|
6.1 |
Avian Influenza: WHO Fact Sheet |
(modified from ProMed Jan. 23, 2006)
http://www.alertnet.org/thenews/newsdesk/N20130277.htm
The H5N1 avian influenza virus can survive for more than a month in bird droppings in cold weather and for nearly a week even in hot summer temperatures, the World Health Organization said on Fri 20 Jan 2006.
When people become infected with avian influenza virus, they get a high fever and pneumonia very quickly, according to an updated fact sheet from the WHO, posted on the internet. The fact sheet incorporatify">When people become infected with avian influenza virus, they get a high fever and pneumonia very quickly, according to anes the most recent findings on the H5N1 avian influenza virus, which WHO says is causing by far the worst outbreak among both birds and people ever recorded. It has been found from South Korea, across South East Asia, into Turkey, Ukraine and Romania. It has infected 149 people and killed 80, according to the WHO figures, which do not include the most recent deaths and infections in Turkey.
Bird droppings may be a significant source of its spread to both people and birds, the WHO said. For example, the highly pathogenic H5N1 virus can survive in bird feces for at least 35 days at low temperature (4 degrees C or 39 degrees F). At a much higher temperature (37 degrees C or 98.6 degrees F), H5N1 viruses have been shown to survive, in fecal samples, for 6 days.
Poultry, especially those kept in small backyard flocks, are the main source of the virus. "These birds usually roam freely as they scavenge for food and often mingle with wild birds or share water sources with them. Such situations create abundant opportunities for human exposure to the virus, esm freely as they scavenge for food and often mingle with wild birds or share water sources with them. pecially when birds enter households or are brought into households during adverse weather, or when they share areas where children play or sleep, WHO states.
According to WHO, H5N1 has different qualities from seasonal flu. The incubation period for H5N1 avian influenza may be longer than that for normal seasonal influenza, which is around 2 to 3 days. Current data for H5N1 infection indicate an incubation period ranging from 2 to 8 days and possibly as long as 17 days. Initial symptoms include a high fever, usually with a temperature higher than 38 degrees C (100.4 degrees F), and influenza-like symptoms. Diarrhea, vomiting, abdominal pain, chest pain, and bleeding from the nose and gums have also been reported as early symptoms in some patients. And with H5N1 infection, all patients have developed pneumonia, and usually very early on the illness, WHO states. On present evidence, difficulty in breathing develops around 5 days following the 1st symptoms. Respiratory distress, a hoarse voice, and a crackling a, and usually very early on the illness, WHO states. On present evidence, difficulty in breathing develops around 5 days fol sound when inhaling are commonly seen. There is bloody sputum. Another common feature is multi-organ dysfunction, notably involving the kidney and heart. The WHO recommends using Tamiflu, known generically as oseltamivir, as soon as possible to treat bird flu.
WHO stresses that H5N1 remains mostly a disease of birds, with tens of millions infected in 2 years. For unknown reasons, most cases have occurred in rural and peri-urban households where small flocks of poultry are kept. Again for unknown reasons, very few cases have been detected in presumed high-risk groups, such as commercial poultry workers, workers at live poultry markets, cullers, veterinarians, and health staff caring for patients without adequate protective equipment. Also lacking is an explanation for the puzzling concentration of cases in previously healthy children and young adults (tropical.forestry@btinternet.com).
Avian influenza ("bird flu") and the significance of its transmission to humans
children and young adults (tropical.forestry@btinternet.com).Avian influen A. The disease in birds: impact and control measures All birds are thought to be susceptible to infection with avian influenza,
though some species are more resistant to infection than others. Infection
causes a wide spectrum of symptoms in birds, ranging from mild illness to a
highly contagious and rapidly fatal disease resulting in severe epidemics.
The latter is known as "highly pathogenic avian influenza." This form is
characterized by sudden onset, severe illness, and rapid death, with a
mortality that can approach 100 per cent. 15 subtypes of influenza virus are known to infect birds, thus providing an
extensive reservoir of influenza viruses potentially circulating in bird
populations. To date, all outbreaks of the highly pathogenic form have been
wn to infect birds, thus providing an
extensive reservoir of influenza viruses potentially circulating in bird
caused by influenza A viruses of subtypes H5 and H7. Migratory waterfowl -- most notably wild ducks -- are the natural reservoir
of avian influenza viruses, and these birds are also the most resistant to
infection. Domestic poultry, including chickens and turkeys, are
particularly susceptible to epidemics of rapidly fatal influenza. Direct or indirect contact of domestic flocks with wild migratory waterfowl
has been implicated as a frequent cause of epidemics. Live bird markets
have also played an important role in the spread of epidemics. Recent research has shown that viruses of low pathogenicity can, after
circulation for sometimes short periods in a poultry population, mutate
into highly pathogenic viruses. During a 1983-1984 epidemic in the United
States of America, the H5N2 virus initially caused low mortality, but
within 6 months became highly pathogenic, with a mortality approaching 90
per cent. Control of the outbreak required destruction of more than 17
millioially caused low mortality, but
within 6 months became highly pathogenic, with a mortality approaching 90
n birds at a cost of nearly USD65 million. During a 1999-2001
epidemic in Italy, the H7N1 virus, initially of low pathogenicity, mutated
within 9 months to a highly pathogenic form. More than 13 million birds
died or were destroyed. The quarantining of infected farms and destruction of infected or
potentially exposed flocks are standard control measures aimed at
preventing spread to other farms and eventual establishment of the virus in
a country's poultry population. Apart from being highly contagious, avian
influenza viruses are readily transmitted from farm to farm by mechanical
means, such as by contaminated equipment, vehicles, feed, cages, or
clothing. Highly pathogenic viruses can survive for long periods in the
environment, especially when temperatures are low. Stringent sanitary
measures on farms can, however, confer some degree of protection. In the absence of prompt control measures backed by good surveillance,
epidemics can last for years. For example, an epidemic of H5N2 avian
, however, confer some degree of protection. In the absence of prompt control measures backed by good surv influenza, which began in Mexico in 1992, started with low pathogenicity,
evolved to the highly fatal form, and was not controlled until 1995. B. A constantly mutating virus: 2 consequences The tendency of influenza viruses to undergo frequent and permanent
antigenic changes necessitates constant monitoring of the global influenza
situation and annual adjustments in t The tendency of influenza viruses to undergo frequent and permanent
antigenic changes necessitates he composition of influenza vaccines.
Both activities have been a cornerstone of the WHO Global Influenza
Program since its inception in 1947. Influenza viruses have a 2nd characteristic of great public health concern:
influenza A viruses, including subtypes from different species, can swap or "re-assort" genetic materials and merge. This re-assortment process, known as
antigenic shift, results in a novel subtype different from both parent
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. For this to happen, the novel subtype
needs to have genes from human influenza viruses that make it readily
transmissible from person to person for a sustainable period. Conditions favorable for the emergence of antigenic shift have long been
thought to involve humans living in close proximity to domestic poultry and
pigs. Because pigs are susceptible to infection with both avian and favorable for the emergence of antigenic shift have long been
thought to involve humans living in close proximity to domestic
mammalian viruses, including human strains, they can serve as a "mixing
vessel" for the scrambling of genetic material from human and avian
viruses, resulting in the emergence of a novel subtype. Recent events, however, have identified a 2nd possible mechanism. Evidence
is mounting that, for at least some of the 15 avian influenza virus
subtypes circulating in bird populations, humans themselves can serve as
the "mixing vessel." C. Human infection with avian influenza viruses: a timeline Extensive inThe infection of humans
coincided with an epidemic of highly pathogenic avian influenza, caused by
thevestigation of that outbreak determined that close contact with
live infected poultry was the source of human infection. Studies at the
genetic level further determined that the virus had jumped directly from
birds to humans. Limited transmission to health care workers occurred, but
did not cause severe disease. Rapid destruction -- within 3 days -- of Hong Kong's entire poultry
population, estimated at around 1.5 million birds, reduced opportunities
for further direct transmission to humans, and may have averted a pandemic. That event alarmed public health authorities, as it marked the 1st time
that an avian influenza virus was transmitted directly to humans and caused
severe illness with high mortality. Alarm mounted again in February 2003,
when an outbreak of H5N1 avian influenza in Hong Kong caused 2 cases and 1
death in members of a family who had recently traveled to southern China.
Another child in the family died during that visit, but the cause of death
is not known. 2 other avian influenza viruses have recently caused illness in humans. An
outbreak of highly pathogenic H7N7 avian influenza, which began in the
Netherlands in February 2003, caused the death of one veterinarian 2 months
later, and mild illness in 83 other humans. Mild cases of avian influenza
H9N2 in children occurred in Hong Kong in 1999 (2 cases) and in
mid-December 2003 (one case). H9N2 is not highly pathogenic in birds. The most recent cause for alarm occurred in January 2004, when laboratory
tests confirmed the presence of H5N1 avian influenza virus in human cases
of severe respiratory disease in the northern part of Viet Nam. D. Why H5N1 is of particular concern The epidemic of highly pathogenic avian influenza caused by H5N1, which
began in mid-December 2003 in the Republic of Korea and is now being seen
in other Asian countries, is therefore of particular public health concern.
H5N1 variants demonstrated a capacity to directly infect humans in 1997,
and have done so again in Viet Nam in January 2004. The spread of infection
in birds increases the opportunities for direct infection of humans. If
more humans become infected over time, the likelihood also increases that
humans, if concurrently infected with human and avian influenza strains,
could serve as the "mixing vessel" for the emergence of a novel subtype
with sufficient humanes that
humans, if concurrently infected with human and avian influenza strains,
could serve as the &qu genes to be easily transmitted from person to person.
Such an event would mark the start of an influenza pandemic. E. Influenza pandemics: can they be averted? Experts agree that another influenza pandemic is inevitable and possibly
imminent. Most influenza experts also agree that the prompt culling of Hong Kong's entire poultry population in 1997 probably averted a pandemic. Several measures can help minimize the global public health risks that
could arise from large outbreaks of highly pathogenic H5N1 avian influenza
in birds. An immediate prio Several measures can help minimize the global public health risks that
could arise from larrity is to halt further spread of epidemics in
poultry populations. This strategy works to reduce opportunities for human
exposure to the virus. 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. Workers involved in the culling of
poultry flocks must be protected, by proper clothing and equipment, against
infection. These workers should also receive antiviral drugs as a
prophylactic measure. When cases of avian influenza in humans occur, information on the extent of
influenza infection in animals as well as humans and on circulating
influenza viruses is urgently needed to aid the assessment of risks to
public health and to guide the best protective measures. Thorough investigation of each case is also essential. While WHO and the
ded to aid the assessment of risks to
public health and to guide the best protective measures.
While all these activities can reduce the likelihood that a pandemic strain
will emerge, the question of whether another influenza pandemic can be
averted cannot be answered with certainty. F. Clinical course and treatment of human cases of H5N1 avian influenza Tests for diagnosing all influenza strains of animals and humans are rapid
and reliable. Many laboratories in the WHO global influenza network have
the necessary high-security facilities and reagents for performing these
tests as well as considerable experience. Rapid bedside tests for the
diagnosis of human influenza are also available, but do not have the
precision of the more extensive laboratory testing that is currently needed
to fully understand the most recent cases and determine whether human
infection is spreading, either directly from birds or from person to person. 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. Some of
these drugs are also expensive and supplies are limited. Experience in the production of influenza vaccines is also considerable,
particularly as vaccine co Some of
these drugs are also expensive and supplies are limited. Experience in the mposition changes each year to match changes in
circulating virus due to antigenic drift. 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. Update: influenza activity --- United States, 2 Oct to 3 Dec 2005 Influenza viral surveillance and characterization CDC has characterized antigenically 16 influenza viruses collected by US
laboratories since 1 Oct 2005. These include 14 influenza A (H3N2) viruses
that are similar to A/California/07/2004, the influenza A (H3N2) component
included in the 2005-06 influenza vaccines, and 2 influenza B viruses, one
that belongs to the B/Victoria lineage and one that belongs to the
B/Yamagata lineage and was characterized as B/Florida/07/2004-like. Recently circulating influenza B viruses have belonged to 2 antigenically
and genetically distinct lineages represented by B/Victoria/2/87 viruses
and B/Yamagata/16/88 viruses. The influenza B/Florida/07/2004-like virus
isolated is a minor antigenic variant of Shanghai/361/2002, the
recommended influenza B component for the 2005-06 influenza vaccine. Influenza-Related Pediatric Mortality Influenza-Related Pediatric Mortality Pneumonia and influenza (P&I) mortality surveillance Patient visits for influenza-Like Illness (ILI) Influenza activity levels reported by state and territorial epidemiologists Influenz--------------------------------------------------------------------------------------- Pediatric hospitalizations associated with laboratory-confirmed influenza
infection Human cases of avian influenza A (H5N1) (Reported by: WHO Collaborating Center for Surveillance, Epidemiology, and
Control of Influenza; S Wang, MPH, R Dhara, MPH, L Brammer, MPH, A Postema,
MPH, M Katz, MD, T Uyeki, MD, J Bresee, MD, A Balish, T Wallis, H Hall, A
Klimov, PhD, N Cox, PhD, Div of Viral and Rickettsial Diseases, National
Center for Infectious Diseas Postema,
MPH, M Katz, MD, T Uyeki, MD, J Bresee, MD, A Balish, T Wallis, H Hall, A
Klimov, PhD, N Cox,es; J Ortiz, MD, EIS Officer, CDC.) MMWR editorial note Influenza surveillance reports for the United States are posted online
weekly during October--May and are available at Sporadic cases of avian influenza A (H5N1) in humans continue to be
reported in Asia; in November, for the first time during the current Sporadic cases of avian influenza A (H5N1) in humans continue to be
reporec 2003 to 9 Dec 2005), China reported laboratory-confirmed
cases (4). The majority of cases appear to have been acquired from direct
contact with infected poultry. No evidence of sustained human-to-human
transmission of H5N1 has been detected, although rare cases of
human-to-human transmission likely have occurred (5). Recently, influenza A (H5N1) was reported for the first time in avian
species in Europe (6), although the likely Asian origin of the outbreaks
has been confirmed by virus sequencing analysis and virus isolation (7).
This westward spread of disease might be attributed to transport of virus
by wild migratory birds from Asia (8); further research is needed to better
understand the role of migratory birds in the current H5N1 epizootic. CDC continues to recommend enhanced surveillance for suspected H5N1 cases
among travelers with unexplained severe respiratory illness returning from
H5N1-affected countries (1) as a defense against further spread of the
disease from H5N1-affected countries. Additional informatio among travelers with unexplained severe respiratory illness returning from
H5N1-affected countries (1) as a defense against n regarding
avian influenza is available at <http://www.cdc.gov/flu/avian/index.htm>. References ProMED-mail [The latest Bulletin of the European Influenza Surveillance Scheme
similarly reports that clinical influenza activity in Europe remains at All countries reported a lowluenza virus detections (N=56)
have been influenza A and 41 percent influenza B. No human cases of
influe intensity of influenza activity in week
48/2005. The incidence of influenza-like illness or acute respiratory see also: See Avian Influenza Update Information page for a complete list of updates/news since August 2005. Gamblin, S.J. et al. 2004. The tes/news since August 2005.
Avian influenza is an infectious disease of birds caused by type A strains
of the influenza virus. The disease, which was first identified in Italy
more than 100 years ago, occurs worldwide.
All type A influenza viruses, including those that regularly cause seasonal
epidemics of influenza in humans, are genetically labile and well adapted
to elude host defenses. Influenza viruses lack mechanisms for the"proofreading" and repair of errors that occur during replication. As a
result of these uncorrected errors, the genetic composition of the viruses
changes as they replicate in humans and animals, and the existing strain is
replaced with a new antigenic variant. These constant, permanent and
usually small changes in the antigenic composition of influenza A viruses
are known as antigenic drift.
Avian influenza viruses do not normally infect species other than birds and
pigs. The 1st documented infection of humans with an avian influenza virus
occurred in Hong Kong in 1997, when the H5N1 strain caused severe
respiratory disease in 18 humans, of whom 6 died. The infection of humans
coincided with an epidemic of highly pathogenic avian influenza, caused by
the same strain, in Hong Kong's poultry population.
Of the 15 avian influenza virus subtypes, H5N1 is of particular concern for
several reasons. H5N1 mutates rapidly and has a documented propensity to
acquire genes from viruses infecting other animal species. Its ability to
cause severe disease in humans has now been documented on 2 occasions. In
H5N1 mutates rapidly and has a documented propensity to
acquire genes from viruses infecting other animal species. Its abili addition, laboratory studies have demonstrated that isolates from this
virus have a high pathogenicity and can cause severe disease in humans.
Birds that survive infection excrete virus for at least 10 days, orally and
in feces, thus facilitating further spread at live poultry markets and by
migratory birds.
Based on historical patterns, influenza pandemics can be expected to occur,
on average, 3-4 times each century when new virus subtypes emerge and are
readily transmitted from person to person. However, the occurrence of
influenza pandemics is unpredictable. In the 20th century, the great
influenza pandemic of 1918-1919, which caused an estimated 40 to 50 million
deaths worldwide, was followed by pandemics in 1957-1958 and 1968-1969.
Published information about the clinical course of human infection with
H5N1 avian influenza is limited to studies of cases in the 1997 Hong Kong
outbreak. In that outbreak, patients developed symptoms of fever, sore
throat, cough and, in several of the fatal cases, severe respiratory
distress secondary to viral pneumonia. Previously healthy adults and
children, and some with chronic mfever, sore
throat, cough and, in several of the fatal cases, severe respiratory
distress secondary toedical conditions, were affected.
6.2
Avian Influenza Activity, 2005/2006: CDC Update
-----------------------------------------------------------------------
During the period 2 Oct to 3 Dec 2005, low-level influenza activity was reported in the United States. This rep2005
-----------------------------------------------------------------------
During tort summarizes US influenza
activity* since the beginning of the 2005-06 influenza surveillance season
and updates the previous summary (1).
--------------------------------------------------------------
During the current influenza surveillance season, US World Health
Organization (WHO) collaborating laboratories and National Respiratory and
Enteric Virus Surveillance System (NREVSS) laboratories in the United
States tested 20 336 respiratory specimens for influenza viruses; 173 (0.9
per cent) were positive. The weekly percentages of specimens testing
positive for influenza virus ranged from 0.4 per cent to 1.4 per cent.
Since 2 Oct 2005, influenza viruses have been reported from 30 states. Of
the 173 influenza viruses identified, a total of 151 (87 per cent) were
influenza A viruses, and 22 (13 per cent) were influenza B viruses. Of the
151 influenza A viruses, 78 (52 per cent) have been subtyped, with 76 (97
per cent) determined to be influenza influenza A viruses, and 22 (13 per cent) were influenza B viruses. Of the
151 influenza A viruses, 78 (5A (H3N2) viruses and 2 (3 per cent)
determined to be influenza A (H1N1) viruses.
------------------------------------------------
Only one influenza-related pediatric death has been for the 2005-06 influenza vaccine.
-----------------------reported during the
current surveillance season -- from California.
-----------------------------------------------------------------------
During the current influenza surveillance season, 5.7-6.7 per cent of all
deaths reported to the 122 Cities Mortality Reporting System were
attributable to P&I. Each week, the percentage of P&I deaths was below the
epidemic threshold.
---------------------------------------------------------
During the current influenza surveillance season, weekly percentages of
patient visits for ILI reported by approximately 1000 US sentinel providers
in 50 states, New York City, Chicago, and the District of Columbia have
ranged from 1.2 per cent to 1.7 per cent; 1.6 per cent in the week ending 3
Dec 2005 (national baseline 2.2 per cent).
----------1.7 per cent; 1.6 per cent in the week ending 3
Dec 2005 (national baseline 2.2 per cent).
No state has reported widespread or regional influenza activity during the
current influenza surveillance season. In the week ending 3 Dec 2005, only
Nebraska reported local influenza activity; 29 states, New York City, and
Puerto Rico reported sporadic influenza activity; 20 states and the
District of Columbia reported no influenza activity.
-------------------------------------------------------------------------------------------------------------
The Emerging Infections Program (EIP), which began surveillance for the
2005-06 season on 1 Oct 2005, yielded a preliminary influenza-associated
hospitalization rate for children aged 0-4 years of 0.06 per 10 000. No
influenza-associated hospitalizations among children aged 5-17 years were
reported during the same period. The New Vaccine Surveillance Network
(NVSN), which began surveillance for the 2005 influenza-associated hospitalizations among children aged 5-17 years were
reported during the same period. T-06 season on 30 Oct 2005,
reported no laboratory-confirmed influenza-associated hospitalizations
among children aged 0-4 years during the period 30 Oct to 26 Nov 2005.
--------------------------------------------------------
No human case of avian influenza A (H5N1) virus infection has been
identified in the United States. From January 2004 through 9 Dec 2005, a
total of 137 laboratory-confirmed human cases of avian influenza A (H5N1)
infections were reported to the World Health Organization (2). Of these, 70
(51 per cent) were fatal. All cases were reported from 5 countries in Asia
(Cambodia, China, Indonesia, Thailand, and Viet Nam).
----------------------------
Vaccination is the best way to prevent influenza (3). 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). The degree of antigenic match between the
current vaccine strains and strains that will circulate this season will be
determined as more strains become available for analysis.
<http://www.cdc.gov/flu/weekly/fluactivity.htm>. Additional information
about influenza viruses, influenza surveillance, and the influenza vaccine
is available at <http://www.cdc.gov/flu>.
outbreak (26 D/www.cdc.gov/flu>.
---------------
1. Update: influenza activity---United States and worldwide, 22 May -- 3
Sep 2005, and 2005--06 season vaccination recommendations. MMWR 2005; 54:
899-902.
2. WHO. Confirmed human cases of avian influenza A (H5N1). Geneva,
Switzerland: World Health Organization; 2005. Available at
<http://www.who.int/csr/disease/avian_influenza/en>.
3. CDC. Prevention and control of influenza: recommendations of the
Advisory Committee on Immunization Practices (ACIP). MMWR 2005 (No. RR-6).
4. WHO. Avian influenza---situation in China, Indonesia (update 41).
Geneva, Switzerland: World Health Organization; 2005.
5. Ungchusak K, Auewarakul P, Dowell SF, et al. Probable person-to-person
transmission of avian influenza A (H5N1). N Engl J Med 2005; 352: 333-40.
6. World Organisation for Animal Health (OIE). Highly pathogenic avian
influenza Probable person-to-person
transmission of avian influenza A (H5N1). N Engl J Med 2005; 352: 333-40.
in Romania. Paris, France: World Organisation for Animal Health
(OIE); 2005.
7. World Organisation for Animal Health (OIE). Highly pathogenic avian
influenza in Romania. Follow-up report no. 3. Paris, France: World
Organisation for Animal Health (OIE); 2005.
8. WHO. Avian influenza---new areas with infection in birds (update 34).
Geneva, Switzerland: World Health Organization; 2005.
<promed@promedmail.org>
baseline levels. Sporadic laboratory-confirmed cases of influenza were
detected in England, Estonia, Poland, Scotland and Sweden in week 48/2005.
So far this season 59 per cent of total influenza virus detections (N=56)
have been influenza A and 41 percent influenza B. No human cases of
influenza A(H5N1) virus have been reported in Europe.
infections remained at baseline levels in all countries. 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. Other
countries reported no influenza activity, meaning that the overall level of
clinical activity remained at baseline levels. Further details and a map
can be accessed at <http://www.eiss.org/index.cgi>. - Mod.CP]
Influenza activity update & 2005/2006 vaccine reco... 20050915.2726
Influenza activity, 2004/2005: CDC Update 20050701.1860
Influenza B virus - New Caledonia 20050623.1767
Influenza B virus - New Zealand 20050622.1755
Influenza update - Northern Hemisphere (04) 20050413.1071
20050623.1767
Influenza B virus - New Zealand 20050622.17 Influenza A virus, European gulls, new HA type (H16) 20050309.0701
Influenza update - Northern Hemisphere (03) 20050224.0586
Influenza update - Northern Hemisphere (02) 20050213.0487
Influenza update - Northern Hemisphere 20050210.0459]
6.3
Avian Influenza Update Information
Selected References
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Koopmans, M. et al. 2004. Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands . Lancet, 363: 587-593.
Laver, G., Garman, E. 2001. The origin and control of pandemic influenza Science, 293: 1776-1777
Liem, N.T. et al. 2005. Lack of H5N1 avian influenza transmission to hospital employees, Hanoi , 2004. Emerging Infectious Disease ,11: 2,210-215.
Nicholson, KG et al. 2003. Influenza. Lancet , 362:1733-1745.
Osterholm, M.T. 2005. Preparing for the next pandemic. New England Journal of Medicine 352: 1839-1842
Palese, P. 2004. Influenza: old and new threats. Nature Medicine Suppl. 10:12, S82-S87.
Suzuki, Y. 2005. Sialobiology of influenza L molecular mechanism of host range variation of influenza viruses. Bioalese, P. 2004. Influenza: old and new threats. Nature Medicine Suppl. 10:12, S82-S87.
Suzuki, Y. 20l Pharm Bull , 28:399-408.
Ungchusak, K. et al. 2005. Probable person-to-person transmission of avian Influenza A (H5N1) New England Journal of Medicine, 352:4,333-340.
http://europa.eu.int/comm/health/ph_threats/com/Influenza/avian_influenza_en.htm
http://www.promedmail.org/pls/promed/f?p=2400:1600:15323012213163428114
http://gamapserver.who.int/GlobalAtlas/home.asp
http://www.who.int/csr/disease/avian_influenza/en/
en-info/facts.htm">http://www.cdc.gov/flu/avian/gen-info/facts.htm