Influenza

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	Section 1 Section 2 Section 3 Section 4 Section 5 Appendices

The following text is from an archived Red Book^® edition and may not reflect current recommendations or information. To view the current edition, click here.

Section 3. Summaries of Infectious Diseases

Influenza

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Influenza classically is characterizedby sudden onset of fever, often with chills or rigors, headache,malaise, diffuse myalgia, and a nonproductive cough. Subsequently,the respiratory tract signs of sore throat, nasal congestion,rhinitis, and cough become more prominent. Conjunctival injection,abdominal pain, nausea, and vomiting can occur. In some children,influenza can appear as an upper respiratory tract infectionor as a febrile illness with few respiratory tract signs. Inyoung infants, influenza can produce a sepsis-like picture andoccasionally can cause croup, bronchiolitis, or pneumonia. Acutemyositis characterized by calf tenderness and refusal to walkmay develop after several days of influenza illness, particularlywith type B infection. Reye syndrome has been associated withinfluenza infection, primarily with influenza B. Influenza canalter the metabolism of certain medications, especially theophylline,potentially resulting in the development of toxic effects fromhigh serum concentrations.

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ETIOLOGY: Influenza viruses are orthomyxoviruses of 3 antigenictypes (A, B, and C). Epidemic disease is caused by influenzavirus types A and B. Influenza A viruses are subclassified by2 surface antigens, hemagglutinin (HA) and neuraminidase (NA).Viruses bearing 3 immunologically distinct hemagglutinin subtypes(H1, H2, and H3) and 2 neuraminidase subtypes (N1 and N2) havebeen recognized as causing global human epidemics. Specificantibodies to these various antigens, especially hemagglutinin,are important determinants of immunity. Major changes leadingto the emergence of a new hemagglutinin, such as H1 to H2, oremergence of a new hemagglutinin or new neuraminidase, are calledantigenic shifts; minor antigenic variations within the samesubtypes are called antigenic drifts. Antigenic shift has occurredonly with influenza A, usually at irregular intervals of . . . [Go to Full Text]

Related text in Red Book:

Summary of Major Changes in the 2003 Red Book: Red Book 2003: xxv. [Extract] [Full Version]
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