Case Study Avian Influenza H5N1 Instructions
Be sure to carry out the following:
• Read the Case Study rubric carefully and provide all of the requested information and discussion questions/responses (use Google Scholar, PubMed, etc. to find information on vaccines, virulence factors, and the like including the scientific references)
• Make sure you have referenced everything and avoided any inadvertent plagiarism
• You should have at least 3-4 facts (with in-text references for these facts in proper format) for each of the boxed sections (Epidemiology, Pathogenesis, etc.).
• Try to have post-2019 references for your information/facts
• There is a standard format for patient presentation (see attached).
• Narrative format
• May use illustrative maps, patient photos, and figures which can convey some great information about a pathogen.
• please avoid the use of AI – the information is often incorrect, its writing style is boring, and it can often “hallucinate” (invent or conflate) references.
• How should I format my references for my case study?
• You will need references for all factual information in your case study. Pertinent references can be
• listed at the bottom of your outline in a small font. Your references must include at least three current
• peer-reviewed publications from the scientific literature post-2019. Use APA 7th Edition Style format
• for all references (a PDF document is provided with the case study directions).
• For example, your text book in-text citation would look like this (Anderson, Salm, & Beins, 2022) and
• your textbook would be shown on your reference page as:
• Anderson, D., Salm, S., & Beins, M. (2022). Microbiology: A Human Perspective. New
• York: McGraw-Hill.
How to create a case study
The case studies are meant to be an enjoyable, interesting, and informative assignment. This is your chance to show that you understand the key teaching points about a microbe and to communicate these points in a written format.
What information belongs in my case study?
• Have at least 3-4 key referenced points in each of the five areas shown in the Case Study Information Chart (see below).
• The left-hand heading in the chart suggests the type of information requested for the pathogen.
• Outlines can be in whatever form you prefer (bullets/charts/outlines/diagrams or a mix).
• Be sure to include two discussion questions (and provide thorough, complete answers) that you can incorporate into your case study (place them at the end of your write-up). These questions should help connect your case to other material in the course. For example, what other microbes have an endotoxin? What other viruses are transmitted by fecal-oral spread?
How much information should I provide for my case study?
• For the Case Study, you are asked to provide at least the information requested in the chart below.
• The boxed questions are suggestions for the minimum amount of information within each category.
• The more detailed the information, the better the study. You may consult your textbook, CDC, WHO, Access, Medicine, Google Scholar, Pub Med at NCBI, WebMD, etc. to find the information. For example, if you perform a Google search using the name of the pathogen and the word ‘vaccine’, you will find information on current vaccines (if any), those in clinical trials, vaccines used only in animals, etc.
Case Study Avian Influenza H5N1
Chief Complaint: “I got a really bad cold”
HPI: 46 y/o, make patient present to the emergency department complaining of flu-like symptoms for the last 2 days. Patient reports shortness of breath, persistent, acute cough, headache, sore throat, eye redness and discharge, nasal congestion, low grade fever, fatigue, and body aches. Patient reports symptoms have gotten progressively worse, which made him come to the ED today. Patient denies prior medical history. Denies previous surgeries. Patient states no one else is sick at home. Patient is married with two children. He works at a poultry farm, where he has daily exposure to live chickens and poultry meat.
Review of Symptoms:
Constitutional: Positive for fever, chills, fatigue, malaise.
HEENT: Positive for sore throat, nasal congestion, rhinorrhea, headache. Negative for ear pain or sinus pressure.
Eyes: Positive for redness, discharge, and vision changes.
Respiratory: Positive for non-productive cough, mild shortness of breath.
Cardiovascular: Negative for palpitations, chest pain.
Gastrointestinal: Denies nausea, vomiting, or diarrhea.
Musculoskeletal: Positive for myalgias, arthralgias, generalized body aches.
Skin: Negative for rash or lesions.
Neurological: Positive for headache. Negative for dizziness, weakness, numbness.
Psychiatric: Negative for confusion, anxiety, or depression.
Physical Exam:
General: Appears ill, fatigued. Febrile.
Vital Signs: Temp: 101.3°F, HR 110 bpm, RR: 24, BP 110/72 mmHg, O2 Sat 92 %
HEENT: Conjunctival injection, nasal congestion, rhinorrhea. Pharyngeal erythema without exudates.
Respiratory: Abnormal breath sounds: crackles audible in lungs bases, bilaterally.
Cardiovascular: Tachycardia, regular rate and rhythm, no murmurs.
Neurologic: Alert, awake and oriented x 3. No neuro deficits noted.
Laboratory Data/Imaging:
Upper respiratory Panel: Positive for Influenza A
RT-PCR: ordered, pending results
Chest X-ray: Diffuse, multifocal infiltrates, especially in lung bases, bilaterally.
CBC: Leukopenia, Thrombocytopenia, neutropenia. Elevated liver enzymes.
DOI: 10.1056/NEJMc2405371
https://www.nejm.org/doi/full/10.1056/NEJMc2405371
(Please address questions below)
Description of the infectious agent
• If it is a bacterium, how is it classified?
• If it is a virus, what kind of nucleic acid does it have?
• Does it target specific cellular types (tropism)?
• Does it form a spore?
• Is it aerobic?
• Is it intracellular?
• Can it only be grown in a specific type of media?
• How is it distinguished from other members of the species?
• Does the pathogen have a significant history with humans or animals?
Epidemiology
• What do you feel are the most important points about the epidemiology of the disease?
• Incidence? Portal of entry? Source?
• Is it a normal microbiota component in the human body?
• Does it only occur in certain populations or certain geographical areas?
• Is there a map of the disease’s current range or geographic occurence?
• Is there a vector involved?
• What and who is the vector? Is it zoonotic? Does it seasonally?
• Are there currently any outbreaks of this pathogen?
• What is its ecological niche?
• Is there a reservoir?
• Are there currently any outbreaks or epidemics of disease from this pathogen?
Pathogenesis
• What is the range of diseases caused by the agent?
• What organs are affected?
• What symptoms might the patient have?
• What is the disease course?
• Will the patient recover?
• Are there any long-term sequelae of infection?
• Latency?
Prophylaxis/Treatment
• Is there an antitoxin?
• Specific antibiotics or a class of antibiotics that are used?
• Is there a vaccine available?
• Is treatment curative?
• Does infection make you immune?
• Is this immunity life-long?
• Is there drug resistance?
• Are there novel treatments?
Discussion Questions With Responses
• Two (2) discussion questions with responses and scientific literature
references are required to complete the Case Study;
• These questions should help connect your case to other material in the course. For
example, what other microbes have an A-B toxin? What other viruses are transmitted by fecal-oral spread? Is this pathogen a candidate for use as a biological weapon?
References