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TRANSMISSION
• The virus spreads through droplets when infected
people cough, sneeze, or speak. These droplets
move towards the mucous membranes of the nose
and mouth of others.
• Every virus has a specific cell type that it attaches
to
• The virus surface proteins attach to the receptors
on the surface of human respiratory tract cells.
• An attachment forms in a key and lock fashion.
Statistics and Trends
CURRENT (TRIVALENT) VACCINE RECOMMENDATION FOR 2016-2017

• A/California/7/2009 (H1N1)pdm09-like virus,

• A/Hong Kong/4801/2014 (H3N2)-like virus and a
• B/Brisbane/60/2008-like virus (B/Victoria
lineage)
MOLECULAR BACKGROUND
• Antigenic shift occurred in 2009
• Obligate intracellular parasite (nonliving)
• Surface glycoproteins: HA (hemagglutine) and NA
(neuraminidase)
• HA is responsible for viral RNA release into the human cell
• NA is responsible for attachment into the mucus membrane and
also the release of virus particles from infected cells
STEPS ON VIRAL LIFE CYCLE
1) Attachment
2) Penetration (HA)
3) Uncoating and Targeting
4) Gene expression
5) Genome replication
6) Virion assembly
7) Release of virus
VIRAL REPLICATION
SIGNS AND SYMPTOMS


• Symptoms start 1 to 4 days after exposure

• Fever or feeling feverish/chills
• Cough
• Sore throat
• Runny or stuffy nose
• Muscle or body aches
• Headaches
• Weakness
• Diarrhea and vomiting might be seen in children
WHY DO YOU THESE SPECIFIC SYMPTOMS OCCUR?

• The virus attacks the respiratory system

• Ex: cough and sneezing,
• General well-being declines because your body
fights the virus
• Ex: weakness and body aches
COMPLICATIONS
• Young children, the geriatric population and
people who already have a low immune system
are likely to develop other serious conditions
that may require hospitalization
• Ex: pneumonia in patients who already have
chronic lung disease
 GENERAL DIAGNOSTIC PROCEDURE

• Questions the physician may ask you…

• Do you have a cough? Sore throat? Nausea and

vomiting? Watery and red eyes? Or other flu like
symptoms?

• Have you had contact with pigs or other people who

have?

• Comprised immune system?

 DIAGNOSTIC TESTS

• Multiple tests can be used to detect influenza

• Two main tests for H1N1: Rapid Influenza Diagnostic Tests

(RIDTs) and CDC Real-time reverse transcriptase-polymerase
chain reaction (rRT-PCR) Swine Flu Panel

• Others include: virus isolation in cell culture

 LAB TESTS

• RIDTs: Use immunoassays able to detect the presence of

influenza A and B viral nucleoprotein antigens from respiratory
specimens.

• rRT-PCR Swine Flu Panel: Use RT-PCR probe hydrolysis and in

vitro qualitative detection to detect.
 DIAGNOSTIC TESTING RESULTS
• RIDTs:

• Positive: detected an influenza viral antigen; blue control

line AND shade of pink-to-red test line

• Negative: does not exclude influenza virus infection; ONLY

blue Control Line

• rRT-PCR:

• Positive: infected with 2009 H1N1, but does not indicate

stage of infection

• Negative: does not rule out influenza virus infection

 CURRENT TREATMENT

• Influenza antiviral drugs

• Two recommended:
• Oseltamivir

• Zanamivir
 HOW DOES THE TREATMENT WORK?

• Oseltamivir: drug binds to virus enzyme and the

enzyme loses ability to cleave salic acid residues
(Oral).

• Zanamivir: Inhibits enzyme needed to spread the

virus (Inhaled).
ACTIVITY TIME!
REFERENCES
"2009 H1N1 Flu May Be More Serious for Some." Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention, n.d. Web. 20 Jan. 2017.
2009 H1N1 Flu (“Swine Flu”) and You. Retrieved from https://www.cdc.gov/h1n1flu/
qa.htm
"A viral nucleus." Virology blog. N.p., 19 Jan. 2017. Web. 20 Jan. 2017. http://www.virology.ws/
2009/04/30/structure-of-influenza-virus/
CDC protocol of realtime RTPCR for swine influenza A (H1N1). (April 28, 2009). Retrieved
from http://www.who.int/csr/resources/publications/swineflu/
CDCrealtimeRTPCRprotocol_20090428.pdf
Fact Sheet for Healthcare Providers: Interpreting CDC rRT-PCR Swine Influenza Detection
Panel Test Results. (December 18, 2009). Retrieved from http://www.fda.gov/
MedicalDevices/Safety/EmergencySituations/ucm195386.htm
"Flu Symptoms - When Influenza Symptoms Need Medical Help." WebMD. WebMD, n.d. Web.
20 Jan. 2017.
REFERENCES
"H1N1: Swine Flu." H1N1 Swine Flu. N.p., n.d. Web. 20 Jan. 2017. http://h1n1.net/viruses/virus-
lifecycle/.

"Influenza: Questions and Answers." Immunization Action Coalition. N.p., n.d. Web. 20 Jan. 2017.
http://www.immunize.org/catg.d/p4208.pdf.

Interim Guidance for the Detection of Novel Influenza A Virus Using Rapid Influenza Diagnostic
Tests. Retrieved from (August 10, 2009). https://www.cdc.gov/h1n1flu/guidance/
rapid_testing.htm

(January 18, 2017). Rapid Influenza Diagnostic Tests. Retrieved from https://www.cdc.gov/flu/
professionals/diagnosis/clinician_guidance_ridt.htm

Mayo Clinic Staff. Swine Flu (H1N1 flu). Retrieved from http://www.mayoclinic.org/diseases-
conditions/swine-flu/basics/definition/con-20034916
REFERENCES
Student Health Center Manuals. Rapid Flu Testing. Retrieved from http://shs-manual.ucsc.edu/
policy/rapid-flu-testing

Tamiflu. Oseltamivir. Retrieved from https://virus.stanford.edu/pox/2000/oseltamivir.html

Zanamivir. (n. d.). In Encyclopedia Britannica online. Retrieved from https://

www.britannica.com/science/zanamivir