Influenza A(H1N1) virus is a subtype of influenzavirus A and the most common causeof influenza (flu) in humans. Some strains of H1N1 are endemic in humans and causea small fraction of all influenza-like illness and a large fraction of allseasonal influenza. H1N1 strains caused roughly half of all human flu infectionsin 2006.[1] Other strains of H1N1 are endemic in pigs (swine influenza) and inbirds (avian influenza).In June 2009, World Health Organization declared that flu due to a new strain ofswine-origin H1N1 was responsible for the 2009 flu pandemic. This strain iscommonly called "swine flu" by the public mediaNomenclature The various types of influenza viruses in humans. Solid squares show theappearance of a new strain, causing recurring influenza pandemics. Broken linesindicate uncertain strain identifications.[2]Influenza A virus strains are categorized according to two proteins found on thesurface of the virus: hemagglutinin (H) and neuraminidase (N). All influenza Aviruses contain hemagglutinin and neuraminidase, but the structures of theseproteins differ from strain to strain, due to rapid genetic mutation in the viralgenome.Influenza A virus strains are assigned an H number and an N number based on whichforms of these two proteins the strain contains. There are 16 H and 9 N subtypesknown in birds, but only H 1, 2 and 3, and N 1 and 2 are commonly found inhumans.[3]The Spanish flu, also known as La Gripe Española, or La Pesadilla, was anunusually severe and deadly strain of avian influenza, a viral infectious disease,that killed some 50 million to 100 million people worldwide over about a year in1918 and 1919. It is thought to be one of the most deadly pandemics in humanhistory. It was caused by the H1N1 type of influenza virus.[4]The 1918 flu caused an unusual number of deaths, this might have been due to itcausing a cytokine storm in the body.[5][6] (The recent[when?] epidemic of birdflu, also an Influenza A virus, had a similar effect.)[7] The Spanish flu virusinfected lung cells, leading to overstimulation of the immune system via releaseof cytokines into the lung tissue. This leads to extensive leukocyte migrationtowards the lungs, causing destruction of lung tissue and secretion of liquid intothe organ. This makes it difficult for the patient to breathe. In contrast toother pandemics, which mostly kill the old and the very young, the 1918 pandemickilled unusual numbers of young adults, which may have been due to their healthyimmune systems being able to mount a very strong and damaging response to theinfection.[2]The term "Spanish" flu was coined because Spain was at the time the only Europeancountry where the press were printing reports of the outbreak, which had killedthousands in the armies fighting the First World War. Other countries suppressedthe news in order to protect morale.[8][edit] Russian fluSee Influenza A virus subtype H2N2#Russian flu for the 1889–1890 Russian fluThe more recent Russian flu was a 1977–1978 flu epidemic caused by strainInfluenza A/USSR/90/77 (H1N1). It infected mostly children and young adults under23 because a similar strain was prevalent in 1947–57, causing most adults to havesubstantial immunity. Some have called it a flu pandemic, but because it onlyaffected the young it is not considered a true pandemic. The virus was included inthe 1978–1979 influenza vaccine.[9][10][11][12]In the 2009 flu pandemic, the virus isolated from patients in the United Stateswas found to be made up of genetic elements from four different flu viruses –North American Mexican influenza, North American avian influenza, human influenza,and swine influenza virus typically found in Asia and Europe – "an unusuallymongrelised mix of genetic sequences."[13] This new strain appears to be a resultof reassortment of human influenza and swine influenza viruses, in all four
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