流感病毒-INFLUENZA VIRUS.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * TREATMENT - DRUGS RIMANTADINE (M2) type A only, needs to be given early AMANTADINE (M2) type A only, needs to be given early ZANAMIVIR (NA) types A and B, needs to be given early OSELTAMIVIR (NA) types A and B, needs to be given early * NA protein - neuraminidase . . . . . . . . . . . . . . . . . . . * OTHER TREATMENT REST, LIQUIDS, ANTI-FEBRILE AGENTS (NO ASPIRIN FOR AGES 6MTHS-18YRS) BE AWARE OF COMPLICATIONS AND TREAT APPROPRIATELY * TYPE A ++++ yes yes yes shift, drift yes sensitive sensitive 2 severity of illness animal reservoir human pandemics human epidemics antigenic changes segmented genome amantadine, rimantidine zanamivir surface glycoproteins TYPE B ++ no no yes drift yes no effect sensitive 2 TYPE C + no no no (sporadic) drift yes no effect (1) * END * live vaccine development * * * * * * * * * * * * * * * * * * * * * * Rapid tests - signifcance in ascertaining whether the infection is influenza and which type it is since now have therapeutic agents (some of which are type specific) - signifcance in differential diagnosis - eg if need to determine if Flu v. SARS - advent of rapid easy tests may increase diagnosis - may realise that flu involved in more illnesses than realised (eg enhanced surveillance of patients 21 at low risk for complications who were admitted to hospital for a variety of symptoms revealed that more severe morbitity and mortality assoc with influenza that was realised -2003). * * * * * PROTECTION AGAINST RE-INFECTION IgG and IgA IgG less efficient but lasts longer antibodies to both HA and NA important antibody to HA more important (can neutralize) * SYMPTOMS FEVER HEADACHE MYALGIA COUGH RHINITIS OCULAR SYMPTOMS * CLINICAL FINDINGS SEVERITY VERY YOUNG ELDERLY IMMUNO-COMPROMISED HEART OR LUNG DISEASE * PULMONARY COMPLICATIONS CROUP (YOUNG CHILDREN) PRIMARY INFLUENZA VIRUS PNEUMONIA SECONDARY BACTERIAL INFECTION Streptococcus pneumoniae Staphlyococcus au