Ce diaporama a bien été signalé.
Nous utilisons votre profil LinkedIn et vos données d’activité pour vous proposer des publicités personnalisées et pertinentes. Vous pouvez changer vos préférences de publicités à tout moment.

Influenza and influenza vaccine

5 986 vues

Publié le

  • Identifiez-vous pour voir les commentaires

Influenza and influenza vaccine

  2. 2. What is influenza?  Influenza, commonly known as “the flu”, is a highly contagious infection of the airways caused by influenza viruses.  It is often referred to as “seasonal” influenza because these viruses circulate annually in the winter season in the northern hemisphere.  The timing and duration of influenza season varies -outbreaks can happen as early as October but most often activity peaks in January or later.  Late season outbreaks occurring in April and even May have also been reported.
  3. 3. A, B and C influenza viruses  Influenza A and B viruses cause seasonal epidemics, while type C viruses cause mild respiratory illness  Influenza A viruses are classified into different strains or subtypes based on two proteins or antigens on the virus surface: hemagglutinin (H) and neuraminidase (N) e.g., H1N1 and H3N2  Influenza B viruses can be classified into two antigenically distinct lineages, Yamagata and Victoria like viruses  Influenza A and B strains are included in each year's influenza vaccine  The vaccine does not protect against influenza C
  4. 4. Signs and symptoms of influenza  Sudden onset  Typically starts with a headache, chills and cough, followed rapidly by fever, loss of appetite, muscle aches and fatigue, runny nose, sneezing, watery eyes and throat irritation  Nausea, vomiting and diarrhea may also occur, especially in children
  5. 5. How is influenza spread?  The virus is spread mainly from person to person when those with influenza cough or sneeze (droplet spread)  The droplets are propelled about 3 feet through the air  People may also become infected by touching an object or a surface that has the influenza virus on it and then touching their mouth, eyes or nose
  6. 6. Impact of Influenza-United States, 1990-1999  Approximately 36,000 influenza-associated deaths during each influenza season  Persons 65 years of age and older account for more than 90% of deaths  Higher mortality during seasons when influenza type A (H3N2) viruses predominate
  7. 7. Impact of Influenza-United States, 1990-1999  Highest rates of complications and hospitalization among young children and person 65 years and older  Average of more than 200,000 influenza-related excess hospitalizations  57% of hospitalizations among persons younger than 65 years of age  Greater number of hospitalizations during type A (H3N2) epidemics
  8. 8. Influenza vaccine development  Each February, the World Health Organization (WHO) provides a recommendation on the strains to be included in the influenza vaccine for the northern hemisphere  Two influenza "A" viruses and one influenza "B" virus are selected based on the characteristics of the current circulating influenza virus strains (two "B" viruses are selected for quadrivalent vaccines)  A new vaccine is reformulated each year to protect against new influenza infections  Each vaccine lot is tested on healthy individuals to ensure the vaccine is safe and effective
  9. 9. Influenza vaccine development (cont’d)  There are currently eight trivalent influenza vaccines licensed for use in Canada  Seven are trivalent inactivated influenza vaccine (TIV)  One is a live attenuated influenza vaccine (LAIV)  There are currently three quadrivalent influenza vaccines licensed for use in Canada  Two are quadrivalent inactivated influenza vaccine (QIV)  One is a live attenuated influenza vaccine (QLAIV)  For the 2014–2015 influenza immunization program, Alberta will be using three TIV products and one QLAIV product
  10. 10. How does inactivated influenza vaccine work?  Both humoral and cell-mediated responses play a role in immunity  Administration of inactivated influenza vaccine results in the production of circulating IgG antibodies to the viral haemagglutinin as well as a cytotoxic T lymphocyte response  Humoral antibody levels, which correlate with vaccine protection, are generally achieved 2 weeks after immunization and immunity usually lasts less than 1 year  Initial antibody response may be lower in the elderly and immune.
  11. 11. How does live attenuated influenza vaccine work?  Immune mechanisms conferring immunity following administration of live attenuated vaccine are not fully understood  Administered by the intranasal route, QLAIV is thought to result in an immune response that mimics that induced by natural infection with wild-type virus, developing both mucosal and systemic immunity  Serum antibodies, mucosal antibodies and influenza- specific T cells may play a role  The viral strains in QLAIV are engineered to be cold adapted (can only replicate in the nasopharynx), temperature sensitive (cannot replicate in the warm temperatures of the lower airways and lungs) and attenuated (unable to cause clinical disease)
  12. 12. Effectiveness of influenza vaccine  Vaccine effectiveness depends on the similarity between vaccine strains and the strains in circulation during influenza season  With a good "match," influenza immunization prevents disease in 70 to 90% of healthy individuals  This drops to 30 to 40% in the frail and elderly  It does, however, prevent death in 85% of the frail and elderly  It prevents hospitalization in 50 to 60% of individuals immunized  Even with an imperfect match, Canadian studies show the vaccine still reduces the overall risk of infection by about 40-60%  A vaccine that is not perfectly matched can still offer
  13. 13. Vaccine strains for 2014-2015  The strains that will be included in the 2014-2015 influenza vaccine for the Northern hemisphere are:  A/California/7/2009 (H1N1)pdm09-like virus  A/Texas/50/2012 (H3N2)-like virus  B/Massachusetts/2/2012-like virus  B/Brisbane/60/2008-like virus (B/Victoria lineage) (Quadrivalent QLAIV only)
  14. 14. Facts about trivalent inactivated influenza vaccine (TIV)  Is an inactivated (killed) vaccine –cannot cause influenza disease in the vaccine recipient  The virus is grown in hens’ eggs, inactivated, broken apart and highly purified  In addition to the antigen, the vaccine may contain:  Thimerosal (preservative in multidose vials)  Trace residual amounts of egg proteins, formaldehyde, kanamycin, neomycin, cetyl trimethyl ammonium bromide (CTAB), polysorbate 80, sodium deoxycholate and sucrose  Check the product monograph as ingredients vary with specific inactivated influenza vaccines
  15. 15. Facts about live attenuated influenza vaccine (QLAIV)  Is a live vaccine –cannot cause influenza disease in the vaccine recipient because the virus is attenuated or weakened (however is contraindicated in immuno compromised individuals)  The virus is grown in specific pathogen-free eggs from specific pathogen-free chicken flocks  In addition to the antigen, the vaccine may contain:  Trace residual amount of arginine, gelatin hydrolysate (porcine type A), gentamicin, monosodium glutamate, ovalbumin and sucrose  Check the product monograph for other product excipients
  16. 16. ages  6 months up to & including 8 years of age  2 doses  * if never been previously immunized with seasonal influenza vaccine (spaced 4 weeks apart –minimum interval)  1 dose only if previously immunized with seasonal influenza vaccine  9 years of age and older  1 dose  *This recommendation applies whether or not the child received monovalent pH1N1 vaccine in 2009-2010.
  17. 17. Reactions to inactivated influenza vaccine  The majority of people do not have a reaction to TIV; however some reactions that may occur are outlined below. These reactions generally start 6 to 12 hours after immunization and can last for 1 to 2 days  Common Reactions  Injection site redness, swelling, pain  Fatigue, headache, myalgia  Arthralgia, fever, chills, malaise
  18. 18. Reactions to live attenuated influenza vaccine  Most people have no reaction to QLAIV. If reactions occur they tend to be mild and last for 1-3 days, peaking 2 days following immunization.  Common Reactions  Runny, stuffy nose in children and adults  Children –decreased appetite, headache, weakness and fever  Adults –sore throat, headache, cough and weakness  For children requiring two doses of vaccine, the symptoms tend to be less frequent following the second dose.