Flu

Influenza Virus Avian influenza Flu season Research Vaccine Treatment Genome project H5N1 strain

The flu vaccine is a vaccine to protect against the highly variable influenza virus. Image File history File links Flu_und_legende_color_c. ... Influenza, commonly known as flu, is an infectious disease of birds and mammals caused by an RNA virus of the family Orthomyxoviridae (the influenza viruses). ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus The Orthomyxoviridae are a family of RNA viruses which infect vertebrates. ... Avian influenza (also known as bird flu, avian flu, influenzavirus A flu, type A flu, or genus A flu) is a flu (influenza) due to a type of influenza virus that is hosted by birds, but may infect several species of mammals. ... Flu season is mostly a colloquial term used to describe the regular outbreak in flu cases, or even cases of the common cold during the late fall or winter. ... Flu research includes molecular virology, pathogenesis, host immune responses, genomics, and epidemiology. ... This article is about flu treatment in humans for mild human flu, which includes both efforts to reduce symptoms and to battle the flu virus itself. ... The Influenza Genome Sequencing Project is funded by the National Institute of Allergy and Infectious Diseases (NIAID) which is a component of the National Institutes of Health (NIH), which is an agency of the United States Department of Health and Human Services. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ... Image File history File links Influenza_virus. ... NIH can refer to: National Institutes of Health Norwegian School of Sports Sciences: (Norges idrettshøgskole - NIH) Not Invented Here This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... Influenza, commonly known as flu, is an infectious disease of birds and mammals caused by an RNA virus of the family Orthomyxoviridae (the influenza viruses). ... This article is about biological infectious particles. ...

The flu kills an estimated 36,000 people in the United States each year. The annually updated trivalent flu vaccine for the 2006–2007 season consists of hemagglutinin (HA) surface glycoprotein components from influenza H3N2, H1N1, and B influenza viruses.^[1] In chemistry, valency is the power of an atom of an element to combine with other atoms measured by the number of electrons which an atom will give, take, or share to form a chemical compound. ... Hemagglutinin, as depicted in a simplified molecular model. ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... H1N1 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... Influenzavirus B is a genus in the virus family Orthomyxoviridae. ...

Each year the influenza virus changes and different strains become dominant. Due to the high mutability of the virus a particular vaccine formulation usually only works for about a year. The World Health Organization coordinates the contents of the vaccine each year to contain the most likely strains of the virus to attack the next year. The flu vaccine is usually recommended for anyone in a high-risk group who would be likely to suffer complications from influenza. A vaccine is an antigenic preparation used to establish immunity to a disease. ... “WHO” redirects here. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... Influenza, commonly known as flu, is an infectious disease of birds and mammals caused by an RNA virus of the family Orthomyxoviridae (the influenza viruses). ...

History of the flu vaccine

See also: Timeline of vaccines

Vaccines are used in both humans and nonhumans. Human vaccine is meant unless specifically identified as a veterinary or poultry or livestock vaccine. Timeline of vaccines This is a timeline of the development of prophylactic vaccines. ...

Vaccines prior to flu vaccines

A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or ameliorate the effects of infection by any natural or "wild" strain of the organism. The process of distributing and administrating vaccines is referred to as vaccination. Smallpox is the first disease people tried to prevent by purposely inoculating themselves with other types of infections. Smallpox inoculation is believed to have started in India or China before 200 BC.^[2] In 1718, Lady Mary Wortley Montague reported that the Turks have a habit of deliberately inoculating themselves with fluid taken from mild cases of smallpox and she inoculated her own children. In 1796 Edward Jenner inoculated using cowpox (a mild relative of the deadly smallpox virus). Pasteur and others built on this.^[3] A vaccine is an antigenic preparation used to establish immunity to a disease. ... For the server security software, see Microsoft Forefront. ... Immunity is a medical term that describes a state of having sufficient biological defenses to avoid infection, disease, or other unwanted biological invasion. ... An infection is the detrimental colonization of a host organism by a foreign species. ... A vial of the vaccine against influenza. ... Smallpox (also known by the Latin names Variola or Variola vera) is a contagious disease unique to humans. ... Inoculation, originally Variolation, is a method of purposefully infecting a person with smallpox (Variola) in a controlled manner so as to minimise the severity of the infection and also to induce immunity against further infection. ... Year 1718 (MDCCXVIII) was a common year starting on Saturday (link will display the full calendar) of the Gregorian calendar (or a common year starting on Tuesday of the 11-day slower Julian calendar). ... The Lady Mary Wortley Montagu (May 26, 1689 - August 21, 1762), was an English woman of letters. ... Year 1796 (MDCCXCVI) was a leap year starting on Friday (link will display the full calendar) of the Gregorian calendar (or a leap year starting on Monday of the 11-day slower Julian calendar). ... Portrait of Edward Jenner Edward Jenner, FRS, (17 May 1749 – 26 January 1823) was an English country doctor who studied nature and his natural surroundings from childhood and practiced medicine in Berkeley, Gloucestershire, England. ... Cowpox is a disease of the skin caused by a virus (Cowpox virus) that is related to the Vaccinia virus. ... Louis Pasteur (December 27, 1822 – September 28, 1895) was a French microbiologist and chemist who demonstrated the germ theory of disease and developed techniques of inoculation, most notably the first vaccine against rabies. ...

Influenza

Influenza, commonly known as the flu, is an infectious disease that infects birds and mammals (primarily of the upper airways and lungs in mammals) and is caused by an RNA virus of the Orthomyxoviridae family (the influenza viruses). The most common and characteristic symptoms of influenza in humans are fever, pharyngitis (sore throat), myalgia (muscle pains), severe headache, coughing, and malaise (weakness and fatigue).^[4] Hippocrates first described the symptoms of influenza in 412 B.C. Since then, the virus has undergone mutations and shifts and has caused numerous pandemics. The first influenza pandemic was recorded in 1580, since this time, various methods have been employed to eradicate its cause.^[5] The etiological cause of influenza, the orthomyxoviridae was finally discovered by the Medical Research Council (MRC) of the United Kingdom in 1933.^[6] Influenza, commonly known as flu, is an infectious disease of birds and mammals caused by an RNA virus of the family Orthomyxoviridae (the influenza viruses). ... This false-colored electron micrograph shows a malaria sporozoite migrating through the midgut epithelia. ... For other uses, see Bird (disambiguation). ... Subclasses & Infraclasses Subclass †Allotheria* Subclass Prototheria Subclass Theria Infraclass †Trituberculata Infraclass Metatheria Infraclass Eutheria Mammals (class Mammalia) are warm-blooded, vertebrate animals characterized by the presence of sweat glands, including those that produce milk, and by the presence of: hair, three middle ear bones used in hearing, and a neocortex... The heart and lungs (from an older edition of Grays Anatomy) The lung is an organ belonging to the respiratory system and interfacing to the circulatory system of air-breathing vertebrates. ... An RNA virus is a virus that either uses RNA as its genetic material, or whose genetic material passes through an RNA intermediate during replication. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus The Orthomyxoviridae are a family of RNA viruses which infect vertebrates. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus The Orthomyxoviridae are a family of RNA viruses which infect vertebrates. ... This article needs additional references or sources for verification. ... ώ:For the noisegrind band, see Sore Throat. ... Myalgia means muscle pain and is a symptom of many diseases and disorders. ... A headache (cephalalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Malaise is a feeling of general discomfort or uneasiness, an out of sorts feeling, often the first indication of an infection or other disease. ... For other uses, see Hippocrates (disambiguation). ... Current MRC logo The Medical Research Council (MRC) is a UK organisation dedicated to promot[ing] the balanced development of medical and related biological research in the UK. // The MRC is one of seven Research Councils and is answerable to, although politically independent from, the Office of Science and Innovation...

Known flu pandemics:^[7]

• 1889–90 - Asiatic (Russian) Flu, mortality rate said to be 0.75-1 death per 1000 possibly H2N2
• 1900 - possibly H3N8
• 1918–20 – Spanish Flu, 500 million ill, at least 20-40 million died of H1N1
• 1957–58 – Asian Flu, 1 to 1.5 million died of H2N2
• 1968–69 – Hong Kong Flu, 3/4 to 1 million died of H3N2

Year 1889 (MDCCCLXXXIX) was a common year starting on Tuesday (link will display the full calendar) of the Gregorian calendar (or a common year starting on Sunday of the 12-day slower Julian calendar). ... Year 1890 (MDCCCXC) was a common year starting on Wednesday (link will display the full calendar) of the Gregorian calendar (or a common year starting on Monday of the Julian calendar). ... The Asian Flu was a pandemic outbreak of influenza that originated in China in 1957 and spread worldwide that same year. ... Äž: For the film, see: 1900 (film). ... H3N8 is a subtype of the species avian influenza virus (bird flu virus). ... 1918 (MCMXVIII) was a common year starting on Tuesday of the Gregorian calendar (see link for calendar) or a common year starting on Wednesday of the Julian calendar. ... 1920 (MCMXX) was a leap year starting on Thursday. ... The 1918 flu pandemic, commonly referred to as the Spanish flu, was a category 5 influenza pandemic caused by an unusually severe and deadly Influenza A virus strain of subtype H1N1. ... H1N1 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... Year 1957 (MCMLVII) was a common year starting on Tuesday (link displays the 1957 Gregorian calendar). ... Year 1958 (MCMLVIII) was a common year starting on Wednesday (link will display full calendar) of the Gregorian calendar. ... The Avian Flu was a pandemic outbreak of influenza that originated in China in 1957 and spread worldwide that same year. ... The Asian Flu was a pandemic outbreak of influenza that originated in China in 1957 and spread worldwide that same year. ... Year 1968 (MCMLXVIII) was a leap year starting on Monday (link will display full calendar) of the Gregorian calendar. ... Also: 1969 (Stargate SG-1) episode. ... The Hong Kong Flu was a pandemic outbreak of influenza that began in Hong Kong in 1968 and spread to the United States of America that year. ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ...

Flu vaccine origins

In the world wide Spanish flu pandemic of 1918, "Physicians tried everything they knew, everything they had ever heard of, from the ancient art of bleeding patients, to administering oxygen, to developing new vaccines and sera (chiefly against what we now call Hemophilus influenzae—a name derived from the fact that it was originally considered the etiological agent—and several types of pneumococci). Only one therapeutic measure, transfusing blood from recovered patients to new victims, showed any hint of success."^[8] The 1918 flu pandemic, commonly referred to as the Spanish flu, was a category 5 influenza pandemic caused by an unusually severe and deadly Influenza A virus strain of subtype H1N1. ...

"In 1931, viral growth in embryonated hens' eggs was discovered, and in the 1940s, the U.S. military developed the first approved inactivated vaccines for influenza, which were used in the Second World War".^[3]

Flu vaccine acceptance

The current egg-based technology for producing influenza vaccine was created in the 1950s.^[9]

"The WHO Global Influenza Surveillance Network was established in 1952. The network comprises 4 WHO Collaborating Centres (WHO CCs) and 112 institutions in 83 countries, which are recognized by WHO as WHO National Influenza Centres (NICs). These NICs collect specimens in their country, perform primary virus isolation and preliminary antigenic characterization. They ship newly isolated strains to WHO CCs for high level antigenic and genetic analysis, the result of which forms the basis for WHO recommendations on the composition of influenza vaccine for the Northern and Southern Hemisphere each year."^[10] National Influenza Centers (also called National Influenza Centres) are institutions which are formally recognized as such by WHO. Among the more than 110 National Influenza Centers are the WHO collaborating centres and reference laboratories that are involved in annual influenza vaccine composition recommendations. ... Look up who in Wiktionary, the free dictionary. ...

In the U.S. swine flu scare of 1976 President Gerald Ford was confronted with a potential swine flu pandemic. The vaccination program was plagued by delays and public relations problems, but about 24% of the population was vaccinated by the time the program was canceled with much concern and doubt about flu vaccination.^[11] Swine Flu is a form of Type A influenza that is normally virulent only in pigs. ... For other persons named Gerald Ford, see Gerald Ford (disambiguation). ... A vial of the vaccine against influenza. ...

According to the CDC: "Influenza vaccination is the primary method for preventing influenza and its severe complications. [...] Vaccination is associated with reductions in influenza-related respiratory illness and physician visits among all age groups, hospitalization and death among persons at high risk, otitis media among children, and work absenteeism among adults. Although influenza vaccination levels increased substantially during the 1990s, further improvements in vaccine coverage levels are needed".^[12]

Current status

Flu research includes molecular virology, molecular evolution, pathogenesis, host immune responses, genomics, and epidemiology. These help in developing influenza countermeasures such as vaccines, therapies and diagnostic tools. Improved influenza countermeasures require basic research on how viruses enter cells, replicate, mutate, evolve into new strains and induce an immune response. The Influenza Genome Sequencing Project is creating a library of influenza sequences that will help us understand what makes one strain more lethal than another, what genetic determinants most affect immunogenicity, and how the virus evolves over time. Solutions to limitations in current vaccine methods are being researched. Flu research includes molecular virology, pathogenesis, host immune responses, and epidemiology. ... Molecular Virology is the study of viruses at the molecular level. ... Molecular evolution is the process of the genetic material in populations of organisms changing over time. ... Pathogenesis is the mechanism by which a certain etiological factor causes disease (pathos = disease, genesis = development). ... A request has been made on Wikipedia for this article to be deleted in accordance with the deletion policy. ... Genomics is the study of an organisms entire genome; Rathore et al, . Investigation of single genes, their functions and roles is something very common in todays medical and biological research, and cannot be said to be genomics but rather the most typical feature of molecular biology. ... Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... The Influenza Genome Sequencing Project is funded by the National Institute of Allergy and Infectious Diseases (NIAID) which is a component of the National Institutes of Health (NIH), which is an agency of the United States Department of Health and Human Services. ... This page is a candidate to be copied to Wiktionary using the Transwiki process. ...

"Today, we have the capability to produce 300 million doses of trivalent vaccine per year - enough for current epidemics in the Western world, but insufficient for coping with a pandemic."^[3][13]

Clinical trials of vaccines

A vaccine is assessed in terms of the reduction of the risk of disease produced by vaccination, its efficacy. In contrast, in the field, the effectiveness of a vaccine is the practical reduction in risk for an individual when they are vaccinated under real-world conditions.^[14] Measuring efficacy of influenza vaccines is relatively simple, as the immune response produced by the vaccine can be assessed in animal models, or the amount of antibody produced in vaccinated people can be measured,^[15] or most rigorously, by immunising adult volunteers and then challenging with virulent influenza virus.^[16] In studies such as these, influenza vaccines showed high efficacy and produced a protective immune response. For ethical reasons, such challenge studies cannot be performed in the population most at risk from influenza - the elderly and young children. However, studies on the effectiveness of flu vaccines in the real world are uniquely difficult. The vaccine may not be matched to the virus in circulation, virus prevalence varies widely between years and influenza is often confused with other flu-like illnesses.^[17]

Nevertheless, multiple clinical trials of both live and inactivated influenza vaccines have been performed and their results pooled and analyzed in several recent meta-analyses. Studies on live vaccines have very limited data, but these preparations may be more effective than inactivated vaccines.^[16] The meta-analyses examined the efficacy and effectiveness of inactivated vaccines in adults,^[18] children,^[19] and the elderly.^[20][21] In adults, vaccines show high efficacy against the targeted strains, but low effectiveness overall, so the benefits of vaccination are small, with a one-quarter reduction in risk of contracting influenza but no effect on the rate of hospitalization.^[18] In children, vaccines again showed high efficacy, but low effectiveness in preventing "flu-like illness", in children under two the data are extremely limited, but vaccination appeared to confer no measurable benefit.^[19] In the elderly, vaccination does not reduce the frequency of influenza, but may reduce pneumonia, hospital admission and deaths from influenza or pneumonia.^[20][21] The measured effectiveness of the vaccine in the elderly varies depending on whether the population studies is in residential care homes, or in the community, with the vaccine appearing more effective in an institutional environment. This apparent effect may be due to selection bias or differences in diagnosis and surveillance.

Overall, the benefit of influenza vaccination is clearest in the elderly, with vaccination in children of questionable benefit. Vaccination of adults is not predicted to produce significant improvements in public health. The apparent contradiction between vaccines with high efficacy, but low effectiveness, may reflect the difficulty in diagnosing influenza under clinical conditions and the large number of strains circulating in the population.^[17]

Who should get it

U.S. Navy personnel receiving influenza vaccination

Yearly influenza vaccination should be routinely offered to patients at risk of complications of influenza: Image File history File linksMetadata Download high resolution version (3008x1960, 623 KB) Summary Vaccination / Schutzimpfung Source: [1] 041028-N-9864S-021 Yokosuka, Japan (Oct. ... Image File history File linksMetadata Download high resolution version (3008x1960, 623 KB) Summary Vaccination / Schutzimpfung Source: [1] 041028-N-9864S-021 Yokosuka, Japan (Oct. ... USN redirects here. ...

• the elderly (UK recommendation is those aged 65 or above)
• patients with chronic lung diseases (asthma, COPD, etc.)
• patients with chronic heart diseases (congenital heart disease, chronic heart failure, ischaemic heart disease)
• patients with chronic liver diseases (including liver cirrhosis)
• patients who are immunosuppressed (those with HIV or who are receiving drugs to suppress the immune system such as chemotherapy and long-term steroids) and their household contacts
• all people who are institutionalized in an environment where influenza can spread rapidly, such as in prisons or nursing homes
• healthcare workers (both to prevent sickness and to prevent spread to patients)^[22]

The only contraindication is known anaphylaxis to the vaccine or its component. Chronic obstructive pulmonary disease (COPD) is an umbrella term for a group of respiratory tract diseases that are characterised by airflow obstruction or limitation. ... Cross-section of a healthy heart. ... Ischaemic (or ischemic) heart disease is a disease characterized by reduced blood supply to the heart. ... Cirrhosis is a chronic disease of the liver in which liver tissue is replaced by connective tissue, resulting in the loss of liver function. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ... In chemistry and biology, Steroids are a type of lipid, characterized by a carbon skeleton with four fused rings. ... Anaphylaxis is an acute systemic (multi-system) and severe Type I Hypersensitivity allergic reaction in humans and other mammals. ...

In the United States a person aged 50–64 is nearly ten times more likely to die an influenza-associated death than a younger person, and a person over age 65 is over ten times more likely to die an influenza-associated death than the 50–64 age group.^[23] Vaccination of those over age 65 reduces influenza-associated death by about 50%.^[24][25] However, it is unlikely that the vaccine completely explains the results since elderly people who get vaccinated are probably more healthy and health-conscious than those who do not.^[26]

As mortality is high among infants who contract influenza, the household contacts and caregivers of infants should be vaccinated to reduce the risk of passing an influenza infection to the infant.

Data from the years when Japan required annual flu vaccinations for school-aged children indicate that vaccinating children—the group most likely to catch and spread the disease—has a strikingly positive effect on reducing mortality among older people: one life saved for every 420 children who received the flu vaccine.^[27] This may be due to herd immunity or to direct causes, such as individual older people not being exposed to influenza. For example, retired grandparents often risk infection by caring for their sick grandchildren in households where the parents can't take time off work or are sick themselves. …Herd immunity describes a type of immunity that occurs when the vaccination of the a portion of the population (or herd) provides protection to un-vaccinated individuals. ...

Flu vaccine virus selection

Selecting viruses for the vaccine manufacturing process is very difficult.

At the U.S.'s Food and Drug Administration's (FDA) Center for Biologics Evaluation and Research's Vaccines and Related Biological Products Advisory Committee's 101st meeting of February 16, 2005, an extensive discussion and vote was held concerning the following year's flu vaccine virus selection, but began with a summary of the previous year: Motto: (Out Of Many, One) (traditional) In God We Trust (1956 to date) Anthem: The Star-Spangled Banner Capital Washington D.C. Largest city New York City None at federal level (English de facto) Government Federal constitutional republic  - President George Walker Bush (R)  - Vice President Dick Cheney (R) Independence from... “FDA” redirects here. ... The Center for Biologics Evaluation and Research (CBER) is one of five main centers for the United Statess Food and Drug Administration (US FDA). ... is the 47th day of the year in the Gregorian calendar. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ...

Influenza B

"For Influenza B, the question was asked: are there new strains present? And the answer was yes, and in 2004, the majority of the viruses were similar to a strain called B/Shanghai/361/2002, which is from the so-called B/Yamagata/1688 hemagglutinin lineage. That lineage was not the one that was being used in the vaccine that was current last year. In a minority of the strains that were found during the epidemiologic studies were similar to the strain that was in the vaccine for last year, which was B/Hong Kong/330/2001, which belongs to the HA lineage that we represent with the strain B/Victoria/287. In answer to the question were these new viruses spreading, the answer, of course, is definitely yes. The Fujian-like viruses had become widespread around the world and were predominant everywhere, and these B/Shanghai-like strains at the time we were holding this meeting in February were predominant not only in North America and the United States, but also in Asia and Europe."

Influenzavirus B is a genus in the virus family Orthomyxoviridae. ...

New viruses

"Were the new viruses that were identified and spreading, were those inhibited by the current vaccines? And this question, as it sometimes is, was not a very definite no or yes. It was a little bit difficult to interpret, but it seemed like many of the A/Fujian-like viruses were not well inhibited by the current vaccines, although some of them were. For the B/Shanghai-like strains, of course, we've known for a long time that these two divergent hemagglutinin lineages are not that well inhibited one by the other, and as time has gone on and antigenic drift has occurred in these strains, that has become truer. Generally we also know that for the B/Yamagata-like strains and the B/Victoria-like strains, that very young children and people who haven't been immunologically primed, exposure to one of these does not seem to immediately give antibodies that cross-react with the other HA lineage."

Manufacturing issues

"So were there strains that were suitable for manufacturing? And the answer was yes. Of course, we all know that for inactivated vaccines and for live attenuated vaccines manufacturing depends on having egg adapted strains, either the wild-type or reassortant, and in the case of the live vaccine, of course, it has to be a reassortant for the attenuation phenotype. But there were A/Fujian-like strains that were available, and there was a high growth reassortant that was being used in manufacturing for the Southern Hemisphere already, the A/Wyoming/3/2003 X 147 reassortant. For the B strain, there were a number of wild-type isolates that seemed to be suitable for manufacturing, including B/Jilin/20/2003 and B/Jiangsu/10/2003, in addition to the B/Shanghai/361 strain itself."

Strains selected

"So based on that, the strains that were selected for this year include A/New Caledonia/20/99-like strain, which in this case really is A/New Caledonia/20/99. For the B/Shanghai/361/2002-like recommendation that was made, there were all three of these strains, B/Shanghai, B/Jilin, and B/Jiangsu. And for the A/Fujian/411/2002-like recommendation that was made and the A/Wyoming/3/2003 strain was chosen or is the one that has become widely used for vaccine preparation. Now, the implications of the strain selection were that preparation of the vaccines was on schedule throughout the year. All of the strains seemed to be typical and easy to adapt for manufacturing purposes, and going into the summer, the supply of vaccine was expected to match the demand predicted by previous years' experiences."

Unexpected difficulties

"But what happened was that we ended up with a vaccine shortage at the end of the summer, and just to try to put that into a little perspective, from January until August, manufacturing had been progressing on schedule even including these two new strains that were recommended for use in vaccines, and it was anticipated there were going to be about 100 million doses of vaccine from all of the manufacturers combined for this year. In August of 2004, Chiron notified regulatory authorities about a sterility issue and indicated that investigation to identify the cause and the implementation of corrections was underway, and at that time Chiron made a public announcement indicating that there would be a possible delay in distribution and possibly a reduction in the amount of vaccine that would be available. You also probably all know that in early October of 2004, the MHRA, the UK regulatory authority, announced that they were suspending Chiron's license to manufacture inactivated influenza vaccine for three months, and that was based on the issues that have previously been identified and were in investigation and correction by Chiron. Subsequently, over the next few weeks and certainly by November of 2004, it became clear after consultation between FDA and MHRA that the vaccine that Chiron had planned to make was not going to be available for us in the United States."

Response to unexpected difficulties

"In response to that, there were a number of things that happened within the Public Health Service, and I'll just very briefly indicate some of those. At FDA there was a lot of work done to evaluate manufacturers who were not licensed in the United States to identify whether their vaccines could be used under IND. There was consultation with manufacturers to discuss regulatory mechanisms going forward from this time for getting approval of new products in the United States. That includes accelerated approval, fast track and priority reviews to facilitate those new licenses, and all of these things actually have been continuing."^[28]

Flu vaccine manufacturing

Flu vaccines are available both as an injection of killed virus and as nasal spray of live attenuated influenza virus (LAIV) (sold as FluMist). Clinical trials suggest that the live virus may be more effective at preventing infection, but FluMist has not been approved in the United States for use in children younger than 5.^[29] An injection is a method of putting liquid into the body with a hollow needle and a syringe which is pierced through the skin long enough for the material to be forced into the body. ... Nasal sprays are used for the nasal delivery of a drug or drugs, generally to alleviate cold or allergy symptoms. ... FluMist is the product name of a nasal spray vaccine against the flu virus. ...

Flu vaccine is usually grown in fertilized chicken eggs. Both types of flu vaccines are contraindicated for those with severe allergies to egg proteins and people with a history of Guillain-Barré syndrome.^[30] This article or section does not adequately cite its references or sources. ... An allergy is an abnormal, acquired sensitivity to a given substance, including pollen, drugs, or numerous environmental triggers. ... Guillain-Barré syndrome (GBS) or acute inflammatory demyelinating polyradiculoneuropathy is an acute, autoimmune disease that affects the peripheral nervous system and is usually triggered by an acute infectious process. ...

On October 5, 2004, Chiron Corporation, a corporation contracted to deliver half of the expected flu vaccine for the United States and a significant portion to the UK, issued a press release^[31] that stated it was unable to dispense its stock for the 2004-2005 season, due to suspension of the corporation's license to produce the vaccine by the Medicines and Healthcare Products Regulatory Agency. However, the Centers for Disease Control and Prevention took swift action to enlist the help of other companies such as MedImmune and Sanofi pasteur to supply vaccine in high-risk populations in the United States. is the 278th day of the year (279th in leap years) in the Gregorian calendar. ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... Chiron Corporation (NASDAQ: NVS) was a multinational biotechnology firm based in Emeryville, California that was acquired by Novartis International AG on April 30, 2006. ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... The logo of the MHRA. The Medicines and Healthcare products Regulatory Agency (MHRA) is the UK government agency which is responsible for ensuring that medicines and medical devices work and are acceptably safe. ... The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ... MedImmune is a Maryland-based biotechnology company. ... Sanofi pasteur is the vaccines business of sanofi-aventis Group. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ...

Flu vaccines in the United States still contain Thiomersal, despite having been banned in many countries (, including Denmark, Great Britain???, and Austria, for two decades??).

H5N1

H5N1

Influenza A virus subtype H5N1 Genetic structure Infection Human mortality Global spread in 2006 Social impact Pandemic

WHO pandemic phases Low risk New virus Self limiting Person to person Epidemic exists Pandemic exists

Main article: Flu research

There are several H5N1 vaccines for several of the avian H5N1 varieties, some for use in humans and some for use in poultry. H5N1 continually mutates, meaning vaccines based on current samples of avian H5N1 cannot be depended upon to work in the case of a future pandemic of H5N1. While there can be some cross-protection against related flu strains, the best protection would be from a vaccine specifically produced for any future pandemic flu virus strain. Dr. Daniel Lucey, co-director of the Biohazardous Threats and Emerging Diseases graduate program at Georgetown University has made this point, "There is no H5N1 pandemic so there can be no pandemic vaccine." However, "pre-pandemic vaccines" have been created; are being refined and tested; and do have some promise both in furthering research and preparedness for the next pandemic. Vaccine manufacturing companies are being encouraged to increase capacity so that if a pandemic vaccine is needed, facilities will be available for rapid production of large amounts of a vaccine specific to a new pandemic strain. Image File history File links Colorized_transmission_electron_micrograph_of_Avian_influenza_A_H5N1_viruses. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus Influenzavirus A is a genus of the family of viruses called Orthomyxoviridae in virus classification. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ... H5N1 genetic structure refers to the molecular structure of the H5N1 viruss RNA. H5N1 is an Influenza A virus subtype. ... See Epidemiology of WHO-confirmed human cases of avian influenza A(H5N1) infection. ... The thin line represents average mortality of recent cases. ... The global spread of H5N1 in birds is considered a significant pandemic threat. ... Main article: Global spread of H5N1 Notes: Source WHO Confirmed Human Cases of H5N1 [T]he incidence of human cases peaked, in each of the three years in which cases have occurred, during the period roughly corresponding to winter and spring in the northern hemisphere. ... See Influenza pandemic for government preparation for an H5N1 pandemic H5N1 impact is the effect or influence of H5N1 in human society; especially the financial, political, social and personal responses to both actual and predicted deaths in birds, humans, and other animals. ... An influenza pandemic is a large scale epidemic of the influenza virus, such as the 1918 Spanish flu. ... An influenza pandemic is a large scale epidemic of the influenza virus, such as the 1918 Spanish flu. ... Flu research includes molecular virology, pathogenesis, host immune responses, and epidemiology. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ... This article is about large epidemics. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ...

Problems with H5N1 vaccine production include: Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ...

• lack of overall production capacity
• lack of surge production capacity (it is impractical to develop a system that depends on hundreds of millions of 11-day old specialized eggs on a standby basis)
• the pandemic H5N1 might be lethal to chickens

Cell culture (cell-based) manufacturing technology can be applied to influenza vaccines as they are with most viral vaccines and thereby solve the problems associated with creating flu vaccines using chicken eggs as is currently done.^[32][33] The US government has purchased from Sanofi Pasteur and Chiron Corporation several million doses of vaccine meant to be used in case of an influenza pandemic of H5N1 avian influenza and is conducting clinical trials with these vaccines.^[34] Researchers at the University of Pittsburgh have had success with a genetically engineered vaccine that took only a month to make and completely protected chickens from the highly pathogenic H5N1 virus.^[35] Epithelial cells in culture, stained for keratin (red) and DNA (green) Cell culture is the process by which either prokaryotic or eukaryotic cells are grown under controlled conditions. ... Sanofi pasteur is the vaccines business of sanofi-aventis Group. ... Chiron Corporation (NASDAQ: NVS) was a multinational biotechnology firm based in Emeryville, California that was acquired by Novartis International AG on April 30, 2006. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... An influenza pandemic is a large scale epidemic of the influenza virus, such as the 1918 Spanish flu. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ...

According to the United States Department of Health & Human Services: The United States Department of Health and Human Services, often abbreviated HHS, is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. ...

In addition to supporting basic research on cell-based influenza vaccine development, HHS is currently supporting a number of vaccine manufacturers in the advanced development of cell-based influenza vaccines with the goal of developing U.S.-licensed cell-based influenza vaccines produced in the United States. Dose-sparing technologies. Current U.S.-licensed vaccines stimulate an immune response based on the quantity of HA (hemagglutinin) antigen included in the dose. Methods to stimulate a strong immune response using less HA antigen are being studied in H5N1 and H9N2 vaccine trials. These include changing the mode of delivery from intramuscular to intradermal and the addition of immune-enhancing adjuvant to the vaccine formulation. Additionally, HHS is soliciting contract proposals from manufacturers of vaccines, adjuvants, and medical devices for the development and licensure of influenza vaccines that will provide dose-sparing alternative strategies.^[36]

Chiron Corporation is now recertified and under contract with the National Institutes of Health to produce 8,000-10,000 investigational doses of Avian Flu (H5N1) vaccine. MedImmune and Aventis Pasteur are under similar contracts.^[37] The United States government hopes to obtain enough vaccine in 2006 to treat 4 million people. However, it is unclear whether this vaccine would be effective against a hypothetical mutated strain that would be easily transmitted through human populations, and the shelflife of stockpiled doses has yet to be determined.^[38] A vaccine is an antigenic preparation used to establish immunity to a disease. ... Hemagglutinin, as depicted in a simplified molecular model. ... For the server security software, see Microsoft Forefront. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ... In medicine, adjuvants are agents which modify the effect of other agents while having few if any direct effects when given by themselves. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... In medicine, adjuvants are agents which modify the effect of other agents while having few if any direct effects when given by themselves. ... Chiron Corporation (NASDAQ: NVS) was a multinational biotechnology firm based in Emeryville, California that was acquired by Novartis International AG on April 30, 2006. ... National Institutes of Health Building 50 at NIH Clinical Center - Building 10 The National Institutes of Health (NIH) is an agency of the United States Department of Health and Human Services and is the primary agency of the United States government responsible for biomedical research. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ... MedImmune is a Maryland-based biotechnology company. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ...

The New England Journal of Medicine reported on March 30, 2006 on one of dozens of vaccine studies currently being conducted. The Treanor et al. study was on vaccine produced from the human isolate (A/Vietnam/1203/2004 H5N1) of a virulent clade 1 influenza A (H5N1) virus with the use of a plasmid rescue system, with only the hemagglutinin and neuraminidase genes expressed and administered without adjuvant. "The rest of the genes were derived from an avirulent egg-adapted influenza A/PR/8/34 strain. The hemagglutinin gene was further modified to replace six basic amino acids associated with high pathogenicity in birds at the cleavage site between hemagglutinin 1 and hemagglutinin 2. Immunogenicity was assessed by microneutralization and hemagglutination-inhibition assays with the use of the vaccine virus, although a subgroup of samples were tested with the use of the wild-type influenza A/Vietnam/1203/2004 (H5N1) virus." The results of this study combined with others scheduled to be completed by Spring 2007 is hoped will provide a highly immunogenic vaccine that is cross-protective against heterologous influenza strains.^[39] The New England Journal of Medicine (New Engl J Med or NEJM) is a peer-reviewed medical journal published by the Massachusetts Medical Society. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ...

On August 18, 2006. the World Health Organization changed the H5N1 strains recommended for candidate vaccines for the first time since 2004. "The WHO's new prototype strains, prepared by reverse genetics, include three new H5N1 subclades. The hemagglutinin sequences of most of the H5N1 avian influenza viruses circulating in the past few years fall into two genetic groups, or clades. Clade 1 includes human and bird isolates from Vietnam, Thailand, and Cambodia and bird isolates from Laos and Malaysia. Clade 2 viruses were first identified in bird isolates from China, Indonesia, Japan, and South Korea before spreading westward to the Middle East, Europe, and Africa. The clade 2 viruses have been primarily responsible for human H5N1 infections that have occurred during late 2005 and 2006, according to WHO. Genetic analysis has identified six subclades of clade 2, three of which have a distinct geographic distribution and have been implicated in human infections: “WHO” redirects here. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ... Hemagglutinin, as depicted in a simplified molecular model. ... A map showing countries commonly considered to be part of the Middle East The Middle East is a region comprising the lands around the southern and eastern parts of the Mediterranean Sea, a territory that extends from the eastern Mediterranean Sea to the Persian Gulf. ... For other uses, see Europe (disambiguation). ... A world map showing the continent of Africa Africa is the worlds second-largest and second most-populous continent, after Asia. ...

• Subclade 1, Indonesia
• Subclade 2, Middle East, Europe, and Africa
• Subclade 3, China

On the basis of the three subclades, the WHO is offering companies and other groups that are interested in pandemic vaccine development these three new prototype strains:

• An A/Indonesia/2/2005-like virus
• An A/Bar headed goose/Quinghai/1A/2005-like virus
• An A/Anhui/1/2005-like virus

[...] Until now, researchers have been working on prepandemic vaccines for H5N1 viruses in clade 1. In March, the first clinical trial of a U.S. vaccine for H5N1 showed modest results. In May, French researchers showed somewhat better results in a clinical trial of an H5N1 vaccine that included an adjuvant. Vaccine experts aren't sure if a vaccine effective against known H5N1 viral strains would be effective against future strains. Although the new viruses will now be available for vaccine research, WHO said clinical trials using the clade 1 viruses should continue as an essential step in pandemic preparedness, because the trials yield useful information on priming, cross-reactivity, and cross-protection by vaccine viruses from different clades and subclades."^[40][41]

As of November 2006, the United States Department of Health and Human Services still had enough H5N1 pre-pandemic vaccine to treat about 3 million people (5.9 million full-potency doses) in spite of 0.2 million doses used for research and 1.4 million doses that have begun to lose potency (from the original 7.5 million full-potency doses purchased from Sanofi Pasteur and Chiron Corp.). The expected shelf life of seasonal flu vaccine is about a year so the fact that most of the H5N1 pre-pandemic stockpile is still good after about 2 years is considered encouraging.^[42] The United States Department of Health and Human Services, often abbreviated HHS, is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. ... Sanofi pasteur is the vaccines business of sanofi-aventis Group. ... Chiron Corporation NASDAQ: NVS was acquired by Novartis on April 20, 2006. ... Human Flu refers to a subset of Orthomyxoviridae that create influenza in humans and are endemic in humans. ...

Flu seasons

2003–2004 season (Northern Hemisphere)

The production of flu vaccine requires a lead time of about six months before the season. It is possible that by flu season a strain becomes common for which the vaccine does not provide protection. In the 2003–2004 season the vaccine was produced to protect against A/Panama, A/New Caledonia, and B/Hong Kong. A new strain, A/Fujian, was discovered after production of the vaccine started and vaccination gave only partial protection against this strain. A vaccine is an antigenic preparation used to establish immunity to a disease. ... Year 2003 (MMIII) was a common year starting on Wednesday of the Gregorian calendar. ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ...

Nature magazine reported that the Influenza Genome Sequencing Project, using phylogenetic analysis of 156 H3N2 genomes, "explains the appearance, during the 2003–2004 season, of the 'Fujian/411/2002'-like strain, for which the existing vaccine had limited effectiveness" as due to an epidemiologically significant reassortment. "Through a reassortment event, a minor clade provided the haemagglutinin gene that later became part of the dominant strain after the 2002–2003 season. Two of our samples, A/New York/269/2003 (H3N2) and A/New York/32/2003 (H3N2), show that this minor clade continued to circulate in the 2003–2004 season, when most other isolates were reassortants." ^[43] The Influenza Genome Sequencing Project is funded by the National Institute of Allergy and Infectious Diseases (NIAID) which is a component of the National Institutes of Health (NIH), which is an agency of the United States Department of Health and Human Services. ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... Reassortment is the exchange of DNA between viruses inside a host cell. ... Reassortment is the exchange of DNA between viruses inside a host cell. ... Hemagglutinin (HA) is an antigenic glycoprotein found on the surface of the Influenza virus and is responsible for binding the virus to the cell that is being infected. ... Also see: 2002 (number). ... Year 2003 (MMIII) was a common year starting on Wednesday of the Gregorian calendar. ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... Year 2003 (MMIII) was a common year starting on Wednesday of the Gregorian calendar. ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ...

According to the CDC: The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ...

During the 2003–2004 influenza season, influenza A (H1), A (H3N2), and B viruses co-circulated worldwide, and influenza A (H3N2) viruses predominated. Several Asian countries reported widespread outbreaks of avian influenza A (H5N1) among poultry. In Vietnam and Thailand, these outbreaks were associated with severe illnesses and deaths among humans. In the United States, the 2003–2004 influenza season began earlier than most seasons, peaked in December, was moderately severe in terms of its impact on mortality, and was associated predominantly with influenza A (H3N2) viruses.^[44]

During September 28, 2003–May 22, 2004, WHO and NREVSS collaborating laboratories in the United States tested 130,577 respiratory specimens for influenza viruses; 24,649 (18.9%) were positive. Of these, 24,393 (99.0%) were influenza A viruses, and 249 (1.0%) were influenza B viruses. Among the influenza A viruses, 7,191 (29.5%) were subtyped; 7,189 (99.9%) were influenza A (H3N2) viruses, and two (0.1%) were influenza A (H1) viruses. The proportion of specimens testing positive for influenza first increased to >10% during the week ending October 25, 2003 (week 43), peaked at 35.2% during the week ending November 29 (week 48), and declined to <10% during the week ending January 17, 2004 (week 2). The peak percentage of specimens testing positive for influenza during the previous four seasons had ranged from 23% to 31% and peaked during late December to late February.^[44] Flu season is mostly a colloquial term used to describe the regular outbreak in flu cases, or even cases of the common cold during the late fall or winter. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus Influenzavirus A is a genus of the family of viruses called Orthomyxoviridae in virus classification. ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... Influenzavirus B is a genus in the virus family Orthomyxoviridae. ... This article is about biological infectious particles. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ... Look up who in Wiktionary, the free dictionary. ...

As of June 15, 2004, CDC had antigenically characterized 1,024 influenza viruses collected by U.S. laboratories since October 1, 2003: 949 influenza A (H3N2) viruses, three influenza A (H1) viruses, one influenza A (H7N2) virus, and 71 influenza B viruses. Of the 949 influenza A (H3N2) isolates characterized, 106 (11.2%) were similar antigenically to the vaccine strain A/Panama/2007/99 (H3N2), and 843 (88.8%) were similar to the drift variant, A/Fujian/411/2002 (H3N2). Of the three A (H1) isolates that were characterized, two were H1N1 viruses, and one was an H1N2 virus. The hemagglutinin proteins of the influenza A (H1) viruses were similar antigenically to the hemagglutinin of the vaccine strain A/New Caledonia/20/99. Of the 71 influenza B isolates that were characterized, 66 (93%) belonged to the B/Yamagata/16/88 lineage and were similar antigenically to B/Sichuan/379/99, and five (7%) belonged to the B/Victoria/2/87 lineage and were similar antigenically to the corresponding vaccine strain B/Hong Kong/330/2001.^[44] H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... H7N2 is a subtype of the species avian influenza virus (bird flu virus). ... H1N2 is a subtype of the species avian influenza virus (bird flu virus) currently endemic in both human and pig populations. ...

H9N2

In December 2003, one confirmed case of avian influenza A (H9N2) virus infection was reported in a child aged 5 years in Hong Kong. The child had fever, cough, and nasal discharge in late November, was hospitalized for 2 days, and fully recovered. The source of this child's H9N2 infection is unknown.^[44] H9N2 is a subtype of the species avian influenza virus (bird flu virus). ...

H5N1

During January–March 2004, a total of 34 confirmed human cases of avian influenza A (H5N1) virus infection were reported in Vietnam and Thailand. The cases were associated with severe respiratory illness requiring hospitalization and a case-fatality proportion of 68% (Vietnam: 22 cases, 15 deaths; Thailand: 12 cases, eight deaths). A substantial proportion of the cases were among children and young adults (i.e., persons aged 5–24 years). These cases were associated with widespread outbreaks of highly pathogenic H5N1 influenza among domestic poultry.^[44] Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ...

H7N3

During March 2004, health authorities in Canada reported two confirmed cases of avian influenza A (H7N3) virus infection in poultry workers who were involved in culling of poultry during outbreaks of highly pathogenic H7N3 on farms in the Fraser River Valley, British Columbia. One patient had unilateral conjunctivitis and nasal discharge, and the other had unilateral conjunctivitis and headache. Both illnesses resolved without hospitalization.^[44] H7N3 is a subtype of the species avian influenza virus (bird flu virus). ...

H7N2

During the 2003–2004 influenza season, a case of avian influenza A (H7N2) virus infection was detected in an adult male from New York, who was hospitalized for upper and lower respiratory tract illness in November 2003. Influenza A (H7N2) virus was isolated from a respiratory specimen from the patient, whose acute symptoms resolved. The source of this person's infection is unknown.^[44] H7N2 is a subtype of the species avian influenza virus (bird flu virus). ...

2004 season (Southern Hemisphere)

The composition of influenza virus vaccines for use in the 2004 Southern Hemisphere influenza season recommended by the World Health Organization was:

• an A/New Caledonia/20/99(H1N1)-like virus
• an A/Fujian/411/2002(H3N2)-like virus (A/Kumamoto/102/2002 and A/Wyoming/3/2003 were egg-grown A/Fujian/411/2002-like viruses)
• a B/Hong Kong/330/2001-like virus (B/Shandong/7/97, B/Hong Kong/330/2001 and B/Hong Kong/1434/2002 were among those used at the time. B/Brisbane/32/2002 was also available.)

^{[45] [46]}

2004–2005 season (Northern Hemisphere)

According to the CDC: The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ...

On the basis of antigenic analyses of recently isolated influenza viruses, epidemiologic data, and postvaccination serologic studies in humans, the Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee (VRBPAC) recommended that the 2004–05 trivalent influenza vaccine for the United States contain A/New Caledonia/20/99-like (H1N1), A/Fujian/411/2002-like (H3N2), and B/Shanghai/361/2002-like viruses. Because of the growth properties of the A/Wyoming/3/2003 and B/Jiangsu/10/2003 viruses, U.S. vaccine manufacturers are using these antigenically equivalent strains in the vaccine as the H3N2 and B components, respectively. The A/New Caledonia/20/99 virus will be retained as the H1N1 component of the vaccine.^[44]

See H5N1 flu and Flu for details about the illnesses and H5N1 and H3N2 for details about the causitive agents. ...

2005 season (Southern Hemisphere)

The composition of influenza virus vaccines for use in the 2005 Southern Hemisphere influenza season recommended by the World Health Organization was:

• an A/New Caledonia/20/99(H1N1)-like virus;
• an A/Wellington/1/2004(H3N2)-like virus;
• a B/Shanghai/361/2002-like virus (B/Shanghai/361/2002, B/Jilin/20/2003 and B/Jiangsu/10/2003 were used at the time)

^{[47] [48]}

2005–2006 season (Northern Hemisphere)

The vaccines produced for the 2005–2006 season use: A vaccine is an antigenic preparation used to establish immunity to a disease. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ...

• an A/New Caledonia/20/1999-like(H1N1);
• an A/California/7/2004-like(H3N2) (or the antigenically equivalent strain A/New York/55/2004);
• a B/Jiangsu/10/2003-like viruses.

In people in the U.S., overall flu and pneumonia deaths were below those of a typical flu season with 84% Influenzavirus A and the rest Influenzavirus B. Of the patients who had Type A viruses, 80% had viruses identical or similar to the A bugs in the vaccine. 70% of the people testing positive for a B virus had Type B Victoria, a version not found in the vaccine.^[49] This article is about the year. ... H1N1 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... Year 2003 (MMIII) was a common year starting on Wednesday of the Gregorian calendar. ... Respiratory disease properly named influenza(say: in-floo-en-zah ). Some specific varities of influenza with a vaccination available are: A-New Caledonia, A-California, B-Shanghai. ... This article is about human pneumonia. ... Flu season is mostly a colloquial term used to describe the regular outbreak in flu cases, or even cases of the common cold during the late fall or winter. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus Influenzavirus A is a genus of the family of viruses called Orthomyxoviridae in virus classification. ... Influenzavirus B is a genus in the virus family Orthomyxoviridae. ...

"During the 2005–06 season, influenza A (H3N2) viruses predominated overall, but late in the season influenza B viruses were more frequently isolated than influenza A viruses. Influenza A (H1N1) viruses circulated at low levels throughout the season. Nationally, activity was low from October through early January, increased during February, and peaked in early March. Peak activity was less intense, but activity remained elevated for a longer period of time this season compared to the previous three seasons. The longer period of elevated activity may be due in part to regional differences in the timing of peak activity and intensity of influenza B activity later in the season."^[50]

2006 season (Southern Hemisphere)

The composition of influenza virus vaccines for use in the 2006 Southern Hemisphere influenza season recommended by the World Health Organization was:

• an A/New Caledonia/20/99(H1N1)-like virus;
• an A/California/7/2004(H3N2)-like virus (A/New York/55/2004 was used at the time);
• a B/Malaysia/2506/2004-like virus

^{[51] [52]}

2006–2007 season (Northern Hemisphere)

The 2006–2007 influenza vaccine composition recommended by the World Health Organization on February 15, 2006 and the U.S. FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) on February 17, 2006 use:

• an A/New Caledonia/20/99 (H1N1)-like virus;
• an A/Wisconsin/67/2005 (H3N2)-like virus (A/Wisconsin/67/2005 and A/Hiroshima/52/2005 strains);
• a B/Malaysia/2506/2004-like virus from B/Malaysia/2506/2004 and B/Ohio/1/2005 strains which are of B/Victoria/2/87 lineage.^[53]

2007 season (Southern Hemisphere)

The composition of influenza virus vaccines for use in the 2006 Southern Hemisphere influenza season recommended by the World Health Organization on September 20, 2006 ^[54] was:

• an A/New Caledonia/20/99(H1N1)-like virus,
• an A/Wisconsin/67/2005(H3N2)-like virus (A/Wisconsin/67/2005 and A/Hiroshima/52/2005 were used at the time),
• a B/Malaysia/2506/2004-like virus

^{[55] [56]}

2007-2008 season (Northern Hemisphere)

The composition of influenza virus vaccines for use in the 2007–2008 Northern Hemisphere influenza season recommended by the World Health Organization on February 14, 2007 ^[57] was:

• an A/Solomon Islands/3/2006 (H1N1)-like virus;
• an A/Wisconsin/67/2005 (H3N2)-like virus (A/Wisconsin/67/2005 (H3N2) and A/Hiroshima/52/2005 were used at the time);
• a B/Malaysia/2506/2004-like virus

^{[58] [59]}

2008 season (Southern Hemisphere)

The WHO vaccine recommendation for the 2008 season will be made after the bi-annual meeting scheduled for 17–19 September 2007. ^[60]

Flu vaccine for nonhumans

"Vaccination in the veterinary world pursues four goals: (i) protection from clinical disease, (ii) protection from infection with virulent virus, (iii) protection from virus excretion, and (iv) serological differentiation of infected from vaccinated animals (so-called DIVA principle). In the field of influenza vaccination, neither commercially available nor experimentally tested vaccines have been shown so far to fulfil all of these requirements."^[61]

Horses with horse flu can run a fever, have a dry hacking cough, have a runny nose, and become depressed and reluctant to eat or drink for several days but usually recover in 2 to 3 weeks. "Vaccination schedules generally require a primary course of 2 doses, 3–6 weeks apart, followed by boosters at 6–12 month intervals. It is generally recognised that in many cases such schedules may not maintain protective levels of antibody and more frequent administration is advised in high-risk situations."^[62] Horse flu (or Equine influenza) refers to varieties of influenzavirus A that are endemic in horses. ...

"[P]oultry vaccines, made on the cheap, are not filtered and purified [like human vaccines] to remove bits of bacteria or other viruses. They usually contain whole virus, not just the hemagglutin spike that attaches to cells. Purification is far more expensive than the work in eggs, Dr. Stöhr said; a modest factory for human vaccine costs $100 million, and no veterinary manufacturer is ready to build one. Also, poultry vaccines are "adjuvated" — boosted — with mineral oil, which induces a strong immune reaction but can cause inflammation and abscesses. Chicken vaccinators who have accidentally jabbed themselves have developed painful swollen fingers or even lost thumbs, doctors said. Effectiveness may also be limited. Chicken vaccines are often only vaguely similar to circulating flu strains — some contain an H5N2 strain isolated in Mexico years ago. 'With a chicken, if you use a vaccine that's only 85 percent related, you'll get protection,' Dr. Cardona said. 'In humans, you can get a single point mutation, and a vaccine that's 99.99 percent related won't protect you.' And they are weaker [than human vaccines]. 'Chickens are smaller and you only need to protect them for six weeks, because that's how long they live till you eat them,' said Dr. John J. Treanor, a vaccine expert at the University of Rochester. Human seasonal flu vaccines contain about 45 micrograms of antigen, while an experimental A(H5N1) vaccine contains 180. Chicken vaccines may contain less than 1 microgram. 'You have to be careful about extrapolating data from poultry to humans,' warned Dr. David E. Swayne, director of the agriculture department's Southeast Poultry Research Laboratory. 'Birds are more closely related to dinosaurs.'"^[63] H5N2 is a strain of avian influenza virus. ... Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ... Orders & Suborders Saurischia Sauropodomorpha Theropoda Ornithischia Thyreophora Ornithopoda Marginocephalia Dinosaurs were vertebrate animals that dominated the terrestrial ecosystem for over 160 million years, first appearing approximately 230 million years ago. ...

Researchers, led by Nicholas Savill of the University of Edinburgh in Scotland, used mathematical models to simulate the spread of H5N1 and concluded that "at least 95 per cent of birds need to be protected to prevent the virus spreading silently. In practice, it is difficult to protect more than 90 per cent of a flock; protection levels achieved by a vaccine are usually much lower than this."^[64] Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. ...

See also

• Vaccine for information valid about all vaccines, not just flu vaccines.
• Vaccine controversy for the pros and cons of being vaccinated.
• Thimerosal is a controversial mercury-containing organic compound used as an antiseptic and antifungal agent in vaccines.

A vaccine is an antigenic preparation used to establish immunity to a disease. ... The vaccine controversy refers to doubt over the safety and efficacy of widespread vaccination. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ...

Sources and notes

Robert G. (Rob) Webster (born May 7, 1932), in Balclutha New Zealand, is the virologist who in 1957 was the first to announce a link between human flu and bird flu. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 173rd day of the year (174th in leap years) in the Gregorian calendar. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 298th day of the year (299th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 313th day of the year (314th in leap years) in the Gregorian calendar. ... The United States Department of Health and Human Services, often abbreviated HHS, is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... Hemagglutinin, as depicted in a simplified molecular model. ... Neuraminidase is a glycoside hydrolase enzyme (EC 3. ... For the server security software, see Microsoft Forefront. ... In most birds and reptiles, an egg (Latin ovum) is the zygote, resulting from fertilization of the ovum. ... Avian influenza (also known as bird flu, avian flu, influenzavirus A flu, type A flu, or genus A flu) is a flu (influenza) due to a type of influenza virus that is hosted by birds, but may infect several species of mammals. ... This article or section does not adequately cite its references or sources. ... Epithelial cells in culture, stained for keratin (red) and DNA (green) Cell culture is the process by which either prokaryotic or eukaryotic cells are grown under controlled conditions. ... By the mid 20th century humans had achieved a mastery of technology sufficient to leave the surface of the Earth for the first time and explore space. ... Poliomyelitis (polio), or infantile paralysis, is a viral paralytic disease. ... Rubella, commonly known as German measles, is a disease caused by the rubella virus. ... This article is about the disease Chickenpox. ... A bioreactor may refer to any device or system that supports a biologically active environment. ... The Associated Press, or AP, is an American news agency, the worlds largest such organization. ...

Further reading

• Read Congressional Research Service (CRS) Reports regarding Influenza and vaccines
• What's in a Flu Shot?