INFLUENZA VIRUS

Disease history, causative agent, mode of

transmission
Types/ classifications, Species
Description/Characteristics,
Morphology,
Life cycle
Diagnosis, Signs and Symptoms
Treatment and Preventive measures

TIMELINE OF HUMAN FLU PANDEMIC

1918 Spanish flu H1N1
The most devastating flu pandemic in recent
history, killing more than 500,000 people in the
United States, and 20 million to 50 million
people worldwide
1957-1958 "Asian flu" H2N2
First identified in China, this virus caused
roughly 70,000 deaths in the United States
during the 1957-58 season. Because this strain
has not circulated in humans since 1968, no one
under 30 years old has immunity to this strain.

TIMELINE OF HUMAN FLU PANDEMIC

1968-1969 "Hong Kong flu" H3N2
First detected in Hong Kong, this virus caused
roughly 34,000 deaths in the United States during
the 1968-69 season. H3N2 viruses still circulate
today.
2009-2010 Swine Flu H1N1
The CDC(Centers
for Disease Control and Prevention) estimates that
43 million to 89 million people had H1N1 between
April 2009 and April 2010. They estimate between
8,870 and 18,300 H1N1 related deaths.

CAUSATIVE AGENT
Influenza virus one
of the genera of
Orthomyxoviruses

MODE OF TRANSMISSION
PERSON TO PERSON
- direct contact with an infected individual
within 6 feet
- nasal secretions of an infected person
- speaking, coughing, sneezing, kissing
- transmitted primarily by droplets or
respiratory secretions of infected persons

MODE OF TRANSMISSION
ANIMAL TO PERSON
-when people's work brings them in contact with
infected animals.
-when people contact infected animals during their
everyday lives, such as when visiting live animal markets
or when these animals are kept as part of the household.
-when people handle or slaughter infected animals, or
work with raw meat and by-products from infected
animals.
-when people contact things around them, such as
animal housing areas and equipment, ponds and other
water sources, faeces, and feathers, if these things are
contaminated with influenza viruses.

MODE OF TRANSMISSION
FOMITES - any object or substance
capable
of
carryinginfectious
organisms, such as viruses and
bacteria

TYPES/ CLASSIFICATIONS OF
INFLUENZA VIRUS
Influenza Virus A

causesinfluenzain birds and somemammals, and is

the onlyspeciesof influenza virus A.

the most virulent human pathogens among the three

influenza types and cause the most severe disease
Strains of all subtypes of influenza A virus have been
isolated from wild birds, although disease is uncommon.
Someisolatesof influenza A virus cause severe disease
both in domestic poultry and, rarely, in humans.
Occasionally, viruses are transmitted from wild aquatic
birds to domestic poultry, and this may cause an outbreak
or give rise to human influenzapandemics.

TYPES/ CLASSIFICATIONS OF
INFLUENZA VIRUS
Influenza Virus B
is a genus in
thevirusfamilyOrthomyxoviridae
are only known to infecthumansandseals
Influenza B almost exclusively infects
humans and is less common than influenza
A. This type of influenza mutates at a rate
23 times lower than type A. This reduced
rate of antigenic change, combined with its
limited host range ensures that pandemics
of influenza B do not occur.

TYPES/ CLASSIFICATIONS OF
INFLUENZA VIRUS
Influenza Virus C
Influenza C virus, which infects humans,
dogs and pigs, sometimes causing both
severe illness and local epidemics.
However, influenza C is less common than
the other types and usually only causes
mild disease in children.

DESCRIPTION
Influenza

Highly infectious viral illness

First pandemic in 1580
At least 4 pandemics in 19th century
Estimated 21 million deaths worldwide in pandemic of 19181919
Virus first isolated in 1933

Influenza Virus

Single-stranded RNA virus

Orthomyxoviridae family
3 types: A, B, C
Subtypes of type A determined by hemagglutinin and
neuraminidase

MORPHOLOGY
Virions possess a lipid envelope that is derived from
the host cellular membrane during the budding. They
are generally spherical or elliptical in shape, ranging
from approximately 80120nm in diameter and are
occasionally filamentous, reaching more than 20m in
length. Sometimes, however, they take on an irregular
shape. Virions are covered with numerous membranespanning glycoproteins, HA and NA, and small amounts
of M2. The peripheral membrane protein, M1, which is
one of the most abundant viral proteins in the virion,
binds to the lipid envelope to maintain virion
morphology. The segmented genome is enclosed in the
virion in the form of the RNP. Although small amounts
of NEP are present within the virion (Yasuda et al.,
1993), its localization is unknown.

MORPHOLOGY

In virus classification influenza viruses are RNA

viruses that make up three of the five genera of
the family Orthomyxoviridae:
Influenza virus A
Influenza virus B
Influenza virus C
These viruses are only distantly related to the
human parainfluenza viruses, which are RNA
viruses belonging to the paramyxovirus family that
are a common cause of respiratory infections in
children such as croup, but can also cause a
disease similar to influenza in adults.
A fourth family of influenza viruses has been
proposed - influenza D. The type species for this
family is Bovine Influenza D virus which was first
isolated in 2012.

INFLUENZA VIRUS A
Wild aquatic birds are the natural hosts for a large variety of
influenza A. Occasionally, viruses are transmitted to other species
and may then cause devastating outbreaks in domestic poultry or
give rise to human influenza pandemics. The influenza A virus can
be subdivided into different serotypes based on the antibody
response to these viruses. The serotypes that have been
confirmed in humans, ordered by the number of known human
pandemic deaths, are:
H1N1, which caused Spanish Flu in 1918, and Swine Flu
in 2009
H2N2, which caused Asian Flu in 1957
H3N2, which caused Hong Kong Flu in 1968
H5N1, which caused Bird Flu in 2004
H7N7, which has unusual zoonotic potential
H1N2, endemic in humans, pigs and birds
H9N2, H7N2, H7N3, H10N7, H7N9

INFLUENZA VIRUS B
This genus has one species, influenza B virus. Influenza B
almost exclusively infects humans and is less common than
influenza A. The only other animals known to be susceptible
to influenza B infection are the seal and the ferret. This type
of influenza mutates at a rate 23 times slower than type A
and consequently is less genetically diverse, with only one
influenza B serotype. As a result of this lack of antigenic
diversity, a degree of immunity to influenza B is usually
acquired at an early age. However, influenza B mutates
enough that lasting immunity is not possible. This reduced
rate of antigenic change, combined with its limited host
range (inhibiting cross species antigenic shift), ensures that
pandemics of influenza B do not occur.

INFLUENZA VIRUS C
This genus has one species, influenza C
virus, which infects humans, dogs and pigs,
sometimes causing both severe illness and
local epidemics. However, influenza C is less
common than the other types and usually
only causes mild disease in children

DIAGNOSIS OF INFLUENZA
Firm diagnosis is by means of virus isolation and
serology. The virus can be isolated from the nose or
a throat swab. This is used to infect cells in culture
(or eggs).Hemadsorptionmay be used to detect
infected cells. Polymerase chain reaction (PCR)
test are being developed to detect viral RNA.
Recently, rapid tests that can be used in a
physician's office have been approved. Provisional
diagnosis is often made clinically, based on
knowledge of a current outbreak of influenza
combined with appropriate clinical symptoms (fever,
cough, runny nose, malaise).

DIAGNOSIS OF INFLUENZA
Symptom:

Sensitivity

Specificity

Fever

6886%

2573%

Cough

8498%

729%

Nasal congestion

6891%

1941%

Fever and extreme coldness (chills shivering, shaking (rigor))

Cough
Nasal congestion
Runny nose
Sneezing
Body aches, especially joints and throat
Fatigue
Headache
Irritated, watering eyes
Reddened eyes, skin (especially face), mouth, throat and nose
Petechial rash
In children, gastrointestinal symptoms such as diarrhea and
abdominal pain,
(may be severe in children with influenza B)

SYMPTOMS AND COMPLICATIONS

1. Uncomplicated influenza
Fever (38 - 40 degrees Celsius)
Myalgias, headache
Ocular symptoms - photophobia, tears,
ache
Dry cough, nasal discharge
H1N1 strain, the 2009 "swine flu", also
gives rise to gastro-intestinal symptoms
(e.g. vomiting, diarrhea)

SYMPTOMS AND COMPLICATIONS

2. Pulmonary Complications
-Croup (Acute laryngotracheobronchitis) in young children
-Secondary bacterial infection ( caused by Streptococcus
pneumoniae, Staphylococcus aureus and Hemophilus
influenzae)

3. Non-Pulmonary Complications
-Myositis
-Cardiac complications
-Encephalopathy
-Reyes syndrome
-Guillain-Barre syndrome

SYMPTOMS AND COMPLICATIONS

TREATMENT AND PREVENTIVE

MEASURES
Treatment
Antivirals
The two classes of antiviral drugs
used against influenza are
neuraminidase inhibitors
(oseltamivir and zanamivir) and
M2 protein inhibitors (adamantane
derivatives).

TREATMENT AND PREVENTIVE

MEASURES
INFECTION CONTROL

TREATMENT AND PREVENTIVE

MEASURES

TREATMENT AND PREVENTIVE

MEASURES