Reply #18: From new England Journal of Medicine and others> [View All]

[bluedawg12]

New England Journal of Medicine

Previous Volume 353:1374-1385 September 29, 2005 Number 13

Avian Influenza A (H5N1) Infection in Humans
The Writing Committee of the World Health Organization (WHO) Consultation on Human Influenza A/H5

“An unprecedented epizootic avian influenza A (H5N1) virus that is highly pathogenic has crossed the species barrier in Asia to cause many human fatalities and poses an increasing pandemic threat. This summary describes the features of human infection with influenza A (H5N1) and reviews recommendations for prevention and clinical management presented in part at the recent World Health Organization (WHO) Meeting on Case Management and Research on Human Influenza A/H5, which was held in Hanoi, May 10 through 12, 2005.1 Because many critical questions remain, modifications of these recommendations are likely...

Conclusions

Infected birds have been the primary source of influenza A (H5N1) infections in humans in Asia. Transmission between humans is very limited at present, but continued monitoring is required to identify any increase in viral adaptation to human hosts. Avian influenza A (H5N1) in humans differs in multiple ways from influenza due to human viruses, including the routes of transmission, clinical severity, pathogenesis, and perhaps, response to treatment. Case detection is confounded by the nonspecificity of initial manifestations of illness, so that detailed contact and travel histories and knowledge of viral activity in poultry are essential. Commercial rapid antigen tests are insensitive, and confirmatory diagnosis requires sophisticated laboratory support. Unlike human influenza, avian influenza A (H5N1) may have higher viral titers in the throat than in the nose, and hence, analysis of throat swabs or lower respiratory samples may offer more sensitive means of diagnosis. Recent human isolates are fully resistant to M2 inhibitors, and increased doses of oral oseltamivir may be warranted for the treatment of severe illness. Despite recent progress, knowledge of the epidemiology, natural history, and management of influenza A (H5N1) disease in humans is incomplete. There is an urgent need for more coordination in clinical and epidemiologic research among institutions in countries with cases of influenza A (H5N1) and internationally. “
...........

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16213784&query_hl=5
.........
J Clin Virol. 2005 Oct 4; Related Articles, Links


Avian influenza A (H5N1).
de Jong MD, Hien TT.
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, District 5, Ho Chi Minh City, Viet Nam.
Since their reemergence in 2003, highly pathogenic avian influenza A (H5N1) viruses have reached endemic levels among poultry in several southeast Asian countries and have caused a still increasing number of more than 100 reported human infections with high mortality. These developments have ignited global fears of an imminent influenza pandemic. The current knowledge of the virology, clinical spectrum, diagnosis and treatment of human influenza H5N1 virus infections is reviewed herein.
..................
Semin Pediatr Infect Dis. 2005 Oct;16(4):326-35. Related Articles, Links


Avian Influenza Virus H5N1: A Review of Its History and Information Regarding Its Potential to Cause the Next Pandemic.

Ligon BL.

Baylor College of Medicine, Houston, Texas.

Avian influenza virus H5N1, which has been limited to poultry, now has spread to migrating birds and has emerged in mammals and among the human population. It presents a distinct threat of a pandemic for which the World Health Organization and other organizations are making preparations. This article reviews information about the virus itself and its spread among poultry, migrating birds, mammals, and humans

.........