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BIRD FLU
Definition
Avian influenza is flu infection in birds. The disease is of concern tohumans, who have noimmunityagainst it. The virus that causes thisinfection in birds can mutate (change) to easily infect humans. Suchmutation can start a deadly worldwide epidemic.Humans have known and feared diseases caused by viruses for thousandsof years. Among the diseases that viruses cause are infectious hepatitis,polio, rabies, and AIDS. It is easy to see why the late Sir Peter Medawar,Nobel laureate in physiology or medicine, wrote, _A virus is a piece of badnews wrapped in protein._ Perhaps the most lethal virus in human historyhas been the influenza virus. Some 21 million Americans and Europeansdied of flu within 18 months in 1918 and 1919, an astonishing number. Therecent outbreak in Hong Kong of a potentially deadly strain of flu hasfocused the world's attention once again on flu.Flu viruses are RNA animal viruses. An individual flu virus resembles a rodstudded with spikes composed of two kinds of protein .There are threegeneral "types" of flu virus, distinguished by their capsid (inner membrane)protein, which is different for each type: Type A flu virus causes most of theserious flu epidemics in humans, and also occurs in mammals and birds.Type B and Type C viruses are restricted to humans and rarely causeserious health problems. A potentially deadly new strain of flu virus,A(H5N1), has emerged in the last few months, again in Hong Kong. Itsarrival was greeted with unusual caution by scientists for two reasons. First,A(H5N1) represents a novel combination of H and N spikes, the sort of new
 
combination that has in the past been associated with major flu epidemics.Second, unlike all previous instances of new flu strains, A(H5N1) passed tohumans directly from birds, in this case chickens. A(H5N1) was firstidentified in chickens in 1961, and in the spring of 1997 devastated flocksof chickens in Hong Kong. The first human case of "bird flu" occurred inMay, 1997, in a 3-year-old boy who died of the infection. The number of human infections by A(H5N1) remains small, with 17 confirmed cases bythe end of the year. Five have died, and three more are in intensive careunits, surviving with the aid of mechanical respirators.
Different strains of flue virus
Different strains of flu virus differ in their protein spikes. One of theseproteins, hemagglutinin (H) aids the virus in gaining access to the hostcell's interior. The other, neuraminidase (N) helps the daughter virus breakfree of the host cell once virus replication has been completed. Thestructures of both the H and N molecules are known in detail. The Hmolecule, for example, is made of three parts, and stands on the surface of the virus somewhat like a tripod, with clublike projections on top. Each "leg"of the H molecule contains "hot spots" that display an unusual tendency tochange as a result of mutation of the virus RNA during imprecisereplication. Point mutations cause changes in these spike proteins in 1 of 100,000 viruses during the course of each generation. These very variablesegments of the H molecule functions as targets against which the body'santibodies are directed. Because of accumulating changes in the H and Nmolecules, different flu vaccines are required to protect against differentsubtypes. Type A flu viruses are currently classified into 13 distinct Hsubtypes and 9 distinct N subtypes, each of which requires a different
 
vaccine to protect against infection. Thus the type A virus that caused theHong Kong flu epidemic of 1968 has type 3 H molecules and type 2 Nmolecules, and is called A(H3N2).
Development of new strains of virus
The problem in combating flu viruses arises not through mutation, butthrough recombination. Viral genes are readily reassorted by geneticrecombination, sometimes putting together novel combinations of H andN spikes unrecognizable by human antibodies specific for the oldconfiguration. Viral recombination of this kind seems to have beenresponsible for the three major flu pandemics (that is, world wideepidemics) that have occurred in this century, by producing drastic shiftsin H N combinations. The "killer flu" of 1918, A(H1N1), killed 21 millionpeople. The Asian flu of 1957, A(H2N2), killed over 100,000 Americans.The Hong Kong flu of 1968, A(H3N2), infected 50 million people in theUnited States alone, of which 70,000 died
.
Flu epidemics in Asia
It is no accident that new strains of flu usually originate in the far east. Themost common hosts for influenza virus are ducks, chickens, and pigs,which in Asia often live in close proximity to each other and to humans.Pigs are subject to infection by both bird and human strains of the virus,and individual animals are often simultaneously infected with multiplestrains. This creates conditions favoring genetic recombination betweenstrains, producing new combinations of H and N subtypes. The Hong Kongflu, for example, arose from recombination between A(H3N8) [from ducks]
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