Birdflu

Will it be just a scare … or a scar on human history? Bird flu

It has become the headlines of news channels It’s circulating largely among bird flocks in Asia … Thailand on Monday 7/11/05 reported its 20 th human victim since 2003 … China reports sixth case in this year … It’s bird flu …that’s spreading through ! High mortality rate : 62% human fatal cases WHO

“ A pandemic of bird flu” Health experts fear that the avian flu virus could mutate and acquire the ability to infect large numbers of people ... Should that happen, without immediate and effective interventions to contain it … the Global Impact could be incalculable

[object Object],[object Object],[object Object],[object Object],[object Object],FLU

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],BIRD / AVIAN FLU

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TRANSMISSION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Can be passed bird -> bird, or bird -> human when virus is inhaled, as it is an air-borne disease WHO

AVIAN INFLUENZA : BIRDS TO HUMANS ,[object Object],[object Object],[object Object],[object Object],[object Object],Migratory water birds Domestic birds Humans

HOW FLU VIRUSES CHANGE ,[object Object],[object Object],[object Object],[object Object],WHO

ANTIGENIC DRIFT ,[object Object],[object Object],[object Object],[object Object],WHO

ANTIGENIC SHIFT ,[object Object],[object Object],[object Object],[object Object],WHO

REASSORTMENT : Pigs New subtype influenza

REASSORTMENT : Humans New subtype influenza

CONSEQUENCES : ANTIGENIC SHIFT ,[object Object],[object Object],[object Object],[object Object],[object Object],WHO

Circulating influenza strains and pandemics in 20 th century 1920 1940 1960 1980 2000 H1N1 1918: “Spanish Flu” 20-40 million deaths WHO H2N2 1957: “Asian Flu” 1 million deaths H3N2 1968: “Hong Kong Flu” 1 million deaths

H5N1 : WHY SUCH CONCERN ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],WHO

Opportunities for virus emergence and spread ,[object Object],[object Object],[object Object],[object Object],[object Object]

WHO IS AT RISK? ,[object Object],[object Object],[object Object]

MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],Neuraminidase inhibitors ,[object Object],[object Object],Adamantanes

NEJM 2005 Fusion with host cell Attachment to host cell receptor – sialic acids Virus Replicates its genetic material inside host cell Viral progeny Attached to host cell receptor-sialic acids Releases the attached progeny; removing sialic acid LIFE CYCLE OF INFLUENZA H spike N spike M 2 protein NEURAMINIDASE INHIBITORS Prevent the virus from infecting new cell

NEURAMINIDASE vs ADAMANTANES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],NEJM 2005; 353: 1363-73

Bird Flu : H5N1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Birdflu

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Birdflu