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These conditions can impair coughing, swallowing, clearing the airways, and in the worst cases, breathing. Therefore, they worsen the flu symptoms.
Influenza reaches peak prevalence in winter, and because the Northern and Southern Hemispheres have winter at different times of the year, there are actually two different flu seasons each year.
This is why the World Health Organization assisted by the National Influenza Centers makes recommendations for two different vaccine formulations every year; one for the Northern, and one for the Southern Hemisphere.
A long-standing puzzle has been why outbreaks of the flu occur seasonally rather than uniformly throughout the year. One possible explanation is that, because people are indoors more often during the winter, they are in close contact more often, and this promotes transmission from person to person.
Increased travel due to the Northern Hemisphere winter holiday season may also play a role. Dry particles are lighter and can thus remain airborne for a longer period.
However, seasonal changes in infection rates also occur in tropical regions, and in some countries these peaks of infection are seen mainly during the rainy season.
A combination of these small seasonal effects may be amplified by dynamical resonance with the endogenous disease cycles.
An alternative hypothesis to explain seasonality in influenza infections is an effect of vitamin D levels on immunity to the virus.
This could explain why influenza occurs mostly in winter and during the tropical rainy season, when people stay indoors, away from the sun, and their vitamin D levels fall.
Every year about , to , people die due to influenza globally, with an average of , Although the number of cases of influenza can vary widely between years, approximately 36, deaths and more than , hospitalizations are directly associated with influenza a year in the United States.
As influenza is caused by a variety of species and strains of viruses , in any given year some strains can die out while others create epidemics , while yet another strain can cause a pandemic.
Typically, in a year's normal two flu seasons one per hemisphere , there are between three and five million cases of severe illness,    which by some definitions is a yearly influenza epidemic.
Roughly three times per century, a pandemic occurs, which infects a large proportion of the world's population and can kill tens of millions of people see pandemics section.
New influenza viruses are constantly evolving by mutation or by reassortment. This is called antigenic drift , which slowly creates an increasing variety of strains until one evolves that can infect people who are immune to the pre-existing strains.
This new variant then replaces the older strains as it rapidly sweeps through the human population, often causing an epidemic. In contrast, when influenza viruses reassort, they acquire completely new antigens—for example by reassortment between avian strains and human strains; this is called antigenic shift.
If a human influenza virus is produced that has entirely new antigens, everybody will be susceptible, and the novel influenza will spread uncontrollably, causing a pandemic.
From a public health point of view, flu epidemics spread rapidly and are very difficult to control. Most influenza virus strains are not very infectious and each infected individual will only go on to infect one or two other individuals the basic reproduction number for influenza is generally around 1.
However, the generation time for influenza is extremely short: the time from a person becoming infected to when he infects the next person is only two days.
The short generation time means that influenza epidemics generally peak at around 2 months and burn out after 3 months: the decision to intervene in an influenza epidemic, therefore, has to be taken early, and the decision is therefore often made on the back of incomplete data.
Another problem is that individuals become infectious before they become symptomatic, which means that putting people in quarantine after they become ill is not an effective public health intervention.
The word Influenza comes from the Italian language meaning "influence" and refers to the cause of the disease; initially, this ascribed illness to unfavorable astrological influences.
It was introduced into English in the mid-eighteenth century during a pan-European epidemic. An overall lack of data up until precludes meaningful search for the influenza outbreaks in the more distant past.
The first convincing record of an influenza pandemic was a minor pandemic chronicled in , which began in East Asia before spreading to North Africa and then Europe.
In Rome , over 8, people were killed. Several Spanish cities saw large scale deaths, among the fatalities the Queen of Spain, Anna of Austria.
Pandemics continued sporadically throughout the 17th and 18th centuries, with the pandemic of — being particularly widespread; it infected approximately a quarter of the people exposed.
The most famous and lethal outbreak was the flu pandemic Spanish flu type A influenza , H1N1 subtype , which lasted into One observer wrote, "One of the most striking of the complications was hemorrhage from mucous membranes , especially from the nose, stomach, and intestine.
Bleeding from the ears and petechial hemorrhages in the skin also occurred. The flu pandemic was truly global, spreading even to the Arctic and remote Pacific islands.
The unusually severe disease killed between two and twenty percent of those infected, as opposed to the more usual flu epidemic mortality rate of 0.
The total mortality of the — pandemic is not known, but it is estimated that 2. Later flu pandemics were not so devastating. In later pandemics antibiotics were available to control secondary infections and this may have helped reduce mortality compared to the Spanish flu of It was incorrectly assumed that the cause of influenza was bacterial in origin from with Haemophilus influenzae being discovered by and suggested as the origin of influenza by R.
The first significant step towards preventing influenza was the development in of a killed-virus vaccine for influenza by Thomas Francis, Jr.
This built on work by Australian Frank Macfarlane Burnet , who showed that the virus lost virulence when it was cultured in fertilized hen's eggs.
Influenza produces direct costs due to lost productivity and associated medical treatment, as well as indirect costs of preventive measures.
Preventive costs are also high. Governments worldwide have spent billions of U. It is still too early to determine whether the H1N1 pandemic has had any long-term economic effects.
Research on influenza includes studies on molecular virology , how the virus produces disease pathogenesis , host immune responses , viral genomics , and how the virus spreads epidemiology.
These studies help in developing influenza countermeasures; for example, a better understanding of the body's immune system response helps vaccine development, and a detailed picture of how influenza invades cells aids the development of antiviral drugs.
One important basic research program is the Influenza Genome Sequencing Project , which was initiated in to create a library of influenza sequences and help clarify which factors make one strain more lethal than another, which genes most affect immunogenicity , and how the virus evolves over time.
The sequencing of the influenza genome and recombinant DNA technology may accelerate the generation of new vaccine strains by allowing scientists to substitute new antigens into a previously developed vaccine strain.
There has been some research success towards a "universal flu vaccine" that produces antibodies against proteins on the viral coat which mutate less rapidly, and thus a single shot could potentially provide longer-lasting protection.
A number of biologics , therapeutic vaccines and immunobiologics are also being investigated for treatment of infection caused by viruses.
Therapeutic biologics are designed to activate the immune response to virus or antigens. Influenza models, such as murine influenza, are convenient models to test the effects of prophylactic and therapeutic biologics.
For example, lymphocyte T-cell immunomodulator inhibits viral growth in the murine model of influenza. Influenza infects many animal species, and transfer of viral strains between species can occur.
Birds are thought to be the main animal reservoirs of influenza viruses. All known subtypes HxNy are found in birds, but many subtypes are endemic in humans, dogs, horses, and pigs; populations of camels, ferrets, cats , seals, mink, and whales also show evidence of prior infection or exposure to influenza.
The main variants named using this convention are: bird flu , human flu , swine flu , horse flu and dog flu. Cat flu generally refers to feline viral rhinotracheitis or feline calicivirus and not infection from an influenza virus.
In pigs, horses and dogs, influenza symptoms are similar to humans, with cough, fever and loss of appetite.
These vaccines can be effective against multiple strains and are used either as part of a preventive strategy, or combined with culling in attempts to eradicate outbreaks.
Flu symptoms in birds are variable and can be unspecific. Some strains such as Asian H9N2 are highly virulent to poultry and may cause more extreme symptoms and significant mortality.
An avian-adapted, highly pathogenic strain of H5N1 called HPAI A H5N1 , for "highly pathogenic avian influenza virus of type A of subtype H5N1" causes H5N1 flu , commonly known as "avian influenza" or simply "bird flu", and is endemic in many bird populations, especially in Southeast Asia.
It is epizootic an epidemic in non-humans and panzootic a disease affecting animals of many species, especially over a wide area , killing tens of millions of birds and spurring the culling of hundreds of millions of other birds in an attempt to control its spread.
Most references in the media to "bird flu" and most references to H5N1 are about this specific strain. In almost all cases, those infected have had extensive physical contact with infected birds.
The exact changes that are required for this to happen are not well understood. In March , the Chinese government reported three cases of H7N9 influenza infections in humans, two of whom had died and the third became critically ill.
Although the strain of the virus is not thought to spread efficiently between humans,   by mid-April, at least 82 persons had become ill from H7N9, of which 17 had died.
These cases include three small family clusters in Shanghai and one cluster between a neighboring girl and boy in Beijing, raising at least the possibility of human-to-human transmission.
The WHO points out that one cluster did not have two of the cases lab confirmed and further points out, as a matter of baseline information, that some viruses are able to cause limited human-to-human transmission under conditions of close contact but are not transmissible enough to cause large community outbreaks.
In pigs swine influenza produces fever, lethargy, sneezing, coughing, difficulty breathing and decreased appetite. Although mortality is usually low, the virus can produce weight loss and poor growth, causing economic loss to farmers.
In all, 50 human cases are known to have occurred since the virus was identified in the midth century, which have resulted in six deaths. In , a swine-origin H1N1 virus strain commonly referred to as "swine flu" caused the flu pandemic , but there is no evidence that it is endemic to pigs i.
From Wikipedia, the free encyclopedia. Infectious disease, "the flu". For other uses, see Influenza disambiguation.
Not to be confused with Haemophilus influenzae. For other uses, see Flu disambiguation and Grippe disambiguation. Main article: Influenza vaccine.
Further information: Influenza prevention. Main article: Influenza treatment. Further information: Flu season. See also: United States influenza statistics by flu season.
Further information: Flu pandemic. Further information: Influenza pandemic , Spanish flu , and Hong Kong flu.
Further information: Social impact of H5N1. Further information: Influenza research. Archived from the original on 30 November Retrieved 30 November Harrison's principles of internal medicine 18th ed.
New York: McGraw-Hill. July Answer: To calculate 10 percent off a price, you entered the price on the calulator tool, and apply 10 percent to it.
Answer: To calculate 20 percent off a price, you enter 20 percent and the price on the calulator tool, and apply 20 percent to it.
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