Influenza
Influenza
Influenza rate occasionally causes pandemics the most famous being the one that occurred after World War one which was estimated killed 20 million people.
The most recent one was the swine flu pandemic a few years ago infant ER a is not just infection of humans it also infects animals such as pigs and is very prevalent in birds geese duck and chickens.
For example it's an RNA virus it's covered in a surface membrane and in that surface membrane are embedded two proteins here agglutinin and narara days those are important because they the structure of those proteins defines the type of virus you have.
There are only three main structural types which affect humans that's H 1 N 1 H 1 n 2 H 3 n 2 and most of the influenza that affects humans are some variations on those free types as I mentioned the human types cause winter epidemics and occasional pandemics in addition to the normal human types of influenza.
A virus you occasionally gain infection was even in front now these are viral types that affect birds but can spread from those birds to infect a human and they cause quite an aggressive disease and you've probably heard about avian influenza through the news because there is a lot of discussion about this as a cause of severe viral infection.
Fortunately this is sporadic infection and does not spread from the infected person to another infected person as yet and the most famous examples h5n1.
So, what are the clinical manifestations when friends of ours well these are created by the fact that it's a virus that infects and kills the spiritual epithelial cells.
If, somebody is infective influenza raid they will cough our virus particles those are inhaled by the next person to get infected and then they are invaded the FE yourselves replicated in epithelial cells and then eventually kill the epithelial cells releasing the viruses to infect more epithelial cells in the same person and also to get coughs back out into environment to cause infection and because of this ability to transmit between people readily that's just why the virus causes epidemics and pandemics the actual infection of the respiratory premium itself causes several distinct clinical problems.
Firstly, as I've mentioned already it causes a bronchitis, a cough phlegm production some systemic symptoms with feeling ill and fever but not infecting deep in the lungs just in the tracheobronchial tree and with that you may get a sore throat and the upper spirits tract symptoms or a runny nose etc occasionally device also causes gastroenteritis symptoms because it affects the gastrointestinal system and very rarely it can spread to causing and careful it is within the lung.
There are three main problems which cause deaths one is that the infection of the virus unfortunately weakens the immune system against bacteria and that means that influenza infection well our bacteria to get into the lungs and cause a secondary bacterial pneumonia and that is the main method by which the pandemics have caused death in the past.
In addition, the virus itself can spread to affect the alveoli and cause what we call primary very ammonia and these are don't generally speaking very aggressive and they are associated with a high mortality but they're relatively rare.
The normal winter epidemics unfortunately if, they affect somebody who's got chronic heart lung or kidney disease will cause the line disease to be to deteriorate to get worth it and so, in friends array is a common cause of exacerbations of COPD heart failure and renal impairment and that's associated with a high degree of morbidity and mortality.
So, what's the management inventory well for most people actually, we just clinically recognized they had in frontier, they take a couple of days off, work they get better if you need to if the patient's badly affected coming into a hospital for example then you would like to confirm the presence of in Firenze array and that can be done by a nasopharyngeal swab which can be tested using immunofluorescence antibodies against influenza antigens
Or the pin rays chain reaction to try and amplify the presence of influenza rate DNA and that will identify patients who have active infection and it's a very good test there's only really necessary in the high-risk patients.
If you're there being Ospital eyes if you have somebody with with infant array and you want to treat them the neuraminidase inhibitors which target that surface protein in there as in certain new amaura days will help patient recover from infection more quickly than if they were not given treatment itself.
It also probably reduces the chance of infection been transmitted to other people because of this risk of added superadded bacterial infection of the lung.
Some patients will need at antibiotics if there is a suspicion they may be directing about tearing ammonia a very important point that in Firenze array is those highly contagious and if somebody's in hospital in frontier, they need to be isolated so, they do not spread the disease to other people and because of this ability of the viral infection to upset the body's physiology and just cause exacerbations or underlying disease.
It's very dangerous even for Aundre is allowed to spread to other people within the hospital lastly and probably most critically is an infant or is a disease that could be prevented by vaccination.
In general and every year patients who are risk of disease or severe disease the elderly and those of underlying chronic disease such as COPD or heart failure should be vaccinated to prevent from getting that year's version of influenza rain.
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