1 : Avian Influenza A (H5N1) Virus

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Since 1997, highly pathogenic avian influenza A (H5N1) viruses have caused unprecedented widespread poultry outbreaks with high mortality in a number of Asian, European, Middle Eastern, and African countries; have infected other animal species; and have caused sporadic, severe, and fatal human infections. Influenza viruses are single-stranded, negative-sense RNA viruses with eight gene segments that encode 10 proteins and belong to the family . It is now known that H5N1 virus emerged in southern China in 1996 and that outbreaks of highly pathogenic avian influenza (HPAI) H5N1 among poultry have occurred in southern China for several years. Epidemiological studies conducted in Hong Kong during the 1997 H5N1 outbreak implicated avian-to-human transmission of H5N1 virus. Clinical case reports of H5N1 infection reflect surveillance for severe respiratory illness in hospitals. There are few descriptions of the clinical features of mild or atypical disease. Detection of H5N1 RNA by conventional or real-time PCR testing of respiratory specimens using H5-specific primers under biosafety level 2 (BSL2) laboratory conditions is the most common method of H5N1 diagnosis. The key to preventing human infections with H5N1 virus is to avoid unprotected direct contact with diseased and dead poultry, materials contaminated by poultry feces, and uncooked or inadequately cooked poultry or poultry products. There are several challenges to producing a pandemic influenza vaccine. Aside from the problems with production capacity and distribution, three additional challenges to creating an H5N1 vaccine are antigenic drift, immunogenicity, and vaccine pathogenicity to embryonated chicken eggs.

Citation: Ortiz J, Uyeki T. 2007. Avian Influenza A (H5N1) Virus, p 1-22. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch1
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Figure 1.

Confirmed human H5N1 cases in Eurasia reported from January 2004 to February 2006. (Source: World Health Organization [http://www.who.int/csr/disease/avian_influenza/updates/en/index.html]. Map by Margaret McCarron.)

Citation: Ortiz J, Uyeki T. 2007. Avian Influenza A (H5N1) Virus, p 1-22. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch1
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Image of Figure 2.
Figure 2.

WHO confirmed H5N1 cases as of 4 July 2006. Eleven of 12 Turkish cases are represented. (Source: World Health Organization [http://www.who.int/csr/disease/avian_influenza/country/cases_table_2006_02_06/en/index.html].)

Citation: Ortiz J, Uyeki T. 2007. Avian Influenza A (H5N1) Virus, p 1-22. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch1
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Figure 3.

WHO H5N1 case definitions used in Vietnam, 2004 (source: reference ).

Citation: Ortiz J, Uyeki T. 2007. Avian Influenza A (H5N1) Virus, p 1-22. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch1
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Table 1.

Influenza pandemics of the 20th century

Citation: Ortiz J, Uyeki T. 2007. Avian Influenza A (H5N1) Virus, p 1-22. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch1
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Table 2.

WHO pandemic phases

Citation: Ortiz J, Uyeki T. 2007. Avian Influenza A (H5N1) Virus, p 1-22. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch1
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Table 3.

WHO human influenza A (H5N1) confirmed cases and deaths

Citation: Ortiz J, Uyeki T. 2007. Avian Influenza A (H5N1) Virus, p 1-22. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch1

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