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Influenza
Classification and external resources

TEM of negatively stained influenza virions, magnified approximately 100,000 times
ICD-10 J10., J11.
ICD-9 487
DiseasesDB 6791
MedlinePlus 000080
eMedicine med/1170 ped/3006
MeSH D007251
.Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae (the influenza viruses), that affects birds and mammals.^ The flu is caused by the influenza virus.
  • Clearwater,FL Influenza; Influenza (flu) is a viral infection . People ... 28 January 2010 0:00 UTC www.mpmhealth.com [Source type: FILTERED WITH BAYES]

^ Infectious disease: Vietnam's war on flu .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ It is caused by infection with RNA viruses of the family Orthomyxiviridae.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.The most common symptoms of the disease are chills, fever, sore throat, muscle pains, severe headache, coughing, weakness/fatigue and general discomfort.^ In humans, common symptoms of the disease are the chills , then fever , sore throat , muscle pains , severe headache , coughing , weakness and general discomfort .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The flu causes a fever, body aches, a headache, a dry cough, and a sore or dry throat.
  • Clearwater,FL Influenza; Influenza (flu) is a viral infection . People ... 28 January 2010 0:00 UTC www.mpmhealth.com [Source type: FILTERED WITH BAYES]

^ The disease often begins with fever and chills, accompanied by headache and sore throat, muscular pain, general bodily discomfort, loss of appetite, and a dry cough.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[1] .Sore throat, fever and coughs are the most frequent symptoms.^ It is a common respiratory illness that affects 30 to 50 million Americans each season, bringing headaches, fever, chills, muscle pains, exhaustion, a stuffy nose, sore throat, and a cough.

^ For this system, ILI is defined as fever (temperature of 100°F [37.8°C] or greater) and a cough and/or a sore throat in the absence of a KNOWN cause other than influenza.
  • CDC - Seasonal Influenza (Flu) - Flu Activity & Surveillance 16 September 2009 9:09 UTC www.cdc.gov [Source type: News]

^ Develop a sick leave policy that does not penalize sick employees, thereby encouraging employees who have influenza-related symptoms (e.g., fever, headache, cough, sore throat, runny or stuffy nose, muscle aches, or upset stomach) to stay home so that they do not infect other employees.
  • Guidance on Preparing Workplaces for an Influenza Pandemic 28 January 2010 0:00 UTC www.osha.gov [Source type: FILTERED WITH BAYES]

.In more serious cases, influenza causes pneumonia, which can be fatal, particularly for the young and the elderly.^ In rare cases, the flu may cause a more serious problem, such as pneumonia .
  • Clearwater,FL Influenza; Influenza (flu) is a viral infection . People ... 28 January 2010 0:00 UTC www.mpmhealth.com [Source type: FILTERED WITH BAYES]

^ In more serious cases, influenza causes pneumonia , which can be fatal, particularly in young children and the elderly.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza and its complications cause more than 100,000 hospitalizations and 20,000 deaths a year in the United States, especially in the very young, elderly, and in those with compromised immune systems or pre-existing lung disease.

.Although it is often confused with other influenza-like illnesses, especially the common cold, influenza is a much more severe disease than the common cold and is caused by a different type of virus.^ On the other hand, outbreaks in pigs are common and do not cause severe mortality.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Ideally, it has to be more pathogenic than other competing influenza strains.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Types of influenza virus .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[2] Influenza may produce nausea and vomiting, particularly in children,[1] but these symptoms are more common in the unrelated gastroenteritis, which is sometimes called "stomach flu" or "24-hour flu".[3]
.Typically, influenza is transmitted through the air by coughs or sneezes, creating aerosols containing the virus.^ The infection spreads through droplets (aerosols) that are generated by coughing or sneezing.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Influenza spreads by aerosols created by coughs or sneezes.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Typically influenza is transmitted from infected mammals through the air by coughs or sneezes, creating aerosols containing the virus, and from infected birds through their droppings .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Influenza can also be transmitted by direct contact with bird droppings or nasal secretions, or through contact with contaminated surfaces.^ Influenza can also be transmitted by saliva , nasal secretions , faeces and blood .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Most cases of H5N1 influenza infection in humans have resulted from contact with infected poultry or surfaces contaminated with secretions/excretions from infected birds.
  • Guidance on Preparing Workplaces for an Influenza Pandemic 28 January 2010 0:00 UTC www.osha.gov [Source type: FILTERED WITH BAYES]

^ How Influenza Can Spread Between People Influenza is thought to be primarily spread through large droplets (droplet transmission) that directly contact the nose, mouth or eyes.
  • Guidance on Preparing Workplaces for an Influenza Pandemic 28 January 2010 0:00 UTC www.osha.gov [Source type: FILTERED WITH BAYES]

.Airborne aerosols have been thought to cause most infections, although which means of transmission is most important is not absolutely clear.^ The most common and important causes of viral respiratory disease i ...
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

^ On clinical grounds it is difficult to make a clear distinction between infections caused by influenza viruses and those caused by other viruses or some bacteria.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Echinacea is generally thought to work by temporarily stimulating the immune system, although most (but not all) recent evidence has tended to cast doubt on this belief.

[4] .Influenza viruses can be inactivated by sunlight, disinfectants and detergents.^ Most influenza strains can be inactivated easily by disinfectants and detergents .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Psoralen inactivation of influenza and herpes simplex viruses and of virus-infected cells.

^ VI. Reactivation of influenza viruses after inactivation by ultraviolet light.

[5][6] .As the virus can be inactivated by soap, frequent hand washing reduces the risk of infection.^ Reduce the spread of the virus to people at high risk for severe complications of the flu ( high-risk groups ).
  • Clearwater,FL Influenza; Influenza (flu) is a viral infection . People ... 28 January 2010 0:00 UTC www.mpmhealth.com [Source type: FILTERED WITH BAYES]

^ This allows for the possibility of frequent infections in pigs with both human and bird strains of the virus.

^ Intranasal immunization with formalin-inactivated virus vaccine induces a broad spectrum of heterosubtypic immunity against influenza A virus infection in mice.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.Influenza spreads around the world in seasonal epidemics, resulting in the deaths of between &0000000000250000.000000250,000 and &0000000000500000.000000500,000 people every year,[7] and millions in pandemic years.^ Don’t people get the flu every year?
  • St. Lawrence University: University Communications 14 January 2010 14:46 UTC www.stlawu.edu [Source type: FILTERED WITH BAYES]

^ A pandemic occurs when a disease spreads rapidly between people all over the world.
  • St. Lawrence University: University Communications 14 January 2010 14:46 UTC www.stlawu.edu [Source type: FILTERED WITH BAYES]

^ Pandemic flu would be an influenza (flu) that has spread around the world.
  • St. Lawrence University: University Communications 14 January 2010 14:46 UTC www.stlawu.edu [Source type: FILTERED WITH BAYES]

.On average 41,400 people died each year in the United States between 1979 and 2001 from influenza.^ Influenza-associated hospitalizations in the United States ".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ People have suffered from influenza for thousands of years.

^ Deaths per 100,000 persons in each age group, United States, for the interpandemic years 1911–1917 (dashed line) and the pandemic year 1918 (solid line).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[8] .Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans.^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ It is impossible to predict which influenza strain will be the next pandemic virus.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Potential pandemic-an influenza virus in animals has infected people.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

.Often, these new strains appear when an existing flu virus spreads to humans from other animal species, or when an existing human strain picks up new genes from a virus that usually infects birds or pigs.^ This allows for the possibility of frequent infections in pigs with both human and bird strains of the virus.

^ Often, these new strains result from the spread of an existing flu virus to humans from other animal species .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ In contrast, the pig is a permissive host for both the human and bird strains.

.An avian strain named H5N1 raised the concern of a new influenza pandemic, after it emerged in Asia in the 1990s, but it has not evolved to a form that spreads easily between people.^ The current H5N1 strains in Asia, including t...
  • Early Detection of Highly Pathogenic Avian Influenza in Alaska: Workshop - January 18-19, 2006 Anchorage, AK 28 January 2010 0:00 UTC wildlifedisease.nbii.gov [Source type: Academic]

^ Strategies for containing an emerging influenza pandemic in Southeast Asia .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Fortunately, this virus has not mutated to a form that spreads easily between people.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[9] .In April 2009 a novel flu strain evolved that combined genes from human, pig, and bird flu, initially dubbed "swine flu" and also known as influenza A/H1N1, emerged in Mexico, the United States, and several other nations.^ Swine flu is properly titled H1N1 to label the viral strains.
  • St. Lawrence University: University Communications 14 January 2010 14:46 UTC www.stlawu.edu [Source type: FILTERED WITH BAYES]

^ The current swine flu outbreak was detected in April, 2009.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

^ One of those strains is H1N1, the formerly titled "swine" flu.
  • St. Lawrence University: University Communications 14 January 2010 14:46 UTC www.stlawu.edu [Source type: FILTERED WITH BAYES]

.The World Health Organization officially declared the outbreak to be a pandemic on June 11, 2009 (see 2009 flu pandemic).^ On June 11, WHO declared that a pandemic is under way.
  • St. Lawrence University: University Communications 14 January 2010 14:46 UTC www.stlawu.edu [Source type: FILTERED WITH BAYES]

^ The World Health Organization declared H1N1 as a pandemic event in June 2009.
  • St. Lawrence University: University Communications 14 January 2010 14:46 UTC www.stlawu.edu [Source type: FILTERED WITH BAYES]

^ WHO World Health Organization 2009f.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.The WHO's declaration of a pandemic level 6 was an indication of spread, not severity, the strain actually having a lower mortality rate than common flu outbreaks.^ On the other hand, outbreaks in pigs are common and do not cause severe mortality.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Pandemic flu is not a type of flu but is the way the flu spreads.
  • St. Lawrence University: University Communications 14 January 2010 14:46 UTC www.stlawu.edu [Source type: FILTERED WITH BAYES]

^ The first convincing record of an influenza pandemic was of an outbreak in 1580, which began in Asia and spread to Europe via Africa.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[10]
.Vaccinations against influenza are usually given to people in developed countries[11] and to farmed poultry.^ Vaccines have also been developed to protect poultry from avian influenza .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Vaccinations against influenza are usually given to people in developed countries with a high risk of contracting the disease [10] and to farmed poultry.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ We know the world-wide death toll exceeds a few hundred thousand people a year, but even in developed countries the numbers are uncertain, because medical authorities don't usually verify who actually died of influenza and who died of a flu-like illness."
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[12] .The most common human vaccine is the trivalent influenza vaccine (TIV) that contains purified and inactivated material from three viral strains.^ Improvement of inactivated influenza virus vaccines.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Influenza B and C strains have been isolated from human infections.

^ The most common human vaccine is the trivalent influenza vaccine that contains purified and inactivated material from three viral strains.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Typically, this vaccine includes material from two influenza A virus subtypes and one influenza B virus strain.^ Improvement of inactivated influenza virus vaccines.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Study on the purification of influenza virus vaccine.

^ Influenza virus grown in culture could be sent to a public health laboratory to determine if the strain of influenza A is the antigenic type (H5N1) found in birds and chickens.

[13] .The TIV carries no risk of transmitting the disease, and it has very low reactivity.^ Low or no reactivity of 'avian-like' swine viruses in HI tests with monoclonal antibodies raised against classical swine viruses was associated with amino acid substitut...
  • Early Detection of Highly Pathogenic Avian Influenza in Alaska: Workshop - January 18-19, 2006 Anchorage, AK 28 January 2010 0:00 UTC wildlifedisease.nbii.gov [Source type: Academic]

.A vaccine formulated for one year may be ineffective in the following year, since the influenza virus evolves rapidly, and new strains quickly replace the older ones.^ Improvement of inactivated influenza virus vaccines.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Typically, this vaccine includes material from two influenza A virus subtypes and one influenza B virus strain.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ A vaccine formulated for one year may be ineffective in the following year, since the influenza virus changes rapidly over time, and different strains become dominant.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Antiviral drugs can be used to treat influenza, with neuraminidase inhibitors being particularly effective.^ Use of the selective oral neuraminidase inhibitor oseltamivir to prevent influenza.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Neuraminidase inhibitors for influenza ".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Antiviral drugs can be used to treat influenza, with neuraminidase inhibitors being particularly effective.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

Contents

Classification

Types of influenza virus

.
Structure of the influenza virion.
^ Structure of the influenza virion .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.The hemagglutinin (HA) and neuraminidase (NA) proteins are shown on the surface of the particle.^ The hemagglutinin (HA or H) and neuraminidase (NA or N) proteins are targets for antiviral drugs .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Hemagglutinin (HA) and neuraminidase (NA) are the components that vary the most.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The hemagglutinin (HA) and neuraminidase (NA) proteins are shown on the surface of the particle.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

The viral RNAs that make up the genome are shown as red coils inside the particle and bound to Ribonuclear Proteins (RNPs).
In virus classification influenza viruses are RNA viruses that make up three of the five genera of the family Orthomyxoviridae:[14]
.These viruses are only distantly related to the human parainfluenza viruses, which are RNA viruses belonging to the paramyxovirus family that are a common cause of respiratory infections in children such as croup,[15] but can also cause a disease similar to influenza in adults.^ Respiratory infections are not always influenza .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ The most common and important causes of viral respiratory disease i ...
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

^ Equine influenza is a common respiratory infection.
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

[16]

Influenzavirus A

.This genus has one species, influenza A virus.^ Influenza A H1N1 virus infection, or within 7 days of travel to community either within the United States or internationally where there are one or more confirmed Influenza A H1N1 cases, or resides in a community where there are one or more confirmed Influenza A H1N1 cases.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

^ A rapid influenza antigen test to detect the virus in nasal secretions is one of the most common methods to diagnose this infection.

^ Influenza A viruses occur in a large variety of species, mainly birds, notably aquatic ones, in which infection is largely intestinal, waterborne, and asymptomatic.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.Wild aquatic birds are the natural hosts for a large variety of influenza A. Occasionally, viruses are transmitted to other species and may then cause devastating outbreaks in domestic poultry or give rise to human influenza pandemics.^ Wild aquatic birds are the natural hosts for a large variety of influenza A viruses.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza A viruses infect a large variety of animal species, including humans, pigs, horses, sea mammals and birds, occasionally producing devastating pandemics in humans, such as in 1918, when ov...
  • Early Detection of Highly Pathogenic Avian Influenza in Alaska: Workshop - January 18-19, 2006 Anchorage, AK 28 January 2010 0:00 UTC wildlifedisease.nbii.gov [Source type: Academic]

^ A variety of birds and mammals can be infected with influenza A and B viruses, naturally or in the laboratory (Kilbourne, 1987).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[17] .The type A viruses are the most virulent human pathogens among the three influenza types and cause the most severe disease.^ Influenza viruses, cell enzymes, and pathogenicity.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Its ability to cause severe disease in humans has now been documented on 2 occasions.

^ What determines virulence of influenza viruses?

.The influenza A virus can be subdivided into different serotypes based on the antibody response to these viruses.^ Isolation of influenza virus from a clinical specimen Detection of influenza virus nucleic acid in a clinical specimen Identification of influenza virus antigen by DFA test in a clinical specimen Influenza specific antibody response Sub typing of the influenza isolate should be performed, if possible .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Of the 3,175 pig sera tested, 8 (0.25%) were positive for avian H5N1 influenza viruses isolated in 2004 by virus neutralization assay and Western blot analysis.
  • Early Detection of Highly Pathogenic Avian Influenza in Alaska: Workshop - January 18-19, 2006 Anchorage, AK 28 January 2010 0:00 UTC wildlifedisease.nbii.gov [Source type: Academic]

^ This A(H1N1) virus is the result of a combination of two swine influenza viruses that contained genes of avian and human origin.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[18] The serotypes that have been confirmed in humans, ordered by the number of known human pandemic deaths, are:

Influenzavirus B

Influenza virus nomenclature (for a Fujian flu virus)
.This genus has one species, influenza B virus.^ Influenza A H1N1 virus infection, or within 7 days of travel to community either within the United States or internationally where there are one or more confirmed Influenza A H1N1 cases, or resides in a community where there are one or more confirmed Influenza A H1N1 cases.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

^ Influenza A viruses occur in a large variety of species, mainly birds, notably aquatic ones, in which infection is largely intestinal, waterborne, and asymptomatic.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The Virus Itself The pandemic in 1918 was hardly the first influenza pandemic, nor was it the only lethal one.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.Influenza B almost exclusively infects humans[18] and is less common than influenza A. The only other animals known to be susceptible to influenza B infection are the seal[20] and the ferret.^ Equine influenza is a common respiratory infection.
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

^ Influenza B and C strains have been isolated from human infections.

^ Influenza virus infections and immunity: A review of human and animal models.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[21] .This type of influenza mutates at a rate 2–3 times slower than type A[22] and consequently is less genetically diverse, with only one influenza B serotype.^ This type of influenza mutates at a rate 2–3 times lower than type A [33] and consequently is less genetically diverse, with only one influenza B serotype.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ According to WHO (reported in UpToDate), the H1N1 transmissibility appears substantially higher than that of seasonal influenza, with a secondary attack rate of the H1N1 strain estimated to be 22 to 33 percent, compared with 5 to 15 percent for seasonal influenza.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

^ In the 1918-19 Avian flu pandemic, the mortality was 2.5% -- 25 times the rate we see with the seasonal arrival of flu each year of one in a thousand or 0.1%.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

[18] .As a result of this lack of antigenic diversity, a degree of immunity to influenza B is usually acquired at an early age.^ As a result of this lack of antigenic diversity, a degree of immunity to influenza B is usually acquired at an early age.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The size of epidemics and pandemics are a direct result of antigenic variation of the virus, the amount of protective immunity in populations, and the relative virulence of the viruses.

^ As populations will have no immunity to the new subtype, and as no existing vaccines can confer protection, antigenic shift has historically resulted in highly lethal pandemics.

However, influenza B mutates enough that lasting immunity is not possible.[23] .This reduced rate of antigenic change, combined with its limited host range (inhibiting cross species antigenic shift), ensures that pandemics of influenza B do not occur.^ This reduced rate of antigenic change, combined with its limited host range (inhibiting cross species antigenic shift ), ensures that pandemics of influenza B do not occur.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Viral Polymerase Mediates Adaptation of an Avian Influenza Virus to a Mammalian Host 880 From article (online abstract only): Mammalian influenza viruses are descendants of avian strains that crossed the species barrier and underwent further adaptation.
  • Early Detection of Highly Pathogenic Avian Influenza in Alaska: Workshop - January 18-19, 2006 Anchorage, AK 28 January 2010 0:00 UTC wildlifedisease.nbii.gov [Source type: Academic]

^ For the 1918 pandemic, a herald wave that caused substantial mortality occurred at least 6 months before the OCR for page 105 The Threat of Pandemic Influenza: Are We Ready?
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[24]

Influenzavirus C

.This genus has one species, influenza C virus, which infects humans, dogs and pigs, sometimes causing both severe illness and local epidemics.^ Influenza A and C infect multiple species, while influenza B almost exclusively infects humans.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza sometimes associated with severe complications .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ "History of influenza epidemics and discovery of influenza virus".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[25][26] .However, influenza C is less common than the other types and usually only causes mild disease in children.^ Influenza is a common, usually mild infection in non-domestic waterfowl that can cause serious disease in domestic waterfowl and humans.

^ Equine Influenza Equine influenza is a common disease that causes acute respiratory signs.
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

^ Viral cultures are usually used to track flu outbreaks and to identify the particular strain that is causing them (sometimes the influenza will mutate enough to make the flu vaccine less effective and sometimes an unexpected flu strain will predominate).

[27][28]

Structure, properties, and subtype nomenclature

.Influenzaviruses A, B and C are very similar in overall structure.^ The following applies for influenza A viruses, although other strains are very similar in structure: [39] .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[29] .The virus particle is 80–120 nanometres in diameter and usually roughly spherical, although filamentous forms can occur.^ The influenza A virus particle or virion is 80–120 nm in diameter and usually roughly spherical, although filamentous forms can occur.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ They are spherical or filamentous in structure, ranging from 80 to 120 nm in diameter (Figure 4 and 5).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Comparative characteristics of spherical and filamentous virions of influenza virus type A. Vopr Virusol.

[30][31] .These filamentous forms are more common in influenza C, which can form cordlike structures up to 500 micrometres long on the surfaces of infected cells.^ When you sneeze your body is getting rid of infected cells and an average sneeze will spread over 100,000 virus cells up to 30 feet.

^ Equine Influenza Reported in China More than 5,500 horses in the Xinjiang autonomous region of China have equine influenza, according to a Nov.
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

^ Psoralen inactivation of influenza and herpes simplex viruses and of virus-infected cells.

[32] .However, despite these varied shapes, the viral particles of all influenza viruses are similar in composition.^ The effectiveness of these influenza vaccines is variable.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ However, because these viruses are so widespread, it is perhaps more accurate to say that colds are caused by a decrease in immunity that allows one of these viruses to take hold.

^ Avian influenza - Acute viral nasopharyngitis - Infectious mononucleosis - Influenza - Severe acute respiratory syndrome - Viral pneumonia - Human parainfluenza viruses - RSV - hMPV .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[32] .These are made of a viral envelope containing two main types of glycoproteins, wrapped around a central core.^ The core of the viral particle consists of ribonucleoproteins surrounded by a lipid envelope that contains two types of glycoproteins in the form of spikes.

^ The best-characterised of these viral proteins are hemagglutinin and neuraminidase , two large glycoproteins found on the outside of the viral particles.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Relatedness of viral core and envelope proteins is shown by similarity of color.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.The central core contains the viral RNA genome and other viral proteins that package and protect this RNA. RNA tends to be single stranded but in special cases it is double.^ The viral RNAs that make up the genome are shown as red coils inside the particle and bound to Ribonuclear Proteins (RNPs).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Other viral proteins have multiple actions in the host cell, including degrading cellular mRNA and using the released nucleotides for vRNA synthesis and also inhibiting translation of host-cell mRNAs.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Heterologous protection against influenza by injection of DNA encoding a viral protein.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[31] .Unusually for a virus, its genome is not a single piece of nucleic acid; instead, it contains seven or eight pieces of segmented negative-sense RNA, each piece of RNA containing either one or two genes.^ The influenza virus A and B genomes each consist of eight separate RNA segments.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ RNA genome segments of influenza virus.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Characterization of five of the eight RNA segments of the 1918 influenza virus indicates that it was the common ancestor of both subsequent human and swine H1N1 lineages, and experiments testing models of virulence using reverse genetics approaches with 1918 influenza genes have begun in hopes of identifying genetic features that confer virulence in humans.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[32] For example, the influenza A genome contains 11 genes on eight pieces of RNA, encoding for 11 proteins: hemagglutinin (HA), neuraminidase (NA), nucleoprotein (NP), M1, M2, NS1, NS2(NEP), PA, PB1, PB1-F2 and PB2.[33]
.Hemagglutinin (HA) and neuraminidase (NA) are the two large glycoproteins on the outside of the viral particles.^ The hemagglutinin (HA or H) and neuraminidase (NA or N) proteins are targets for antiviral drugs .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Hemagglutinin (HA) and neuraminidase (NA) are the components that vary the most.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The best-characterised of these viral proteins are hemagglutinin and neuraminidase , two large glycoproteins found on the outside of the viral particles.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.HA is a lectin that mediates binding of the virus to target cells and entry of the viral genome into the target cell, while NA is involved in the release of progeny virus from infected cells, by cleaving sugars that bind the mature viral particles.^ The neuraminidase facilitates release of viral progeny from infected cells as well as the spread of the virus from one cell to another.

^ NA is concerned with the release of progeny virions from the cell surface.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ By contrast, hemagglutinin is a lectin that mediates binding of the virus to target cells and entry of the viral genome into the target cell.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[34] .Thus, these proteins are targets for antiviral drugs.^ The guiding principal of any antiviral drug development is to inhibit viral replication, thus dramatically reducing the number of infectious particles.

^ This allows for antiviral drug design, targeting the active site without major concern regarding the development of resistance.

^ These workers should also receive antiviral drugs as a prophylactic measure.

[35] Furthermore, they are antigens to which antibodies can be raised. .Influenza A viruses are classified into subtypes based on antibody responses to HA and NA. These different types of HA and NA form the basis of the H and N distinctions in, for example, H5N1.^ Haemagglutinin mutations responsible for the binding of H5N1 influenza A viruses to human-type receptors .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ The nomenclature for influenza A reflects this, for example, H3N2 refers to HA of subtype 3 and NA of subtype 2.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ For example, influenza virus types A, B and C differ for both internal proteins and the HA and NA external glycoproteins.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[36] .There are 16 H and 9 N subtypes known, but only H 1, 2 and 3, and N 1 and 2 are commonly found in humans.^ All known subtypes (HxNy) are found in birds, but many subtypes are endemic in humans, dogs , horses , and pigs ; populations of camels , ferrets , cats , seals , mink , and whales also show evidence of prior infection or exposure to influenza.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ There is some evidence that only a limited number of antigenic types recirculate over time in human populations.

[37]

Replication

.
Host cell invasion and replication by the influenza virus.
^ Host cell invasion and replication by the influenza virus.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Promoted cell death of cells expressing human MxA by influenza virus infection.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Genomic analysis of increased host immune and cell death responses induced by 1918 influenza virus .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

The steps in this process are discussed in the text.
.Viruses can only replicate in living cells.^ It's only in the acid state that your body gets into that causes the growth of bacteria, viruses, fungus, molds, and cancer, cancer cells.
  •  Chemtrails flu influenza disease conspiracy Horowitz 14 January 2010 14:46 UTC www.bariumblues.com [Source type: Original source]

^ In birds, influenza viruses replicate in the epithelial cells of the gastrointestinal tract, and are excreted in great quantity into the environment.

[38] .Influenza infection and replication is a multi-step process: firstly the virus has to bind to and enter the cell, then deliver its genome to a site where it can produce new copies of viral proteins and RNA, assemble these components into new viral particles and finally exit the host cell.^ Block to influenza virus replication in cells preirradiated with ultraviolet light.

^ Host cell invasion and replication by the influenza virus.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Sequence-specific binding of the influenza virus RNA polymerase to sequences located at the 5' ends of the viral RNAs.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[32]
.Influenza viruses bind through hemagglutinin onto sialic acid sugars on the surfaces of epithelial cells; typically in the nose, throat and lungs of mammals and intestines of birds (Stage 1 in infection figure).^ Influenza viruses, cell enzymes, and pathogenicity.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Influenza viruses bind through hemagglutinin onto sialic acid sugars on the surfaces of epithelial cells ; typically in the nose, throat and lungs of mammals and intestines of birds (Stage 1 in infection figure).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Hemagglutinin (HA) is the viral glycoprotein that binds to the cell receptor, sialic acid.

[39] .After the hemagglutinin is cleaved by a protease, the cell imports the virus by endocytosis.^ The cell imports the virus by endocytosis .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The first stage of infection with the virus is mediated by the hemagglutinin (HA) membrane glycoprotein that allows for binding and fusion with host cells.

^ The mature virus buds off from the cell in a sphere of host phospholipid membrane, acquiring hemagglutinin and neuraminidase with this membrane coat (step 7).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[40]
.Once inside the cell, the acidic conditions in the endosome cause two events to happen: first part of the hemagglutinin protein fuses the viral envelope with the vacuole's membrane, then the M2 ion channel allows protons to move through the viral envelope and acidify the core of the virus, which causes the core to dissemble and release the viral RNA and core proteins.^ Relatedness of viral core and envelope proteins is shown by similarity of color.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Influenza A virus M2 ion channel protein: A structure-function analysis.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ It inhibits splicing of host cell M1 mRNA at the m3 5' site once it binds to the 5' end of the RNA. It permits binding of splicing factor 2 to purine-rich sequences in M1, and activates the sub-optimal M2 splice site.The PA, PB1, PB2, and NP proteins are transported to the host cell nucleus, first catalysing (+ ) strand RNAs, then (-) strand virion RNAs.

[32] .The viral RNA (vRNA) molecules, accessory proteins and RNA-dependent RNA polymerase are then released into the cytoplasm (Stage 2).^ In the acidic endosome , part of the hemagglutinin protein fuses the viral envelope with the vacuole's membrane, releasing the viral RNA (vRNA) molecules, accessory proteins and RNA-dependent RNA transcriptase into the cytoplasm (Stage 2).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The viral RNAs that make up the genome are shown as red coils inside the particle and bound to Ribonuclear Proteins (RNPs).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Other viral proteins have multiple actions in the host cell, including degrading cellular mRNA and using the released nucleotides for vRNA synthesis and also inhibiting translation of host-cell mRNAs.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[41] .The M2 ion channel is blocked by amantadine drugs, preventing infection.^ The antiviral drugs amantadine and rimantadine are designed to block a viral ion channel ( M2 protein ) and prevent the virus from infecting cells.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Amantadine and rimantadine have been used to help prevent and treat the flu caused by influenza A (but not influenza B) infection.
  • Clearwater,FL Influenza; Influenza (flu) is a viral infection . People ... 28 January 2010 0:00 UTC www.mpmhealth.com [Source type: FILTERED WITH BAYES]

^ Zanamivir or oseltamivir (used to treat and prevent influenza A and B infections) Amantadine or rimantadine (used to prevent or treat influenza A infections) What To Think About .
  • Clearwater,FL Influenza; Influenza (flu) is a viral infection . People ... 28 January 2010 0:00 UTC www.mpmhealth.com [Source type: FILTERED WITH BAYES]

[42]
.These core proteins and vRNA form a complex that is transported into the cell nucleus, where the RNA-dependent RNA polymerase begins transcribing complementary positive-sense vRNA (Steps 3a and b).^ The vRNA and viral core proteins leave the nucleus and enter this membrane protrusion (step 6).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ These proteins and vRNA form a complex that is transported into the cell nucleus , where the RNA-dependent RNA transcriptase begins transcribing complementary positive-sense vRNA (Steps 3a and b).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The viral core is then translocated into the nucleus where replication begins.

[43] .The vRNA is either exported into the cytoplasm and translated (step 4), or remains in the nucleus.^ The vRNA is either exported into the cytoplasm and translated (step 4), or remains in the nucleus.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Newly-synthesised viral proteins are either secreted through the Golgi apparatus onto the cell surface (in the case of neuraminidase and hemagglutinin, step 5b) or transported back into the nucleus to bind vRNA and form new viral genome particles (step 5a).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The vRNA and viral core proteins leave the nucleus and enter this membrane protrusion (step 6).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Newly synthesised viral proteins are either secreted through the Golgi apparatus onto the cell surface (in the case of neuraminidase and hemagglutinin, step 5b) or transported back into the nucleus to bind vRNA and form new viral genome particles (step 5a).^ The vRNA and viral core proteins leave the nucleus and enter this membrane protrusion (step 6).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ By contrast, hemagglutinin is a lectin that mediates binding of the virus to target cells and entry of the viral genome into the target cell.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Newly-synthesised viral proteins are either secreted through the Golgi apparatus onto the cell surface (in the case of neuraminidase and hemagglutinin, step 5b) or transported back into the nucleus to bind vRNA and form new viral genome particles (step 5a).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Other viral proteins have multiple actions in the host cell, including degrading cellular mRNA and using the released nucleotides for vRNA synthesis and also inhibiting translation of host-cell mRNAs.^ Synthesis of influenza virus protein in the inhibition of cellular DNA transcription.

^ It inhibits splicing of host cell M1 mRNA at the m3 5' site once it binds to the 5' end of the RNA. It permits binding of splicing factor 2 to purine-rich sequences in M1, and activates the sub-optimal M2 splice site.The PA, PB1, PB2, and NP proteins are transported to the host cell nucleus, first catalysing (+ ) strand RNAs, then (-) strand virion RNAs.

^ As soon as the virion encounters an epithelial cell of the respiratory tract, a receptor on the surface of that host cell interacts with the haemaggultinin on the surafce of the viral particle.

[44]
.Negative-sense vRNAs that form the genomes of future viruses, RNA-dependent RNA polymerase, and other viral proteins are assembled into a virion.^ Negative-sense vRNAs that form the genomes of future viruses, RNA-dependent RNA transcriptase, and other viral proteins are assembled into a virion.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ In the acidic endosome , part of the hemagglutinin protein fuses the viral envelope with the vacuole's membrane, releasing the viral RNA (vRNA) molecules, accessory proteins and RNA-dependent RNA transcriptase into the cytoplasm (Stage 2).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The viral RNAs that make up the genome are shown as red coils inside the particle and bound to Ribonuclear Proteins (RNPs).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Hemagglutinin and neuraminidase molecules cluster into a bulge in the cell membrane.^ Hemagglutinin and neuraminidase molecules cluster into a bulge in the cell membrane.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ In the acidic endosome , part of the hemagglutinin protein fuses the viral envelope with the vacuole's membrane, releasing the viral RNA (vRNA) molecules, accessory proteins and RNA-dependent RNA transcriptase into the cytoplasm (Stage 2).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The first stage of infection with the virus is mediated by the hemagglutinin (HA) membrane glycoprotein that allows for binding and fusion with host cells.

.The vRNA and viral core proteins leave the nucleus and enter this membrane protrusion (step 6).^ The vRNA and viral core proteins leave the nucleus and enter this membrane protrusion (step 6).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ In the acidic endosome , part of the hemagglutinin protein fuses the viral envelope with the vacuole's membrane, releasing the viral RNA (vRNA) molecules, accessory proteins and RNA-dependent RNA transcriptase into the cytoplasm (Stage 2).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Newly-synthesised viral proteins are either secreted through the Golgi apparatus onto the cell surface (in the case of neuraminidase and hemagglutinin, step 5b) or transported back into the nucleus to bind vRNA and form new viral genome particles (step 5a).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.The mature virus buds off from the cell in a sphere of host phospholipid membrane, acquiring hemagglutinin and neuraminidase with this membrane coat (step 7).^ Genomic analysis of increased host immune and cell death responses induced by 1918 influenza virus .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Global host immune response: Pathogenesis and transcriptional profiling of type A influenza viruses expressing the hemagglutinin and neuraminidase genes from the 1918 pandemic virus.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Effect of ultraviolet irradiation and formalin on the antigenic properties of the hemagglutinin and neuraminidase from the influenza A/-Victoria/72 virus.

[45] .As before, the viruses adhere to the cell through hemagglutinin; the mature viruses detach once their neuraminidase has cleaved sialic acid residues from the host cell.^ As before, the viruses adhere to the cell through hemagglutinin; the mature viruses detach once their neuraminidase has cleaved sialic acid residues from the host cell.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The mature virus buds off from the cell in a sphere of host phospholipid membrane, acquiring hemagglutinin and neuraminidase with this membrane coat (step 7).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza viruses bind through hemagglutinin onto sialic acid sugars on the surfaces of epithelial cells ; typically in the nose, throat and lungs of mammals and intestines of birds (Stage 1 in infection figure).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[39] .Drugs that inhibit neuraminidase, such as oseltamivir, therefore prevent the release of new infectious viruses and halt viral replication.^ Avian influenza - Acute viral nasopharyngitis - Infectious mononucleosis - Influenza - Severe acute respiratory syndrome - Viral pneumonia - Human parainfluenza viruses - RSV - hMPV .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Use of the selective oral neuraminidase inhibitor oseltamivir to prevent influenza.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Since it is completely new, people are naturally not immune protected against it at all, and therefore such a virus variant can lead to a widespread influenza pandemic.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[35] .After the release of new influenza viruses, the host cell dies.^ Influenza viruses, cell enzymes, and pathogenicity.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ After the release of new influenza viruses, the host cell dies.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ New technologies are also being developed to grow viruses in cell culture , which promises higher yields, less cost, better quality and surge capacity.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Because of the absence of RNA proofreading enzymes, the RNA-dependent RNA polymerase that copies the viral genome makes an error roughly every 10 thousand nucleotides, which is the approximate length of the influenza vRNA. Hence, the majority of newly manufactured influenza viruses are mutants; this causes "antigenic drift", which is a slow change in the antigens on the viral surface over time.^ RNA genome segments of influenza virus.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Influenza viruses, cell enzymes, and pathogenicity.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ From time to time new influenza A or B virus variants emerge due to genetic changes in the virus that cause alterations in the antigens on the surface of the virus (antigenic drift).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[46] .The separation of the genome into eight separate segments of vRNA allows mixing or reassortment of vRNAs if more than one type of influenza virus infects a single cell.^ The influenza virus A and B genomes each consist of eight separate RNA segments.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ RNA genome segments of influenza virus.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Types of influenza virus .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.The resulting rapid change in viral genetics produces antigenic shifts, which are sudden changes from one antigen to another.^ The resulting rapid change in viral genetics produces antigenic shifts and allows the virus to infect new host species and quickly overcome protective immunity.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ From time to time new virus variants emerge due to genetic changes in the virus that cause alterations in the antigens on the surface of the virus (antigenic drift).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ As populations will have no immunity to the new subtype, and as no existing vaccines can confer protection, antigenic shift has historically resulted in highly lethal pandemics.

.These sudden large changes allow the virus to infect new host species and quickly overcome protective immunity.^ The resulting rapid change in viral genetics produces antigenic shifts and allows the virus to infect new host species and quickly overcome protective immunity.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ While the number of horses and properties infected with the virus in New South Wales and Queensland has continued to grow, EI has not spread to other Australian states.
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

^ From time to time new virus variants emerge due to genetic changes in the virus that cause alterations in the antigens on the surface of the virus (antigenic drift).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[36] This is important in the emergence of pandemics, as discussed below in the section on Epidemiology.

Signs and symptoms

Most sensitive symptoms for diagnosing influenza[47]
Symptom: sensitivity specificity
Fever 68–86% 25–73%
Cough 84–98% 7–29%
Nasal congestion 68–91% 19–41%
  • All three findings, especially fever, were less sensitive in patients over 60 years of age.
.
Symptoms of influenza,[48], with fever and cough the most common symptoms.
^ "Understanding the symptoms of the common cold and influenza".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Common symptoms of the flu such as fever, headaches, and fatigue come from the huge amounts of proinflammatory cytokines and chemokines (such as interferon or tumor necrosis factor ) produced from influenza-infected cells.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Symptoms of influenza A(H1N1) virus in humans are usually similar to regular human seasonal influenza symptoms, involving fever of sudden onset and respiratory symptoms; diarrhoea might also occur.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[47]
.Symptoms of influenza can start quite suddenly one to two days after infection.^ Symptoms of influenza can start quite suddenly one to two days after infection.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Most people who get influenza will recover in one to two weeks, but others will develop life-threatening complications (such as pneumonia ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza A H1N1 virus infection, or within 7 days of travel to community either within the United States or internationally where there are one or more confirmed Influenza A H1N1 cases, or resides in a community where there are one or more confirmed Influenza A H1N1 cases.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

.Usually the first symptoms are chills or a chilly sensation, but fever is also common early in the infection, with body temperatures ranging from 38-39 °C (approximately 100-103 °F).^ Symptoms of influenza A(H1N1) virus in humans are usually similar to regular human seasonal influenza symptoms, involving fever of sudden onset and respiratory symptoms; diarrhoea might also occur.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ One major complication to controlling the disease is the fact that flu, during the early phase of the infection, is often confused with the common cold.

^ Influenza is a common, usually mild infection in non-domestic waterfowl that can cause serious disease in domestic waterfowl and humans.

[49] .Many people are so ill that they are confined to bed for several days, with aches and pains throughout their bodies, which are worse in their backs and legs.^ Many people are so ill that they are confined to bed for several days, with aches and pains throughout their bodies, which are worst in their backs and legs.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ For several days there were no coffins and the bodies piled up something fierce….
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Note: In most of these studies, participants used vitamin C throughout the cold season, and found that when they developed colds, the colds were less severe.

[1] Symptoms of influenza may include:
.It can be difficult to distinguish between the common cold and influenza in the early stages of these infections,[2] but a flu can be identified by a high fever with a sudden onset and extreme fatigue.^ Equine influenza is a common respiratory infection.
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

^ "Understanding the symptoms of the common cold and influenza".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Upper respiratory tract infection - Common cold - Rhinitis - Sinusitis - Pharyngitis ( Strep throat ) - Tonsillitis - Laryngitis - Tracheitis - Croup - Epiglottitis .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Diarrhea is not normally a symptom of influenza in adults,[47] although it has been seen in some human cases of the H5N1 "bird flu"[53] and can be a symptom in children.^ First human deaths from 'bird flu' .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Influenza A H5N1 replication sites in humans.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Flu symptoms in birds are variable and can be unspecific.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[50] .The symptoms most reliably seen in influenza are shown in the table to the right.^ In its most highly pathogenic form, influenza in chickens and turkeys produces a sudden appearance of severe symptoms and almost 100% mortality within two days.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[47]
.Since antiviral drugs are effective in treating influenza if given early (see treatment section, below), it can be important to identify cases early.^ Recently, new antiviral drugs for prevention and treatment of influenza have been developed.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Since anti-viral drugs are effective in treating influenza if given early (see treatment section, below), it can be important to identify cases early.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Antiviral drugs can be used to treat influenza, with neuraminidase inhibitors being particularly effective.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Of the symptoms listed above, the combinations of fever with cough, sore throat and/or nasal congestion can improve diagnostic accuracy.^ Of the symptoms listed above, the combinations of findings below can improve diagnostic accuracy.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ In humans, common symptoms of the disease are the chills , then fever , sore throat , muscle pains , severe headache , coughing , weakness and general discomfort .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The greatest response was seen in earache, sleeplessness, nasal drainage, and sore throat, but other cold symptoms improved as well.

[54] .Two decision analysis studies[55][56] suggest that during local outbreaks of influenza, the prevalence will be over 70%,[56] and thus patients with any of these combinations of symptoms may be treated with neuraminidase inhibitors without testing.^ Tests on viruses obtained from patients in Mexico and the United States have indicated that the 2009 novel influenza virus A(H1N1) is sensitive to neuraminidase inhibitors, but that the virus is resistant to the other class of drugs, the adamantanes ( WHO, 2009g ).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ The effect of a previous attack of Al influenza on susceptibility to A2 virus during the 1957 outbreak.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract ( Sambucus nigra L. ) during an outbreak of influenza B Panama.

.Even in the absence of a local outbreak, treatment may be justified in the elderly during the influenza season as long as the prevalence is over 15%.^ These tests may be especially useful during the influenza season (prevalence=25%) but in the absence of a local outbreak, or peri-influenza season (prevalence=10% [57] ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Even in the absence of a local outbreak, treatment may be justified in the elderly during the influenza season as long as the prevalence is over 15%.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Projected during influenza season (prevalence=25%) .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[56]
.The available laboratory tests for influenza continue to improve.^ The available laboratory tests for influenza continue to improve.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The specimens are sent to the national reference laboratory and are tested for influenza viruses (if positive, subtypes are determined) and other respiratory viruses.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ The pretest probability has a strong seasonal variation; the current prevalence of influenza among patients in the United States receiving sentinel testing is available at the CDC .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.The United States Centers for Disease Control and Prevention (CDC) maintains an up-to-date summary of available laboratory tests.^ CDC Centers for Disease Control and Prevention 2009a.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Travel advisories For updated information about travel advisories, see the United States Centers for Disease Control and Prevention website ( http://wwwn.cdc.gov/travel/ ) and/or the World Health Organization website ( http://www.who.int/csr/disease/swineflu/en/index.html ).
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

^ Although it is uncertain as to where the first wave in the spring of 1918 originated, all available evidence indicates that it appeared in the United States in March of 1918.

[57] .According to the CDC, rapid diagnostic tests have a sensitivity of 70–75% and specificity of 90–95% when compared with viral culture.^ According to the CDC, rapid diagnostic tests have a sensitivity of 70–75% and specificity of 90–95% when compared with viral culture.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Rapid diagnostic tests have already been developed and distributed to state health departments by the CDC, based on real-time reverse transcriptase (RT)-PCR. Test results can be available within several hours.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

^ IDEXX noted that its R. equi test uses PCR methods that are more rapid and sensitive than culture, and can identify virulent R. equi.
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

.These tests may be especially useful during the influenza season (prevalence=25%) but in the absence of a local outbreak, or peri-influenza season (prevalence=10%[56]).^ These tests may be especially useful during the influenza season (prevalence=25%) but in the absence of a local outbreak, or peri-influenza season (prevalence=10% [57] ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Even in the absence of a local outbreak, treatment may be justified in the elderly during the influenza season as long as the prevalence is over 15%.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Seasonal outbreaks occur especially during the cold seasons.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

Mechanism

Transmission

Sneezing can transmit influenza.
.People who contract influenza are most infective between the second and third days after infection, and infectivity lasts for around ten days.^ People who contract influenza are most infective between the second and third days after infection and infectivity lasts for around ten days.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Most people who get influenza will recover in one to two weeks, but others will develop life-threatening complications (such as pneumonia ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[58] .Children are much more infectious than adults and shed virus from just before they develop symptoms until two weeks after infection.^ Children are notably more infectious than adults and shed virus from just before they develop symptoms until two weeks after infection.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ In addition, more than ten other studies performed in developing countries have found that zinc supplements at nutritional doses can increase resistance to respiratory and other infection in children, and that they might reduce symptom severity.

^ Most people who get influenza will recover in one to two weeks, but others will develop life-threatening complications (such as pneumonia ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[58][59] .The transmission of influenza can be modeled mathematically, which helps predict how the virus will spread in a population.^ However, if we translate the death toll associated with the 1918 influenza virus to the current population, there could be 180 million to 360 million deaths globally ( Osterholm 2005 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ With influenza virus, extensive genetic variation leads to the problem that different dominant viral strains circulate in the human population each year (Figure 5-1).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Influenza virus transmission is dependent on relative humidity and temperature ".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[60]
.Influenza can be spread in three main ways:[61][62] by direct transmission (when an infected person sneezes mucus directly into the eyes, nose or mouth of another person); the airborne route (when someone inhales the aerosols produced by an infected person coughing, sneezing or spitting) and through hand-to-eye, hand-to-nose, or hand-to-mouth transmission, either from contaminated surfaces or from direct personal contact such as a hand-shake.^ Spread by direct contact may also occur.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ The infection spreads through droplets (aerosols) that are generated by coughing or sneezing.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Spread of infection is by direct contact.

.The relative importance of these three modes of transmission is unclear, and they may all contribute to the spread of the virus.^ Thai dogs carry bird-flu virus, but will they spread it?
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ In all three pandemics in the twentieth century, the majority of associated deaths occurred 6 months to a year after the pandemic virus first emerged.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ And then you sell these beleaguered and defeated countries all of the pharmaceuticals and chemicals that they need to maintain any semblance of healthy function.
  •  Chemtrails flu influenza disease conspiracy Horowitz 14 January 2010 14:46 UTC www.bariumblues.com [Source type: Original source]

[4][63] .In the airborne route, the droplets that are small enough for people to inhale are 0.5 to 5 µm in diameter and inhaling just one droplet might be enough to cause an infection.^ A cold is a respiratory infection caused by one of hundreds of possible viruses.

^ If it was a bacterial or viral infection, it would have caused a fever in these people.
  •  Chemtrails flu influenza disease conspiracy Horowitz 14 January 2010 14:46 UTC www.bariumblues.com [Source type: Original source]

^ While there may be airborne transmission, droplets are probably a significant route and the one that individuals can best protect against through good hygiene practices.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

[61] .Although a single sneeze releases up to 40,000 droplets,[64] most of these droplets are quite large and will quickly settle out of the air.^ When you sneeze your body is getting rid of infected cells and an average sneeze will spread over 100,000 virus cells up to 30 feet.

[61] .How long influenza survives in airborne droplets seems to be influenced by the levels of humidity and UV radiation: with low humidity and a lack of sunlight in winter aiding its survival.^ He proposed that the cause of influenza epidemics during winter may be connected to seasonal fluctuations of vitamin D, which is produced in the skin under the influence of solar (or artificial) UV radiation .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Highly pathogenic avian viruses can survive in the environment for long periods, especially in low temperatures (i.e., in manure-contaminated water).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Highly pathogenic viruses can survive for long periods in the environment, especially when temperatures are low.

[61]
.As the influenza virus can persist outside of the body, it can also be transmitted by contaminated surfaces such as banknotes,[65] doorknobs, light switches and other household items.^ These constraints and other extraneous factors, such as the microbial contamination of vaccines manufactured in the past year in the UK , leaves influenza vaccine technology currently in a state of disconnect with imminent pandemic threats and the corresponding health demands.

^ Vaccines elicit immune responses that attack the neuraminidase and haemagglutinin proteins found on the surface of the influenza virus.

^ Human transmission to swine Preliminary reports suggest that the new H1N1 influenza virus has been transmitted from a farm worker in Alberta, Canada, to a herd of swine.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

[1] .The length of time the virus will persist on a surface varies, with the virus surviving for one to two days on hard, non-porous surfaces such as plastic or metal, for about fifteen minutes from dry paper tissues, and only five minutes on skin.^ But a friend suggested I try the nasal flush and even upon first usage I knew this was a powerful tool, and have since combatted back cold after cold (in about six months only one cold has burst through the nasal flush barrier, but that cold only survived about 3 days, compared to the two or three weeks that cold usually bombard me).
  • Fight the Flu Naturally 16 September 2009 9:09 UTC www.truthseek.net [Source type: General]

^ Most people who get influenza will recover in one to two weeks, but others will develop life-threatening complications (such as pneumonia ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ From time to time new virus variants emerge due to genetic changes in the virus that cause alterations in the antigens on the surface of the virus (antigenic drift).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[66] .However, if the virus is present in mucus, this can protect it for longer periods (up to 17 days on banknotes).^ However, at least 4 months would be needed to produce a new vaccine, in significant quantities, capable of conferring protection against a new virus subtype.

^ In water, the virus can survive for up to four days at 22 C, and more than 30 days at 0C. In frozen material, the virus probably survives indefinitely.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Ducks have recently been shown to be able to excrete highly pathogenic H5N1 strains for up to 17 days ( Hulse Post 2005 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[61][65] .Avian influenza viruses can survive indefinitely when frozen.^ Avian influenza - Acute viral nasopharyngitis - Infectious mononucleosis - Influenza - Severe acute respiratory syndrome - Viral pneumonia - Human parainfluenza viruses - RSV - hMPV .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ This strain is unusual in that it appears to be a cross between swine Influenza A H1N1 viruses found in North America, Asia, and Europe, as well as North American avian influenza viruses, and human influenza viruses.
  • Influenza A H1N1 - Medpedia 28 January 2010 0:00 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

^ Avian-to-human transmission of the PB1 gene of influenza A viruses in the 1957 and 1968 pandemics.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[67] They are inactivated by heating to 56 °C (133 °F) for a minimum of 60 minutes, as well as by acids (at pH <2).[67]

Pathophysiology

.
The different sites of infection (shown in red) of seasonal H1N1 versus avian H5N1.
^ Avian influenza A (H5N1) infection in humans.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Avian influenza A viruses differ from human viruses by recognition of sialyloigosaccharides and gangliosides and by a higher conservation of the HA receptor-binding site.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

This influences their lethality and ability to spread.
.The mechanisms by which influenza infection causes symptoms in humans have been studied intensively.^ Influenza B and C strains have been isolated from human infections.

^ Avian influenza A (H5N1) infection in humans.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The frequency of animal diseases are not as well-studied as human infection, but an outbreak of influenza in harbour seals caused approximately 500 seal deaths off the New England coast in 1979–1980.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

One of the mechanisms is believed to be the inhibition of adrenocorticotropic hormone (ACTH) resulting in lowered cortisol levels.[68] .Knowing which genes are carried by a particular strain can help predict how well it will infect humans and how severe this infection will be (that is, predict the strain's pathophysiology).^ Influenza B and C strains have been isolated from human infections.

^ We do not know how severe it will be.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[26][69]
.For instance, part of the process that allows influenza viruses to invade cells is the cleavage of the viral hemagglutinin protein by any one of several human proteases.^ Influenza viruses, cell enzymes, and pathogenicity.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Enhancement of the infectivity of influenza A and B viruses by proteolytic cleavage of the hemagglutinin polypeptide.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Intracellular warfare between human influenza viruses and human cells: The roles of the viral NS1 protein.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[40] .In mild and avirulent viruses, the structure of the hemagglutinin means that it can only be cleaved by proteases found in the throat and lungs, so these viruses cannot infect other tissues.^ C. Human infection with avian influenza viruses: a timeline Avian influenza viruses do not normally infect species other than birds and pigs.

^ All these subtypes infect aquatic birds, and human pandemic viruses have arisen from avian viruses by reassortment (Webster, 2002).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Avian species are considered the predominant natural hosts for viruses composed of other glycoprotein subtypes (see diagram) although a variety of animal species have been infected with various viruses.

.However, in highly virulent strains, such as H5N1, the hemagglutinin can be cleaved by a wide variety of proteases, allowing the virus to spread throughout the body.^ This allows for the possibility of frequent infections in pigs with both human and bird strains of the virus.

^ Immunity to previous pandemic influenza strains and vaccination may have limited the spread of the virus and may have helped prevent further pandemics.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The polymerase complex genes contribute to the high virulence of the human H5N1 influenza virus isolate A/Vietnam/1203/04.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[69]
.The viral hemagglutinin protein is responsible for determining both which species a strain can infect and where in the human respiratory tract a strain of influenza will bind.^ Influenza A and C infect multiple species, while influenza B almost exclusively infects humans.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza B and C strains have been isolated from human infections.

^ In humans, viral replication is restricted to the respiratory tract.

[70] .Strains that are easily transmitted between people have hemagglutinin proteins that bind to receptors in the upper part of the respiratory tract, such as in the nose, throat and mouth.^ Other diseases of upper respiratory tract .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Upper respiratory tract infection - Common cold - Rhinitis - Sinusitis - Pharyngitis ( Strep throat ) - Tonsillitis - Laryngitis - Tracheitis - Croup - Epiglottitis .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The current person-to-person capability of the virulent H5N1 is extremely low or non-existent, due to the fact that the hemagglutinin molecule is not configured properly to interact with human cell surface receptor proteins of the respiratory tract.

.In contrast, the highly-lethal H5N1 strain binds to receptors that are mostly found deep in the lungs.^ Noteworthy is the fact that humans do not have any immunity to H5, hence this strain is highly pathogenic, and in many cases lethal.

^ This highly virulent strain of chicken influenza, H5N1, was of avian origin and had not re-assorted with human viruses, infecting humans in direct contact with those domestic fowl.

^ Ducks have recently been shown to be able to excrete highly pathogenic H5N1 strains for up to 17 days ( Hulse Post 2005 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[71] .This difference in the site of infection may be part of the reason why the H5N1 strain causes severe viral pneumonia in the lungs, but is not easily transmitted by people coughing and sneezing.^ Avian viral strain H9N2 in 1998 also caused human infection.

^ Avian influenza - Acute viral nasopharyngitis - Infectious mononucleosis - Influenza - Severe acute respiratory syndrome - Viral pneumonia - Human parainfluenza viruses - RSV - hMPV .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[72][73]
.Common symptoms of the flu such as fever, headaches, and fatigue are the result of the huge amounts of proinflammatory cytokines and chemokines (such as interferon or tumor necrosis factor) produced from influenza-infected cells.^ Common symptoms of the flu such as fever, headaches, and fatigue come from the huge amounts of proinflammatory cytokines and chemokines (such as interferon or tumor necrosis factor ) produced from influenza-infected cells.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ "Understanding the symptoms of the common cold and influenza".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Body aches, especially joints and throat Coughing and sneezing Extreme coldness and fever Fatigue Headache Irritated watering eyes Nasal congestion Reddened eyes, skin (especially face), mouth, throat and nose Abdominal pain (in children with influenza B) [52] It can be difficult to distinguish between the common cold and influenza in the early stages of these infections, [2] but usually the symptoms of the flu are more severe than their common cold equivalents.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[2][74] .In contrast to the rhinovirus that causes the common cold, influenza does cause tissue damage, so symptoms are not entirely due to the inflammatory response.^ In contrast to the rhinovirus that causes the common cold , influenza does cause tissue damage, so symptoms are not entirely due to the inflammatory response.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ "Understanding the symptoms of the common cold and influenza".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Dorn M. Plant immunostimulant alleviates symptoms of the common cold.

[75] .This massive immune response might produce a life-threatening cytokine storm.^ These mechanisms might ultimately lead to a cytokine storm and death ( Peiris 2004 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.This effect has been proposed to be the cause of the unusual lethality of both the H5N1 avian influenza,[76] and the 1918 pandemic strain.^ "The geography and mortality of the 1918 influenza pandemic.".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The effect of public health measures on the 1918 influenza pandemic in U.S. cities ".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The geography and mortality of the 1918 influenza pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[77][78] .However, another possibility is that these large amounts of cytokines are just a result of the massive levels of viral replication produced by these strains, and the immune response does not itself contribute to the disease.^ However, in another trial, a multivitamin tablet without minerals actually worsened participants' response to the vaccine.

^ Often, these new strains result from the spread of an existing flu virus to humans from other animal species .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The best-characterised of these viral proteins are hemagglutinin and neuraminidase , two large glycoproteins found on the outside of the viral particles.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[79]

Prevention

Vaccination

Giving an influenza vaccination.
.Vaccination against influenza with an influenza vaccine is often recommended for high-risk groups, such as children and the elderly, or in people who have asthma, diabetes, heart disease, or are immuno-compromised.^ Vaccination of people outside the risk groups .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ How effective is influenza vaccination in the elderly?
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Vaccination is especially recommended for groups at risk for complications following influenza such as the elderly and people with chronic medical conditions, such as lung and heart disease, and people whose immune systems are weak.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.Influenza vaccines can be produced in several ways; the most common method is to grow the virus in fertilized hen eggs.^ Improvement of inactivated influenza virus vaccines.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Vaccination is the most effective way to prevent influenza .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Influenza vaccines can be produced in several ways; the most common method is to grow the virus in fertilized hen eggs.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.After purification, the virus is inactivated (for example, by treatment with detergent) to produce an inactivated-virus vaccine.^ Improvement of inactivated influenza virus vaccines.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ After purification, the virus is inactivated (for example, by treatment with detergent) to produce an inactivated-virus vaccine.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Intranasal immunization with formalin-inactivated virus vaccine induces a broad spectrum of heterosubtypic immunity against influenza A virus infection in mice.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.Alternatively, the virus can be grown in eggs until it loses virulence and the avirulent virus given as a live vaccine.^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ For the vast majority of the 6.5 billion living human beings, there will be no vaccine available any time soon after the arrival of a new pandemic influenza virus.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Recombitek Equine Influenza Virus vaccine is proven against a recent, highly virulent American strain of equine influenza (N/5/03) and helps stop the spread of ...
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

[36] .The effectiveness of these influenza vaccines are variable.^ The effectiveness of these influenza vaccines is variable.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ How effective is influenza vaccination in the elderly?
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Influenza vaccination is effective and cost saving .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.Due to the high mutation rate of the virus, a particular influenza vaccine usually confers protection for no more than a few years.^ Improvement of inactivated influenza virus vaccines.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Due to the high mutation rate of the virus, a particular influenza vaccine usually confers protection for no more than a few years.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ It attracted very little attention because pneumonic complications were few and deaths even fewer; it appeared as no more than just another bout with the kind of respiratory disease that so often circulates during that time of the year.

.Every year, the World Health Organization predicts which strains of the virus are most likely to be circulating in the next year, allowing pharmaceutical companies to develop vaccines that will provide the best immunity against these strains.^ It is impossible to predict which influenza strain will be the next pandemic virus.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Every year, the World Health Organization predicts which strains of the virus are most likely to be circulating in the next year, allowing pharmaceutical companies to develop vaccines that will provide the best immunity against these strains.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Frequently, these vaccines are based on the previous year's strains.

[80] .Vaccines have also been developed to protect poultry from avian influenza.^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Vaccination of persons at high risk of exposure to infected poultry, using existing vaccines effective against currently circulating human influenza strains, can reduce the likelihood of co-infection of humans with avian and influenza strains, and thus reduce the risk that genes will be exchanged.

^ Protective CD4+ and CD8+ T-cells against influenza virus induced by vaccination with nucleoprotein DNA. Virology 72:5648–5653.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.These vaccines can be effective against multiple strains and are used either as part of a preventative strategy, or combined with culling in attempts to eradicate outbreaks.^ The effectiveness of these influenza vaccines is variable.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ These vaccines can be effective against multiple strains and are used either as part of a preventative strategy, or combined with culling in attempts to eradicate outbreaks.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[81]
.It is possible to get vaccinated and still get influenza.^ It is possible to get vaccinated and still get influenza.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Although influenza vaccinations begin in October, vaccination in December and beyond is still beneficial; influenza activity usually does not peak in the United States until December--March (3).

^ There are still chances, however, that people who are vaccinated will get influenza but the chance of complications and mortality is lower ( Wang et al., 2007 ).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.The vaccine is reformulated each season for a few specific flu strains but cannot possibly include all the strains actively infecting people in the world for that season.^ The vaccine is reformulated each season for a few specific flu strains but cannot possibly include all the strains actively infecting people in the world for that season.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Will a seasonal flu vaccine aid me in fighting the flu?
  • Fight the Flu Naturally 16 September 2009 9:09 UTC www.truthseek.net [Source type: General]

^ The new viral strain will eventually reach everywhere, and will infect practically every human being within a period of a few years.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.It takes about six months for the manufacturers to formulate and produce the millions of doses required to deal with the seasonal epidemics; occasionally, a new or overlooked strain becomes prominent during that time and infects people although they have been vaccinated (as by the H3N2 Fujian flu in the 2003–2004 flu season).^ Will a seasonal flu vaccine aid me in fighting the flu?
  • Fight the Flu Naturally 16 September 2009 9:09 UTC www.truthseek.net [Source type: General]

^ Nearly everyone catches colds occasionally, but some people catch colds quite frequently, and others tend to stay sick an unusually long time.

^ It is therefore reasonable to assume that the vast majority of people living today will have no access to either vaccine or antiviral drugs for many, many months.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[82] .It is also possible to get infected just before vaccination and get sick with the very strain that the vaccine is supposed to prevent, as the vaccine takes about two weeks to become effective.^ Recovery takes about one to two weeks.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ It is also possible to get infected just before vaccination and get sick with the very strain that the vaccine is supposed to prevent, as the vaccine takes about two weeks to become effective.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ There is however a debate about how effective the influenza vaccine in elderly really is.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[83]
.The 2006–2007 season was the first in which the CDC had recommended that children younger than 59 months receive the annual influenza vaccine.^ The 2006–2007 season was the first in which the CDC had recommended that children younger than 59 months receive the annual influenza vaccine.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Recommended composition of influenza virus vaccines for use in the 2006-2007 northern hemisphere influenza season.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The European Commission has adopted recommendations regarding seasonal influenza vaccination.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[84] .Vaccines can cause the immune system to react as if the body were actually being infected, and general infection symptoms (many cold and flu symptoms are just general infection symptoms) can appear, though these symptoms are usually not as severe or long-lasting as influenza.^ The usual influenza symptoms .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Vaccines can cause the immune system to react as if the body were actually being infected, and general infection symptoms (many cold and flu symptoms are just general infection symptoms) can appear, though these symptoms are usually not as severe or long-lasting as influenza.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ "Understanding the symptoms of the common cold and influenza".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.The most dangerous side-effect is a severe allergic reaction to either the virus material itself or residues from the hen eggs used to grow the influenza; however, these reactions are extremely rare.^ Influenza vaccines can be produced in several ways; the most common method is to grow the virus in fertilized hen eggs.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ As unpredictable as influenza pandemics are, as unpredictable is the virus itself.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The most dangerous side-effect is a severe allergic reaction to either the virus material itself or residues from the hen eggs used to grow the influenza; however, these reactions are extremely rare.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[85]
.In addition to vaccination against seasonal influenza, researchers are working to develop a vaccine against a possible influenza pandemic.^ It is possible to get vaccinated and still get influenza.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Research - Vaccine - Avian influenza - Treatment - Genome sequencing - Season .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Governments worldwide have spent billions of U.S. dollars preparing and planning for a potential H5N1 avian influenza pandemic, with costs associated with purchasing drugs and vaccines as well as developing disaster drills and strategies for improved border controls .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.The rapid development, production, and distribution of pandemic influenza vaccines could potentially save millions of lives during an influenza pandemic.^ Influenza vaccination is effective and cost saving .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ From lethal virus to life-saving vaccine: developing inactivated vaccines for pandemic influenza .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ In all three pandemics in the twentieth century, the majority of associated deaths occurred 6 months to a year after the pandemic virus first emerged, suggesting that intense and timely surveillance of both age-specific mortality and new influenza viruses could provide sufficient time for production and distribution of vaccines and antivirals to prevent much, if not most, of the mortality impact.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.Due to the short time frame between identification of a pandemic strain and need for vaccination, researchers are looking at non-egg-based options for vaccine production.^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The efficacy of interventions, such as vaccines and antivirals, during pandemics needs to be studied and proven beforehand as much as possible in order to make such interventions available in time.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ As it happens, in the short span of time between 1997 and 2004, five influenza outbreaks have occurred in which some people contracted their illnesses directly from birds.
  • Fight the Flu Naturally 16 September 2009 9:09 UTC www.truthseek.net [Source type: General]

.Live attenuated (egg-based or cell-based) technology and recombinant technologies (proteins and virus-like particles) could provide better "real-time" access and be produced more affordably, thereby increasing access for people living in low- and moderate-income countries, where an influenza pandemic may likely originate.^ An influenza pandemic is caused by an influenza virus that is new to people.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ As unpredictable as influenza pandemics are, as unpredictable is the virus itself.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Death by influenza virus protein .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

.As of July 2009, more than 70 known clinical trials have been completed or are ongoing for pandemic influenza vaccines.^ The epidemiology and clinical impact of pandemic influenza.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Generation and evaluation of a high-growth reassortant H9N2 influenza A virus as a pandemic vaccine candidate.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[86] .In September 2009, the US Food and Drug Administration approved four vaccines against the 2009 H1N1 influenza virus (the current pandemic strain), and expect the initial vaccine lots to be available within the following month.^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ WHO Europe Pandemic (H1N1) 2009 .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ It is impossible to predict which influenza strain will be the next pandemic virus.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[87]

Infection control

.Reasonably effective ways to reduce the transmission of influenza include good personal health and hygiene habits such as: not touching your eyes, nose or mouth[88]; frequent hand washing (with soap and water, or with alcohol-based hand rubs)[89]; covering coughs and sneezes; avoiding close contact with sick people; and staying home yourself if you are sick.^ U.S. Navy personnel receiving influenza vaccination Good personal health and hygiene habits are reasonably effective in avoiding and minimizing influenza.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Efficacy of soap and water and alcohol-based hand-rub preparations against live H1N1 influenza virus on the hands of human volunteers.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Since influenza spreads through aerosols and contact with contaminated surfaces, it is important to persuade people to cover their mouths while sneezing and to wash their hands regularly.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

Avoiding spitting is also recommended.[90]
.Although face masks might help prevent transmission when caring for the sick,[91][92] there is mixed evidence on beneficial effects in the community.^ In addition, another double-blind study found preliminary evidence that oral consumption of a green tea extract might help prevent both colds and flus.

^ Face mask use and control of respiratory virus transmission in households.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ There are also prescription antiviral medications that can help prevent flu and also reduce its length and severity if you do come down with it.

[90][93] .Smoking raises the risk of contracting influenza, as well as producing more severe disease symptoms.^ For more information about seasonal influenza symptoms see European Union definition of influenza and Definition and scope .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ In humans, common symptoms of the disease are the chills , then fever , sore throat , muscle pains , severe headache , coughing , weakness and general discomfort .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract ( Sambucus nigra L. ) during an outbreak of influenza B Panama.

[94][95][96][97][98] .Thus, according to the laws of mathematical modelling of infectious diseases, smokers raise the exponential growth rates of influenza epidemics and may indirectly be responsible for a large percentage of influenza cases.^ An optimization model for influenza A epidemics.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ According to Biosecurity Queensland's Chief Veterinary Officer Ron Glanville said the number of influenza cases is now quickly winding down.
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

^ Courtesy: National Institute of Allergy and Infectious Disease In contrast to epidemics, pandemics are rare events that occur every 10 to 50 years.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.Since influenza spreads through both aerosols and contact with contaminated surfaces, surface sanitizing may help prevent some infections.^ The infection spreads through droplets (aerosols) that are generated by coughing or sneezing.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ General hygiene measures are applied to determine contamination or spread of infections with influenza prevention.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ All birds are thought to be susceptible to infection with avian influenza, though some species are more resistant to infection than others.

[99] .Alcohol is an effective sanitizer against influenza viruses, while quaternary ammonium compounds can be used with alcohol so that the sanitizing effect lasts for longer.^ Alcohol is an effective sanitizer against influenza viruses, while quaternary ammonium compounds can be used with alcohol to increase the duration of the sanitizing action.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The M2 ion channel blockers or adamantanes (amantadine and rimantadine) have been available since the sixties of the previous century, however, its use is limited because of rapid development of resistance, serious adverse effects, and being only active against influenza A viruses.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ In hospitals, quaternary ammonium compounds and halogen-releasing agents such as sodium hypochlorite are commonly used to sanitize rooms or equipment that have been occupied by patients with influenza symptoms.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[100] .In hospitals, quaternary ammonium compounds and bleach are used to sanitize rooms or equipment that have been occupied by patients with influenza symptoms.^ In hospitals, quaternary ammonium compounds and halogen-releasing agents such as sodium hypochlorite are commonly used to sanitize rooms or equipment that have been occupied by patients with influenza symptoms.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Alcohol is an effective sanitizer against influenza viruses, while quaternary ammonium compounds can be used with alcohol to increase the duration of the sanitizing action.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[100] At home, this can be done effectively with a diluted chlorine bleach.[101]
.During past pandemics, closing schools, churches and theaters slowed the spread of the virus but did not have a large effect on the overall death rate.^ That did not happen during the pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Prophylaxis was economically beneficial in high-risk subpopulations, which account for 78 % of deaths, and in pandemics in which the death rate was > 0.6 %.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ In 13 studies of hospitalized pregnant women during the 1918 pandemic, the death rate ranged from 23 to 71 percent (Jordon, 1927:273).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[102][103] .It is uncertain if reducing public gatherings, by for example closing schools and workplaces, will reduce transmission since people with influenza may just be moved from one area to another; such measures would also be difficult to enforce and might be unpopular.^ In Philadelphia, when the public health commissioner closed all schools, houses of worship, theaters, and other public gathering places, one newspaper went so far as to say that this order was “not a public health measure” and reiterated that “there is no cause for panic or alarm.” But as people heard these reassurances, they could see neighbors, friends, and spouses dying horrible deaths.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Most people who get influenza will recover in one to two weeks, but others will develop life-threatening complications (such as pneumonia ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Since it is completely new, people are naturally not immune protected against it at all, and therefore such a virus variant can lead to a widespread influenza pandemic.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[90] .When small numbers of people are infected, isolating the sick might reduce the risk of transmission.^ The results showed that E. purpurea was associated with perhaps a 20% decrease in the number of people who got sick, and E. angustifolia with a 10% decrease.

^ In addition, a decrease in the number of persons per household has probably resulted in a reduced transmission rate and spread of the influenza virus.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ In addition, the number of people in risk groups increases due to improvements in the (early) diagnosis by GP’s of diseases such as diabetes mellitus and cardiovascular disease.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[90]

Treatment

.People with the flu are advised to get plenty of rest, drink plenty of liquids, avoid using alcohol and tobacco and, if necessary, take medications such as acetaminophen (paracetamol) to relieve the fever and muscle aches associated with the flu.^ Further information: Influenza treatment People with the flu are advised to get plenty of rest, drink a lot of liquids, avoid using alcohol and tobacco and, if necessary, take medications such as paracetamol (acetaminophen) to relieve the fever and muscle aches associated with the flu.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The predominant symptoms of flu are fever, malaise, and muscle aches.

^ Influenza is sometimes associated with severe complications such as pneumonia, worsening of chronic medical conditions, acute otitis media and sinus problems in children.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[104] .Children and teenagers with flu symptoms (particularly fever) should avoid taking aspirin during an influenza infection (especially influenza type B), because doing so can lead to Reye's syndrome, a rare but potentially fatal disease of the liver.^ Children and teenagers with flu symptoms (particularly fever) should avoid taking aspirin during an influenza infection (especially influenza type B ), because doing so can lead to Reye's syndrome , a rare but potentially fatal disease of the liver .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Body aches, especially joints and throat Coughing and sneezing Extreme coldness and fever Fatigue Headache Irritated watering eyes Nasal congestion Reddened eyes, skin (especially face), mouth, throat and nose Abdominal pain (in children with influenza B) [52] It can be difficult to distinguish between the common cold and influenza in the early stages of these infections, [2] but usually the symptoms of the flu are more severe than their common cold equivalents.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Common symptoms of the flu such as fever, headaches, and fatigue come from the huge amounts of proinflammatory cytokines and chemokines (such as interferon or tumor necrosis factor ) produced from influenza-infected cells.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[105] .Since influenza is caused by a virus, antibiotics have no effect on the infection; unless prescribed for secondary infections such as bacterial pneumonia.^ Since then, the virus has caused numerous pandemics.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Antibiotic treatment should be reserved for the treatment of secondary bacterial pneumonia.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Since influenza is caused by a virus, antibiotics have no effect on the infection; unless prescribed for secondary infections such as bacterial pneumonia , they may lead to resistant bacteria.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Antiviral medication can be effective, but some strains of influenza can show resistance to the standard antiviral drugs.^ Antiviral drugs, some of which can be used for both treatment and prevention, are clinically effective against influenza A virus strains in otherwise healthy adults and children, but have some limitations.

^ All birds are thought to be susceptible to infection with avian influenza, though some species are more resistant to infection than others.

^ To this purpose, the WHO has recently started creating an international stockpile of 3 million courses of antiviral drugs to be dispatched to the area of an emerging influenza pandemic ( WHO 20000824 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[106]
.The two classes of antiviral drugs used against influenza are neuraminidase inhibitors and M2 protein inhibitors (adamantane derivatives).^ Use of the selective oral neuraminidase inhibitor oseltamivir to prevent influenza.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The hemagglutinin (HA or H) and neuraminidase (NA or N) proteins are targets for antiviral drugs .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The two classes of anti-virals are neuraminidase inhibitors and M2 inhibitors ( adamantane derivatives).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Neuraminidase inhibitors are currently preferred for flu virus infections since they are less toxic and more effective.^ Neuraminidase inhibitors are currently preferred for flu virus infections.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Like the H5N1 virus that is currently circulating in Asia, the 1918 'Spanish Flu' pandemic virus may have originated from birds in China.
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ This form of immunity does not generally prevent all infection by the heterosubtypic virus but it leads to more rapid viral clearance and to reduction in morbidity and mortality.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[79] .The CDC recommended against using M2 inhibitors during the 2005–06 influenza season due to high levels of drug resistance.^ The CDC recommended against using M2 inhibitors during the 2005–06 influenza season.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ High levels of adamantane resistance among influenza A (H3N2) viruses and interim guidelines for use of antiviral agents--United States, 2005-06 influenza season.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ CDC Recommends against the Use of Amantadine and Rimantadine for the Treatment or Prophylaxis of Influenza in the United States during the 2005–06 Influenza Season.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[107] .As pregnant women seem to be more severely affected than the general population by the 2009 H1N1 influenza virus, prompt treatment with anti-influenza drugs has been recommended.^ Prevention or treatment of influenza by anti-virals .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Novel influenza A (H1N1) 2009 .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ October 2009 Influenza Novel influenza A (H1N1) 2009 .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[108]

Neuraminidase inhibitors

.Antiviral drugs such as oseltamivir (trade name Tamiflu) and zanamivir (trade name Relenza) are neuraminidase inhibitors that are designed to halt the spread of the virus in the body.^ Antiviral drugs such as oseltamivir (trade name Tamiflu) and zanamivir (trade name Relenza) are neuraminidase inhibitors that are designed to halt the spread of the virus in the body.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Most of currently circulating seasonal A(H1N1) viruses are resistant against oseltamivir but sensitive for zanamivir and the adamantanes, whilst most of currently circulating seasonal A(H3N2) viruses are resistant against the adamantanes but sensitive for the neuraminidase inhibitors.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ If it is caused by a H5N1 virus, the neuraminidase inhibitors oseltamivir and zanamivir may be critical in the planning for a pandemic ( Moscona 2005 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[109] .These drugs are often effective against both influenza A and B.[110] The Cochrane Collaboration reviewed these drugs and concluded that they reduce symptoms and complications.^ Investigation of past human flu pandemics is giving clues to revealing both the origins of pandemic influenza viruses and their evolutionhow they evolved.
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Although these two drugs are not currently available, they are now in preclinical and clinical drug trials, and give encouragement towrds developing an effective chemotherapeutic approach to the treatment of influenza.

^ "These birds usually roam freely as they scavenge for food and often mingle with wild birds or share water sources with them.

[111] .Different strains of influenza viruses have differing degrees of resistance against these antivirals, and it is impossible to predict what degree of resistance a future pandemic strain might have.^ It is impossible to predict which influenza strain will be the next pandemic virus.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Existing antivirals are effective against influenza viruses with genes from the 1918 pandemic virus.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Different strains of influenza viruses have differing degrees of resistance against these antivirals, and it is impossible to predict what degree of resistance a future pandemic strain might have.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[112]

M2 inhibitors (adamantanes)

.The antiviral drugs amantadine and rimantadine block a viral ion channel (M2 protein) and prevent the virus from infecting cells.^ The antiviral drugs amantadine and rimantadine are designed to block a viral ion channel ( M2 protein ) and prevent the virus from infecting cells.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The drug blocks the channel so that proteins cannot enter the virus.

^ Influenza A virus M2 ion channel protein: A structure-function analysis.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[42] .These drugs are sometimes effective against influenza A if given early in the infection but are always ineffective against influenza B because B viruses do not possess M2 molecules.^ Respiratory infections are not always influenza .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ The M2 ion channel blockers or adamantanes (amantadine and rimantadine) have been available since the sixties of the previous century, however, its use is limited because of rapid development of resistance, serious adverse effects, and being only active against influenza A viruses.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[110] .Measured resistance to amantadine and rimantadine in American isolates of H3N2 has increased to 91% in 2005.[113] This high level of resistance may be due to the easy availability of amantadines as part of over-the-counter cold remedies in countries such as China and Russia,[114] and their use to prevent outbreaks of influenza in farmed poultry.^ These drugs are sometimes effective against influenza A if given early in the infection but are always ineffective against influenza B. [92] Measured resistance to amantadine and rimantadine in American isolates of H3N2 has increased to 91% in 2005.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ It may offer the additional useful benefit of helping to prevent colds.

^ The M2 ion channel blockers or adamantanes (amantadine and rimantadine) have been available since the sixties of the previous century, however, its use is limited because of rapid development of resistance, serious adverse effects, and being only active against influenza A viruses.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[115][116]

Prognosis

.Influenza's effects are much more severe and last longer than those of the common cold.^ Influenza and the common cold .

^ Ideally, it has to be more pathogenic than other competing influenza strains.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Equine Influenza Reported in China More than 5,500 horses in the Xinjiang autonomous region of China have equine influenza, according to a Nov.
  • The Horse | Influenza 28 January 2010 0:00 UTC www.thehorse.com [Source type: News]

.Most people will recover completely in about one to two weeks, but others will develop life-threatening complications (such as pneumonia).^ Complications of flu are mainly from bacterial infections such as pneumonia and normally affect the very young, the elderly or people who are already ill or weak due to a previous illness.

^ The probiotic supplement was taken in two doses: one, two weeks before the vaccine, and the other, two weeks after.

^ If you have got flu, the chances are you think you are dying, but most people recover in a few days and do not need to see a doctor.

.Influenza, thus, can be deadly, especially for the weak, young and old, or chronically ill.^ Influenza, however, can be deadly, especially for the weak, old or chronically ill.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ People over 50 years old, very young children and people of any age with chronic medical conditions are more likely to get complications from influenza, such as pneumonia, bronchitis , sinus , and ear infections .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[36] .People with a weak immune system, such as people with advanced HIV infection or transplant patients (whose immune systems are medically suppressed to prevent transplant organ rejection), suffer from particularly severe disease.^ Complications of flu are mainly from bacterial infections such as pneumonia and normally affect the very young, the elderly or people who are already ill or weak due to a previous illness.

^ Vaccination is especially recommended for groups at risk for complications following influenza such as the elderly and people with chronic medical conditions, such as lung and heart disease, and people whose immune systems are weak.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ The elderly People with chronic medical conditions, such as lung and heart disease, and people whose immune systems are weak There are different approaches in the various European countries regarding the groups to be vaccinated.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[117] .Other high-risk groups include pregnant women and young children.^ For other risk groups than older people, it is difficult to compare vaccination rates among countries ( Kroneman et al., 2003 ).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ The single group most likely to die if infected were pregnant women.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Further information: Influenza vaccine Vaccination against influenza with an influenza vaccine is often recommended for high-risk groups, such as children and the elderly.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[118]
.The flu can worsen chronic health problems.^ Usually, the disease lasts for up to a week, but infection is especially dangerous for the very young and the elderly, as well as those with certain chronic health problems.

^ Influenza is sometimes associated with severe complications such as pneumonia, worsening of chronic medical conditions, acute otitis media and sinus problems in children.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.People with emphysema, chronic bronchitis or asthma may experience shortness of breath while they have the flu, and influenza may cause worsening of coronary heart disease or congestive heart failure.^ People with emphysema, chronic bronchitis or asthma may experience shortness of breath while they have the flu, and influenza may cause worsening of coronary heart disease or congestive heart failure .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Pneumonia (usually additional bacterial infections) Worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Investigation of past human flu pandemics is giving clues to revealing both the origins of pandemic influenza viruses and their evolutionhow they evolved.
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

[119] .Smoking is another risk factor associated with more serious disease and increased mortality from influenza.^ The risk of complications and mortality from influenza increases significantly in elderly.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Smoking is another risk factor associated with more serious disease and increased mortality from influenza.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza hits the Northern hemisphere every winter and causes a substantial disease burden and mortality.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[120]
.According to the World Health Organization: "Every winter, tens of millions of people get the flu.^ WHO World Health Organization 2009f.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Geneva, Switzerland: World Health Organization; 2005.

^ Just the simple, almost cute flu kills more people every year than does AIDS, cancer and heart attacks combined.
  • Fight the Flu Naturally 16 September 2009 9:09 UTC www.truthseek.net [Source type: General]

.Most are only ill and out of work for a week, yet the elderly are at a higher risk of death from the illness.^ Most are only ill and out of work for a week, yet the elderly are at a higher risk of death from the illness.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Mortality showed a more characteristic pattern, similar to that seen in seasonal epidemics, with most excess deaths confined to infants and the elderly ( WHO 2005 b ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Influenza vaccination has the objective to prevent influenza risk and thereby serious illness, complications and death.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.We know the worldwide death toll exceeds a few hundred thousand people a year, but even in developed countries the numbers are uncertain, because medical authorities don't usually verify who actually died of influenza and who died of a flu-like illness."^ People have suffered from influenza for thousands of years.

^ We know the world-wide death toll exceeds a few hundred thousand people a year, but even in developed countries the numbers are uncertain, because medical authorities don't usually verify who actually died of influenza and who died of a flu-like illness."
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ It attracted very little attention because pneumonic complications were few and deaths even fewer; it appeared as no more than just another bout with the kind of respiratory disease that so often circulates during that time of the year.

[121] .Even healthy people can be affected, and serious problems from influenza can happen at any age.^ Even healthy people can be affected, and serious problems from influenza can happen at any age.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Healthy people overcome influenza within 1 to 2 weeks.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Data presentation shows the proportion of people aged 65 and over who have been immunised against influenza during the last 12 months.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.People over 50 years old, very young children and people of any age with chronic medical conditions are more likely to get complications from influenza, such as pneumonia, bronchitis, sinus, and ear infections.^ Influenza is sometimes associated with severe complications such as pneumonia, worsening of chronic medical conditions, acute otitis media and sinus problems in children.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ These are older age groups (65 years and older) and people with underlying medical conditions.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Acute otitis media and sinus problems in children Those aged 65 years and older and persons of any age with chronic medical conditions, i.e.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[83]
.In some cases, an autoimmune response to an influenza infection may contribute to the development of Guillain-Barré syndrome.^ The immune response to influenza infection.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Influenza patients may develop several types of encephalopathy (brain disorders) ( Mizuguchi et al., 2007 ).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ In some studies of immunizations with NP, immune responses were observed but little or no protection OCR for page 263 The Threat of Pandemic Influenza: Are We Ready?
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[122] .However, as many other infections can increase the risk of this disease, influenza may only be an important cause during epidemics.^ The frequency of animal diseases are not as well-studied as human infection, but an outbreak of influenza in harbour seals caused approximately 500 seal deaths off the New England coast in 1979–1980.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ He proposed that the cause of influenza epidemics during winter may be connected to seasonal fluctuations of vitamin D, which is produced in the skin under the influence of solar (or artificial) UV radiation .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Therefore, the influenza vaccination not only reduces the mortality risk for influenza-related pneumonia and COPD, which occur mainly during influenza season, but also long-term complications such as stroke, cardiovascular diseases, or other major causes of death.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[122][123] .This syndrome can also be a rare side-effect of influenza vaccines, with an incidence of about one case per million vaccinations.^ There is however a debate about how effective the influenza vaccine in elderly really is.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Guillain-Barre syndrome following vaccination in the National Influenza Immunization Program, United States, 1976--1977.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ At present, the world has a production capacity of about 300 million trivalent influenza vaccines per year, most of which is produced in nine countries ( Fedson 2005 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[124]

Epidemiology

Seasonal variations

.Influenza reaches peak prevalence in winter, and because the Northern and Southern Hemispheres have winter at different times of the year, there are actually two different flu seasons each year.^ Influenza reaches peak prevalence in winter, and because the Northern and Southern Hemispheres have winter at different times of the year, there are actually two different flu seasons each year.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Flu times two .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ We know the world-wide death toll exceeds a few hundred thousand people a year, but even in developed countries the numbers are uncertain, because medical authorities don't usually verify who actually died of influenza and who died of a flu-like illness."
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.This is why the World Health Organization (assisted by the National Influenza Centers) makes recommendations for two different vaccine formulations every year; one for the Northern, and one for the Southern Hemisphere.^ This is why the World Health Organization (assisted by the National Influenza Centers ) makes recommendations for two different vaccine formulations every year; one for the Northern, and one for the Southern Hemisphere.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ WHO World Health Organization 2009f.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Vaccination in the northern hemisphere is recommended to start in October.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[80]
.A long-standing puzzle has been why outbreaks of the flu occur seasonally rather than uniformly throughout the year.^ It is not completely clear why outbreaks of the flu occur seasonally rather than uniformly throughout the year.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Even in the absence of a local outbreak, treatment may be justified in the elderly during the influenza season as long as the prevalence is over 15%.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza reaches peak prevalence in winter, and because the Northern and Southern Hemispheres have winter at different times of the year, there are actually two different flu seasons each year.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.One possible explanation is that, because people are indoors more often during the winter, they are in close contact more often, and this promotes transmission from person to person.^ One possible explanation is that, because people are indoors more often during the winter, they are in close contact more often, and this promotes transmission from person to person.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ During the first week of the disease it is contagious in close contact.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Particles do not remain suspended in the air, and close contact (up to 3-6 feet) is required for transmission.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.Increased travel due to the Northern Hemisphere winter holiday season may also play a role.^ Increased travel due to the Northern Hemisphere winter holiday season may also play a role.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza hits the Northern hemisphere every winter and causes a substantial disease burden and mortality.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Seasonal changes in contact rates from school terms, which are a major factor in other childhood diseases such as measles and pertussis , may also play a role in the flu.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[125] .Another factor is that cold temperatures lead to drier air, which may dehydrate mucus, preventing the body from effectively expelling virus particles.^ Another is that cold temperatures lead to drier air, which may dehydrate mucus, preventing the body from effectively expelling virus particles.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Immunity to previous pandemic influenza strains and vaccination may have limited the spread of the virus and may have helped prevent further pandemics.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ A contributing factor is that aerosol transmission of the virus is highest in cold environments (less than 5 °C) with low humidity.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.The virus also survives longer on surfaces at colder temperatures and aerosol transmission of the virus is highest in cold environments (less than 5 °C) with low relative humidity.^ In water, the virus can survive for up to four days at 22 C, and more than 30 days at 0C. In frozen material, the virus probably survives indefinitely.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Highly pathogenic avian viruses can survive in the environment for long periods, especially in low temperatures (i.e., in manure-contaminated water).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The results showed that participants receiving garlic were almost two-thirds less likely to catch cold than those receiving placebo.

[126] .Indeed, the lower air humidity in winter seems to be the main cause of seasonal influenza transmission in temperate regions.^ He proposed that the cause of influenza epidemics during winter may be connected to seasonal fluctuations of vitamin D, which is produced in the skin under the influence of solar (or artificial) UV radiation .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza virus transmission is dependent on relative humidity and temperature ".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza hits the Northern hemisphere every winter and causes a substantial disease burden and mortality.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[127][128]
.However, seasonal changes in infection rates also occur in tropical regions, and in some countries these peaks of infection are seen mainly during the rainy season.^ However, seasonal changes in infection rates also occur in tropical regions, and these peaks of infection are seen mainly during the rainy season.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ These tests may be especially useful during the influenza season (prevalence=25%) but in the absence of a local outbreak, or peri-influenza season (prevalence=10% [57] ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ However, these episodes may be the exception, at least in some settings.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[129] .Seasonal changes in contact rates from school terms, which are a major factor in other childhood diseases such as measles and pertussis, may also play a role in the flu.^ Seasonal changes in contact rates from school terms, which are a major factor in other childhood diseases such as measles and pertussis , may also play a role in the flu.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ However, seasonal changes in infection rates also occur in tropical regions, and these peaks of infection are seen mainly during the rainy season.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Increased travel due to the Northern Hemisphere winter holiday season may also play a role.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

A combination of these small seasonal effects may be amplified by dynamical resonance with the endogenous disease cycles.[130] .H5N1 exhibits seasonality in both humans and birds.^ H5N1 exhibits seasonality in both humans and birds.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Further information: Flu season Cumulative Confirmed Human Cases of H5N1.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Human H5N1 isolates from 2003 and 2004 exhibited a substantially greater level of virulence in ferrets than other H5N1 viruses isolated from humans since 1997 ( Maines 2005 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[131]
.An alternative hypothesis to explain seasonality in influenza infections is an effect of vitamin D levels on immunity to the virus.^ Control of influenza virus infection by immunity to conserved viral features.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Effect of heterosubtypic immunity on infection with attenuated influenza-A virus vaccines in young children.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Influenza virus infections and immunity: A review of human and animal models.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[132] .This idea was first proposed by Robert Edgar Hope-Simpson in 1965.[133] He proposed that the cause of influenza epidemics during winter may be connected to seasonal fluctuations of vitamin D, which is produced in the skin under the influence of solar (or artificial) UV radiation.^ This idea was first proposed by Robert Edgar Hope-Simpson in 1965.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ He proposed that the cause of influenza epidemics during winter may be connected to seasonal fluctuations of vitamin D, which is produced in the skin under the influence of solar (or artificial) UV radiation .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ These tests may be especially useful during the influenza season (prevalence=25%) but in the absence of a local outbreak, or peri-influenza season (prevalence=10% [57] ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.This could explain why influenza occurs mostly in winter and during the tropical rainy season, when people stay indoors, away from the sun, and their vitamin D levels fall.^ Symptoms of influenza A(H1N1) virus in humans are usually similar to regular human seasonal influenza symptoms, involving fever of sudden onset and respiratory symptoms; diarrhoea might also occur.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ As it happens, in the short span of time between 1997 and 2004, five influenza outbreaks have occurred in which some people contracted their illnesses directly from birds.
  • Fight the Flu Naturally 16 September 2009 9:09 UTC www.truthseek.net [Source type: General]

^ Half of influenza-related deaths during the 1968 pandemic, and large proportions of influenza-related deaths during the 1957 and the 1918 pandemics, occurred among persons < 65 years old ( Simonson 1998 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

Epidemic and pandemic spread

Antigenic drift creates influenza viruses with slightly modified antigens, while antigenic shift generates viruses with entirely novel antigens.
.As influenza is caused by a variety of species and strains of viruses, in any given year some strains can die out while others create epidemics, while yet another strain can cause a pandemic.^ How antigenic shift, or reassortment, can result in novel and highly pathogenic strains of human influenza As influenza is caused by a variety of species and strains of viruses , in any given year some strains can die out while others create epidemics , while yet another strain can cause a pandemic .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.Typically, in a year's normal two flu seasons (one per hemisphere), there are between three and five million cases of severe illness and up to 500,000 deaths worldwide, which by some definitions is a yearly influenza epidemic.^ Typically, in a year's normal two flu seasons (one per hemisphere), there are between three and five million cases of severe illness and up to 500,000 deaths worldwide, which by some definitions is a yearly influenza epidemic.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Every year, the global burden of influenza epidemics is believed to be 3-5 million cases of severe illness and 300,000-500,000 deaths.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Deaths per 100,000 persons in each age group, United States, for the interpandemic years 1911–1917 (dashed line) and the pandemic year 1918 (solid line).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[134] .Although the incidence of influenza can vary widely between years, approximately 36,000 deaths and more than 200,000 hospitalizations are directly associated with influenza every year in the United States.^ Mortality associated with influenza and respiratory syncytial virus in the United States ".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza-associated hospitalizations in the United States ".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Although the incidence of influenza can vary widely between years, approximately 36,000 deaths and more than 200,000 hospitalizations are directly associated with influenza every year in America.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[135][136] .Roughly three times per century, a pandemic occurs, which infects a large proportion of the world's population and can kill tens of millions of people (see history section).^ During the twentieth century, three influenza pandemics occurred (table 1).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Pandemics have occurred three times in the previous century.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Influenza pandemics have occurred three times in the previous century.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.Indeed, one study estimated that if a strain with similar virulence to the 1918 influenza emerged today, it could kill between 50 and 80 million people.^ However, if we translate the death toll associated with the 1918 influenza virus to the current population, there could be 180 million to 360 million deaths globally ( Osterholm 2005 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The following applies for influenza A viruses, although other strains are very similar in structure: [39] .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ To this purpose, the WHO has recently started creating an international stockpile of 3 million courses of antiviral drugs to be dispatched to the area of an emerging influenza pandemic ( WHO 20000824 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[137]
Antigenic shift, or reassortment, can result in novel and highly pathogenic strains of human influenza
.New influenza viruses are constantly evolving by mutation or by reassortment.^ It is obviously tempting to speculate that the emergence of a completely new human-adapted avian influenza virus in 1918 (n=1) could be deadlier than the introduction of reassortant viruses in 1957 and 1968 (n=2), but such speculation is not scientific.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Will it be mild like the last two pandemics of 1968 and 1957, when the new pandemic strain resulted from the reassortment of the pre-existing human strains and an avian influenza strain?
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ As influenza viruses mutate constantly, vaccine formulations need to be re-examined annually.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[18] .Mutations can cause small changes in the hemagglutinin and neuraminidase antigens on the surface of the virus.^ Mutations can cause small changes in the hemagglutinin and neuraminidase antigens on the surface of the virus.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Point mutations lead to “antigenic drift” (small, incremental changes).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Widespread outbreaks of influenza are caused by influenza viruses type A or B. Type A influenza viruses are further subtyped by their surface antigens hemagglutinin (H1-H16) and neuraminidase (N1-N9), e.g.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.This is called antigenic drift, which slowly creates an increasing variety of strains until one evolves that can infect people who are immune to the pre-existing strains.^ This is called antigenic drift , which creates an increasing variety of strains over time until one of the variants eventually achieves higher fitness , becomes dominant, and rapidly sweeps through the human population—often causing an epidemic.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Most people who get influenza will recover in one to two weeks, but others will develop life-threatening complications (such as pneumonia ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Further information: Flu pandemic Antigenic drift creates influenza viruses with slightly modified antigens, while antigenic shift generates viruses with entirely novel antigens.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.This new variant then replaces the older strains as it rapidly sweeps through the human population—often causing an epidemic.^ This is called antigenic drift , which creates an increasing variety of strains over time until one of the variants eventually achieves higher fitness , becomes dominant, and rapidly sweeps through the human population—often causing an epidemic.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ With influenza virus, extensive genetic variation leads to the problem that different dominant viral strains circulate in the human population each year (Figure 5-1).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[138] .However, since the strains produced by drift will still be reasonably similar to the older strains, some people will still be immune to them.^ Since it is completely new, people are naturally not immune protected against it at all, and therefore such a virus variant can lead to a widespread influenza pandemic.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ There are still chances, however, that people who are vaccinated will get influenza but the chance of complications and mortality is lower ( Wang et al., 2007 ).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Since then, the lungs of people — not just pigs — are not considered potential incubating vessels for a future pandemic strain.
  • Fight the Flu Naturally 16 September 2009 9:09 UTC www.truthseek.net [Source type: General]

.In contrast, when influenza viruses reassort, they acquire completely new antigens—for example by reassortment between avian strains and human strains; this is called antigenic shift.^ There is also a possibility that a completely new subtype of influenza A virus will emerge (antigenic shift).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Genetic reassortment between avian and human influenza A viruses in Italian pigs.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Avian Influenza, human: Genetic risk?
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.If a human influenza virus is produced that has entirely new antigens, everybody will be susceptible, and the novel influenza will spread uncontrollably, causing a pandemic.^ Since then, the virus has caused numerous pandemics.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ An influenza pandemic is caused by an influenza virus that is new to people.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ As unpredictable as influenza pandemics are, as unpredictable is the virus itself.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[139] .In contrast to this model of pandemics based on antigenic drift and shift, an alternative approach has been proposed where the periodic pandemics are produced by interactions of a fixed set of viral strains with a human population with a constantly changing set of immunities to different viral strains.^ In contrast to this model of pandemics based on antigenic drift and shift, an alternative approach has been proposed where the periodic pandemics are produced by interactions of a fixed set of viral strains with a human population with a constantly changing set of immunities to different viral strains.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ With influenza virus, extensive genetic variation leads to the problem that different dominant viral strains circulate in the human population each year (Figure 5-1).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[140]

History

Etymology

.The word Influenza comes from the Italian language meaning "influence" and refers to the cause of the disease; initially, this ascribed illness to unfavorable astrological influences.^ The word influenza comes from the Italian language and refers to the cause of a disease; initially, this ascribed illness to unfavorable astrological influences.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza hits the Northern hemisphere every winter and causes a substantial disease burden and mortality.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ The word influenza was first used in English in 1743 when it was adopted, with an anglicized pronunciation, during an outbreak of the disease in Europe.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[141] .Changes in medical thought led to its modification to influenza del freddo, meaning "influence of the cold". The word influenza was first used in English in 1743 when it was adopted, with an anglicized pronunciation, during an outbreak of the disease in Europe.^ The word influenza was first used in English in 1743 when it was adopted, with an anglicized pronunciation, during an outbreak of the disease in Europe.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Changes in medical thought led to its modification to influenza del freddo , meaning "influence of the cold".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The first convincing record of an influenza pandemic was of an outbreak in 1580, which began in Asia and spread to Europe via Africa.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[142] .Archaic terms for influenza include epidemic catarrh, grippe (from the French), sweating sickness, and Spanish fever (particularly for the 1918 flu pandemic strain).^ Characterization of the reconstructed 1918 Spanish influenza pandemic virus.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Spanish and avian flu pandemics.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The geography and mortality of the 1918 influenza pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[143]

Pandemics

.
The difference between the influenza mortality age distributions of the 1918 epidemic and normal epidemics.
^ Pandemic versus epidemic influenza mortality: A pattern of changing age distribution.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The geography and mortality of the 1918 influenza pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The 1918 influenza epidemic in Mamre.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.Deaths per 100,000 persons in each age group, United States, for the interpandemic years 1911–1917 (dashed line) and the pandemic year 1918 (solid line).^ In 13 studies of hospitalized pregnant women during the 1918 pandemic, the death rate ranged from 23 to 71 percent (Jordon, 1927:273).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Influenza pandemic preparedness action plan for the United States: 2002 update.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ More people died in each one of those 5-year groups than the total deaths among all those over age 60, and the combined deaths of those aged 20 to 34 more than doubled the deaths of all those over 50 (U.S. Bureau of the Census, 1921).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[144]
.The symptoms of human influenza were clearly described by Hippocrates roughly 2,400 years ago.^ The symptoms of human influenza were clearly described by Hippocrates roughly 2,400 years ago.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ With influenza virus, extensive genetic variation leads to the problem that different dominant viral strains circulate in the human population each year (Figure 5-1).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Symptoms of influenza A(H1N1) virus in humans are usually similar to regular human seasonal influenza symptoms, involving fever of sudden onset and respiratory symptoms; diarrhoea might also occur.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[145][146] .Although the virus seems to have caused epidemics throughout human history, historical data on influenza are difficult to interpret, because the symptoms can be similar to those of other respiratory diseases.^ Historical data on influenza are difficult to interpret, because the symptoms can be similar to those of other diseases, such as diphtheria , pneumonic plague , typhoid fever , dengue , or typhus .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Other diseases of upper respiratory tract .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Respiratory syncytial virus (RSV) epidemics often overlap with influenza epidemics.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[147][148] .The disease may have spread from Europe to the Americas as early as the European colonization of the Americas; since almost the entire indigenous population of the Antilles was killed by an epidemic resembling influenza that broke out in 1493, after the arrival of Christopher Columbus.^ The first convincing record of an influenza pandemic was of an outbreak in 1580, which began in Asia and spread to Europe via Africa.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Immunity to previous pandemic influenza strains and vaccination may have limited the spread of the virus and may have helped prevent further pandemics.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The unusually severe disease killed between 2 and 20% of those infected, as opposed to the more usual flu epidemic mortality rate of 0.1%.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[149][150]
.The first convincing record of an influenza pandemic was of an outbreak in 1580, which began in Russia and spread to Europe via Africa.^ The first convincing record of an influenza pandemic was of an outbreak in 1580, which began in Asia and spread to Europe via Africa.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Conditions for a pandemic influenza outbreak .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ An influenza pandemic is a global outbreak .
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.In Rome, over 8,000 people were killed, and several Spanish cities were almost wiped out.^ In Rome , over 8,000 people were killed, and several Spanish cities were almost wiped out.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Pandemics continued sporadically throughout the 17th and 18th centuries, with the pandemic of 1830–1833 being particularly widespread; it infected approximately a quarter of the people exposed.^ Pandemics continued sporadically throughout the 17th and 18th centuries, with the pandemic of 1830–1833 being particularly widespread; it infected approximately a quarter of the people exposed.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ It is generally assumed that during the first year of the next pandemic 2 billion people will become infected with the new virus and that half of them will have symptoms.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[148]
.The most famous and lethal outbreak was the 1918 flu pandemic (Spanish flu pandemic) (type A influenza, H1N1 subtype), which lasted from 1918 to 1919. It is not known exactly how many it killed, but estimates range from 20 to 100 million people.^ Characterization of the reconstructed 1918 Spanish influenza pandemic virus.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Spanish and avian flu pandemics.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The 1918 'Spanish' flu: pearls from swine?
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

[151][152] .This pandemic has been described as "the greatest medical holocaust in history" and may have killed as many people as the Black Death.^ We have no idea whether the next pandemic will kill 2, 20, or 200 million people.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Throughout history, there have been influenza pandemics, some of which may have rivaled 1918’s lethality.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ A devastating pandemic might therefore, in the course of only a few months, cause three times as many deaths as would normally occur in an entire year.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[148] .This huge death toll was caused by an extremely high infection rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms.^ Prophylaxis was economically beneficial in high-risk subpopulations, which account for 78 % of deaths, and in pandemics in which the death rate was > 0.6 %.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Frank Macfarlane Burnet, who won his Nobel Prize for immunology but who spent most of his life studying influenza, estimated the death toll as probably 50 million, and possibly as high as 100 million.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The virus of 1918 was extremely virulent and caused many deaths through secondary bacterial pneumonia.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[152] .Indeed, symptoms in 1918 were so unusual that initially influenza was misdiagnosed as dengue, cholera, or typhoid.^ Symptoms in 1918 were so unusual that, initially, it was misdiagnosed as dengue fever, cholera, or typhoid ( Barry 2004 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Symptoms in 1918 were so unusual that initially influenza was misdiagnosed as dengue, cholera, or typhoid.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Initial genetic characterization of the 1918 “Spanish” influenza virus.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.One observer wrote, "One of the most striking of the complications was hemorrhage from mucous membranes, especially from the nose, stomach, and intestine.^ One observer wrote, “One of the most striking of the complications was hemorrhage from mucous membranes, especially from the nose, stomach, and intestine.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

Bleeding from the ears and petechial hemorrhages in the skin also occurred."[151] The majority of deaths were from bacterial pneumonia, a secondary infection caused by influenza, but the virus also killed people directly, causing massive hemorrhages and edema in the lung.[144]
.The 1918 flu pandemic (Spanish flu pandemic) was truly global, spreading even to the Arctic and remote Pacific islands.^ Spanish and avian flu pandemics.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The 1918 'Spanish' flu: pearls from swine?
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ The Spanish flu pandemic was truly global, spreading even to the Arctic and remote Pacific islands.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.The unusually severe disease killed between 2 and 20% of those infected, as opposed to the more usual flu epidemic mortality rate of 0.1%.^ The unusually severe disease killed between 2 and 20% of those infected, as opposed to the more usual flu epidemic mortality rate of 0.1%.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Cities struck later in the epidemic also usually had lower mortality rates.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Type A is more important than type B in terms of disease severity and mortality.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

[144][151] .Another unusual feature of this pandemic was that it mostly killed young adults, with 99% of pandemic influenza deaths occurring in people under 65, and more than half in young adults 20 to 40 years old.^ Worry kills more people than the epidemic” (Robertson, 1918).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Another unusual feature of this pandemic was that it mostly killed young adults, with 99% of pandemic influenza deaths occurring in people under 65, and more than half in young adults 20 to 40 years old.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ For the 1968 pandemic, the majority of European deaths occurred after a 1-year delay.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[153] .This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70).^ This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ People over 50 years old, very young children and people of any age with chronic medical conditions are more likely to get complications from influenza, such as pneumonia, bronchitis , sinus , and ear infections .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza, however, can be deadly, especially for the weak, old or chronically ill.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.The total mortality of the 1918–1919 pandemic is not known, but it is estimated that 2.5% to 5% of the world's population was killed.^ "The geography and mortality of the 1918 influenza pandemic.".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The geography and mortality of the 1918 influenza pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The total mortality of the 1918–1919 pandemic is not known, but it is estimated that 2.5% to 5% of the world's population was killed.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.As many as 25 million may have been killed in the first 25 weeks; in contrast, HIV/AIDS has killed 25 million in its first 25 years.^ As many as 25 million may have been killed in the first 25 weeks; in contrast, HIV/AIDS has killed 25 million in its first 25 years.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Flu spreads around the world in seasonal epidemics , killing millions of people in pandemic years and hundreds of thousands in non-pandemic years.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Every ten to twenty years, a pandemic occurs, which infects a large proportion of the world's population and can kill tens of millions of people (see history section).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[151]
.
The influenza viruses that caused Hong Kong flu.
^ Hong Kong influenza immunologic recapitulation.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Investigation of past human flu pandemics is giving clues to revealing both the origins of pandemic influenza viruses and their evolutionhow they evolved.
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

(magnified approximately 100,000 times)
.Later flu pandemics were not so devastating.^ Later flu pandemics were not so devastating.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ In later pandemics antibiotics were available to control secondary infections and this may have helped reduce mortality compared to the Spanish Flu of 1918.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.They included the 1957 Asian Flu (type A, H2N2 strain) and the 1968 Hong Kong Flu (type A, H3N2 strain), but even these smaller outbreaks killed millions of people.^ Outbreak of chicken flu rattles Hong Kong .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ H3N2 caused Hong Kong Flu.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ They included the 1957 Asian Flu (type A, H2N2 strain) and the 1968 Hong Kong Flu (type A, H3N2 strain), but even these smaller outbreaks killed millions of people.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

In later pandemics antibiotics were available to control secondary infections and this may have helped reduce mortality compared to the Spanish Flu of 1918.[144]
Known flu pandemics[36][148][154]
Name of pandemic Date Deaths Subtype involved Pandemic Severity Index
Asiatic (Russian) Flu 18891890 1 million possibly H2N2 NA
1918 flu pandemic (Spanish flu) 19181920 20 to 100 million H1N1 5
Asian Flu 19571958 1 to 1.5 million H2N2 2
Hong Kong Flu 19681969 0.75 to 1 million H3N2 2
2009 flu pandemic 2009Present 10,000 to Dec 6 H1N1 NA
.The first influenza virus to be isolated was from poultry, when in 1901 the agent causing a disease called "fowl plague" was passed through Chamberland filters, which have pores that are too small for bacteria to pass through.^ After the recent isolation of oseltamivir-resistant isolates in serious H5N1 infection, other antiviral agents to which oseltamivir-resistant influenza viruses remain susceptible, should be included in treatment arsenals for influenza A (H5N1) virus infections ( de Jong 2005 ) - in other words: zanamivir.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Characterization of an avian influenza A (H5N1) virus isolated from a child with a fatal respiratory illness.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The polymerase complex genes contribute to the high virulence of the human H5N1 influenza virus isolate A/Vietnam/1203/04.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[155] .The etiological cause of influenza, the Orthomyxoviridae family of viruses, was first discovered in pigs by Richard Shope in 1931.[156] This discovery was shortly followed by the isolation of the virus from humans by a group headed by Patrick Laidlaw at the Medical Research Council of the United Kingdom in 1933.[157] However, it was not until Wendell Stanley first crystallized tobacco mosaic virus in 1935 that the non-cellular nature of viruses was appreciated.^ This discovery was shortly followed by the isolation of the virus from humans by a group headed by Patrick Laidlaw at the Medical Research Council of the United Kingdom in 1933.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The etiological cause of influenza, the Orthomyxoviridae family of viruses, was first discovered in pigs by Richard Schope in 1931.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ However, it was not until Wendell Stanley first crystallized tobacco mosaic virus in 1935 that the non-cellular nature of viruses was appreciated.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.
The main types of influenza viruses in humans.
^ "The evolution of human influenza viruses".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Recombination of human influenza A viruses in nature .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Avian influenza - Acute viral nasopharyngitis - Infectious mononucleosis - Influenza - Severe acute respiratory syndrome - Viral pneumonia - Human parainfluenza viruses - RSV - hMPV .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Solid squares show the appearance of a new strain, causing recurring influenza pandemics.^ Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

Broken lines indicate uncertain strain identifications.[158]
The first significant step towards preventing influenza was the development in 1944 of a killed-virus vaccine for influenza by Thomas Francis, Jr.. .This built on work by Australian Frank Macfarlane Burnet, who showed that the virus lost virulence when it was cultured in fertilized hen's eggs.^ The first significant step towards preventing influenza was the development in 1944 of a killed-virus vaccine for influenza by Thomas Francis, Jr. This built on work by Frank Macfarlane Burnet , who showed that the virus lost virulence when it was cultured in fertilized hen's eggs.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Frank Macfarlane Burnet, who won his Nobel Prize for immunology but who spent most of his life studying influenza, estimated the death toll as probably 50 million, and possibly as high as 100 million.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Alternatively, the virus can be grown in eggs until it loses virulence and the avirulent virus given as a live vaccine.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[159] .Application of this observation by Francis allowed his group of researchers at the University of Michigan to develop the first influenza vaccine, with support from the U.S. Army.^ Antibodies will provide some protection against the new influenza strain, but to develop antibodies you have to either be infected or vaccinated.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Development of adenoviral-vector-based pandemic influenza vaccine against antigenically distinct human H5N1 strains in mice.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Influenza vaccines are currently prepared in fertilised chicken eggs, a process which was developed over 50 years ago ( Osterholm 2005 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[160] .The Army was deeply involved in this research due to its experience of influenza in World War I, when thousands of troops were killed by the virus in a matter of months.^ The Army was deeply involved in this research due to its experience of influenza in World War I , when thousands of troops were killed by the virus in a matter of months.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Flu Influenza Virus Avian influenza Flu season Research Vaccine Treatment Genome project H5N1 strain .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[151] .In comparison to vaccines, the development of anti-influenza drugs has been slower, with amantadine being licensed in 1966 and, almost thirty years later, the next class of drugs (the neuraminidase inhibitors) being developed.^ Neuraminidase inhibitor susceptibility network position statement: antiviral resistance in influenza A/H5N1 viruses.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Use of the selective oral neuraminidase inhibitor oseltamivir to prevent influenza.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The 2004 U.S. Pandemic Influenza Preparedness and Response Plan developed by the National Vaccine Program Office has not yet defined such priority groups (DHHS, 2004:24).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[37]

Society and culture

.Influenza produces direct costs due to lost productivity and associated medical treatment, as well as indirect costs of preventative measures.^ Further information: Social impact of H5N1 Influenza produces direct costs due to lost productivity and associated medical treatment, as well as indirect costs of preventative measures.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Governments worldwide have spent billions of U.S. dollars preparing and planning for a potential H5N1 avian influenza pandemic, with costs associated with purchasing drugs and vaccines as well as developing disaster drills and strategies for improved border controls .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ As a result of such measures, the cost of poultry farming has increased, while the cost to consumers has gone down due to demand for poultry falling below supply.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.In the United States, influenza is responsible for a total cost of over $10 billion per year, while it has been estimated that a future pandemic could cause hundreds of billions of dollars in direct and indirect costs.^ The economic impact of pandemic influenza in the United States: Priorities for intervention.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ For the 1918 pandemic, a herald wave that caused substantial mortality occurred at least 6 months before the OCR for page 105 The Threat of Pandemic Influenza: Are We Ready?
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[161] .However, the economic impacts of past pandemics have not been intensively studied, and some authors have suggested that the Spanish influenza actually had a positive long-term effect on per-capita income growth, despite a large reduction in the working population and severe short-term depressive effects.^ The epidemiology and clinical impact of pandemic influenza.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The economic impact of pandemic influenza in the United States: Priorities for intervention.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Characterization of the reconstructed 1918 Spanish influenza pandemic virus.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[162] .Other studies have attempted to predict the costs of a pandemic as serious as the 1918 Spanish flu on the U.S. economy, where 30% of all workers became ill, and 2.5% were killed.^ Spanish and avian flu pandemics.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The 1918 'Spanish' flu: pearls from swine?
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Other studies have attempted to predict the costs of a pandemic as serious as the 1918 Spanish flu on the U.S. economy , where 30% of all workers became ill, and 2.5% were killed.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

A 30% sickness rate and a three-week length of illness would decrease the gross domestic product by 5%. .Additional costs would come from medical treatment of 18 million to 45 million people, and total economic costs would be approximately $700 billion.^ Additional costs would come from medical treatment of 18 million to 45 million people, and total economic costs would be approximately $700 billion.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ When comparing strategies for stockpiling these drugs to treat and prevent influenza in Singapore, the treatment-only strategy had optimal economic benefits: stockpiles of antiviral agents for 40 % of the population would save an estimated 418 lives and $414 million, at a cost of $52.6 million per shelf-life cycle of the stockpile.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ In an ideal world, we would have 6.5 billion vaccine doses the day after the pandemic starts; in addition, we would have 6.5 billion syringes to inject the vaccine; and finally, we would have an unlimited number of health personnel to administer the vaccine.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[163]
.Preventative costs are also high.^ Preventative costs are also high.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Governments worldwide have spent billions of U.S. dollars preparing and planning for a potential H5N1 avian influenza pandemic, with costs associated with purchasing drugs and vaccines as well as developing disaster drills and strategies for improved border controls.^ Avirulent Avian influenza virus as a vaccine strain against a potential human pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Strategies for mitigating an influenza pandemic .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Governments worldwide have spent billions of U.S. dollars preparing and planning for a potential H5N1 avian influenza pandemic, with costs associated with purchasing drugs and vaccines as well as developing disaster drills and strategies for improved border controls .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[164] .On 1 November 2005, United States President George W. Bush unveiled the National Strategy to Safeguard Against the Danger of Pandemic Influenza[165] backed by a request to Congress for $7.1 billion to begin implementing the plan.^ Influenza pandemic preparedness action plan for the United States: 2002 update.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Strategies for mitigating an influenza pandemic .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ The economic impact of pandemic influenza in the United States: Priorities for intervention.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[166] .Internationally, on 18 January 2006, donor nations pledged US$2 billion to combat bird flu at the two-day International Pledging Conference on Avian and Human Influenza held in China.^ January 2006 Zambon MC. "The pathogenesis of influenza in humans".
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Internationally, on January 18 , 2006 , donor nations pledged US$2 billion to combat bird flu at the two-day International Pledging Conference on Avian and Human Influenza held in China.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Avian Influenza, human: Genetic risk?
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[167]
.In an assessment of the 2009 H1N1 pandemic on selected countries in the Southern Hemisphere, data suggest that all countries experienced some time-limited and/or geographically-isolated socio/economic effects and a temporary decrease in tourism most likely due to fear of 2009 H1N1 disease.^ Indeed, social and economic disruption would occur in all countries to varying extents.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ What does matter is that the pandemic most likely did not begin in Asia.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Workshop Summary manner, in some families all were sick together, in some towns almost all were sick so that it was a time of disease” (Pettit, 1976).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.It is still too early to determine whether the H1N1 pandemic has caused any long-term economic impacts.^ However, the economic impacts of past pandemics have not been intensively studied, and some authors have suggested that the Spanish influenza actually had a positive long-term effect on per-capita income growth, despite a large reduction in the working population and severe short-term depressive effects.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ In the early 20th century, science was sufficiently sophisticated to anticipate that influenza, which had twice reached pandemic proportions in the late 19th century, would recur, but was largely powerless to blunt the devastating impact of the 1918 (H1N1) pandemic.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The economic impact of pandemic influenza in the United States: Priorities for intervention.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[168]

Research

Dr. Terrence Tumpey examining a reconstructed 1918 Spanish flu virus in a biosafety level 3 environment.
.Research on influenza includes studies on molecular virology, how the virus produces disease (pathogenesis), host immune responses, viral genomics, and how the virus spreads (epidemiology).^ Genomic analysis of increased host immune and cell death responses induced by 1918 influenza virus .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ RNA genome segments of influenza virus.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The immune response to influenza infection.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.These studies help in developing influenza countermeasures; for example, a better understanding of the body's immune system response helps vaccine development, and a detailed picture of how influenza invades cells aids the development of antiviral drugs.^ The immune response to influenza infection.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ These studies help in developing influenza countermeasures; for example, a better understanding of the body's immune system response helps vaccine development, and a detailed picture of how influenza invades cells aids the development of antiviral drugs.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Immune response to influenza vaccination of elderly people.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.One important basic research program is the Influenza Genome Sequencing Project, which is creating a library of influenza sequences; this library should help clarify which factors make one strain more lethal than another, which genes most affect immunogenicity, and how the virus evolves over time.^ RNA genome segments of influenza virus.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Ideally, it has to be more pathogenic than other competing influenza strains.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Flu Influenza Virus Avian influenza Flu season Research Vaccine Treatment Genome project H5N1 strain .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[169]
.Research into new vaccines is particularly important, as current vaccines are very slow and expensive to produce and must be reformulated every year.^ Research into new vaccines is particularly important, as current vaccines are slow and expensive to produce and must be reformulated every year.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The new viral strain will eventually reach everywhere, and will infect practically every human being within a period of a few years.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Current vaccines focus on variable, strain-specific epitopes of circulating influenza virus strains and new viral strains require new vaccines.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.The sequencing of the influenza genome and recombinant DNA technology may accelerate the generation of new vaccine strains by allowing scientists to substitute new antigens into a previously developed vaccine strain.^ New technologies may one day be able to develop vaccines more ( Palese 2006 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ The sequencing of the influenza genome and recombinant DNA technology may accelerate the generation of new vaccine strains by allowing scientists to substitute new antigens into a previously developed vaccine strain.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Research - Vaccine - Avian influenza - Treatment - Genome sequencing - Season .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[170] .New technologies are also being developed to grow viruses in cell culture, which promises higher yields, less cost, better quality and surge capacity.^ New technologies are also being developed to grow viruses in cell culture , which promises higher yields, less cost, better quality and surge capacity.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ New technologies may one day be able to develop vaccines more ( Palese 2006 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ After the release of new influenza viruses, the host cell dies.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[171] .Research on a universal influenza A vaccine, targeted against the external domain of the transmembrane viral M2 protein (M2e), is being done at the University of Ghent by Walter Fiers, Xavier Saelens and their team[172][173][174] and has now successfully concluded Phase I clinical trials.^ What are the prospects for a universal influenza vaccine?
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Research on a universal influenza A vaccine, targeted against the external domain of the transmembrane viral M2 protein (M2e), is being done at the University of Ghent by Walter Fiers , Xavier Saelens and their team [99] [100] [101] and has now successfully concluded Phase I clinical trials.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ A universal influenza A vaccine based on the extracellular domain of the M2 protein .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

.A number of biologics, therapeutic vaccines and immunobiologics are also being investigated for treatment of infection caused by viruses.^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Vaccines can cause the immune system to react as if the body were actually being infected, and general infection symptoms (many cold and flu symptoms are just general infection symptoms) can appear, though these symptoms are usually not as severe or long-lasting as influenza.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ As influenza viruses are normally highly species specific, they only rarely spill over to cause infection in other species.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.Therapeutic biologics are designed to activate the immune response to virus or antigens.^ Genomic analysis of increased host immune and cell death responses induced by 1918 influenza virus .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Immunity to Influenza Virus: B- and T-cell Responses The immune system clears infection the first time a virus is encountered.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.Typically, biologics do not target metabolic pathways like anti-viral drugs, but stimulate immune cells such as lymphocytes, macrophages, and/or antigen presenting cells, in an effort to drive an immune response towards a cytotoxic effect against the virus.^ Influenza A virus nucleoprotein is a major target antigen for cross-reactive anti-influenza A virus cytotoxic T-lymphocytes.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Protective CD4+ and CD8+ T-cells against influenza virus induced by vaccination with nucleoprotein DNA. Virology 72:5648–5653.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ HA is the major antigen for neutralising antibodies, and is involved in the binding of the virus to host cell receptors.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

Infuenza models, such as murine influenza, are convenient models to test the effects of prophylactic and therapeutic biologics. .For example, Lymphocyte T-Cell Immune Modulator inhibits viral growth in the murine model of influenza.^ Other viral proteins have multiple actions in the host cell, including degrading cellular mRNA and using the released nucleotides for vRNA synthesis and also inhibiting translation of host-cell mRNAs.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Genomic analysis of increased host immune and cell death responses induced by 1918 influenza virus .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Overexpression of the influenza virus polymerase can titrate out inhibition by the murine Mx1 protein.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[175]

Infection in other animals

.Influenza infects many animal species, and transfer of viral strains between species can occur.^ Further information: Influenzavirus A , H5N1 and Transmission and infection of H5N1 Influenza infects many animal species, and transfer of viral strains between species can occur.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ With influenza virus, extensive genetic variation leads to the problem that different dominant viral strains circulate in the human population each year (Figure 5-1).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ The new viral strain will eventually reach everywhere, and will infect practically every human being within a period of a few years.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.Birds are thought to be the main animal reservoirs of influenza viruses.^ Birds are thought to be the main animal reservoirs of influenza viruses.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Wild aquatic birds are the natural hosts for a large variety of influenza A viruses.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ A variety of birds and mammals can be infected with influenza A and B viruses, naturally or in the laboratory (Kilbourne, 1987).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[176] .Sixteen forms of hemagglutinin and nine forms of neuraminidase have been identified.^ Sixteen forms of hemagglutinin and nine forms of neuraminidase have been identified.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.All known subtypes (HxNy) are found in birds, but many subtypes are endemic in humans, dogs, horses, and pigs; populations of camels, ferrets, cats, seals, mink, and whales also show evidence of prior infection or exposure to influenza.^ More cats found with bird flu .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Influenza: Including its infection among pigs.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Avian influenza A (H5N1) infection in humans.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[23] .Variants of flu virus are sometimes named according to the species the strain is endemic in or adapted to.^ Variants of flu virus are sometimes named according to the species the strain is endemic in or adapted to.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ According to this investigation, the 1918 virus was not a reassortant virus (like those of the 1957 and 1968 pandemics), but more likely an entirely avian-like virus that adapted to humans.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ With influenza virus, extensive genetic variation leads to the problem that different dominant viral strains circulate in the human population each year (Figure 5-1).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.The main variants named using this convention are: Bird Flu, Human Flu, Swine Flu, Horse Flu and Dog Flu.^ First human deaths from 'bird flu' .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Flu symptoms in birds are variable and can be unspecific.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The main variants named using this convention are: Bird Flu , Human Flu , Swine Flu , Horse Flu and Dog Flu .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.(Cat flu generally refers to Feline viral rhinotracheitis or Feline calicivirus and not infection from an influenza virus.^ Control of influenza virus infection by immunity to conserved viral features.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Cat flu generally refers to Feline viral rhinotracheitis or Feline calicivirus and not infection from an influenza virus.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Generation and evaluation of a high-growth reassortant H9N2 influenza A virus as a pandemic vaccine candidate.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

) .In pigs, horses and dogs, influenza symptoms are similar to humans, with cough, fever and loss of appetite.^ In pigs, horses and dogs, influenza symptoms are similar to humans, with cough, fever and loss of appetite.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ All known subtypes (HxNy) are found in birds, but many subtypes are endemic in humans, dogs , horses , and pigs ; populations of camels , ferrets , cats , seals , mink , and whales also show evidence of prior infection or exposure to influenza.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ In humans, common symptoms of the disease are the chills , then fever , sore throat , muscle pains , severe headache , coughing , weakness and general discomfort .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[23] .The frequency of animal diseases are not as well-studied as human infection, but an outbreak of influenza in harbour seals caused approximately 500 seal deaths off the New England coast in 1979–1980.[177] On the other hand, outbreaks in pigs are common and do not cause severe mortality.^ The frequency of animal diseases are not as well-studied as human infection, but an outbreak of influenza in harbour seals caused approximately 500 seal deaths off the New England coast in 1979–1980.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ On the other hand, outbreaks in pigs are common and do not cause severe mortality.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza: Including its infection among pigs.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[23]

Bird flu

.Flu symptoms in birds are variable and can be unspecific.^ Flu symptoms in birds are variable and can be unspecific.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The main variants named using this convention are: Bird Flu , Human Flu , Swine Flu , Horse Flu and Dog Flu .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[178] .The symptoms following infection with low-pathogenicity avian influenza may be as mild as ruffled feathers, a small reduction in egg production, or weight loss combined with minor respiratory disease.^ The symptoms following infection with low-pathogenicity avian influenza may be as mild as ruffled feathers, a small reduction in egg production, or weight loss combined with minor respiratory disease.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Symptoms of influenza may include: .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Avian influenza A (H5N1) infection in humans.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[179] .Since these mild symptoms can make diagnosis in the field difficult, tracking the spread of avian influenza requires laboratory testing of samples from infected birds.^ Since these mild symptoms can make diagnosis in the field difficult, tracking the spread of avian influenza requires laboratory testing of samples from infected birds.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ These tests may be especially useful during the influenza season (prevalence=25%) but in the absence of a local outbreak, or peri-influenza season (prevalence=10% [57] ).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ These drugs are often effective against both influenza A and B. [92] The Cochrane Collaboration reviewed these drugs and concluded that they reduce symptoms and complications.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Some strains such as Asian H9N2 are highly virulent to poultry and may cause more extreme symptoms and significant mortality.^ Some strains such as Asian H9N2 are highly virulent to poultry and may cause more extreme symptoms and significant mortality.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ In some cases, prophylaxis could be indicated when a current epidemic is caused by a strain which is not represented in the vaccine.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[180] .In its most highly pathogenic form, influenza in chickens and turkeys produces a sudden appearance of severe symptoms and almost 100% mortality within two days.^ In its most highly pathogenic form, influenza in chickens and turkeys produces a sudden appearance of severe symptoms and almost 100% mortality within two days.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Role of domestic ducks in the propagation and biological evolution of highly pathogenic H5N1 influenza viruses in Asia.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Genesis of a highly pathogenic and potentially pandemic H5N1 influenza virus in eastern Asia.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

[181] .As the virus spreads rapidly in the crowded conditions seen in the intensive farming of chickens and turkeys, these outbreaks can cause large economic losses to poultry farmers.^ Chicken flu races through Dutch poultry farms .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Authorities are using mass culling and vaccination of birds in an attempt to limit virus spread in chickens.
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

.An avian-adapted, highly pathogenic strain of H5N1 (called HPAI A(H5N1), for "highly pathogenic avian influenza virus of type A of subtype H5N1") causes H5N1 flu, commonly known as "avian influenza" or simply "bird flu", and is endemic in many bird populations, especially in Southeast Asia.^ Avian flu: H5N1 virus outbreak in migratory waterfowl .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Geographical spread of H5N1 avian influenza in birds.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Genesis of a highly pathogenic and potentially pandemic H5N1 influenza virus in eastern Asia.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

.This Asian lineage strain of HPAI A(H5N1) is spreading globally.^ This Asian lineage strain of HPAI A(H5N1) is spreading globally .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ H5N1 Influenza A virus subtype H5N1 Genetic structure Infection Human mortality Global spread in 2004 , 2005 , 2006 , 2007 Social impact Pandemic .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.It is epizootic (an epidemic in non-humans) and panzootic (a disease affecting animals of many species, especially over a wide area), killing tens of millions of birds and spurring the culling of hundreds of millions of other birds in an attempt to control its spread.^ It is epizootic (an epidemic in non-humans) and panzootic (a disease affecting animals of many species, especially over a wide area), killing tens of millions of birds and spurring the culling of hundreds of millions of other birds in an attempt to control its spread.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ The importance of animal influenza for human disease.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.Most references in the media to "bird flu" and most references to H5N1 are about this specific strain.^ Like the H5N1 virus that is currently circulating in Asia, the 1918 'Spanish Flu' pandemic virus may have originated from birds in China.
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ The H5N1 virus has already 'jumped' from birds to humans, and in one case of bird flu may have passed directly from one person to another, but this may not be the only such case, nor the last.
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

[182][183]
.At present, HPAI A(H5N1) is an avian disease, and there is no evidence suggesting efficient human-to-human transmission of HPAI A(H5N1).^ At present, H5N1 avian influenza remains largely a disease of birds.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Avian influenza A (H5N1) infection in humans.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ At present, HPAI A(H5N1) is an avian disease, and there is no evidence suggesting efficient human-to-human transmission of HPAI A(H5N1).
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

.In almost all cases, those infected have had extensive physical contact with infected birds.^ All these subtypes infect aquatic birds, and human pandemic viruses have arisen from avian viruses by reassortment (Webster, 2002).
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

[184] .In the future, H5N1 may mutate or reassort into a strain capable of efficient human-to-human transmission.^ In the future, H5N1 may mutate or reassort into a strain capable of efficient human-to-human transmission.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Haemagglutinin mutations responsible for the binding of H5N1 influenza A viruses to human-type receptors .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

The exact changes that are required for this to happen are not well understood.[185] .However, due to the high lethality and virulence of H5N1, its endemic presence, and its large and increasing biological host reservoir, the H5N1 virus was the world's pandemic threat in the 2006–07 flu season, and billions of dollars are being raised and spent researching H5N1 and preparing for a potential influenza pandemic.^ Genesis of a highly pathogenic and potentially pandemic H5N1 influenza virus in eastern Asia.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Genesis of a highly pathogenic and potentially pandemic H5N1 influenza virus in eastern Asia .
  • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

^ Flu Influenza Virus Avian influenza Flu season Research Vaccine Treatment Genome project H5N1 strain .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[164]

Swine flu

Chinese inspectors on an airplane, checking passengers for fevers, a common symptom of swine flu
.In pigs swine influenza produces fever, lethargy, sneezing, coughing, difficulty breathing and decreased appetite.^ Typically influenza is transmitted from infected mammals through the air by coughs or sneezes, creating aerosols containing the virus, and from infected birds through their droppings .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ In pigs, horses and dogs, influenza symptoms are similar to humans, with cough, fever and loss of appetite.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Influenza spreads by aerosols created by coughs or sneezes.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[186] In some cases the infection can cause abortion. Although mortality is usually low, the virus can produce weight loss and poor growth, causing economic loss to farmers.[186] Infected pigs can lose up to 12 pounds of body weight over a 3 to 4 week period.[186] .Direct transmission of an influenza virus from pigs to humans is occasionally possible (this is called zoonotic swine flu).^ European swine virus as a possible source for the next influenza pandemic?
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Swine influenza: Experimental transmission and pathology.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

^ Swine influenza virus in swine and man in Illinois.
  • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

.In all, 50 human cases are known to have occurred since the virus was identified in the mid-20th century, which have resulted in six deaths.^ Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ Since 1959, human infections with avian influenza viruses have only rarely occurred.
  • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

^ Influenza B virus is almost exclusively a human pathogen and is less common than influenza A. The only other animal known to be susceptible to influenza B infection is the seal .
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

[187]
In 2009, a swine-origin H1N1 virus strain commonly referred to as "swine flu" caused the 2009 flu pandemic, but there is no evidence that it is endemic to pigs (i.e. actually a swine flu) or of transmission from pigs to people, instead the virus is spreading from person to person.[188][189] This strain is a reassortment of several strains of H1N1 that are usually found separately, in humans, birds, and pigs.[190]

See also

Information concerning flu research can be found at

References

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  178. ^ Elbers A, Koch G, Bouma A (2005). "Performance of clinical signs in poultry for the detection of outbreaks during the avian influenza A (H7N7) epidemic in The Netherlands in 2003". Avian Pathol 34 (3): 181–7. doi:10.1080/03079450500096497. PMID 16191700. 
  179. ^ Capua I, Mutinelli F. "Low pathogenicity (LPAI) and highly pathogenic (HPAI) avian influenza in turkeys and chicken." In: Capua I, Mutinelli F. (eds.), A Colour Atlas and Text on Avian Influenza, Papi Editore, Bologna, 2001, pp. 13–20
  180. ^ Bano S, Naeem K, Malik S (2003). "Evaluation of pathogenic potential of avian influenza virus serotype H9N2 in chickens". Avian Dis 47 (3 Suppl): 817–22. doi:10.1637/0005-2086-47.s3.817. PMID 14575070. 
  181. ^ Swayne D, Suarez D (2000). "Highly pathogenic avian influenza". Rev Sci Tech 19 (2): 463–82. PMID 10935274. 
  182. ^ Li K, Guan Y, Wang J, Smith G, Xu K, Duan L, Rahardjo A, Puthavathana P, Buranathai C, Nguyen T, Estoepangestie A, Chaisingh A, Auewarakul P, Long H, Hanh N, Webby R, Poon L, Chen H, Shortridge K, Yuen K, Webster R, Peiris J (2004). "Genesis of a highly pathogenic and potentially pandemic H5N1 influenza virus in eastern Asia". Nature 430 (6996): 209–13. doi:10.1038/nature02746. PMID 15241415. 
  183. ^ Li KS, Guan Y, Wang J, Smith GJ, Xu KM, Duan L, Rahardjo AP, Puthavathana P, Buranathai C, Nguyen TD, Estoepangestie AT, Chaisingh A, Auewarakul P, Long HT, Hanh NT, Webby RJ, Poon LL, Chen H, Shortridge KF, Yuen KY, Webster RG, Peiris JS. "The Threat of Pandemic Influenza: Are We Ready?" Workshop Summary The National Academies Press (2005) "Today's Pandemic Threat: Genesis of a Highly Pathogenic and Potentially Pandemic H5N1 Influenza Virus in Eastern Asia", pages 116–130
  184. ^ Liu J (2006). "Avian influenza—a pandemic waiting to happen?" (PDF). J Microbiol Immunol Infect 39 (1): 4–10. PMID 16440117. http://jmii.org/content/pdf/v39n1p4.pdf. 
  185. ^ Salomon R, Webster RG (February 2009). "The influenza virus enigma". Cell 136 (3): 402–10. doi:10.1016/j.cell.2009.01.029. PMID 19203576. 
  186. ^ a b c Kothalawala H, Toussaint MJ, Gruys E (June 2006). "An overview of swine influenza". Vet Q 28 (2): 46–53. PMID 16841566. 
  187. ^ Myers KP, Olsen CW, Gray GC (April 2007). "Cases of swine influenza in humans: a review of the literature". Clin. Infect. Dis. 44 (8): 1084–8. doi:10.1086/512813. PMID 17366454. PMC 1973337. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17366454. 
  188. ^ Maria Zampaglione (April 29, 2009). "Press Release: A/H1N1 influenza like human illness in Mexico and the USA: OIE statement". World Organisation for Animal Health. http://www.oie.int/eng/press/en_090427.htm. Retrieved April 29, 2009. 
  189. ^ "W.H.O. Gives Swine Flu a Less Loaded, More Scientific Name - NYTimes.com". http://www.nytimes.com/2009/05/01/health/01name.html?scp=5&sq=&st=nyt. 
  190. ^ "Virus’s Tangled Genes Straddle Continents, Raising a Mystery About Its Origins - NYTimes.com". http://www.nytimes.com/2009/05/01/health/01origin.html?scp=2&sq=&st=nyt. 

Further reading

General
  • Beigel JH, Farrar J, Han AM, et al. (September 2005). ."Avian influenza A (H5N1) infection in humans".^ Avian-to-human transmission of the PB1 gene of influenza A viruses in the 1957 and 1968 pandemics.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ^ Of the hundreds of strains of avian influenza A viruses, only four are known to have caused human infection: H5N1, H7N3, H7N7, and H9N2 ( WHO 200601 ).
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    ^ Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO. 23 December 2005.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    .N Engl J Med. 353 (13): 1374–85. doi:10.1056/NEJMra052211.^ Nature 442, 114-115 (13 July 2006) doi :10.1038/442114a .
    • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

    ^ Full text at http://content.nejm.org/cgi/content/extract/353/13/1374 WHO 20050818.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    ^ N Engl J Med 2005b; 353: 2667-72.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    PMID 16192482. .http://content.nejm.org/cgi/content/full/353/13/1374. 
  • Bernd Sebastian Kamps, Christian Hoffmann and Wolfgang Preiser (Eds.^ NEJM's Avian Influenza Bernd Sebastian Kamps, Christian Hoffmann and Wolfgang Preiser (Eds.
    • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

    ) .Influenza Report, 225 pp, PDF, free download.^ Download (free) PDF, 225 pages, 2.8 MB ISBN 3-924774-51-X 25 € Publish this book under your own name 1.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    .Flying Publisher 2006
  • Levine, Arnold J. (1992).^ Influenza Report 2006 Flying publisher 2006.
    • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

    ^ Arnold J. Levine, Viruses , Scientific American Library, WH Freeman, 1992, ISBN 0-7167-5031-7 Samuel Baron, et al.
    • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

    ^ Flying Publisher, Wuppertal, 2006 - Available from http://www.influenzareport.com/ir/vaccines.htm Kuiken T, Rimmelzwaan G, van Riel D, et al.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    Viruses. .New York: Scientific American Library.^ Arnold J. Levine, Viruses , Scientific American Library, WH Freeman, 1992, ISBN 0-7167-5031-7 Samuel Baron, et al.
    • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

    .ISBN 0-7167-5031-7. 
  • Baron, Samuel (1996).^ Arnold J. Levine, Viruses , Scientific American Library, WH Freeman, 1992, ISBN 0-7167-5031-7 Samuel Baron, et al.
    • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

    Medical microbiology (4th ed.). .Galveston, Tex: University of Texas Medical Branch at Galveston.^ Medical Microbiology Fourth Edition, The University of Texas Medical Branch at Galveston, 1996, ISBN 0-9631172-1-1 .
    • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

    ISBN 0-9631172-1-1. .http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed. 
  • Cox NJ, Subbarao K (October 1999).^ Available from http://www.cdc.gov/ncidod/EID/vol12no01/05-1371.htm WHO 2006b.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    ^ Available: http://www.hhs.gov/nvpo/pandemicplan/ [accessed December 17, 2004].
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ^ According to data from http://www.census.gov/ipc/www/world.html + http://Influenzareport.com/link.php?id=20 .
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    "Influenza". Lancet 354 (9186): 1277–82. doi:10.1016/S0140-6736(99)01241-6. PMID 10520648. 
  • ISBN 9783211808924 The Influenza Viruses Hoyle L 1968 Springer Verlag
History
  • Kilbourne ED (January 2006). ."Influenza pandemics of the 20th century".^ In the early 20th century, science was sufficiently sophisticated to anticipate that influenza, which had twice reached pandemic proportions in the late 19th century, would recur, but was largely powerless to blunt the devastating impact of the 1918 (H1N1) pandemic.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ^ Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans.
    • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

    ^ In particular, these studies reveal a signature change in excess mortality from the elderly to younger age groups, a “pandemic age shift,” that occurred with each of the three pandemics of the 20th century.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    .Emerging Infect Dis. 12 (1): 9–14. PMID 16494710.^ Emerg Infect Dis 2005; 11: 1036-41.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    ^ Emerg Infect Dis 2005; 11: 201-9.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    ^ Emerg Infect Dis 2005; 11: 699-701.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    .http://www.cdc.gov/ncidod/EID/vol12no01/05-1254.htm.
     
  • Collier, Richard (1974).^ Full text at http://www.cdc.gov/ncidod/EID/vol12no01/05-0965.htm Gilbert M. Free-grazing Ducks and Highly Pathogenic Avian Influenza, Thailand.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    ^ Courtesy of CDC/ Cynthia Goldsmith, Jacqueline Katz, and Sharif R. Zaki, Public Health Image Library, http://phil.cdc.gov/Phil/home.asp .
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    ^ Full text at http://www.cdc.gov/ncidod/EID/vol12no01/05-0979.htm Taubenberger JK, Reid AH, Krafft AE, Bijwaard KE, Fanning TG. Initial genetic characterization of the 1918 "Spanish" influenza virus.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    .The plague of the Spanish lady: the influenza pandemic of 1918–1919.^ Characterization of the reconstructed 1918 Spanish influenza pandemic virus.
    • Influenza Book | Overview; 32 pages, 153 references 28 January 2010 0:00 UTC www.influenzareport.com [Source type: Academic]

    ^ The geography and mortality of the 1918 influenza pandemic.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ^ Pandemic influenza 1918.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    New York: Macmillan. ISBN 0-333-13864-3. 
  • Barry, John M. (2004). .The great influenza: the epic story of the deadliest plague in history.^ The Great Influenza: The Epic Story of the 1918 Pandemic by John M. Barry .
    • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

    ^ Influenza: The Last Great Plague, an Unfinished Story of Discovery.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ^ Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It .
    • Avian flu : Web focus : Nature 14 January 2010 14:46 UTC www.nature.com [Source type: Academic]

    .New York, N.Y: Viking.^ New York: Viking Press.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ISBN 0-670-89473-7.
     
Microbiology
.
  • Webster RG, Bean WJ, Gorman OT, Chambers TM, Kawaoka Y (1 March 1992).^ Schafer JR, Kawaoka Y, Bean WJ, Suss J, Senne D, Webster RG. 1993.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ^ Gorman OT, Bean WJ, Kawaoka Y, Donatelli I, Guo YJ, Webster RG. 1991.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ^ Kawaoka Y, Krauss S, Webster RG. 1989.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ."Evolution and ecology of influenza A viruses".^ Evolution and ecology of influenza A viruses.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ^ Positive Darwinian evolution in human influenza A viruses.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ^ Evolution of influenza A virus nucleoprotein genes: Implications for the origins of H1N1 human and classical swine viruses.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    .Microbiol Rev. 56 (1): 152–79. PMID 1579108.^ Microbiol Rev 56:152–179.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    PMC 372859. .http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=1579108. 
  • Steinhauer DA, Skehel JJ (2002).^ Gamblin SJ, Haire LF, Russell RJ, Stevens DJ, Xiao B, Ha Y, Vasisht N, Steinhauer DA, Daniels RS, Elliot A, Wiley DC, Skehel JJ. 2004.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ."Genetics of influenza viruses". Annu.^ Genetic reassortment between avian and human influenza A viruses in Italian pigs.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    ^ Multiple genetic reassortment of avian and human influenza A viruses in European pigs, resulting in the emergence of an H1N2 virus of novel genotype.
    • The Threat of Pandemic Influenza: Are We Ready? Workshop Summary 28 January 2010 0:00 UTC www.nap.edu [Source type: Academic]

    Rev. Genet.
    36: 305–32. doi:10.1146/annurev.genet.36.052402.152757. PMID 12429695. 
Pathogenesis
Epidemiology
Treatment and prevention
Research

External links

.

Source material

Up to date as of January 22, 2010
(Redirected to The Influenza article)

From Wikisource

The Influenza
by Winston Churchill
A poem written in 1890, when Churchill was only 15 years old and attending Harrow School.
    Oh how shall I its deeds recount
    Or measure the untold amount
    Of ills that it has done?
    From China’s bright celestial land
    E’en to Arabia’s thirsty sand
    It journeyed with the sun.

    O’er miles of bleak Siberia’s plains
    Where Russian exiles toil in chains
    It moved with noiseless tread;
    And as it slowly glided by
    There followed it across the sky
    The spirits of the dead.
.
    The Ural peaks by it were scaled
    And every bar and barrier failed
    To turn it from its way;
    Slowly and surely on it came,
    Heralded by its awful fame,
    Increasing day by day.
^ This way you can be sure to be protected when the flu season peaks around the month of February.
  • Preparing for Influenza Season 28 January 2010 0:00 UTC www.foh.dhhs.gov [Source type: General]

^ The disturbing revelation that something you do every day could be increasing your risk of infection.
  • Pandemic Flu Advantage 14 January 2010 14:46 UTC fluadvantage.com [Source type: General]

^ The flu vaccines that are given to the population every year are not a sure way since the vaccine only builds immunity to one or two antigens.
  • influenza@Everything2.com 28 January 2010 0:00 UTC www.everything2.com [Source type: FILTERED WITH BAYES]
  • influenza@Everything2.com 14 January 2010 14:46 UTC www.everything2.com [Source type: FILTERED WITH BAYES]


.
    On Moscow’s fair and famous town
    Where fell the first Napoleon’s crown
    It made a direful swoop;
    The rich, the poor, the high, the low
    Alike the various symptoms know,
    Alike before it droop.
^ The contagious period varies, but probably begins the day before symptoms appear and lasts for about a week.
  • Influenza Fact Sheet 28 January 2010 0:00 UTC health.utah.gov [Source type: FILTERED WITH BAYES]

^ Since you can have the flu for 3 days before showing symptoms, it makes sense to keep a low level of elderberry in the system throughout flu season.

^ The flu can be spread from an infected person from the day before illness until about seven days after they first have symptoms, so infected people are contagious before they even know they are sick.
  • Influenza Fact Sheet 28 January 2010 0:00 UTC www.doh.wa.gov [Source type: FILTERED WITH BAYES]



    Nor adverse winds, nor floods of rain
    Might stay the thrice-accursed bane;
    And with unsparing hand,
    Impartial, cruel and severe
    It travelled on allied with fear
    And smote the fatherland.
.
    Fair Alsace and forlorn Lorraine,
    The cause of bitterness and pain
    In many a Gaelic breast,
    Receive the vile, insatiate scourge,
    And from their towns with it emerge
    And never stay nor rest.
^ Many people with uncomplicated influenza use over-the-counter medicines to help lessen their symptoms, in addition to staying home and getting adequate rest and fluids.
  • Influenza (Flu) Antiviral Drugs and Related Information 14 January 2010 14:46 UTC www.fda.gov [Source type: Academic]



    And now Europa groans aloud,
    And ‘neath the heavy thunder-cloud
    Hushed is both song and dance;
    The germs of illness wend their way
    To westward each succeeding day
    And enter merry France.
.
    Fair land of Gaul, thy patriots brave
    Who fear not death and scorn the grave
    Cannot this foe oppose,
    Whose loathsome hand and cruel sting,
    Whose poisonous breath and blighted wing
    Full well thy cities know.
^ SK: Well, who knows?
  • GQ Blog on men.style.com 16 September 2009 9:09 UTC men.style.com [Source type: General]

^ It’s the ideal way to grasp where you stand as well as knowing what’s going in your state, in your city, in your town, and in your neighborhood.
  • Swine Flu Symptoms & How to Avoid Swine Flu 14 January 2010 14:46 UTC swineflusymptomsof.com [Source type: General]

^ But what concerns the World Health Organization (WHO) most is the increased number of people diagnosed with H1N1 strains as well as the increase in the death toll.
  • Swine Flu Symptoms & How to Avoid Swine Flu 14 January 2010 14:46 UTC swineflusymptomsof.com [Source type: General]


.
    In Calais port the illness stays,
    As did the French in former days,
    To threaten Freedom’s isle;
    But now no Nelson could o’erthrow
    This cruel, unconquerable foe,
    Nor save us from its guile.
^ If you are sick with a flu-like illness, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer.

^ Extend the period for ill persons to stay home: If influenza severity increases, people with flu-like illness should stay home for at least 7 days, even if they have no more symptoms.
  • VDOE :: H1N1 Influenza A (Swine Flu) & Virginia Public Schools 28 January 2010 0:00 UTC www.doe.virginia.gov [Source type: FILTERED WITH BAYES]

^ (Previous recommendations were to stay home for 7 days after illness onset or until 24 hours after the resolution of symptoms, whichever was longer.
  • Clarkson University: Flu Information 14 January 2010 14:46 UTC www.clarkson.edu [Source type: News]



    Yet Father Neptune strove right well
    To moderate this plague of Hell,
    And thwart it in its course;
    And though it passed the streak of brine
    And penetrated this thin line,
    It came with broken force.

    For though it ravaged far and wide
    Both village, town and countryside,
    Its power to kill was o’er;
    And with the favouring winds of Spring
    (Blest is the time of which I sing)
    It left our native shore.
.
    God shield our Empire from the might
    Of war or famine, plague or blight
    And all the power of Hell,
    And keep it ever in the hands
    Of those who fought ‘gainst other lands,
    Who fought and conquered well.
^ Clean Hands Saves lives : Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others.
  • Influenza Information (EUSD Emergency Information) 28 January 2010 0:00 UTC sites.google.com [Source type: General]

^ On the other hand, those who experience some brief anxiety, like missing an important meeting because they have to wait in a long line for a flu shot, may respond better to the vaccine.

^ To talk to other people who share your health issues, check out our health community .
  • Scientists May Have New Way to Fight the Flu - US News and World Report 16 September 2009 9:09 UTC health.usnews.com [Source type: News]

PD-icon.svg This work is in the .public domain in the United States because it was published before January 1, 1923. It may be copyrighted outside the U.S. (see Help:Public domain).^ A. On April 26, 2009, the United States Department of Health & Human Services declared a nationwide public health emergency involving 2009 H1N1.
  • H1N1 (Swine) Influenza Information 28 January 2010 0:00 UTC browardschools.com [Source type: FILTERED WITH BAYES]

^ That is why, although you may have had flu before, you can contract it again because your body has not built up an immunity to the new strain.

^ Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators.
  • OSAP: H1N1 Page 28 January 2010 0:00 UTC www.osap.org [Source type: FILTERED WITH BAYES]

Flag of the United States.svg

1911 encyclopedia

Up to date as of January 14, 2010

From LoveToKnow 1911

INFLUENZA (syn. ."grip," la grippe), a term applied to an infectious febrile disorder due to a specific bacillus, characterized specially by catarrh of the respiratory passages and alimentary canal, and occurring mostly as an epidemic.^ Influenza types A and B are responsible for epidemics of respiratory illness that occur almost every winter and are often associated with increased rates for hospitalization and death.
  • Influenza 28 January 2010 0:00 UTC www.umm.edu [Source type: FILTERED WITH BAYES]
  • Influenza (Flu) - University of Chicago Medical Center 28 January 2010 0:00 UTC www.uchospitals.edu [Source type: FILTERED WITH BAYES]

^ Influenza types A and B are responsible for epidemics of respiratory illness that occur almost every winter and are often associated with increased rates of hospitalization and death.
  • Influenza Information on Healthline 28 January 2010 0:00 UTC www.healthline.com [Source type: FILTERED WITH BAYES]
  • Influenza | CHOP | The Children's Hospital of Philadelphia 28 January 2010 0:00 UTC www.chop.edu [Source type: FILTERED WITH BAYES]

^ Epidemics occur each winter, and usually begin with a sudden increase in its appearance in the primary care facilities of school-age children with febrile (associated with fever) respiratory tract illnesses.

.The Italians in the 17th century ascribed it to the influence of the stars, and hence the name "influenza."^ The name influenza comes from the Italian influenza, meaning "influence" (Latin: influentia).
  • Flu Remedies and Natural Cures from the Earth Clinic Community. 14 January 2010 14:46 UTC www.earthclinic.com [Source type: General]

^ The name influenza is Italian and means "influence" .

^ The name influenza has its origin in early fifteenth century Italy and was adopted in Europe to explain the sudden appearance of an epidemic disease thought to be under the influence of the stars.
  • Swine influenza: a zoonosis - (c) Veterinary Sciences Tomorrow 28 January 2010 0:00 UTC www.vetscite.org [Source type: Academic]

.The French name grippe came into use in 1743, and those of petite poste and petit courier in 1762, while general became another synonym in 1780. Apparently the scourge was common; in 1403 and 1557 the sittings of the Paris law courts had to be suspended through it, and in 1427 sermons had to be abandoned through the coughing and sneezing; in is io masses could not be sung.^ The infection spreads through droplets (aerosols) that are generated by coughing or sneezing.
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

^ Influenza, also known as the flu, is transmitted from person to person through sneezes, coughs and touching with hands that were sneezed or coughed into without being washed afterwards.
  • Flu in New Mexico - Influenza Information 14 January 2010 14:46 UTC www.health.state.nm.us [Source type: News]

^ H1N1 is a type of influenza which means it is a respiratory disease that is spread from person-to-person by coming into contact with the germs spread when someone who is infected coughs or sneezes.
  • H1N1 Influenza (swine flu) 28 January 2010 0:00 UTC www.co.thurston.wa.us [Source type: FILTERED WITH BAYES]

Epidemics occurred in 1580, 1676, 1703, 1732 and 1737, and their cessation was supposed to be connected with earthquakes and volcanic eruptions.
.The disease is referred to in the works of the ancient physicians, and accurate descriptions of it have been given by medical writers during the last three centuries.^ Antigenic shift refers to a major change in NA or HA that occurs in influenza A (antigenic shift) at infrequent intervals (10 to 40 yr during the last century); as a result, the population has no immunity to the new virus, and pandemic influenza may occur.
  • Influenza: Respiratory Viruses: Merck Manual Professional 28 January 2010 0:00 UTC www.merck.com [Source type: Academic]

^ The Centers for Disease Control and Prevention (CDC) estimates that 5 to 20 percent of Americans come down with the flu during each flu season, which typically lasts from November to March.
  • The Flu Types—Seasonal, Pandemic, Avian (Bird), Swine 14 January 2010 14:46 UTC www3.niaid.nih.gov [Source type: FILTERED WITH BAYES]
  • Fight the Flu | Womens Health Base 14 January 2010 14:46 UTC www.womenshealthbase.com [Source type: FILTERED WITH BAYES]

^ In the last century this has happened three times: in 1918 (Spanish influenza), 1957 (Asian influenza) and 1968 (Hong Kong influenza).
  • Influenza - EUphact 28 January 2010 0:00 UTC www.euphix.org [Source type: Academic]

.These various accounts agree substantially in their narration of the phenomena and course of the disease, and influenza has in all times been regarded as fulfilling all the conditions of an epidemic in its sudden invasion, and rapid and extensive spread.^ The effectiveness of these influenza vaccines is variable.
  • Bing Health Article - Influenza 28 January 2010 0:00 UTC www.bing.com [Source type: Academic]

^ List of all conditions/diseases .

^ The name influenza has its origin in early fifteenth century Italy and was adopted in Europe to explain the sudden appearance of an epidemic disease thought to be under the influence of the stars.
  • Swine influenza: a zoonosis - (c) Veterinary Sciences Tomorrow 28 January 2010 0:00 UTC www.vetscite.org [Source type: Academic]

.Among the chief epidemics were those of 1762, 1782, 1787, 1803, 1833, 1837 and 1847. It appeared in fleets at sea away from all communication with land, and to such an extent as to disable them temporarily for service.^ Do home and community-based service providers in day and residential programs for people with disabilities have priority for receiving the 2009 H1N1 flu vaccines?
  • Flu FAQs Related to H1N1 & Seasonal Vaccines 14 January 2010 14:46 UTC answers.flu.gov [Source type: News]

^ Screening patients for influenza-like illness by phone or before coming into the facility and rescheduling appointments for those whose care is nonemergency Canceling all nonemergency services when there is pandemic influenza in the community .
  • HHS Pandemic Influenza Plan  Supplement 4 Infection Control 28 January 2010 0:00 UTC www.hhs.gov [Source type: Academic]

^ When a new subtype appears, all people are susceptible except those who have lived through earlier epidemics caused by a related subtype.
  • Influenza- Blue Book: IDEAS - Victorian Government 28 January 2010 0:00 UTC www.health.vic.gov.au [Source type: Academic]

.This happened in 1782 in the case of the squadron of Admiral Richard Kempenfelt (1718-1782), which had to return to England from the coast of France in consequence of influenza attacking his crews.^ We’ve just returned from England (lots of swine flu) to France (not so many cases) and my children spent the journey back thinking of badge designs and slogans to indicate that they might be infectious and should not be kissed.
  • Dabbled » Blog Archive » Oh Joy! The Flu! 16 September 2009 9:09 UTC dabbled.org [Source type: FILTERED WITH BAYES]

^ For the geographical spread of influenza, England, France and Scotland reported sporadic influenza activity, which means that isolated cases of laboratory-confirmed influenza infection have been detected.
  • Influenza 28 January 2010 0:00 UTC