analysis of blood, CSF, or other relevant
sample
Treatment, Prevention, and Control
• OPV and IPV polio vaccines
P
icornaviridae is one of the largest families of viruses and
includes some of the most important human and animal
viruses (Box 46-1). As the name indicates, these viruses are
small (pico) ribonucleic acid (RNA) viruses that have a
naked capsid structure. The family has more than 230
members divided into nine genera, including Enterovirus,
Rhinovirus, Hepatovirus (hepatitis A virus; discussed in
Chapter 55), Cardiovirus, and Aphthovirus. The enterovi-
ruses are distinguished from the rhinoviruses by the stabil-
ity of the capsid at pH 3, the optimum temperature
for growth, the mode of transmission, and their diseases
HIV infection
Mode of transmission, pathogenesis, clinical manifestations, laboratory diagnosis, treatment, prevention, prognosis, scope of AIDS vaccine.
The new virus has made the jump from pigs to humans and has demonstrated it can also pass from human to human. This is why it is demanding so much attention from health authorities. The virus passes from human to human like other types of flu, either through coughing, sneezing, or by touching infected surfaces, although little is known about how the virus acts on humans.
Polio: flaccid paralysis, major and minor
disease, fecal-oral
Coxsackievirus A: vesicular diseases,
meningitis; coxsackievirus B (body):
pleurodynia, myocarditis
Other echovirus and enteroviruses: like
coxsackievirus
Rhinoviruses: common cold, acid labile, does
not replicate above 33° C
Biology, Virulence, and Disease
• Small size, icosahedral capsid, positive RNA
genome with terminal protein
• Genome is sufficient for infection
• Encodes RNA-dependent RNA polymerase,
replicates in cytoplasm
Enteroviruses
• Capsid virus resistant to inactivation
• Disease due to lytic infection of important
target tissue
• Polio: cytolytic infection of motor neurons of
anterior horn and brainstem, paralysis
• Coxsackievirus A: herpangina, hand-foot-
and-mouth disease, common cold,
meningitis
• Coxsackievirus B: pleurodynia, neonatal
myocarditis, type 1 diabetes
Rhinoviruses
• Acid labile and cannot replicate at body
temperature
• Restricted to upper respiratory tract
• Common cold
Epidemiology
• Enteroviruses transmitted by fecal-oral route
and aerosols
• Rhinoviruses transmitted by aerosols and
contact
Diagnosis
• Immune assays (ELISA) or RT-PCR genome
analysis of blood, CSF, or other relevant
sample
Treatment, Prevention, and Control
• OPV and IPV polio vaccines
P
icornaviridae is one of the largest families of viruses and
includes some of the most important human and animal
viruses (Box 46-1). As the name indicates, these viruses are
small (pico) ribonucleic acid (RNA) viruses that have a
naked capsid structure. The family has more than 230
members divided into nine genera, including Enterovirus,
Rhinovirus, Hepatovirus (hepatitis A virus; discussed in
Chapter 55), Cardiovirus, and Aphthovirus. The enterovi-
ruses are distinguished from the rhinoviruses by the stabil-
ity of the capsid at pH 3, the optimum temperature
for growth, the mode of transmission, and their diseases
HIV infection
Mode of transmission, pathogenesis, clinical manifestations, laboratory diagnosis, treatment, prevention, prognosis, scope of AIDS vaccine.
The new virus has made the jump from pigs to humans and has demonstrated it can also pass from human to human. This is why it is demanding so much attention from health authorities. The virus passes from human to human like other types of flu, either through coughing, sneezing, or by touching infected surfaces, although little is known about how the virus acts on humans.
COVID-19 I Coronavirus Disease I Harshit JadavHarshit Jadav
This presentation highlights all the basic information regarding the current pandemic COVID-19.
This presentation includes an introduction, recent stats, the structure of coronavirus, pathogenesis of coronavirus, diagnosis, treatment and preventive measures of COVID-19
They are members of the family Coronaviridae, enveloped and positive stranded RNA viruses. The virions are typically decorated with large, club-or petal-shaped surface projections (spikes) which in electron micrographs of spherical particles create an image reminiscent of the solar corona.
Pathogenesis and Clinical manifestation
COVID-19 has 5 clinical variants based on severity;
• Asymptomatic form – in this form, one gets infected without manifesting any symptom whatsoever. The person thus ends up just as a mere carrier, spreading the infection to others.
• Mild disease –this affects the upper respiratory tract producing symptoms such as sneezing, mild fever, cough, malaise, etc; The infected individual recovers rapidly, with or without any supportive treatment.
• Moderate disease –this is a lower respiratory tract infection, which may present as pneumonia and would need some supportive treatment, but may not be sick enough to need oxygen therapy.
• Severe disease – this group develop severe pneumonia and get so sick that they need oxygen therapy.
• Critical disease – this group of patients get so bad and develop acute respiratory disease syndrome and ventilator respiratory failure, so much that they would need a ventilator to survive.
definition of malnutrition, the definition of protein-energy malnutrition , the etiology 0f protein-energy malnutrition, the pathophysiology of malnutrition, features of marasmus, features of kwashiorkor, vitamins and micronutrient deficiencies, signs of micronutrients deficiency, diagnosis, management of malnutrition,prognosis of malnutrition ,prevention of malnutrition
Definition of erythema infectiosum, the causative factor, clinical presentation, the three stages of rash, the slipped cheek, the sequences of the rash, the diagnosis of the fifth disease, the differential diagnosis of fifth disease, the treatment of erythema infectiosum, the prognosis of fifth disease , congenital erythema infectiosum, the complications of fifth disease , Human parvovirus B19
What is kingella kingae bacterium,features of K. kingae,Species of Kingella,epidemiology of k. kingae,Proposed pathogenesis of K. kingae infections,Transmission of k. kingae ,Pathegenesis of k. kingae,diagnosis ,NAAT for k.kingae ,treatment of k.kingae,prevension ,osteomyelitis due to k,kingae.endocarditis due to k.kingae,Septic Arthritis due to k. kingae,Spondylodiscitis due to k. kingae, prevention of k. kingae infection
What is congenital nephrotic syndrome ,what is the definition of congenital nephrotic syndrome,what is the inheritance,what are the responsible genes ,what are the types of congenital nephrotic syndrome,what is the presentation ,diagnosis ,and treatment of congenital nephrotic syndrome, primary type and secondary type of congenital nephrotic syndrome
What is nonalcoholic fatty liver disease, what is the prevalence among children ,the definition of NAFLD,What are the relationship between obesity and over weight with the development of NAFLD,what are the sequences ,what is NASH,Who are at risk , How to diagnosis NAFLD what is the differential diagnosis ,what is the treatment
#what is listeriosis #,listeria monocytoges ,#what is the mode of transmission,#food-born infection ,#vertical infection ,#early and late onset ,#meningitis و#Sepsis ;#Early vs.Late onset neonatal listeriosis ,diagnosis of neonatal listeriosis ,treatment of neonatal listeriosis ,prevention of neonatal listeriosis
What is achondroplasia, definition , etiology ,types of dwarfism , genetic background,clinical presentations ,history and clinical examination , differential diagnosis ,diagnostic tests ,radiological findings ,CT scan and MRI , Medical care and role of growth hormone ,Surgical care and consultation,
Definition of neonatal sepsis,type of neonatal sepsis ,early onset neonatal sepsis,late onset neonatal sepsis,Pathophysiology of neonatal sepsis,,sign and symptoms of neonatal sepsis, diagnosis of neonatal sepsis,management of neonatal sepsis, antibiotic used for neonatal sepsis,prevention of neonatal sepsis, prognosis of neonatal sepsis ,and A summary
What is bronchiolitis and its definition, the age group, signs and symptoms and clinical presentation The clinical practice guidelines, how to diagnosis, clinical criteria, what are the severity degrees and How to assess the severity, what are the investigations that may be needed, Is there any diagnostic test, what is the prognosis
What is the management,
What is your knowledge regarding electrical burn in children,types of electrical burns in children.,characteristic features of each type ,minor electrical burn , high -voltage electrical burn ,lightning electrical burn what are the clinical presentations and management ,cardiac complication of electrical burn,neurological complication of electrical burn , cutaneous and oral complication ,masculoskeletal complication and ocular and renal complications
what is community acquired pneumonia(CAP),what is the prevalence of (CAP) ,what are the risk factors and what are the causative agents ,what are the clinical presentations ,how to diagnose it,what are the needed investigations ,what is the management ,what are the procedures to decrease the incidence,
definition what is FPIES, what it defers from other food allergy, what are the signs and symptoms ,what are the different types of food allergy ,how to diagnose FPIES ,what are the oral food challenge (OFC) ,what is the treatment , the prognosis of FPIES
What is Fifth disease, what is erythema infectiosum What is the causative factor, pathophysiology ,clinical presentation ,diagnosis ,laboratory investigations ,treatment , precautions and prognosis ,
حساسية الجلد ماهي فوائد الجلد ماهي الحساسية ماهي انواع حساسية الجلد ماهي العوامل التي تؤدي لحدوث الحساسية ماهي انواع الحساسية ماهي اعراض الحساسية ماهي طرق الوقاية من الحساسية ماهو علاج الحساسية
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
NVBDCP.pptx Nation vector borne disease control program
Infleunza
1. Influenza (Flu)
Prof. Dr. Saad S Al Ani
Senior Pediatric Consultant
Head of Pediatric Department
Khorfakkan Hospital
Sharjah ,UAE
saadsalani@yahoo.com
2. Facts
• Influenza is a highly contagious viral
infection of the nose, throat, and lungs
that occurs most often in the late fall,
winter, and early spring.
http://www.nfid.org/idinfo/influenza
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
2
3. Facts
• Influenza is a serious infection that
affects between 5-20% of the US
population annually.
http://www.nfid.org/idinfo/influenza
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
3
4. • During the 2017-2018 season:
An estimated 900,000 individuals
were hospitalized
Nearly 80,000 deaths
Occurred in the US from flu and flu-
related complications.
http://www.nfid.org/idinfo/influenza
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
4Facts
5. • In temperate climates:
Seasonal epidemics occur mainly during
winter
• In tropical regions:
Influenza may occur throughout the year,
causing outbreaks more irregularly.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
5Facts
6. • Incubation period, is about 2 days, but
ranges from one to four days
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
6Facts
7. The pathogen
• There are 4 types of seasonal influenza
viruses, types A, B, C and D.
• Influenza A and B viruses circulate and
cause seasonal epidemics of disease.
http://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
7
8. Influenza A viruses
• 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.
http://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
8
10. Influenza A viruses
• Currently circulating in humans are
subtype A(H1N1) and A(H3N2)
influenza viruses.
• Only influenza type A viruses are known
to have caused pandemics.
http://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
10
11. Influenza B viruses
• Influenza B viruses 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.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
11
12. Influenza C virus
• Influenza C virus is detected less
frequently and usually causes mild
infections, thus does not present public
health importance.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
12
13. Influenza D viruses
• Influenza D viruses primarily affect
cattle and are not known to infect or
cause illness in people.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
13
14. Epidemiology
• All age groups can be affected but
there are groups that are more at risk
than others.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
14
15. Epidemiology (Cont.)
• Pregnant women
• Children under 59 months
• The elderly
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
15
16. Epidemiology(Cont.)
• Individuals with:
Chronic medical conditions (such as
chronic cardiac, pulmonary, renal, metabolic,
neurodevelopmental, liver or hematologic
diseases)
Immunosuppressive conditions
(such as HIV/AIDS, receiving chemotherapy or
steroids, or malignancy).
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
16
17. Epidemiology (Cont.)
• Health care workers are at high risk
acquiring influenza virus infection
due to increased exposure to the
patients
risk further spread particularly to
vulnerable individuals.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
17
18. Epidemiology (Cont.)
• Illnesses range from mild to
severe and even death
• Hospitalization and death occur
mainly among high risk groups.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
18
19. Transmission
• Seasonal influenza spreads easily,
with rapid transmission in
crowded areas including schools
and nursing homes.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
19
20. Transmission (Cont.)
• Coughs or sneezes, droplets
containing viruses (infectious
droplets)
• Infectious droplets can spread up
to one meter
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
20
21. Transmission (Cont.)
• Infect persons in close proximity
who breathe these droplets in.
• The virus can also be spread by
hands contaminated with
influenza viruses.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
21
22. Transmission(Cont.)
• To prevent transmission, people should:
Cover their mouth and nose with a tissue
when coughing
Wash their hands regularly
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
22
23. Signs and symptoms
• Seasonal influenza is characterized by
a sudden onset of :
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
23
Fever Muscle and Joint pain
Cough
(usually dry)
Severe malaise
Headache Sore throat
Runny nose
24. Diagnosis
• The majority of cases of human
influenza are clinically diagnosed
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
24
25. Diagnosis (Cont.)
• The clinical differentiation of
influenza from other pathogens is
difficult:-
During periods of low influenza
activity
Outside of epidemics situations,
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
25
26. Diagnosis (Cont.)
• Other respiratory viruses that can present
as Influenza-like Illness (ILI) include:
Rhinovirus
Respiratory syncytial virus
Parainfluenza
Adenovirus
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
26
27. Laboratory confirmation
of influenza virus
• Throat, nasal and nasopharyngeal
secretions or tracheal aspirate or
washings is commonly performed
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
27
WHO recommended surveillance standards, Second edition.
28. Laboratory confirmation
of influenza virus (cont.)
• Direct antigen detection
• Virus isolation
• Detection of influenza-specific RNA
by reverse transcriptase-polymerase
chain reaction (RT-PCR).
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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WHO recommended surveillance standards, Second edition.
29. Treatment
• Uncomplicated seasonal influenza:
Not from a high risk group
Symptomatic treatment
if symptomatic
Stay home in order to minimize the
risk of infecting others in the community
Group at high risk
Antivirals + Symptomatic treatment
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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30. Treatment(Cont.)
• Severe or progressive clinical illness
(associated with suspected or confirmed
influenza virus infection)
Clinical syndromes of :
Pneumonia
Sepsis
Exacerbation of chronic underling
diseases
Antiviral drug
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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31. Treatment(Cont.)
• Neuraminidase inhibitors (i.e. Oseltamivir)
as soon as possible (ideally, within 48
hours following symptom onset) to
maximize therapeutic benefits.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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32. Treatment(Cont.)
Administration of the drug should
also be considered in patients
presenting later in the course of
illness.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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33. Treatment(Cont.)
A minimum of 5 days, but can be
extended until there is satisfactory
clinical improvement
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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34. Treatment(Cont.)
• Corticosteroids should not be used
routinely (unless indicated for other
reasons e.g.: asthma and other specific
conditions); as it has been associated
with:
Prolonged viral clearance
Immunosuppression leading to
bacterial or fungal superinfection.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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35. Treatment(Cont.)
• All currently circulating influenza
viruses are resistant to adamantane
antiviral drugs (such as amantadine and
rimantadine), and these are therefore
not recommended for monotherapy.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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36. Prevention
• The most effective way to prevent
the disease is vaccination
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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37. Prevention
• Annual vaccination is
recommended to protect against
influenza as immunity from
vaccination wanes over time
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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38. Prevention
• Injected inactivated influenza
vaccines are most commonly used
throughout the world.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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39. Prevention(Cont.)
• Vaccination is especially important
for people:
At high risk of influenza
complications
Who live with or care for the
people at high risk
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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40. Prevention(Cont.)
WHO recommends annual vaccination for:
• Pregnant women at any stage of pregnancy
• Children aged between 6 months to 5 yrs.
• Elderly individuals (aged more than 65yrs.
• Individuals with chronic medical conditions
• Health-care workers.
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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41. Prevention(Cont.)
• Personal protective measures
Regular hand washing
Good respiratory hygiene
Early self-isolation of those feeling unwell,
feverish and having other symptoms of influenza
Avoiding close contact with sick people
Avoiding touching one’s eyes, nose or
mouth
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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42. Summary
Antiviral Treatment Recommendations for
Seasonal Influenza
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
42
Patient with
Flu Symptoms
Assess clinically
and investigate
Mild or Uncomplicated illness. Severe Acute Respiratory
Infection(SARI)
· Requiring hospital admission
· Pregnancy
· Severe illness
No risk
factor
High risk*
Treat with Tamiflu immediately
do not wait for lab confirmation
43. Summary Cont.)
Antiviral Treatment Recommendations for
Seasonal Influenza (Cont.)
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
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Mild or Uncomplicated illness
No risk
factor
High
risk*
.Consider Antiviral if within 48 Hrs.
· Infection control
· Return to care within 72 Hrs. if no
improvement
.Treat with Antiviral
· Close follow up
· Infection control
· Return to care within 72 Hrs in no
improvement
*High Risk :
· Children below 5 especially
<2 years
· Elderly >65 years
· Pregnant women till 2Wks
post partum
· Comorbidities
44. Seasonal Influenza Contact Management
Recommendations
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
44Summary Cont.)
• No need to screen contacts ·
• Vaccination is not recommended as post exposure measure
• Close Contact: Resides with or taking care of confirmed
H1N1 case, Sharing eating or drinking utensils,
Does not include walking by infected person or sitting
across the room
• Infectious Period: “One day before fever begins until 24
Hrs. after fever ends”
45. 22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
45Summary Cont.)
Assess contact risk profile
High risk contacts
• Provide Tamiflu as Prophylaxis
• Follow up
• Report to service if symptoms develop
46. 22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
46Summary Cont.)
Assess contact risk profile (Cont.)
Healthcare workers and Emergency Medical
personnel
• Provide Tamiflu as Prophylaxis
• Follow up
• Report to service if symptoms develop
47. 22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
47Summary Cont.)
Assess contact risk profile
Healthy Children and Adults
• Do not provide prophylaxis especially
>48 Hrs. since last close contact
Contact not during the infectious period
48. Consider Early treatment as an alternative to
Chemoprophylaxis:
• Counsel contacts on early Flu symptoms,
• Close follow up for high risk contacts,
• Start Tamiflu as treatment as soon as
symptoms develop
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
48Summary Cont.)
49. Seasonal Influenza Laboratory Testing Guide
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
49Summary Cont.)
Asymptomatic contact of laboratory
confirmed influenza case
Laboratory testing not required**
50. Seasonal Influenza Laboratory Testing Guide
(Cont.)
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
50Summary Cont.)
Influenza Like Illness: (ILI)
An acute respiratory infection with measured fever
of ≥ 38 C°, and cough; with onset within the last 10
days.
Healthy Children and Adults High risk category*
Laboratory testing not
required**
Laboratory testing
recommended
51. Seasonal Influenza Laboratory Testing Guide
(Cont.)
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
51Summary Cont.)
Influenza Like Illness: (ILI)
An acute respiratory infection with measured fever
of ≥ 38 C°, and cough; with onset within the last 10
days.
High risk category*
Laboratory testing
recommended
*Start Antiviral treatment immediately
Do not wait for the Laboratory result
52. Seasonal Influenza Laboratory Testing Guide
(Cont.)
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
52Summary Cont.)
Influenza Like Illness: (ILI)
An acute respiratory infection with measured fever
of ≥ 38 C°, and cough; with onset within the last 10
days.
Healthy Children and Adults
Laboratory testing not
required**
**Post exposure
Preventive measure
done without screening
53. Seasonal Influenza Laboratory Testing Guide
(Cont.)
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
53Summary Cont.)
Severe Acute Respiratory Infection: (SARI)*
An acute respiratory infection with: History
of fever or measured fever of ≥ 38 C°; and
cough; with onset within the last 10 days;
and requires hospitalization.
Laboratory testing recommended
54. Seasonal Influenza Laboratory Testing Guide
(Cont.)
22/12/2018Influenza (Flu) Prof. Dr. Saad S Al Ani
54Summary Cont.)
Severe Acute Respiratory Infection: (SARI)*
An acute respiratory infection with: History
of fever or measured fever of ≥ 38 C°; and
cough; with onset within the last 10 days;
and requires hospitalization.
Laboratory testing recommended
*Start Antiviral treatment immediately
Do not wait for the Laboratory result
55. Reference
• Influenza seasonal : https://www.who.int/en/news-room/fact-
sheets/detail/influenza-(seasonal)
• Estimates of US influenza-associated deaths made using four
different methods.
Thompson WW, Weintraub E, Dhankhar P, Cheng OY,
Brammer L, Meltzer MI, et al. Influenza Other Respi Viruses.
2009;3:37-49
• Global burden of respiratory infections due to seasonal
influenza in young children: a systematic review and meta-
analysis.
Nair H, Abdullah Brooks W, Katz M et al. Lancet 2011; 378:
1917–3
• WHO recommended surveillance standards, Second edition.
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