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Influenza Epidemics and Pandemics

References

Label Authors Title Source Year
1

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  • Influenza viruses continuously undergo antigenic evolution.1 It is this quality that allows them to evade the pre-existing immunity of the host, which implies that immune responses mounted against earlier forms of the virus are less effective or completely ineffective against newer variants.
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  • These are commonly referred to as “antigenic drift” and “antigenic shift”.1 Antigenic drift occurs through continuous mutation of the RNA genome of the virus.
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  • Occasionally, an entirely new influenza A virus subtype of avian origin emerges in the human population.
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  • Antigenic drift is a gradual process.
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  • As illustrated in Figure 13, the 1957 Asian H2N2 virus subtype obtained its HA, NA, and PB1 genes from an avian virus and the other fives genes from the circulating H1N1 human strain,1,4,7,14–17 the human H1N1 virus in turn being a distant descendent of the 1918 Spanish flu virus.3 Likewise, the 1968 Hong Kong H3N2 virus acquired its HA and PB1 genes from an avian virus, but retained the NA and remaining five other genes from the then circulating H2N2 human virus.
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PF Wright, RG Webster. Orthomyxoviruses. DM Knipe, PM Howley, DE Griffin (Eds.) et al. Fields Virology 4th edn. (Lippincott Williams & Wilkins, 2001) (1533 - 1579) 2001
2

References in context

  • Other viral antigens undergo significantly less variation, but – under immunological pressure – may also contribute to the evasion of the immune defence of the host.2 The antigenic evolution of influenza viruses forms the primary basis for the occurrence of annual influenza epidemics and occasional pandemics.
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PG Thomas, R Keating, DJ Hulse-Post, PC Doherty. Cell-mediated protection in influenza infection. Emerg Infect Dis 12 (2006) (48 - 54) 2006
3

References in context

  • By far the most devastating pandemic was the Spanish flu outbreak, which hit at the end of the First World War.3,4 It spread across the globe in three consecutive waves in 1918–19, killing at least 50 million people.5 The subsequent pandemics in 1957 and 1968 were milder,4 but nonetheless also caused a total of approximately 2 million deaths.
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  • Rarely, a highly pathogenic avian influenza (HPAI; see also Chapter 2) virus is transmitted directly from birds to humans.3,11,15–18 It was not until the 1997 H5N1 bird flu outbreak in Hong Kong that it was appreciated that such direct transmission could occur.
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  • Indeed, there is some circumstantial evidence that the 1918 virus entered the human population several years before the pandemic.3,22 There is a close genetic relationship between the 1918 virus and the porcine A/Swine/Iowa/30 (H1N1) virus.
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  • Indeed, there is some circumstantial evidence that the 1918 virus entered the human population several years before the pandemic.3,22 There is a close genetic relationship between the 1918 virus and the porcine A/Swine/Iowa/30 (H1N1) virus.
    Go to context

  • Indeed, there is some circumstantial evidence that the 1918 virus entered the human population several years before the pandemic.3,22 There is a close genetic relationship between the 1918 virus and the porcine A/Swine/Iowa/30 (H1N1) virus.
    Go to context

  • Indeed, there is some circumstantial evidence that the 1918 virus entered the human population several years before the pandemic.3,22 There is a close genetic relationship between the 1918 virus and the porcine A/Swine/Iowa/30 (H1N1) virus.
    Go to context

  • As illustrated in Figure 13, the 1957 Asian H2N2 virus subtype obtained its HA, NA, and PB1 genes from an avian virus and the other fives genes from the circulating H1N1 human strain,1,4,7,14–17 the human H1N1 virus in turn being a distant descendent of the 1918 Spanish flu virus.3 Likewise, the 1968 Hong Kong H3N2 virus acquired its HA and PB1 genes from an avian virus, but retained the NA and remaining five other genes from the then circulating H2N2 human virus.
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JK Taubenberger, DM Morens. 1918 influenza: the mother of all pandemics. Emerg Inf Dis 12 (2006) (15 - 22) 2006
4

References in context

  • By far the most devastating pandemic was the Spanish flu outbreak, which hit at the end of the First World War.3,4 It spread across the globe in three consecutive waves in 1918–19, killing at least 50 million people.5 The subsequent pandemics in 1957 and 1968 were milder,4 but nonetheless also caused a total of approximately 2 million deaths.
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  • By far the most devastating pandemic was the Spanish flu outbreak, which hit at the end of the First World War.3,4 It spread across the globe in three consecutive waves in 1918–19, killing at least 50 million people.5 The subsequent pandemics in 1957 and 1968 were milder,4 but nonetheless also caused a total of approximately 2 million deaths.
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  • Despite their annual seasonal character, influenza epidemics are unpredictable.4,7 When precisely they will start and how long they will last are questions that are difficult to answer in advance. Figure 11 illustrates the variation in the onset and duration of influenza epidemics recorded in the Netherlands in the last three decades of the previous century.
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  • While the bird flu outbreak in 1997 was the first documented example of a purely avian virus causing respiratory disease and deaths among humans,18–20 it has since become apparent that the 1918 Spanish flu virus was also an avian virus.3,22–25 Even though the precise origin of the 1918 virus remains enigmatic,3,11,22 based on characterization of genetic material isolated from victims of the 1918 pandemic, it is clear now that the virus was not a human–avian reassortant, but rather an avian-like virus that was introduced in its entirety into the human population and subsequently adapted to the new host.
    Go to context

  • As illustrated in Figure 13, the 1957 Asian H2N2 virus subtype obtained its HA, NA, and PB1 genes from an avian virus and the other fives genes from the circulating H1N1 human strain,1,4,7,14–17 the human H1N1 virus in turn being a distant descendent of the 1918 Spanish flu virus.3 Likewise, the 1968 Hong Kong H3N2 virus acquired its HA and PB1 genes from an avian virus, but retained the NA and remaining five other genes from the then circulating H2N2 human virus.
    Go to context

  • A third way by which an antigenic shift may occur and a pandemic arise is reintroduction of an “old” strain into the human population.
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  • Figure 14 gives an overview of the influenza pandemics that occurred in the past century.4,29,30 The most terrible outbreak was the Spanish flu in 1918, with an estimated 50 million deaths,5 justifying its description as “the last great plague of mankind”.
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ED Kilbourne. Influenza pandemics of the 20th century. Emerg Inf Dis 12 (2006) (9 - 14) 2006
5

References in context

  • By far the most devastating pandemic was the Spanish flu outbreak, which hit at the end of the First World War.3,4 It spread across the globe in three consecutive waves in 1918–19, killing at least 50 million people.5 The subsequent pandemics in 1957 and 1968 were milder,4 but nonetheless also caused a total of approximately 2 million deaths.
    Go to context

  • Figure 14 gives an overview of the influenza pandemics that occurred in the past century.4,29,30 The most terrible outbreak was the Spanish flu in 1918, with an estimated 50 million deaths,5 justifying its description as “the last great plague of mankind”.
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  • In just 10 months, approximately 50 million people worldwide were killed,5 more than the total number of victims of the 1914–18 war.
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NP Johnson, J Mueller. Updating the accounts: global mortality of the 1918–1920 “Spanish” influenza pandemic. Bull Hist Med 76 (2002) (105 - 115) 2002
6

References in context

  • There is no doubt that there will be other pandemics in the future.6,7 Having its reservoir among migratory waterfowl, the influenza virus is non-eradicable and will continue to affect humans.
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RJ Webby, RG Webster. Are we ready for pandemic influenza?. Science 302 (2003) (1519 - 1522) 2003
7

References in context


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  • There is no doubt that there will be other pandemics in the future.6,7 Having its reservoir among migratory waterfowl, the influenza virus is non-eradicable and will continue to affect humans.
    Go to context

  • Despite their annual seasonal character, influenza epidemics are unpredictable.4,7 When precisely they will start and how long they will last are questions that are difficult to answer in advance. Figure 11 illustrates the variation in the onset and duration of influenza epidemics recorded in the Netherlands in the last three decades of the previous century.
    Go to context

  • As illustrated in Figure 13, the 1957 Asian H2N2 virus subtype obtained its HA, NA, and PB1 genes from an avian virus and the other fives genes from the circulating H1N1 human strain,1,4,7,14–17 the human H1N1 virus in turn being a distant descendent of the 1918 Spanish flu virus.3 Likewise, the 1968 Hong Kong H3N2 virus acquired its HA and PB1 genes from an avian virus, but retained the NA and remaining five other genes from the then circulating H2N2 human virus.
    Go to context

  • There is no doubt that there will be influenza pandemics in the future.7,11,22 It is not so much a matter of whether they will occur but rather when they will occur.
    Go to context

  • In May 2001, and in February and April 2002, the H5N1 virus subtype was once again detected in Hong Kong's poultry markets,7,33 the specific virus strain differing significantly from the 1997 H5N1 bird flu virus.
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KG Nicholson, JM Wood, M Zambon. Influenza. Lancet 362 (2003) (1733 - 1745) 2003
8

References in context

  • As a result of the infidelity of RNA replication, the mutation frequency in the influenza virus RNA is approximately one in 100,000 nucleotides.8 Considering that the size of the entire influenza virus genome is about 14,000 nucleotides, this implies that many new viral RNA genome copies will contain one or more mutations.
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J Stech, X Xiong, V Scholtissek, RG Webster. Independence of evolutionary and mutational rates after transmission of avian influenza viruses to swine. J Virol 73 (1999) (1878 - 1884) 1999
9

References in context

  • While in tropical countries influenza may be present all year round, epidemics in temperate regions occur almost exclusively in the winter months, from October to April in the northern hemisphere and from April to October in the southern hemisphere.
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JP Fox, MK Cooney, CE Hall, HM Foy. Influenza virus infections in Seattle families, 1975–1979. II. Pattern of infection in invaded households and relation of age and prior antibody to occurrence of infection and related illness. Am J Epidemiol 116 (1982) (228 - 242) 1982
10

References in context

  • In addition, the uncertainty in predicting epidemic virus strains has been further reduced by mathematical modeling of the antigenic distance between different viruses, allowing a more accurate selection of the strains that need to be included in the vaccine.10 However, when occasional mismatches do occur, people in target groups should nonetheless be encouraged to be vaccinated, as there is still benefit in spite of the reduced efficacy of the vaccine under these conditions.
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DJ Smith, AS Lapedes, JC de Jong, et al.. Mapping the antigenic and genetic evolution of influenza virus. Science 305 (2004) (371 - 376) 2004
11

References in context

  • Currently available information suggests that the natural reservoir of influenza A viruses is among aquatic birds.11–13 All 16 HA and nine NA subtypes have been identified in birds (see Chapter 2).
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  • Rarely, a highly pathogenic avian influenza (HPAI; see also Chapter 2) virus is transmitted directly from birds to humans.3,11,15–18 It was not until the 1997 H5N1 bird flu outbreak in Hong Kong that it was appreciated that such direct transmission could occur.
    Go to context

  • While the bird flu outbreak in 1997 was the first documented example of a purely avian virus causing respiratory disease and deaths among humans,18–20 it has since become apparent that the 1918 Spanish flu virus was also an avian virus.3,22–25 Even though the precise origin of the 1918 virus remains enigmatic,3,11,22 based on characterization of genetic material isolated from victims of the 1918 pandemic, it is clear now that the virus was not a human–avian reassortant, but rather an avian-like virus that was introduced in its entirety into the human population and subsequently adapted to the new host.
    Go to context

  • Remarkably, the H5N1 virus isolated from victims of the recent outbreaks in Asia have acquired a number of mutations in the polymerase complex that are also present in the 1918 virus.25 These mutations are likely important for efficient replication of the virus in humans.
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  • There is no doubt that there will be influenza pandemics in the future.7,11,22 It is not so much a matter of whether they will occur but rather when they will occur.
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RG Webster, M Peiris, H Chen, et al.. H5N1 outbreaks and enzootic influenza. Emerg Inf Dis 12 (2006) (3 - 8) 2006
12

References in context

  • Currently available information suggests that the natural reservoir of influenza A viruses is among aquatic birds.11–13 All 16 HA and nine NA subtypes have been identified in birds (see Chapter 2).
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RG Webster, WJ Bean, OT Gorman, et al.. Evolution and ecology of influenza A viruses. Microbiol Rev 56 (1992) (152 - 179) 1992
13

References in context

  • Currently available information suggests that the natural reservoir of influenza A viruses is among aquatic birds.11–13 All 16 HA and nine NA subtypes have been identified in birds (see Chapter 2).
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DJ Alexander. A review of avian influenza viruses in different bird species. Vet Microbiol 74 (2000) (3 - 13) 2000
14

References in context

  • Occasionally, a new influenza virus subtype is introduced into the human population, in a process referred to as antigenic shift.14 As indicated above, there are several ways by which such new human virus subtypes may arise (Figure 12), and it is likely that each has played a role in the influenza pandemics of the 20th century.
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  • As illustrated in Figure 13, the 1957 Asian H2N2 virus subtype obtained its HA, NA, and PB1 genes from an avian virus and the other fives genes from the circulating H1N1 human strain,1,4,7,14–17 the human H1N1 virus in turn being a distant descendent of the 1918 Spanish flu virus.3 Likewise, the 1968 Hong Kong H3N2 virus acquired its HA and PB1 genes from an avian virus, but retained the NA and remaining five other genes from the then circulating H2N2 human virus.
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  • Clearly, a number of conditions must be satisfied in order for an outbreak of influenza to be classified as a “pandemic”.14 These include: (i) the emergence of a new influenza A virus subtype in the human population, unrelated to the virus subtypes that circulated immediately before the outbreak; (ii) a total lack of immunity to the new virus among the population; (iii) capacity of the virus to spread by person-to-person transmission; and (iv) rapid dissemination of the infection beyond its site of origin.
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RG Webster, WG Laver. Pandemic variation of influenza viruses. ED Kilbourne (Ed.) The Influenza Viruses and Influenza (Academic Press, 1975) (269 - 314) 1975
15

References in context

  • Rarely, a highly pathogenic avian influenza (HPAI; see also Chapter 2) virus is transmitted directly from birds to humans.3,11,15–18 It was not until the 1997 H5N1 bird flu outbreak in Hong Kong that it was appreciated that such direct transmission could occur.
    Go to context

  • As illustrated in Figure 13, the 1957 Asian H2N2 virus subtype obtained its HA, NA, and PB1 genes from an avian virus and the other fives genes from the circulating H1N1 human strain,1,4,7,14–17 the human H1N1 virus in turn being a distant descendent of the 1918 Spanish flu virus.3 Likewise, the 1968 Hong Kong H3N2 virus acquired its HA and PB1 genes from an avian virus, but retained the NA and remaining five other genes from the then circulating H2N2 human virus.
    Go to context

KF Shortridge. Pandemic influenza: a zoonosis?. Semin Respir Infect 7 (1992) (11 - 25) 1992
16

References in context

  • Rarely, a highly pathogenic avian influenza (HPAI; see also Chapter 2) virus is transmitted directly from birds to humans.3,11,15–18 It was not until the 1997 H5N1 bird flu outbreak in Hong Kong that it was appreciated that such direct transmission could occur.
    Go to context

  • As illustrated in Figure 13, the 1957 Asian H2N2 virus subtype obtained its HA, NA, and PB1 genes from an avian virus and the other fives genes from the circulating H1N1 human strain,1,4,7,14–17 the human H1N1 virus in turn being a distant descendent of the 1918 Spanish flu virus.3 Likewise, the 1968 Hong Kong H3N2 virus acquired its HA and PB1 genes from an avian virus, but retained the NA and remaining five other genes from the then circulating H2N2 human virus.
    Go to context

RG Webster. Influenza virus: transmission between species and relevance to emergence of the next human pandemic. Arch Virol Suppl 13 (1997) (105 - 113) 1997
17

References in context

  • Rarely, a highly pathogenic avian influenza (HPAI; see also Chapter 2) virus is transmitted directly from birds to humans.3,11,15–18 It was not until the 1997 H5N1 bird flu outbreak in Hong Kong that it was appreciated that such direct transmission could occur.
    Go to context

  • As illustrated in Figure 13, the 1957 Asian H2N2 virus subtype obtained its HA, NA, and PB1 genes from an avian virus and the other fives genes from the circulating H1N1 human strain,1,4,7,14–17 the human H1N1 virus in turn being a distant descendent of the 1918 Spanish flu virus.3 Likewise, the 1968 Hong Kong H3N2 virus acquired its HA and PB1 genes from an avian virus, but retained the NA and remaining five other genes from the then circulating H2N2 human virus.
    Go to context

T Horimoto, Y Kawaoka. Pandemic threat posed by avian influenza A viruses. Clin Microbiol Rev 14 (2001) (129 - 149) 2001
18

References in context

  • Rarely, a highly pathogenic avian influenza (HPAI; see also Chapter 2) virus is transmitted directly from birds to humans.3,11,15–18 It was not until the 1997 H5N1 bird flu outbreak in Hong Kong that it was appreciated that such direct transmission could occur.
    Go to context

  • During this outbreak, 18 people were reportedly infected with the H5N1 virus, six of whom died.18–20 The virus isolated from the victims had the same genetic make-up as the virus causing the epidemic among chickens in Hong Kong at the time, indicating that it was transmitted directly from chickens to humans.
    Go to context

  • While the bird flu outbreak in 1997 was the first documented example of a purely avian virus causing respiratory disease and deaths among humans,18–20 it has since become apparent that the 1918 Spanish flu virus was also an avian virus.3,22–25 Even though the precise origin of the 1918 virus remains enigmatic,3,11,22 based on characterization of genetic material isolated from victims of the 1918 pandemic, it is clear now that the virus was not a human–avian reassortant, but rather an avian-like virus that was introduced in its entirety into the human population and subsequently adapted to the new host.
    Go to context

JC De Jong, ECJ Claas, ADME Osterhaus, RG Webster, WL Lim. A pandemic warning?. Nature 389 (1997) (554) 1997
19

References in context

  • During this outbreak, 18 people were reportedly infected with the H5N1 virus, six of whom died.18–20 The virus isolated from the victims had the same genetic make-up as the virus causing the epidemic among chickens in Hong Kong at the time, indicating that it was transmitted directly from chickens to humans.
    Go to context

  • While the bird flu outbreak in 1997 was the first documented example of a purely avian virus causing respiratory disease and deaths among humans,18–20 it has since become apparent that the 1918 Spanish flu virus was also an avian virus.3,22–25 Even though the precise origin of the 1918 virus remains enigmatic,3,11,22 based on characterization of genetic material isolated from victims of the 1918 pandemic, it is clear now that the virus was not a human–avian reassortant, but rather an avian-like virus that was introduced in its entirety into the human population and subsequently adapted to the new host.
    Go to context

EC Claas, AD Osterhaus, R van Beek, et al.. Human influenza A H5N1 virus related to a highly pathogenic avian influenza virus. Lancet 351 (1998) (472 - 477) 1998
20

References in context

  • During this outbreak, 18 people were reportedly infected with the H5N1 virus, six of whom died.18–20 The virus isolated from the victims had the same genetic make-up as the virus causing the epidemic among chickens in Hong Kong at the time, indicating that it was transmitted directly from chickens to humans.
    Go to context

  • While the bird flu outbreak in 1997 was the first documented example of a purely avian virus causing respiratory disease and deaths among humans,18–20 it has since become apparent that the 1918 Spanish flu virus was also an avian virus.3,22–25 Even though the precise origin of the 1918 virus remains enigmatic,3,11,22 based on characterization of genetic material isolated from victims of the 1918 pandemic, it is clear now that the virus was not a human–avian reassortant, but rather an avian-like virus that was introduced in its entirety into the human population and subsequently adapted to the new host.
    Go to context

K Subbarao, A Klimov, J Katz, et al.. Characterisation of an avian influenza A (H5N1) virus isolated from a child with a fatal respiratory disease. Science 279 (1998) (393 - 396) 1998
21

References in context

  • Rarely, a highly pathogenic avian influenza (HPAI; see also Chapter 2) virus is transmitted directly from birds to humans.3,11,15–18 It was not until the 1997 H5N1 bird flu outbreak in Hong Kong that it was appreciated that such direct transmission could occur.
    Go to context

Y Guan, KF Shortridge, S Krauss, RG Webster. Molecular characterization of H9N2 influenza viruses: were they the donors of the “internal” genes of H5N1 viruses in Hong Kong?. Proc Natl Acad Sci USA 96 (1999) (9363 - 9367) 1999
22

References in context

  • While the bird flu outbreak in 1997 was the first documented example of a purely avian virus causing respiratory disease and deaths among humans,18–20 it has since become apparent that the 1918 Spanish flu virus was also an avian virus.3,22–25 Even though the precise origin of the 1918 virus remains enigmatic,3,11,22 based on characterization of genetic material isolated from victims of the 1918 pandemic, it is clear now that the virus was not a human–avian reassortant, but rather an avian-like virus that was introduced in its entirety into the human population and subsequently adapted to the new host.
    Go to context

  • Indeed, there is some circumstantial evidence that the 1918 virus entered the human population several years before the pandemic.3,22 There is a close genetic relationship between the 1918 virus and the porcine A/Swine/Iowa/30 (H1N1) virus.
    Go to context

  • Indeed, there is some circumstantial evidence that the 1918 virus entered the human population several years before the pandemic.3,22 There is a close genetic relationship between the 1918 virus and the porcine A/Swine/Iowa/30 (H1N1) virus.
    Go to context

  • Indeed, there is some circumstantial evidence that the 1918 virus entered the human population several years before the pandemic.3,22 There is a close genetic relationship between the 1918 virus and the porcine A/Swine/Iowa/30 (H1N1) virus.
    Go to context

  • There is no doubt that there will be influenza pandemics in the future.7,11,22 It is not so much a matter of whether they will occur but rather when they will occur.
    Go to context

RG Webster. 1918 Spanish influenza: the secrets remain elusive. Proc Natl Acad Sci 96 (1999) (1164 - 1166) 1999
23

References in context

  • While the bird flu outbreak in 1997 was the first documented example of a purely avian virus causing respiratory disease and deaths among humans,18–20 it has since become apparent that the 1918 Spanish flu virus was also an avian virus.3,22–25 Even though the precise origin of the 1918 virus remains enigmatic,3,11,22 based on characterization of genetic material isolated from victims of the 1918 pandemic, it is clear now that the virus was not a human–avian reassortant, but rather an avian-like virus that was introduced in its entirety into the human population and subsequently adapted to the new host.
    Go to context

  • The adaptation involved a combination of mutations in different genes of the virus, including the HA and polymerase genes.3,23–25 Adaptation of an avian virus to the human host might thus give rise to a virus capable of human-to-human transmission.
    Go to context

AH Reid, TG Fanning, JV Hultin, et al.. Origin and evolution of the 1918 “Spanish” influenza virus hemagglutinin gene. Proc Natl Acad Sci 96 (1999) (1651 - 1656) 1999
24

References in context

  • While the bird flu outbreak in 1997 was the first documented example of a purely avian virus causing respiratory disease and deaths among humans,18–20 it has since become apparent that the 1918 Spanish flu virus was also an avian virus.3,22–25 Even though the precise origin of the 1918 virus remains enigmatic,3,11,22 based on characterization of genetic material isolated from victims of the 1918 pandemic, it is clear now that the virus was not a human–avian reassortant, but rather an avian-like virus that was introduced in its entirety into the human population and subsequently adapted to the new host.
    Go to context

  • The adaptation involved a combination of mutations in different genes of the virus, including the HA and polymerase genes.3,23–25 Adaptation of an avian virus to the human host might thus give rise to a virus capable of human-to-human transmission.
    Go to context

  • Determination of the structure and receptor-binding properties of the 1918 HA24 has suggested that, indeed, by mutation of the receptor-binding site, the HA acquired the ability to interact with human α2,6-linked sialic acid receptors (see Chapter 2).
    Go to context

SJ Gamblin, LF Haire, RJ Russell, et al.. The structure and receptor binding properties of the 1918 influenza hemagglutinin. Science 303 (2004) (1838 - 1842) 2004
25

References in context

  • While the bird flu outbreak in 1997 was the first documented example of a purely avian virus causing respiratory disease and deaths among humans,18–20 it has since become apparent that the 1918 Spanish flu virus was also an avian virus.3,22–25 Even though the precise origin of the 1918 virus remains enigmatic,3,11,22 based on characterization of genetic material isolated from victims of the 1918 pandemic, it is clear now that the virus was not a human–avian reassortant, but rather an avian-like virus that was introduced in its entirety into the human population and subsequently adapted to the new host.
    Go to context

  • The adaptation involved a combination of mutations in different genes of the virus, including the HA and polymerase genes.3,23–25 Adaptation of an avian virus to the human host might thus give rise to a virus capable of human-to-human transmission.
    Go to context

  • Remarkably, the H5N1 virus isolated from victims of the recent outbreaks in Asia have acquired a number of mutations in the polymerase complex that are also present in the 1918 virus.25 These mutations are likely important for efficient replication of the virus in humans.
    Go to context

JK Taubenberger, AH Reid, RM Lourens, et al.. Characterization of the 1918 influenza virus polymerase genes. Nature 437 (2005) (889 - 893) 2005
26

References in context

  • As illustrated in Figure 13, the 1957 Asian H2N2 virus subtype obtained its HA, NA, and PB1 genes from an avian virus and the other fives genes from the circulating H1N1 human strain,1,4,7,14–17 the human H1N1 virus in turn being a distant descendent of the 1918 Spanish flu virus.3 Likewise, the 1968 Hong Kong H3N2 virus acquired its HA and PB1 genes from an avian virus, but retained the NA and remaining five other genes from the then circulating H2N2 human virus.
    Go to context

  • The first convincing report of an influenza pandemic describes an outbreak in 1580, which started in Asia in the summer, and then spread via Africa to Europe and finally to America.26 In Britain it came in two waves, a pattern that was also seen in subsequent influenza pandemics.
    Go to context

WJ Bean, M Schell, J Katz, et al.. Evolution of the H3 influenza virus hemagglutinin from human and nonhuman hosts. J Virol 66 (1992) (1129 - 1138) 1992
27

References in context

  • The pig provides an ideal “mixing vessel”, since pigs are readily infectable by both human and avian influenza viruses due to the molecular nature of their sialic acid receptors27 (see Chapter 2).
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T Ito, JN Couceiro, S Kelm, et al.. Molecular basis for the generation in pigs of influenza A viruses with pandemic potential. J Virol 72 (1998) (7367 - 7373) 1998
28

References in context

  • A third way by which an antigenic shift may occur and a pandemic arise is reintroduction of an “old” strain into the human population.
    Go to context

  • As mentioned above, the virus was subsequently found to be virtually identical to one that had caused a human epidemic in 1950.28 Consequently, most people over 23 years old possessed antibody to it.
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  • A cyclic theory has been proposed suggesting that pandemics may appear in a specific recurring pattern.28 The interval between the 1889 (H2) and 1900 pandemics (H3) matches that between the 1957 (H2) and 1968 (H3) pandemics.
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K Nakajima, U Desselberger, P Palese. Recent human influenza A (H1N1) viruses are closely related genetically to strains isolated in 1950. Nature 274 (1978) (334 - 339) 1978
29

References in context


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  • Historic records indicate that influenza pandemics have been among us for many centuries.29 A report by Hippocrates describes an outbreak as early as 412 BC that could have been due to influenza.
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  • Historic records indicate that influenza pandemics have been among us for many centuries.29 A report by Hippocrates describes an outbreak as early as 412 BC that could have been due to influenza.
    Go to context

  • Figure 14 gives an overview of the influenza pandemics that occurred in the past century.4,29,30 The most terrible outbreak was the Spanish flu in 1918, with an estimated 50 million deaths,5 justifying its description as “the last great plague of mankind”.
    Go to context

CW Potter. Chronicle of influenza pandemics. KG Nicholson, RG Webster, AJ Hay (Eds.) Textbook of Influenza (Blackwell Science, Oxford, 1998) (3 - 18) 1998
30

References in context

  • Figure 14 gives an overview of the influenza pandemics that occurred in the past century.4,29,30 The most terrible outbreak was the Spanish flu in 1918, with an estimated 50 million deaths,5 justifying its description as “the last great plague of mankind”.
    Go to context

WIB Beveridge. The chronicle of influenza epidemics. Hist Phil Life Sci 13 (1991) (223 - 235) 1991
31

References in context

  • Recently, based on fragments of genetic material isolated from the remains of a victim of the Spanish flu pandemic buried in the permafrost of Alaska, the 1918 virus has been resurrected,31 using reverse genetics techniques (see Chapter 9).
    Go to context

TM Tumpey, CF Basler, PV Aguilar, et al.. Characterization of the reconstructed 1918 Spanish influenza pandemic virus. Science 310 (2005) (77 - 80) 2005
32

References in context

  • There is evidence that the precursor viruses of the H5N1 bird flu virus, including the goose H5N1 virus, remained in circulation.32 Since 1998, culling has also included geese to prevent the goose H5N1 precursor virus from taking a firm hold in poultry in Hong Kong.
    Go to context

Y Guan, KF Shortridge, S Krauss, et al.. H9N2 influenza viruses possessing H5N1-like internal genomes continue to circulate in poultry in southeastern China. J Virol 74 (2000) (9372 - 9380) 2000
33

References in context

  • In May 2001, and in February and April 2002, the H5N1 virus subtype was once again detected in Hong Kong's poultry markets,7,33 the specific virus strain differing significantly from the 1997 H5N1 bird flu virus.
    Go to context

Y Guan, JSM Peiris, AS Lipatov, et al.. Emergence of multiple genotypes of H5N1 avian influenza viruses in Hong Kong SAR. Proc Natl Acad Sci USA 99 (2002) (8950 - 8955) 2002
34

References in context

  • Then, in the spring of 2004, there was a major outbreak of highly pathogenic H5N1 avian influenza first detected in southern Vietnam and then spreading quickly to neighbouring countries, and quite recently also to Europe and Africa.34–36 To date (March 1, 2006) there have been 179 confirmed cases of human H5N1 infections, with 94 fatalities, including four deaths in Turkey in January 2006.37 This high case-fatality rate underscores the extremely high pathogenicity of the H5N1 virus involved.
    Go to context

A Apisarnthanarak, R Kitphati, K Thongphubeth, et al.. Atypical avian influenza (H5N1). Emerg Infect Dis 10 (2004) (1321 - 1324) 2004
35

References in context

  • Then, in the spring of 2004, there was a major outbreak of highly pathogenic H5N1 avian influenza first detected in southern Vietnam and then spreading quickly to neighbouring countries, and quite recently also to Europe and Africa.34–36 To date (March 1, 2006) there have been 179 confirmed cases of human H5N1 infections, with 94 fatalities, including four deaths in Turkey in January 2006.37 This high case-fatality rate underscores the extremely high pathogenicity of the H5N1 virus involved.
    Go to context

MD de Jong, VC Bach, TQ Phan, et al.. Fatal avian influenza A (H5N1) in a child presenting with diarrhea followed by coma. New Engl J Med 352 (2005) (686 - 691) 2005
36

References in context

  • Then, in the spring of 2004, there was a major outbreak of highly pathogenic H5N1 avian influenza first detected in southern Vietnam and then spreading quickly to neighbouring countries, and quite recently also to Europe and Africa.34–36 To date (March 1, 2006) there have been 179 confirmed cases of human H5N1 infections, with 94 fatalities, including four deaths in Turkey in January 2006.37 This high case-fatality rate underscores the extremely high pathogenicity of the H5N1 virus involved.
    Go to context

TH Tran, TL Nguyen, TD Nguyen, et al.. Avian influenza A (H5N1) in 10 patients in Vietnam. New Engl J Med 350 (2004) (1179 - 1188) 2004
37

References in context

  • Then, in the spring of 2004, there was a major outbreak of highly pathogenic H5N1 avian influenza first detected in southern Vietnam and then spreading quickly to neighbouring countries, and quite recently also to Europe and Africa.34–36 To date (March 1, 2006) there have been 179 confirmed cases of human H5N1 infections, with 94 fatalities, including four deaths in Turkey in January 2006.37 This high case-fatality rate underscores the extremely high pathogenicity of the H5N1 virus involved.
    Go to context

World Health Organization. Cumulative number of confirmed human cases of avian influenza A/(H5N1) reported to WHO. (www.who.int/csr/disease/avian_influenza/country/en/index.html)
38

References in context

  • In March 1999, there were two further cases in Hong Kong.38 In no case was there serological evidence for H9N2 infection among family members or health-care workers in close contact with the infected individuals, indicating that there was no human-to-human transmission.
    Go to context

M Peiris, KY Yuen, CW Leung, et al.. Human infection with influenza H9N2. Lancet 354 (1999) (916 - 917) 1999
39

References in context

  • In the Netherlands in 2003, an outbreak of H7N7 fowl plague affected mainly poultry workers and veterinarians, causing conjunctivitis in most cases and influenza-like illness in about 10%.39 There was one death – a 57-year-old veterinarian who visited one of the infected farms and later died of acute respiratory distress syndrome.
    Go to context

RA Fouchier, PM Schneeberger, FW Rozendaal, et al.. Avian influenza A virus (H7N7) associated with human conjunctivitis and a fatal case of acute respiratory distress syndrome. Proc Natl Acad Sci USA 101 (2004) (1356 - 1361) 2004
40

References in context

  • In 1999, the WHO issued its first pandemic preparedness plan,40 which was updated in 2005.41 In 2002, the WHO adopted the Global Agenda on Influenza Surveillance and Control as a strategic approach to increase the level of global pandemic preparedness.42,43 This global agenda sets out a series of activities around four primary objectives: (i) strengthening surveillance; (ii) improving knowledge of disease burden; (iii) increasing vaccine usage; and (iv) accelerating pandemic preparedness.
    Go to context

World Health Organization. Influenza pandemic preparedness plan. The role of WHO and guidelines for national or regional planning. (www.who.int/csr/resources/publications/influenza/WHO_CDS_CSR_EDC_99_1/en/) (1999) 1999
41

References in context

  • Definition of successive pre-pandemic and pandemic phases.
    Go to context

  • In 1999, the WHO issued its first pandemic preparedness plan,40 which was updated in 2005.41 In 2002, the WHO adopted the Global Agenda on Influenza Surveillance and Control as a strategic approach to increase the level of global pandemic preparedness.42,43 This global agenda sets out a series of activities around four primary objectives: (i) strengthening surveillance; (ii) improving knowledge of disease burden; (iii) increasing vaccine usage; and (iv) accelerating pandemic preparedness.
    Go to context

  • Based on these definitions, the WHO has developed an algorithm to identify specific phases in the period preceding a pandemic and during the actual pandemic, which require different levels of alertness and actions.41 These phases are indicated in Table 4.
    Go to context

  • Pandemic preparedness should be achieved at global, regional and national levels.41 The WHO and other global bodies such as the FAO (UN Food and Agriculture Organization) and OIE (World Organization for Animal Health) are responsible for the infrastructure at a global level, whereas national health authorities are primarily responsible for the infrastructural measures within individual countries.
    Go to context

  • The WHO has made recommendations for stockpiling antivirals and H5N1 vaccines for immediate use at the onset of a potential pandemic outbreak.41,46 It has also advised national health authorities to make pre-pandemic purchase agreements with vaccine manufacturers for pandemic vaccines.46 It will take at least 4–6 months after the WHO has announced the pandemic before the first pandemic vaccine doses will become available for distribution.
    Go to context

World Health Organization. Global influenza preparedness plan. The role of WHO and recommendations for national measures before and during pandemics. (www.who.int/csr/resources/publications/influenza/WHO_CDS_CSR_GIP_2005_5/en/index.html) (2005) 2005
42

References in context

  • In 1999, the WHO issued its first pandemic preparedness plan,40 which was updated in 2005.41 In 2002, the WHO adopted the Global Agenda on Influenza Surveillance and Control as a strategic approach to increase the level of global pandemic preparedness.42,43 This global agenda sets out a series of activities around four primary objectives: (i) strengthening surveillance; (ii) improving knowledge of disease burden; (iii) increasing vaccine usage; and (iv) accelerating pandemic preparedness.
    Go to context

  • According to the WHO, one important way to achieve a considerably improved level of pandemic preparedness is to encourage the annual uptake of influenza vaccines.42,46 Following the logic of “demand drives supply” for seasonal influenza vaccines, an increased annual use of influenza vaccines, according to existing recommendations, will be followed by investments from the vaccine industry to increase their vaccine production capacity.
    Go to context

K Stöhr. The global agenda on influenza surveillance and control. Vaccine 21 (2003) (1774) 1748 2003
43

References in context

  • In 1999, the WHO issued its first pandemic preparedness plan,40 which was updated in 2005.41 In 2002, the WHO adopted the Global Agenda on Influenza Surveillance and Control as a strategic approach to increase the level of global pandemic preparedness.42,43 This global agenda sets out a series of activities around four primary objectives: (i) strengthening surveillance; (ii) improving knowledge of disease burden; (iii) increasing vaccine usage; and (iv) accelerating pandemic preparedness.
    Go to context

World Health Organization. Global agenda on influenza – adopted version. Part I. Wkly Epidemiol Rec 77 (2002) (179 - 182) Part II Wkly Epidemiol Rec 77 (2002) (191 - 196) ( www.who.int/docstore/wer/pdf/2000/wer7535.pdf ) ( www.who.int/docstore/wer/pdf/2002/wer7728.pdf ) 2002
44

References in context

  • In many countries, influenza is not a prominent item on the national health agenda due to other health priorities.
    Go to context

World Health Organization. Meeting on avian influenza and human pandemic influenza. Geneva. (www.who.int/mediacentre/events/2005/avian_influenza/en/index.html) (7–9 November 2005) 79 November 2005
45

References in context

  • In many countries, influenza is not a prominent item on the national health agenda due to other health priorities.
    Go to context

International pledging conference on avian and human pandemic influenza (Co-sponsored by the Government of the People's Republic of China, the European Commission & the World Bank, Beijing, 17–18 January 2006) (www.who.int/dg/lee/speeches/2006/flumeeting_beijing/en/index.html) 1718 January 2006
46

References in context

  • According to the WHO, one important way to achieve a considerably improved level of pandemic preparedness is to encourage the annual uptake of influenza vaccines.42,46 Following the logic of “demand drives supply” for seasonal influenza vaccines, an increased annual use of influenza vaccines, according to existing recommendations, will be followed by investments from the vaccine industry to increase their vaccine production capacity.
    Go to context

  • The WHO has made recommendations for stockpiling antivirals and H5N1 vaccines for immediate use at the onset of a potential pandemic outbreak.41,46 It has also advised national health authorities to make pre-pandemic purchase agreements with vaccine manufacturers for pandemic vaccines.46 It will take at least 4–6 months after the WHO has announced the pandemic before the first pandemic vaccine doses will become available for distribution.
    Go to context

  • The WHO has made recommendations for stockpiling antivirals and H5N1 vaccines for immediate use at the onset of a potential pandemic outbreak.41,46 It has also advised national health authorities to make pre-pandemic purchase agreements with vaccine manufacturers for pandemic vaccines.46 It will take at least 4–6 months after the WHO has announced the pandemic before the first pandemic vaccine doses will become available for distribution.
    Go to context

World Health Organization. Guidelines on the Use of Vaccines and Antivirals during Influenza Pandemics. Geneva, 2004. Document WHO/CDS/CSR/RMD/2004.8. (www.who.int/csr/resources/publications/influenza/en/11_29_01_A.pdf)
47

References in context

  • There is also an urgent need for development of more effective vaccine formulations, such that the dose of antigen per vaccination may be reduced and a more equitable global distribution of scarce pandemic vaccine may be achieved (see also Chapter 9).
    Go to context

World Health Organization. Meeting on development and evaluation of influenza pandemic vaccines. Geneva. (www.who.int/vaccine_research/diseases/influenza/mtg_021205/en/) (2–3 November 2005) 23 November 2005
48

References in context

  • There is also an urgent need for development of more effective vaccine formulations, such that the dose of antigen per vaccination may be reduced and a more equitable global distribution of scarce pandemic vaccine may be achieved (see also Chapter 9).
    Go to context

European Medicines Agency (EMEA). Guideline on submission of marketing authorisation application for pandemic influenza vaccines through the centralised procedure. April 2004. Document EMEA/CPMP/VEG/4986/03. ( www.emea.eu.int/pdfs/human/vwp/498603en.pdf ) ( www.emea.eu.int/pdfs/human/vwp/471703en.pdf )
49

References in context

  • As an integral part of pandemic preparedness planning, a “pandemic simulation” project “Common Ground” was carried out in the European Union in November 2005.49 The objective was to test the level of preparedness of each of the member states and identify gaps in their respective national pandemic preparedness plans.
    Go to context

Health Protection Agency. Health Protection Agency coordinates EU pandemic influenza exercise. (www.medicalnewstoday.com/medicalnews.php?newsid=32376)

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