The Current Status of Influenza Testing

Size: px
Start display at page:

Download "The Current Status of Influenza Testing"

Transcription

1 The Current Status of Influenza Testing Norman Moore, PhD Director of Scientific Affairs, Infectious Diseases 0

2 Objectives Discuss the health impacts of influenza in the US Discuss the diagnostic options available for influenza Discuss the biology of how an influenza infection can predispose a person to pneumococcal pneumonia

3 Infectious Disease in the US 1970: William Stewart, the Surgeon General of the United States declared the U.S. was ready to close the book on infectious disease as a major health threat ; modern antibiotics, vaccination, and sanitation methods had done the job. 1995: Infectious disease had again become the third leading cause of death, and its incidence is still growing!

4 Treating Respiratory Diseases in the Emergency Department Is the pathogen bacterial or viral? Influenza and pneumonia symptoms can overlap dramatically Who do you test? If it is flu season, do you test for other pathogens? What do you test them for? Different age groups are linked to different pathogens. Can treatment be impacted if the appropriate testing is done? Stop indiscriminate use broad spectrum antibiotics.

5 Misuse of Antibiotics Can Lead to Other Medical Issues Pneumonia may be treated with fluoroquinolone Disrupts normal intestinal flora O27 strain of C. difficile is specifically resistant to fluoroquinolone

6 Influenza A&B Impact of influenza in the US Hospitalizations up from 114,000 to 226,000 36,000 deaths annually Influenza target population: 188MM in US 5-20% of US population affected by influenza each year Most deaths affect elderly and young children Also affects otherwise healthy individuals

7 The old thinking... it s just the flu

8 A bit of history There are flu epidemics every 1 to 3 years for at least the last 400 years. Pandemics (worldwide) occur around every 10 to 20 years.

9 History Hippocrates described flu back in the 5 th century. Columbus brought a devastating flu on his second voyage to the new world. Spanish flu of was the single greatest epidemic in history. 50 to 100 million people were killed (3-6% of the world s population!) Another 500 million were infected (1/3 rd of the world s population)

10 Aren t you supposed to build immunity to influenza? The problem with influenza, like the common cold, is that there are many different strains. That is also why the performance of rapid tests are different every year!

11 Influenza A versus Influenza B Influenza A More severe disease than B Can cause disease in a wide variety of animals Influenza B Causes a milder flu, usually in the spring months

12 What rapid tests targets Detecting influenza A and influenza B nucleoproteins (Ag) The nucleoproteins are conserved throughout a given species

13 So what is with the H and N? H stands for hemagglutinin Allows virus to stick to cells Around 13 types N stands for neuraminidase Helps release new virus from cells Around 9 types Influenza A types have designations like H5N1, while influenza B viruses don t Novel H1N1 is the same as swine flu

14 Symptoms of Influenza Fever Headache Extreme tiredness Dry cough Sore throat Runny nose Muscle aches Can also have nausea, vomiting, and diarrhea This has been more common with the novel H1N1

15 H1N1 Infants Children Adults Novel Fever Cough Myalgias Sore throat Headache Diarrhea Vomiting Rhinitis Malaise / lethargy Neurologic symptoms - rare, + uncommon, ++ common, +++ very common

16 Influenza symptoms are ambiguous Is it a very serious cold that you don t treat? Is it pneumonia that you treat with antibiotics? Research by Aleta Bonner showed that there was a cost savings by running rapid influenza tests on patients.

17 Results Cost Savings Associated with using a Rapid Test Flu positive Flu negative MD aware MD unaware P value MD aware MD unaware P value N=96 N=106 N=97 N=92 CBC 0 13 <0.001 Blood Culture 0 11 <0.001 Urine dipstick Urinalysis Urine culture CSF studies/culture Chest X-ray Lab/radiology charges per patient $15.65 $92.37 <0.001 $93.07 $ Antibiotics 7 26 <0.001 Antivirals Time (min. from exam to discharge) < Bonner, et al, Pediatrics (2003) 112:

18 Pediatric Study Children who were positive by a rapid influenza test were; More likely to be prescribed an antiviral. Less likely prescribed an antibiotic. Jennings et al. Effect of Rapid Influenza Testing on the Clinical Management of Paediatric Influenza.

19 Spread of Influenza Flu is spread person-to-person through coughing or sneezing. Quick incubation of around 2 days Hands can spread influenza if the person then touches their nose. Healthy adults can infect others one day BEFORE symptoms develop and up to 5-7 days after.

20 Viral Shedding Shedding can begin 1 day before sickness Peak of the shedding is within first 3 days of illness Subsides around 5-7 days Can be longer in children

21 Treatment Nothing Antiviral treatment Who gets priority for antiviral treatment? People who are hospitalized Under the age of 2 or over the age of 65 Pregnant women Particular chronic or immunosuppressive conditions People under 19 who are receiving long-term aspirin therapy

22 Treatment season Influenza A was approximately 97% resistant to Tamiflu The novel H1N1 was mostly sensitive to Tamiflu Next year? What strains are in the population? Potential combination therapy

23 Treatment The other big issue Antiviral drugs should be given within the first 48 hours of illness. Some people don t go in on the first day of symptoms. Therefore, the treatment window can be small.

24 How the virus changes Shift vs. Drift Antigenic drift small changes in the virus that happen over time. It allows new strains that can evade the body s immune system. Antigenic shift an abrupt, major change that results in a new hemagglutinin and/or new hemagglutinin and neuraminidase protein.

25 How do you make a pandemic flu? Avian H3 Human H2 Human H3

26 Risk factors for severe disease with novel H1N1 - Overall, similar to risk factors for seasonal influenza - Chronic medical conditions including cardiopulmonary disease and immunosuppression - Pregnancy - neurodevelopmental delay - Obesity (this is not recognized as a risk factor for seasonal influenza) - Extremes of age have not been a risk factor for H1N1

27 Natural protection against H1N1 Protected Not Protected Older adults have natural protection from H1N1 J.A. McCullers Unpublished research

28 Specimen Collection

29 Influenza Sample Collection Appropriate specimens Nasal wash/aspirate, nasopharyngeal swab, or nasal swab Throat swabs have dramatically reduced sensitivity Samples should be collected within first 24 to 48 hours of symptoms since that is when viral titers are highest and antiviral therapy is effective Testing can be done immediately with rapids or sample placed in transport media Infectivity is maintained up to 5 days when 4-8 C If the sample cannot be evaluated in this time period, the sample should be -70 C.

30 Diagnostic Methods for Influenza Culture DFA PCR Rapid Tests

31 Viral Culture Pro Highly sensitive as long as sample is properly handled Con Can t give same day result to help monitor therapy High level of difficult/equipment

32 DFA Pro Usually considered to have high level of sensitivity Can usually test for other respiratory pathogens at the same time Results can be achieved in same day Con Labor intensive needed experienced users Turn-around time from lab usually takes many hours

33 Molecular Assays Pro For respiratory specimens, high performance Same day results Con Turn around time from lab may be extensive, especially if batching specimens Expensive May require experienced technicians, labs, dedicated equipment, etc.

34 Rapid Tests Pro Tests take minimal time Some tests are so simple that they can be CLIAwaived Can be used to triage patients Positive results can be used to rule out other issues like pneumonia so don t give unnecessary chest x-ray, antibiotics, etc. Con Performance is not as good as culture, PCR, and DFA

35 RAPID MOLECULAR TESTS

36 The Power of Sample Amplification Amplify the sample up to 1 trillion times! Without amplification, a positive test might not be detected. Detection threshold Amplified Flu+ Sample Not Amplified Flu+ Sample

37 CDC Website Creates a New Diagnostic Category 36

38 Technology Comparison IMMUNOASSAY RAPIDS LAT FLOW READERS PCR MOLECULAR Rapid FAST CONVENIENT POC-FRIENDLY ACTIONABLE RESULTS REMOVES SUBJECTIVITY CONNECTED EXCELLENT PERFORMANCE CONFIDENTIAL

39 Healthcare s Triple Aim Better Health Better Care Lower cost

40 Better Health (Clinical) Detect more true positives than gold standard Increased confidence in diagnosis may lead to better directed therapy Better Health

41 Better Care (Operational) Confidently make appropriate clinical decisions sooner Molecular results in the time of a rapid assay Actionable results at the point of care Better Care

42 Lower Cost (Economic) Limit number of cultures being done Reduce follow-up burden on staff More rapid discharge/treatment decision compared to traditional testing Lower cost

43 Sensitivity vs Specificity vs PPV vs NPV Sensitivity: Probability test=positive if patient=positive Specificity: Probability test=negative if patient=negative PPV: Probability patient=positive if test=positive NPV: Probability patient=negative if test=negative

44 Flu is seasonal. Prevalence of the disease is different in June than in January. This will impact the perceived performance of the test Test 1,000 persons Test Specificity = 99.6% (4/1000) Prevalence = 10% True positive: 100 False positive: 4 Positive predictive value: 100/104 = 96%

45 Test 1,000 persons Test Specificity = 99.6% (4/1000) Prevalence = 10% True positive: 100 False positive: 4 Positive predictive value: 100/104 = 96% Prevalence = 0.4% True positive: 4 False positive: 4 Positive predictive value: 4/8 = 50%

46 The Connection Between Influenza and S. pneumoniae

47 Statistics of influenza and pneumonia Influenza pandemics of 1957 and 1968 Bacterial etiology in roughly 70% of patients with severe pneumonia (life threatening or fatal) 1,2 Influenza hospitalizations rates (non pandemic) 44-57% bacterial pneumonia 3-6 Approximately 25% of influenza-related deaths have a secondary bacterial pneumonia 7

48 EID - Predictors of Pneumococcal Coinfection with Pandemic (H1N1) Study in Spain July March Looked at adults who had influenza-like illness and sought medical attention and had 1 risk factor for contracting influenzarelated complications Emerging Infectious Diseases. Vol

49 EID Study- Data Collection Samples Oropharyngeal and nasopharyngeal swab samples Urine sample Sputum and 2 blood cultures Assays PCR for the detection of influenza Blood, urinary antigen, or qualified sputum for S. pneumoniae

50 EID Study - Results 418 patients were evaluated 179 were confirmed H1N1 In PCR H1N1 negative, 25.1% had pneumococcal disease Of 100 patients with influenza 14% had pneumococcal infection Infection in more than half these patients would not have been diagnosed if a pneumococcal urinary antigen test had not been performed.

51 EID Study When Coinfection Found... Patients more frequently admitted to the hospital and to the intensive care unit Had lower oxygen saturation Had higher axillary temperature

52 EID Study - Conclusions Concurrent infection significantly increased risk of patient complications If only looking for influenza, pneumococcal pneumonia may be missed or only looking for pneumonia, influenza may be missed.

53 H1N1 Pandemic with S. pneumoniae in Argentina 1 May 2009 pandemic H1N1 had estimated fatality rate of 0.6% July 2009 Argentina reported fatality rate of 4.5% (137 deaths out of 3056 cases) Similar to seasonal influenza No genetic difference in virus S. pneumoniae associated with 56.4% of severe disease

54 Proposed Mechanisms Bacterial adherence after epithelial destruction Autopsy evidence in 1918 outbreak with S. aureus 1 Neutrophil apoptosis in presence of influenza and S. pneumoniae 2 Upregulation of molecules that S. pneumoniae can use as receptors Incubation with cytokines from viral infections 3 Environmental factors High temperature, ATP, norepinephrine

55 Conclusions Diagnostic technologies for respiratory infections allow more directed therapy Biological mechanisms do exist which predispose patients with influenza to pathogens such as S. pneumoniae A superinfection with bacterial pneumonia has been shown to increase morbidity/mortality in influenza infections Testing for both influenza and bacterial pneumonia in select populations can help predict how well patients do

Novel H1N1 Influenza. It s the flu after all! William Muth M.D. Samaritan Health Services 9 November 2009

Novel H1N1 Influenza. It s the flu after all! William Muth M.D. Samaritan Health Services 9 November 2009 Novel H1N1 Influenza It s the flu after all! William Muth M.D. Samaritan Health Services 9 November 2009 Influenza A Primer.. What is the flu? How do you get it? What s a virus anyhow? Can the flu be prevented,

More information

Acute respiratory illness This is a disease that typically affects the airways in the nose and throat (the upper respiratory tract).

Acute respiratory illness This is a disease that typically affects the airways in the nose and throat (the upper respiratory tract). Influenza glossary Adapted from the Centers for Disease Control and Prevention, US https://www.cdc.gov/flu/glossary/index.htm and the World Health Organization http://www.wpro.who.int/emerging_diseases/glossary_rev_sept28.pdf?ua=1

More information

Influenza B viruses are not divided into subtypes, but can be further broken down into different strains.

Influenza B viruses are not divided into subtypes, but can be further broken down into different strains. Influenza General Information Influenza (the flu) is a highly transmissible respiratory illness caused by influenza viruses. It can cause mild to severe illness, and may lead to death. Older people, young

More information

Influenza. Giovanni Maciocia

Influenza. Giovanni Maciocia Influenza Giovanni Maciocia Zhang Zhong Jing (about 150-219AD) Ye Tian Shi (1667-1746) Wu Ju Tong (1758-1836) 1. WESTERN MEDICINE VIEW a) INFLUENZA INFLUENZA IN CHINESE MEDICINE Epidemiologists predict

More information

Pandemic H1N1 2009: The Public Health Perspective. Massachusetts Department of Public Health November, 2009

Pandemic H1N1 2009: The Public Health Perspective. Massachusetts Department of Public Health November, 2009 Pandemic H1N1 2009: The Public Health Perspective Massachusetts Department of Public Health November, 2009 Training Objectives Describe and distinguish between seasonal and pandemic influenza. Provide

More information

H1N1 Influenza. Influenza-A Basics. Influenza Basics. April 1, History of Influenza Pandemics. April 1 September 25, 2009

H1N1 Influenza. Influenza-A Basics. Influenza Basics. April 1, History of Influenza Pandemics. April 1 September 25, 2009 April 1, 2009 H1N1 Influenza Jeff Goad, Pharm.D., MPH Associate Professor of Clinical Pharmacy USC School of Pharmacy April 1 September 25, 2009 History of Influenza Pandemics 400 B.C. 1889 Russian Flu

More information

Influenza: The Threat of a Pandemic

Influenza: The Threat of a Pandemic April, 2009 Definitions Epidemic: An increase in disease above what you what would normally expect. Pandemic: A worldwide epidemic 2 What is Influenza? Also called Flu, it is a contagious respiratory illness

More information

PUBLIC HEALTH SIGNIFICANCE SEASONAL INFLUENZA AVIAN INFLUENZA SWINE INFLUENZA

PUBLIC HEALTH SIGNIFICANCE SEASONAL INFLUENZA AVIAN INFLUENZA SWINE INFLUENZA INFLUENZA DEFINITION Influenza is an acute highly infectious viral disease characterized by fever, general and respiratory tract catarrhal manifestations. Influenza has 3 Types Seasonal Influenza Avian

More information

Novel H1N1 Influenza A: Protecting the Public

Novel H1N1 Influenza A: Protecting the Public Novel H1N1 Influenza A: Protecting the Public Humayun J. Chaudhry, DO, MS, SM, FACOI, FACP, FAODME President, American College of Osteopathic Internists; Clinical Associate Professor of Preventive Medicine,

More information

Swine Flu; Symptoms, Precautions & Treatments

Swine Flu; Symptoms, Precautions & Treatments Swine Flu; Symptoms, Precautions & Treatments What is the swine flu? Swine flu, also known as the H1N1 virus, is a relatively new strain of an influenza virus that causes symptoms similar to the regular

More information

U.S. Human Cases of Swine Flu Infection (As of April 29, 2009, 11:00 AM ET)

U.S. Human Cases of Swine Flu Infection (As of April 29, 2009, 11:00 AM ET) Swine Flu Call Center Script 4/29/2009 3:00 PM SWINE FLU QUESTIONS What is swine flu? Swine Influenza, also called swine flu, is a respiratory disease of pigs caused by type A influenza viruses. Outbreaks

More information

TABLE OF CONTENTS. Peterborough County-City Health Unit Pandemic Influenza Plan Section 1: Introduction

TABLE OF CONTENTS. Peterborough County-City Health Unit Pandemic Influenza Plan Section 1: Introduction TABLE OF CONTENTS 1. Introduction...1-2 1.1 Background...1-2 1.2 Why Does Peterborough County and City Need a Plan for Influenza Pandemic?...1-2 1.3 About Influenza...1-3 1.4 When Does Influenza Become

More information

DRAFT WGE WGE WGE WGE WGE WGE WGE WGE WGE WGE WGE WGE WGE WGE GETREADYNOWGE GETREADYNOWGE GETREADYNOWGE GETREADYNOWGE.

DRAFT WGE WGE WGE WGE WGE WGE WGE WGE WGE WGE WGE WGE WGE WGE GETREADYNOWGE GETREADYNOWGE GETREADYNOWGE GETREADYNOWGE. What Can I Do As A National Leader? This publication was produced by the AI.COMM project, managed by the Academy for Educational Development (AED), and funded by the U.S. Agency for International Development

More information

Peterborough County-City Health Unit Pandemic Influenza Plan Section 1: Background

Peterborough County-City Health Unit Pandemic Influenza Plan Section 1: Background 1. Background Every expert on influenza agrees that the ability of the influenza virus to re-assort genes means that another influenza pandemic not only can happen, it almost certainly will happen Influenza

More information

Influenza-Associated Pediatric Mortality rev Jan 2018

Influenza-Associated Pediatric Mortality rev Jan 2018 rev Jan 2018 Infectious Agent Influenza A, B or C virus BASIC EPIDEMIOLOGY Transmission Transmission occurs via droplet spread. After a person infected with influenza coughs, sneezes, or talks, influenza

More information

THIS ACTIVITY HAS EXPIRED. CME CREDIT IS NO LONGER AVAILABLE

THIS ACTIVITY HAS EXPIRED. CME CREDIT IS NO LONGER AVAILABLE THIS ACTIVITY HAS EXPIRED. CME CREDIT IS NO LONGER AVAILABLE The following content is provided for informational purposes only. PREVENTION AND CONTROL OF INFLUENZA Lisa McHugh, MPH Influenza can be a serious

More information

Q: If antibody to the NA and HA are protective, why do we continually get epidemics & pandemics of flu?

Q: If antibody to the NA and HA are protective, why do we continually get epidemics & pandemics of flu? Influenza virus Influenza virus Orthomyxoviridae family of viruses RNA enveloped viruses that make up three genera Influenzavirus A Influenzavirus B Influenzavirus C The type A viruses are the most virulent

More information

INFLUENZA AND OTHER RESPIRATORY VIRUSES

INFLUENZA AND OTHER RESPIRATORY VIRUSES INFLUENZA AND OTHER RESPIRATORY VIRUSES Lung Foundation Australia Patient Seminar 21 st October 2017 Lynette Reid Respiratory Clinical Nurse Specialist, RHH What is influenza (the flu )? Influenza (flu)

More information

AVIAN FLU BACKGROUND ABOUT THE CAUSE. 2. Is this a form of SARS? No. SARS is caused by a Coronavirus, not an influenza virus.

AVIAN FLU BACKGROUND ABOUT THE CAUSE. 2. Is this a form of SARS? No. SARS is caused by a Coronavirus, not an influenza virus. AVIAN FLU BACKGROUND 1. What is Avian Influenza? Is there only one type of avian flu? Avian influenza, or "bird flu", is a contagious disease of animals caused by Type A flu viruses that normally infect

More information

Influenza Infection In Human. Dr. Zuhaida A. Jalil Surveillance Sector Disease Control Division, MOH Malaysia 3 May 2018

Influenza Infection In Human. Dr. Zuhaida A. Jalil Surveillance Sector Disease Control Division, MOH Malaysia 3 May 2018 Influenza Infection In Human Dr. Zuhaida A. Jalil Surveillance Sector Disease Control Division, MOH Malaysia 3 May 2018 Objective of the session: After completing this session, you will be able to: Understand

More information

Influenza Fact Sheet

Influenza Fact Sheet What is influenza? Influenza, also known as the flu, is caused by a virus that affects the nose, throat, bronchial airways, and lungs. There are two types of flu that affect humans, types A and B. Influenza

More information

Understanding mortality from pandemic and seasonal influenza

Understanding mortality from pandemic and seasonal influenza Understanding mortality from pandemic and seasonal influenza Jonathan A. McCullers Associate Member Department of Infectious Diseases St. Jude Children s Research Hospital H1 H2 H3 H4 H5 H6 H7 H8 H9 H10

More information

Influenza RN.ORG, S.A., RN.ORG, LLC

Influenza RN.ORG, S.A., RN.ORG, LLC Influenza WWW.RN.ORG Reviewed May, 2017, Expires May, 2019 Provider Information and Specifics available on our Website Unauthorized Distribution Prohibited 2017 RN.ORG, S.A., RN.ORG, LLC PURPOSE: This

More information

Running head: INFLUENZA VIRUS SEASON PREPAREDNESS AND RESPONSE 1

Running head: INFLUENZA VIRUS SEASON PREPAREDNESS AND RESPONSE 1 Running head: INFLUENZA VIRUS SEASON PREPAREDNESS AND RESPONSE 1 Electron micrograph of H1N1 Virus (CDC, 2009) Influenza Virus Season Preparedness and Response Patricia Bolivar Walden University Epidemiology

More information

We ll be our lifesaver. We ll get the flu vaccine.

We ll be our lifesaver. We ll get the flu vaccine. We ll be our lifesaver. We ll get the flu vaccine. The flu vaccine is a lifesaver for healthcare workers and the people they care for. www.immunisation.ie Flu Vaccine 2017-18 Healthcare workers prevent

More information

Influenza: The past, the present, the (future) pandemic

Influenza: The past, the present, the (future) pandemic Influenza: The past, the present, the (future) pandemic Kristin Butler, MLS (ASCP) cm Department of Clinical Laboratory Sciences Louisiana Health Sciences Center - Shreveport Fall 2017 Objectives 1) Detail

More information

We ll be our own lifesavers. We ll get the flu vaccine.

We ll be our own lifesavers. We ll get the flu vaccine. We ll be our own lifesavers. We ll get the flu vaccine. The flu vaccine is a lifesaver for older people and those with long-term health conditions. www.immunisation.ie Flu Vaccine 2017-18 What is seasonal

More information

Swine flu - information prescription

Swine flu - information prescription Swine flu - information prescription Introduction Swine flu is a relatively new strain of influenza (flu) that was responsible for a flu pandemic during 2009-2010. It is sometimes known as H1N1 influenza

More information

Ralph KY Lee Honorary Secretary HKIOEH

Ralph KY Lee Honorary Secretary HKIOEH HKIOEH Round Table: Updates on Human Swine Influenza Facts and Strategies on Disease Control & Prevention in Occupational Hygiene Perspectives 9 July 2009 Ralph KY Lee Honorary Secretary HKIOEH 1 Influenza

More information

Community school Influenza like illness In season HPZ : February 2019

Community school Influenza like illness In season HPZ : February 2019 rd Public Health England South West T +44 (0)300 303 8162 3 Floor, 2 Rivergate F +44 (0)117 930 0205 Temple Quay, Bristol, BS1 6EH Follaton House, Plymouth Road F: +44 (0)1392 367356 Totnes, Devon TQ9

More information

How many students at St. Francis Preparatory School in New York City have become ill or been confirmed with swine flu?

How many students at St. Francis Preparatory School in New York City have become ill or been confirmed with swine flu? Swine Flu Call Center Script SWINE FLU QUESTIONS What is swine flu? Swine Influenza, also called swine flu, is a respiratory disease of pigs caused by type A influenza viruses. Outbreaks of swine flu happen

More information

Pandemic Influenza A Matter of Time

Pandemic Influenza A Matter of Time Pandemic Influenza A Matter of Time A Community Education Package Package developed by: Mary Smith Grampians Region Infection Control Consultant Department of Human Services What is Seasonal Influenza?

More information

INFLUENZA VIRUS. INFLUENZA VIRUS CDC WEBSITE

INFLUENZA VIRUS. INFLUENZA VIRUS CDC WEBSITE INFLUENZA VIRUS INFLUENZA VIRUS CDC WEBSITE http://www.cdc.gov/ncidod/diseases/flu/fluinfo.htm 1 THE IMPACT OF INFLUENZA Deaths: PANDEMICS 1918-19 S p a n is h flu 5 0 0,0 0 0 U S 2 0,0 0 0,0 0 0 w o rld

More information

COUNTY OF MORRIS DEPARTMENT OF LAW & PUBLIC SAFETY OFFICE OF HEALTH MANAGEMENT

COUNTY OF MORRIS DEPARTMENT OF LAW & PUBLIC SAFETY OFFICE OF HEALTH MANAGEMENT 1 COUNTY OF MORRIS DEPARTMENT OF LAW & PUBLIC SAFETY OFFICE OF HEALTH MANAGEMENT P.O. Box 900 Morristown, NJ 07963 (973) 631-5485 (973) 631-5490 Fax www.morrishealth.org 2012-2013 Influenza Season FREQUENTLY

More information

Buy The Complete Version of This Book at Booklocker.com:

Buy The Complete Version of This Book at Booklocker.com: Amazing breakthrough remedy for swine flu from mother nature. How to Beat Swine Flu Naturally Buy The Complete Version of This Book at Booklocker.com: http://www.booklocker.com/p/books/4341.html?s=pdf

More information

American Academy of Pediatrics Section on Telehealth Care

American Academy of Pediatrics Section on Telehealth Care American Academy of Pediatrics Section on Telehealth Care Educational Information for Telephone Triage Nurses Educational Information for Telephone Triage Nurses Volume 6 Number 2 April 2009 Editor Andrew

More information

2009 H1N1 (Pandemic) virus IPMA September 30, 2009 Anthony A Marfin

2009 H1N1 (Pandemic) virus IPMA September 30, 2009 Anthony A Marfin 2009 H1N1 (Pandemic) virus IPMA September 30, 2009 Anthony A Marfin Introduction to Influenza What is influenza? What is pandemic influenza? What is 2009 H1N1 influenza? Current situation & predictions

More information

IT S A LIFESAVER EVERY YEAR FLU CAUSES SEVERE ILLNESS AND DEATH. GET YOUR FLU VACCINE NOW. IF YOU ARE: worker

IT S A LIFESAVER EVERY YEAR FLU CAUSES SEVERE ILLNESS AND DEATH. GET YOUR FLU VACCINE NOW. IF YOU ARE: worker FLU VACCINE Information FOR Health care workers EVERY YEAR FLU CAUSES SEVERE ILLNESS AND DEATH. IF YOU ARE: A health care worker Over 65 Have a longterm illness Pregnant GET YOUR FLU VACCINE NOW. IT S

More information

Guidance for Influenza in Long-Term Care Facilities

Guidance for Influenza in Long-Term Care Facilities Guidance for Influenza in Long-Term Care Facilities DSHS Region 2/3 Epidemiology Team January 2018 1. Introduction Every year, the flu affects people around the world, regardless of age. However, residents

More information

Overview of the Influenza Virus

Overview of the Influenza Virus Overview of the Influenza Virus Victor C. Huber, Ph.D. September 24, 2015 victor.huber@usd.edu General Features of Influenza Virus Infections Clinical Features of Influenza Sudden onset of symptoms Incubation

More information

1918 Influenza; Influenza A, H1N1. Basic agent information. Section I- Infectious Agent. Section II- Dissemination

1918 Influenza; Influenza A, H1N1. Basic agent information. Section I- Infectious Agent. Section II- Dissemination 1918 Influenza; Influenza A, H1N1 Basic agent information Section I- Infectious Agent Risk Group: - RG3 Synonym or Cross reference: - Spanish Flu - 1918 Flu - El Grippe Characteristics: - SELECT AGENT

More information

What is the Flu? The Flu is also called Influenza (In-flu-en-za) It is caused by an infection of the. Nose Throat And lungs

What is the Flu? The Flu is also called Influenza (In-flu-en-za) It is caused by an infection of the. Nose Throat And lungs Flu Facts What is the Flu? The Flu is also called Influenza (In-flu-en-za) It is caused by an infection of the Nose Throat And lungs Seasonal Flu Illness that can spread from person to person Every winter

More information

Swine Influenza A: Information for Child Care Providers INTERIM DAYCARE ADVISORY General Information: do not

Swine Influenza A: Information for Child Care Providers INTERIM DAYCARE ADVISORY General Information: do not Swine Influenza A: Information for Child Care Providers INTERIM DAYCARE ADVISORY 4-29-2009 The State of Connecticut Department of Public Health (DPH) would like to provide information to childcare providers

More information

2009 / 2010 H1N1 FAQs

2009 / 2010 H1N1 FAQs The information contained within this document was compiled from sources that include the Center for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, and the Oregon Department

More information

Diagnosis of Seasonal and Pandemic Influenza. Objectives. Influenza Infections 11/7/2014

Diagnosis of Seasonal and Pandemic Influenza. Objectives. Influenza Infections 11/7/2014 Diagnosis of Seasonal and Pandemic Influenza Michael Klepser, Pharm.D., FCCP Professor Ferris State University College of Pharmacy Objectives Given a patient case, be able to identify signs and symptoms

More information

UPDATE ON CANINE INFLUENZA IN TENNESSEE. Staci Cannon, DVM, MPH, DACVPM, DABVP (Shelter Medicine Practice)

UPDATE ON CANINE INFLUENZA IN TENNESSEE. Staci Cannon, DVM, MPH, DACVPM, DABVP (Shelter Medicine Practice) UPDATE ON CANINE INFLUENZA IN TENNESSEE Staci Cannon, DVM, MPH, DACVPM, DABVP (Shelter Medicine Practice) Headlines What is Canine Influenza? Highly contagious respiratory infection of dogs Caused by influenza

More information

Flu is a more severe form of what people generally associate with as Cough, Cold and Fever and symptoms are usually incapacitating.

Flu is a more severe form of what people generally associate with as Cough, Cold and Fever and symptoms are usually incapacitating. SEASONAL HUMAN INFLUENZA (THE FLU) What is Seasonal Human Influenza? Seasonal Influenza is a viral infection that affects millions of people worldwide. It is transmitted from person to person through direct

More information

What is Influenza? Patricia Daly MD, FRCPC Medical Health Officer and Medical Director of Communicable Disease Control

What is Influenza? Patricia Daly MD, FRCPC Medical Health Officer and Medical Director of Communicable Disease Control Vancouver Coastal Health & The Vancouver Coastal Health Research Institute presents: On Call with VGH Experts Lecture Series The Flu and You What is Influenza? Patricia Daly MD, FRCPC Medical Health Officer

More information

RESPIRATORY TRACT INFECTIONS. CLS 212: Medical Microbiology Zeina Alkudmani

RESPIRATORY TRACT INFECTIONS. CLS 212: Medical Microbiology Zeina Alkudmani RESPIRATORY TRACT INFECTIONS CLS 212: Medical Microbiology Zeina Alkudmani Lower Respiratory Tract Upper Respiratory Tract Anatomy of the Respiratory System Nasopharynx Oropharynx Respiratory Tract Infections

More information

Influenza. Gwen Clutario, Terry Chhour, Karen Lee

Influenza. Gwen Clutario, Terry Chhour, Karen Lee Influenza Gwen Clutario, Terry Chhour, Karen Lee Overview Commonly referred to as the flu Defined as a highly contagious viral infection where it starts at the upper respiratory tract and attacks the nose,

More information

دکتر بهروز نقیلی استاد بیماریهای عفونی مرکس تحقیقات بیماریهای عفونی و گرمسیری پاییس 88

دکتر بهروز نقیلی استاد بیماریهای عفونی مرکس تحقیقات بیماریهای عفونی و گرمسیری پاییس 88 دکتر بهروز نقیلی استاد بیماریهای عفونی مرکس تحقیقات بیماریهای عفونی و گرمسیری پاییس 88 FLU.. How often can you escape? Three viral types are distinguished by their matrix and nucleoproteins Type Host Clinical

More information

Revised Recommendations for the Use of Influenza Antiviral Drugs

Revised Recommendations for the Use of Influenza Antiviral Drugs QUESTIONS & ANSWERS Revised Recommendations for the Use of Influenza Antiviral Drugs Background On September 8, 2009 CDC updated its recommendations for the use of influenza antiviral medicines to provide

More information

1/31/2013 DISEASE BASICS. Influenza; Implications for Public Health Professionals. Influenza: An Age-Old Disease, A Disease for All Ages

1/31/2013 DISEASE BASICS. Influenza; Implications for Public Health Professionals. Influenza: An Age-Old Disease, A Disease for All Ages Influenza; Implications for Public Health Professionals Phillip L. Barkley, M.D. Director of Student Health University of Florida DISEASE BASICS Influenza: An Age-Old Disease, A Disease for All Ages Epidemics

More information

Influenza (flu) Infection Prevention and Control. What is influenza? What are the symptoms of influenza? What causes influenza?

Influenza (flu) Infection Prevention and Control. What is influenza? What are the symptoms of influenza? What causes influenza? What is influenza? Influenza (also known as flu) is a respiratory illness which is caused by the influenza virus. For most people influenza is just a nasty experience, but for some it can lead to illnesses

More information

Clinical Guidance for 2009 H1N1 Influenza and Seasonal Influenza. Barbara Wallace, MD New York State Department of Health (Updated 10/8/09)

Clinical Guidance for 2009 H1N1 Influenza and Seasonal Influenza. Barbara Wallace, MD New York State Department of Health (Updated 10/8/09) Clinical Guidance for 2009 H1N1 Influenza and Seasonal Influenza Barbara Wallace, MD New York State Department of Health (Updated 10/8/09) 1 Outline Clinical assessment Diagnostic testing Antiviral medications

More information

Tiredness/Fatigue Mild Moderate to severe, especially at onset of symptoms Head and Body Aches and Pains

Tiredness/Fatigue Mild Moderate to severe, especially at onset of symptoms Head and Body Aches and Pains What is the difference between a cold COLD FLU and the flu? How it starts Symptoms It s Cold and Flu Season in Snohomish County! Colds and Flu are respiratory illnesses caused by viruses. Our Immune Systems

More information

Influenza. What Is Influenza?

Influenza. What Is Influenza? Flu is usually a mild, but uncomfortable disease. You can treat it yourself by staying home and drinking plenty of fluids. What Is?, often just called the flu, is the most common disease in the world,

More information

2009 (Pandemic) H1N1 Influenza Virus

2009 (Pandemic) H1N1 Influenza Virus 2009 (Pandemic) H1N1 Influenza Virus September 15, 2009 Olympia, Washington Anthony A Marfin Washington State Department of Health Goals Understand current situation & pattern of transmission of 2009 H1N1

More information

We ll be our lifesaver. We ll get the flu vaccine.

We ll be our lifesaver. We ll get the flu vaccine. We ll be our lifesaver. We ll get the flu vaccine. www.hse.ie/flu Flu Vaccine 2018-19 Healthcare workers prevent the spread of flu and save lives every year by getting vaccinated with the flu vaccine.

More information

WHO Technical Consultation on the severity of disease caused by the new influenza A (H1N1) virus infections

WHO Technical Consultation on the severity of disease caused by the new influenza A (H1N1) virus infections WHO Technical Consultation on the severity of disease caused by the new influenza A (H1N1) virus infections Original short summary posted 6 May 2009. Revised full report posted May 9 2009. On 5 May 2009

More information

What is Swine Flu (800)

What is Swine Flu (800) What is Swine Flu Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs People do not normally get swine flu, but human infections

More information

In the United States, flu season runs from October to May, with most cases occurring between late December and early March.

In the United States, flu season runs from October to May, with most cases occurring between late December and early March. Partners in Pediatrics, PC 7110 Forest Ave Suite 105 Richmond, VA 23226 804-377-7100 Influenza (Flu) Influenza, commonly known as "the flu," is a highly contagious viral infection of the respiratory tract.

More information

Pandemic Influenza. Bradford H. Lee, MD Nevada State Health Officer. Public Health: Working for a Safer and Healthier Nevada

Pandemic Influenza. Bradford H. Lee, MD Nevada State Health Officer. Public Health: Working for a Safer and Healthier Nevada Pandemic Influenza Bradford H. Lee, MD Nevada State Health Officer EXHIBIT C Legislative Committee on Health Care Document consists of 29 slides. Entire document provided. Due to size limitations, pages

More information

Swine Flu Update and FAQ

Swine Flu Update and FAQ Swine Flu Update and FAQ There have now been almost 6000 laboratory proven cases of A/H1N1 in the UK and the numbers are increasing rapidly on a daily basis. The published figure will significantly underestimate

More information

QHSE Campaign- Health

QHSE Campaign- Health THE INFLUENZA(FLU) VIRUS:H1N1(Swine). Medic ation Vaccin ate Prevention The three-step approach to fighting the flu (Influenza virus). We recommend a three-step approach to fighting influenza (flu). The

More information

A Just in Time Primer on H1N1 Influenza A and Pandemic Influenza developed by the National Association of State EMS Officials and Revised by the

A Just in Time Primer on H1N1 Influenza A and Pandemic Influenza developed by the National Association of State EMS Officials and Revised by the A Just in Time Primer on H1N1 Influenza A and Pandemic Influenza developed by the National Association of State EMS Officials and Revised by the Michigan Department of Community Health EMS and Trauma Systems

More information

Pandemic Influenza Planning:

Pandemic Influenza Planning: Pandemic Influenza Planning: Get Information. Stay Informed. U.S. Department of Health and Human Services May 2006 While the Federal Government will use all resources at its disposal to prepare for and

More information

Seasonal Flu Vaccination

Seasonal Flu Vaccination Seasonal Flu Vaccination What You Need to Know to Protect: Your Patients Your Colleagues Your Family Yourself Advice for Healthcare Workers This leaflet is for NHS staff to help them advise patients and

More information

Swine Flu, Fiction or Reality

Swine Flu, Fiction or Reality Philadelphia University, Jordan From the SelectedWorks of Philadelphia University, Jordan 2009 Swine Flu, Fiction or Reality Philadelphia University, Philadelphia University Available at: https://works.bepress.com/philadelphia_university/98/

More information

FACT SHEET. H1N1 Influenza phone

FACT SHEET. H1N1 Influenza phone www.cookcountypublichealth.org 708-492-2000 phone H1N1 Influenza FACT SHEET What is novel H1N1? Novel H1N1 (referred to as swine flu early on) is a new influenza virus causing illness in people. This new

More information

NOVEL INFLUENZA A (H1N1) Swine Flu

NOVEL INFLUENZA A (H1N1) Swine Flu Introduction Definitions Influenza-like Illness Emergency Department Assessment Anitiviral Medication Oseltamivir (Tamiflu) Dosing Infection Control Issues Staff Exposure References Introduction This guideline

More information

INFLUENZA 2009 H1N1. INACTIVATED (the flu shot ) W H A T Y O U N E E D T O K N O W. 1 What is 2009 H1N1 influenza? H1N1 influenza vaccine

INFLUENZA 2009 H1N1. INACTIVATED (the flu shot ) W H A T Y O U N E E D T O K N O W. 1 What is 2009 H1N1 influenza? H1N1 influenza vaccine 2009 H1N1 INFLUENZA INACTIVATED (the flu shot ) VACCINE W H A T Y O U N E E D T O K N O W Many Vaccine Information Statements are available in Spanish and other languages. See http://www.immunize.org/vis.

More information

Incidence of Seasonal Influenza

Incidence of Seasonal Influenza What Is All the Fuss? A Just-in in-time Primer on H1N1 Influenza A and Pandemic Influenza provided by the National Association of State EMS Officials May 1, 2009 Disclaimer This self-learning learning

More information

H1N1 FLU H1N1 Influenza (Flu) 2009 H1N1 Flu in People. What is 2009 H1N1 flu swine flu? Why is 2009 H1N1 flu sometimes called swine flu?

H1N1 FLU H1N1 Influenza (Flu) 2009 H1N1 Flu in People. What is 2009 H1N1 flu swine flu? Why is 2009 H1N1 flu sometimes called swine flu? 2009 H1N1 Influenza (Flu) What is 2009 H1N1 flu swine flu? 2009 H1N1 (also known as swine flu ) is a new flu virus that makes people sick. The 2009 H1N1 flu spreads from person to person like seasonal

More information

Austin Public Health Epidemiology and Disease Surveillance Unit. Travis County Influenza Surveillance

Austin Public Health Epidemiology and Disease Surveillance Unit. Travis County Influenza Surveillance Travis County Influenza Surveillance Summary Season 2016-2017 (Data through the week ending March 18, 2017). Travis County influenza and influenza-like illness (ILI) activity: Since March 18 th, influenza

More information

A Virus is a very small organism which can only be viewed under the electron microscope.

A Virus is a very small organism which can only be viewed under the electron microscope. Pandemic Influenza Fact Sheet What is a Virus? A Virus is a very small organism which can only be viewed under the electron microscope. Properties of viruses Although they are very small, they are live

More information

Pandemic H1N1 Frequently Asked Questions

Pandemic H1N1 Frequently Asked Questions Pandemic H1N1 Frequently Asked Questions What is pandemic H1N1 flu? Pandemic H1N1 influenza (once referred to as swine flu ) is a new flu virus that causes respiratory illness in people. The Centers for

More information

Influenza and the Flu Shot Facts for Health Care Workers

Influenza and the Flu Shot Facts for Health Care Workers Influenza and the Flu Shot Facts for Health Care Workers 2014-2015 Presentation to (group name) Your Name Your Title Date Influenza Facts o Highly contagious and common respiratory illness caused by influenza

More information

Enterovirus-D68 (EV-D68) Frequently Asked Questions September 29, 2014 New information in italics

Enterovirus-D68 (EV-D68) Frequently Asked Questions September 29, 2014 New information in italics Enterovirus-D68 (EV-D68) Frequently Asked Questions September 29, 2014 New information in italics What are enteroviruses? Enteroviruses (EV) are common viruses; there are more than 100 types. It is estimated

More information

INFLUENZA (FLU) Cleaning to Prevent the Flu

INFLUENZA (FLU) Cleaning to Prevent the Flu INFLUENZA (FLU) Cleaning to Prevent the Flu Cleaning to Prevent the Flu 24 hours How long can the flu virus live on objects, such as doorknobs and tables? The flu virus can live on some surfaces for up

More information

Module 1 : Influenza - what is it and how do you get it?

Module 1 : Influenza - what is it and how do you get it? Module 1 : Influenza - what is it and how do you get it? Responsible/facilitators General Objective Specific Objectives Methodology Agency medical coordinator Understand the mechanism how influenza is

More information

SAU 55 N.H. School Administrative Unit 55

SAU 55 N.H. School Administrative Unit 55 SAU 55 N.H. School Administrative Unit 55 OFFICE OF THE SUPERINTENDENT OF SCHOOLS Serving The 30 Greenough Road Plaistow, NH 03865 603/382-6119 Timberlane Regional School District FAX 603/382-3334 Hampstead

More information

Novel H1N1 Influenza A Update. William Muth MD 2 Oct 2009

Novel H1N1 Influenza A Update. William Muth MD 2 Oct 2009 Novel H1N1 Influenza A Update William Muth MD 2 Oct 2009 Novel H1N1 Influenza A Update Epidemiology Treatment Chemoprophylaxis Vaccine Infection Prevention Novel H1N1 Influenza A International Epidemiology

More information

Most people confuse influenza with a heavy cold; however influenza is usually a more severe illness than the common cold.

Most people confuse influenza with a heavy cold; however influenza is usually a more severe illness than the common cold. What is influenza? Influenza (also known as flu) is a respiratory illness which is caused by the influenza virus. For most people influenza is just a nasty experience, but for some it can lead to illnesses

More information

FLU VACCINE MYTHS & FACTS. Get the facts to keep you and your loved ones flu-free. Sponsored by:

FLU VACCINE MYTHS & FACTS. Get the facts to keep you and your loved ones flu-free. Sponsored by: FLU VACCINE MYTHS & FACTS Get the facts to keep you and your loved ones flu-free. Sponsored by: The flu isn t that serious... Many people are unaware that influenza, the flu, is a serious disease. According

More information

INFLUENZA. Rob Young (James. J. Reid) Faculty of Medicine University of Auckland (Otago)

INFLUENZA. Rob Young (James. J. Reid) Faculty of Medicine University of Auckland (Otago) INFLUENZA Rob Young (James. J. Reid) Faculty of Medicine University of Auckland (Otago) INFLUENZA Don t confuse with the common cold Symptoms may be similar BUT those with influenza are sick those with

More information

FREQUENTLY ASKED QUESTIONS SWINE FLU

FREQUENTLY ASKED QUESTIONS SWINE FLU FREQUENTLY ASKED QUESTIONS SWINE FLU Updated 5/6/09 ER FAQ What is swine flu? Swine flu is common disease of pigs and is caused by the same category of influenza virus (influenza A) that causes flu in

More information

INFLUENZA VACCINATION AND MANAGEMENT SUMMARY

INFLUENZA VACCINATION AND MANAGEMENT SUMMARY INFLUENZA VACCINATION AND MANAGEMENT SUMMARY Morbidity and mortality related to influenza occur at a higher rate in people over 65 and those with underlying chronic medical conditions. Annual influenza

More information

INTERNATIONAL SOCIETY FOR HEART AND LUNG TRANSPLANTATION a Society that includes Basic Science, the Failing Heart, and Advanced Lung Disease

INTERNATIONAL SOCIETY FOR HEART AND LUNG TRANSPLANTATION a Society that includes Basic Science, the Failing Heart, and Advanced Lung Disease International Society of Heart and Lung Transplantation Advisory Statement on the Implications of Pandemic Influenza for Thoracic Organ Transplantation This advisory statement has been produced by the

More information

Influenza. Tim Uyeki MD, MPH, MPP, FAAP

Influenza. Tim Uyeki MD, MPH, MPP, FAAP Influenza Tim Uyeki MD, MPH, MPP, FAAP Influenza Division National Center for Immunization and Respiratory Diseases Coordinating Center for Infectious Diseases Centers for Disease Control and Prevention

More information

Human infection with pandemic (H1N1) 2009 virus: updated interim WHO guidance on global surveillance

Human infection with pandemic (H1N1) 2009 virus: updated interim WHO guidance on global surveillance Human infection with pandemic (H1N1) 2009 virus: updated interim WHO guidance on global surveillance 10 July 2009 Background This document updates the interim WHO guidance on global surveillance of pandemic

More information

ESCMID Online Lecture Library. by author

ESCMID Online Lecture Library. by author INFLUENZA IN CHILDREN Cristian Launes Infectious Diseases Unit. Department of Paediatrics. Hospital Sant Joan de Déu (Universitat de Barcelona) Innovation in Severe Acute Respiratory Infections (SARI),

More information

Conflict of Interest and Disclosures. Research funding from GSK, Biofire

Conflict of Interest and Disclosures. Research funding from GSK, Biofire Pandemic Influenza Suchitra Rao, MBBS, Assistant Professor, Pediatric Infectious Diseases, Hospital Medicine and Epidemiology Global Health and Disasters Course, 2018 Conflict of Interest and Disclosures

More information

Respiratory System Virology

Respiratory System Virology Respiratory System Virology Common Cold: Rhinitis. A benign self limited syndrome caused by several families of viruses. The most frequent acute illness in industrialized world. Mild URT illness involving:

More information

Influenza Vaccine Fact Sheet 2010/2011

Influenza Vaccine Fact Sheet 2010/2011 Influenza Vaccine Fact Sheet 2010/2011 This fact sheet provides basic information only. It must not take the place of medical advice, diagnosis or treatment. Always talk to a healthcare professional about

More information

YOUR SEASONAL FLU GUIDE

YOUR SEASONAL FLU GUIDE YOUR SEASONAL FLU GUIDE b What is the seasonal flu? b What can you do to prevent the seasonal flu? b Resources WWW.FIGHTFLU.CA To promote and protect the health of Canadians through leadership, partnership,

More information

Influenza Backgrounder

Influenza Backgrounder Influenza Backgrounder Influenza Overview Influenza causes an average of 36,000 deaths and 200,000 hospitalizations in the U.S. every year. 1,2 Combined with pneumonia, influenza is the seventh leading

More information

بسم هللا الرحمن الرحيم

بسم هللا الرحمن الرحيم - 1 - - - 1 P a g e بسم هللا الرحمن الرحيم This sheet was made from record section 1 all information are included - Introduction Our respiratory tract is divided anatomically to upper (URT),middle and

More information

10/6/2014. INFLUENZA: Why Should We Take The Vaccine? OUTLINE INFLUNZA VIRUS INFLUENZA VIRUS INFLUENZA VIRUS

10/6/2014. INFLUENZA: Why Should We Take The Vaccine? OUTLINE INFLUNZA VIRUS INFLUENZA VIRUS INFLUENZA VIRUS INFLUENZA: Why Should We Take The Vaccine? Baptist Hospital Baptist Children s Hospital Doctors Hospital J. Milton Gaviria, MD, FACP October 17, 2014 Homestead Hospital Mariners Hospital Baptist Cardiac

More information

Influenza Update for Iowa Long-Term Care Facilities. Iowa Department of Public Health Center for Acute Disease Epidemiology

Influenza Update for Iowa Long-Term Care Facilities. Iowa Department of Public Health Center for Acute Disease Epidemiology Influenza Update for Iowa Long-Term Care Facilities Iowa Department of Public Health Center for Acute Disease Epidemiology Webinar Information All participants will be muted during the presentation. Questions

More information