Avian Influenza: A New Pandemic Threat?

In December 2003, the largest outbreak of highly pathogenic avian influenza H5N1 occurred among poultry in 8 Asian countries. A limited number of human H5N1 infections have been reported from Vietnam and Thailand, with a mortality rate approaching 70%. Deaths have occurred in otherwise healthy young individuals, which is reminiscent of the 1918 Spanish influenza pandemic. The main presenting features were fever, pneumonitis, lymphopenia, and diarrhea. Notably, sore throat, conjunctivitis, and coryza were absent. The H5N1 strains are resistant to amantadine and rimantadine but are susceptible to neuraminidase inhibitors, which can be used for treatment and prophylaxis. The widespread epidemic of avian influenza in domestic birds increases the likelihood for mutational events and genetic reassortment. The threat of a future pandemic from avian influenza is real. Adequate surveillance, development of vaccines, outbreak preparedness, and pandemic influenza planning are important. This article summarizes the current knowledge on avian influenza, including the virology, epidemiology, diagnosis, and management of this emerging disease.

[1]  J. Bartlett,et al.  Pegylated Interferon-alpha Protects Type 1 Pneumocytes Against SARS Coronavirus Infection in Macaques , 2004 .

[2]  D. J. Stevens,et al.  The Structure and Receptor Binding Properties of the 1918 Influenza Hemagglutinin , 2004, Science.

[3]  Constance Schultsz,et al.  Avian influenza A (H5N1) in 10 patients in Vietnam. , 2004, The New England journal of medicine.

[4]  R. Webster Wet markets—a continuing source of severe acute respiratory syndrome and influenza? , 2004, The Lancet.

[5]  M. Bergeron,et al.  Multiplex Real-Time PCR Assay for Detection of Influenza and Human Respiratory Syncytial Viruses , 2004, Journal of Clinical Microbiology.

[6]  R. Webster,et al.  Are We Ready for Pandemic Influenza? , 2003, Science.

[7]  S. Baigent,et al.  Influenza type A in humans, mammals and birds: determinants of virus virulence, host-range and interspecies transmission. , 2003, BioEssays : news and reviews in molecular, cellular and developmental biology.

[8]  Zelalem Temesgen,et al.  SARS: Epidemiology, Clinical Presentation, Management, and Infection Control Measures , 2003, Mayo Clinic Proceedings.

[9]  A. Osterhaus,et al.  Animal influenza virus surveillance. , 2003, Vaccine.

[10]  E. Garman,et al.  Pandemic influenza: its origin and control. , 2002, Microbes and infection.

[11]  M. Hilleman,et al.  Realities and enigmas of human viral influenza: pathogenesis, epidemiology and control. , 2002, Vaccine.

[12]  P. Chan,et al.  Outbreak of avian influenza A(H5N1) virus infection in Hong Kong in 1997. , 2002, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[13]  C. Bridges,et al.  Risk of influenza A (H5N1) infection among poultry workers, Hong Kong, 1997-1998. , 2002, The Journal of infectious diseases.

[14]  M. Zambon,et al.  The pathogenesis of influenza in humans , 2001, Reviews in medical virology.

[15]  R. Sung,et al.  Pathology of fatal human infection associated with avian influenza A H5N1 virus , 2001, Journal of medical virology.

[16]  Yoshihiro Kawaoka,et al.  Pandemic Threat Posed by Avian Influenza A Viruses , 2001, Clinical Microbiology Reviews.

[17]  Albert D. M. E. Osterhaus,et al.  Detection of Influenza A Viruses from Different Species by PCR Amplification of Conserved Sequences in the Matrix Gene , 2000, Journal of Clinical Microbiology.

[18]  Laurent Kaiser,et al.  Influenza virus neuraminidase inhibitors , 2000, The Lancet.

[19]  M. Peiris,et al.  Human infection with influenza H9N2 , 1999, The Lancet.

[20]  C. Bridges,et al.  Case-control study of risk factors for avian influenza A (H5N1) disease, Hong Kong, 1997. , 1999, The Journal of infectious diseases.

[21]  R. Webster,et al.  Influenza: an emerging disease. , 1998, Emerging infectious diseases.

[22]  R. Webster,et al.  Human influenza A H5N1 virus related to a highly pathogenic avian influenza virus , 1998, The Lancet.

[23]  M. Peiris,et al.  Clinical features and rapid viral diagnosis of human disease associated with avian influenza A H5N1 virus , 1998, The Lancet.

[24]  C. Dolea,et al.  World Health Organization , 1949, International Organization.

[25]  Eric C J Claas,et al.  Human influenza A H 5 N 1 virus related to a highly pathogenic avian influenza virus , 2005 .

[26]  T. Kuiken,et al.  Avian influenza A virus (H7N7) associated with human conjunctivitis and a fatal case of acute respiratory distress syndrome , 2004 .

[27]  Cases of influenza A (H5N1)--Thailand, 2004. , 2004, MMWR. Morbidity and mortality weekly report.

[28]  R. Pearl Outbreaks of avian influenza A (H5N1) in Asia and interim recommendations for evaluation and reporting of suspected cases--United States, 2004. , 2004, MMWR. Morbidity and mortality weekly report.

[29]  Development of a vaccine effective against avian influenza H5N1 infection in humans. , 2004, Releve epidemiologique hebdomadaire.

[30]  John Bartlett,et al.  Avian influenza A (H5N1) in 10 patients in Vietnam , 2004 .

[31]  Atlanta,et al.  Morbidity and Mortality Weekly Report Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (acip) Editorial and Production Staff Lead Technical Writer-editor Project Editor Recommendations for Using Antiviral Agents for Influenza . 24 Indications fo , 2022 .