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Flu, Grippe, Avian Influenza, Grippe Aviaire, Fowl Plague, Swine Influenza, Hog Flu, Pig Flu, Equine Influenza, Canine Influenza
Last Updated: December 29, 2009
Influenza viruses are RNA viruses in the family Orthomyxoviridae that can affect birds and mammals including humans. Influenza B and C viruses are maintained only in human populations, although they are isolated occasionally from other mammals. 1-9 Influenza A viruses can affect many species, with the vast majority of these viruses occurring among birds. Waterfowl and shorebirds seem to the reservoir hosts for avian influenza viruses, which are usually carried asymptomatically in these populations.1,10-17 Avian influenza viruses can also become established among poultry, causing two forms of disease. Low pathogenicity avian influenza (LPAI) viruses, the form usually carried in wild birds, generally cause asymptomatic infections, mild respiratory disease or decreased egg production in poultry.11,13,14,18,19 Some LPAI viruses can mutate in poultry populations to become high pathogenicity avian influenza (HPAI) viruses. HPAI viruses cause a severe illness that can kill up to 90-100% of a flock.10,11,13 A few influenza A viruses have become adapted to mammals including humans, swine, horses and dogs, and circulate in these populations. These viruses are called human influenza A viruses, swine influenza viruses, equine influenza viruses and canine influenza viruses, respectively. In the mammalian species to which they are adapted, influenza viruses cause respiratory disease with high morbidity but low mortality rates. More severe cases can occur in conjunction with other diseases or debilitation, as well as in infancy or old age. Influenza A viruses that circulate in birds and mammals are occasionally transmitted from one species to another. In most cases, these infections do not spread efficiently; they remain limited to an individual or a small group, and soon disappear from the novel host population.1-4,11,20-24 However, some of these viruses can become adapted to a new species and cause outbreaks, epidemics or pandemics. 1,2,16,20,25-32 One equine influenza virus recently began circulating in dog populations, becoming the first canine influenza virus.28-30 Similarly, avian influenza viruses have caused or contributed to past pandemics in humans and pigs. 2,20,27,31 Avian and swine influenza viruses, which are the only animal influenza viruses known to recurrently affect humans, are of the greatest concern as zoonotic agents. The effects of avian influenza viruses on people are highly variable. Although many human infections are limited to conjunctivitis or mild respiratory disease, some viruses can cause severe disease and death.2,11,12,15,26,33-41 Currently, HPAI H5N1 avian influenza viruses seem to be the greatest threat to people, as well as to poultry. These viruses first emerged in the late 1990s. They have since become established among birds in Asia, have spread to other geographic regions, and continue to threaten new areas.11,12,42 As of December 2009, H5N1 viruses have been responsible for approximately 450 human infections, generally as the result of close contact with poultry; about 60% of all laboratory confirmed cases have been fatal.43 Asian lineage H5N1 viruses have also caused disease in housecats, several species of large felids, palm civets, raccoon dogs, stone martens, a dog and a mink. 9,11,44-55 Some of these infections were fatal. In addition, H5N1 viruses have been detected in pigs and pikas, and experimental infections have been established in a variety of species including foxes, ferrets, rodents and rabbits.34,51,56-58,58-70 Unusually, numerous deaths have been reported in wild birds, which are rarely affected by avian influenza viruses.11,12,51,54,7173 There are fears that an Asian lineage H5N1 strain could eventually become adapted to humans, possibly resulting in a severe human pandemic. Other avian influenza viruses can also undergo cross-species transmission. H9N2 (LPAI) viruses, which have become endemic in poultry in parts of Asia and the Middle East, may be of particular concern.36,74,75 These viruses have caused outbreaks among poultry in many countries,75-77 and it has been recently recognized that some isolates share internal genes with H5N1 viruses.74,78,79 H9N2 viruses have been detected in pigs with respiratory disease and fatal paralysis in China. 74 Antibodies to H9N2 viruses, as well as rare clinical cases, have also been reported in humans. 3638,74,74,80,81 As of December 2009, known human H9N2 infections have been relatively mild, and fatal cases have not been reported.36-38,74 Swine influenza virus infections also occur sporadically among people. Most of these cases have been relatively mild and some may have been asymptomatic, but
Author: Anna Rovid Spickler, DVM, PhD
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severe illnesses and a few deaths have been reported.1-3,2124,82-94 Swine influenza viruses are usually not welladapted to humans, and little or no person-to-person transmission usually occurs.1,2,22,24,89 Nevertheless, these viruses appear to have been responsible for the first human pandemic of the 21st century. In April 2009, a novel virus with the subtype H1N1 began circulating in people.93,95,96 The genetic analysis of this virus suggests that it originated from North American and Eurasian swine influenza viruses that reassorted.97-99 The novel H1N1 virus has also been transmitted from people to animals. Pigs are susceptible to this virus, and sporadic outbreaks have been reported among swine herds in a number of countries.100-116 Outbreaks have also been reported in turkey flocks, and a few cases have been recognized in pet ferrets, cats and dogs, as well as in a cheetah in a zoo.117-129 may contain some genes from one parent virus and some genes from the other.20 Reassortment between different strains results in the periodic emergence of novel strains. Reassortment between subtypes can result in the emergence of a new subtype. Reassortment can also occur between avian, swine, equine, canine and human influenza A viruses. This type of reassortment can result in a „hybrid‟ virus with, for example, both avian and human influenza virus proteins. An abrupt change in the subtypes found in a host species is called an „antigenic shift.‟ Antigenic shifts can result from three mechanisms: 1) genetic reassortment between subtypes, 2) the direct transfer of a whole virus from one host species into another, or 3) the re-emergence of a virus that was found previously in a species but is no longer in circulation.1,2 For example, human viruses can continue to circulate in pigs and could re-emerge into the human population.2 Antigenic drift and antigenic shifts result in the periodic emergence of novel influenza viruses. By evading the immune response, these viruses can cause influenza epidemics and pandemics.
Avian influenza viruses
Viruses in the family Orthomyxoviridae cause influenza. There are three genera of influenza viruses: influenzavirus A, influenzavirus B and influenzavirus C.130 Separate viral species are not recognized within these genera; the members of each genus belong to the three species “influenza A virus,” “influenza B virus” or “influenza C virus,” respectively.130 These viruses are also called type A, type B and type C influenza viruses. Influenza A viruses Influenza A viruses include avian, swine, equine and canine influenza viruses, as well as the human influenza A viruses. Influenza A viruses are classified into subtypes based on two surface antigens, the hemagglutinin (H) and neuraminidase (N) proteins. There are 16 hemagglutinin antigens (H1 to H16) and nine neuraminidase antigens (N1 to N9).11,13,19,23 These two proteins are involved in cell attachment and release from cells, and are also major targets for the immune response.2,20,131 Wild birds carry most of the known hemagglutinin and neuraminidase antigens, but some, such as H14 and H15, are uncommon and seem to occur only in limited geographic areas.17 Only limited subtypes are found in each species of mammal.3 Influenza A viruses are also classified into strains. Strains of influenza viruses are described by their type, host, place of first isolation, strain number (if any), year of isolation, and antigenic subtype.1,3 [e.g., the prototype strain of the H7N7 subtype of equine influenza virus, first isolated in Czechoslovakia in 1956, is A/eq/Prague/56 (H7N7).] For human strains, the host is omitted.
Antigenic shift and drift in influenza A viruses
Influenza A viruses change frequently. Strains evolve as they accumulate point mutations during virus replication; this process is sometimes called „antigenic drift.‟3 A more abrupt change can occur during genetic reassortment. Reassortment is possible whenever two different influenza viruses infect a cell simultaneously; when the new viruses (the „progeny‟) are assembled, they
Last Updated: December 2009 © 2009
Avian influenza viruses circulate in a variety of domesticated and wild birds.1,11,14,17,34 They are also isolated occasionally from mammals including humans.1,9,11,25,26,35,37,44-53,55-57,132,133 Avian influenza viruses are classified as either high pathogenicity (HPAI) or low pathogenicity (LPAI) viruses, based on the genetic features of the virus and the severity of disease in experimentally inoculated chickens.11,13,19 Although there are exceptions (e.g., viruses that fit the genetic description of HPAI viruses but cause mild illness), HPAI viruses usually cause severe disease in poultry, while LPAI infections are generally much milder. To date, all HPAI viruses have contained the H5 or H7 hemagglutinin; subtypes that contained other hemagglutinins have been found only in the LPAI form.12,18,19 H5 and H7 LPAI viruses can evolve into high pathogenicity strains, typically while they are circulating among poultry.11,12,15 When a subtype has become established and circulates for a time, numerous variants may occur in the population. For example, multiple genotypes and a number of clades of Asian lineage H5N1 viruses are currently found among poultry.11,40,42,134,135 In wild species, avian influenza viruses are especially common among birds that live in wetlands and other aquatic environments.17 Waterfowl (order Anseriformes) and shorebirds (order Charadriiformes) seem to be the natural reservoirs for influenza A viruses, and carry all of the known subtypes, usually in the LPAI form. 1,12-17,23 Important reservoir hosts include ducks, geese, swans, gulls, terns and waders.17 The LPAI viruses found in wild birds can be divided into Eurasian and American lineages.17 Although viruses occasionally cross between these two geographic regions, this is uncommon.17 The predominant subtypes in wild ducks change periodically. 1 H3, H4 and H6 are detected most often in North
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American and northern European wild ducks, but nearly all hemagglutinin and neuraminidase antigens can be found.17 Waders (families Charadriidae and Scolopacidae) seem to have a wider variety of hemagglutinin/ neuraminidase combinations than ducks. In the eastern U.S., H1 through H12 (LPAI) viruses have been isolated from these birds; H1, H2, H5, H7 and H9-H12 viruses are particularly common.17 Gulls are often infected with H13 LPAI viruses, which are rare in other avian species.17 They can also carry H16 viruses.17 Most, though not all, infections in wild waterfowl and shorebirds are asymptomatic.1,2,11,12,136,137 Limited information is available on the subtypes found in other species of birds. Subtypes that have been detected in ratites include H3N2, H4N2, H4N6, H5N1, H5N2, H5N9, H7N1, H7N3, H9N2, H10N1, H10N4 and H10N7.18,51,138-140 Isolates from cage birds usually contain H3 or H4; however, infections with high pathogenicity subtypes containing H7 or H5 can also occur.18,51,60,71,141,142 Very few avian influenza viruses were found in wild passerine birds, pigeons and doves in one survey.143
Swine influenza viruses
Swine influenza viruses mainly affect pigs, but they can cause disease in turkeys.1,3 Outbreaks have also been described recently in ferrets and mink.91,144 Other species may also be infected, although this seems to be rare. One H1N1 swine influenza virus, which was avirulent for both poultry and pigs, was isolated from a duck in Hong Kong, and experimental infections have been reported in calves.145,146 The most common subtypes currently found in pigs are H1N1, H1N2 and H3N2; however, the situation is complex, as two or more viruses of each subtype are circulating in swine populations.2,16,20,147 One H1N1 virus found in North America is the „classical‟ H1N1 swine influenza virus. This virus, the first influenza virus known to have infected pigs, was first detected in swine populations in 1918.1,2,16,20 Reassortant H1N1 viruses, which contain the same neuraminidase and hemagglutinin as the classical H1N1 virus, but have internal proteins from triple reassortant H3N2 viruses (see below), have recently become prominent among pigs in North America.148-150 An „avian-like‟ H1N1 virus circulates mainly in European pigs.2,16,20 This virus seems to be an avian influenza virus that was transmitted whole to pigs.16,20,151 It has, in some locations, replaced the classical H1N1 virus.16,20 A different „avian-like‟ H1N1 virus has been detected, together with the classical H1N1 virus, among pigs in Asia.9,16 Other variants have also been found. For example, H1N1 reassortant viruses consisting of classical swine influenza virus genes and a human PB1 polymerase gene have been detected in pigs in Canada152 and a wholly human lineage H1N1 virus was reported from pigs in China in 2007.153 In North America, some of the most important swine influenza viruses are the triple reassortant H3N2 viruses.
Last Updated: December 2009 © 2009
These viruses first emerged in U.S. pigs in the late 1990s, mainly in the Midwest,20,34,152,154,155 and they have been detected in Canada since 2005.89,144,156 The North American H3N2 triple reassortant viruses contain hemagglutinin and neuraminidase proteins from a human influenza virus, and internal proteins from the classical swine influenza virus, an avian influenza virus and a human influenza virus.154 The particular combination of internal genes carried by these viruses is known as the triple reassortant internal gene (TRIG) cassette. This cassette seems to be especially efficient in generating swine influenza virus recombinants with new hemagglutinin and neuraminidase genes, including some from human influenza viruses.149,150 Viruses with this cassette have had increased antigenic drift compared to other swine influenza viruses.149 H3N2 viruses also occur in Europe and Asia, but these viruses seem to be the result of reassortment between a human H3N2 virus, circulating there in pigs since the 1970s, and the H1N1 „avian-like‟ virus.2 The European H3N2 viruses contain human H3 and N2 proteins, and internal proteins from the avian virus.2 In China, H3N2 viruses that have been detected include double reassortants that contain human H3 and N2 and internal genes from avian influenza viruses, and triple reassortants with human H3 and N2 and internal gene segments from both swine and avian influenza viruses.157 Some wholly human-like H3N2 viruses have also been found among pigs in China.157 The H1N2 virus in the U.S. is a reassortant of the classical H1N1 swine influenza virus and the North American triple reassortant H3N2 virus.2 Other variants have also been detected. Some H1N2 viruses isolated from Canadian pigs contained neuraminidase and hemagglutinin genes from two different human influenza viruses, the polymerase gene from human H1N2 viruses, and other internal genes from classical H1N1 swine influenza viruses.152 The H1N2 virus in Europe is a reassortant of a human H1N1 virus and the „human-like‟ European H3N2 virus.2,16 In China, both the H1N2 swine influenza virus from North America, and apparent reassortants between the H1N1 classical swine influenza virus and North American H3N2 human influenza viruses have been reported.158 Other novel reassortants of swine influenza viruses continue to be discovered.159,160 New subtypes have also been found in some swine populations. The novel subtype H3N1 has recently been isolated from pigs in the U.S.161,162 This subtype appears to contain genes from human, swine and avian influenza viruses.161,162 A different H3N1 influenza virus, containing human and swine influenza virus genes, has been found in Korea163 and an H3N1 virus which may be a novel reassortant between H3N2 and H1N1 swine influenza viruses has been reported in Italy.164 An H2N3 virus isolated from pigs with respiratory disease in the U.S. contained genes from avian and swine influenza viruses.165 An avian H9N2 virus has been reported from
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outbreaks of respiratory disease and paralysis in pigs in southeastern China, and may circulate in swine populations there.74 This subtype appears to contain neuraminidase and hemagglutinin genes from avian H9N2 viruses and internal genes from an H5N1 virus (Sw/SD/2/03) that also infects pig populations in the area.74 Avian (LPAI) H5N2 and avian/swine H5N2 reassortant viruses have been isolated from pigs in Korea.166 The avian H5N2 virus appears to have been circulating among pigs since 2006.166
The novel H1N1 virus of swine origin
Swine influenza viruses are occasionally found in humans.1-4,21-24,82-94,144 In most cases, these viruses are poorly adapted to humans, and little or no person-toperson transmission occurs. 1,2,22,24,89 In 2009, a novel H1N1 virus, which seems to have originated from one or more swine influenza viruses, emerged in human populations.97-99 This virus appears to be a reassortant between North American and Eurasian swine influenza viruses; it contains a hemagglutinin gene that is most closely related to swine influenza viruses in North America, a neuraminidase gene that is related to swine influenza viruses in Eurasia, and internal genes from two or more swine influenza viruses including the North American triple reassortant H3N2 viruses and a Eurasian virus.97-99 Similarly to some of the swine influenza viruses described above, the parental swine influenza viruses include some gene segments that originally came from avian and human influenza viruses. 98,99 In 2009, the novel H1N1 virus was the dominant influenza virus being transmitted in human populations in most parts of the world.167 It has also been transmitted to animals, including pigs, apparently from infected humans. 100117,119-129
This virus appears to be an avian influenza virus. A related virus caused influenza in a few hundred horses the following year but there were no deaths. The avian-like virus continued to circulate in horses in China for at least five years without further fatalities. One equine H3N8 virus recently jumped into dogs in North America.28,29,173 Equine influenza viruses can also infect dogs without becoming established in canine populations. A limited outbreak with an equine H3N8 (American lineage) virus was reported among foxhounds in the U.K. in 2002,32 and equine H3N8 viruses were shown to infect dogs asymptomatically during close contact with horses in an experimental study.174 Infections with equine H3N8 viruses have been reported among pigs in China.175
Canine influenza viruses
An H3N8 canine influenza virus has been reported in canine populations in a number of U.S. states. 30,176-183 This virus appears to be an equine influenza virus (Florida sublineage) that recently jumped species, and it bears a close resemblance to an isolate seen in horses in Wisconsin in 2004; however, the canine influenza virus has diverged genetically from equine influenza viruses.28-30 An H3N2 virus, isolated during an outbreak of canine respiratory disease in Korea in 2007, has the potential to become a second canine influenza virus.133 There is evidence that this virus may have been transmitted between dogs during the outbreak, and dog-to-dog transmission occurs readily in experimentally infected dogs.133,184 The H3N2 virus seems to have originated in birds.133 It contains gene segments that may have come from several different avian viruses.133 At least three different isolates of this virus have been recovered.133
Human influenza A viruses
Equine influenza viruses
Equine influenza viruses mainly infect horses and other Equidae (i.e., donkeys, mules and zebras).1,25,168,169 The two subtypes known to circulate in equine populations and cause disease are H7N7 (equine virus 1) and H3N8 (equine virus 2).1,3,25 There is less antigenic drift in these viruses than human influenza A viruses. 3,25 H7N7 equine influenza viruses have become extinct or are present at only very low levels in most parts of the world where surveillance is conducted.1,25,170 In contrast, H3N8 viruses circulate widely. H3N8 viruses have diverged into distinct Eurasian and American evolutionary lineages.171,172 The American lineage contains the classical American lineage (also called the Kentucky lineage), the Florida sublineage (originally called the Florida lineage) and the South American lineage.172 Some viruses of the American lineage (Florida sublineage) have also become established in Europe and Asia.171,172 In 1989, a novel strain of equine influenza [A/eq/Jilin/89 (H3N8)] caused a serious epidemic, with high morbidity and mortality rates, in Chinese horses. 25,170
Last Updated: December 2009 © 2009
Human influenza A viruses are mainly found in people, but they can also infect ferrets and sometimes swine.1,3,5,16,152,153,185-188 Experimental infections have been reported in raccoons.189 Human viruses can also replicate, to a limited extent, in the nasal epithelium of experimentally infected horses.170 H1N1, H1N2 and H3N2 viruses are currently in general circulation in humans.11,190 H1N2 viruses were first seen in human populations in 2001, probably as a result of genetic reassortment between the H3N2 and H1N1 viruses.190,191 H2N2 viruses circulated in the human population between 1957 and 1968.1 A novel H1N1 virus (see above) emerged in human populations in 2009. Human influenza viruses change frequently as the result of antigenic drift, and occasionally as the result of antigenic shift. Epidemics occur every few years, due to small changes in the influenza viruses.2,192 Human pandemics, resulting from antigenic shifts, were most recently reported in 1918, 1957, 1968 and 2009.
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dogs and horses. and it is now co-circulating with the B/Victoria/2/87 lineage.203 Recent evidence suggests that reassortment occurs frequently between different strains of influenza C viruses. and can infect housecats. rabbits and macaques. ferrets.60-64.213 There is no evidence that the canine influenza virus is currently circulating outside the U. they are actually different viruses (see „Etiology‟). and are circulating in.9..9.11 Influenza B viruses undergo antigenic drift.199 Recent evidence suggests that recombination between these two lineages is resulting in antigenic shifts.1-8 Influenza C viruses are not classified into subtypes. but they are classified into strains. reindeer and deer.1.1 They have also been found occasionally in animals.193 With the possible exception of H5N1 viruses in pikas.194-196 There are also some indications.1. Arkansas. In 2004-2006.g. Kansas.206 Avian influenza (LPAI) viruses also occur worldwide in wild birds and poultry.220.127.116.11-183.57 there is currently no evidence that influenza viruses have become adapted to. infections were seen in racing greyhounds in a number of states including Florida. including the novel H1N1 virus that entered human populations in 2009.215 These cases appear to have been caused by H3N8 equine influenza viruses that did not become established in the canine population. an equine H3N8 virus was responsible for an outbreak of respiratory disease in a foxhound kennel in 2002.9 and swine influenza viruses have caused outbreaks in mink and ferrets. the B/Victoria/2/87 lineage predominated in human populations. These viruses can cause epidemics.210 Swine influenza viruses are enzootic in most areas that have dense populations of pigs. Alabama. pikas.1. they had never been linked to large-scale epidemics.177. been responsible for pandemics. and influenza B viruses were said not to undergo antigenic shifts.201 However.207. several species of large felids. mink. a nationwide epidemic of influenza C was reported in Japan between January and July 2004.9.S.192.47-49.9. Equine influenza occurs in nearly all countries with substantial numbers of horses. some Asian lineage H5N1 HPAI viruses are also circulating in wild bird populations in Eurasia.200 Influenza C viruses Influenza C viruses circulate in human populations. pigs.18.104.22.168 The Asian lineage H5N1 avian influenza viruses appear to have an unusually wide host range. including the detection of viral nucleic acids by RT-PCR. West Virginia.2.12 From 2003 to 2007.131.198 In the 1990s. Arizona. but later disappeared from that region. humans. HPAI H5N1 viruses spread into domesticated or wild birds in other regions of Asia as well as into parts of Europe.192.211 This disease is common in North and South America.202 Influenza C viruses have also been found in animals. infections with equine influenza viruses are occasionally reported among dogs in other regions.44. goats.7173. but the virus later spread to other states. 4.34. palm civets.208 As of December 2009. The Asian lineage H5N1 HPAI outbreak began among poultry in Southeast Asia in 2003.214 H3N8 infections were reported from dogs in Australia during an equine influenza outbreak in 2007. and it has been reported from Africa.180 Infections were first reported in the general canine population in Florida.193 and a variety of mammals have been infected experimentally. that reptiles and amphibians can be infected with influenza viruses.170 The H3N8 canine influenza virus has been reported in the U.201 Until recently.K. Europe and parts of Asia.178.S.14 HPAI viruses have been eradicated from domesticated poultry in most developed nations.12.132 Unpublished research suggests that some raccoons in Japan have antibodies to H5N1 viruses.1.189.214 Limited serological evidence also suggests that some U. Iowa.4. but they have not. Influenza B viruses Influenza B viruses are known to circulate only in human populations. any species other than birds.213 The distribution of this virus in the U.189.10. dogs.204 Last Updated: December 2009 © 2009 page 5 of 46 .212 The H3N8 subtype is widespread in horse populations. stone martens. Texas.91. They are also classified into strains. rodents. 11. all countries in Europe) eradicate these viruses whenever they occur in domesticated birds. swine..209.1.11 Although some countries (e. sheep.1. are found worldwide. Colorado.3. in some cases. Rhode Island and Massachusetts.67-69. and are mainly associated with disease in people. and accumulates few changes over time. it caused an outbreak or was detected serologically in an area. yak. and Europe are the same.32. In the U.168-170.168.K. the Pacific. cattle.11 Each strain is antigenically stable. viruses of the B/Yamagata/16/88 lineage circulated to a very limited extent in Asia. foxes.51-22.214.171.124.16 Although the subtypes of the swine influenza viruses found in the U. Avian influenza viruses have infected pinnipeds. the Middle East and Africa. is patchy.1.5.11 Unusually.205.S.Influenza Influenza A viruses in other species Geographic Distribution Human influenza viruses.170 The H7N7 subtype is either extinct or present at very low levels.25.198 This lineage emerged in various parts of the world in 2001. wild bird surveillance has not detected these viruses in North America or New Zealand.131.190 Until recently. though it occurs more slowly than in influenza A viruses. this epizootic is ongoing and worldwide eradication is not expected in the short term. cetaceans and mink.S. to date. these were also equine viruses that did not become Influenza A viruses are occasionally isolated from outbreaks or isolated cases in other species of mammals. 169 Only a few countries such as New Zealand and Iceland are known to be free from this disease.198.144 Antibodies to influenza viruses have been detected in other species including raccoons.11.197 Influenza B viruses are categorized into lineages rather than subtypes. raccoon dogs. However. foxhounds were exposed to an H3N8 virus in 2003.
13.226 LPAI viruses are reported to persist in distilled water for more than 100 days at 28°C (82°F) and 200 days at 17°C (63°F).1.188 Transmission of avian influenza viruses among birds In birds. LPAI viruses were reported to survive for at least 44 or 105 days in feces.217 Respiratory transmission of LPAI viruses is thought to be unimportant in most wild birds.213 As of December 2009. and by contact with nasal discharges. In ferrets. particularly those that live on land. stopover or wintering sites.2.207. and 9 weeks at 5°C (41°F).217.11. as well page 6 of 46 .17.208.220 Although infected eggs are unlikely to hatch.25.216 One recent study suggested that H5 and H7 HPAI viruses may survive for shorter periods in water than LPAI viruses. LPAI viruses (H7N2) persisted for up to two weeks in feces and on cages.223. 30°C (86°F) or 37°C (98. Close contact with dead or sick birds seems to be the principal way this virus is spread to humans.224 HPAI H5N2 viruses have also been detected recently in some asymptomatic wild ducks and geese in Africa. these viruses reassort and/or mutate to produce HPAI viruses.227 In other studies. however.49. the disease could be introduced into flocks by migratory waterfowl or shorebirds.218.65.3. mice and foxes.216 Mammalian influenza viruses (which are shed in respiratory secretions) are relatively labile. the Asian lineage HPAI H5N1 strains appear to occur regularly in wild birds. these strains may no longer be transmitted primarily by the fecal-oral route.1. broken eggs could transmit the virus to other chicks in the incubator.17 Once they are introduced into poultry. experimentally infected cats. in utero transmission can occur with high viremia after experimental infection.17 Some recent isolates of Asian lineage H5N1 (HPAI) viruses have been found in higher quantities in respiratory secretions than the feces. leopards and tigers in zoos.16. Transmission is best understood for the Asian lineage H5N1 (HPAI) viruses. swine influenza viruses were inactivated in untreated pig slurry in 1-2.216. they still persisted in fresh water for 100 days or more at 17°C (63°F) and for approximately 26-30 days at 28°C (82°F).17. 228 Routes of transmission of avian influenza viruses to mammals Some avian influenza viruses can be transmitted to mammals by direct or indirect contact.227 These viruses could survive for up to 32 days at 15-20°C (59-68oF).1. due to the close proximity of the birds. However. but can persist for several hours in dried mucus. particularly at low temperatures. however.63. ferrets. although their importance in transmitting these viruses to Last Updated: December 2009 © 2009 The survival of avian influenza viruses in the environment is influenced by temperature.12.3.3. Fomites can be important in transmission and flies may act as mechanical vectors. and for at least 20 days at 28-30°C (82-86oF).17 Fecal transmission is facilitated by the persistence of avian influenza viruses in aquatic environments for prolonged periods. either directly or on fomites.49.13 Migrating birds. In one study. which are often transmitted between birds in feces.225 Survival of influenza viruses in the environment Transmission Transmission of mammalian influenza viruses In mammals. but the current evidence suggests this is very rare.66.133 poultry is controversial.6°F).229 One Asian lineage H5N1 infection occurred in a dog that had eaten infected duck carcasses.15 Avian influenza viruses have also been found in the yolk and albumen of eggs from hens infected with HPAI viruses.13. at least in some wild birds. and swimming in contaminated water is theoretically a source of exposure.11. two weeks at 20°C (68°F).222 In countries where HPAI has been eradicated from domesticated poultry.190-192 Close contact and closed environments favor transmission.226 They appear to survive best at low temperatures and in fresh or brackish water rather than salt water. as well as infected poultry or fomites.217. may exchange viruses with other populations at staging.217.5 hours at 50-55°C (122-131°F). Similarly.192 There is little information on the survival of mammalian influenza viruses in water or organic material.13.221. and rarely in humans. pigs.73 Fecal-cloacal transmission might also be possible.12.12.Influenza adapted to dogs. It might also be possible for LPAI viruses to be shed in eggs.1. but they were inactivated more quickly when mixed with chicken manure.13 The feces contain large amounts of virus.73.216. the H3N2 influenza virus has been reported only from dogs in Korea.12. influenza viruses are transmitted in aerosols created by coughing and sneezing. which can fly long distances.217 Avian influenza viruses might survive indefinitely when frozen. 17 Wild birds usually carry only the low pathogenicity form of avian influenza viruses. avian influenza viruses are shed in the feces as well as in saliva and nasal secretions.147. In one study.219 This suggests that.15. if it occurs at all. it is possible that is might play a role in some species. may persist for relatively long periods in aquatic environments. and fecal-oral transmission is the predominant means of spread for LPAI viruses in wild bird populations.11.226 These viruses. it can spread on the farm by both the fecal–oral route and aerosols. Once an avian influenza virus has entered a poultry flock.216. other felids and dogs. but a few cases may have resulted from indirect exposure via contaminated feces. pH. salinity and the presence of organic material.45.216 These viruses also remained viable for at least 35 days in peptone water at 4°C (39°F).41 Ingestion of H5N1 viruses has been reported in naturally infected housecats.12.216 Various avian influenza viruses were reported to survive for four weeks at 18°C (64°F).216 A few studies have examined virus persistence in feces.
32.53. seals and pigs.26.144 Generally.25. is a good example. as well as by intranasal or intratracheal inoculation. limited transmission and cross-species jumps Ordinarily.11.69 In experimentally infected dogs.1. however. Transmission of Asian lineage H5N1 viruses between mammals Because Asian lineage H5N1 avian influenza viruses can cause fatal disease in humans and other mammals.40.2. After intraocular inoculation of mice and ferrets with H7 and H5N1 (HPAI) isolates.68 In one experiment.48. but pigs are known to shed it only from the respiratory tract. In rural China and other regions.235 Although reassortment can occur anywhere. For example. and might have acquired the H5N1 virus from this source. which caused the deadly 1918 „Spanish flu‟ pandemic. mink and turkeys.231 In addition.4. quail cells have also been shown to bind both human and avian influenza viruses.1. the virus is usually poorly adapted to the new host population and often affects only one or a few individuals.46. human and avian influenza viruses.132 Infected raccoon dogs in China were fed chicken carcasses.63 Infected housecats in an animal shelter probably ingested contaminated feces from a swan while they were grooming.55 In humans. however.42. The canine influenza virus.16.16. efficient transmission requires a novel hemagglutinin and/or neuraminidase protein to evade the immune response.20 Occasionally.20 It could also occur in an intermediate host. was used to inoculate the cattle.2. 70 Fecal shedding of Asian lineage H5N1 virus may also be possible in humans: this virus has been recovered from a child with diarrhea. a high dose of the virus. Over the decade that H5N1 viruses have been circulating among birds. all routes have not been reported in each species. In most of the cases mentioned above. many new viruses originate in Asia.126.96.36.199. Infections have been established in cats by intratracheal inoculation with Asian lineage H5N1 viruses and by feeding them H5N1-infected chicks. from 1999 to 2002. but additional routes of exposure also existed.53. together with viral proteins that are well adapted to the new host‟s cells.28.50. H5N1 avian influenza viruses isolated from healthy ducks in southern China acquired the ability to replicate and cause lethal disease in page 7 of 46 . viral antigens and nucleic acids were detected in the fetus of a woman who died of an Asian lineage H5N1 infection.134. This has happened occasionally with whole viruses that jump to new hosts. Last Updated: December 2009 © 2009 avian influenza viruses among birds. 230 Experimental studies suggest that Asian lineage H5N1 viruses can be transmitted to mammals by the respiratory.66.196. these viruses have changed and differentiated into a number of strains and clades. Repeated reassortment between human. 189 These raccoons could transmit this virus to uninfected raccoons.234 There are few detailed reports of mammalian infections with avian LPAI viruses. equine influenza viruses among the Equidae.20 Pigs have receptors that can bind swine. Some evidence also suggests that the H1N1 virus.11.2.20. it may be found in the urine of some mammals. which had been recovered from cats. Raccoons that were intranasally inoculated with LPAI H4N8 viruses shed virus from the respiratory but not the digestive tract. the virus eventually disappeared from the novel host population. however.3.31 Dissemination is more likely if the new virus reassorts with a virus that is already adapted to the species.Influenza as some housecats.9 The eye might act as an entry point for some HPAI viruses.34 This results in an increased opportunity for virus reassortment.63. horses. they have been called „mixing vessels‟ for the formation of new viruses.11. 58. but aerosol transmission could not be ruled out.65 Cats appear to shed these viruses from the intestinal tract as well as the respiratory tract.1.232.20 Many outbreaks end without permanent adaptation of the virus to the species.91.9. swine influenza viruses have caused outbreaks in ferrets.135 An early study showed that.23. the viruses could be detected in the respiratory tract and caused systemic disease.229 There are other human cases where ingestion probably occurred. swine influenza viruses circulate only among pigs.66. cattle excreted small amounts of H5N1 viruses from the respiratory tract after intranasal inoculation. avian influenza viruses have affected mink.12.45. Although these viruses occasionally infect species other than their normal host. there are grave concerns about the possibility that these viruses might become adapted to these species. possible for a virus to become established in the new species. particularly a pig. was probably an intact avian virus that became adapted to humans.233 Transplacental transmission of avian influenza viruses is not well studied in mammals. avian and swine influenza viruses has resulted in a wide variety of novel swine influenza viruses that contain segments originating from two or more species.189 Transmission of influenza viruses between species – sporadic cases. and human influenza viruses among people. and equine influenza viruses have infected dogs. but fecal shedding has not been reported. which jumped from horses to dogs.65 Pigs and foxes can also be infected by feeding them H5N1-infected poultry.69 Infected foxes can excrete this virus in both respiratory secretions and feces. were apparently infected when they ate raw birds.147 For this reason. one of these viruses may cause an outbreak.3. oral and intraocular routes.) Recently.11. (See „Etiology‟ for a description of some of these viruses. It is.67.11 Reassortment can occur in the new host‟s own cells. the strongest evidence for oral transmission is that two people became infected with an Asian lineage H5N1 virus after eating uncooked duck blood.11. a variety of species including ducks are kept in close proximity to each other and to humans. Asian lineage H5N1 viruses have been found in respiratory secretions.
34. only rare cases of limited person-toperson spread have been documented. and may have been eliminated by infection control measures. there is recent evidence that Asian lineage H5N1 viruses might have become established among some pika populations in China.2. veterinarians and hunters may be regularly exposed to avian influenza viruses of various subtypes.38. Some currently circulating H9N2 viruses might undergo relatively frequent cross-species transmission. with the possible exception of pikas. have been associated with disease in Chinese pigs.74 H9N2 (LPAI) viruses.236 This particular isolate was found only once.12 Zoonotic influenza viruses reported in humans Infections with avian or swine influenza viruses are reported periodically in humans.81 Symptomatic infections have occasionally been reported in H9N2-virus infected humans.11.58.21-24. No sustained person-toperson transmission has been reported. three family members of poultry workers were also infected. 2.35 The virus subtype was H7N7.9294.94. which circulate among poultry in parts of Asia and the Middle East.38 Most of these infections have resulted from direct contact with infected poultry or fomites. Avian influenza viruses in humans Asian lineage H5N1 avian influenza viruses have been responsible for nearly 450 confirmed clinical cases in humans. H7 and H9 avian influenza viruses are documented occasionally in people.34.80 Another survey reported seroprevalences of 0% to 1. an H1N1 swine influenza virus. to date. H10 and H11 viruses have been found in healthy people.62 As of December 2009.11. H7. to date. 15. these cases appear to be clinically indistinguishable from human influenza virus infections.12. it is difficult to determine whether these viruses are more likely to infect humans than other subtypes. Limited transmission of Asian lineage H5N1 viruses has been reported among zoo tigers and experimentally infected housecats.38. during a 2003 outbreak in the Netherlands. and these cases occurred after close. little or no host-to-host transmission has been seen in mammals.81. accompanied in some cases by mild respiratory signs and other influenza symptoms.12 In 2007.43 Because exposure to these viruses can be high in some human populations.12.244 Most of these infections occur after direct contact with pigs. but viruses may also spread to people through another host.11. For example.81 In one study.245 How often swine influenza viruses infect people is unknown.Influenza mice.37.2. prolonged contact.11. Sustained person-to-person transmission has never been reported.23.38 Swine influenza viruses in humans Two of the last four human pandemics appear to have been the result of reassortment between avian and human influenza viruses.20 The H3N2 „Hong Kong flu‟ virus of 1968 had two new proteins from an avian virus – the new hemagglutinin and an internal protein – but kept the neuraminidase and remaining proteins from the H2N2 virus. however. the overall seroprevalence was 4.132 In one study.67 However. have been established in human volunteers inoculated with some subtypes including H4N8.2. H6. was then transmitted to a laboratory technician who developed respiratory signs.7% in poultry workers.41 (thus more likely to be diagnosed).7% of farmers and other poultry workers.20 Illnesses caused by H5. these viruses do not seem to cause severe clinical signs in these animals. they may not be Last Updated: December 2009 © 2009 page 8 of 46 .5%. and clinical illness is typically severe 12.80.5% of the human populations studied have antibodies to H9 viruses.5% of poultry retailers. as of December 2009. which had infected a turkey herd. after contact with infected poultry. these viruses have not become adapted to people.1.6-5.240-242 These antibodies may be more common among people who are exposed to free-range or backyard poultry than workers in poultry confinement facilities. H9.3% of the general population were seropositive. H5.37 In general.74. Infections with swine influenza viruses are reported sporadically in humans. or to three dogs in contact with infected cats. and five other proteins from a human H1N1 strain.242.50.243 Experimental infections. H10N7 and H6N1.75 Humans can also be infected with H9N2 viruses.12. depending on the geographic area. If most infections resemble human influenza.20 The 1957 H2N2 („Asian flu‟) virus contained avian hemagglutinin.34. antibodies to H4.82-90.15.63 No animal-toanimal transmission was reported in asymptomatic cats infected by exposure to a sick swan.80.36 Some serological evidence suggests that poultry workers. with any of the viruses currently circulating in bird populations.2. or in experimentally infected pigs. With rare exceptions. and 1.11.36. an Asian lineage H5N1 virus was not transmitted to one dog or three cats in contact with four experimentally infected dogs.57 In humans.74.11. Surveys in China report that from 0% to 4.236 Whether this modification would allow the virus to be transmitted more efficiently from person to person is unknown. an Asian lineage H5N1 virus with the ability to bind human receptors was isolated from a person in Thailand. neuraminidase and an internal protein.
12 In most cases.206.2..201.190-192 Diarrhea. 12 cases were reported to the CDC.103.256-258 In one recent study.192.22 Until 2009.Influenza investigated and recognized as zoonoses. it may range from two to eight days and could be as long as 17 days. pericarditis and myositis. can be seen in some individuals.192.S.21 One college student transmitted the virus to his roommate. myalgia. and it is not known how humans acquired the novel H1N1 virus. when approximately 500 of 12.1. and febrile seizures can occur in severe cases. oxidizing agents. 1. but more severe cases with lower respiratory signs including bronchitis or pneumonia can also occur.191 Most people recover in one to seven days.1.249. most infections appear after one to four days. quaternary ammonium compounds.190192 Infections with the novel H1N1 virus circulating in humans usually become apparent in two to seven days.1. acids. phenols. especially those with chronic respiratory or heart disease.204.203.250 Genetic analysis suggests that this virus was probably transmitted to people very recently.190. and that it might have been circulating among pigs in an unknown location for years before it emerged in humans.190.252 Equine influenza viruses and canine influenza viruses in humans aldehydes (glutaraldehyde.190-192 Secondary bacterial or viral infections may also occur. headache.188.8.131.52. vomiting and otitis media are common in children.000 people on a military base in Fort Dix. Serological evidence and one experiment in volunteers suggest that humans might be susceptible to equine viruses. weakness. povidone-iodine and lipid solvents. approximately one case was reported to the Centers for Disease Control and Prevention (CDC) every 1-2 years. transverse myelitis.21 Similarly. These viruses are mainly thought to cause mild upper respiratory disease in children and young adults.216. anorexia. the first symptoms occur in two to five days.12 Clinical Signs Seasonal human influenza Uncomplicated infections with human influenza A or B viruses are usually characterized by upper respiratory symptoms.131. for this virus. sometimes cases are followed by a few infections among close contacts. chills.184.108.40.206 Recent serological evidence suggests that swine influenza infections might occur regularly in people who have contact with pigs. as well as by ionizing radiation or low pH (pH 2).1. but in some cases.227 Avian influenza viruses seem to be more resistant to high temperatures and low pH than mammalian influenza viruses. a novel H1N1 virus with genes of swine origin became established in human populations.188. myocarditis.21. several health care workers developed influenza symptoms after exposure to a pregnant woman with swine influenza in Wisconsin.130. the initial signs may mimic bacterial sepsis.1.108.253 They can also be inactivated by heat of 56°C (133°F) for a minimum of 60 minutes (or higher temperatures for shorter periods).23. sneezing. In 2009. the There are no published reports of equine or canine influenza viruses causing disease in humans after natural exposure. causing a pandemic. abdominal pain and photophobia are also possible.22 This virus remained limited to the base and did not spread to the surrounding community. New Jersey became seropositive to a swine influenza virus.130. 3.131.9 Infections in Humans Incubation Period The incubation period for seasonal human influenza is short. formaldehyde).1 Disinfection Influenza viruses are susceptible to a wide variety of disinfectants including sodium hypochlorite. Reye syndrome.131.99 As of December 2009. who remained asymptomatic.190.190.251 but people might be involved in disseminating the virus to pigs and other animals.216.192 More severe syndromes. some recent descriptions suggest that clinical cases may be indistinguishable from influenza A or B. the most extensive person-to-person transmission was reported in 1976. rhinitis. when swine influenza in humans became reportable in the U.12 Limited data from Asian lineage H5N1 infections suggest that. including pneumonia.191 In addition.2. influenza A has been associated with encephalopathy.191 In young children. 70% ethanol.254. sore throat and a nonproductive cough.192 Because influenza C viruses are difficult to isolate.98 There is no evidence that pigs are playing an significant role in the spread of this virus among people. which may include fever.188 Nausea. Last Updated: December 2009 © 2009 page 9 of 46 . five family members of an infected laboratory worker became ill.190. the symptoms may last up to two weeks or longer. Before 2005.119-129.93 From December 2005 through February 2009.246-248 Although many swine influenza virus infections seem to be limited to a single person. In Czechoslovakia.40 The World Health Organization (WHO) currently suggests using an incubation period of seven days for field investigations and monitoring patient contacts.131.255 The incubation period for avian influenza in humans is difficult to determine. there are few reports on their clinical features. this swine population has not been found.
34 One of the two people died.12.34. headache. there may also be mucosal bleeding. other cases. in some cases.260.38 Asian lineage H5N1 viruses LPAI viruses.255. vomiting and abdominal pain. 256 Gastrointestinal symptoms including diarrhea and vomiting have been reported in some patients.39 One H5N1 infection in a child with upper respiratory signs and an uncomplicated recovery after antibiotic treatment was recognized only by routine virus surveillance.167.40 Heart failure. fever.257 This study also documented lower respiratory tract signs including pneumonia and bronchiolitis in a few patients. antibodies to an avian H7N2 virus were found in one person after an LPAI outbreak among poultry in Virginia.260-262 Vomiting and diarrhea have been reported in a significant number of cases. 12.267-270 A significant number of serious or fatal cases have been reported in healthy children or young adults.264. In 1999. but no testing was done. as well as those with chronic medical conditions.41 The following human infections with Asian lineage H5N1 and other avian influenza viruses were reported between 1997 and 2009: In 1997. bronchitis or bronchiolitis. and some cases may be complicated by secondary bacterial infections. sore throat and cough and.167.2. very young age or pregnancy increase the risk of severe disease.35 Most cases occurred in The Asian lineage H5N1 HPAI viruses appear to cause more severe disease than other HPAI viruses or Last Updated: December 2009 © 2009 page 10 of 46 .167.12.15. but 29 of 179 children were hospitalized with more serious illnesses such as pneumonia.12.40.260 Severe primary viral pneumonia and/or acute respiratory distress syndrome occur in a small percentage of cases.260.11. and recover within a week.38 The illnesses were mild and both children recovered.261.264 Multiple organ failure may be seen. the novel H1N1 virus can also exacerbate chronic medical conditions.255.34. who would not be expected to have a high risk of complications.265 Like other influenza viruses.12 Many patients develop lower respiratory tract disease shortly after the first signs.268 Avian influenza infections in humans Infections with avian influenza viruses have occasionally been reported in humans.264.260. encephalitis and multiorgan dysfunction are common in the later stages. the novel H1N1 virus causes a relatively mild illness. severe enough to require hospitalization.12. have been affected.40 The respiratory secretions and sputum are sometimes bloodtinged. sore throat and rhinorrhea were reported in four infected children in Cuba. especially those caused by Asian lineage H5N1 viruses. and may be fatal. avian influenza (LPAI H9N2) was confirmed in two children with upper respiratory signs.257 Some influenza C infections may be asymptomatic. severe respiratory distress and viral pneumonia. Healthy children and adults. the first eighteen H5N1 infections in people were reported during an HPAI outbreak among poultry in Hong Kong.262-265 Patients who become severely ill usually begin to deteriorate 3-5 days after the onset of the symptoms. cough. hoarseness of the voice and crackles during inspiration.267. abdominal pain and vomiting in Hong Kong. In 2003.255.205.256. 12 Similarly. which resembles the disease caused by other human influenza viruses.34 The symptoms included fever.38 High fever and upper respiratory symptoms resembling human seasonal influenza tend to be the initial signs. all six people recovered. with rhinitis. wheezing and/or otitis in some individuals.12.260.2. Six unrelated H9N2 infections associated with acute respiratory disease were also reported from mainland China in 1998-99.11. in a few infants. often progressing to respiratory failure within 24 hours.205.261. were serious or fatal.40. Novel H1N1 virus of swine origin In most people.266 Underlying health conditions.11.39 Asymptomatic infections with Asian lineage H5N1 viruses seem to be rare.220.127.116.11. kidney disease. 347 total (suspected and confirmed) and 89 confirmed human infections were associated with an H7N7 HPAI outbreak among poultry in the Netherlands.260.11. two HPAI H5N1 infections were reported in a Hong Kong family that had traveled to China.12 Some infections have been limited to conjunctivitis and/or typical influenza symptoms.271 In some patients. or gastrointestinal symptoms such as diarrhea. tachypnea. and their condition rapidly becomes serious.265.Influenza most common clinical signs were fever.12.11. dyspnea.271 Respiratory signs are not always present at diagnosis. No other cases were found. two patients from southern Vietnam had acute encephalitis without symptoms to indicate respiratory involvement.258 A study from Spain reported high fever and lower respiratory tract illness.18.104.22.168.33. the symptoms may include chest pain. a patient from Thailand exhibited only fever and diarrhea.271 Milder cases have been reported occasionally. coinfections with gastrointestinal pathogens were present in some but not all cases.12 Eighteen people were hospitalized and six died. Another family member died of a respiratory illness while in China. particularly among children.257 Fever. cough and rhinorrhea.12.259 Serious disease was most common in children less than two years of age.38 In 2002.12 Most patients deteriorate rapidly. especially respiratory diseases such as asthma or chronic obstructive pulmonary disease. sore throat.259 Fever and cough were the most common signs in 14 patients from France.11 In 2003.33-35.255. pharyngitis.262 Most people have a self-limiting illness. and disseminated intravascular coagulation can occur. arthralgia.38.
35 In 78 of the confirmed cases. (This virus is not the same virus involved in the swine-origin H1N1 pandemic of 2009.”) The single death occurred in an otherwise healthy veterinarian who developed acute respiratory distress syndrome and other complications. (Four cases were classified as “other. an LPAI H7N2 infection with respiratory signs was reported in a patient in New York. There is no indication in the report that this case was more severe than the previously reported infections.244 Serological evidence suggests that approximately 500 people on the fort had been infected by person-to-person spread. In 2003. an H1N1 swine influenza virus was isolated from a pregnant woman with viral pneumonia in Wisconsin.37 Last Updated: December 2009 © 2009 In 2009. The virus isolated from the fatal case had accumulated a significant number of mutations.196 Cases of conjunctivitis have been reported after contact with HPAI H7N7 avian viruses in infected seals. 263 cases were fatal.2.246-248 Because few infections with swine influenza viruses have been described. but the infection did not spread further. Ten other infections were suspected but not confirmed. and died shortly after giving birth. a mild LPAI H9N2 virus infection was reported in a 9-month-old child in Hong Kong. an H9N2 virus infection was reported in a 3-year-old child with a fever.12. an H9N2 virus was found in a 2-monthold infant in China. an H1N1 virus caused severe viral pneumonia in a 29-year-old swine farmer in the Netherlands. 11 In 2008.35 This virus also caused severe or fatal infections in experimentally infected ferrets and mice. these cases included both conjunctivitis and upper respiratory symptoms.21. coughing and muscle aches.22 Other people on the base may also have been ill with the same infection. In 1986. A localized outbreak was reported at Fort Dix. All of the infections were associated with an H7N3 virus outbreak in poultry. two cases of conjunctivitis and flu-like symptoms were confirmed in poultry workers in Canada.43 In 2007.85 The farmer had been in contact with pigs showing signs of respiratory disease.11. In 2004.82 Serological evidence of possible infection was found in five contacts. Swine influenza virus (H1N1) was isolated from an immunocompromised child with fulminant pneumonia who died in 1982. 11.240.35 Two people had influenza symptoms such as fever.23 Reported swine influenza infections include the following cases. it is not known whether the symptoms caused by these viruses differ significantly from human influenza. including one who died of pneumonia.21 page 11 of 46 . Swine influenza virus infections in humans Serological evidence suggests that swine influenza virus infections might occur regularly among people who are occupationally exposed.88 She apparently became infected while attending an agricultural fair. was hospitalized but recovered.Influenza poultry workers. the other was HPAI. An H1N1 swine influenza virus was isolated from five recruits with respiratory disease. 445 confirmed human cases had been reported to WHO.1. an H9N2 LPAI infection was confirmed in a child in Hong Kong. who had serious underlying medical conditions. From 2004 to 2008. cough and rhinorrhea in Hong Kong. conjunctivitis was the only sign of infection. who recovered.36 The symptoms included mild fever.1. In 1980. while viruses from most of the other individuals had not. It should be kept in mind that severe or fatal cases are more likely to be investigated than mild illnesses that resemble human seasonal influenza.11 The person. while other H7 viruses from milder human cases in North America were significantly less virulent.35 In 2003. an H1N1 virus infection with influenza symptoms including diarrhea occurred in a young boy.) A self-limiting illness with influenza symptoms was reported in a college student infected with an H1N1 virus in 1979.11 One virus was LPAI. Both people recovered after treatment with an antiviral drug.23. As of December 11 2009. sporadic human illness and deaths were associated with widespread outbreaks of Asian lineage H5N1 high pathogenicity avian influenza among poultry.22 There was no evidence of spread to his family.2. In 1988.22 There was evidence that his roommate had been infected but remained asymptomatic. Several health care workers developed influenzasymptoms after exposure. mild dehydration and cough. but three family members also became ill. Five had both conjunctivitis and influenza-like illnesses.35 His initial symptoms included a persistent high fever and headache but no signs of respiratory disease.26.37 She was hospitalized but recovered. New Jersey in 1976.36 The child was hospitalized but recovered.
Four cases involved H3N2 viruses. In 2005. and virus could be isolated for up to 10 days. No one who had been in contact with the caretaker became ill. was a triple reassortant H3N2 virus with genes from swine. headache.191 Humans have transmitted influenza viruses to ferrets and occasionally to swine.84 The symptoms included fever. In 2005. In November 2008. Infected adults usually begin to shed influenza A viruses the day before the symptoms appear.190. sore throat.192 Young children can shed virus for up to six days before. All cases were described in the literature as upper respiratory disease. He had no direct contact with animals. In 1993. coughing. A recent literature review summarized 49 cases of swine influenza that had been documented in scientific journals as of April 2006 (including many of the cases described above).24 The child recovered without complications.187 For the novel (2009 pandemic) H1N1 virus. and 10 or more days after they become ill. human and avian influenza viruses. Nine of the patients had a history of contact with pigs. Other workers on the farm were treated prophylactically and did not become ill. but was not tested for the virus.87 The physician who treated her reported an influenza-like illness shortly afterward.24 He recovered without complications. a healthy young laboratory animal caretaker in Maryland died of pneumonia caused by an H1N1 influenza virus. dizziness and occasional vomiting.21 Thirteen of the cases were from the outbreak at Fort Dix. fever and myalgia.86 This case was diagnosed only because the physician participated in an influenza surveillance program and collected a laboratory sample for virus identification. and are infectious for 3-5 days after the initial signs. Two children were hospitalized for dehydration. 190. and only one person was seropositive. but lived on a communal farm. and recovered uneventfully. an Asian H1N2 swine influenza virus was isolated in the Philippines from a 25-yearold man with symptoms of influenza including high fever. which was also found in sick pigs on the farm. the remainder were H1N1.83 He had close contact with pigs in a research facility. Communicability Human influenza viruses are readily transmitted from person to person. the other 37 were described as „cases in civilians. self-limited case of H1N1 swine influenza was reported from a 50year-old woman who worked on a swine farm in Spain.1 Human volunteers inoculated with an equine virus became ill. The virus appeared to be a reassortant. and there was no evidence that the virus had infected others. Between 2005 and February 2009.89 The virus. shortness of breath and conjunctivitis. In 2007. but seven deaths were reported. to as long as 7 days after their page 12 of 46 . a 26-year-old previously healthy woman and a 48-year-old woman with asthma and a history of smoking.190. 11 human infections with triple reassortant H1N1 swine influenza viruses were reported to the U. Two patients. Equine and canine influenza virus infections in humans Antibodies to equine H3N8 viruses have been reported in humans. an H1N1 swine influenza virus caused severe viral pneumonia in a 5-year-old child who lived on a pig farm in the Netherlands. Four of 7 household members and 4 of 46 other people on the farm had antibodies to this virus.3. but all of the gene segments were of swine influenza virus origin.1 There are no reports of clinical cases caused by natural exposure to equine influenza viruses or canine influenza viruses.90 The child was hospitalized but recovered. and one additional case identified in an ongoing survey of swine influenza among farmers. a mild. There was no evidence of person-to-person transmission. acute respiratory disease or pneumonia.1. One patient had three family members with suspected but unconfirmed swine influenza virus infections.191 Severely immunocompromised individuals may remain infectious for weeks to months. diarrhea. vomiting. the estimated period of communicability is from 1 day before the symptoms appear.85 In 2004.Influenza In 1991. myalgia. an Asian H1N1 swine influenza virus was isolated from a 4-year-old boy in Thailand with rhinorrhea. but recovered. Most patients recovered.185. others had immunosuppressive conditions including cancer and pregnancy. an H3N2 swine influenza virus was isolated from an infant with respiratory disease in Canada. No other potential cases were associated with this infection.‟ Twenty of the 37 civilian patients were previously healthy. but recovered without other complications. The infected individual was given antiviral drugs. and one case was thought to have been transmitted from person to person. experienced severe illness with pneumonia and respiratory failure.153.S. Last Updated: December 2009 © 2009 Centers for Disease Control and Prevention (CDC). a recombinant swine influenza virus was recovered from a farm worker with influenza symptoms in Canada.
1. at most.281 Diagnostic Tests Human influenza A and influenza B infections can be diagnosed by virus isolation or by the detection of antigens or nucleic acids. one day sooner.S. Four drugs amantadine.110.40 Virus isolation is done at World Health Organization (WHO) H5 Reference Laboratories. may occur.113. antigen detection or virus isolation from respiratory and throat swab samples. have been reported in humans infected with avian influenza viruses.22. but they are currently uncommon. including neuropsychiatric events. and virus could be isolated for 1 to 7 days. and no cases of sustained transmission.277 Amantadine and rimantadine (adamantanes) are active against human influenza A viruses. may be treated with antiviral drugs. human influenza viruses circulating in the U.93. One was a localized outbreak among recruits infected with an H1N1 virus at a military base in Fort Dix.35 Fecal shedding of the Asian lineage H5N1 virus has been documented in a child with diarrhea.104.252 Rare cases of probable person-to-person transmission.000 people.82 There are two known outbreaks with more extensive spread.275 Serology is currently used mainly in epidemiology and research. and may emerge during treatment.94 Approximately 500 people on the base.Influenza onset.11.190 During the 2006-2008 flu seasons.93. 275 Last Updated: December 2009 © 2009 page 13 of 46 .273 Humans can transmit the novel H1N1 virus to animals as well as people. possibly zoonotic.191 Testing must be done to determine each individual virus‟s drug susceptibility.277Treatment usually results in milder symptoms and recovery. this appears to be less common than resistance to adamantanes. are available on the CDC and WHO Web sites (see Internet Resources).191 Infections can also be diagnosed by serology.108. The viruses can be isolated in cell lines or chicken embryos.277 Side effects. RT-PCR and antigen testing of avian influenza viruses must be carried out in Biosafety Level (BSL) 2 laboratory conditions. Serological tests include complement fixation. the virus did not spread to the surrounding community. hemagglutination inhibition and immunodiffusion. More severe cases.11.275 Samples should be collected as soon as possible after the onset of illness.40 Serology has been used for surveillance.280. samples that test positive by PCR or antigen tests are confirmed by the CDC.131. or infections that have an elevated risk of complications.191.2.191 RT-PCR or culture can be used for the diagnosis of influenza C. 249 One study presented at a recent conference found that viral nucleic acids could be detected by reverse transcription polymerase chain reaction (RT-PCR) assays in children for 1 to 13 days after they became febrile.131. which contained 12. for 2-3 days after the fever has resolved.191 RT-PCR techniques are also available.190.278 Current recommendations for the treatment of infections with the novel H1N1 virus.190.11..191 Commercial rapid diagnostic test kits can provide a diagnosis within 30 minutes.131.190.190-192.190.277 Laboratory studies have shown that influenza viruses can also become resistant to zanamivir and oseltamivir.234 Swine influenza viruses have typically been transmitted only to a few close contacts.274. and Canada exhibited high resistance to amantadine and rimantadine.22 The other is the 2009 H1N1 pandemic in humans. Antigens can be detected in respiratory secretions by immunofluorescence or enzyme-linked immunosorbent assays (ELISAs).131.are used to treat influenza. and in some cases.167. rimantadine. New Jersey.1.131. Avian influenza viruses can be identified by RTPCR. felids and dogs have apparently been infected from human contacts.274.190. however.191.40 An influenza test that is positive for influenza A.179.272 Atypical prolonged shedding up to 28 days (by PCR) has been reported in healthy adults with severe or relatively severe cases.2. Swine herds.202 Infections with the novel H1N1 virus can be confirmed by RT-PCR or virus isolation from respiratory secretions. including the use of antiviral drugs. Drug resistance develops rapidly in viruses exposed to amantadine or rimantadine.38.1.278-280 Oseltamivir-resistant isolates of this virus have been reported sporadically.277 The CDC recommends that these two drugs be avoided until the circulating strains become susceptible again. ferrets.93.117. but does not detect the hemagglutinins in common human influenza viruses suggests a novel. 231 Transmission of this virus across the placenta may also be possible. a rising titer must be seen. turkeys. if treatment is begun within the first 48 hours.22.40 RT-PCR is usually the primary test for infection with Asian lineage H5N1 viruses.40 Enhanced BSL 3+ laboratory conditions are needed for the isolation of H5N1 HPAI viruses.249 People may shed this virus for as long as they are ill.103.261.276 Treatment Supportive care for uncomplicated influenza in humans includes fluids and rest.191.277 Zanamivir and oseltamivir are effective for both influenza A and influenza B.277 The novel (swine origin) H1N1 virus circulating among humans in 2009 is resistant to amantadine and rimantadine (adamantanes). The current immunofluorescence or rapid antigen tests for human influenza cannot distinguish other human influenza viruses from the novel H1N1 virus. influenza virus.119-129. but it is usually sensitive to oseltamivir and zanamivir.272 Children and people who are immunocompromised might be infectious for longer. were infected or exposed. however. zanamivir and oseltamivir . with identification by hemagglutination and neuraminidase inhibition tests or by RT-PCR. on average.131.11.S.1.21.40 In the U. The microneutralization assay is the most reliable test for detecting antibodies to avian influenza viruses.190-192.
the CDC recommends that these two drugs be avoided in the U.40 These viruses are resistant to amantadine and rimantadine.261.291 People who remain home should minimize contact with others in the household during their illness.290 The CDC has published specific guidelines for self-isolation and treatment. but they may be used voluntarily by individuals at risk for complications.284 Last Updated: December 2009 © 2009 page 14 of 46 .190.289.287 In other cases.249. as well as recommendations for infection control measures in health care settings (see Internet Resources).249. communities or non-healthcare occupational settings.12. There is no indication that any swine influenza virus can be acquired by eating well-cooked pork.290. 211 Ordinary food safety precautions including hand washing before and after handling raw meat. in meat).286 Antiviral drugs may be used for prophylaxis in some high risk populations after exposure. and recombination can occur between human and swine influenza viruses.1. and they are not ordinarily expected to occur outside these tissues (e.284 To protect others.282 Further testing.190.190 The vaccine is given in the fall before the flu season.can be used for prophylaxis in high-risk populations such as the elderly or immunocompromised.131 It contains the viral strains that are most likely to produce epidemics during the following winter. Preventative measures for swine influenza viruses occurring in pigs Good hygiene and sanitation. gloves and other personal protective equipment also reduce exposure. and stay home except for necessities (for instance.187 If contact is unavoidable.157.amantadine. vaccine types.277 Other preventative measures include the avoidance of contact with people with symptomatic disease. anyone with an undiagnosed flu-like illness should also avoid unnecessary close contact with species susceptible to the latter virus. good hygiene and the use of face masks and/or other measures that prevent accidental droplet transmission from coughs and sneezes may be helpful. people at an increased risk for complications should consider avoiding crowded conditions or close contact with others.285 but vaccines for the novel H1N1 virus became available in Fall 2009. particularly if it is given early. anyone who has a flu-like illness should avoid contact with this species.191.292 Influenza viruses are also killed by sanitizing cutting boards with 1 tbsp bleach in a gallon of water. as influenza viruses have been transmitted occasionally to or from this species. seeking medical care).271. particularly on the optimum dose and duration of treatment.263. the prevention of crosscontamination of foods or surfaces used for food preparation.249. cats (both housecats and other felines) and dogs.288 The CDC currently recommends that anyone infected with the novel H1N1 virus and anyone who has an undiagnosed flu-like illness limit contact with others. nose or mouth. specific risk groups may be targeted first for vaccination.283 There appears to be little or no cross-reactivity with the H1N1 strains in the current seasonal human influenza vaccine. ferrets. as well as frequent hand washing.277 Due to the high resistance of currently circulating viruses to amantadine and rimantadine.40.. Care should also be taken to avoid spreading the virus to other animals.287 In areas where infections with the novel H1N1 virus are common. as well as hand washing and other hygiene measures. and by cooking pork to an internal temperature of 160°F (71. and treated at the first sign of disease.g. To protect ferrets from infection with human influenza. the mouth and nose should be covered when coughing or sneezing.93.293 In pigs.11 Although resistance to zanamivir and oseltamivir has also been reported in H5N1 viruses.131. Preventative measures for the novel H1N1 virus circulating in humans Preventative measures are similar to those for seasonal human influenza.284 To prevent virus transmission to pigs.287 The CDC Web site has detailed information on the current recommendations.190. people who are ill should avoid contact with these animals. Protective clothing. and include the avoidance of close contact (approximately 6 feet) with people who have flu-like illnesses. until the influenza strains become susceptible again.191 Three antiviral drugs .1°C).40. and recommendations for vaccination in specific population groups are available from the CDC. and the use of hot soapy water to wash contaminated surfaces would be protective if any viruses survived long enough to reach consumers.292 Prevention Preventative measures for seasonal human influenza viruses An annual vaccine is available for influenza A and B. particularly turkeys. Details on vaccine efficacy. rimantadine and oseltamivir . is still needed. swine influenza viruses replicate in the lungs and upper respiratory tract. people may be monitored.292. including frequent hand washing.291 Face masks and respirators are no longer recommended in homes.S. the avoidance of unnecessary hand contact with the eyes. can help prevent human infections with swine influenza viruses. Because infections with seasonal human influenza viruses cannot be distinguished clinically from infections with the novel (pandemic) H1N1 virus. it is currently uncommon. Where limited quantities of these vaccines are available. Avoidance of contact with swine should also be considered. and other common sense hygiene measures.93. and it is updated annually.191.12.Influenza Oseltamivir appears to increase the chance of survival in patients infected with Asian lineage H5N1 viruses.11.
and 0. Until recently. an epidemic.11 Eggs should be cooked until the whites and yolks are both firm. an epidemic of influenza A usually occurs every 1. poultry farms and live bird markets should be avoided. these vaccines are stockpiled by the government and will be distributed by public health officials if they are needed.16. After a pandemic.131 During influenza pandemics. In areas where H5N1 viruses might be present in domesticated poultry. are caused by antigenic shifts in influenza A viruses. in 2004.192 Infections are more severe in the elderly. and an epidemic of influenza B every 3-4 years.295 Hunters should not handle or eat sick game.2.S. tribal or federal natural resource agencies.131.295 If an avian influenza pandemic occurs in humans. Sanitary precautions and cooking methods recommended to destroy Salmonella and other poultry pathogens are sufficient to kill avian influenza viruses.131 Epidemics in tropical regions are not usually seasonal. smoking. and those who are immunosuppressed. the World Health Organization recommends prophylaxis with antiviral drugs in people who cull birds infected with Asian lineage H5N1 HPAI viruses. as well as equipment and surfaces.188. drinking.16. people with respiratory or cardiac disease. Antibodies offer limited or no protection against other virus types or subtypes.191 Immunity to the viral surface antigens (the hemagglutinin and neuraminidase) reduces the risk of infection and severity of disease.Influenza Preventative measures for avian influenza viruses Controlling avian influenza epidemics in poultry decreases the risk of exposure for humans.3 years.11.1. 1957. crowded conditions and close contact with other people should be avoided.192 Since 1968. an influenza virus usually becomes established in the population and circulates for years.131.190.191 Over 90% of these deaths occur in the elderly.11.131 During epidemics. coveralls. Wild birds should be observed from a distance. then spreads to preschool children and adults.11. During a pandemic.20. and an estimated 20-50 million deaths worldwide. in 1918. young children (particularly infants). or rubbing the eyes. influenza appears first among schoolaged children.131. the type A (H3N2) viruses have caused the most serious outbreaks with the highest mortality rates. uncomplicated infections with human influenza viruses are rarely fatal in healthy individuals. these viruses were thought to cause only sporadic cases of influenza and minor localized outbreaks.11 Avian influenza viruses can be carried in wild birds.294 In the U. and these birds could be the initial source of infection in an area.295 Dead or diseased wildlife should be reported to state.000 deaths were reported in the U.295 The hands. should be thoroughly washed after dressing the carcass. infection control measures such as good hygiene.297 Morbidity and Mortality Seasonal human influenza Although the morbidity rate for seasonal influenza is high.0004 .294 Avian influenza vaccines for humans are not commercially available in the U.131 During a typical epidemic.202 Influenza C infections seem to be most serious in very young Last Updated: December 2009 © 2009 page 15 of 46 .20 They are also discouraged from having contact with sick birds while suffering flu symptoms.1. but can occur. additional precautions will be necessary.190-192 Influenza-related deaths are usually the result of pneumonia or the exacerbation of a cardiopulmonary condition or other chronic disease.11 Cutting boards and utensils should be washed with soap and hot water.1% in those over 65.191 In the most severe pandemic. close contact is discouraged. people in contact with infected birds should be vaccinated against human influenza.11.12.11 Poultry should be cooked to a temperature of at least 74°C (165ºF).296 Respirators and other protective equipment may be advisable during close contact with an infected individual.22.214.171.124 H5N1 vaccines have also been developed.S.0.2.131 It should be noted that antiviral drugs and antibiotics were not available at the time.190 The estimated mortality rate from seasonal influenza is 0.11 Precautions should also be taken when handling raw meat and eggs.11 The hands should be washed thoroughly with soap and warm water after handling poultry products. which last occurred in 1918. and intensive care procedures were less effective. and they should always wear rubber or latex gloves while handling and cleaning wild birds.20. a nationwide influenza C epidemic was reported in Japan.131.0006% in persons under 50 years old.S.192.20 Although a new virus may spread among a population before the “flu season.20 The outbreak usually lasts for three to six weeks. the morbidity and mortality rates may increase dramatically in all age groups.0075% between the ages of 50 and 64. 15% to 40% of the population may be infected.1.11 Less is known about influenza C than influenza A or B.20 Approximately 500.1 Antigenic drift is usually responsible for small-scale epidemics and localized outbreaks.190 Human influenza can occur as a localized outbreak. 296.295 If birds or contaminated surfaces are touched.1.201 However. gloves and respirators. a pandemic or as sporadic cases. the morbidity rate was 25-40% and the case fatality rate 2-5%. cancellation of social events and voluntary quarantines of infected individuals can limit the spread of disease.1. 296 In addition.12 To prevent reassortment between human and avian influenza viruses.295 All game should be cooked thoroughly.12 People working with infected birds should follow good hygiene practices and wear appropriate protective clothing such as boots (or shoe covers).190. the hands should be washed with soap and water before eating.2 In North America.191 Deaths are rare in children.11 In addition.191 Pandemics.” epidemics in temperate regions usually do not begin until after school starts in the fall.1.. 0. 1968 and 2009.
but they are more likely to have severe symptoms if they become ill.284.269 The mortality rate in the Southern Hemisphere was relatively low.96.2126.96.36.1999. severe or fatal cases have also been reported among some young. 1.298-301 2009 pandemic: Novel H1N1 virus of swine origin Morbidity and mortality information for the novel H1N1 virus are still preliminary. a human pandemic was declared.249.309.269 but data from other countries suggest that this is not necessarily the case among HIV-infected individuals who are receiving antiretroviral drugs.262.264.267. 30% of the children hospitalized with severe infections were less than two years old. and two were immunosuppressed by cancer.269 A small number of H1N1 infections may be asymptomatic.279. then by the recognition of sustained person-to-person transmission outside Mexico.264. six cases were fatal. and those who are obese. one person died of pneumonia.265 In Victoria.21.259 however.255. pregnant women. like other human influenza viruses. with 20% of hospitalized patients transferred to an intensive care unit (ICU).84 Most sporadic cases of swine influenza have been relatively mild and some may have been asymptomatic.205. however.240.267-270.82.268. individual countries reported mortality rates from 0 to 36. the overall mortality rate from influenza was lower than in previous years. and serological evidence of infection was found in approximately 500 of 12. previously healthy individuals. and an additional 12% were between the ages of two and five.264.Influenza children.260. some cardiovascular conditions or immunosuppression.000 population. who are not ordinarily expected to be at high risk. at least twelve additional cases thought to be swine influenza were reported. Australia.000 cases and 188.8.131.52.1 per million population. depending on the country and the conditions that are defined as predisposing. most (75%) in people who had other health issues.95.167.306 In New South Wales. people with underlying health conditions such as chronic respiratory disease. more than 622. The initial outbreak with this virus occurred in Mexico in April.250 As of November 27 2009.265 In Taiwan.259 Symptomatic influenza C infections are reported less often than illnesses caused by influenza A or B viruses. the reported hospitalization rates from various countries ranged from 2. one had secondary bacterial infection.21 Four of these patients had primary viral pneumonia. viral pneumonia has been a significant concern with this virus.0 to 31.1.306.256.269 Although the vast majority of cases have been mild and uncomplicated. this underestimates the number of cases.22. However. Because the virus emerged in April. one was pregnant.265.310 and this group has had lower morbidity rates than expected.305 Cases were reported in both the Northern and Southern Hemispheres during the initial stage of the outbreak.264.307 The reported percentage of hospitalized patients who have had no significant preexisting conditions ranges from approximately 24% to 59%.269 Peru reported 8381 confirmed cases and 143 deaths.800 deaths attributed to this virus had been reported to the World Health Organization.302-304 This was followed by the identification of the virus among travelers in other countries.279. Australia.21. this occurred first in the Southern Hemisphere. but severe illness was seen in some high risk groups.305 Because many countries no longer count or report individual cases.269 In Victoria.306 Secondary bacterial infections have also contributed to some severe cases and deaths.21 Two patients who died were described as previously healthy.2.308 Some older people may have some immunity to the novel H1N1 virus. but some severe illnesses and a few deaths have been reported. During the flu season in the Southern Hemisphere. 85% of these critically ill patients survived.302-304 In June.260.82-90 During the outbreak at the Fort Dix military base.269 Transmission of the novel H1N1 virus appears to have declined normally after the flu season in the temperate regions of the Southern Hemisphere.000 population in most countries.307.96.265. visitors at agricultural fairs or livestock shows.8 per 100. serological studies suggest that a large percentage of the population is exposed to influenza C viruses in childhood.167 Unusually.23. and a meat packer.269 Zoonotic swine influenza The overall prevalence of swine influenza virus infections in humans is unknown. of 37 other cases reported in the literature.2.1.95. which begins in the autumn. with hospitalization and mortality rates that were 3-7 times greater than in non-indigenous groups.000 people on the base. and 0. In one study. serological evidence suggests that exposure may be relatively common among people who work with pigs.206. approximately 5% of the population is thought to have become ill. particular those that are mild.279.244 One review reported that.262.266 The risk of severe illness has been greatest in children under the age of 2 years (especially infants under a year of age).305.167.3% of those infected were hospitalized.260.22.24. other probable cases were suspected.21.22.257. 21.21 Infections not associated with swine contact have included instances of limited person-to-person transmission and some published cases with no known connection to swine. the novel H1N1 virus has been transmitted most widely during the traditional flu season.206.1. with less than 1 death per 100. In a series of 11 infections with North American triple reassortant Last Updated: December 2009 © 2009 page 16 of 46 .83 The health status of one person was not known.246-248 Swine influenza infections have been reported among farm workers.93. 279 The autumn flu season in the Northern Hemisphere has been very active in the initial stages. laboratory workers. and one had extensive involvement of the abdominal organs. the mortality rate among 91 hospitalized patients was approximately 10%.307 HIV infection was linked to more severe illness in South Africa.307 The impact of the novel H1N1 virus has been greater among indigenous people in both the Northern and Southern Hemispheres.22.
71. orioles. circulate in some of these species. red-billed leiothrix (Leiothrix lutea). budgerigars (order Psittaciformes). Cong2007 /id.11 Most patients infected with these viruses have been young and have had no predisposing conditions.51. A single death was reported in an otherwise healthy veterinarian who became infected with an H7N7 virus. and severe illnesses were reported in a previously healthy 26year-old woman and a 48-year-old woman with asthma and a history of smoking. H6. shrikes.315-318 Host range of the Asian lineage H5N1 avian influenza viruses Infections in Animals Species Affected Influenza A viruses Influenza A viruses can cause disease in birds and many mammals including swine.314 Interestingly. as well as housecats.38.61-63. as of December 11.271. jackdaws. can also cause serious disease in other avian species including gulls. mesias. but influenza symptoms have also been seen. swans and geese) and Charadriiformes (shore birds.194. guineafowl and peafowl (order Galliformes). coots and sultans (order Gruiformes). was 59%. 263 of them fatal.74 Most infections with H7 viruses have been limited to conjunctivitis.67.11. owls (order Strigiformes). raccoon dogs and captive palm civets (Chrotogale owstoni).84 All of the patients in this study recovered. emus (order Struthioniformes). gulls and terns).26.25. H5. cranes. ferrets. eagles. Many H5N1 viruses have been isolated from birds in the order Anseriformes.72. were reported to WHO.12. kites.11. leopards (Panthera pardus).36-38. partridges.38. two children were hospitalized for dehydration. storks and herons (order Ciconiiformes). pigeons (order Columbiformes). veterinarians and waterfowl hunters. cats. ravens. stone martens (Mustela foina).319 Symptomatic or fatal infections have also been reported in pheasants.136.57. appear to be the natural reservoir hosts. only individual cases or limited outbreaks have been reported in others.1.16 Poultry can develop serious or mild disease. no seropositive individuals were identified in serum samples collected during H7N1 epidemics from 1999-2002. cormorants and pelicans (order Pelecaniformes).26. which tend to carry these viruses asymptomatically. egrets. varying with the country and the clade of the virus.314 In other studies. jungle fowl.311-313 A few milder cases have been documented. H7. wood ducks.33-38.196 Waterfowl and shorebirds. mynahs. Eurasian tree sparrows (Passer montanus).73.34. munias.55. dogs. particularly among children.51.136 Disease can also occur in passeriform birds. and they have not been-fatal.Influenza H1N1 swine influenza viruses between 2005 and 2009. such as the Asian lineage H5N1 viruses or an H5N3 virus isolated from terns in the 1960s. crows. 184.108.40.206 From 2003 through December 11 2009. starlings. unrecognized infections. however.43 Higher or lower case fatality rates have been reported in smaller series. Influenza viruses Asian lineage H5N1 viruses can infect and/or cause disease in many species of birds in addition to poultry. horses.35 Some isolates may also cause asymptomatic or mild.240-242.54. crakes.220.127.116.11. moorhens. grebes (order Podicipediformes). goshawks.4455 Asymptomatic infections have been reported in some Last Updated: December 2009 © 2009 page 17 of 46 . there was no apparent difference in the prevalence of the H5N1 virus between waterfowl and other birds.44-53. Particularly severe infections have been reported with Asian lineage H5N1 (HPAI) viruses.43 The overall case fatality rate. farmed ostriches. particularly the families Anatidae (ducks. house sparrows (Passer domesticus).224 In a recent study from Thailand. H10 and H11 avian influenza viruses have been found in poultry workers. During an H7N3 LPAI outbreak in Italy in 2003. 445 laboratory confirmed human H5N1 avian virus infections. A few isolates. kestrels.11.71. exposure to antigens or crossreactions with human influenza viruses remains to be determined.9. species that can be affected include finches. but some strains can also infect and/or cause disease in mammals. a dog. H9. pinnipeds and cetaceans. asymptomatic infections seem to be rare.208. terns. Zoonotic avian influenza The severity of avian influenza varies with the virus isolate.71. mink.2. clouded leopards (Neofelis nebulos). Avian influenza viruses Avian influenza viruses mainly infect birds.69.41 Human disease has also been reported occasionally after infection with various H7 viruses and H9N2 viruses.60.13.11. 3. Wang2009 /id] Whether these antibodies result from productive infections. watercocks.71. bustards. hornbills (order Coraciiformes) and flamingos (order Phoenicopteriformes).8% of poultry workers tested developed antibodies to H7 viruses.54.12.51. depending on the subtype and strain of the virus. Jia2009 /id.39 The prevalence of human infections with Asian lineage H5N1 viruses is unknown.9.65.224 Symptomatic infections with Asian lineage H5N1 viruses have also been reported in mammals including captive tigers (Panthera tigris).74 The reported infections with H9N2 viruses have resembled human influenza. quail.317 Asian lineage H5N1 viruses have also been found in a variety of birds that appeared healthy. Japanese white-eye (Zosterops japonicus) and magpies.137. lions (Panthera leo) and Asiatic golden cats (Catopuma temminckii).1.39 One H5N1 infection in a child with upper respiratory signs and an uncomplicated recovery after antibiotic treatment was recognized only by routine virus surveillance. Peiris2009 /id.138-142. falcons. a wild mink (Mustela vison).51. Oriental magpie robins (Copsychus saularis).11. antibodies to H4.11. emus and passerine birds. and buzzards/ vultures (order Falconiformes).
caimans. but they can also occur in zebras. crocodiles.9 Mink can also be infected with H5N3. and H3N8 and H4N6 avian influenza viruses have been established in mink.174. To date. 9 Human influenza viruses have been isolated from some of these species.238. ferrets and seals.185-188 the novel (swine origin) H1N1 virus.193 Experimental infections have been established in housecats.152.5.132 During outbreaks in poultry.1.324-327 In 1984.126-129 Experimental infections have been established in ferrets. H8N4 and H11N4 viruses.323 Last Updated: December 2009 © 2009 page 18 of 46 . mice and cynomolgus macaques (Macaca fascicularis). and these viruses have also been isolated from pigs and a horse.144 Experimental infections with H1N1 and H3N2 human influenza viruses. 175 Experimental infections have been established in cattle. but the animals remained asymptomatic despite shedding virus.262. and they can be infected experimentally with avian LPAI H4N8 viruses and human H3N2 viruses.170. pigs. dogs and humans.32. H6. H1N1 swine influenza virus. H8 and H12 viruses have also been found in these animals. toads and frogs. including humans.9.56.213 Recently. was isolated from a duck in Hong Kong. yak.1. becoming the first canine influenza virus. and have been reported in dogs.9 Antibodies to H1. H7. and Asian lineage H5N1 viruses have been recovered from populations of apparently healthy wild pikas. and influenza A viruses have been detected by RT-PCR in caimans.S.1. serological evidence of infection or exposure has been reported in cats. 9 Serological evidence of infection with influenza A viruses has also been reported from some other mammals including cattle.9Antibodies to influenza A viruses have been reported in sea lions and porpoises.173 The new H3N8 canine influenza viruses have diverged genetically from the viruses found among horses.9 Influenza B viruses Influenza B viruses can cause disease in humans. and an H3N2 virus isolated from cattle caused an illness resembling influenza in calves. An H3N2 swine influenza virus caused a recent outbreak in mink.58. and dogs. sheep.28.170. have been isolated from seals. dogs.3 Outbreaks have been described recently in ferrets and mink.70 The currently circulating H5N1 strains are continuing to evolve.1.29 An H3N2 virus has been reported in dogs in Korea.1. closely related to avian viruses. an H3N8 equine influenza virus jumped into dogs.1.1.34. canine influenza virus infections have not been reported in other species. suggest that influenza B infections in swine are sporadic and do not spread to other pigs.194.196. swine and equine influenza viruses have also been established in this species. H3N3. infections with equine H3N8 viruses were reported among pigs in China. ferrets.1.189 Unpublished research suggests that some raccoons in Japan have antibodies to H5N1 viruses. have serological evidence of infection with H1.9.185-188 They can also infect pigs. and antibodies to equine H3N8 viruses have been detected in dogs and humans.9 There is evidence that some of these viruses were avian.145 Human influenza viruses Human seasonal influenza A viruses mainly cause disease in people and ferrets.5.3.29. H7N7.321] A few clinical cases have also been reported in pet ferrets.100-118. alligators.59 Unpublished research suggests that some raccoons in Japan also have antibodies to H5N1 viruses.5 The novel (swine origin) H1N1 virus circulating in humans has infected pigs and turkeys. 9 Antibodies to influenza A viruses have been reported in reptiles and amphibians including snakes.184 Swine influenza viruses Swine influenza viruses mainly affect pigs.310. H3.1. and viruses have been isolated rarely from pigs in China.328 Serological studies from the U.91.174.91 Experimental infections with avian. goats.Influenza housecats.144 One H1N1 swine influenza virus.189 Novel H1N1 virus of swine origin In ferrets.9 This virus is thought to have been of avian origin. cynomolgus macaques and rabbits.320.193 Influenza A viruses can infect pinnipeds and cetaceans. H4N5 and H4N6 viruses.60-70 Cattle can be experimentally infected with viruses isolated from cats. H3. H7N7. human and equine influenza viruses.262.322 and an H1N1 swine influenza virus. H13N2 and H13N9 viruses have been isolated from whales.18.104.22.168 Clinical cases have also been reported in dogs exposed to infected horses. H4.232. cattle and birds.9 Raccoons in the U. chickens exposed to infected pigs did not become infected. H3N8 equine influenza virus.2.K. dogs.32.169 Recently. reindeer and deer.146 Experimental infections have been reported in calves. foxes.125. H4 and H10 viruses. which was avirulent for both poultry and pigs.322 In one experiment. rodents.1.153 Experimental infections have been established in horses and raccoons. clinical cases or outbreaks have been reported in animals infected with human influenza viruses. cats. a cheetah in a zoo.30 and circulate only in dogs. donkeys and mules.119-124.119122. and H1N3. dogs and swine. an H10N4 virus was isolated from mink during an epidemic in Sweden.165. alligators and crocodiles.310.51.197 Serological evidence of infection has been found in pigs.328 Influenza A infections have been reported sporadically in cetaceans.25. horses and seals. but they can also cause disease in turkeys. Equine and canine influenza viruses Influenza viruses in other species Equine influenza viruses mainly affect horses.168.58. and other species may also be susceptible to infection and/or disease.
140 Avian influenza is often subclinical in wild birds.17.13.142 In one study. cyanosis of the head. which experienced only mild depression and survived.19 Most of the flock usually dies. dogs and horses.13 The incubation period for mammalian influenza viruses is also short.72 However.13. mimicking high pathogenicity avian influenza. turkeys and other gallinaceous birds.253.14. Ostriches that were experimentally infected with an HPAI H7N1 virus developed mild depression and hemorrhagic diarrhea.323.1. a cross between wild and domesticated ducks) or wood ducks (Aix sponsa) resulted in drowsiness.178.317 Incubation Period In poultry. there can be coughing.137. or somewhat increased flock mortality rates may be seen.140 High mortality is occasionally seen in young ostriches infected with either LPAI or HPAI viruses.331 LPAI viruses usually cause subclinical infections or mild illness in poultry. decreased feed and water consumption.60. The birds can be markedly depressed.54.330 The incubation period for H3N8 canine influenza can be two to five days.219.71-73. severe weakness and neurological signs.137. fever first appeared at 24 hours in experimentally infected dogs. respiratory distress and/or neurological signs were seen.3. blood-tinged oral and nasal discharges.136. Anorexia and depression occurred in experimentally infected zebra finches. and starlings. these birds are generally found dead. extreme lethargy. ruffled feathers.136. respiratory signs. dark green diarrhea.60. ecchymoses on the shanks and feet.1 Serological evidence of infection has been found in pigs.136. diarrhea and increased mortality. with death within 12 days. is used for an avian population in the context of disease control. 1.8 Clinical signs tend to be minimal in ducks and geese infected with avian influenza viruses.13. none of these signs is pathognomonic.1. some recent H5N1 isolates have caused severe acute disease with neurological signs and high mortality rates in domesticated ducks.72. the clinical signs included weakness.142 House finches and budgerigars developed anorexia.12. and green to white diarrhea may also be seen.1.343 Symptomatic infections with H5N1 viruses have also been reported in experimentally infected gulls and passerine or psittacine birds. it is also possible for an HPAI virus to be isolated from gallinaceous birds showing mild signs consistent with LPAI.Influenza Influenza C viruses Influenza C viruses have been isolated from humans and swine.19 Last Updated: December 2009 © 2009 page 19 of 46 .54 In other cases. decreased fertility or hatchability of the eggs.13 Systemic signs.13 Sinusitis.344 Diving ducks. lethargy.319 Experimental infections with H5N1 viruses resulted in severe neurological disease in some mute swans and sudden death in others. domestica.3.18 Decreased egg production. depression and neurological signs. while some birds shed virus subclinically. the most common signs are sinusitis. but some indigenous North American ducks including mallards (Anas platyrhynchos).329 although incubation periods up to 5 days have been reported in some horses. lacrimation.6. northern pintails (Anas acuta).142 In another study. One gull that recovered had a persistent head tilt. sneezing.332-342 More severe disease.140 Green diarrhea was the only sign of illness in ostriches inoculated with an LPAI virus of the same subtype.11.136. may be noted in chickens. In ducks. grebes and mergansers also seem to be highly susceptible to these viruses.7. the incubation period can be a few hours to a week. which takes into account the transmission dynamics of the virus. and all of the birds died within five days of inoculation.13 Because a virus can be defined as HPAI based on its genetic composition. which remained asymptomatic. another recovered completely.13. loss of egg pigmentation and deformed or shell-less eggs. blue-winged teals (Anas crecca) and redheads (Aythya americana) remained asymptomatic when inoculated with one of these strains.13-15 However.317 Laughing gulls (Larus atricilla) developed severe neurological disease.1-4.4.13 The clinical signs are variable. edema of the head.19 Sudden death of large numbers of birds is a common presentation. and ruffled feathers. misshapen eggs.73.3. H5N1 infections were mild in house sparrows.201 These viruses can cause disease in experimentally infected dogs. pigs or seals.19 In addition. anorexia. often fatal infections. however. can occur if the birds are concurrently infected with other viruses or there are other exacerbating factors. respiratory signs.25. without apparent clinical signs.184 Clinical Signs Avian influenza HPAI viruses usually cause severe disease in poultry. and died rapidly. but some strains can cause illness and death. incoordination and torticollis.3.14 A 21-day incubation period.170.10. and in some cases.147. cloudy eyes.168. and sudden death may occur with few other signs. The clinical signs usually appear within 1-3 days in horses.136 Most infected gulls died. and other clinical signs began 2-8 days after inoculation.343 There are few descriptions of the clinical signs in other domesticated birds. within a few hours. 1. comb and wattle.11-13.54 Swans have been severely affected by H5N1 viruses.22.214.171.124 Experimental infections with H5N1 viruses in call ducks (Anas platyrhyncha var.319 Strains known to cause fatal illness include some of the currently circulating Asian lineage H5N1 viruses.213 Little is known about H3N2 influenza virus in dogs.137 Some captive wild birds infected with these viruses have died suddenly. These viruses can cause serious infections in some species of birds on a farm while leaving others unaffected. decreased egg production.3. with decreased feed and water consumption. house sparrows but not starlings had severe.126.96.36.199.13-15. neurological disease. but most cases appear in 2-3 days. including most HPAI viruses.
61.60 Experimental infections have been established in foxes. but recovered. although no naturally infected animals have been reported. however.169. anorexia.229 Cattle inoculated with high titers of H5N1 viruses isolated from infected cats remained asymptomatic but could transiently shed virus.45. convulsions and ataxia. the pathogenicity varied with the specific isolate and the route of inoculation (intranasal or intragastric).168. convalescence can take up to six months. an initial (usually low grade) fever is followed by a persistent cough and sometimes a purulent Last Updated: December 2009 © 2009 page 20 of 46 . corneal opacity and enlarged submandibular lymph nodes.253. diarrhea and neurological signs. the clinical signs included fever.25.55 Other raccoon dogs on the same farm had died with respiratory signs and/or diarrhea before the virus was found. but the cough may persist longer.253 Other influenza viruses in horses Horses experimentally infected with human influenza virus (H3N2 „Hong Kong‟) developed a mild febrile illness. myalgia. extreme lethargy.53 little is known about the clinical signs after natural exposure in this species.168.253 Loss of eyesight has also been reported. Some infected foxes developed fever but no other clinical signs.25. chronic bronchiolitis and emphysema. there was no evidence that the pika population was seriously affected.25. 1.46 During an outbreak in Cambodia.25.50 Some of these animals exhibited respiratory distress.3 Avian H5N1 influenza in mammals Both symptomatic and subclinical Asian lineage H5N1 virus infections have been seen in felids. apathy and anorexia.318 Other influenza viruses in birds Turkeys infected with swine influenza viruses may develop respiratory disease.168. however. weight loss. followed by a deep.330 Other clinical signs may include a serous to mucopurulent nasal discharge.179. high fever and neurological signs before death. the syndromes ranged from very mild upper respiratory infections to severe.253 Young foals without maternal antibodies can develop rapidly fatal viral pneumonia. One cat had fever. have decreased egg production.1. fatal disease. photophobia. some Asian lineage H5N1 strains caused slight and transient weight loss.57 Asian lineage H5N1 infections in pigs appear to be mild or asymptomatic.25. 47.Influenza Other subtypes can also be pathogenic to some wild birds. Canine influenza (H3N8) Canine influenza is an emerging disease in dogs.66 Similarly.188.8.131.52.67 Fatal infections have also been reported in some captive tigers and leopards. in canaries and a siskin141 and an H5N3 HPAI virus caused an outbreak with a high mortality rate among South African terns in the 1960s. respiratory disease.65. with evidence of interstitial pneumonia.48 and a few infected housecats were found dead.66 The clinical signs in severe cases included high fever.55 Captive palm civets had neurological signs. mice and cattle.61.11.3. 47 In contrast. asymptomatic infections were reported in housecats that had been accidentally exposed to a sick. tigers.132 In experimentally infected housecats.3.54 Other mammals may also be affected by Asian lineage H5N1 viruses.25. leopards and Asiatic golden cats were lethargic and had decreased appetites without respiratory signs for 5-7 days. serosanguineous nasal discharge.330 Equine influenza is sometimes complicated by secondary bacterial infections.47 One of the latter cats was apparently well up to 24 hours before its death. inappetence. dyspnea.1.46.68 Fatal respiratory disease was reported in infected raccoon dogs.253 Interstitial myocarditis can occur during or after the infection.25.168 Secondary bacterial infections prolong recovery.9 Some infections in palm civets were fatal.9 A wild stone marten was also found with neurological signs. ferrets.168 Death in adult horses usually results from bacterial pneumonia. An H7N1 (HPAI) virus caused conjunctivitis.330 Postinfection encephalopathy has also been reported in foals. Although fatal infections have been reported in some housecats.177. or produce abnormal eggs.253 Animals with partial immunity can have milder.66 One group reported that miniature pigs were resistant to infection. and lung lesions were much less severe than those caused by swine influenza viruses.253. dyspnea and death.1 The virus could be isolated for up to five days. H5N1-infected swan.253 In severely affected animals. the first sign is usually a high fever.330 There may be edema of the legs and scrotum.70 Equine influenza Equine influenza usually spreads rapidly in a group of animals.213 In this form.330 Healthy adult horses usually recover within 1-3 weeks. atypical infections with little or no coughing or fever. conjunctivitis.253.169.9. with a high mortality rate.168. depression. 168. encephalitis and hepatitis at necropsy. but other clinical signs were not seen. fever and transient anorexia were observed in some experimentally infected pigs. and enteritis (spasmodic impaction colic) has been reported in some epidemics.48. A dog that ate infected poultry developed a high fever.69 In ferrets.58 In another study. In naïve horses. infections in mice varied with the isolate and the route of inoculation (respiratory or intragastric). with panting and lethargy. lung lesions were reported at necropsy.63. captive lions. lethargy.67. and died the following day.9 HPAI H5N1 viruses have been isolated from wild pikas.49 Experimentally infected dogs have been asymptomatic or developed only transient fever and conjunctivitis. Mild respiratory signs including cough. protrusion of the third eyelid. The most common presentation seen with H3N8 viruses is relatively mild and resembles kennel cough. 25 Sequelae may include chronic pharyngitis. dry cough. pleuritis or purpura hemorrhagica.
sometimes progressing to loss of consciousness. coughing.91 The virus was a triple reassortant H1N1 swine influenza virus. sneezing.117.211 Sneezing.30.186.188 The infection is not usually fatal in adult animals.4. and severe pathological changes were seen in the lungs. which generally recover in five days to two weeks. 184.108.40.2060 Infected turkey flocks reported in Chile and Canada experienced only decreased egg production and reduced quality of the eggs. one cat became dyspneic and severely ill but recovered with medical care.211 Coughing can occur in the later stages of the disease.108. which may include fever.4.S.213 Asymptomatic seroconversion also occurs.127 An infected cheetah developed lethargy. and two cats died. 129 There is little information on cases in dogs.111 Experimentally infected pigs developed mild disease. with little sneezing.1-220.127.116.11.108. coughing. lethargy.322 Influenza viruses in ferrets Ferrets are susceptible to human influenza viruses. lethargy. crusting of the nose and eyes. but the novel H1N1 virus was isolated from sick animals in China.2.28. nasal discharge. with no mortality or other clinical signs. anorexia and a cough.127. and radiological evidence of pneumonia. which was diagnosed as bronchointerstitial pneumonia. in another.110.32 The disease.147.147 Severe..128 The dog in the U.113-116.178 The nasal discharge appears to resolve with antibiotics.K.184 The clinical signs in dogs experimentally infected with influenza C virus included nasal discharge and conjunctivitis.16.213 Lethargy and anorexia are common.118 Decreased egg production was also reported in a turkey flock in the U. sneezing.32 One dog died and several were euthanized.Influenza nasal discharge.114-116.174 The only known outbreak of H3N2 canine influenza was characterized by severe respiratory disease with fever. and swine influenza viruses can circulate in pigs with few or no clinical signs. sneezing. weight loss and labored breathing.1 Swine influenza Swine influenza is an acute upper respiratory disease characterized by a variety of clinical signs. depression. lethargy and weakness.187.177. anorexia. fever. coughing and nasal discharges occurred in experimentally inoculated dogs.125 Upper or lower respiratory signs including sneezing and coughing in some cases. was ill with clinical signs of lethargy. and the clinical signs have resembled those caused by other swine influenza viruses. nasal discharge and ruffled fur were reported in one study. page 21 of 46 .128 Respiratory disease has been reported in naturally infected ferrets.345 Coughing.123 Although some animals apparently had milder cases. weakness and decreased Last Updated: December 2009 © 2009 appetite have been reported. sneezing.103.28.179. which persisted for 10 days.103.119. The clinical signs may include fever.346 Diarrhea was reported in some experimentally infected animals.111.122 A single outbreak caused by a swine influenza virus has been reported in ferrets.147 Some outbreaks are more severe than others. but one death was reported. and pneumonia in others.119.122 Several ferrets recovered.1. sneezing. miniature pigs remained asymptomatic although they shed the virus. anorexia.122 In experimentally infected ferrets.321. nasal discharge. nasal discharge and weakness.74 Novel H1N1 virus of swine origin in mammals A number of swine herds have been infected with the novel H1N1 virus circulating in humans. an H3N8 equine influenza (American lineage) virus caused a limited outbreak among foxhounds in 2002. fever and coughing.323 In one study.188 More severe or fatal disease can be seen in neonates.133. purulent nasal discharge and coughing.321 The illness has been mild. potentially fatal bronchopneumonia is occasionally seen. but one died. which was used to infect dogs via close contact with horses.123. nasal discharge. suggesting that secondary bacterial infections may be important in this disease.124 and a dog in the U. conjunctivitis and/or abortions may also be seen. the clinical signs included fever.129 The illness lasted for several weeks in some animals.100. and severe dyspnea.129 Some cats with respiratory disease did not have a fever.188 Infections with the novel 2009 H1N1 (swine origin) virus have also been reported after contact with humans.100-111.120. was hospitalized and treated with supportive care including antibiotics.S.30.120. with little or no mortality. and the clinical signs included sneezing.178 More severely affected dogs exhibit a high fever with an increased respiratory rate and other signs of pneumonia or bronchopneumonia.149 Complications may include secondary bacterial or viral infections.185. listlessness.323.28 Other influenza viruses in dogs In the U.105. anorexia.173. but recovered. with nasal discharge.213 Some dogs have been found dead peracutely with evidence of hemorrhages in the respiratory tract. coughing and anorexia.213 The clinical signs can last for up to a month regardless of treatment.3 H9N2 influenza viruses in pigs An avian H9N2 virus caused respiratory disease and paralysis in pigs in southeastern China.262 and lethargy and weight loss. this syndrome has been seen in racing greyhounds.252 Abortions or diarrhea have also been seen in some herds. decreased appetite. sneezing and fever as the most prominent signs. 133 Four of five pet dogs seen at veterinary clinics died. The clinical signs (see previous section) appeared to be similar to those caused by human seasonal influenza viruses.32 Asymptomatic infections were reported in an experimental study with a Japanese H3N8 (Florida sublineage) isolate.S.18.104.22.168 Some severely affected animals died. was characterized by coughing.2. but does not seem to be prominent in pets.30.2. 133 Fever. have been described in cats. and recovered.
and for less than two weeks. and shedding for as long as 36 days has been reported in experimentally infected birds.61.26 Clinical signs in seals included weakness. however. respiratory signs.Influenza Natural infections with avian influenza viruses have not been documented.196. 2. anorexia. including birds.26. pigs. 189 According to yet unpublished research.189 Raccoons that were inoculated with a human H3N2 virus shed virus mainly from respiratory secretions.58.193 Influenza in marine mammals Influenza A viruses have been associated with outbreaks of pneumonia in seals and disease in a pilot whale.326 In one study. virus shedding has been described. foxes or cattle. diarrhea.57 A recent study suggests that raccoons may be able to transmit some influenza viruses.61.132 Limited animal-to-animal transmission was reported among tigers in a zoo. Mink naturally infected with a Canadian H3N2 swine influenza virus had respiratory signs including pneumonia. Chickens can begin shedding avian influenza viruses as soon as 1-2 days after infection.326 Experimental Asian lineage H5N1 virus infections in ferrets ranged from very mild upper respiratory infections to severe. Experimental infections with these viruses were milder or asymptomatic.226.132 Horizontal transmission was not observed in this instance. coughing.65. and were able to infect sentinel cats in close contact. and could infect other raccoons in contact.9 Communicability Influenza viruses are readily transmitted between animals in the species to which they are adapted. H5N1 viruses have been detected only in respiratory secretions.3. and ducks can shed these viruses for up to 30 days.66.61. the inoculation of an HPAI H7 virus from a fatal case in a Dutch veterinarian resulted in severe disease with fever. and nasal and ocular discharges.61.226 Waterfowl are often infected subclinically.324. incoordination.1.189 Raccoons that were experimentally infected with avian LPAI H4N8 or human H3N2 viruses shed these viruses but remained asymptomatic. asymptomatic cats appeared to shed Asian lineage H5N1 viruses only sporadically.50 Horizontal transmission of Asian lineage H5N1 viruses has not been reported inexperimentally infected dogs.196 In another experiment.67 Experimentally infected cats shed Asian lineage H5N1 viruses by the third day postinoculation. transient weight loss and respiratory signs. diarrhea and neurological signs. antibodies to H5N1 viruses have also been found among raccoons in Japan. ferrets infected with an H7N3 (LPAI) virus had only a transient elevation in temperature.16. anorexia. but did not have an elevated temperature. H4 and H10 viruses has been reported in wild raccoons. Limited animal-to-animal transmission seems to occur. and usually shed these viruses for 4-5 days or less after the onset of clinical signs. suggesting that co-infections may have increased the severity of the clinical signs.9 The clinical signs included anorexia. the signs were nonspecific and included extreme emaciation. under some conditions. with sneezing and shivering. with increased mortality particularly on ranches where the mink were co-infected with other pathogens. severe weight loss.144 Influenza in raccoons Serological evidence of infection with H1. nasal discharge.66-69 In experimentally infected dogs and pigs.324 Animals inoculated with avian H7 (LPAI and HPAI) viruses from recent outbreaks developed illness of varying severity. but ferrets have been infected experimentally with a few of these viruses. ferrets inoculated with influenza viruses from various species.189 page 22 of 46 .69 As of December 2009. the pathogenicity varied with the specific isolate and the route of inoculation (intranasal or intragastric). the recent isolation of H5N1 viruses from pikas suggests that these viruses may be maintained in this population.196 Although most viruses caused relatively mild illness with fever. an H10N4 avian influenza virus caused an epidemic on 33 mink farms in Sweden.227 Turkeys may excrete some avian influenza viruses for up to 72 days. fatal disease. naturally infected.66 Influenza in mink In 1984.222 Most chickens shed LPAI influenza viruses for only a week. and developed no other clinical signs. and typically shed the viruses for 7-10 days. developed rhinitis. dyspnea and neurological signs. and many mink died.329 Influenza B infections have been reported in some stranded seals.63.9 In the single known case in a whale. but whether clinical signs occur is unknown. but minimal intestinal shedding was also reported.1.329 A white or bloody nasal discharge was seen in some animals.65 In contrast. difficulty maneuvering and Last Updated: December 2009 © 2009 sloughing skin.94. these viruses were found in both respiratory secretions and feces.94 Horses begin excreting equine influenza viruses during the incubation period.147 Shedding up to four months has been documented in one pig.16. but a minority of the flock can excrete the virus in feces for up to two weeks. lethargy.53.9. sustained or prolonged transmission of Asian lineage H5N1 viruses has not been reported in any of these mammals.66 Some of these infections were fatal.66 The clinical signs in severe cases included high fever. 189 The H3N2 virus was not transmitted to uninfected raccoons.226 Pigs may begin excreting swine influenza viruses within 24 hours of infection. However. Raccoons that were experimentally infected with an avian LPAI H4N8 virus shed this virus in respiratory secretions but not from the digestive tract.25. extreme lethargy. dyspnea and subcutaneous emphysema of the neck. 66-68 but in experimentally infected foxes. weight loss. sneezing.329 The viruses appeared to be of avian origin. with the currently circulating Asian lineage H5N1 viruses. H3. Cats can shed these viruses from the intestinal tract as well as the respiratory tract.253 Animals that have been infected with influenza viruses from other species may or may not transmit the virus.
13. severe pulmonary congestion and edema.14 Some birds may have signs of acute renal failure and visceral urate deposition. In one study.48. conjunctivitis. Experimentally infected wood ducks had multiple petechial hemorrhages in the pancreas. and less frequently. beneath the lining of the gizzard.14 Lower respiratory tract lesions such as pneumonia are usually Last Updated: December 2009 © 2009 seen only in birds with secondary bacterial infections. especially when there is acute high morbidity in the flock. and they may exude fluid when cut.13 The ovary can be hemorrhagic in laying hens. hemorrhagic.13 The lungs may be reddened from hemorrhages and congestion.13 Yolk may be present in the abdominal cavity.142 Low pathogenicity avian influenza Rhinitis and catarrhal to purulent sinusitis are often seen in young birds infected with LPAI viruses. and sharply demarcated. but they are usually more extensive in the ventral regions. fluid (which may contain blood) in the nares and oral cavity.347 There may be subcutaneous edema on the head and neck.53 The lungs were also affected in experimentally infected cats. as well as enlarged mandibular and/ or retropharyngeal lymph nodes.13 The oviduct may also be edematous. and the comb and wattle are often edematous.58 In one study. and in the intestinal mucosa.14.Influenza Post Mortem Lesions Click to view images High pathogenicity avian influenza The lesions in chickens and turkeys are highly variable and resemble those found in other systemic avian diseases. tracheitis. house finches and budgerigars despite high mortality rates in these species. and severe hemorrhagic pancreatitis have been reported in naturally infected cats.65 These lesions were similar whether the cats were infected intratracheally or by the ingestion of infected chicks. 66 Experimentally infected foxes also developed lesions mainly in the lung. on serosal surfaces and on the peritoneum.13.136 More extensive lesions were reported in experimentally infected laughing gulls. the liver lesions were accompanied by generalized icterus. with mild to moderate bronchiolitis and alveolitis detected on histopathologic examination.14. intestines. 69 Swine influenza In uncomplicated infections. swelling and hemorrhages of the conjunctivae. edema of the wattles and/or neck. subepicardial hemorrhages. renal and splenic congestion. The peritoneal cavity often contains yolk from ruptured ova.49 Pulmonary lesions including interstitial pneumonia have been noted in some experimentally infected pigs. petechial hemorrhages were found in the ventriculus.13 The ovaries may be hemorrhagic or degenerated. pneumonia. the gross lesions included severe pulmonary consolidation and multifocal hemorrhages in multiple organs including the lung. the tracheal lesions may be limited to excess mucoid exudate.65 Petechial hemorrhages occurred in the liver of some cats. cerebral. and congestion.13. and they can sometimes be found in the muscles. and can cause severe air sacculitis and peritonitis. with exudates in the lumen.13.13 Congestion and inflammation may also occur in the trachea.2 Affected parts of the lungs are depressed and consolidated.65 In naturally infected tigers and leopards. dark red to purplered. lymph nodes. hemorrhages in the intestinal serosa. which may cause severe airsacculitis and peritonitis.4 Severe pulmonary edema.4 Lesions may be found throughout the lungs.46 Bloody nasal discharge.2. stomach. as well as serous or serofibrinous pleuritis.4 The bronchial and mediastinal lymph nodes are typically edematous but not congested.348 Mild or absent gross lesions were reported in experimentally infected zebra finches. cerebrum and pancreas. edema and diffuse subcutaneous hemorrhages on the feet and shanks.14 Avian H5N1 influenza viruses in mammals Pulmonary edema.4 The airways are often dilated and filled with mucopurulent exudate.347 Postmortem lesions have occasionally been described in wild birds infected with Asian lineage H5N1 viruses.347 Birds that die peracutely and young birds may have few or no lesions.347 Hemorrhages may also be seen on the mucosa and in the glands of the proventriculus. the lungs. in these birds. congested and/or cyanotic. Asian lineage H5N1infected pigs had mild to minimal gross lung lesions. and congestion of the spleen. one study reported that the most consistent lesions were multifocal hemorrhagic necrosis in the pancreas. in others.13. apex of the heart.2. 69 More severe lesions were seen in foxes inoculated intratracheally than in animals fed infected birds. multifocal hepatic necrosis.13.14 Hemorrhagic tracheitis can be seen in some birds.14.13 Petechiae may be noted throughout the abdominal fat. with multiple to coalescing foci of pulmonary consolidation. 4 Some strains of swine influenza viruses produce more marked lesions page 23 of 46 . and in one cat. the gross lesions are mainly those of a viral pneumonia.63. and pulmonary congestion and edema. thymus.4 Other parts of the lungs may be pale and emphysematous. or petechial hemorrhages in the proventriculus may be particularly suggestive of an HPAI infection. with areas of necrosis.136 In naturally infected swans. with involuted and degenerated ova.13 A study of the 2003 H7N7 outbreak in the Netherlands suggested that the occurrence of peritonitis.10. liver and lymph nodes. may also be seen. heart. and some of these animals also had histopathologic evidence of encephalitis and myocarditis.13 The kidneys can be severely congested and are sometimes plugged with urate deposits.347 In other cases. 47. perirenal tissue and/or diaphragm. kidney and liver were reported in a naturally infected dog. cats infected by ingestion also had enlarged tonsils with multifocal petechial hemorrhages.2. the sinuses may be swollen. 319 Pancreatic lesions alone or no gross lesions have also been seen in some swans.
28. tracheal and cloacal swabs (or intestinal contents). bronchiolitis.330 Ventral edema of the trunk and lower limbs can also occur. and severe multilobular bronchiolitis and alveolitis.184 Mild to moderate thickening of the alveolar septa was also seen. intestine.19 These viruses can be recovered from oropharyngeal. but there was no evidence of severe hemorrhagic pneumonia.19 Viral antigens can be detected with ELISAs including rapid tests.136 Swine influenza Last Updated: December 2009 © 2009 page 24 of 46 .349 Serological tests including agar gel immunodiffusion. in some cases. bronchitis and bronchiolitis have been reported in fatal cases.253 Canine influenza In dogs that die of canine influenza (H3N8).14.28. lungs. and organ samples (trachea.170.19 RT-PCR assays can identify avian influenza viruses in clinical samples. some serological tests may underestimate the prevalence of H5N1 infections.253. hemorrhages may be found in the lungs.19 Oropharyngeal.13 In wild birds.26.25. 19 Some rapid tests. Diagnostic Tests Avian influenza Avian influenza can be diagnosed by a variety of techniques including virus isolation. mediastinum and pleural cavity. but hemagglutination inhibition tests are subtype specific and may miss some infections.13. are used to differentiate LPAI from HPAI viruses.329 In a single case in a whale. cannot be collected without harming the bird). 133. focal areas of pulmonary discoloration and pervasive discoloration of the liver. kidney.9 The gross lesions in ferrets inoculated with zoonotic avian H7 viruses ranged from mild pulmonary lesions to widespread hemorrhages. have been reported with some strains.19. hemagglutinating activity indicates the presence of influenza virus. Feces can be substituted in small birds if cloacal samples are not practical (e. and cranioventral lung consolidation was rarely seen. which are most often seen in young foals.213 There is limited information on the lesions found in mild cases. 117 Equine influenza The gross lesions are typically those of an upper respiratory infection (including nasal discharge).213 On histological examination.Influenza than others.173 The lungs may exhibit signs of severe pneumonia.14. and can replace virus isolation in some cases.184 The histopathologic lesions included severe multilobular or diffuse necrotizing tracheobronchitis. pneumonia with necrotizing bronchitis.173. the bronchial lymph nodes were edematous. rubbery texture and areas of bronchiopneumonia were reported in pigs experimentally infected with the novel H1N1 virus. suppurative secondary bacterial pneumonia may be seen alone. 253 Severe necrotizing myocarditis.19 Real-time RT-PCR is the method of choice for diagnosis in many laboratories.170. bronchiolitis and hemorrhagic alveolitis has been reported.19. peritonitis and interrupted follicular development were the only lesions reported in turkeys.173.213 Hemorrhagic lesions are not always present in fatal cases.13. were evaluated and compared in a recent review.14.30 Fibrinous pleuritis may also be noted.349 As of 2008.. bronchitis.133 Influenza in other mammals In seals infected with avian influenza viruses. liver and heart) are tested in dead birds.184 No lesions were found outside the respiratory tract.19 Virus isolation is performed in embryonated eggs.213 In animals that were inoculated with Korean H3N2 viruses isolated from dogs. AGID tests can recognize all avian influenza subtypes in poultry.213 The most severely affected puppies had small focal areas of pulmonary hemorrhage scattered throughout the lungs.13. serology can be valuable for surveillance and to demonstrate freedom from infection.196 The extent of the lesions varied with the isolate. there may be tracheitis. hemagglutination inhibition and ELISAs are useful as supplemental tests. together with genetic tests to identify characteristic patterns in the hemagglutinin. including a diffusely non-collapsed parenchyma. hepatic congestion and pulmonary consolidation were reported in one outbreak of severe disease in swine. AGID tests are not reliable for detecting avian influenza in ducks or geese. and are often accompanied by enlargement of the lymph nodes of the head.g. Avian influenza viruses are subtyped with specific antisera in AGID or hemagglutination and neuraminidase inhibition tests. and severe interstitial or bronchointerstitial pneumonia.173.253 Interstitial pneumonia.13.349 These tests can also distinguish some subtypes. and can be dark red to black. hemagglutination. air sacs.19 Although most gallinaceous birds and other susceptible birds die before developing antibodies. multifocal to coalescing reddish consolidation was found in the lungs.13.133.1 Novel H1N1 virus of swine origin Typical swine influenza lesions in the lungs. as well as catarrhal or hemorrhagic enteritis. spleen. including various PCR assays. the lungs were hemorrhagic and a hilar lymph node was greatly enlarged.13. the World Organization for Animal Health (OIE) recommended that antigen detection tests be used to identify avian influenza only in flocks and not in individual birds. brain.323 Salpingitis.19 The virus can be identified as an influenza A virus with agar gel immunodiffusion (AGID) or ELISAs. tracheal and/ or cloacal swabs in live birds. In experimentally infected puppies with this form.19 Virulence tests in susceptible birds.2 Generalized lymphadenopathy.329 Acute interstitial pneumonia was seen in mink infected with a swine influenza virus.
213.S.350 Virus isolation may also be successful in some dogs. and from nasal or pharyngeal swabs taken from acutely ill pigs. 133 In experimentally infected dogs. most dogs are not expected to have pre-existing titers to the canine influenza virus.213. using paired serum samples. Treatment Animals with influenza are usually treated with supportive care and rest. peak virus shedding is thought to occur during the first 24 to 48 hours of fever. ferrets have been treated with amantadine as well as antihistamines.185 Antiviral drugs could also be of use in valuable horses.3. but only during the early stages of disease before antibodies develop.168 In horses. 133 RT-PCR can also detect this virus.3.213 However. In horses. the disease is confirmed by virus isolation.168.28.350 Because canine influenza is an emerging disease.169.147 Immunofluorescent techniques can detect antigens in fresh lung tissue. or most other countries. nations may consider vaccination as a preventative or adjunct control measure during an outbreak. horses. 213 Virus neutralization (microneutralization test) can also be done. virus recovery should be attempted in both embryonated eggs and cell cultures.169 Equine influenza viruses can be isolated from nasopharyngeal swabs or nasal and tracheal washes.213.2 ELISA kits are available.25.13. single titers are still considered to be less useful.3..213 The H3N8 canine influenza virus can be found in lung tissue samples taken post-mortem. samples should be collected within the first 3-5 days after the onset of clinical signs. probably because the amount of virus shed is low. however. these viruses were shed in nasal secretions from one to six days after inoculation.177.352 The vaccines do not always prevent infection or virus shedding.2.350 The H3N8 canine influenza virus has been isolated in both embryonated eggs and cell cultures (MDCK cells) 213.4.169 Equine influenza can also be diagnosed retrospectively by serology. these tests may be able to detect H3N8 canine influenza during outbreaks at kennels or other large facilities.168 As in swine. they seem to be particularly important in the treatment of canine influenza.25.147 Swine influenza viruses are often recovered in Madin–Darby canine kidney cells.168. in some countries.4. Influenza vaccines may change periodically to reflect the current subtypes and strains in a geographic area. Antigen-capture ELISA tests do not seem to be reliable in individual dogs.177.19. 213. birds.25.14. dogs and. Some H3N2 viruses were isolated from nasal swabs taken from dogs during an outbreak.14. the detection of viral antigens (e.2.147 These viruses can be isolated from lung tissues at necropsy. Uncommonly used serological tests in swine include agar gel immunodiffusion.25.147 Equine influenza Equine influenza may tentatively be diagnosed based on the clinical signs.168.2.2. the indirect fluorescent antibody test and virus neutralization.147 Recovery is best from an animal with a fever.25. 24-48 hours after the onset of illness..147 RT-PCR assays are used to detect viral RNA.4 The hemagglutination inhibition test. is most often used.4. the detection of viral antigens or nucleic acids. nasal swabs have been more likely to yield virus than nasopharyngeal swabs. swine and equine viruses display less antigenic drift than human viruses. nasal epithelial cells or bronchoalveolar lavage.4. 133 Serology is expected to be useful. but other cell types can also be used.169 Canine influenza At this time.169 Ideally.1.350 RT-PCR is the most reliable method to detect the virus directly.11 Prevention Vaccines Influenza vaccines are available for pigs. by ELISA).168. avian influenza vaccines are used most often in turkeys and are intended only to prevent infection by LPAI viruses. Mammalian influenza viruses can be isolated in embryonated chicken eggs or cell cultures. which is subtype specific.169 The most commonly used serological tests in horses are the hemagglutination inhibition test and a single-radial hemolysis (SRH) test.147 Other antigen detection tests include immunohistochemistry on fixed tissue samples. serology and RT-PCR are the most reliable methods for detecting H3N8 canine influenza.253 Antibiotics may be used to control secondary bacterial infections.147.25 In the U. but virus isolation fails to detect the virus in many infected dogs that do not die of the disease.10. but this test is usually too cumbersome for routine use.2. whenever possible. and these vaccines are changed less often. however.213 Little is known about testing for Korean H3N2 viruses in dogs.353 Avian vaccines are usually autogenous or from viruses of the same subtype or page 25 of 46 .350 In experimental infections. and ELISAs.4. antibiotics and other supportive therapy.g.19 HPAI vaccines are not used routinely in the U.147 It may not detect new viruses. prolonged recovery and more severe disease have been associated with increased stress.179 Antiviral drugs are not generally given to most animals.147 Serology on paired samples can diagnose swine influenza retrospectively.25.25.147 Isolated viruses can be subtyped with hemagglutination inhibition and neuraminidase inhibition tests or RT-PCR. and serology. or the detection of nucleic acids by RT-PCR. In general.2. but the disease is usually milder if it occurs.350 Hemagglutination inhibition is the most commonly used serological test.3. however. 213 This test can be used on nasal swabs Last Updated: December 2009 © 2009 from live animals or lung tissue samples at necropsy.2.S.213.351 Poultry flocks infected with HPAI viruses are depopulated and are not treated.213. 213 Acute and convalescent titers should be submitted if possible.Influenza Swine influenza can be diagnosed by virus isolation.
Influenza hemagglutinin type. increased poultry trade during winter festivals.4. LPAI viruses usually result in mild or asymptomatic infections.359 The risk of infection can be decreased by all-in/ all-out flock management. some of the Asian lineage H5N1 viruses have caused outbreaks with high mortality rates.147. influenza is usually introduced into a facility in a new animal. In mammals.353-355 Methods used to recognize infections with field viruses in vaccinated flocks include “DIVA” (differentiating vaccinated from infected animals) strategies.11. good hygiene. low mortality rates and rapid recovery.94 Infected swine herds can be cleared of influenza viruses by depopulation. particularly birds and humans.216 Mammals should not be fed poultry or other birds that may be infected with the avian influenza viruses. In pigs and horses.16.10. include inactivated whole virus and recombinant fowlpox.357 Other preventative measures Poultry can be infected by contact with newly introduced birds or fomites. however. as well as by contact with wild birds. these infections are reportable to the OIE. In poultry.15 Illegal poultry movements may be of primary importance in transmission in some regions.3.119-124. 3.73. in a number of countries.319 High mortality rates have been reported in some but not page 26 of 46 . Because H5 and H7 LPAI viruses can mutate to become HPAI viruses.51. and the use of sentinel birds.13.11. strict hygiene and biosecurity measures are necessary to prevent virus transmission on fomites.168 Similarly to birds. good biosecurity is important.15. and the public should be restricted from entering swine operations. the virus usually persists in the herd and causes periodic outbreaks. prolong recovery and result in complications such as pneumonia.330 Secondary bacterial infections can exacerbate the clinical signs. but may also mimic HPAI viruses. The use of these vaccines requires the approval of the state veterinarian and. high pathogenicity avian influenza has very high morbidity and mortality rates. During outbreaks of H5N1 avian influenza.11 The outbreak is managed by quarantine.168.13 Any surviving birds are usually in poor condition.2-4.187 If contact is unavoidable. Because vaccines may allow birds to shed virus while remaining asymptomatic.25. Felids (including housecats and a cheetah) and dogs have Last Updated: December 2009 © 2009 also been infected with the novel H1N1 virus from humans.18.16.15 Keeping flocks indoors is often recommended in areas where the H5N1 virus has been isolated from wild birds.1-4. may be helpful.2. but outbreaks with high pathogenicity H5 and H7 viruses are also seen occasionally.25 Good hygiene can keep the virus from spreading on fomites.12.25 Infected facilities should be cleaned and disinfected after the outbreak. quarantines and isolation of infected animals help prevent virus dissemination.71. an outbreak that began at Qinghai Lake in central China resulted in the death of more than 6000 migratory wild birds. Avian influenza Avian influenza outbreaks occur in most countries including the U.127-129 Eradication and prevention of virus transmission during outbreaks During an outbreak of influenza among mammals.355. cleaning and disinfection.1.S.16.15 In addition.13.72. and by preventing any contact with wild birds or their water sources. 283 In domesticated poultry (particularly chickens). in the case of H5 and H7 vaccines.1. Poultry should not be returned to the farm from live bird markets or other slaughter channels. To prevent human influenza viruses from entering a herd. cats and dogs should be kept indoors whenever possible.10.283 The reason for the seasonality is unknown. and people with influenza should avoid contact with this species.168 Pigs should also be protected from the influenza viruses found in other species. Low pathogenicity forms occur most often. and surveillance around the affected flocks. uncomplicated infections are usually associated with high morbidity rates. and wild bird movements. up to 90-100%.12 Asian lineage H5N1 viruses have also been isolated sporadically from other dead birds.19 Currently licensed vaccines in the U. as well as the use of face masks and/or other measures to prevent droplet transmission from coughs and sneezes.170. swine workers who are ill should avoid contact with pigs.353. and are being controlled similarly in many countries.356 Vaccination may place selection pressures on avian influenza viruses.73 In April 2005.19 High mortality is occasionally seen in young ostriches infected with either LPAI or HPAI viruses.94 Isolation of newly acquired animals can decrease the risk of transmission to the rest of the herd.12.360 Once a herd of swine has been infected with a swine influenza virus. however. this virus has tended to reemerge during colder temperatures in the Northern Hemisphere.45 They should also kept from contact with potentially infected flocks and wild birds. and might eventually result in the evolution of vaccine-resistant isolates.13.11 Seasonality has been reported in the current H5N1 epidemic.140 Symptomatic infections are unusual in wild birds.S.10-12. but it may be the result of multiple factors such as increased virus survival in the cold.2. Rest decreases virus shedding in horses. good management can decrease the severity of disease.358.3.H5 vaccines. outbreaks of high pathogenicity avian influenza are controlled by eradication. particularly waterfowl and shorebirds.94 Ferrets can be infected by human influenza viruses (including the novel H1N1 virus).19 Morbidity and Mortality The severity of an influenza virus infection varies with the dose and strain of virus and the host‟s immunity. good surveillance and movement controls are critical in a vaccination campaign. including waterfowl.10.54.4.354. depopulation. USDA approval. Strict hygiene is necessary to prevent virus transmission on fomites.
3. B and C viruses.9. but little or no mortality has been seen. pigs can be infected with human influenza A.56 Although Asian lineage H5N1 viruses have been reported in pigs. palm civets and experimentally infected ferrets9. and four died.136 Four of six infected wood ducks also became severely ill while two others remained asymptomatic.22.214.171.124.1. deaths have not been reported among experimentally infected pigs. Asiatic golden cats and lions at a wildlife rescue center in Cambodia all recovered after an illness lasting 5-7 days. Fatal cases were reported in some naturally infected housecats. but all house sparrows experienced mild disease and survived. Mallard. In an unpublished study from Thailand.16. the mortality rate was 66-100% in house sparrows.16 High seroprevalence rates to swine influenza viruses have also been reported in other countries. typical signs of influenza may occur in only 25% to 30% of the pigs.323. and in temperate regions.1. the severity of the clinical signs varied with the specific isolate and the route of inoculation (intranasal or intragastric).68 In experimentally infected ferrets and mice.S. 49. blue-winged teal and redhead ducks inoculated with the same viral strains did not become ill.108.25%) had been exposed to H5N1 influenza viruses in 2004. but captive leopards.28 In Japan. 147 In the 1918 epizootic.54 Asymptomatic or mild infections have been reported in experimentally infected dogs.102-104. northern pintail. house finches and budgerigars.108. 61. and can survive in a few carrier animals for up to four months. antibodies to these viruses were found in 8 of 11 cats and 160 of 629 dogs.132 Few of these cats shed virus. but no deaths were seen in starlings. and some experimentally infected cats exhibited severe disease and high mortality rates.60 Swine influenza Influenza is a major cause of acute respiratory disease in finishing pigs.59 In contrast.94 Annual outbreaks are often seen. deaths have been reported in housecats. mortality rates approached 100% in zebra finches.. it usually persists in the herd.2 Viruses may also infect the herd with few or no clinical signs.65 In contrast.58 Asian lineage H5N1 viruses have also been detected in swine in Last Updated: December 2009 © 2009 Indonesia. secondary infections or cold weather. some large felids.132 Similarly.107.94 Influenza epidemics can occur if a virus infects a population without immunity to the virus. stress.Influenza all experimentally infected wild birds.1. In one study.1. and none became ill despite the presence of other viral and bacterial infections.55.16 Approximately 10% of the pigs were seropositive for influenza C viruses. and high stress levels in this population.252.61.345. or if the infection is exacerbated by factors such as poor husbandry. but only sporadic infections with the human influenza B viruses were found.4.147 In uncomplicated cases. and thousands of the infections were fatal. but one death was reported in a naturally infected dog.16.201 In the U.8 Swine influenza viruses are usually introduced into a herd in an infected animal.4 Once the virus has been introduced.16. there are no reports of severe illness among swine.46. asymptomatic infections were reported in cats exposed to an infected swan in an animal shelter.66 Interestingly. A serological study conducted in Vietnam found that a low percentage of pigs (0.136 Morbidity and mortality rates in passerine and psittacine birds have varied with the species. there is no evidence that HPAI H5N1 viruses are causing significant illness among infected pikas in China.5. the case fatality rate has ranged from less than 1% to 4%. a similar study found antibodies to the type C viruses in 19% of pigs.346 Decreased egg production may be the main effect in turkeys.1-6. Approximately 25-33% of 6-7 month-old finishing pigs and 45% of breeding pigs have antibodies to the classical swine H1N1 virus in the U.47. fatal cases were reported among captive tigers and leopards in Thailand.66 However. no antibodies were detected in 171 cats from areas of Austria and Germany where infections had been reported in wild birds.1. Experimental infections also suggest that the clinical signs may be mild in this species. millions of pigs developed influenza.56 and these viruses have been isolated rarely from pigs in China. Morbidity rates from less than 1% to as high as 90% have been reported.16 In the epidemic form.45-126.96.36.1990.94 Maternal antibodies decrease the severity of disease in young pigs.2.50.9.K.16.321 Experimental studies support this view. In a turkeys flock in Chile. the morbidity rate was page 27 of 46 . the virus spreads rapidly in pigs of all ages.1 Novel H1N1 virus of swine origin The H1N1 virus circulating in humans appears to cause mild disease in pigs.67.58 However. a study found antibodies to both swine and human influenza viruses in 14% of all pigs. a dog. In one study.142 In a study with a different Asian lineage H5N1 virus.66 and miniature pigs were resistant to infection in one study. both mild and severe cases have been reported in several of these species.57 and Asian lineage H5N1 viruses isolated from Indonesian pigs were less virulent in mice than isolates from poultry.2.4.103. all six laughing gulls infected with recent strains of H5N1 became severely ill. up to 100% of the animals may become ill but most animals recover within 3-7 days if there are no secondary bacterial infections or other complications.94 Many infections in endemically infected herds are subclinical.107.111116. occur mainly during the colder months.1.361 Some infections with Asian lineage H5N1 viruses have been fatal.136 Three of the sick ducks died and one recovered.3.63. severe disease does not seem to occur in this species.53.16 In addition. 317 Avian H5N1 influenza in mammals Asian lineage H5N1 viruses have been reported in a variety of mammalian species. raccoon dogs. and all starlings remained asymptomatic. 24. tigers.58.2.94 In a newly infected herd.8.
Influenza in other mammals In 1984. crowding and transportation are typical risk factors for disease.1.176.183. 91 In seals. is not yet known.000 mink.168.310. a Yorkshire terrier and two Jindo dogs ( a Korean breed of hunting dog). but no deaths were seen.179 Higher case fatality rates have been reported in small groups of greyhounds.330 Higher mortality rates have been reported in foals. influenza outbreaks are not as seasonal as they are in pigs or humans. with morbidity rates of 60-90% or greater.123.25.180. in naïve populations. donkeys and zebras. In 1989. and clinical signs can occur in 60-80% of the dogs infected.25 Close contact with other horses.Influenza 61%. another developed severe illness with dyspnea but recovered with medical care. most of the population is expected to be fully susceptible. although coughing can persist.3. the case fatality rate was estimated to be 20% in one outbreak with an H7N7 virus. It had no recent history of respiratory disease.177.170 The virus appeared to be an avian influenza virus. Similarly. Because dogs have not been exposed to the canine influenza virus before.25.S. 170 Widespread epidemics can be seen. a novel strain of equine influenza [A/eq/Jilin/89 (H3N8)] caused a serious epidemic in Chinese horses.28. turkey flock.127-129 Several ferrets recovered. was ill with pneumonia.168. the morbidity rate was 8% and the mortality rate was 0. and may have been infected there. and recover. A related virus caused influenza in a few hundred horses the following year but there were no deaths.179. if it exists at all. a cocker spaniel.1 Explosive epidemics in seals are thought to be exacerbated by high population densities and unseasonably warm temperatures. egg production dropped by approximately 80%.1. It affected 33 farms and killed 3. and required hospitalization and supportive care.9 In an outbreak caused by a triple reassortant H1N1 swine influenza virus in ferrets.330 In horses. as well as 13 dogs of unknown breed at an animal shelter.129 An infected dog in the U. Canine influenza Canine H3N8 influenza was first reported in racing greyhounds and. a more severe form with pneumonia may occur in a minority. cases are seen mainly in young and newly introduced animals.25. appeared to be confined to this breed.253. at first. The fate of the dogs in the animal shelter was not stated. H3N8 canine influenza has been seen in a variety of breeds at veterinary clinics and animal shelters in several states.28. in Canada.25 Most outbreaks are associated with sales.177. with a mortality rate of 3%. but one died.25.30.S. and are usually the result of secondary bacterial infections.168.121. races and other events where horses congregate.253 The H3N8 viruses usually cause more severe disease than the H7N7 viruses. healthy adult horses usually recover within 1-3 weeks. the overall mortality rate is thought to be 1-5%. but recovered.213 Most dogs are expected to develop the less severe form of the disease.119. new evidence suggests that the H3N8 virus may Last Updated: December 2009 © 2009 have been circulating in U. greyhound populations as early as 1999. 25 In populations that have been previously exposed.28. 25 Avian influenza viruses have rarely been reported in horses.1.25. in affected turkey flocks in Canada. The H3N2 virus has been reported from outbreaks at three veterinary hospitals and a kennel in South Korea.25 Deaths are rare in adult horses.178 In kennels.363 More recently. however.120.178. however. a survey found antibodies to the H3N8 virus in only one of 225 dogs in 2006.330 In 1987. animals in poor condition. an equine influenza epidemic in India affected more than 27.122 Two infected cats died.1.133 Only one of the five dogs seen at veterinary clinics survived. The avian-like virus continued to circulate in horses for at least five years without further fatalities.25.362 Decreased egg production and no mortality were reported in a U.S.1 The morbidity rate was nearly 100%.213 All dogs regardless of breed or age are now considered to be susceptible.177.213 Although this disease was first reported in 2004.329 and they may be more severe if the animals are co-infected with other pathogens. an avian H10N4 virus caused an outbreak on Swedish mink farms. it may have been unrelated to the H1N1 infection. the case fatality rate was 36%.000 animals and killed several hundred.179.173. pet ferrets and dogs have been infected naturally with the novel H1N1 virus. severe disease is more likely in dogs that are in poor condition or are concurrently exposed to other pathogens.S.9 Internet Resources page 28 of 46 .1.364 This dog was a greyhound that had come from a racetrack in Florida. ferrets and nonhuman primates suggest that this virus might cause more severe lung pathology and/or clinical signs than seasonal human H1N1 viruses. 133 Cases were described in a miniature schnauzer. 178. or that the illness might last longer.118 Although a slight increase in flock mortality occurred in the latter case. tracheal clearance rates can be depressed for up to a month after infection.117 Egg production in this flock dropped from 70% to 31%.213 In dogs with severe disease.119-124. One study suggests that canine influenza is rare.170 The morbidity rate was at least 80% and the mortality rate was 20-35%. and some cats apparently had milder cases.125 A few cats.262.128 Experimental studies in mice. In the province of Ontario.25 Unless there are complications.213 The prevalence of this disease in the U. and 4% in an outbreak with an H4N5 virus.322 Equine influenza In horses.28 High case fatality rates are not expected in most canine populations.179. the infection rate may reach 100%.6%.181.213 At one Florida greyhound racetrack.
usda. H1N1 Flu (Swine Flu) http://www.gc.int/eng/normes/mmanual/a_summry.aphis.oie. Suzuki H. 9.jsp United States Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS). Prevalence of antibody to influenza C virus among pigs in Hyogo Prefecture. Japan. Accessed 19 Jan 2007.int/csr/disease/avian_influenza/en/ World Organization for Animal Health (OIE) http://www. Line S. Foreign Animal Diseases.php PHAC. Interspecies transmission of influenza C virus between humans and pigs. Hannoun C. 155-72. Studdert MJ. Recommendations of the Advisory Committee on Immunization Practices.utmb.gov/h1n1flu/ CDC.cdc. Villar E.org/publish/articles/000041/print.16:367-71.usda. Serological studies of influenza viruses in pigs in Great Britain 1991-2. 580. Itoh M.aphis. Available at: http://www. Beard CW. 1997. 4. NJ: Merck and Co. 2003 Sept 15. 6.com/pubs/mmanual/ The Merck Veterinary Manual http://www. 10.gc.cdc. VA: United States Animal Health Association. Veterinary virology.int/ OIE Manual of Diagnostic Tests and Vaccines for Terrestrial Animals http://www. 7. 3rd ed.merckvetmanual. Heinen P. Available at: http://www. Biosecurity for the Birds http://www. Avian influenza. 2006.htm OIE Terrestrial Animal Health Code http://www.usgs. Kimura H.merck.usda. Nakamura K. 1993.html The Merck Manual http://www. 1991. Swine influenza.merckvetmanual.htm References 1.ht ml. Abiko C. 1995.usda. Rev Sci.gov/wps/portal/!ut/p/_s. Influenza. Accessed 26 Aug 2004. Epidemiol Infect. Muraki Y. Harris PA. http://www. Hongo S. Kahn CM.htm Public Health Agency of Canada (PHAC). Kitame F.usaha.gov/mmwr/preview/mmwrhtml/rr5510 a1. Acha PN. The Merck veterinary manual [online].aphis.pdf United States Geological Survey. p.com/mvm/index. Reperant LA. Zoonoses and communicable diseases common to man and animals.shtml Centers for Disease Control and Prevention (CDC). H1N1 Flu Virus http://www.shtml USDA APHIS.inspection.jsp. Swine influenza: a zoonosis.oie. editors. 1987. 5. Manuguerra JC. Seasonal influenza (flu). Avian Influenza http://www.oie.gov/disease_information/avian_ influenza/affected_species_chart. Murphy FA.gov/animal_health/birdbiosecur ity/ USDA APHIS. San Diego.gov/flu/avian/ CDC.com/mvm/index. 3. p. Avian Influenza.phac-aspc. Tech.gov/flu/ Medical Microbiology http://www.org/pubs/fad.7_0_A/7_0_1 OB?navid=AVIAN_INFLUENZA&navtype=SU USDA APHIS. List of species affected by H5N1 (avian influenza) http://www. Szyfres B (Pan American Health Organization 309).gsbs.48:71-9. p.Influenza Canadian Food Inspection Agency. Last Updated: December 2009 © 2009 page 29 of 46 . http://www.edu/microbook Prevention and Control of Influenza.who. http://www. Brown IH. CA: Academic Press Inc. Cabezas JA. 2. J Gen Virol.gc. Simon F.cdc.usda. Kuiken T. In: Foreign animal diseases. Numazaki Y.gov USDA APHIS.ca/english/anima/disemala/s wigri/queste.gov/wps/portal/?navid=USDA_H1N1 United States Animal Health Association.int/eng/normes/mcode/A_summry.gov/newsroom/hot_issues/avian _influenza/avian_influenza.phac-aspc. Rimmelzwaan GF. Richmond.ca/msds-ftss/index. White DO.htm.cdc. Hotta H.72:711-4. Orthomyxoviridae. 2003. 1998. Fenner F. Yamaoka M. Sugawara K. Avian influenza viruses in mammals. Mizuta K. Avian Influenza Portal http://www. Virus Res. Material Safety Data Sheets http://www. rickettsioses and viroses. 2009:28(1):137-59. National Wildlife Health Center. 2006 http://www. H1N1 Flu Virus (Human Swine Influenza) Questions and Answers [includes biosecurity and waiting period recommendations for veterinarians examining potentially infected herds] http://www. Whitehouse Station.ca/alert-alerte/h1n1/indexeng. 473-484. Homma M. Chlamydiosis. Washington DC: PAHO. Volume 2. H1N1 Flu http://www. 8..114:511-20. World Health Organization http://www. Alexander DJ. Natural infection of dogs by influenza C virus: a serological survey in Spain. 71-80. http://www.vetscite.nwhc. Bachmann PA. Gibbs EPJ. New Microbiol. Peng G. Vet Sci Tomorrow [serial online].jsp?cfile= htm/bc/121407. Scientific and Technical Publication No.
31. Serologic evidence of H1 swine influenza virus infection in swine farm residents and employees. Available at: http://www. Gray GC.35:161-5. Avian influenza (“bird flu”) fact sheet [online]. 2005. 2003.310:482-5. Komadina N. 2003. Fiorelli P. Olsen CW.ivis.htm. Thawatsupha P. editor. Enserink M. Bowman SJ. Rev Sci Tech. Klimov AI.asp. U. Epidemiology of low pathogenic avian influenza viruses in wild birds. RimandoMagalong J. Accessed 1 Dec 2009. Jin G. Nowotny N. Arden N. Avian influenza. Centers for Disease Control and Prevention [CDC]. 1984.ch/gent_abstracts/Alexander. 2006 Feb. Avian influenza. Sporadic occurrence of zoonotic swine influenza virus infections. Nature. VS. 21. Florida. 29. © 2009 Last Updated: December 2009 page 30 of 46 . 23. FL: United States Animal Health Association. avian & human influenza viruses [monograph online]. Clin Infect Dis. 32. Accessed 30 Aug 2004. Olsen CW.html.htm. 27. Waicharoen S.htm. 2002 Feb. Emerg Infect Dis. 24. Young JF.Influenza 11. 30.8:814-9.S. 13.cdc. Katz JM. Wang R. Cox NJ.sciencemag. Bean WJ. Bomasang E. Science Now. 2007. Medina M-J. 17. 22. Hinshaw VS. Chen L.usda.sciencemag. Barr IG. Donis RO. Ithaca NY: International Veterinary Information Service 189. Myers KP. 04_AI. In: Lekeux P. Kahn CM. Department of Agriculture. Olsen CW. editors. Fanning TG. Part 1: swine. Avian flu [Website online]. Smith C.14(3):461-4.51:863-5. Emerg Infect Dis. Avian influenza. Dubovi EJ. Available at: http://www. Science. 2009. NJ: Merck and Co.pdf. Line S. 15.03. Accessed 27 Sept 2005. Taubenberger JK. p. poultry [online]. Johnson CM. Stephenson I.esvv.org/special_books/Lekeux/toc. 12.aphis. Veterinary Services [USDA APHIS.com/influenza. Lourens RM. 18. Baker I. Transmission of equine influenza virus to dogs. Highly pathogenic avian influenza. The origin of the 1918 pandemic influenza virus: a continuing enigma. 19. Miller J. Sawanpanyalert P. Crawford PC. 28.oie. Flu virus jumps from horses to dogs [online].org/cgi/content/full/ 2005/926/2. Influenza A virus (H3N8) in dogs with respiratory disease. Accessed 19 Jan 2007. 2001. 20. 16. Quarles JM.html#humans. Available at: http://www. Cases of swine influenza in humans: a review of the literature. Ferro P. Katz JM. Available at: http://www. Pompey J. WHO.20:833-5. Chen LM. Payungporn S.437:889-93. American Association for the Advancemennt of Science. Alexander DY.28(1):49-58. Dubovi EJ.who. Are seals frequently infected with avian influenza viruses? J Virol. CDC. Couch RB. 14. Accessed 31 Dec 2006. Kouo TS. Accessed 1 Aug 2007. 2008. Hill RC.pighealth. Iannello P.unizh. 26 September 2005. Donis RO. Munster VJ. 2007. Accessed 29 Dec 2006.jsp?cfile= htm/bc/206200. Hurt AC. Manual of diagnostic tests and vaccines for terrestrial animals [online]. 2005.int/eng/normes/mmanual/2008/pdf/2. USDA APHIS. The Merck veterinary manual [online]. Taubenberger JK. World Organization for Animal Health [OIE]. 25. Castleman WL. Webster RG. Castleman WL.merckvetmanual. Equine respiratory diseases. Available at: http://sciencenow.84:2285-92.com/mvm/index. Bright RA. Available at: http://www. (OIE/FAO/EU International Reference Laboratory for Avian Influenza). Daly JM. Characterization of the 1918 influenza virus polymerase genes. Reid AH. Genetic analysis of two influenza A (H1) swine viruses isolated from humans in Thailand and the Philippines.int/mediacentre/factsheets/avian_influe nza/en/index. In: Foreign animal diseases. Virus Genes. 2008. Daly JM. Paris. Available at: http://www. Brammer L. Cox NJ. Fouchier RA. Whitehouse Station. Kasel JA.gov/flu/avian/index. Gibbs EPJ. Macrae S. 137-46. A review of avian influenza [monograph online]. Pompey J. Available at: http://www.14(6):902-8. 17 Jan 2007.44(8):1084-8. J Gen Virol. A threat to U. Portrait of a killer [online]. Six HR. Blunden AS. Dacso CC.gov/oa/pubs/avianflu. 1984. World Health Organization [WHO]. VS].org/cgi/content/full/2007/ 117/2. Roque V. Transmission of equine influenza virus to English foxhounds. Smith KC. Mumford JA.S. Boca Raton. Brown IH. Influenza virus infections of pigs. ScienceNOW Daily News. Available at: http://sciencenow. J Clin Microbiol. 26. Belay E.* Accessed 30 Aug 2004. Crawford PC.htm l. Rehg JE. Accessed 10 Jan 2006. Available at: http://www. 2008. Animal and Plant Health Inspection Service. Easterday BC. Geraci JR. Early G. Influenza infections [online]. Accessed 31 Dec 2008. Kolodziejek J. OIE. Chatterjee R. Emerg Infect Dis 2002. Rivera M. Swayne DE. Reid AH. American Association for the Advancemennt of Science. St Aubin DJ. 2008.
Hancock K. Thanawongnuwech R. List of species affected by H5N1 (avian influenza) [online]. Clin Infect Dis. Genetic analysis of influenza A virus (H5N1) derived from domestic cat and dog in Thailand. Luby SP. 2006.101:10452-7. Abbott. USGS. Leung YH. Damrongwatanapokin S. Arch Virol. Teifke JP. Dec 24. Pattanarangsan R. 44. Pariyothorn N. Goswami D. Science. 51. Pariyothorn N. Vahlenkamp TW. 2009. 41. Emerg Infect Dis. Emerg Infect Dis. Jam-on R. Fouchier RAM. Schutten M. 2007. Poovorawan Y. Vong S. Amonsin A. 2007 Jun. Tunhikorn S. 2005. WHO. 2009. Avian flu finds new mammal hosts.jsp. Payungporn S. Accessed 15 Dec 2009. Fry AM. 39. Achenbach J.199(12):1744-52.int/csr/don/2006_03_09a/en/index. Human fatality adds fresh impetus to fight against bird flu. Siregar ES.who.html. 53. Available at: http://www. Donis RO. Sorn S. Lekdumrongsak T.152:1925-33. Peiris JS. Rimmelzwaan GF. Poovorawan Y.15(8):1311-3. Ratanakorn P. 46. 45.12:681-3. Avian influenza viruses in humans. Brooks WA. Mettenleiter TC. Cumulative number of confirmed human cases of avian influenza A/(H5N1) reported to WHO [online]. Probable tiger-to-tiger transmission of avian influenza H5N1. Dung DH.10:2189-91. Sae-Heng N. Saad MD. Tantilertcharoen R. Nahar S.28(1):341-8. Koch G. Chen H. Rozendaal FW.promedmail. Alamgir AS. Osterhaus ADME. Smith GJ.Influenza 33. Available at: http://www. Payungporn S. Holl D.org. Accessed 28 Dec 2009. Oraveerakul K. J Clin Microbiol. Bangladesh. Chutinimitkul S. The evolution of H5N1 influenza viruses in ducks in southern China. Zhang L. Meemak N. Schneeberger PM. Munster V. Nahar K. 2009. 2004. J Infect Dis. Malik Peiris JS. 37. Xu KM. Guan Y. Proc Natl Acad Sci U S A. Rev Sci Tech. Kemink SAG. Weaver J. Butt KM. Theamboonlers A. Buchy P. Poovorawan Y. Webster RG. Theamboonlers A. Jiao P. Uyeki TM. 43. Pariyothorn N. Avian influenza H5N1 in tigers and leopards.htm l. Accessed 15 Dec 2009. Sok T. Yu K. Chutinimitkul S. Rahman M. Nature 2003. 2005. Uyeki TM.12:1744-7. 2004. Shu B. World Health Organization [WHO]. Koopmans M. Fouchier RA.12:1295-7. Rev Sci Tech. Archive Number 20091224. National Wildlife Health Center. Uhl W. Jam-On R. Human infection with highly pathogenic avian influenza A (H5N1) virus: review of clinical issues. Webster RG. Nanthapornphiphat K. Payungporn S. 52. Lindstrom S. Chen H. Wolf PU. Emerg Infect Dis. Seng H.gov/disease_information/avian_infl uenza/affected_species_chart. Human infection with an avian H9N2 influenza A virus in Hong Kong in 2003. Kesdangsakonwut S. Van Kerkhove MD.423:5.11 Dec 2009. World Health Organization [WHO] Avian influenza – H5N1 infection found in a stone marten in Germany [online]. Available at: http://www. Liu Z. 40. Sultana R. Tian G. 48. Yuen KY. Payungporn S.49(2):279-90. in child. WHO. Thanawongnuwech R. Poovorawan Y. Proc Natl Acad Sci USA. Osterhaus DM. Theamboonlers A. Amonsin A.nwhc. detected through routine surveillance. 47. Sae-Heng N. 38. A. Tantilertcharoen R.11:699-701. Songserm T. 2006. 2007. Haider MS. 35. Arya N. Kuiken T. 2009. Payungporn S. Kaiser J.usgs. Daniels P. Li Y. 2004. Zaman RU. Yingst SL. Bosman A. Amonsin A. Zhang LJ. 2006 March.28(1):161-74. Accessed 8 Jan 2006. Butler E. Distribution of lesions and antigen of highly pathogenic avian influenza virus A/Swan/Germany/R65/06 (H5N1) in domestic cats after presumptive infection by wild birds.305:1385. Amonsin A. Harder T. Eagles D. Wong F.43:5760-7. Songserm T. Ratanamungklanon S. Wattanodorn S. Klopfleisch R. Qinghai-like H5N1 from domestic cats. human (124): H9N2 China (HK). Li Z. Tunak E. Rahman M. Broekman JM. Available at http://www. Vivatthanavanich V. Islam MS. Last Updated: December 2009 © 2009 page 31 of 46 . Songserm T.int/csr/disease/avian_influenza/country /cases_table_2009_12_11/en/index. Theamboonlers A. Vet Pathol. 2006. northern Iraq. Kuiken T. United States Geological Survey [USGS]. H5N1 highly pathogenic avian influenza in Southeast Asia. Songserm T. 2006. 2009. PRO/AH/EDR> Avian influenza. Ly S. Emerg Infect Dis. 49. Sae-Heng N. 2004. 34. Amonsin A. Uyeki TM.Fatal avian influenza A H5N1 in a dog. Katz JM.101:1356–61. Enserink M. 42. Starick E. 50. Keawcharoen J. ProMed Mail. Jam-on R. Avian influenza A virus (H7N7) associated with human conjunctivitis and a fatal case of acute respiratory distress syndrome. Felt SA. 36. Noppornpanth S. Davis CT. Emerg Infect Dis. van Doornum GJJ. Lim W. Risk factors associated with subclinical human infection with avian influenza A (H5N1) virus-Cambodia. Emerg Infect Dis.4328. Deng G. 2009.who. Avian influenza virus A (H5N1). Gerst S. Poovorawan Y. Theambooniers A.44:261-8. Avian influenza H5N1 in naturally infected domestic cat.
Sturm-Ramirez KM. 2005. Pathogenicity of a highly pathogenic avian influenza virus. Guan Y. van-Amerongen G. Zhou J. Proc Natl Acad Sci U S A. 68. Zhu Q. Govorkova EA. Webby RJ. Webster RG.88:2035-41. J Virol. 63. Wu N. Emerg Infect Dis. Al Maaitah HM. van Riel D. Webster RG. Characterization of the H5N1 highly pathogenic avian influenza virus derived from wild pikas in China. Bissett L. Emerg Infect Dis. 2009. 66. Liu QF. Qi X. Ruuls L. 2008. Al-Natour MQ. Qin K. Zhang XL. Auewarakul P.168:176-83. Luk GS. Suarez DL. Lei F. Mettenleiter TC. Ong S. Baars M. Butler D. 2005. 70. Desvaux S. but will they spread it? Nature. Xu L. Peiris M. Beer M. Osterhaus AD. Shortridge KF. 55. Bestebroer TM. Xiao H. J Virol. Rimmelzwaan GF.78:4892-901.33:492-505. Nguyen TD. Manuguerra JC. Emerg Infect Dis. Teifke JP. Wang J. Osterhaus AD. Lipatov AS. Peiris JS. Krauss S.79:10821-5. Sakai-Tagawa Y. Lager KM. 72.14:308-10. Jiang X. Li X. Am J Pathol. 56. Fan WX.4(7):e1000102. Webster RG. Sakoda Y. Gao GF. Emergence of multiple genotypes of H5N1 avian influenza viruses in Hong Kong SAR. Zhang GZ. Mazzacan E. A/chicken/Yamaguchi/7/04 (H5N1) in different species of birds and mammals. Long HT. Cong YL. Antigenic and genetic characterization of H9N2 swine influenza viruses in China. Rehg JE. 2002. Rimmelzwaan G. 2007. Nidom CA. Arch Virol. Dyrting KC. Hui PY. Bousfield B. Van der Werf S. Giese M. 61. Buranathal C. Amarin NM. Krauss S.15(3):475-8. 2004. Avian H5N1 influenza in cats. Avian Dis. Hanh NT. Bousfield RB. Guan Y. Guan Y. Marx N.Influenza 54. Ma SK. Puthavathana P. Harder T. Chaisingh A. Breithaupt A. PLoS One. Webster RG. Cattoli G. Reemerging H5N1 influenza viruses in Hong Kong in 2002 are highly pathogenic to ducks. Dyrting K. 2008. Sorn S. Lethality to ferrets of H5N1 influenza viruses isolated from humans and poultry in 2004. Influenza A virus (H5N1) infection in cats causes systemic disease with potential novel routes of virus spread within and between hosts.14:1835-41.79:2191-8. Wang G. Guan Y. Kuiken T. Ellis TM. Nguyen TD. Harder TC. Liu W. 2008.309:1206. Kida H. 73. Stockhofe-Zurwieden N. Dobson AP. Fan W. Monne I. van Rooij E. Luo K. Kuiken T. Kawaoka Y. Genetic comparison of H9N2 AI viruses isolated in Jordan in 2003. 64 Perkins LE. Zhao D. Chen H. Domestic pigs have low susceptibility to H5N1 highly pathogenic avian influenza viruses. Bissett LA. 2009. Fouchier R. 62. Kishida N. 2006. Fouchier RA. Wang H. Koch G.14:1132-4. 2009. Rider P. 2006. 60. Cambodia. Sturm-Ramirez K. Studies of H5N1 influenza virus infection of pigs by using viruses isolated in Vietnam and Thailand in 2004. 71. 67. Li L. Shinya K. Yang Y. Kuiken T. 69. Swayne DE. Guan Y. Sun W. Lim W. Yan Y. Highly pathogenic avian influenza virus (H5N1) outbreak in captive wild birds and cats. © 2009 Last Updated: December 2009 page 32 of 46 . Lipatov AS. PLoS Pathog.154(4):677-81. Maas R. 59. Klopfleisch R. Yin W. Wang J. Ellis TM.151:1267-79.47(3 Suppl):956-67. Buranathai C. J Gen Virol. Hoffmann B. Zhang LJ. Malik Peiris JS. van Amerongen G. J Virol. 2004. Reperant LA. 2007. 75. van Amerongen G. Durban M. Liu J. Lu S. J Virol. Hanh TH. Liao M.51:451-4. Science. 2004. 57. Swayne DE. Thai dogs carry bird-flu virus. Kalthoff D. Kiso M. Investigation of outbreaks of highly pathogenic H5N1 avian influenza in waterfowl and wild birds in Hong Kong in late 2002. Emerg Infect Dis. Vahlenkamp TW. Ma J.439:773. 74. Reynes JM. 2008. Pu J. Takano R. Dyrting KC. Brown EG. Gu H. 2005. Umemura T. Emerg Infect Dis. Avian Dis.306:241. Highly pathogenic avian influenza virus (H5N1) infection in red foxes fed infected bird carcasses. 2009. Rehg JE. Experimental infection and natural contact exposure of dogs with avian influenza virus (H5N1). Guo J. Peiris M. Liu JH. Tsim ST. Experimental infection of cattle with highly pathogenic avian influenza virus (H5N1). Poon L. 58. Tacken M. Peiris JS. Muramoto Y. Osterhaus A. Huang Y. Choi YK. Avian influenza (H5N1) susceptibility and receptors in dogs. Hunt M. Kwon YK.83(17):8957-64. Liu F. 2003. A comparison of the pathogenicity of avian and swine H5N1 influenza viruses in Indonesia. Comparative susceptibility of selected avian and mammalian species to a Hong Kongorigin H5N1 high-pathogenicity avian influenza virus. Avian Pathol. Molecular characterization of highly pathogenic H5N1 avian influenza A viruses isolated from raccoon dogs in China. Peiris M. Feng Y. van Riel D. Webster RG.13:1219-21. Matsuda K. Puthavathana P. Arch Virol. Rimmelzwaan GF. 2006. Ellis T. Spackman E.4(3):e4682. van-de-Bildt MW. 2007. Wang S. Yamada S. 65.99:8950-5. Hoffmann E. Zhang XW. Zhang XL. Ozaki H. Sarmento LV. Capua I. Science. Baars M. Yen HL. Isoda N. Highly pathogenic H5N1 influenza virus infection in migratory birds. Bai GR. Gaidet N.
51:189-93. Archive Number 20090427. Gao S. van Loon AM. Vagasky S. Wang XJ. Broukhanski G. N Engl J Med. Wang J. 2000. Shinde V. Bastien N. 20052009. World Health Organization [WHO]. Antibodies against H5 and H9 avian influenza among poultry workers in China. J Virol.360(25):2616-25.eurosurveillance. 2006.282:301-6. Marshall F. 2009. 81. Henning BM. Zakowski PC. Am J Epidemiol. Sheerar MG. Shu B. Cherry JD. Pokamunski S. 87. de Vlas SJ. Accessed 19 Jan 2009. Accessed 29 Apr 2009. Dufficy D. Omeñaca Terés M. J Vet Diagn Invest. 83. Euro Surveill. 86. Richardus JH. Jalalee MA. Trautman MS. Lu S. Robinson JL. Avian influenza in Pakistan: outbreaks of low.cdc. Naeem K. 92. Cooley AJ. South Dakota reports swine flu case. responsible for a fatal case of human influenza. Fouchier RAM. Charbonneau G. Nicoll A. Liu T. 89. Garten RJ. Rocha EP. Li Y. Zhou JP. Janke BH. 1989. Hinshaw VS. Triple-reassortant swine influenza A (H1) in humans in the United States. Banet-Noach C. Canada. J Clin Microbiol. Smith TF. 2007. Sánchez Villanueva P. China. 2009.13(12):1865-70. Tendler Y. Available at: http://www. Pascoe N. Virology. Lindstrom S. Finelli L. Pirak M. Patel J. Pozo F. Liu W. Yang GP. Triple reassortant H3N2 influenza A viruses. Cox NJ.47(10):3294300. J Clin Microbiol. Smith F. Grebenyuk N. 79. 80. Lu S. Wang M. Hinshaw VS. The epidemiology and evolution of influenza viruses in pigs.360(24):2583-4. Zhang X. 96.aspx?Arti cleId=19120. Zhang P. Vet Microbiol. Available at: http://www. Siddique N. 77. Naturally occurring influenza infection in a ferret (Mustela putorius furo) colony.edu/cidrap/content/influenza/gen eral/news/jan1509swine-ms.html. 1994. Harmon MW.promedmail. Ge FF. Zheng BJ. 2007. Liu H. Liu X. pii: 19124. Lack of significant personto-person spread of swine influenza-like virus following fatal infection in an immunocompromised child. Aragon. 2009. Gubareva LV. Cao WC. CDC. 2009. 2007. Gerber S. Belliveau RR. 78. Wen QL. Thompson BL. Grimsrud K. Pérez Breña P. Available at http://www. WHO. Bridges CB. Xu F. Sun QY. Ma YH. (Center for Infectious Disease Research and Policy 95. Rozenblut E. 2009 Apr. Alves D.org. Rodrigo Val P. Apr 27.27(6):1413-6. Balish A. Xu X. Fu CX. Martin K.83(17):8428-38. Zhan L. Perk S. Tang Y. A novel genotype H9N2 influenza virus possessing human H5N1 internal genomes has been circulating in poultry in eastern China since 1998. Spain.119:152-8. Ayaz M. H9N2 influenza viruses from Israeli poultry: a five-year outbreak. Panshin A. Patterson AR. Cooper VL. Zhang WY. A human case of swine influenza virus infection in Europe--implications for human health and research. 84.14(7).who. 93.12:1132-5. Avian Dis. Uyeki TM. Avian Dis. Martínez Cuenca S. Yoon KJ. Accessed 29 Apr 2009. Dang RL. Rota PA. Last Updated: December 2009 © 2009 page 33 of 46 . Kendal AP. Sheng LP. Carman S.51:290-6. Casas I. University of Minnesota). Low DE. Serological reports of human infections of H7 and H9 avian influenza viruses in northern China.14(7). Regnery HL. Seal RF.68(4):2051-8. 82. Karasin AI. Adiego Sancho B. An influenza A (H1N1) virus.umn. 94.44(3):225-9. Euro Surveill. Cox NJ.int/csr/don/2009_04_28/en/index. Wu Y. Xu X. J Virol. Antigenic and genetic characterization of swine influenza A (H1N1) viruses isolated from pneumonia patients in The Netherlands. Olsen CW. 2009.H1N1 flu (swine flu). 2009. 91. CIDRAP.cidrap. Rimmelzwaan GF.Influenza 76. Liu X. McGregor MW.org/ViewArticle.1583. 88. Gauger PC. Liu YX. Wentworth DE. Genetic evolution of H9 subtype influenza viruses from live poultry markets in Shanghai. Laboratory characterization of a swine influenza virus isolated from a fatal case of human influenza. Burton L. 85. Kawaoka Y. Centers for Disease Control and Prevention [CDC]. Liu J. Human case of swine influenza A (H1N1). Zhang JS. 2005.html. Kappus KD. 95. Jia N. Conover C. Lee BE. Brown IH. Canada. 2009 Jan 14. Deyde V. Update 4. Bestebroer TM.74(12):29-46. Accessed 27 Apr 2009. 90. Klimov A. Cox NJ. Available at: http://www. Influenza A (H1N1) – “swine flu” worldwide. J Clin Virol. Emerg Infect Dis. 1984. King R. Available at: http://www. Ju HB. 2009. de Jong JC. Ritger K. Bastien N. Osterhaus ADME. Promed Mail. Accessed 1 May 2009. Peng D. Swine influenza [online]. Harris M. 2001. Van Reeth K. Auerbach DM. 2009. Ojkic D. November 2008. Schnirring L. Claas ECJ. McCusker J. Swine influenza (H3N2) infection in a child and possible community transmission. 2009. Bresee JS.gov/swineflu/. Quinlisk P. Li Y. Zhang L. Emerg Infect Dis. closely related to swine influenza virus. Apr 2009. Liu PH.21(4):527-30. Patriarca PA. Simanov L. N Engl J Med.and highpathogenicity avian influenza in Pakistan during 20032006.
org. Nature. Promed Mail. Archive Number 20090826. Accessed 5 Nov 2009. Available at http://www. Archive Number 20091106.4144. Worobey M. swine.promedmail. Oct 2.promedmail.2978. Accessed 5 Nov 2009.org. Promed Mail. avian.58(15):400-2.4220.org. 115. Accessed 18 Sept 2009. Available at http://www.3629. 2009.org. 2009. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Available at http://www. swine. Accessed 5 Nov 2009. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Peiris JS. 2009. 111. Dec 11.org. Dec 11.3840.promedmail.3618. Oct 22. 100. 2009. Oct 21. swine. animal (20): USA (NE) ferret. Lindstrom S. Promed Mail. Archive Number 20090828. Available at http://www. 2009. Archive Number 20091205. swine. animal health (05): Austr. Rambaut A. Archive Number 20091022. Available at http://www. Raghwani J. Shu B. animal (19): Iceland swine. Last Updated: December 2009 © 2009 page 34 of 46 . et al. 118. Oct 22. Accessed 30 Nov 2009.Influenza 97. Available at http://www. OIE.promedmail. 114. OIE. 108. 2009.promedmail. Promed Mail. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Promed Mail. Promed Mail. Archive Number 20091101. swine Aug 28. 2009. Archive Number 20091022. Sept. Archive Number 20091020. Promed Mail. animal health (31): Finland.org.promedmail. infected swine. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Available at http://www. 2009. Accessed 5 Nov 2009.1653. Archive Number 20091211. Swine Influenza A (H1N1) infection in two childrenSouthern California. swine.promedmail. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Accessed 15 Dec 2009. 2009.org. 105. Archive Number 20091019. 102. Available at http://www. OIE. Davis CT.org. animal (35): Italy.org.promedmail. 2009.3737. Dec 5. OIE. conf. 120. 107. Archive Number 20091201. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. animal health (11): Norway. 2009. 110. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. MMWR Morb Mortal Wkly Rep. animal health (04): Chile. animal health (10): Ireland.3857. Nov 6. Accessed 5 Nov 2009. animal (23): Taiwan. swine.3427. Promed Mail. Russell CA. PRO/AH> Influenza pandemic (H1N1) 2009. PRO/AH/EDR> Influenza pandemic (H1N1) 2009.promedmail.promedmail. 2009. 2009. Accessed 15 Dec 2009. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Available at http://www. Available at http://www. 2009. Archive Number 20090502. 109. 113. Archive Number 20091127. Promed Mail. Influenza A (H1N1): animal health(04). Archive Number 20091021. Archive Number 20091002. Nov 7. Available at http://www. Available at http://www. Promed Mail. Available at http://www.promedmail.promedmail. 106. Oct 19.promedmail.org.org. Accessed 18 Sept 2009. Available at http://www. 2009. Promed Mail. Archive Number 20091028. Sept 4.org. Aug 23. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Archive Number 20090904. PRO/AH/EDR> Influenza pandemic (H1N1) 2009.3600. OIE. Smith GJ. October 28. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Accessed 30 Nov 2009. Accessed 30 Nov 2009. Archive Number 20090823. Guan Y.org. 103.promedmail. Available at http://www. animal (16): Canada (ON) avian. 104. Accessed 11 Dec 2009. animal (13): USA swine. 119. Ma SK. Origins and evolutionary genomics of the 2009 swine-origin H1N1 influenza A epidemic. 2009. Promed Mail.org.org.325(5937):197-201. Accessed 5 Nov 2009. May 2. Accessed 3 May 2009. March-April 2009.promedmail. PRO/AH/EDR> Influenza pandemic (H1N1) 2009.org.org. Promed Mail.3114. 2009. Vijaykrishna D. Promed Mail. Garten RJ.. 117. Promed Mail. swine. Accessed 5 Nov 2009. Promed Mail. Aug 26. 112. Nov 1. animal (17): Japan (OS) swine. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. 2009. Accessed 2 Dec 2009. 98. Available at http://www. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. animal health (15): USA (OR) ferret. Promed Mail.3589. Accessed 5 Nov 2009. Available at http://www. 101. Promed Mail. Oct 20. Lycett SJ. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Bhatt S. 2009.promedmail. 116. animal (09): UK (NI) swine. animal health (09): Indonesia. Cheung CL.org. PRO/AH/EDR> Influenza pandemic (H1N1) 2009.promedmail. animal health (06): Canada.4214.4071. animal health (08): Singapore.459(7250):1122-5. Archive Number 20091211. Available at http://www. Promed Mail.4106. Antigenic and genetic characteristics of swineorigin 2009 A(H1N1) influenza viruses circulating in humans. OIE. animal (24): USA.org. Bahl J. 2009. Promed Mail.promedmail. 2009. 2009. OIE. Canada. 99. OIE.3280.3635.3777. Pybus OG. Accessed 18 Sept 2009.promedmail.3027.2999. Available at http://www. 18.org. Science. Archive Number 20091107. Promed Mail. PRO/AH/EDR> Influenza pandemic (H1N1) 2009.org. PRO/AH/EDR> PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Dec 1.promedmail. Accessed 18 Sept 2009. OIE. Archive Number 20090918. OIE. Available at http://www. animal (38): Mexico. Nov 27. animal (39): Germany.promedmail. 2009. 2009. Accessed 5 Nov 2009. Available at http://www.
12:1663-70. Vanek E. Susceptibility of North American ducks and gulls to H5N1 highly pathogenic avian influenza viruses. Promed Mail. Varied pathogenicity of a Hong Kong-origin H5N1 avian influenza virus in four passerine species and budgerigars. Swayne DE. Accessed 2 Dec 2009. Aug 7. Hess M. Wodak E. 4th ed. Swayne DE. animal (30): China. July 18. Fan XH. Nagl I. Piazza V. 2003. 124. ostriches .nih. Weekly disease information. New York: Churchill Livingstone. Molecular epidemiology of H5N1 avian influenza. 2008.promedmail.promedmail. 127. animal (36): USA (CO). Nagy A. Brown IH.112:17-9.3816. 141. Webster RG. Archive Number 20091222.org. ICTV. United States Department of Agriculture [USDA]. © 2009 Last Updated: December 2009 page 35 of 46 . Archive Number 20060718. Orthomyxoviruses [monograph online]. Revilla-Fernández S. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. 1758). 00.promedmail. Available at: http://www.2176. Webby R. 243-7. English C. Rev Sci Tech. 2006.promedmail. Qin K. Park B. Brown I. Leschnik M. Available at http://www. Hesterberg U. animal (26): USA (OR).South Africa.3(1):1-14. Accessed 15 Dec 2009. Ha G.Dtsch Tierarztl Wochenschr. Promed Mail. Nov 5.14:741-6. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. A retrospective description of a highly pathogenic avian influenza A virus (H7N1/Carduelis/Germany/72) in a free-living siskin (Carduelis spinus Linnaeus. Accessed 10 Jan 2007.ncbi. Universal virus database. 143. 2009.Influenza 121. 134. Promed Mail. 2003. OIE. Hornickova J. Thalhammer JG. 132. 137. Archive Number 20091105.org. version 3.org.4305. Influenza Other Respi Viruses. Available at: http://www. 128. Archive Number 20091128. 131. Available at http://www. Avian influenza. Promed Mail. Peiris JS. Smith GJ.4213. 133. 122. 1758) and its accidental transmission to yellow canaries (Serinus canaria Linnaeus. Emergence and predominance of an H5N1 influenza variant in China. Dec 9. Promed Mail.47(3 Suppl):1150-3. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Orthomyxoviridae [online]. Pittman M. Proc Natl Acad Sci U S A. 136. 2009.4008. Archive Number 20040807. animal (21): USA (IA) feline. Available at http://www. Bagó Z.120:9-16.int/wahis/public. OR) feline. Archive Number 20091121. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. International Committee on Taxonomy of Viruses 133.1970. Medical microbiology. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Emerg Infect Dis. Available at http://www. Nov 21. PRO/AH/EDR> Influenza pandemic (H1N1) 2009.edu/microbook/. 125. Huang K.promedmail. Tomci M. 2004. Harris K. 103: 16936–41. Weikel J. 2009.046.org. Wang J. Archive Number 20091209. editor. Accessed 11 Dec 2009.4192. Zhang JX. Nov 28. 2007. Machova J. Perkins LE. Guan Y. Manvell RJ. Pathogenesis of H7 influenza A viruses isolated from ostriches in the homologous host infected experimentally. Couch RB.pdf. Stallknecht DE. 2009. 2007. PRO/AH/EDR> Influenza pandemic (H1N1) 2009.org. Holko I. Smith GJ.org. 2009 pandemic A/H1N1 influenza virus. Accessed Dec 2. Accessed 15 Dec 2009. 135.13.org. Cook A. ferret. animal (28): USA (UT. In: Baron S.utmb. Cheung CL.promedmail. Beck JR. animal (37): USA (OR. Archive Number 20091211. 2009. Highly pathogenic avian influenza virus subtype H5N1 in mute swans in the Czech Republic. Pathol. 2003. Accessed 30 Nov 2009. 2009.4079. Vet. Vijaykrishna D.promedmail. Horyna B. 2006. Available at http://www. Suarez DL.org. 2009. Chen H. Honicke A. 1996.. 2009. 123. Available at http://www. Dec 11. 2009. Available at: http://www. 130. November 30. Benetka V.oie. Available at http://www. Lee C. United States of America. canine. Webster RG. Available at: http://www. Vet Microbiol. Kang B. Nov 14. Accessed 30 Nov 2009. Subclinical infection with avian influenza A (H5N1) virus in cats. Li KS. Avian influenza. 126. 2006. Promed Mail. World Organization for Animal Health [OIE]. Accessed 10 Jan 2007. 2009 pandemic H1N1 influenza presumptive and confirmed results. 129. Promed Mail. 2009 Nov. Kaleta EF. Avian Dis.php?page=single_repor t&pop=1&reportid=8709. 2009.Transmission of avian influenza virus (H3N2) to dogs.promedmail. Nov 30. 142. Jorgensen PH. Guberti V. Archive Number 20091114. Promed Mail. 2005. Guan Y. 140. 2009. 138. Available at: http://www. Song D. Emerg Infect Dis. ostriches – South Africa (H5N2)(03): OIE. Available at http://www. Oh J.org. Brown JD.promedmail. Accessed 22 Dec 2009. Busani L. Avian influenza surveillance in wild birds in the European Union in 2006. Dec 22. Promed Mail.nlm. Kang D.40:14-24. Emerg Infect Dis [serial online]. Möstl K. Stroud D. Accessed 29 Dec 2006. Accessed 30 Nov 2009. Rayner JM.usda. 139. Park S. Accessed 5 Nov 2009. 2009.gov/documents/FINAL_RESULTS_2 009_PANDEMIC_H1N1_INFLUENZA_CHT.3936. animal (40): USA (NY) canine.gov/ICTVdb/ICTVdB. Jung K.gsbs. USDA. CA) feline.28(1):39-47.
2008. Anderson GA. Chen Y. Lelli D. Zhang Q. Liu TQ. Lee YM. 1977-1999: evidence for wholly human and reassortant virus genotypes. Dürrwald R. Genetic evolution of swine influenza A (H3N2) viruses in China from 1970 to 2006. Lager KM. Webster RG. Vemulapalli R. 1987. Liu L. Accessed 7 Jan2008. Zhu Q. [Epub ahead of print] 151. Senne DA. Zhang X. Identification and characterization of a highly virulent triple reassortant H1N1 swine influenza virus in the United States. J Clin Virol. Vet Microbiol.80:5092-6. Novel reassortant of swine influenza H1N2 virus in Germany. 2007. Zhang Y. Cordioli P. Ma W.137:51–9. Kim SY. Zell R. 2006. Olsen CW. Richt JA. Liao M. Barbieri I. Vincent AL. Henry SC. Yoon KJ.08. 155. J Virol. Smith CB. Webby RJ. Rowland RR. 2009. Dürrwald R. 152. Patnayak DP. 2009.OIE. Liu HL. Dewey CE. 2007. Baek YH.46(3):1067-75. Karasin AI. Zhou NN. Lopez JW. Krumbholz A. Identification of H2N3 influenza A viruses from swine in the United States. Gauger PC. 83:24–40. Krumbholz A. Schutten MM. Lee JH. Available at: http://www. Novel swine influenza virus subtype H3N1 in Italy. Two genotypes of H1N2 swine influenza viruses appeared among pigs in China. 159. Lee EH. 2009 Oct 28. Ongoing evolution of swine influenza viruses: a novel reassortant. Investigation of exposure to swine influenza viruses in Ontario (Canada) finisher herds in 2004 and 2005. 2009. Vincent AL. J Clin Microbiol. Carman S. Sung MH. Gauger PC.44:1123-6. 2004 Nov 11-12. 2006.89:271-6. 147. Shin JY. J Gen Virol. Spearman G. Vet Microbiol. Richt JA. Isolation and characterization of novel H3N1 swine influenza viruses from pigs with respiratory diseases in Korea. 153. J Virol. 162. Brockwell CB. 166. 2008. Vincent AL. Lager KM. Swenson SL. 150. Characterization of a Canadian mink H3N2 influenza A virus isolate genetically related to triple reassortant swine influenza virus. 158. Rossow K. Am J Vet Res. 2008. Webster RG. Choi YK. Janke. Zhang Q. Song MS. Paris. 160.104:20949-54. Li GX. Webby RJ. Last Updated: December 2009 © 2009 page 36 of 46 . Olsen CW. Lager KM. Kim HK. Bergmann S. Carman S. Xu C. Chen H. Genetic characterization of H3N2 influenza viruses isolated from pigs in North America. Lager KM. Isolation and genetic characterization of new reassortant H3N1 swine influenza virus from pigs in the midwestern United States. Yu H. Yang H.44:3923-7. 165. Yu H. 164. 154. Qiao C. Loiacono C. Zanoni MG. Tong GZ. Identification of a swine influenza virus (Hsw1N1) isolated from a duck in Hong Kong. Shortridge KF. Ma W. Isolation and genetic characterization of H5N2 influenza viruses from pigs in Korea. Motzke S. Proc Natl Acad Sci USA. 146. Vincent AL.138(3-4):361-7. 2009. Janke BH. 2009 Jul 14. Kim CJ.83(9):4205-15. Virus Res. Gramer M. Krauss S. Lekcharoensuk P.pdf.356:91-6. Canada (2003 to 2005). Emerg Infect Dis. 2006. United States. 156. Identification of human H1N2 and human-swine reassortant H1N2 and H1N1 influenza A viruses among pigs in Ontario.68:71-85. McNab WB. Vet Microbiol.74(1-2):47-58. Arch Virol. Webster RG. Gramer MR. 157. Poo H. Swenson SL. Richt JA. Sozzi E. Relative prevalence of reassortants and subtypes. BH. 1978. Hesse RA. Janke BH. Biochem Biophys Res Commun. Ma W. Hamel A. 2008.153:2085-92. 163. Rossow K. Swine influenza. Ma W. Herwig V. Woodruff M.12:787-94. Cooper LA. In: Proceedings of the Twelfth Annual Swine Disease Conference for Swine Practitioners. Prev Vet Med. 2006. 161. 2008. Moreno A. Hua RH. Song MS. [Epub ahead of print] 149. 2000. Vincent AL. 2000. J Clin Microbiol 2009. Poljak Z. Choi JK. Manual of diagnostic tests and vaccines for terrestrial animals [online]. Gramer MR. 08_SWINE_INFLUENZA. Butterfield WK. Yoon KJ.46: 192–5. J Infect Dis. Isolation and genetic analysis of human origin H1N1 and H3N2 influenza viruses from pigs in China. Wutzler P. J Clin Microbiol. Pascua PN. Novel swine influenza virus subtype H3N1. Subbarao K. 145. Gagnon CA.47(3):796–799. Virus Genes. Xin X. Karasin AI. Choi YK. Emergence of H3N2 reassortant influenza A viruses in North American pigs. Janke BH. Characterization of a newly emerged genetic cluster of H1N1 and H1N2 swine influenza virus in the United States. Webby RJ. Campbell CH. Characterization of an influenza A virus isolated from pigs during an outbreak of respiratory disease in swine and people during a county fair in the United States. Landgraf JS.138(5):686-9. IA. Lager KM. Virus Genes. Tong GZ.int/eng/normes/mmanual/2008/pdf/2. Liu TQ. Ames. Friendship RM.oie. Response of calves to exposure with swine influenza virus. Erickson G. Zell R. Richt JA. Carman S. Luppi A. Kim CJ. Woods GT. Zhang GH. Hua RH.Influenza 144. 148. J Clin Microbiol. World Organization for Animal Health [OIE]. Wutzler P.48(8):1264-8. Lombardi G. Choi HW.
Paris. Smith H. 173. Interspecies transmission of equine influenza virus (H3N8) to dogs by close contact with experimentally infected horses. Available at: http://www. 169.diaglab. Available at: http://www. 22. Zanoni R. NJ: Merck and Co.edu/issues/civ-dect. In: Kirk RW. 186. Cooper VL. Schwartz KJ. Campolo M. 2009. Promed Mail. Zhou H. Oh J. 179.pdf.1279. 2006. 180. 183. 1989. 1980:44. 2008.html. June 20. Accessed 19 Dec 2009.pdf. An outbreak of equine influenza virus in vaccinated horses in Italy is due to an H3N8 strain closely related to recent North American representatives of the Florida sub-lineage. 2006. Available at: http://www.vet. Tu J. World Organization for Animal Health [OIE]. Kahn CM. 174. Last Updated: December 2009 © 2009 page 37 of 46 .promedmail. 2005. 07_EQ_INF. Butts D. Decaro N. Philadelphia: WB Saunders. UF researchers: equine influenza virus likely cause of Jacksonville greyhound deaths [online].gov/documents/ MDA_FerretHealthAdvisorySheet_31881_7. Equine pathology. J Am Vet Med Assoc News Express. canine-USA (Florida). Ames. 182. Whitehouse Station. Matsumura T. Arch Virol. 2005 Sept. Kondo T. 177. Line S.fl. 181. University of Florida College of Veterinary Medicine. Accessed 19 Dec 2009. Accessed 10 Jan 2007. Available at: http://www. Available at http://www.htm. Animal Industry Division. Chambers TM. The Merck veterinary manual [online]. Rooney. 2006.2883.1703. Tiwari A.promedmail.edu/pr/nw_story/greyhds. Kim WI. Manual of diagnostic tests and vaccines for terrestrial animals [online].05. Pathogenicity of influenza virus.org/onlnews/javma/oct05/x051015b. Promed Mail. Emerg Infect Dis.michigan. Influenza. Isolation and molecular characterization of equine H3N8 influenza viruses from pigs in China. Kim H. Harmon KM. Preparing for the second wave: lessons from current outbreaks. Vet Microbiol. Jung K.org. Canine influenza virus detected [online]. 168.int/eng/normes/mmanual/2008/pdf/2. 172. Promed Mail.htm. Sept. March 25. Available at: http://www.promedmail. Yamanaka T. Available at: http://www. Archive Number 20060503.who. Influenza virus infection in racing greyhounds. Griffiths LA.org. Randolph RW. 178.jsp?cfile= htm/bc/170303. Li C. Newton JR. Equine influenza.promedmail. Buonavoglia C. JR. Accessed 27 Sept 2005. 2005. Ferrets: Influenza. Nemoto M. The Merck veterinary manual [online]. Accessed 10 Jan 2007. Sweet C. Michigan Department of Agriculture. Antigenic and genetic variations in European and North American equine influenza virus strains (H3N8) isolated from 2006 to 2007. Janke BH.jsp?cfile= htm/bc/121303. Animal Health Diagnostic Center Announcements.com/mvm/index.a sp.avma. Cornell University College of Veterinary Medicine. Current veterinary therapy X.* Accessed 20 Aug 2004. October 2. Guo X. Equine influenza. 2009.cornell. Available at http://www. 2005. Accessed 11 Nov 2009.vetmed. Bronson alerts public to newly emerging canine flu.org. Available at: http://doacs.asp.merckvetmanual.state.0921. Zou W. Bryant NA. Chen H. p.html. 185. 2006. editor. Sept 21. Tsujimura K. 171. Desario C. 1996.Vet Microbiol. Jin M. MacRae S. Experimental infection of dogs with avianorigin canine influenza A virus (H3N2). Archive Number 20051002.int/csr/disease/swineflu/notes/h1n1_se cond_wave_20090828/en/index. Accessed 27 Sept 2005. IA: Iowa State University Press. 2 p.139(3-4):351-5.15:56-8. Daly JM. Lamb S.* Accessed 27 Sept 2005. Emerg Infect Dis. Troutman J. Martella V. 303-30. Lorusso E. Whitehouse Station. Microbiol Rev. Cavaliere N. Parisi A. 36-38. Bowman S. 175. May 3. 2007. Paillot R. canine-USA (multistate). Influenza. 2005. Di Trani L.ufl. Kang B. 2009154:887–890 176. WHO. Influenza. Available at: http://www. World Health Organization [WHO]. Ross J. Archive Number 20060620. OIE.* Accessed 27 Sept 2005. Ferret health advisory sheet. Archive Number 20060325. Canine influenza virus emerges in Florida [online]. Elia G. News Releases. Song D. 170. Medical and surgical care of the pet ferret: Influenza.org. editors.138(1-2):41-52. Strohbehn J. p.Influenza 167. 28 Aug 2009. NJ: Merck and Co. Oh T. McElroy T. 184. Available at: http://www.121:56-63. Available at: http://www. Promed Mail. Influenza. Accessed 3 Oct 2005. Florida Department of Agriculture and Consumer Services. Jiang T. editors. Yoon KJ. Rash AS.2006.11:1974-6. 775.htm. canine-USA (Wyoming). Lee C. Available at: http://www.merckvetmanual. Cooke A.us/press/2005/09202005. Carey S. Kahn CM. 188. Zhang A.oie. Meier H. Russell CA. 2009. Park B. Influenza. Accessed 31 Dec 2008. American Veterinary Medical Association. Lewis NS. 187. Line S. canine-USA (multistate). Accessed 10 Jan 2007. Elton DM.com/mvm/index. Vet Microbiol.
Sweet C.gc. Mizuta K. Archive Number 20090409. Tam JS. Influenza. Martin V. Microbiol. Suzuki H. Takashita E. Chi XS. Tsuchiya E. Maines TR.who.org.41:5770-3.Influenza 189. Muraki Y. Information for health care professionals [Website online]. Subbarao K. J Clin Microbiol. Arzoz-Padrés J. Arch Virol. Characterization of H5N1 influenza viruses isolated from migratory birds in Qinghai province of China in 2006. 204. Material Safety Data Sheet – Influenza virus. 200. 193. Mizuta K. Mizuta K.7:21. Anatidae migration in the western Palearctic and spread of highly pathogenic avian influenza H5NI virus. Itagaki T. Lubroth J. DeLiberto TJ.html. 2006. Chi XS.promedmail. Bortner JB. Tsuchiya E.14:1842-8. Bales BD. Tumpey TM. Hu A. Landolt G. Tisdale M. Hongo S. Ip HS. Zhao P. Russell S. Mikawa M. Japan. Zhang Z.40:422-9. Sugawara K. J Virol. Aspelund A. Kemble G. Muraki Y. raccoons. 192. serology. Pandemic (H1N1) 2009 . Pilon J. in 1996 and 1998. Kuzuya M. Córdova-Villalobos JA. Zhao P. A. Recommendations of the Advisory Committee on Immunization Practices (ACIP) Morb Mortal Wkly Rep. Barras SC. Apr. Antigenic and genetic characterization of influenza C viruses which caused two outbreaks in Yamagata City.53(2):222-30. 2008. Swafford SR. Takashita E. 9. 194. Cox NJ. Zakay-Rones Z. Santos C. 2007. CDC. Dusek RJ.phacaspc. Bentler KT. Root JJ. 195.html. Yparraguirre D. Centers for Disease Control and Prevention [CDC]. Influenza infection in wild raccoons. Elmore SA.81(20):11139-47. Yin Z. Donis RO. 2006. 2002. Office of Laboratory Security. 2001 Sept. Zhao D. Nishimura H.htm.. Nakamura K. Morag A. Strikas RA. 2003:77: 871–81. Zhang X. J Clin Microbiol.cdc. Belser JA. 190. Shimada S. Prevention and control of influenza.update 73. Tang S. 2009. Smith C.119:37–42. Suzuki H.ca/msds-ftss/index. Emerg Infect Dis. 207. Shay DK. Bolar TV.51:568-72.43:2345-9.gov/mmwr/preview/mmwrhtml/rr5510a 1. WHO. Avian Dis. 1991. Genetic diversity of influenza B virus: the frequent reassortment and cocirculation of the genetically distinct reassortant viruses in a community. Webster. PRO/AH/EDR> Avian influenza (32): Japan. 191. Matsuzaki Y. G. Isolation of influenza C virus during an outbreak of influenza A and B viruses. The influenza A(H1N1) epidemic in Mexico. Hall JS. Last Updated: December 2009 © 2009 page 38 of 46 . Franson JC. Jin H. Katsushima N. 202. Gilbert M. 2003. Hongo S. 209. Sugawara K.45:783-8. J Clin Microbiol.36:1441-2. Méndez JR. A nationwide epidemic of influenza C virus in Japan in 2004. Mizuta K. Domenech J. S. Pabilonia K. Accessed 1 Aug 2007. and R. Kuri-Morales P. Muraki Y. Li Y.12:16506. Xiao X. Li T. Li Y. 2004. Available at: http://www. Replication of avian influenza viruses in humans.int/csr/don/2009_11_06/en/index. 201 Greenbaum E. 2007. J Clin Microbiol. Sarti E. Suzuki H. Accessed 29 Dec 2006. Hoskins J. Matsuzaki Y. 203 Matsuzaki Y. Available at: http://www. ProMed Mail. Lessons learned.Avian influenza H6 viruses productively infect and cause illness in mice and ferrets. Katz JM. Al-Rimawi W. Rappaport R. Antimicrob Agents Chemother. Beare.cdc. Surveillance for high pathogenicity avian influenza virus in wild birds in the Pacific Flyway of the United States. Available at: http://www. J. J. 197. McLean RG. 198. Clin. Jakeman KJ. Co-circulation and evolution of two lineages of influenza B viruses in Europe and Israel in the 20012002 season. 2008. Sato K. Pathogenesis of avian influenza (H7) virus infection in mice and ferrets: enhanced virulence of Eurasian H7N7 viruses isolated from humans. 1991. 205. Yan B. Health Res Policy Syst. Kou Z. Avian Dis. Sullivan H. Smith NM. Accessed 8 Dec 2009. Rappaport R. Lei F. Frequent reassortment among influenza C viruses. Detection and characterization of new influenza B virus variants in 2002. Uyeki TM. Cheng SM. 2006-2007. Hongo S. 199. Accessed 24 Aug 2004. J. Lu X.gov/flu/professionals/background.82:10854-63. 2007. Slingenbergh J. 208.38:1864-7. 1994. Muraki Y. Li S. 196. Bolar TV. Slate D. Takao S. 2004. Zhang D. Virol. Driscoll C. 2006. Yang CF. Cheng SM. Virol. Manuell-Lee G. Wakatsuki K. World Health Organization [WHO].74:132-40. Efficacy of 2‟-deoxy-2‟-fluororibosides against influenza A and B viruses in ferrets. J Virol. Abiko C. Minnis RB. 1998. Chen Z. 206. Available at: http://www. Matsuzaki Y. Emerg Infect Dis. Bresee JS. Ye D. Nishimura H. Accessed 11 Nov 2009.55(RR-10):1-42. Sugawara K. Campbell TA. Gillim-Ross L. Available at http://www. Med. Sugawara K. 2005.htm.. Nishimura H. Hongo S. Chen S.1368. Leone A. Public Health Agency of Canada. 1 Nov 2009. 2009.
Smith TM. Evidence of infection by H5N2 highly pathogenic avian influenza viruses in healthy wild waterfowl. Bach VC. Tangsudjai S. Dubovi EJ. Chaichoune K. Lipatov AS. Hulse-Post DJ. 230. Franks J. 2007. 227. Siengsanan J. Zoonoses Public Health. Promkuntod N. Reed CE. Böhm R.9:314-28. Avian and swine influenza viruses: our current understanding of the zoonotic risk. PLoS Pathog. Hammoumi S. Hagemeijer W. Swayne DE. 222. Webster RG. 29:11951200. Mshelbwala JH. Govorkova EA. Henzler D. 2004. Japanese quail (Coturnix coturnix japonica) and ducks (Anas spp. Ratanakorn P. Haas B. Sept. Capua I. Cappelle J. 217.47(3 Suppl):1015-21. Stanislawek WL.php?page=disease_stat us_lists. Buranathai C. 2005. Krauss S. Peiris JS. 2005. Nguyen BH. Avian Dis. Strauch D. Poland R. Chen H. 2008. 215. Seiler P. Avian Pathol. viii.45(3):740-7. Vo MH. Weinstock D. Senne DA. Equine influenza.2513. 224.157:599. Cork SC. Stilianakis NI. Lubroth J. Njaa BL. Castro AE. 9. Le TP.390(2):212-20. Newton R. Manu S. Antarasena C. Liu J. 211. 221. Fusaro A.199(5):717-25. Cooke A. 2008. Ottosson U. Jones EE. Lu H. Elton D.Virology. Cooper RJ. Day M. Prommuang P. Blacksell SD. Available at http://www.14(2):435-45.38:827-35. Zoonotic potential of highly pathogenic avian H7N3 influenza viruses from Pakistan. Tissue tropism of a Thailand strain of high-pathogenicity avian influenza virus (H5N1) in tissues of naturally infected native chickens (Gallus gallus).54:51-68. Yang Q. PRO/AH/EDR> Avian influenza. Capua I. Laurence CJ. Puthavathana P. Sturm-Ramirez KM. Phonaknguen R. J Wildl Dis. 216. Stallknecht DE. Wiriyarat W. 2006. Last Updated: December 2009 © 2009 page 39 of 46 . ProMed Mail. Persistence of H5 and H7 avian influenza viruses in water. Ahl R. 225..161:142-3. Van Reeth K. Blacksell SD. Hammond TA. Sirimujalin R. Nguyen VV. Pennick K. Ecologic immunology of avian influenza (H5N1) in migratory birds.79:11269-79. Pathogenesis of H5N1 influenza virus infections in mice and ferret models differs according to respiratory tract or digestive system exposure. Rash A. Vet Rec. Humberd J. Blunden AS. Accessed 8 Jan 2008. Inactivation of viruses in liquid manure.13:1139-43. Tran TH. Brandley CA. Webster RG. Do QH.51:285-9. Beld M. Bryant N. Robertson I. Naeem K. Trampel DW. Tenacity of avian influenza viruses. de Jong MD. Surveillance for highly pathogenic avian influenza in migratory shorebirds at the terminus of the East Asian-Australasian Flyway. Pantin-Jackwood MJ.oie.Canine influenza. Vet Res. Dodman T.promedmail. Spickler AR. 1985. Avian Dis. Seiler P. Jackson CF.37:555-77. 2007. Swayne DE.38(2):243-60. Chaisingh A. Brown JD. 1995. 352:686-91. Moses HE. Monne I. Canine influenza virus. 2009.4(8):e1000127. World Animal Health Information Database (WAHID) Interface. 214. Brown JD. N Z Vet J. Phan TQ. 2003. Gaidet N. Inactivation of avian influenza viruses by chemical agents and physical conditions: a review. World Organization for Animal Health [OIE]. 2009. Ellis TM. Daly JM.Influenza 210. Naipospos TS. Brugh M. Pearson JE. 231. Avian Pathol. The onset of virus shedding and clinical signs in chickens infected with high-pathogenicity and low-pathogenicity avian influenza viruses. Johnson DC. Monicat F.57(3):160-5. Rev Sci Tech. Kocharin W. 2008. Emerg Infect Dis. Prommuang P. 213. Micheloni P. J Infect Dis. Bowman S. Am J Vet Res. Accessed 8 Dec 2009. Langstaff IG. Takekawa JY. Nguyen TD.Thailand (06).int/wahis/public. Vet Clin North Am Small Anim Pract. 228. Dunn P. N Engl J Med 2005. 219. OIE. Suwanpukdee S. 2008. Cappucci DT. Guan Y.35:250-3. Newman SH. De Benedictis P. Vet Rec. Avian Dis. Ahmed Z. Available at: http://www. Are ducks contributing to the endemicity of highly pathogenic H5N1 influenza virus in Asia? J Virol. 2009. 226. Stallknecht DE. 212. 2007. human . Burns RE. 223. Pattanarangsan R. Blunden T. 2009. Isolation of avian influenza virus (subtype H5N2) from chicken eggs during a natural outbreak. McKenzie JS.28(1):59-67. Rev Sci Tech. The isolation and identification of fowl plague virus. Domenech J. Prompiram P. 1948. 229. Beato MS. Miller J. Survival of avian influenza virus H7N2 in SPF chickens and their environments.). Tran TT. Farrar J: Fatal avian influenza A (H5N1) in a child presenting with diarrhea followed by coma. Smith KC. Archive Number 20040909.Comparison of outbreaks of H5N1 highly pathogenic avian influenza in wild birds and poultry in Thailand. Long HT. Weber TP. 220. Aamir UB. Sariya L. Camm I. Kwon YK. 2007. 2007. 232. Truong HK. 2009. Roth JA. Joannis T. Obert CA.org. 218. Gil P. Cattoli G. Canine influenza virus: cross-species transmission from horses.
[Epub ahead of print] 243. 2006. Webster RG.1 Xu J.Influenza 233.220(4593):206-8. Peru. May 13. Accessed 5 Nov 2009. Thitithanyanont A. 28 Apr 2009. Accessed 29 Apr 2009.1790. Setterquist SF. Quail carry sialic acid receptors compatible with binding of avian and human influenza viruses. 1983. Merchant JA. 2006. Capuano AW. Chunsutthiwat S. Bridges CB. 1994. Emerg Infect Dis. 2007.gov/swineflu/. 398-399. Garten RJ. Are swine workers in the United States at increased risk of infection with zoonotic influenza virus? Clin Infect Dis.gov/h1n1flu/press/. Canada. CDC.134(1-2):17-28. Last Updated: December 2009 © 2009 page 40 of 46 . Donham KJ. 2008. Ocular infection of mice with influenza A (H7) viruses: a site of primary replication and spread to the respiratory tract. Ardans AA. 241. Ortiz EJ. J Virol. Suzuki Y. Korteweg C. New Jersey (January-February 1976). Olsen CW. García-García ML. Spain. Capuano AW. Zhang B. Lu M. Shortridge KF. 256.42:14-20. 237. Summary and speculation. 244. Wan H. Webby R. Arch Virol.12(10):1621-2. 2006. Gray GC: Avian influenza and poultry workers. Available at: http://www.83(14):7075-84. N Engl J Med. Kanegae Y. Westover KM. Tompkins WA. Press briefing transcript: CDC briefing on public health investigation of human cases of swine influenza. Equine influenza. Chorazy ML. Hinshaw VS.12:1284-6. Gu J. Malden. Pittayawonganon C. Katz JM. Xie Z.inspection. Alavanja MC. CDC. Kayali G. 2006. 236 Auewarakul P. Zee YC. Questions and answers. Evidence for avian influenza A infections among Iowa's agricultural workers. Hiramatsu H. Lipkin WI. Martin RJ. J Occup Med. Gilchrist MJ. Influenza C virus infection in children. swine and human influenza viruses: cocirculation of two distinct lineages of swine virus. Virology.2:61-9. Sugita S. Ortiz EJ.370:1137-45. Available at: http://www.346:278-86. PRO/AH> Influenza A (H1N1): animal health (09). Lindstrom S. 2006. Guo CT. Perez DR.23(4):263-7. 255.shtml. Pandemic H1N1 flu virus: questions and answers. Evidence of previous avian influenza infection among US turkey workers. Emerg Infect Dis. Vana G. Lancet. Influenza Other Respir Viruses. 250. 247. Gong E.int/csr/disease/swineflu/frequently_ask ed_questions/levels_pandemic_alert/en/index. Yu AC. Bean WJ. Kochel TJ. Calvo C. Accessed 17 Nov 2009. Sangma C.cdc. Tumpey TM. Lau LT.who. Yoshioka Y. Emerg Infect Dis. 240. Setterquist SF. Downie J. 253. McCarthy T. Russell PK Swine influenza A at Fort Dix. Available at http://www. Centeno M. Swine influenza virus in swine and man in Illinois. 239. Archive Number 20090513. 1 Oct 2009. 238. Origin and evolutionary pathways of the H1 hemagglutinin gene of avian. Accessed 17 Nov 2009. Promed Mail. Influenza Other Respir Viruses. Gray GC. Serologic evidence of human and swine influenza in Mayan persons. 1977. Available at: http://www. Woods GT. Canadian Food Inspection Agency251. Lynch CF.136 Suppl:S376-80. McNutt MA. Louisirirotchanakul S. 2009. J Exp Med.47:1100-10. 254. Casas I.gc.org. Available at: http://www. H5N1 infection of the respiratory tract and beyond: a molecular pathology study. Swine influenza-like viruses in turkeys: potential source of virus for humans? Science. 2009 Apr 8. Uyeki TM. Senne DA. 1936. Xu X. Gray GC. CanulArmas AB. 242. swine. Nerome K. Mol Phylogenet Evol. The incidence of neutralizing antibodies for swine influenza virus in the sera of human beings of different ages. 251. 249. Suptawiwat O. 11 June 2009. Kongchanagul A. Finelli L. Thacker EL. Dawood FS. Shope RE. Setterquist SF. What is phase 6? WHO.81:99509955. Accessed 18 Sept 2009. Avian influenza among waterfowl hunters and wildlife professionals. Origin of the 1918 Spanish influenza virus: a comparative genomic analysis. Schnurrenberger PR. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. 245. Gray GC.ca/english/anima/disemala/sw igri/queste. Gill JS. In: Hirsch DC. Belser JA. Ayora-Talavera G.63:669-684. Jampangern W. 2007. 2009 H1N1 flu (“swine flu”). World Health Organization [WHO]. Pérez-Breña P. Puthavathana P. J Infect Dis. p. 2009. 2007. Gao Z. Gao Z. Pooruk P.html. CFIA.cdc. 2008. 252. 1999. J Virol. Centers for Disease Control and Prevention [CDC]. Liu J. Top FH Jr. Gubareva LV. 2009. 2009 Nov. 248. 2005. Ungchusak K.11(1):158-61. Wadford DA. Lerdsamran H. 234. MA: Blackwell Science. IV. Lu J. Shaw MW.promedmail. Jain S. Centers for Disease Control and Prevention [CDC]. Zoonoses Public Health. 235. An avian influenza H5N1 virus that binds to human-type receptor. Ye J. 246. Anderson VM. Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team.360(25):2605-15.1:65–9. Veterinary microbiology. Capuano AW. Cadavieco-Burgos JM. Gray GC. Myers KP. 1981. editors.
Herfst S. Archive Number 20091210. Dina J. 272. Interim guidance on specimen collection. Sakamoto M.promedmail. Available at: http://www. 265. Promed Mail. Osterhaus AD. Ritger KA. Tung CV. Centers for Disease Control and Prevention [CDC]. WHO. J Infect Dis. Accessed 5 Nov 2009. Bohm SR.html. Boucher CA.* Accessed 27 Apr 2009. Available at http://www. 2009. Archive Number 20091017.htm. Baker M.gov/swineflu/mitigation. CDC. Interim CDC guidance for nonpharmaceutical community mitigation in response to human infections with swine influenza (H1N1) virus. Available at: http://www. Accessed 5 Nov 2009.int/csr/disease/swineflu/notes/h1n1_cli nical_features_20091016/en/index. Accessed 5 Nov 2009. Ramírez OV.org.promedmail. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (60): bacterial coinfection. 267. September 2006.org.cdc. Accessed 19 Nov 2009. Mizuta K.gov/swineflu/casedef_swineflu. 2009. Khang DD. Taylor WR. Mai le Q. Int J Infect Dis. Freymuth F. Shu B. Interim guidance on case definitions to be used for investigations of swine influenza A (H1N1) cases.org.3534. 275. Oct 1. Promed Mail. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (79): responses in children. 2009. H1N1 2009 influenza virus infection during pregnancy in the USA. 264. 270. Munster VJ. Fouchier RA. Horby P. 13 May 2009. Available at http://www. Accessed 5 Nov 2009.cdc. Long HT.3410. Centers for Disease Control and Prevention [CDC]. Biggerstaff MS. CDC.14(42). Promed Mail. Promed Mail.promedmail. 268.cdc. 258. Accessed 11 Nov 2009. 271.14 Oct 2009. Interim recommendations for clinical use of influenza diagnostic tests during the 2009-10 influenza season. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (86): India (MH).gov/swineflu/guidelines_infection_cont rol.promedmail. 274.org. Petitjean J. Centers for Disease Control and Prevention [CDC].48(12):1639-46. CDC.htm. 269. MacFarlane KF. Katsushima N. Archive Number 20091001. 2009. Farrar J.htm. 2009. 2008. Accessed 16 Nov 2009.org. J Med Virol. Williams JL. and testing for patients with suspected novel influenza A (H1N1) virus infection. Hien ND. Bruce H. Oct 13. Christ CM. van den Brand JM. Burke C. Schrauwen EJ. Báez GG. Harris ML.org.org. Accessed 11 Nov 2009. Lindstrom S.3757. Archive Number 20091013. Accessed 27 Apr 2009. Clinical features of influenza C virus infection in children. Clinical features of human influenza A (H5N1) infection in Vietnam: 20042006. Archive Number 20091030. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (61): FLAARDS. Honein MA. Available at: http://www. Available at http://www. Available at: http://www. 260.gov/h1n1flu/guidance/diagnostic_tests.gov/h1n1flu/specimencollection. CDC. Itagaki T. 263. Available at http://www. Promed Mail. 2008. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (69): case management.325(5939):481-3.Clin Infect Dis. Matsuzaki Y. Koopmans M.htm. Hernández AG. CDC. Shoji M. Liem NT. Hien TT. Accessed 11 Dec 2009. Rimmelzwaan GF. 266. Dec 10. Archive Number 20090930. 16 Oct 2009.3577. 2009.193:1229-35.3796. Wilson N. Archive Number 20091103. Havana. 2009. Centers for Disease Control and Prevention [CDC]. Valdés CS. Available at http://www. Nagai Y. Swerdlow DL.3419. Science. Gouarin S. Chau NQ. Kitaoka S. Available at http://www. 2009. Novel Influenza A (H1N1) Pregnancy Working Group. Bestebroer TM. 273. Pathogenesis and transmission of swine-origin 2009 A(H1N1) influenza virus in ferrets.promedmail. Kuhles DJ. Olsen SJ. Nov 3. Promed Mail. 2009. 276. 261. using a molecular tool. Accessed 5 Nov 2009. Oct 17.who. Jamieson DJ. 259. Ramos AP. Cuvillon-Nimal D. Clinical features of severe cases of pandemic influenza. Last Updated: December 2009 © 2009 page 41 of 46 . Herrera BA.cdc. Hien NT.80(8):1441-6.374(9688):451-8.promedmail. van de Vijver D. Davidson HA. 29 Sept 2009. Detection of influenza C during an outbreak at an internal school. Accessed 5 Nov 2009. Kelly H. 26 Apr 2009. Oct 30.cdc.Influenza 257. Lutterloh E. Louie JK. Cocoros N. Available at: http://www. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (127): France. Pandemic H1N1 influenza lessons from the southern hemisphere. processing. Promed Mail. de Wit E. Study of influenza C virus infection in France. Cuba. UK. 2006. htm.4208. 2009. Brouard J. Nishimura H.12(6):e129-30. World Health Organization [WHO]. Available at http://www. Sept 30. 262. 2009. Centers for Disease Control and Prevention [CDC]. Eggers P. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (72): pneumonia. Vabret A. Lancet. Rasmussen SA. 26 Apr 2009. Kuiken T. Fonseca VP. Interim guidance for infection control for care of patients with confirmed or suspected swine influenza A (H1N1) virus infection in a healthcare setting. Available at: http://www. Finelli L. Wertheim H. Gonzalez G. pii: 19370.promedmail. Euro Surveill.
FDA. Accessed 27 Apr 2009. Samaan G.cdc.gov/h1n1flu/press/. United States Food and Drug Administration 296. Lancet.gov/wps/portal/!ut/p/_s. Accessed 5 Nov 2009. Factors associated with case fatality of human H5N1 virus infections in Indonesia: a case series. 283. VS].* Accessed 31 Jul 2007. Department of Agriculture. Setiawati T. With change in the seasons. 290.htm.h tm.gov/h1n1flu/guidance_homecare. Tresnaningsih E.xml. NIAID. CDC. Enserink M. Centers for Disease Control and Prevention [CDC]. Accessed 17 Nov 2009. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (71): case counts.cdc. Centers for Disease Control and Prevention [CDC]. Accessed 29 Apr 2009. Harun S. Available at: http://www.cdc. USDA APHIS.cdc. Accessed 11 Nov 2009. CDC. Accessed 11 Nov 2009. 2007 Apr.htm.gov/h1n1flu/guidance/exclusion. CDC. U. 2003 Feb. Accessed 27 Apr 2009. 24 Sept 2009. Accessed 11 Nov 2009. Kandun IN. Interim recommendations for facemask and respirator use in certain community settings where swine influenza A (H1N1) virus transmission has been detected. Centers for Disease Control and Prevention [CDC]. National Institutes of Health 279. Lee V.gov/swineflu/masks. Available at: http://www. CDC. 6 Oct 2009. Available at: http://www. Available at: http://www. Available at http://www. Centers for Disease Control and Prevention [CDC]. vaccine for humans against the avian influenza virus H5N1. 288.gov/h1n1flu/antivirals/facts_clinicians. 23 Oct 2009. 2009.htm.m.cdc. National Institute of Allergy and Infectious Diseases 279. Press briefing transcript: CDC media availability on human swine influenza cases. CDC.gov/h1n1flu/recommendations. Press briefing transcript: CDC media availability on human swine influenza cases.S. Accessed 11 Nov 2009. Archive Number 20091030.htm. Interim guidance on antiviral recommendations for patients with confirmed or suspected swine influenza A (H1N1) virus infection and close contacts. CDC.gov/factsheets/fludrugs. Wandra T. 2007.fda. Interim recommendations for facemask and respirator use to reduce 2009 influenza A (H1N1) virus transmission. Available at: http://www. Sariwati E.Influenza 277. Available at: http://www. 4 Nov 2009. Available at: http://www.gov/h1n1flu/masks. 286. Interim guidance for swine influenza A (H1N1): Taking care of a sick person in your home. CDC. Swine and human cases of swine influenza A (H1N1) [online]. CDC recommendations for the amount of time persons with influenza-like illness should be away from others. Veterinary Services [USDA APHIS. CDC. 285. 3 p.cdc. Animal and Plant Health Inspection Service. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (78): USA oseltamivir resist. 17 Nov 2009.cdc. Available at: http://www. Soni E. Available at: http://www. 281. World Health Organization [WHO]. Frequently asked questions. H1N1 clinicians questions and answers. 279.3568. 26 Apr 2009. Accessed 27 Apr 2009. Antiviral drugs and pandemic (H1N1) 2009.html.html.int/csr/disease/swineflu/frequently_ask ed_questions/swineflu_faq_antivirals/en/index. 284. NIH. Available at: http://www. VS. Interim CDC guidance for public gatherings in response to human infections with novel influenza A (H1N1).372:744–9.who.h tm. CDC. 23 Sept 2009. Centers for Disease Control and Prevention [CDC]. 294. Promed Mail. Flu drugs [online]. Promed Mail. Purba WH. Available at: http://www. WHO. Archive Number 20091017. Centers for Disease Control and Prevention [CDC].niaid. 23 Oct 2009. 2009. 289. Accessed 5 Nov 2009.gov/h1n1flu/guidance/public_gathering s. 287. Accessed 11 Nov 2009.7_0_A/7_0_1 OB?contentidonly=true&contentid=2009/04/0131. 278. FDA approves first U.cdc.usda. Centers for Disease Control and Prevention [CDC]. Quick facts for clinicians on antiviral treatments for 2009 H1N1. Oct 17.gov/h1n1flu/vaccination/clinicians_qa. Accessed 11 Nov 2009. Centers for Disease Control and Prevention [CDC]. Available at: http://www. 282.315:448.org. Accessed 17 Nov 2009.htm. 293. 292.* Accessed 11 Nov 2006. Normile D. Oct 30.promedmail. Available at http://www. Centers for Disease Control and Prevention [CDC]. Last Updated: December 2009 © 2009 page 42 of 46 . Centers for Disease Control and Prevention [CDC].cdc. Science.3753. Available at: http://www.org.promedmail.nih. 291. 27 Apr 2009. Press release P07-68. CDC. Septiawati C. 2008. 23 Oct 2009. 2009 Apr. 27 Apr 2009.S.gov/h1n1flu/press/.cdc.htm. 280.gov/bbs/topics/NEWS/2007/NEW0161 1.htm. bird flu returns. Available at: http://www.
Available at: http://www. WHO. 11 Oct 2009. Peiris JS. Ohyama S. Wildlife health bulletin #05-03 [online]. Available at: http://www.html.htm l.who.who. Shindo N. Homma M. Labat DD. Infect Immun. Van TD. PLoS One. Vet Rec. Pandemic flu mitigation. 301. Available at http://www. Influenza C virus infection in France. Puzelli S. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (62): Taiwan hosp cases. Vuong CD.org. Zambon M. MMWR Morb Mortal Wkly Rep. USDHHS. N Engl J Med. Naghdaliyev A. Luong ST. 2009. Nicholls JM. 316. Guan Y. Soeroso S. Taylor W. Available at http://www. Manvell RJ. Nguyen T.gov/publications/wildlife_health _bulletins/WHB_05_03. WHO.* Accessed 31 Jul 2007.worldwide (06): case counts. United States Geological Survey [USGS]. 2009. Peiris JS. Cattoli G. 1980. Horby P. Promed Mail.promedmail. Avian Dis. Influenza A (H1N1) – “swine flu” – worldwide (2). Human antibody to influenza C virus: Its age-related distribution and distinction from receptor analogs. Bui TN. 313. Hoang PV. 305. 2009. May 2. J Infect Dis. Sasaki H. Do HQ. 2007 May. Available at: http://www. Promed Mail. Nakamura K.24:91-9. Pandemic (H1N1) 2009 . Phan PH.nwhc. Leung CW. Di Trani L. Promed Mail.192:1318-22.* Accessed 2 Aug 2007. In vitro and in vivo characterization of new swineorigin H1N1 influenza viruses. Donatelli I. Accessed 29 Apr 2009. 2004. Archive Number 20090502. 311. Archive Number 20090428. Burlini F. Lim WL. Chotpitayasunondh T.html.html. de Jong MD. Mutinelli F. Centers for Disease Control and Prevention (CDC). Accessed 5 Nov 2009.promedmail. Last Updated: December 2009 © 2009 page 43 of 46 . Hannoun C. Re-emergence of fatal human influenza A subtype H5N1 disease. Accessed 27 Apr 2009. 298.27:639-42. 296. USDHHS. Influenza A (H1N1) – “swine flu” – worldwide (5). Panigrahy B. Nguyen HL. Fabiani C.46:298-307.promedmail. Archive Number 20090427. Pham HV.1586.jsp.3(10):e3339. 1993-2000: a spatial and temporal relationship. 299. Gohd RS.30:500-5. Microbiol Immunol. Chan KH.pandemicflu. Katagiri S. Age distribution of the antibody to type C influenza virus. 314. Accessed 30 Nov 2009. et al.org. Phillippines. USGS. Available at http://www.460(7258):1021-5. 2005 Aug. Wertheim HF. 2009.Serum cross-reactive antibody response to a novel influenza A (H1N1) virus after vaccination with seasonal influenza vaccine. Serological analysis of serum samples from humans exposed to avian H7 influenza viruses in Italy between 1999 and 2003.Influenza 295. Capua I.4 virus with a different antiviral susceptibility profile replaced clade 1 virus in humans in northern Vietnam.1654. 2002. Kiso M. Available at: http://www.org.3421. Kitame F.update 76.31:1137-43. World Health Organization [WHO]. Le MT. Pandemic (H1N1) 2009 . Accessed 3 May 2009. National Wildlife Health Center. Manuguerra JC. 2008. Nguyen HH. 2005. Itoh Y. 358:261–73. Lancet. Update on avian influenza A (H5N1) virus infection in humans. Accessed 11 Nov 2009. Promed Mail. 1987. 2008. 2009.org. Avian influenza virus subtypes inside and outside the live bird markets. Lai ST. Apr 28. Yuen KY. Terregino C. Oct 1. Watanabe T. 306. De Marco MA. de Jong MD. World Health Organization [WHO]. Prevalence of the antibody to influenza C virus in a northern Luzon Highland village.gov/plan/community/mitigatio n. 2000. Aguilera JF.pandemicflu. United States Department of Health and Human Services [USDHHS]. Sakoda Y. AbdelGhafar AN. 303. Ngoc BT. Ng TK. Highly pathogenic avian influenza (H7N1) in ostriches farmed in Italy. Accessed 5 Nov 2009. Available at: http://www. J Infect. 304. Capua I.gov/plan/community/maskgui dancecommunity. Crusat M.update 70. Available at http://www. Interim public health guidance for the use of facemasks and respirators in nonoccupational community settings during an influenza pandemic.3.3813. Accessed 25 Jan 2007. Hayden FG. Yu WC. Nature. Sugawara K.363:617–9. Campitelli L.promedmail. Influenza A (H1N1): . 300. 307. 27 Nov 2009. Ng WF. 2009. 297. 302. Nguyen HT. Nguyen CV. United States Department of Health and Human Services [USDHHS]. Aymard M. 1992. Farrar J.org.58(19):521-4. 309. 310.int/csr/don/2009_11_27a/en/index. Nguyen TV. PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (88): PAHO update Nov 4. Fox A. Nguyen DH. 312. 2009.promedmail. Archive Number 20091001. Apr 27. Influenza A H5N1 clade 2. Cheung CY.146:356. 2007 Feb. Senne DA. Nguyen BG. Nguyen TQ.usgs. Archive Number 20091104. Microbiol Immunol. Gao Z.int/csr/don/2009_10_16/en/index. Uyeki TM. Nishimura H. 308. Available at http://www. Nguyen HD.1609. 315. 1982. Writing Committee of the Second World Health Organization Consultation on Clinical Aspects of Human Infection with Avian Influenza A (H5N1) Virus. Pedersen JC. O‟Callaghan RJ. Promed Mail. Shinya K. Nguyen LT.
Role of terrestrial wild birds in ecology of influenza A virus (H5N1).1(8002):68-71. Jayaraman A. Boon AC.47:121418. Viswanathan K. Hooper PT. 1977. Ruchansky D. Accessed 5 Nov 2009. in Pennsylvania. Sasisekharan R.43:142-9. Cox NJ. 2009. Serologic evidence of influenza A and B viruses in South American fur seals (Arctocephalus australis). Shriver ZH. The isolation and classification of Tern virus: influenza A-Tern South Africa: 1961. Zeng H. 322. animal health (07): Chile. 2007. Tumpey TM. Kinde H. Seiler P. OIE. Tumpey TM. Guan Y. Wadford DA. Ziegler AF. Fereidouni S.com/mvm/index. 2003. 320. Vahlenkamp TW. Promed Mail. Kahn CM. Capua I. 331. Bean WJ.40(3):199-203. Gustin KM. Science. Arbiza J. 338. 1966. Hoffmann B. 336.47:828-31. Russell GW. Pavilanis V. 2003. Beer M. Vet Pathol. Maines TR. 1985. Katz JM. Transmission and pathogenesis of swine-origin 2009 A(H1N1) influenza viruses in ferrets and mice. 330. Avian Dis. Wolf PU. 328. 1999.39:458-64. Sheng ZM. Breithaupt A. editors. Clinical. 2009. © 2009 Last Updated: December 2009 page 44 of 46 . gross.and high-pathogenicity avian influenza epidemics in Italy during 1999 and 2000. Hoffmann B. Avian influenza (H9N2) outbreak in Iran. 1995. 319. Taubenberger JK.47:844-8. Nili H. 332.14(6):126.20:422-4. Avian Dis. Eckroade RJ. 329. Avian Dis. Harder TC. Pearce MB.Influenza 317. Marine mammals: Influenza virus. Isolation of an influenza A virus from domestic fowl in Great Britain. Stuart JC. Jagger BW. Cattoli G. Raman R. Moore J. Observations on the relationship in chickens between the virulence of some avian influenza viruses and their pathogenicity for various organs. 2009. Klopfleisch R. Carrick JB. Terregino C. 321. swine. An early 'classical' swine H1N1 influenza virus shows similar pathogenicity to the 1918 pandemic virus in ferrets and mice. Webster RG. Mettenleiter TC. 326. Perez DR. 1976. Kalthoff D.org. The pathology of bronchointerstitial pneumonia in young foals associated with the first outbreak of equine influenza in Australia. Toms GL.54:151-60.111:416. 2008. Characterization of virulent and avirulent A/chicken/Pennsylvania/83 influenza A viruses: potential role of defective interfering RNAs in nature. 1982. Wilkie I. Starick E. Promed Mail. 339. Belser JA. Songserm T.325(5939):484-7. Accessed 18 Sept 2009.merckvetmanual. Mettenleiter TC. 323.1691. PRO/AH/EDR> Influenza A (H1N1): animal health (07).Virology.htm. DiFranco E. Kawaoka Y. Pathogenesis and transmission of the novel swine-origin influenza virus A/H1N1 after experimental infection of pigs. Johnson DC. Suarez DL. Blohm U. Le Bas A.44:137-43. 327.3036. Begg AP. 2005. avian. 337. Alexander DJ. May 6. Emerg Infect Dis.promedmail. Canada. Selleck PW.35(1):71-6. H5N2 avian influenza outbreak in Texas in 2004: the first highly pathogenic strain in the United States in 20 years? J Virol.promedmail. J Wildl Dis. Araya Y. The occurrence of avian influenza A subtype H6N2 in commercial layer flocks in Southern California (2000-02): clinicopathologic findings. Memoli MJ. Wan H. Virol J. Acland H. Becker WB. Asasi K. Webster RG. 333. Sandbulte MR. Globig A. Swayne DE. Maxfield BG. 2009. Lancet. Avian Dis. Boudreault A. J Hyg (London).79:11412-21. Davison S. Axon JE. Mukai J. The Merck veterinary manual [online]. Mutinelli F. Line S.jsp?cfile=h tm/bc/170811. Lee CW. Accessed 19 Dec 2009. Webby RJ. Kash JC. 2009. Available at http://www. Whitehouse Station. 2003. Hammarlund M. Partial direct contact transmission in ferrets of a mallard H7N3 influenza virus with typical avian-like receptor specificity. 335. Teifke JP. An occurrence of avian influenza virus infection in laying chickens. Vet Rec. Read DH. Blanc A. Beer M. Achaval F. Starick E. Available at: http://www.45(2):519-21. Senne DA. Archive Number 20090829. Smith H. Stanislawek WL. Avian Dis. Equine Vet J. Maresch C.90(Pt 9):2119-23. Response of ferrets and monkeys to intranasal infection with human. Dugan VG. 1997-98. Can J Comp Med.org. Wood JM. J Gen Virol. Marois P.13:1720-4. Characteristics of H7N2 (nonpathogenic) avian influenza virus infections in commercial layers.64:309-320. Avian Dis. Song H. Teifke JP.393(2):338-45. 324. Archive Number 20090506. Sweet C. equine and avian influenza viruses. 2007. Lange E. Behaviour in ferrets of swine influenza virus isolated from man. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. and microscopic findings in different avian species naturally infected during the H7N1 low. 334. Pappas C. 29AUG-2009. 325. Pearson JE. Available at http://www. 1971. 2006. 2009. Qi L. Patterson-Kane JC. Linares JA. J Virol. 318. Pathology of natural infections by H5N1 highly pathogenic avian influenza virus in mute (Cygnus olor) and whooper (Cygnus cygnus) swans. Woolcock P. Clara M. Daft BM. Uzal F. NJ: Merck and Co.
fish feed. Yamamoto Y. 2006. Overview of avian influenza DIVA test strategies. Suarez DL. Available at: http://www. 360. Yamada M. 2003. Vaccination policy applied to the control of avian influenza in Italy. 352. and immune response of a lowpathogenicity H7N2 avian influenza virus in specificpathogen-free chickens. Byrne S. Canada: 1st pigs found with new swine flu virus. 346. poultry vs migratory birds. Yamanaka T. Tsujimura K. Quantification of the effect of vaccination on transmission of avian influenza (H7N7) in chickens. Yamamoto Y. Accessed 8 Jan 2006. J Vet Med Sci. 349. Last Updated: December 2009 © 2009 page 45 of 46 . Dev Biol (Basel). Teifke JP. Prevalence of influenza A H5N1 virus in cats from areas with occurrence of highly pathogenic avian influenza in birds. Breithaupt A. Emerg Infect Dis. 2008. Available at http://www. Highly pathogenic avian influenza virus (H5N1) in experimentally infected adult mute swans. clinical presentation. Mase M.aspx. Appropriate samples for detection [online]. 2004. Promed Mail. length of infection. Capua I.org.10:355-8. Schering-Plough.3700. van der Goot JA. and pathology associated with H7N3 avian influenza in British Columbia broiler breeder chickens in 2004. Accessed 5 Nov 2009. Efficacy of oseltamivir phosphate to horses inoculated with equine influenza A virus. 355. Emerg Infect Dis. 362. Harder T. Bowes VA. Associated Press. Koch G. 354. Pathogenicity of avian influenza viruses in poultry. Ellis E. Review of rapid molecular diagnostic tools for avian influenza virus.14:1267-70. Bublot M. 348. New York Times. Swayne DE. Schulz B. 2009. Available at: http://www. Proc Natl Acad Sci U S A.12:1319-24.102:18141-6.71(10):1377-80. Beer M. 358. Available at: http://www. Promed Mail. Avian Dis. J Feline Med Surg. 347.Avian Dis. Capua I. 2009. Biologicals.51:201-8. Huebner J. Matsumura T. Nakamura K. Narita M. Vet Rec. May 12. Hartmann K.promedmail. 350. Kondo T. Globig A. Brookes SM. Elbers AR. 2005.promedmail. Performance of gross lesions at postmortem for the detection of outbreaks during the avian influenza A virus (H7N7) epidemic in The Netherlands in 2003. Matrosovich M.diaglab.org. Foni E. Marangon S.* Accessed 4 May 2009. Robinson JH. Japan. 351. 359.asp?ts=sfa&pgID=6 75&ed_id=7423.promedmail. 344.asp#samp. 2004. Hobo S. 2007. Accessed 27 Apr 2009. in 2008. Cornell University College of Veterinary Medicine. Mase M. Avian influenza – Eurasia: wild birds. Control of avian influenza in poultry. Influenza A (H1N1) infection in pigs. Dec 28. 2 May 2009. NPB advises producers to protect herds. Lu H.edu/issues/civ. Yamada M. 2009. Virus characterization. Sojonky K. Available at: http://www. Marangon S. Archive Number 20051228.33:418-422. 343. Avian Dis. Evaluation of the infectivity. 2006. Harder Priv-Doz TC.33:221-6.com/products/canine-influenzah3n8/ProductDetails_130_121109. 2005. Nunez A. Accessed 10 Jan 2007.51:52-7. Accessed 10 Jan 2007. Archive Number 20060512. Loeffen W. Ikenaga N.48:263-70. Schering-Plough. Das A. 2005.porkmag. Available at: http://www. 345. Severe nonpurulent encephalitis with mortality and feather lesions in call ducks (Anas platyrhyncha var. 342. domestica) inoculated intravenously with H5N1 highly pathogenic avian influenza virus. Avian Pathol. Kuntz-Simon G.org. Irvine RM. Lee CW. Canine influenza virus. Castro AE. Senne DA. J Vet Med Sci. Beer M. Archive Number 20091027. Pork magazine [online].com/aponline/2009/05/02/world/A P-CN-Canada-Swine-Flu. 2004. 353.intervetusa. Dev Biol (Basel). Bidulka JJ. 24 Apr 2009. Effect of vaccine use in the evolution of Mexican lineage H5N2 avian influenza virus. Nakamura K.78:8372-81. Available at http://www. Marschall J. 2006.164(24):760-1. Avian influenza. Maldonado J. OIE. 341. animal (18): Canada (ON) avian. Avian Dis. Suarez DL. Brown IH. Cattoli G.Influenza 340.124:61-7. Koch G. Animal Health Diagnostic Center – Emerging Issues. 2007. Larsen L. H3N8.48:928-934. Kamps B. 356. Pathology of whooper swans (Cygnus cygnus) infected with H5N1 avian influenza virus in Akita.68:923-8.114:213-9. Suarez DL. van Boven M.cornell. Van Reeth K. 361. Oct 27. Mettenleiter TC. J Virol.vet. 2008. de Jong MC. Promed Mail. Huisinga E.com/swineflu. Vahlenkamp Priv-Doz TW. PRO/AH/EDR> Influenza pandemic (H1N1) 2009. Accessed 15 Dec 2009. Kitagawa K. 357. Pantin-Jackwood M. 2006. 2004. Ogawa S. Ritchie SJ. Canine influenza vaccine. Clifford D.nytimes.1350.3719. Essen S. 2009. Kalthoff D.
49:800-2. 1987. Kim JK. 2009. Seroprevalence of antibodies to canine influenza virus in dogs in Ontario. 2009. Available at: http://www. Kitikoon P. Hanson BA.gov/2009H1N1/project2. USDA. Pathogenesis of swine influenza virus (Thai isolates) in weanling pigs: an experimental trial.Can Vet J. Sliwa J (American Society for Microbiology [ASM]). Lewis LA. Kawaoka Y.ars. Available at: http://www.promedmail. 2008. Canine influenza was around as early as 1999.gov/2009H1N1/project3. Accessed 16 Nov 2009. Available at: http://www.asm. Avian influenza A (H5N1) age distribution in humans. Influenza A (H1N1) – “swine flu”: animal health. 15 Aug 2009.Influenza 363.9(3):1262. 375.3(4):121-8. 373. Forrest HL. Available at http://www. Available at: http://www. update. Weese JS.htm. Kedkovid R. Khan SI. Avian Dis. Virol J. Arikawa J. 2008 Mar 16-19.inspection. Cliff AD.org. CDC. Akbar SM.ars. Kruth SA. Available at: http://www. Smallman-Raynor M. 2007 13:510-2. 2009 Oct. 17 Jul 2009. Interim biosafety guidance for all individuals handling clinical specimens or isolates containing 2009-H1N1 Influenza A virus (novel H1N1). Centers for Disease Control and Prevention [CDC]. Mahtab MA. United States Department of Agriculture [USDA]. 372.usda. Promed Mail. 2009. Tohoku J Exp Med.usda.gov/h1n1flu/guidelines_labworkers. Apr 29.136(4):353-8. Swayne DE. Arch Virol. Accessed 29 Apr 2009. 371. Accessed 22 Nov 2009.gc. 366. Available at http://www. Archive Number 20090428.shtml. International Conference on Emerging Infectious Diseases. H1N1 flu virus . 364. Webster RG. Carman S. Tuamsang S. 2003. Intestinal replication of influenza A viruses in two mammalian species. The follow-up study of swine and Hong Kong influenza virus infection among Japanese hogs.pdf. 2009. United States Department of Agriculture [USDA]. 368. 376. including vaccine strains. Accessed 17 Nov 2009. Thanawongnuwech R. CFIA. Negovetich NJ. Stallknecht DE. 2009 Oct.promedmail.ca/english/anima/disemala/sw igri/swigrifse. Ishida N. Bordwell E. Influenza A (H1N1) – “swine flu” – worldwide (07). 367. Webster RG. Yamane N. Rural Remote Health.93:303–8. Senne DA.advice for veterinarians and swine producers.org. Press Release. Archive Number 20090429. Accessed 22 Nov 2009. pandemic 5. Sreta D.asp?bid=57269.47(3 Suppl):867-71.1604. 374.6(1):34. 365.org/Media/index. 369. 2009. Totsukawa K. Ducks: the "Trojan horses" of H5N1 influenza. Apr 28. Swine influenza (H1N1) pandemic: developing countries' perspective. Accessed 30 Apr 2009.pdf.* Accessed 13 Jan 2009. 1982. Canadian Food Inspection Agency251. GA. Avian influenza viruses in Minnesota ducks during 1998–2000. Hossain ST. 377. 370.cdc. USDA. Atlanta.1622.Thirty-pig pathogenesis study with 2009 A/H1N1 influenza virus isolates from California and Mexico. Emerg Infect Dis. *link defunct as of 2009 Last Updated: December 2009 © 2009 page 46 of 46 . Promed Mail. Influenza Other Respi Viruses. Four-pig pathogenesis study with the 2009 A/H1N1 influenza virus.
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