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The Many Lives of Influenza

The Many Lives of Influenza

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An essay for the 2011 Undergraduate Awards (Ireland) Competition by Leanne Sharkey. Originally submitted for Science at NUI Maynooth, with lecturer Dr. James McInerney in the category of Life Sciences
An essay for the 2011 Undergraduate Awards (Ireland) Competition by Leanne Sharkey. Originally submitted for Science at NUI Maynooth, with lecturer Dr. James McInerney in the category of Life Sciences

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Published by: Undergraduate Awards on Aug 31, 2012
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10/27/2013

 
The many Lives of Influenza
 Abstract  Influenza is a highly contagious pandemic- causing virus that has avoided being eradicated from existence for centuries. Even though there is extensive research intocreating vaccines to render the human population immune from all strains of thevirus, it is still going strong today evolving by antigenic drift or antigenic shift. Themany different types of the virus, including avian influenza, and its ability to mutateto human-to-human transmission are great risks to human survival. Trying to containthe virus is virtually impossible due to its various carriers and reservoirs but it needsto be done soon as the morbidity and mortality rate of this virus is very high killing tens of thousands of people every year.What is Inflenza?
The influenza virus, more commonly known as the flu, is a highly contagiousvirus that has caused epidemics and pandemics of human disease for many centuries.It is a relatively fast evolving virus with a high mutation rate (Handel
et al.,
2008),attributing to more than 40,000 deaths annually in the United States (Dushoff et al.,2006). The most common infection, seasonal influenza, is usually mild, withsymptoms such as fever, headache, a cough, and chills but can be more severe ininfants, the elderly and immunodeficient persons in whom it can progress to pneumonia and sepsis (Chang, 2009). Infection with an influenza virus can also leavehosts more susceptible to secondary bacterial infections like meningitis and pneumonia, often resulting in significant morbidity and mortality (Handel
et al.,
2009)and occasionally in neurologic complications (Barnard, 2009). Viruses that havespread from wild birds to domestic poultry (avian influenza) can, but very rarely,infect humans and cause a range of serious and potentially fatal complications- 1 -
 
(Barnard, 2009). The main contributor to influenza’s pandemic potential is theabsence of life long immunity and this makes the creation of a vaccine, that wouldrender the human population immune to all influenza strains, at the momentimpossible (Hay
et al 
., 2001). Due to the highly virulent nature of the influenza virusand therefore the possibilities of global pandemics, tremendous effort is been made todevelop vaccines and antiviral drugs to treat and block the spread of the virus.Understanding the pathogenesis of the various forms of influenza virus is the key tothis and efforts have intensified in recent years in this area (Beigel and Bray, 2008).Its pathogenicity has been studied in mice, macaques, guinea pigs, swine and ferrets(Memoli
et al.,
2009). Pigs and ferrets are naturally susceptible to infection byinfluenza viruses and are therefore important in this developing process. For Example,influenza A viruses can adapt to efficient transmission among pigs, hence theseanimals have been used as a model for testing vaccines, especially against swineinfluenza (van der Laan
et al 
., 2008). As mentioned above the effort to create antiviraldrugs has accelerated but this might not necessarily be not be a good thing. Studieshave suggested that the comprehensive use of antiviral drugs during a large outbreak could result in the emergence of resistance to anti-influenza drugs, such as theneuramindase inhibitors (Handel
et al.,
2009). This is due to the extensive mutationcharacteristic of the virus which therefore can lead to a much more rapid evolution of resistance (Handel
et al.,
2008). If this antiviral resistant strain undergoes further evolution, the result could be a strain that is at the same time drug resistant and morevirulent than the original strain (Handel
et al.
, 2008). Influenza could potentiallyinfect 30% of the world’s population within a matter of months (Gatherer, 2009). Thismakes it unique among other major pandemics such as HIV-1 and Ebola.
The make-up of the Influenza Virus
- 2 -
 
Barnard describes the physical make-up of the Influenza viruses as a“spherical or pleomorphic, single-stranded, negative-sense RNA virus belonging tothe family
Orthomyxoviridae”
. The virus is divided up into three types: A, B, and C(Gatherer, 2009). Every winter, influenza types A and B are to blame for epidemics of respiratory illness that occur. Type C infection does not have the same effect, onlycausing either a mild respiratory illness or no symptoms at all therefore neither a public health threat nor a cause of epidemics (MedicineNet.com, 2009). Type Aviruses are further divided into types based on the differences in two viral surface proteins called hemagglutinin (H) and neuraminidase (N). There are 16 known Hsubtypes of which three have been involved in past pandemics (H1, H2, H3) and nineknown N subtypes (Gatherer, 2009). These surface proteins can occur in manycombinations. The Influenza virus binds to receptors on the surface of the host cell viathe H proteins, whereas the N proteins play a role in the exit of the virus from the cellin preparation for another round of infection (Gatherer, 2009). On occasion, influenzais introduced into human populations and can spread rapidly. This may cause a global pandemic in several ways. If the H protein belonging to an avian influenza virusadapts to human - to- human transmission or if genomic reassortment of an avianvirus took place during co-infection of an influenza-infected mammal such as a pig itcould potentially be the source of new pandemic influenza. This strain of influenzawould incorporate H and/or N proteins against which hosts may have virtually noimmunity to (Gatherer, 2009). The reason the virus is able to re-infect the same population is due to its ability to undergo antigenic drift or antigenic shift in its Hand/or N proteins (Bernard, 2009). This is why we see regular outbreaks of seasonalinfluenza. Random mutations in the genes of a virus is the cause of antigenic drift(MedicineNet.com, 2009) while the adaptation of a H subtype from an animal sourceto a human is known as antigenic shift (Smith
et al,
2009b). The ability to change its- 3 -

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