1. PATHOPHYSIOLOGY OF INFLUENZA

2. Pathophysiology
Binding and destruction of epithelial cells from nasopharynx to alveoli
SYSTEMIC BODY REACTION
Fever, muscle pain, etc.
LOCAL INFLAMMATORY REACTION
Upper respiratory infection
Body
response
Droplets
Aymard M. Vaccine 1995: 47–70. 24

3. Uncomplicated influenza37 39 41
temperature (°C)
Oral 1 2 3 4 5 6 7 8 9 10
Time in days
(RMKTCID 50/ml)
LOG10 nasopharyngeal
virus titer
Incubation period
Virus isolation
Fever curve
Complications
Sore throat, myalgia
Headache
Cough
Malaise, prostration
Coryza
Onset of illness
Kilbourne ED. Influenza. New York: Plenum Medical Book Company; 1987: 156–218. 26

4. Overview – clinical symptoms
Abrupt onset of symptoms
Abrupt onset of fever, drop in temperature after 2 days, increase again
Severe myalgia
Sore throat
Dry cough
Retrosternal pain
Severe malaise lasting several days

5. Symptoms of influenza Percentage of cases Cough Malaise Feverishness10 20 30 40 50 60 70 80 90
100
Cough
Malaise
Feverishness
Sudden onset
Chills
Headache
Anorexia
Coryza
Myalgia
Sore throat
Sputum
Dizziness
Hoarseness
Chest pain
Vomiting
Diarrhoea
Abdominal pain
Fever > 37.8°C
Percentage of cases
Nicholson KG et al., eds. Textbook of Influenza. Malden, Massachusetts: Blackwell Science; 1998.

6. Fulminant influenza DEATH Reported during pandemics
The fulminant form can affect everyone
Pulmonary manifestation
Antibiotics are ineffective
Influenza viral pneumonia
Fever
Cough
Dyspnoea
Cyanosis
DEATH
Aymard M. Vaccine 1995: 47–70. 27

7. By courtesy of APACI Asia-Pacific Advisory Committee on influenza www
By courtesy of APACI Asia-Pacific Advisory Committee on influenza