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Influenza Timothy Wiemken, PhD MPH CIC Assistant Professor Division of Infectious Diseases University of Louisville

Published byStuart Roberts Modified over 9 years ago

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Presentation on theme: "Influenza Timothy Wiemken, PhD MPH CIC Assistant Professor Division of Infectious Diseases University of Louisville"— Presentation transcript:

1 Influenza Timothy Wiemken, PhD MPH CIC Assistant Professor Division of Infectious Diseases University of Louisville tim.wiemken@louisville.edu

2 Overview The influenza virus Influenza transmission Available Vaccines Vaccine Efficacy/Effectiveness

3 The Influenza Virus

4 Three types of influenza viruses A B C

5 The Influenza Virus Three types of influenza viruses Influenza A Separated into serotypes using Hemagglutinin and Neuraminidase 16 different H’s 9 different N’s

6 Influenza A Strains 1918-19 Severe 1957-58 Severe 1968-69 Moderate 1977-78 Mild 2009- 12 H1N1 Mild 1918 1950 1960 1970 1980 2000 2009 2012 H2N2H3N2 2009 H1N1 The Influenza Virus 2012- H3N2 H1N1

7 Influenza A Strains 1918-19 Severe 1957-58 Severe 1968-69 Moderate 1977-78 Mild 2009- 12 H1N1 Mild 1918 1950 1960 1970 1980 2000 2009 2012 H2N2H3N2 2009 H1N1 The Influenza Virus 2012- H3N2 H1N1

8 Influenza A Strains 1918-19 Severe 1957-58 Severe 1968-69 Moderate 1977-78 Mild 2009- 12 H1N1 Mild 1918 1950 1960 1970 1980 2000 2009 2012 H2N2H3N2 2009 H1N1 The Influenza Virus 2012- H3N2 H1N1

9 Influenza A Strains 1918-19 Severe 1957-58 Severe 1968-69 Moderate 1977-78 Mild 2009- 12 H1N1 Mild 1918 1950 1960 1970 1980 2000 2009 2012 H2N2H3N2 2009 H1N1 The Influenza Virus 2012- H3N2 H1N1

10 Influenza A Strains 1918-19 Severe 1957-58 Severe 1968-69 Moderate 1977-78 Mild 2009- 12 H1N1 Mild 1918 1950 1960 1970 1980 2000 2009 2012 H2N2H3N2 2009 H1N1 The Influenza Virus 2012- H3N2 H1N1

11 The Influenza Virus 65-6970-74 75-79 80-84 ≥85 50-64

12 The Influenza Virus Naming of influenza viruses 1.Antigenic type (A, B, C) 2.Host of Origin (unless human) 3.Geographical Origin 4.Strain Number 5.Year of Isolation 6.For A’s, H and N antigens

13 The Influenza Virus A/Perth/16/2009 (H3N2) Influenza A

14 The Influenza Virus A/Perth/16/2009 (H3N2) Influenza A No Host – Human!

15 The Influenza Virus A/Perth/16/2009 (H3N2) Influenza A No Host – Human! From Perth

16 The Influenza Virus A/Perth/16/2009 (H3N2) Influenza A No Host – Human! From Perth 16 th strain

17 The Influenza Virus A/Perth/16/2009 (H3N2) Influenza A No Host – Human! From Perth 16 th strain First isolated in 2009

18 The Influenza Virus A/Perth/16/2009 (H3N2) Influenza A No Host – Human! From Perth 16 th strain First isolated in 2009 Since it is Flu A, need H and N type, H3N2

19 The Influenza Virus B’s are named the same but don’t have subtypes Lineages are Victoria or Yamagata

20 The Influenza Virus

21 Overview The influenza virus Influenza transmission Available Vaccines Vaccine Efficacy/Effectiveness

22 Influenza Transmission Droplet Contact

23 Influenza Transmission

24 Overview The influenza virus Influenza transmission Available Vaccines Vaccine Efficacy/Effectiveness

25 Available Vaccines Trivalent (2 A’s, 1 B) Intramuscular Trivalent Intramuscular High Dose Trivalent Intradermal Quadrivalent (2A’s, 2 B’s) Intramuscular Quadrivalent Intranasal

26 Available Vaccines What should I use? When should I use it?

27 Available Vaccines CDC says whatever.

28 Available Vaccines Kids/around kids = quadrivalent –Intranasal (quadrivalent) HCW = quadrivalent Comorbidities = quadrivalent ≥65 = high dose

29 Available Vaccines Kids/around kids = quadrivalent –Intranasal (quadrivalent) HCW = quadrivalent Comorbidities = quadrivalent ≥65 = high dose In other words, don’t waste the quadrivalent on creepers.

30 Available Vaccines

31 Overview The influenza virus Influenza transmission Available Vaccines Vaccine Efficacy/Effectiveness

32 Efficacy: Did it work in the clinical trial versus placebo? Effectiveness: Does it work in real life? The numbers vary based on the outcome under study.

33 Vaccine Efficacy/Effectiveness Trivalent (2 A’s, 1 B) Intramuscular

34 Vaccine Efficacy/Effectiveness Trivalent (2 A’s, 1 B) Intramuscular Effectiveness for preventing ARI due to Flu Age GroupSubtypeVaccine Effectiveness (95% CI) OverallAll56% (47%-63%) OverallH3N247% (35%-58%) OverallB67% (51%-78%)

35 Vaccine Efficacy/Effectiveness Trivalent (2 A’s, 1 B) Intramuscular I heard it was 9% though?

36 Vaccine Efficacy/Effectiveness Trivalent (2 A’s, 1 B) Intramuscular I heard it was 9% though? For H3N2 only… for those over 65… –Effectiveness 9% –95% CI: -84% to 55% –~200 people only!!!

37 Available Vaccines Pop quiz How effective is the flu vaccine if you don’t receive it?

38 Vaccine Efficacy/Effectiveness Influenza B effectiveness… historically Season% B% Yamagata% VictoriaVaccine 2000–2001461000Yamagata 2001–2002132377Yamagata 2002–2003430.499.6Victoria 2003–20041937Victoria 2004–2005257426Yamagata 2005–2006192278Yamagata 2006–2007212477Victoria 2007–200829982Victoria 2008–2009331783Yamagata 2009–20100.21288Victoria 2010–201130694Victoria 2011–2012145149Victoria

39 Vaccine Efficacy/Effectiveness Quadrivalent (2 A’s, 2 B) Intramuscular

40 2009-2010 TIVQIV2008-2009 TIV H1N1H3N2B/BrisbaneB/Florida % Subjects Seroprotection = HAI titer ≥ 1:40 Striped bar represents strain not contained in each TIV Vaccine Efficacy/Effectiveness

41 Intranasal quadrivalent is essentially the same. Non-inferior to trivalent.

42 Overview The influenza virus Influenza transmission Available Vaccines Vaccine Efficacy/Effectiveness

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