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H1n1 Influenza Essay

Influenza A H1 N1 Virus Essay

Introduction
In 1918-19 approximately 50 million deaths were a detriment of the Spanish H1N1 virus pandemic; a respiratory virus. According to the World Health Organization, the second Influenza A H1N1 pandemic in 2009 spread to more than 200 countries causing more than 18 000 deaths. Before the World Health Organization had announced the official end of the pandemic in August 2010, in July 2009 the World Health Organization sent out a phase 6 warning that H1N1 could soon be a global pandemic. It is important to recognize that the 2 different outbreaks had different A/H1N1strains effecting the world population; this suggests A/H1N1has a high ability for mutation, severely complicating the human body’s natural immune mechanism of antigenic drift. (Qi-Shi Du et al., 2010)
Epidemiology
According to the Swine flu investigation team on April 15 and April 17, 2009, novel swine-origin influenza A (H1N1) virus (S-OIV) was isolated from two epidemiologically unlinked patients in the United States. The same strain was identified in other countries such as Mexico and Canada. In the United States 60% of patients were 18 years of age or younger suggesting that the younger population was more susceptible to the transmission of S-OIV or the possibility that the older population had developed a small amount of antibodies from the 1976 swine influenza vaccine (H1N1). 18% of the patients had recently traveled to Mexico, and 16% were identified from school outbreaks. (France, Jackson & Schrag, 2010) The most common presenting symptoms were fever (94% of patients), cough (92%), and sore throat (66%); 25% of patients had diarrhea, and 25% were experiencing emesis. Therefore, the criteria characterizing the S-OIV infection are comparable to the seasonal influenza symptoms such as cough, sore throat, rhinorrhea, headache, and myalgia. Statistically, the transmission rates were observed to be consistent with the seasonal influenza in Hong Kong 2007. (Cowling, Fang, Riley, Malik Peiris & Leung, 2009) In the investigation conducted by the swine flu investigation team they determined that the transmission in households was completed in less than a week from host to host. (France, Jackson & Schrag, 2010) Still this is significantly less than the school outbreak transmissions (11.3% of household contacts, compared with >30% of school A students) The recommendation to reduce transmission is to encourage domestic discussions about prevention.
PDF Document Attached-Table 2. Symptom Profiles in Groups of Patients with Suspected or Confirmed Pandemic 2009 H1N1 Virus Infection Worldwide. (Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza New England Journal of Medicine 2010; 362:1708-1719May 6, 2010)
Etiology
An influenza virus possesses 8 genes, 6 derived from the triple North American swine virus lineages and 2 from the Eurasian swine virus lineage. (Cauchemez, Donnelly, & Reed, 2003) Influenza A is a part of the...

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Swine influenza virus is a virus that is common in pigs. This type of influenza virus can also infect humans and birds. Swine influenza virus is sometimes called SIV or swine flu.

Swine flu is common in pigs. Normally, it only infects people who have been in close contact with pigs. However, the disease has also spread from one person to another.[1] Swine flu can cause fever, disorientation (not being clear-headed), stiffness of the joints, vomiting, and loss of consciousness. Sometimes this ends in death.[2] There are different types, or strains, of swine flu. They are called H1N1,[3]H1N2,[3]H3N1,[4]H3N2,[3] and H2N3.[5]

Background[change | change source]

H1N1 came from the Spanish flu, which caused a pandemic in humans in 1918 and 1919.[6][7] New viruses came from the Spanish flu. These viruses became common in pigs. Every once in a while, the viruses spread from pigs to humans. This has happened during the 20th century. (However, they happened at the same time as the flu epidemics that happen every year. Because of this, it is hard to tell the difference between 'normal' influenza and swine influenza.)[6] Infections that spread from pigs to humans are rare. Scientists only know of 12 known cases in the United States since 2005.[8]

It is very difficult to prevent the flu virus. This is because the virus changes all the time. If a person gets the flu, his body forms antibodies to fight that virus off if it happens again. But since the flu virus changes all the time, a person's antibodies do not recognize the virus the next time it happens, because it is different. The same thing happens with vaccines.

The changes in the flu virus can cause a flu pandemic. For example, the virus might only change a little bit in about two to three years. After about ten years, most people will have developed antibodies to fight these small changes. But if the virus then changes a lot, there can be a pandemic. Hundreds of millions of people suddenly realize that the antibodies they developed are useless.[9] Even during the Spanish flu pandemic, the first wave of the disease was relatively mild, while the second wave was very deadly.[7]

In 1957, an Asian flu pandemic infected about 45 million Americans and killed 70,000. Eleven years later, from 1968 to 1969, the Hong Kong flu pandemic infected 50 million Americans and caused 33,000 deaths. It also cost about $3.9 billion. In 1976, about 500 soldiers became infected with swine flu over a few weeks. However, by the end of the month, investigators found that the virus had "mysteriously disappeared", and there were no more signs of swine flu anywhere on the post.[7] There were a small number of isolated (far-apart) cases around the U.S. However, these were in people who were thought to have caught the virus from pigs.

Scientists fear the swine flu virus might mutate, or change, into a pandemic as deadly as the 1918/1919 pandemic. They watched the outbreak in 2009, and made plans about what to do if a global pandemic breaks out.

Symptoms[change | change source]

The main symptoms of the swine influenza is much the same as regular influenza. Symptoms include vomiting, nausea, runny nose, (loss of appetite), lethargy (feeling tired), chills, fever, body aches, sore throat, coughing, diarrhea, and stomach ache.

Where swine influenza is found[change | change source]

The bird flu virus H3N2 is endemic in pigs in China. It has recently been found in pigs in Vietnam. Specialists also think that this might lead to new variations of the influenza virus.[10] Pigs can carry human influenza viruses. These viruses can combine in new ways, and exchange certain genes with H5N1. Through mutation, this would create a form of the virus that can pass easily among humans.[11]H3N2 evolved from H2N2 by antigenic shift.[12] In August 2004, researchers in China found H5N1 in pigs.[13]

In 2005 it was discovered that H5N1 could be infecting up to half of the pig population in some areas of Indonesia, but without showing symptoms. Chairul Nidom, a virologist at Airlangga University's tropical disease center in Surabaya, East Java, did some independentresearch: he tested the blood of 10 apparently healthy pigs housed near poultry farms in West Java where avian flu had broken out, Nature reported. Five of the pig samples contained the H5N1 virus. The Indonesian government has since found similar results in the same region. Additional tests of 150 pigs outside the area were negative.[14][15]

Swine Flu in Humans[change | change source]

The Centers for Disease Control and Prevention (CDC), a United States government agency, reports that the symptoms and transmission of the swine flu from human to human is much like seasonal flu. Usually, the symptoms are fever, lethargy (feeling tired), lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhoea.[17] It is believed to be spread between humans when an infected person coughs or sneezes and then touches something. Another person then might touch the same thing with the virus on it and then touch their own nose or mouth.[18] The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can be contagious for up to ten days. Diagnosis can be made by sending a specimen (sample), collected during the first five days, to the CDC for analysis.[19]

The Swine Flu is susceptible to four licensed drugs in the United States, amantadine, rimantadine, oseltamivir and zanamivir. However, for the 2009 outbreak, it is recommended it be treated with oseltamivir and zanamivir.[20] The vaccine for the human seasonal flu does not protect against the swine flu. Even if the virus strains are the same specific variety, the antigenicity is very different.[21]

Veterinary swine flu vaccine[change | change source]

The virus has evolved in recent decades. This has made Swine influenza a bigger problem, mainly because traditional vaccines against influenza do not always work against Swine influenza. There are special vaccines against Swine influenza, but they only work if the virus strain is similar to some extent. In the cases more difficult to treat, special vaccines are produced. These are very similar, as they are made to match the specific virus strain.[22][23]

Present vaccination strategies for SIV control and prevention in swine farms, typically include the use of one of several bivalent SIV vaccines commercially available in the United States. Of the 97 recent H3N2 isolates examined, only 41 isolates had strong serologic cross-reactions with antiserum to three commercial SIV vaccines. Since the protective ability of influenza vaccines depends primarily on the closeness of the match between the vaccine virus and the epidemic virus, the presence of non-reactive H3N2 SIV variants suggests that current commercial vaccines might not effectively protect pigs from infection with a majority of H3N2 viruses.[24][25]

The current vaccine against the seasonal influenza strain H1N1 is thought unlikely to provide protection.[26] The director of CDC's National Center for Immunization and Respiratory Diseases said that the United States' cases were found to be made up of genetic elements from four different flu viruses—North American swine influenza, North American avian influenza, human influenza A virus subtype H1N1, and swine influenza virus typically found in Asia and Europe. On two cases, a complete genome sequence had been obtained. She said that the virus is resistant to amantadine and rimantadine, but susceptible to oseltamivir (Tamiflu) and zanamivir (Relenza).[27][28][29]

2009 outbreak[change | change source]

A new strain of swine influenza A called H1N1 was responsible for the swine flu outbreak in 2009 in humans. It resulted from a combination of several strains of influenza in humans and influenza in birds as well as swine influenza. Tests were done, they found that the hemagglutinin (HA) gene was similar to that of swine flu viruses present in United States pigs since 1999, but the neuraminidase (NA) and matrix protein (M) genes resembled versions present in European swine. Viruses that were built like this had not been found in humans or pigs before. There is no program to monitor what viruses are circulating in pigs in the United States, however.[30]

Related pages[change | change source]

References[change | change source]

  1. Cuevas Mayra, Curley Ann, Hellerman Caleb, Quijano Elaine, Candiotti Susan (25 April 2009). "More cases of swine flu reported; WHO warns of health emergency". 
  2. "World Health Organization: Swine flu could spread globally". CNN.com. Retrieved 2009-04-25. 
  3. 3.03.13.2"Swine Influenza". Swine Diseases (Chest). Iowa State University College of Veterinary Medicine. 
  4. ↑eurekalert Tips from the Journals of the American Society for Microbiology - Novel H3N1 Swine Influenza Virus Identified in Pigs in Korea
  5. ↑PNAS Published online before print December 18, 2007, doi: 10.1073/pnas.0710286104 PNAS December 26, 2007 vol. 104 no. 52 20949-20954
  6. 6.06.1Taubenberger JK, Morens DM (2006). "1918 Influenza: the mother of all pandemics". Emerg Infect Dis12 (1): 15–22. PMID 16494711. https://www.cdc.gov/ncidod/eid/vol12no01/05-0979.htm. 
  7. 7.07.17.2"Soft evidence and hard sell". New York Times. 5 September 1976. 
  8. "U.S. pork groups urge hog farmers to reduce flu risk". Reuters. 26 April 2009. 
  9. ↑"The Last Great Swine Flu Epidemic", Salon.com, April 28, 2009
  10. ↑Yu, H. (March 2008). "Genetic evolution of swine influenza A (H3N2) viruses in China from 1970 to 2006". Journal of Clinical Microbiology46 (3): 1067. doi:10.1128/JCM.01257-07. PMID 18199784. http://jcm.asm.org/cgi/content/full/46/3/1067?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=phylogenetic&searchid=1&FIRSTINDEX=230&resourcetype=HWFIG. 
  11. "Bird flu and pandemic influenza: what are the risks?". UK Department of Health. 
  12. "Genetic analysis of human H2N2 and early H3N2 influenza viruses, 1957–1972: evidence for genetic divergence and multiple reassortment events". ScienceDirect. 
  13. World Health Organization (October 28, 2005). "H5N1 avian influenza: timeline"(PDF). 
  14. "Indonesian pigs have avian flu virus; bird cases double in China". CIDRAP. 27 May 2005. 
  15. Roos Robert, ed. (31 March 2009). University of Minnesota: Center for Infectious Disease Research & Policy http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/mar3109swine-jw.html. Retrieved 2009-04-26.  Report on pigs as carriers
  16. International Committee on Taxonomy of Viruses. "The Universal Virus Database, version 4: Influenza A". 
  17. "Q & A: Key Facts about Swine Influenza (Swine Flu) - Symptoms". Centers for Disease Control and Prevention. 24 April 2009. Retrieved 2009-4-26. 
  18. "Q & A: Key Facts about Swine Influenza (Swine Flu) – Spread of Swine Flu". Centers for Disease Control and Prevention. 24 April 2009. Retrieved 2009-4-26. 
  19. "Q & A: Key Facts about Swine Influenza (Swine Flu) – Diagnosis". Centers for Disease Control and Prevention. 24 April 2009. Retrieved 2009-4-26. 
  20. "Q & A: Key Facts about Swine Influenza (Swine Flu) – Treatment". Centers for Disease Control and Prevention. 2009-4-24. Retrieved 2009-4-26. 
  21. "Q & A: Key Facts about Swine Influenza (Swine Flu) – Virus Strains". Centers for Disease Control and Prevention. 24 April 2009. Retrieved 2009-4-26. 
  22. "Swine flu virus turns endemic". National Hog Farmer. 15 September 2007. 
  23. "Swine". Custom Vaccines. Novartis. 
  24. ↑Gramer Marie René, Lee Jee Hoon, Choi Young Ki, Goyal Sagar M, Joo Han Soo (July 2007). "Serologic and genetic characterization of North American H3N2 swine influenza A viruses". Canadian Journal of Veterinary Research71 (3): 201–206. PMID 1899866. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1899866. 
  25. ↑Myers KP, Olsen CW, Gray GC (April 2007). "Cases of swine influenza in humans: a review of the literature". Clin Infect Dis44 (8): 1084–8. doi:10.1086/512813. PMC 1973337. PMID 17366454. 
  26. "Update: Swine Influenza A (H1N1) Infections --- California and Texas, April 2009". MMWR. Centrers for Disease Control. 24 April 2009. 
  27. Steven Reinberg (24 April 2009). "Swine Flu Cases Now Total 7: CDC". ABC News. 
  28. Rob Stein (23 April 2009). "In California and Texas, 5 New Swine Flu Cases". Washington Post. 
  29. "CDC Briefing on Public Health Investigation of Human Cases of Swine Influenza". CDC online newsroom. 23 April 2009. 
  30. "Swine influenza A (H1N1) infection in two children --- Southern California, March--April 2009". Morbidity and Mortality Weekly Report. Centers for Disease Control. 2009. 

Further reading[change | change source]

Swine Flu h1n1

Pigs can have more than one type of flu at the same time. This means that viruses can mix genes and become a type of flu that could cause a pandemic.
Military hospital during Spanish flu pandemic in 1918.
     Confirmed cases, people died     Confirmed cases, no deaths     Unconfirmed or suspected cases

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