Question

Group the three pathophysiological causes selected in your group under their appropriate physiological systems. Research on the current diagnostic and therapeutic procedure in place to address these leading pathophysiological causes. Explain the transport process involve in the diagnostic and therapeutic procedures in place to address the pathophysiological causes of death selected in your group Font must be 12 times new roman and two pages long for the write-up with an additional one page for reference. NB: Please do not plagiarize.

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Yesss

Diseases is influenza

Answer 1

Disease Influenza

Agent - Influenza virus ( H1N1)

1. Influenza virus belongs to the orthomyxoviridae family ( single-stranded RNA)
2. Based on the core nucleoproteins the virus is divided into A, B, and C
3. Hemagglutinin and neuraminidase antigen plays an important role in the pathogenesis of the disease
4. These antigens are used for typing the virus (Example - H1N1, H3N2, H5N1)
5. Hemagglutinin helps the virus to bind to the epithelial cell and neuraminidase helps in the spread of the virus. It helps release the newly formed virus from its parent and allows it to spread.
6. Influenza has the capacity to infect non-human hosts as well as Example - pigs (swine flu), birds (bird flu)
7. Antigenic shift - exchange of genetic material between two strains of influenza. These lead to the formation of a virus which highly infectious. Humans do not possess any immunity against this new virus. This virus has the potential to cause pandemics. Example - H1N1.
8. Antigenic drift - point mutation in the viral genes. The viral RNA polymerase lacks the ability of error-checking. This causes mutations and the new resultant virus is immune to the acquired immunity of the human host

Host factors -

1. All humans are susceptible to the virus
2. Swine and bird flu have the capacity to spread from animals to humans
3. the incubation period is 4 days
4. A victim spreads the virus 1 day before he becomes symptomatic and continues to spread it for 10 days
5. Children spread the virus longers. They are believed to spread the infection in the community
6. Immunocompromised (HIV, organ transplant recipients) and elderly spread it longers.
7. The portal of entry of the virus is the respiratory tract
8. The virus spreads through the agency of droplet infection (aerosols)

Environment-

1. Influenza occurs throughout the year
2. In the northern hemisphere, starts in autumn.

The diagnostic procedure

1. Real-time - Polymerase chain reaction test ( sensitivity -90%, turn-around time - 24hrs)
2. Rapid influenza diagnostic test - they identify the antigen in the sample ( sensitivity 62% and specificity 98%, turn-around time - 1 hr)
3. Viral isolation, direct immunofluorescence testing, and serological test - are labor-intensive and require complex machinery
4. Samples that can be used
   1. Nasopharyngeal swab - nylon/ dacron swab in 1-3ml of viral transport media
   2. Nasopharyngeal aspirate/ endotracheal aspirate
   3. Throat swabs
   4. The swabs are transported in the viral transport media*
   5. Viral transport media approved by WHO are
      1. COPAN universal transport media
      2. Eagle essential universal medium
      3. Locally prepared medium - 10g veal infusion broth + 2g bovine albumin fraction V in sterile water(400 ml). To this add 0.8 ml gentamicin sulfate (50mg/ml) and 3.2 ml amphotericin B (250mg/dl). This solution is sterilized by filtration.

Treatment -

Prevention

1. Regular influenza (antigenic) surveillance to improve disaster preparedness.
2. Immunization of vulnerable groups - children, pregnant women, elderly, immunocompromised
3. Isolation of cases
4. Quarantine of traveler.
5. Cough etiquette - covering your mouth while coughing and wearing a mask ( and regularly changing them)
6. Chemoprophylaxis - treatment with anti-viral (oseltamivir) for 10 days in people who have had contact with a confirmed case.

Treatment

1. Anti-virals -
   1. Neuraminidase inhibitor - Oseltamivir, peramivir, zanamivir
   2. cap-dependent endonuclease inhibitor - baloxavir marboxil
   3. adamantanes - amantadine and rimantadine ( only active against influenza type A, but type A (H3N2 is resistant to adamantanes)