1. Prepared by- Md.Riaz

2. Acquaintance
 Influenza virus is a negative-sense single-
stranded RNA virus under the orthomyxoviridae
family. It causes Influenza disease commonly
known as ‘Flu’.
 Influenza is a highly contagious viral infection of
the respiratory passages of birds and mammals
including us can occur in epidemics.
 It is the most familiar virus in this present
world.

3. Orthomyxoviridae
 Order : Mononegavirales
 medium sized(80-120 nm), pleomorphic, enveloped
 Genome: linear, segmented (6-8), (-)sense, single-
stranded RNA, 10-13.6 kb
 It has six genera, including genera:-
 Influenzavirus A
 Influenzavirus B
 Influenzavirus C
 cause respiratory illness with systemic symptoms.

4. History
The word ‘Influenza’ comes from Italian language means
‘to influence’ that was first used by J. Hugger in 1703.
 Hippocrates first made accurate description on it.
In 1933 it discovered by the scientists: Christopher
Andrews, Wilson Smith, and Patrick Laidlaw.

5. Electron-Micrograph

6. Morphology
Influenza type A,B, and C are similar in structure. Those are
roughly spherical of 80-120 nm in diameter but type-C may
occur as filamentous.

7. Continued….
 The outer layer is the lipid membrane, spikes are
composed of glycoproteins: Hemagglutanin (HA) and
Neuraminidase (NA).
There present M2 protein embedded in lipid membrane
and M1 protein beneath the lipid membrane.
 The complete genome of Influenza is segmented into 8
fragments but 7 fragments in case of Influenza C. There total
11 genes are located in the genome encoded 11 proteins.
 The genomic size is about 13.5 bp.
* HA and NA proteins determine the subtype of influenza virus.

8. Continued….
NA= Neuraminidase
HA= Hemagglutinin
NP= Neucleoprotein
NS1= Non-structural protein
NS2(NEP)=mediates the export of
RNP-complexes from nucleus.
PB1, PB1-F2, PB2, PA = subunits of
viral RNA polymerase and are all
crucial for viral transcription and
replication.
M1= Matrix proteins form capside.
M2= Proton-selective Ion-channel

9. Genome-organization

10. Variation
 There are total 25 serotypes of Influenza: 16 HA and 9
NA varieties.
Influenza A: most virulent human pathogen among
influenza viruses, wide host-range, highest serotypes;
cause severe disease including: Bird-flu(H5N1), Swine-
flu(H1N1), become pandemics!
Influenza B : mostly found in human and only two serotypes
present. Influenza B don’t cause pandemics due to limited
host range.
Influenza C : It is milder and causes less severe disease.
Don’t become endemic and no subtype present.

11. Hemagglutinin
-Influenza virus surface
glycoprotein, cylinder-
shaped, consists of 549 amino
acids.
-It has a central alpha-helix coil
and three spherical heads contain
sialic acid binding sites
-works in viral attachment with
sialic acid receptor and in fusion of
viral envelope with endosome.
-There are at least 18 different HA
antigens. H18 discovered in 2013.

12. Neuraminidase
-Influenza virus surface
glycoprotein
- It has 9 different NA antigens
- enzymatically cleaves the sialic
acid groups from host cells, thus
promote entry and replication.
- promotes the release of
progeny viruses
- Target of antiviral drugs:
Zanamvir, Oseltamivir

13. L i fe - c y c l e
(Pathology)

14. Pathophysiology
Influenza virus can infect both upper and lower respiratory tracts.
Sialic acid on epithelial cells are the receptors.
 The typical incubation period of influenza is 24 hours to 4 days with
average: 2 days.
 Children's are more readily affected than adults.

15. Symptoms
 Fiver: 100°F to 104°F, can be raised to 106°F
 Headache
Dry cough
runny nose, sore throat
Fatigue (tiredness)
Body aches and Myalgia

16. Transmission
Influenza can be spread in three main ways:
Direct transmission: an infected person frequently touch their
nose, mouth or conjunctiva.
Virus-laden aerosols: coughing,
sneezing, speaking,normal breathing
all produce aerosols. A good sneeze
can generate up to 20,000
aerosols. Even a single droplet may
cause infection. Droplet-nuclei
(1-4 µm) suspended in the air for
long period and spreads the disease much.
Indirect transmission: through contaminated objects :called
fomites, such as toys, doorknobs, light switches etc.

17. Diagnosis
 Isolation
-- Nose, throat swab
-- Tissue culture
 Serology
 Rapid Test: ‘Rapid Influenza diagnostic test’ is most
common done by swabbing nose and throat secretion.
* Albeit, different tests and experiments the symptoms associated with Influenza are most important tools to become
identified as an Influenza patient.
Call your doctor when:
Difficulty breathing or shortness of breath
 Pain or pressure in the chest or abdomen
 Dizziness
 Confusion
 Severe or persistent vomiting

18. Treatments
It includes a range of medications and therapies:-
Antiviral drugs:
a. Oseltamivir: serving as competitive inhibitor of the activity of viral
neuraminidase enzyme on sialic acid.
b. Zanamivir: works by binding to the active site of the
neuraminidase protein, rendering the influenza virus unable to
escape its host cell.
c. M2 inhibitors: The antiviral drugs such as- Amantadine and
Rimantadine block a viral ion channel (M2 protein) and prevent the
virus from infecting cells.

19. Symptomatic treatments
CDC recommends persons suffering from Influenza:
 Stay at home
 Get plenty of rest
 Drink lots of liquids
 Don’t smoke and avoid alcohol
 Remain alert for emergency warning signs

20. Vaccination
 Annual vaccination for a given year.
Each seasonal vaccine contains three/four viral-strain
antigens:
Type A H1N1
Type B H3N2
Type B strains
* CDC said that Flu vaccine is 61% effective and recommends flu
vaccination for all over 6 months.
Side effect:
There is no severe side-effects of influenza vaccine.
Sometimes allergic reaction and increased cough, runny
nose, asthma are identified in childrens.

21. Continued…
• Inactivated subunit (TIV/QIV)
– intramuscular
– trivalent or quardivalent
– split virus and subunit types (killed)
– duration of immunity 1 year or less
• Live attenuated vaccine (LAIV)
– intranasal
– Trivalent
– live attenuated
– duration of immunity at least 1 year

22. Interferon
The Alpha/Beta Interferon Receptor Provides Protection
against Influenza Virus Replication
IFN-gamma treatment at early stages of influenza virus
infection protects mice from death in a NK cell-dependent
manner.
 Side-effects:
Fever
Malaise
Muscle pain
Fatigue

23. Prevention
• Get vaccinated each year
•Washing hands
• Covering nose and mouth while
coughing, sneezing
• Avoid touching nose, mouth, eyes
• Limited contact with sick people.

24. Antigenic Drift
Due to the absence of proofreading activity, the RNA-
dependent RNA polymerase copies the viral genome making
error roughly in every 10 thousand nucleotides (which is
the approximate length of the influenza vRNA). Hence, the
majority of newly assembled influenza viruses are
mutants, thus the antibody-binding sites become changed.
This is called antigenic-drift.
 caused by point mutation
 change in HA and NA
 results in epidemics
 eg. outbreak of influenza A H3N2 (2003-2004)
 occurs in all type A, B and C

25. Continued…

26. Antigenic Shift
When more than one type of influenza virus infects a
single cell the separation of viral genome into eight
separated segments allows mixing or reassortment of
new viral RNAs that induces new strains of influenza
virus. This process called antigenic-shift. It occurs only in
influenza Type A.
 caused by exchange of genetic materials (RNA)
 new strains generate
 results in pandemics
 eg. Asian flu by H2N2 subtype in 1958-1959.
 only in influenza type A

27. Continued…

28. Pandemic (Influenza)
Name of Pandemic Date Deaths
Spanish flu 1918-1920 20-100 million
Asian flu 1957-1958 1-1.5 million
Hong Kong flu 1968-1969 .75-1.0 million
Russian flu 1977-1978 No accurate count.
2009 flu pandemic 2009-2010 18,000

29. Influenza A (H1N1) pandemic: 2009
.

30. Pandemic:2009
The H1N1 resulted when a previous triple reassortment of
bird, swine and human flu viruses further combined with a
Eurasian pig flu virus and spreads out Swine flu.
 The outbreak was first detected in Mexico City on 18 March
2009
 Total 14,286 people have been died worldwide.
U.S. president Barack Obama being vaccinated against H1N1 flu on 20 December
2009

31. Current-Research
• Influenza Genome Sequencing Project (IGSP):
creating a library of influenza sequences to clarify which factors make one strain
more lethal than another. As of mid-2008, over 3000 isolates had been completely
sequenced.
• Research into new vaccines :
the generation of new vaccine strains . The most remarkable is:
research on a universal influenza A
vaccine, targeted against the M2 protein
is being done at the University of Ghent
by Walter Fiers,Xavier Saelens and
their team and now under clinical trials.
• Study the infection in other
animals especially birds.

32. Avian flu
*Avian influenza known as bird-flu. All known viruses
that cause influenza in birds belong to the species
influenza A virus.
*Most highly pathogenic strain H5N1 had been spreading
throughout Asia since 2003 and reached to Europe
In 2005.
*There are many
subtypes of AIV:
H5N1, H7N3, H7N7
H7N9, and H9N2

33. Swine flu
*Swine flu also known as ‘Pig influenza’. It is caused by Swine
influenza viruses including Influenza C and Influenza A
subtypes: H1N1, H1N2, H2N1, H3N1, H3N2, and H2N3.
* Direct transmission of an influenza virus from pigs to humans is
occasionally possible.
* In 2009, a swine-origin
H1N1 virus strain
commonly referred to as
"swine flu" caused the
‘2009 flu pandemic’.

34. Flu in Bangladesh
Institute of Epidemiology, Disease Control and
Research (IEDCR), ICDDRB, CDC (Bangladesh
branch) are disease monitoring arm.
Bangladesh notified its first infection on May 22,
2008
Four flu viruses –H1N1, H5N1, H3N2 and
H9N2— are circulating in Bangladesh.