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RESPIRATORY TRACT
VIRAL INFECTIONS OF THE
RESPIRATORY TRACT
ORTHOMYXOVIRUS PARAMYXOVIRUS
Helical nucleocapsid
NA - neuraminidase
polymerase complex
M1 protein
Antigenic shifts:
major changes based on the reassortment of RNA
segments. It occurs only with influenza A.
Other theories of antigenic shift includes:
Recirculation of existing subtypes
Gradual adaptation of animal viruses to human transmission
Antigenic drifts:
minor changes based on mutations in the RNA
genome.
Animal viruses (aquatic birds, chicken,
swine) are the source of RNA segments
that encode antigenic shift variants.
Avian H3 Human H2
Human H3
A / PHILIPPINES / 82 (H3N2)
EPIDEMIOLOGY
Winter months
CLINICAL FINDINGS
Serology
Demonstration of a rise in serum antibody to the infecting
virus
TREATMENT
Amantidine
The only effective against influenza A.
Act at the level of virus uncoating.
Both therapeutic and prophylactic effects.
Significantly reduces the duration of fever (51
hours as opposed to 74 hours) and illness.
70% protection against influenza A when given
prophylactically.
Rimantadine is an amantadine derivative but not
as effective as amantadine and less toxic.
PREVENTION
Vaccine
killed influenza A (HINI and H3N2 isolates) and B viruses
Protection lasts only 6 months
Yearly boosters are recommended
Should be given to people
Older than 65 years
With chronic respiratory diseases
With chronic cardiovascular diseases.
Immunity to Influenza
Antibody against hemagglutinin (H) is the most important
component in the protection against influenza viruses.
AVIAN INFLUENZA
All strains of the infecting virus were totally avian in origin and there
was no evidence of reassortment.
Sneezing
Nasal discharge
Nasal obstruction
Sore throat
Cough
Headache
Lasts for 1 week
COMPLICATIONS
Acute bacterial sinusitis
The major causes are Pneumococcus, Hemophilus
influenza, Moraxella, and Staphylococci.