Influenza Virus Case Study 5 – Influenza Influenza virus Background Differential Diagnosis Molecular Lab Tests

Influenza Virus Case Study 5 - Influenza Influenza virus Background Differential Diagnosis Molecular Lab Tests www.phwiki.com

Influenza Virus Case Study 5 – Influenza Influenza virus Background Differential Diagnosis Molecular Lab Tests

McCloskey, Cory, Meteorologist has reference to this Academic Journal, PHwiki organized this Journal Influenza Virus Micro401 Case Study 5 Alvaro Gomez Sheila Laqui Jensen Lau November 8, 2007 Case Study 5 – Influenza In late December a 22 year old man suddenly experienced flu-like symptoms. Headache Myalgia Malaise Dry Cough Fever Worsened Cough Nausea Vomiting Initial Symptoms Later Symptoms His family had experienced similar symptoms two weeks prior. Influenza virus Background (-)ss RNA virus Orthomyxoviridae family Influenza A & B are Endemic – Winter, peaks Dec – Jan Mc Queen Nancy, micro 401, Lect 5

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Differential Diagnosis Other Flu-Like Symptoms Respiratory Syncytial Virus (RSV) Meningitis Pneumonia Adenovirus Parainfluenza www.cdc.gov Molecular Lab Tests Viral Culture Immunofluorescence (IF) Enzyme Immunoassay (EIA) Real-Time PCR (RT-PCR) Hemagglutination inhibition (HI) Ellis, J, S. Rev, Med. Virol. Vol 12, 375-389 2002 Lab Tests – Viral Culture Advantages Disadvantages Whole Virus Measured Virus recoverable Requires Infectious Virus Highly Skilled Technicians Time (3-7days) Cost

Lab Tests – IF Advantages Disadvantages Time (2h-1day) Requires Intact Cells Highly Skilled Specialized equip. Cost Lab Tests – EIA Advantages Disadvantages Time (15min-1day) High Throughput Low-Skill No Virus Recoverable Lab Tests – RT-PCR Advantages Disadvantages Sensitive Allows Further Molecular Analysis High Throughput Time (1-2days) Highly Skilled Specialized Equip. Cost

Lab Tests – HI Advantages Disadvantages High Throughput Sensitive Specific Time (2 days) Cost Retrospective Paired Samples Needed Tissue Test Nasopharyngeal (Swab or Aspirate) Bronchoalveolar Lavage Serum (HI) Chest Radiography (Pneumonia) Lumbar Puncture (Meningitis) Final Diagnosis Viral Culture (6 days results) IF (1 day) EIA (1 day) Lumbar Puncture negative as long as Meningitis X-ray scan negative as long as Pneumonia Patient’s results came back positive as long as Influenza B antigens

Anti-Influenza Drugs Amantadine Pre-exposure prophylaxis & treatment of influenza A Blocks M2 proton channel Necessary as long as uncoating Influenza resistance detected in 2005 Zhuang, Xiaowei. “Zhuang Group – Cell Entry Project.” Cellular entry of viruses in addition to non-viral gene delivery vectors. 18 October 2007. Harvard University. 6 November 2007. . Bright, Rick, et. al. Adamantane Resistance Among Influenza A Viruses Isolated Early During the 2005-2006 Influenza Season in the United States. The Journal of the American Medical Association. 2006;295:(doi:10.1001/jama.295.8.joc60020). 6 November 2007. . Dimmock, N.J., et. al. Introduction to Modern Virology – 6th ed. Blackwell Publishing. Malden, MA. 2007. Anti-Influenza Drugs NA Inhibitors Zanamivir (Relenza®) & Oseltamivir (Tamiflu®) Pre-exposure prophylaxis & treatment of influenza A & B “Flu Wiki.” Neuraminidase Inhibitors. 19 December 2006. Melanie Matson. 6 November 2007. . Fiore, Anthony, et. al. “Morbidity in addition to Mortality Weekly Report.” Prevention in addition to Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007. 13 July 2007. Centers as long as Disease Control in addition to Prevention. 1 November 2007. . Spread through large particle respiratory droplets & airborne transmission Incubation period 1-4 days Adults infectious up to 5 days after illness onset Children infectious up to 10 days after illness onset People at Risk People 65 years or older Children in general Adults & children with chronic heart or lung diseases, diabetes, kidney disease or anemia Immunocompromised individuals Fiore, Anthony, et. al. “Morbidity in addition to Mortality Weekly Report.” Prevention in addition to Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007. 13 July 2007. Centers as long as Disease Control in addition to Prevention. 1 November 2007. . Transmission of Influenza

Genetic Variability Antigenic shift: Major change in the influenza A virus subtypes HA in addition to NA protein changes – population has little immunity as long as mutant virus Two Patterns of influenza A: Annual epidemics in most countries Every 10-12 years-extensive p in addition to emics http://virology-online.com/viruses/Influenza.htm Mc Queen NANCY, micro 401, Lec 5 How does the virus change Antigenic Drift Produces new virus strains not recognized by the body’s immune system Occurs continuously over time This “drift” creates new virus strains that the immune system does not recognize or has little or no resistance as long as http://virology-online.com/viruses/Influenza.htm Mc Queen Nancy, micro 401, Lect 5 THANK YOU!!!

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