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Questions and Answers
What is the reported fatality rate for avian influenza?
What is the reported fatality rate for avian influenza?
Where was the H5N1 avian influenza virus first identified in wild geese populations?
Where was the H5N1 avian influenza virus first identified in wild geese populations?
Which of the following groups is NOT considered high-risk for influenza complications?
Which of the following groups is NOT considered high-risk for influenza complications?
What is the recommended vaccination schedule for children six months to eight years of age who have not received at least two doses of the influenza vaccine previously?
What is the recommended vaccination schedule for children six months to eight years of age who have not received at least two doses of the influenza vaccine previously?
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Which institution has residents that are considered high-risk for influenza complications?
Which institution has residents that are considered high-risk for influenza complications?
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What is the primary mode of transmission of H5N1 avian influenza virus?
What is the primary mode of transmission of H5N1 avian influenza virus?
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What is the recommended annual influenza vaccination policy for all people?
What is the recommended annual influenza vaccination policy for all people?
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Which of the following is NOT a high-risk group for influenza complications?
Which of the following is NOT a high-risk group for influenza complications?
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What is the primary factor that contributes to the potential for wide-spread pandemics in influenza A subtypes?
What is the primary factor that contributes to the potential for wide-spread pandemics in influenza A subtypes?
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What is the significance of the numbering system for influenza A subtypes, such as H3N2 or H5N1?
What is the significance of the numbering system for influenza A subtypes, such as H3N2 or H5N1?
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What was the estimated range of seasonal influenza activity in the United States from 2010 to 2018?
What was the estimated range of seasonal influenza activity in the United States from 2010 to 2018?
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What was the characteristic of the 2017-2018 influenza season?
What was the characteristic of the 2017-2018 influenza season?
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What was the primary subtype responsible for most cases during the 2017-2018 influenza season?
What was the primary subtype responsible for most cases during the 2017-2018 influenza season?
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What is the significance of the author disclosure statement?
What is the significance of the author disclosure statement?
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What is the purpose of the patient information section?
What is the purpose of the patient information section?
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What is the source of the epidemiological data on influenza?
What is the source of the epidemiological data on influenza?
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Who is the RIV vaccine not licensed for?
Who is the RIV vaccine not licensed for?
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Which group of people should be targeted for vaccination efforts?
Which group of people should be targeted for vaccination efforts?
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When can LAIV be used in age-appropriate patients?
When can LAIV be used in age-appropriate patients?
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What reduces the effectiveness of LAIV if given within a certain time frame?
What reduces the effectiveness of LAIV if given within a certain time frame?
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What is the AAFP's recommendation for influenza vaccination?
What is the AAFP's recommendation for influenza vaccination?
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What is the benefit of vaccination efforts in healthcare professionals?
What is the benefit of vaccination efforts in healthcare professionals?
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What percentage of patients with influenza experience severe disease due to viral or secondary bacterial pneumonia?
What percentage of patients with influenza experience severe disease due to viral or secondary bacterial pneumonia?
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What is the primary purpose of influenza testing according to the CDC?
What is the primary purpose of influenza testing according to the CDC?
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What is the typical duration of an uncomplicated influenza infection?
What is the typical duration of an uncomplicated influenza infection?
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What is the name of the adjuvanted inactivated trivalent vaccine licensed for use in adults 65 years and older?
What is the name of the adjuvanted inactivated trivalent vaccine licensed for use in adults 65 years and older?
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What is the complication of influenza that is most common in children?
What is the complication of influenza that is most common in children?
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What is the purpose of a symptom-only clinical prediction rule for diagnosing influenza?
What is the purpose of a symptom-only clinical prediction rule for diagnosing influenza?
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What is the term for the onset of influenza symptoms?
What is the term for the onset of influenza symptoms?
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What is the complication of influenza that can occur in patients with medical comorbidities?
What is the complication of influenza that can occur in patients with medical comorbidities?
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What is the scoring system used in the symptom-only clinical prediction rule for diagnosing influenza?
What is the scoring system used in the symptom-only clinical prediction rule for diagnosing influenza?
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What is the term for the respiratory infection that can occur in patients with influenza?
What is the term for the respiratory infection that can occur in patients with influenza?
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What is the title of the publication that reported on influenza activity in the United States during the 2018-19 season?
What is the title of the publication that reported on influenza activity in the United States during the 2018-19 season?
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In which year did Moser et al. publish an article on an outbreak of influenza aboard a commercial airliner?
In which year did Moser et al. publish an article on an outbreak of influenza aboard a commercial airliner?
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What is the name of the publication that reported on the composition of the 2019-20 influenza vaccine?
What is the name of the publication that reported on the composition of the 2019-20 influenza vaccine?
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Who wrote an article on human influenza virus infections?
Who wrote an article on human influenza virus infections?
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What is the name of the publication that reported on the clinical signs and symptoms of influenza?
What is the name of the publication that reported on the clinical signs and symptoms of influenza?
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In which year did Leekha et al. publish an article on the duration of influenza A virus shedding in hospitalized patients?
In which year did Leekha et al. publish an article on the duration of influenza A virus shedding in hospitalized patients?
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Who wrote an article on the hidden burden of influenza?
Who wrote an article on the hidden burden of influenza?
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In which year did von Ranke et al. publish an article on infectious diseases causing diffuse alveolar hemorrhage in immunocompetent patients?
In which year did von Ranke et al. publish an article on infectious diseases causing diffuse alveolar hemorrhage in immunocompetent patients?
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Study Notes
Influenza
- Antigenic shift occurs when there are significant changes in the HA or NA proteins, creating novel influenza subtypes with the potential to cause widespread pandemics.
- Influenza A subtypes are characterized by numbering both the HA and NA proteins (e.g., H3N2, H5N1).
- From 2010 to 2018, estimated seasonal influenza activity in the United States ranged from 9.3 million to 49 million cases and 12,000 to 79,000 deaths per year.
- The 2017-2018 influenza season was the third most severe since 2003-2004, with high severity of disease in all age groups.
Epidemiology
- Most cases were secondary to the A/H3N2 subtype, and low vaccine effectiveness was a significant contributing factor.
- Cases predominantly involved young children exposed to swine, often at state fairs.
- Institutionalized adults (e.g., residents of nursing homes or chronic care facilities), pregnant and postpartum women, and immunosuppressed people are at increased risk of complicated or severe influenza.
Prevention
- The Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) recommend annual influenza vaccination for all people six months and older who do not have contraindications.
- Vaccination efforts should target people at increased risk of complicated or severe influenza and those who care for or live with high-risk individuals, including health care professionals.
- Multiple formulations of the influenza vaccine are available, including inactivated influenza vaccines (IIV), recombinant inactivated vaccine (RIV), and live, attenuated influenza vaccine (LAIV).
Clinical Manifestations and Complications
- Influenza most often causes an uncomplicated respiratory infection with cough, fever, myalgias, chills or sweats, and malaise that persists for two to eight days.
- Atypical gastrointestinal symptoms such as vomiting and diarrhea can occur in children.
- Extrapulmonary complications are rare and can include cardiovascular, cerebrovascular, hematologic, musculoskeletal, neurologic, ocular, pulmonary, and renal complications.
Diagnostic Testing
- Influenza testing can be considered when the results will modify management or when a patient with signs or symptoms of influenza is hospitalized.
- A symptom-only clinical prediction rule may aid clinicians in diagnosing influenza, which assigns points for fever, cough, myalgias, chills or sweats, and symptom onset within the past 48 hours.
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Description
Learn about antigenic shift and its relation to novel influenza subtypes, HA and NA proteins, and pandemic potential.
