1. The Influenza & Parainfluenza viruses1

2. Orthomyxoviridae
&
Paramyxoviridae

3. Classification Family: Genus: Types: Type A Type B Influenza viruses
Type C
ORTHOMYXOVIRIDAE
Genus:
Types: 7 3

4. “myxo” refers to interaction with mucins (glycoproteins)
Different from paramyxoviruses : - segmented genome
- smaller (average 110 nm in diameter against 150 nm).

5. An enveloped viruse, helical symmetry capsid, segmented linear RNA genome
80 to 120 nm
Surface
antigens
Internal
Nucleocapsid:
Nucleoprotein (7 or 8 RNA segments)
Matrix protein (M)
Lipid bilayer
Haemaglutinin (HA)
Neuraminidase (NA) 8 5

6. Each hemagglutinin spike is made up of three entwined molecules while each neuraminidase is comprised of four entwined molecules.
On the surface of the virus are M2 proteins. Inside the lipid envelope, there are eight RNA gene segments called RNPs (RNA molecule+ Nucleoprotein+ Polymerases).
Ball shaped M1 proteins: as cushions for the RNPs inside.

8. Surface glycoproteins
Haemagglutinin
H or HA
responsible for pathogenicity of the virus
allows virus to adhere to endothelial cells in the respiratory tract
main determinant of immunity
Neuraminidase
N or NA
allows release of newly formed viruses within host
determinant of disease severity 8

9. Antibody against the hemagglutinin neutralizes the infectivity of the virus and prevents disease. Ab against neuraminidase only reduces disease.

10. Influenza subgroups Influenza A Influenza B Influenza C
highly infective
infects many species
causes widespread epidemics
Influenza B
found only in humans
capable of producing severe disease
causes regional epidemics
Influenza C
causes mild disease
humans are natural hosts, but isolates also found in pigs
does not cause epidemics 10

11. Reassortment of segments of the genome RNA
Influenza viruses, especially type A show changes in the antigenicity of their hemagglutinin and neuraminidase proteins.  epidemics.
Influenza viruses antigenes
Group-specific (internal ribonucleoprotein) antigenes.
Type-specific (surface N and H) antigens.

12. Many species of animal (eg
Many species of animal (eg. Birds, swine, and hourses) have their own influenza A viruses.
These animal viruses are probably the source of the new antigenic types.
Antigenic shift: Major changes based on reassortment of genome pieces. Occurs every years
Antigenic drift: Minor changes based on mutation occurs every year.

13. Antigenic shift appears to result from genetic recombination of human with animal or bird ,providing major antigenic change.This can cause a major epidemic or pandemic involving most or all age groups.

14. Epidemics and pandemics occur when the antigenicity of the virus has changed sufficiently that the preexisting immunity of many people is no longer effective.

15. 15

16. Various combinations of RNA segments can result in a new subtype of virus (known as antigenic shift
It is even possible to include RNA strands from birds, swine, and human influenza viruses into one virus if a cell becomes infected with all three types of influenza.

18. Occurrence of influenza A viruses
Influenza A viruses 16 HA types
9 NA types
Species affected humans, pigs, horses, birds, marine mammals
In humans 3 HA types (H1, H2, H3)
3 NA types (N1, N2, N8)
In birds all HA types
all NA types 18

19. Influenza viruses nomenclature
For example:
A / Beijing / 32 / 92 (H3N2)
A virus type, here A
Beijing place where the strain was isolated
32 strain number
92 year of first isolation
H3N2 subtypes H3 and N2 virus sub type, here H3N2 19

20. ELECTRON MICROSOPE IMAGE OF H1N1 INFLUENZA VIRUS

21. Pathogenesis
After the virus is inhaled, the neuraminidase degrades the protective mucus layer, allowing the virus to gain access to the cells of the upper and lower respiratory tract.
Viremia rarely occurs, but there is necrosis of the superficial layers of respiratory epithelium.

22. Immunity
Circulating IgG against the virus occurs after infection, but offers little protection. Secretory IgA in the respiratory tract is protective.

23. SYMPTOMS OF SWINE FLU IN HUMANS

24. Clinical findings Incubation period: 24-48 hours
Symptoms: fever, myalgias, headache, cough develop suddenly.
The symptoms resolve spontaneously in 4-7 days but sometimes is complicated with secondary infections.
Rey’s syndrome (Encephalopathy and liver degeneration life-threatening complication in children) following some viral infections, particularly influenza B and chikenpox, if they have been given Asprin to reduce the fever.

25. Pneumonia Respiratory failure
COMPLICATIONS
Pneumonia
Respiratory failure
Convulsion (muscles contract and relax rapidly and repeatedly, resulting in an uncontrolled shaking of the body)

26. When to Seek Emergency Medical Care
has difficulty breathing or chest pain
has purple or blue discoloration of the lips
is vomiting and unable to keep liquids down
has signs of dehydration such as dizziness when standing, absence of urination, or in infants, a lack of tears when they cry
has seizures (for example, uncontrolled convulsions)
is less responsive than normal

27. RISK GROUPS Persons with certain chronic medical condition
School children
Travelers to some high risk places
Border workers
Health care workers or public health workers

28. PREVENTION Prevention in swine or other animal hosts.
Prevention of transmission to humans.
Prevention of its spread among humans.

29. Prevention of its spread among humans.
Frequent washing of hands with soap and water

30. Use of face masks

31. Use of
towel while sneezing

32. Use of alcohol based sanitisers.

33. Lab diagnosis
Virus isolation (by throat washing) with cell culture. Then flurescent-antibody staining of the infected cells by using antisera to influenza A and B.
A rise in antibody titer of at least 4-fold in serum samples using hemmagglutination inhibition or complement fixation.
PCR reactions

34. TREATMENT supportive care is required. Bed Rest
Keep the sick person in a room separate from the common areas of the house.
Antibiotics (to treat this disease, do help prevent bacterial pneumonia and other secondary infections.)
Viral agent is used in severe infections.
(Zanamivir or Tamiflu is recommended by C.D.C.)

35. VACCINE
The current trivalent influenza vaccine is likely to provide protection against the new 2009 H1N1 strain.