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Swine flu H1N1

Swine flu H1N1

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Published by Mahendra Maharjan
Review artical focused on Nepalese context.
Review artical focused on Nepalese context.

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Published by: Mahendra Maharjan on Mar 11, 2010
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11/29/2012

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Swine flu “influenza A” (H1N1) epidemic – 2009
 Mahendra Maharjan
Lecturer Central Department of ZoologyTribhuvan University, Kirtipur 
A new strain of swine flu - influenza A (H1N1) - is spreading throughout the world. The firstdetection of swine flu case started from Mexico on 18 March of this year. It soon stroke UnitedStates after 10 days. Within a period of one month, seven countries (United States, Mexico,Canada, New Zealand, the United Kingdom, Israel and Spain) started reporting confirmed casesof the swine flu. List of cases and affected countries are increasing day by day. 331 cases from11 countries on 1
st
May, 985 cases in 20 countries on 4
th
May with 25 deaths in Mexico, alltogether 2500 cases from 25 countries with 44 deaths on 8
th
May had been reported. Similarly on13
th
May, 33 countries have reported 5728 cases of H1N1 to World Health Organization (WHO).62 countries had reported 17,410 cases till 1
st
June 2009. As of 1
st
July 2009, 120 countriesreported 77,201 laboratory confirmed cases of swine flu infection including 332 deaths globally-mostly from Mexico and the United States. Most cases outside Mexico and the United Stateshave caused by travelers. Our neighboring country India has confirmed 116 cases and numbersof cases are increasing in Tibet as well. Avian Influenza Control Project (AICP), Nepal hadconfirmed first case of Swine flu on 29
th
June and till 5
th
July it reached at the total number of 5. Nepal shares open borders with India, through which around 10,000 people commute. Inairports, infected people can be easily identified and quarantined however it is difficult in openland borders. It increases the risk for both countries. Therefore, it is urgent to fully functionalizeAvian Influenza Control Project (AICA) and immediately set up the health checkup desk in allland crossing borders. Although the swine flu infection caused by influenza A (H1N1) virusseems to be mild, careful monitoring is necessary and we need to be prepared for the potentialemergence of more virulent variants in the days to come.Influenza viruses cause annual epidemics and occasional pandemics that have claimed the livesof millions. The emergence of new strains will continue to pose challenges to public health andthe scientific communities. A prime example is the recent emergence of swine-origin H1N1viruses that have transmitted to and spread among humans, resulting in outbreaks globally.Due to the genome plasticity of influenza virus, point mutation and reassortment events arefrequent phenomenon, which contribute to emergence of new strains of the virus. “Influenza A”viruses belong to the family Orthomyxoviridae. The viruses are classified on the basis of theantigenicity of their haemagglutinin (HA) molecules and neuraminidase (NA) molecules. Thereare 16 HA (H1-H16) and 9 NA (N1-N9) identified antigens. “Influenza A” viruses contain a
 
genome composed of eight segments of single-stranded, negative-sense RNA that each encodesone or two proteins. HA protein facilitates fusion of viral and endomosal membrane while NA protein facilitates virus release from infected cells by removing sialic acids from cellular andviral HA and NA proteins. Replication and transcription of viral RNAs are carried out by thethree polymerase subunits PB2, PB1 and PA and the nucleoprotein NP. PB2 protein is associatedwith the viral replication. Recently it has been shown that the PB2 and HA proteins of theSpanish influenza virus were critical for droplet transmission. PB1 protein is associated with thevirulence of the influenza virus. NS1 protein is believed to be associated with inactivation of hosts’ RNase. Direct contribution of NS1 is still not known.
Influenza outbreaks
 Spanish influenza (H1N1)
Spanish influenza was pandemic during 1918-1919 which killed around 50 million peopleworldwide. By that time mortality rate due to influenza was unusual.
 Asian influenza (H2N2)
In 1957, the Asian influenza originated from china and spread throughout the globe killing morethan 70,000 people worldwide. The pandemic was caused by a human/avian reassortant thatintroduced avian virus H2HA and N2 NA genes into human populations which also containsPB1 gene of avian virus origin.
 Hong Kong influenza (H3N2)
In 1968, H2N2 subtype viruses were replaced by another human/avian reassortant that possessedan H3 HA gene of avian virus origin H3N2 “seasonal flu” which again contains PB1 gene of the pandemic virus. The virus was first isolated in Hong Kong.
 Russian influenza (H1N1)
The outbreak of Russian influenza caused by influenza viruses of the H1N1 was occurred during1977 to 1978. The re-emergence of this virus did not replace the H3N2 viruses. Both virusesremain co-circulating in humans as a result in 2001, H1N2 new virus emerged out, but this virussoon disappeared.
 Highly pathogenic H5N1 influenza viruses
The avian influenza caused by H5N1 viruses is highly pathogenic disease, which was firstreported in Hong Kong. Remarkable features of these viruses are (I) they are lethal even to thenatural reservoir host - waterfouls, (II) they are able to infect fatally to several mammalianspecies. (III) pathogenecity increases over the time passed (IV) their continued transmission tohumans, resulting in severe respiratory infection with high mortality rates. Till May 2009, WHOhas reported 424 human infections with 261 deaths. In this case human to human infection has

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