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

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.^[1] A bird-adapted strain of H5N1, called HPAI A(H5N1) for "highly pathogenic avian influenza virus of type A of subtype H5N1", is the causative agent of H5N1 flu, commonly known as "avian influenza" or "bird flu". It is endemic in many bird populations, especially in Southeast Asia. One strain of HPAI A(H5N1) is spreading globally after first appearing in Asia. It is epizootic (an epidemic in nonhumans) and panzootic (affecting animals of many species, especially over a wide area), killing tens of millions of birds and spurring the culling of hundreds of millions of others to stem its spread. Most mentions of "bird flu" and H5N1 in the media refer to this strain.^[2] 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. ... 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. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus Influenzavirus A is a genus of the family of viruses called Orthomyxoviridae in virus classification. ... A pathogen or infectious agent is a biological agent that causes disease or illness to its host. ... See Epidemiology of WHO-confirmed human cases of avian influenza A(H5N1) infection. ... For the current concern about the transmission of an avian flu to humans see Transmission and infection of H5N1. ... In epidemiology, an infection is said to be endemic in a population when that infection is maintained in the population without the need for external inputs. ... Location of Southeast Asia Southeast Asia is a subregion of Asia. ... The global spread of H5N1 in birds is considered a significant pandemic threat. ... An epizootic is the nonhuman equivalent of an epidemic, meaning that large numbers of animals are infected with a disease. ... To cull is to remove from a group of animals those individuals who show signs of weakness. ...

HPAI A(H5N1) is an avian disease. There is no evidence of efficient human-to-human transmission or of airborne transmission of HPAI A(H5N1) to humans. In almost all cases, those infected with H5N1 had extensive physical contact with infected birds. Still, around 60% of humans known to have been infected with the current Asian strain of HPAI A(H5N1) have died from it, and H5N1 may mutate or reassort into a strain capable of efficient human-to-human transmission. In 2003, world-renowned virologist Robert Webster published an article titled "The world is teetering on the edge of a pandemic that could kill a large fraction of the human population" in American Scientist. He called for adequate resources to fight what he sees as a major world threat to possibly billions of lives.^[3] On September 29, 2005, David Nabarro, the newly-appointed Senior United Nations System Coordinator for Avian and Human Influenza, warned the world that an outbreak of avian influenza could kill anywhere between 5 million and 150 million people.^[4] Experts have identified key events (creating new clades, infecting new species, spreading to new areas) marking the progression of an avian flu virus towards becoming pandemic, and many of those key events have occurred more rapidly than expected. It has been suggested that mutant be merged into this article or section. ... Reassortment is the exchange of DNA between viruses inside a host cell. ... 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. ... American Scientist (ISSN 0003-0996) is an illustrated bimonthly magazine about science and technology. ... is the 272nd day of the year (273rd 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. ... Dr. David Nabarro (born in 1949),is the current Executive Director of Sustainable Development and Healthy Environments, a department under the World Health Organization. ... A clade is a term belonging to the discipline of cladistics. ...

Due to the high lethality and virulence of HPAI A(H5N1), its endemic presence, its increasingly large host reservoir, and its significant ongoing mutations, the H5N1 virus is the world's largest current pandemic threat, and billions of dollars are being spent researching H5N1 and preparing for a potential influenza pandemic.^[5] At least 12 companies and 17 governments are developing pre-pandemic influenza vaccines in 28 different clinical trials that, if successful, could turn a deadly pandemic infection into a nondeadly one. Full-scale production of a vaccine that could prevent any illness at all from the strain would require at least three months after the virus's emergence to begin, but it is hoped that vaccine production could increase until one billion doses were produced by one year after the initial identification of the virus.^[6] Virulence refers to the degree of pathogenicity of a microbe, or in other words the relative ability of a microbe to cause disease. ... An influenza pandemic is a large scale epidemic of the influenza virus, such as the 1918 Spanish flu. ... Model of Influenza Virus from NIH The flu vaccine is a vaccine to protect against the highly variable influenza virus. ...

H5N1 may cause more than one influenza pandemic as it is expected to continue mutating in birds regardless of whether humans develop herd immunity to a future pandemic strain.^[7] Influenza pandemics from its genetic offspring may include influenza A virus subtypes other than H5N1.^[8] While genetic analysis of the H5N1 virus shows that influenza pandemics from its genetic offspring can easily be far more lethal than the Spanish Flu pandemic^[9], planning for a future influenza pandemic is based on what can be done and there is no higher Pandemic Severity Index level than a Category 5 pandemic which, roughly speaking, is any pandemic as bad as the Spanish flu or worse; and for which all intervention measures are to be used.^[10] An influenza pandemic is a large scale epidemic of the influenza virus, such as the 1918 Spanish flu. ... …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. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus Influenzavirus A is a genus of the family of viruses called Orthomyxoviridae in virus classification. ... 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. ... The Pandemic Severity Index (PSI) is a scale or index created in January 2007 by the United States Centers for Disease Control and Prevention (CDC) designed to mimic the system for indexing the severity of hurricanes (which is the Saffir-Simpson Hurricane Scale for tropical cyclones). ... 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. ...

Genetics

The H in H5N1 stands for "Hemagglutinin", as depicted in this molecular model.

Main articles: H5N1 genetic structure and Influenzavirus A

The first known strain of HPAI A(H5N1) (called A/chicken/Scotland/59) killed two flocks of chickens in Scotland in 1959; but that strain was very different from the current highly pathogenic strain of H5N1. The dominant strain of HPAI A(H5N1) in 2004 evolved from 1999 to 2002 creating the Z genotype.^[11] It has also been called "Asian lineage HPAI A(H5N1)". Image File history File links Hemagglutinin_molecule. ... Image File history File links Hemagglutinin_molecule. ... Hemagglutinin, as depicted in a simplified molecular model. ... H5N1 genetic structure refers to the molecular structure of the H5N1 viruss RNA. H5N1 is an Influenza A virus subtype. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus Influenzavirus A is a genus of the family of viruses called Orthomyxoviridae in virus classification. ... This article is about evolution in biology. ...

Asian lineage HPAI A(H5N1) is divided into two antigenic 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: Map This article does not cite any references or sources. ... 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. ... World map showing the location of Europe. ... 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, Europe, Middle East, and Africa (called EMA)
• Subclade 3, China"^[12][13][14]

A 2007 study focused on the EMA subclade has shed further light on the EMA mutations. "The 36 new isolates reported here greatly expand the amount of whole-genome sequence data available from recent avian influenza (H5N1) isolates. Before our project, GenBank contained only 5 other complete genomes from Europe for the 2004–2006 period, and it contained no whole genomes from the Middle East or northern Africa. Our analysis showed several new findings. First, all European, Middle Eastern, and African samples fall into a clade that is distinct from other contemporary Asian clades, all of which share common ancestry with the original 1997 Hong Kong strain. Phylogenetic trees built on each of the 8 segments show a consistent picture of 3 lineages, as illustrated by the HA tree shown in Figure 1. Two of the clades contain exclusively Vietnamese isolates; the smaller of these, with 5 isolates, we label V1; the larger clade, with 9 isolates, is V2. The remaining 22 isolates all fall into a third, clearly distinct clade, labeled EMA, which comprises samples from Europe, the Middle East, and Africa. Trees for the other 7 segments display a similar topology, with clades V1, V2, and EMA clearly separated in each case. Analyses of all available complete influenza (H5N1) genomes and of 589 HA sequences placed the EMA clade as distinct from the major clades circulating in People's Republic of China, Indonesia, and Southeast Asia."^[15]

Terminology

H5N1 isolates are identified like this actual HPAI A(H5N1) example, A/chicken/Nakorn-Patom/Thailand/CU-K2/04(H5N1):

• A stands for the species of influenza (A, B or C).
• chicken is the species the isolate was found in
• Nakorn-Patom/Thailand is the place this specific virus was isolated
• CU-K2 identifies it from other influenza viruses isolated at the same place
• 04 represents the year 2004
• H5 stands for the fifth of several known types of the protein hemagglutinin.
• N1 stands for the first of several known types of the protein neuraminidase.

(Other examples: A/duck/Hong Kong/308/78(H5N3), A/avian/NY/01(H5N2), A/chicken/Mexico/31381-3/94(H5N2), and A/shoveler/Egypt/03(H5N2)).^[16] Hemagglutinin, as depicted in a simplified molecular model. ... Neuraminidase is a glycoside hydrolase enzyme (EC 3. ...

As with other avian flu viruses, H5N1 has strains called "highly pathogenic" (HP) and "low-pathogenic" (LP). Avian influenza viruses that cause HPAI are highly virulent, and mortality rates in infected flocks often approach 100%. LPAI viruses have negligible virulence, but these viruses can serve as progenitors to HPAI viruses. The current strain of H5N1 responsible for the deaths of birds across the world is an HPAI strain; all other current strains of H5N1, including a North American strain that causes no disease at all in any species, are LPAI strains. All HPAI strains identified to date have involved H5 and H7 subtypes. The distinction concerns pathogenicity in poultry, not humans. Normally a highly pathogenic avian virus is not highly pathogenic to either humans or non-poultry birds. This current deadly strain of H5N1 is unusual in being deadly to so many species, including some, like domestic cats, never previously susceptible to any influenza virus. Virulence refers to the degree of pathogenicity of a microbe, or in other words the relative ability of a microbe to cause disease. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus The Orthomyxoviridae are a family of RNA viruses which infect vertebrates. ...

Genetic structure and related subtypes

The N in H5N1 stands for "Neuraminidase", as depicted in this ribbon diagram.

H5N1 is a subtype of the species Influenza A virus of the Influenzavirus A genus of the Orthomyxoviridae family. Like all other influenza A subtypes, the H5N1 subtype is an RNA virus. It has a segmented genome of eight negative sense, single-strands of RNA, abbreviated as PB2, PB1, PA, HA, NP, NA, M and NS. Download high resolution version (810x1024, 571 KB) Wikipedia does not have an article with this exact name. ... Download high resolution version (810x1024, 571 KB) Wikipedia does not have an article with this exact name. ... Neuraminidase is a glycoside hydrolase enzyme (EC 3. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus Influenzavirus A is a genus of the family of viruses called Orthomyxoviridae in virus classification. ... For other uses, see Genus (disambiguation). ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus The Orthomyxoviridae are a family of RNA viruses which infect 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. ... In biology the genome of an organism is the whole hereditary information of an organism that is encoded in the DNA (or, for some viruses, RNA). ... Ribonucleic acid or RNA is a nucleic acid polymer consisting of nucleotide monomers that plays several important roles in the processes that translate genetic information from deoxyribonucleic acid (DNA) into protein products; RNA acts as a messenger between DNA and the protein synthesis complexes known as ribosomes, forms vital portions...

HA codes for hemagglutinin, an antigenic glycoprotein found on the surface of the influenza viruses and is responsible for binding the virus to the cell that is being infected. NA codes for neuraminidase, an antigenic glycosylated enzyme found on the surface of the influenza viruses. It facilitates the release of progeny viruses from infected cells.^[17] The hemagglutinin (HA) and neuraminidase (NA) RNA strands specify the structure of proteins that are most medically relevant as targets for antiviral drugs and antibodies. HA and NA are also used as the basis for the naming of the different subtypes of influenza A viruses. This is where the H and N come from in H5N1. Hemagglutinin, as depicted in a simplified molecular model. ... This article does not cite any references or sources. ... A glycoprotein is a macromolecule composed of a protein and a carbohydrate (an oligosaccharide). ... Neuraminidase is a glycoside hydrolase enzyme (EC 3. ... Ribbon diagram of the enzyme TIM, surrounded by the space-filling model of the protein. ... Each antibody binds to a specific antigen; an interaction similar to a lock and key. ...

Influenza A viruses are significant for their potential for disease and death in humans and other animals. Influenza A virus subtypes that have been confirmed in humans, in order of the number of known human pandemic deaths that they have caused, include:

• H1N1, which caused "Spanish flu" and currently causes seasonal human flu
• H2N2, which caused "Asian flu"
• H3N2, which caused "Hong Kong flu" and currently causes seasonal human flu
• H5N1, the world's major current pandemic threat
• H7N7, which has unusual zoonotic potential and killed one person
• H1N2, which is currently endemic in humans and pigs and causes seasonal human flu
• H9N2, which has infected three people
• H7N2, which has infected two people
• H7N3, which has infected two people
• H10N7, which has infected two people

H1N1 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... 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. ... Human Flu refers to a subset of Orthomyxoviridae that create influenza in humans and are endemic in humans. ... The Asian Flu was a pandemic outbreak of influenza that originated in China in 1957 and spread worldwide that same year. ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... This article is about large epidemics. ... H7N7 is a subtype of the species avian influenza virus (bird flu virus). ... Zoonosis (pronounced ) is any infectious disease that may be transmitted from other animals, both wild and domestic, to humans or from humans to animals (the latter is sometimes called reverse zoonosis). ... H1N2 is a subtype of the species avian influenza virus (bird flu virus) currently endemic in both human and pig populations. ... H9N2 is a subtype of the species avian influenza virus (bird flu virus). ... H7N2 is a subtype of the species avian influenza virus (bird flu virus). ... H7N3 is a subtype of the species avian influenza virus (bird flu virus). ... H10N7 is a subtype of the species avian influenza virus (bird flu virus). ...

Low pathogenic H5N1

Low pathogenic avian influenza H5N1 (LPAI H5N1) also called "North American" H5N1 commonly occurs in wild birds. In most cases, it causes minor sickness or no noticeable signs of disease in birds. It is not known to affect humans at all. The only concern about it is that it is possible for it to be transmitted to poultry and in poultry mutate into a highly pathogenic strain.

• 1975 – LPAI H5N1 was detected in a wild mallard duck and a wild blue goose in Wisconsin.

• 1981 and 1985 – LPAI H5N1 was detected in ducks by the University of Minnesota conducting a sampling procedure in which sentinel ducks were monitored in cages placed in the wild for a short period of time.

• 1983 – LPAI H5N1 was detected in ring-billed gulls in Pennsylvania.

• 1986 - LPAI H5N1 was detected in a wild mallard duck in Ohio.

• 2005 - LPAI H5N1 was detected in ducks in Manitoba, Canada.

"In the past, there was no requirement for reporting or tracking LPAI H5 or H7 detections in wild birds so states and universities tested wild bird samples independently of USDA. Because of this, the above list of previous detections might not be all inclusive of past LPAI H5N1 detections. However, the World Organization for Animal Health (OIE) recently changed its requirement of reporting detections of avian influenza. Effective in 2006, all confirmed LPAI H5 and H7 AI subtypes must be reported to the OIE because of their potential to mutate into highly pathogenic strains. Therefore, USDA now tracks these detections in wild birds, backyard flocks, commercial flocks and live bird markets."^[18]

Properties of H5N1

Main articles: Transmission and infection of H5N1 and Global spread of H5N1

See Epidemiology of WHO-confirmed human cases of avian influenza A(H5N1) infection. ... The global spread of H5N1 in birds is considered a significant pandemic threat. ...

Infectivity

Highly pathogenic H5N1
	→  Countries with poultry or wild birds killed by H5N1.
	→  Countries with humans, poultry and wild birds killed by H5N1.

H5N1 is easily transmissible between birds facilitating a potential global spread of H5N1. While H5N1 undergoes specific mutations and reassorting creating variations which can infect species not previously known to carry the virus, not all of these variant forms can infect humans. H5N1 as an avian virus preferentially binds to a type of galactose receptors that populate the avian respiratory tract from the nose to the lungs and are virtually absent in humans, occurring only in and around the alveoli, structures deep in the lungs where oxygen is passed to the blood. Therefore, the virus is not easily expelled by coughing and sneezing, the usual route of transmission.^[19][20][21] Image File history File links Download high resolution version (1357x628, 53 KB) Summary I made this map by using Image:BlankMap-World. ... The global spread of H5N1 in birds is considered a significant pandemic threat. ... Galactose (also called brain sugar) is a type of sugar found in dairy products, in sugar beets and other gums and mucilages. ... The alveoli (singular:alveolus), tiny hollow sacs which are continuous with the airways, are the sites of gas exchange with the blood. ...

H5N1 is mainly spread by domestic poultry, both through the movements of infected birds and poultry products and through the use of infected poultry manure as fertilizer or feed. Humans with H5N1 have typically caught it from chickens, which were in turn infected by other poultry or waterfowl. Migrating waterfowl (wild ducks, geese and swans) carry H5N1, often without becoming sick.^[22][23] Many species of birds and mammals can be infected with HPAI A(H5N1), but the role of animals other than poultry and waterfowl as disease-spreading hosts is unknown.^[24] This article does not cite any references or sources. ... Falcated Duck at Slimbridge Wildfowl and Wetlands centre, Gloucestershire, England Wildfowl or waterfowl, also waterbirds, is the collective term for the approximately 147 species of swans, geese and ducks, classified in the order Anseriformes, family Anatidae. ... Subfamilies Dendrocygninae Oxyurinae Anatinae Aythyinae Merginae Duck is the common name for a number of species in the Anatidae family of birds. ... Other uses: Goose (disambiguation) Genera Anser Branta Chen Cereopsis † see also: Swan, Duck Anatidae Goose (plural geese) is the general English name for a considerable number of birds, belonging to the family Anatidae. ... Species 6-7 living, see text. ...

Virulence

H5N1 has mutated into a variety of strains with differing pathogenic profiles, some pathogenic to one species but not others, some pathogenic to multiple species. Each specific known genetic variation is traceable to a virus isolate of a specific case of infection. Through antigenic drift, H5N1 has mutated into dozens of highly pathogenic varieties divided into genetic clades which are known from specific isolates, but all currently belonging to genotype Z of avian influenza virus H5N1, now the dominant genotype.^[25][26] H5N1 isolates found in Hong Kong in 1997 and 2001 were not consistently transmitted efficiently among birds and did not cause significant disease in these animals. In 2002 new isolates of H5N1 were appearing within the bird population of Hong Kong. These new isolates caused acute disease, including severe neurological dysfunction and death in ducks. This was the first reported case of lethal influenza virus infection in wild aquatic birds since 1961.^[27] Genotype Z emerged in 2002 through reassortment from earlier highly pathogenic genotypes of H5N1^[2] that first infected birds in China in 1996, and first infected humans in Hong Kong in 1997.^[28][25][26] Genotype Z is endemic in birds in Southeast Asia, has created at least two clades that can infect humans, and is spreading across the globe in bird populations. Mutations are occurring within this genotype that are increasing their pathogenicity.^[29] Birds are also able to shed the virus for longer periods of time before their death, increasing the transmissibility of the virus. It has been suggested that mutant be merged into this article or section. ... In biology, Strain can be used two ways. ... Antigenic drift refers to mutations in the influenza virus over time. ... Subfamilies Dendrocygninae Oxyurinae Anatinae Aythyinae Merginae Duck is the common name for a number of species in the Anatidae family of birds. ... Reassortment is the exchange of DNA between viruses inside a host cell. ...

Transmission and host range

Influenza A virus, the virus that causes Avian flu. Transmission electron micrograph of negatively stained virus particles in late passage. (Source: Dr. Erskine Palmer, Centers for Disease Control and Prevention Public Health Image Library)

Infected birds transmit H5N1 through their saliva, nasal secretions, feces and blood. Other animals may become infected with the virus through direct contact with these bodily fluids or through contact with surfaces contaminated with them. H5N1 remains infectious after over 30 days at 0 °C ( 32.0 °F) (over one month at freezing temperature) or 6 days at 37 °C ( 98.6 °F) (one week at human body temperature) so at ordinary temperatures it lasts in the environment for weeks. In arctic temperatures, it doesn't degrade at all. Image File history File links Influenza A virus, transmission electron micrograph of negatively stained virus particles in late passage. ... Image File history File links Influenza A virus, transmission electron micrograph of negatively stained virus particles in late passage. ... Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus Influenzavirus A is a genus of the family of viruses called Orthomyxoviridae in virus classification. ... A micrograph is a photograph or similar image taken through a microscope or similar device to show a magnified image of an item. ... Saliva is the watery and usually frothy substance produced in the mouths of humans and some animals. ... Mucus is a slippery secretion of the lining of various membranes in the body (mucous membranes). ... Horse feces Feces, faeces, or fæces (see spelling differences) is a waste product from an animals digestive tract expelled through the anus (or cloaca) during defecation. ... Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ...

Because migratory birds are among the carriers of the highly pathogenic H5N1 virus, it is spreading to all parts of the world. H5N1 is different from all previously known highly pathogenic avian flu viruses in its ability to be spread by animals other than poultry.

In October 2004, researchers discovered that H5N1 is far more dangerous than was previously believed. Waterfowl were revealed to be directly spreading the highly pathogenic strain of H5N1 to chickens, crows, pigeons, and other birds, and the virus was increasing its ability to infect mammals as well. From this point on, avian flu experts increasingly referred to containment as a strategy that can delay, but not ultimately prevent, a future avian flu pandemic. Falcated Duck at Slimbridge Wildfowl and Wetlands centre, Gloucestershire, England Wildfowl or waterfowl, also waterbirds, is the collective term for the approximately 147 species of swans, geese and ducks, classified in the order Anseriformes, family Anatidae. ... This article or section does not adequately cite its references or sources. ... Species See text. ... Pigeon redirects here. ...

"Since 1997, studies of influenza A (H5N1) indicate that these viruses continue to evolve, with changes in antigenicity and internal gene constellations; an expanded host range in avian species and the ability to infect felids; enhanced pathogenicity in experimentally infected mice and ferrets, in which they cause systemic infections; and increased environmental stability".^[30]

The New York Times, in an article on transmission of H5N1 through smuggled birds, reports Wade Hagemeijer of Wetlands International stating, "We believe it is spread by both bird migration and trade, but that trade, particularly illegal trade, is more important".^[31]

On August 22, 2007, a 28-year-old Indonesian chicken trader was the 2nd person to die of bird flu on the island of Bali, after 4 days of hospitalization, raising the death toll due to the disease in Indonesia to 84. Tests in 2 local laboratories were positive for the H5N1 strain of the disease. 194 people — the majority of them in Indonesia - have died since 2003, according to the World Health Organization. ^[32] Bali is an Indonesian island located at , the westernmost of the Lesser Sunda Islands, lying between Java to the west and Lombok to the east. ... The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ...

High mutation rate

Influenza viruses have a relatively high mutation rate that is characteristic of RNA viruses. The segmentation of its genome facilitates genetic recombination by segment reassortment in hosts infected with two different influenza viruses at the same time.^[25][26] A previously uncontagious strain may then be able to pass between humans, one of several possible paths to a pandemic. 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. ... In biology the genome of an organism is the whole hereditary information of an organism that is encoded in the DNA (or, for some viruses, RNA). ... Genetic recombination is the process by which a strand of DNA is broken and then joined to the end of a different DNA molecule. ... Reassortment is the exchange of DNA between viruses inside a host cell. ...

The ability of various influenza strains to show species-selectivity is largely due to variation in the hemagglutinin genes. Genetic mutations in the hemagglutinin gene that cause single amino acid substitutions can significantly alter the ability of viral hemagglutinin proteins to bind to receptors on the surface of host cells. Such mutations in avian H5N1 viruses can change virus strains from being inefficient at infecting human cells to being as efficient in causing human infections as more common human influenza virus types.^[33] This doesn't mean that one amino acid substitution can cause a pandemic, but it does mean that one amino acid substitution can cause an avian flu virus that is not pathogenic in humans to become pathogenic in humans. Hemagglutinin, as depicted in a simplified molecular model. ... It has been suggested that mutant be merged into this article or section. ... Phenylalanine is one of the standard amino acids. ... In biochemistry, a receptor is a protein on the cell membrane or within the cytoplasm or cell nucleus that binds to a specific molecule (a ligand), such as a neurotransmitter, hormone, or other substance, and initiates the cellular response to the ligand. ...

H3N2 ("swine flu") is endemic in pigs in China, and has been detected in pigs in Vietnam, increasing fears of the emergence of new variant strains. The dominant strain of annual flu virus in January 2006 was H3N2, which is now resistant to the standard antiviral drugs amantadine and rimantadine. The possibility of H5N1 and H3N2 exchanging genes through reassortment is a major concern. If a reassortment in H5N1 occurs, it might remain an H5N1 subtype, or it could shift subtypes, as H2N2 did when it evolved into the Hong Kong Flu strain of H3N2. H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... Swine Flu is a form of Type A influenza that is normally virulent only in pigs. ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... Amantadine, 1-aminoadamantane, is an antiviral drug that was approved by the FDA in 1976 for the treatment of influenza type A in adults. ... Rimantadine (systematic name 1-(1-aminoethyl)adamantane) is an orally administered medicine used to treat, and in rare cases prevent, Influenzavirus A infection. ... The Asian Flu was a pandemic outbreak of influenza that originated in China in 1957 and spread worldwide that same year. ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ...

Both the H2N2 and H3N2 pandemic strains contained avian flu virus RNA segments. "While the pandemic human influenza viruses of 1957 (H2N2) and 1968 (H3N2) clearly arose through reassortment between human and avian viruses, the influenza virus causing the 'Spanish flu' in 1918 appears to be entirely derived from an avian source".^[11] The Asian Flu was a pandemic outbreak of influenza that originated in China in 1957 and spread worldwide that same year. ... H3N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus). ... For the current concern about the transmission of an avian flu to humans see Transmission and infection of H5N1. ...

Humans and H5N1

The earliest infections of humans by H5N1 coincided with an epizootic (an epidemic in nonhumans) of H5N1 influenza in Hong Kong's poultry population. This panzootic (a disease affecting animals of many species, especially over a wide area) outbreak was stopped by the killing of the entire domestic poultry population within the territory. An epizootic is the nonhuman equivalent of an epidemic, meaning that large numbers of animals are infected with a disease. ... A panzootic (from Greek παν pan all + ζόιον zoion animal) is an epizootic (an outbreak of an infectious disease of animals) that spreads across a large region (for example a continent), or even worldwide. ...

Confirmed human cases and mortality rate of avian influenza (H5N1)
As of August 16, 2007

Country	Report dates															edit this table Total
	2003			2004			2005			2006			2007
	cases	deaths		cases	deaths		cases	deaths		cases	deaths		cases	deaths		cases	deaths
Azerbaijan										8	5	63%				8	5	63%
Cambodia							4	4	100%	2	2	100%	1	1	100%	7	7	100%
PR China	1	1	100%				8	5	63%	13	8	62%	3	2	67%	25	16	64%
Djibouti										1	0	0%				1	0	0%
Egypt										18	10	56%	20	5	25%	38	15	39%
Indonesia							20	13	65%	55	45	82%	29	25	86%	104	83	80%
Iraq										3	2	67%				3	2	67%
Laos													2	2	100%	2	2	100%
Nigeria													1	1	100%	1	1	100%
Thailand				17	12	71%	5	2	40%	3	3	100%				25	17	68%
Turkey										12	4	33%				12	4	33%
Vietnam	3	3	100%	29	20	69%	61	19	31%				2	0	0%	95	42	44%
Total	4	4	100%	46	32	70%	98	43	44%	115	79	69%	58	36	62%	321	194	60%
Source: World Health Organization Communicable Disease Surveillance & Response (CSR)

See Epidemiology of WHO-confirmed human cases of avian influenza A(H5N1) infection. ... 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. ... 2007 is a common year starting on Monday of the Gregorian calendar. ... is the 228th day of the year (229th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... Image File history File links Flag_of_Azerbaijan. ... Image File history File links Flag_of_Cambodia. ... Image File history File links Flag_of_the_Peoples_Republic_of_China. ... For the Chinese civilization, see China. ... Image File history File links Flag_of_Djibouti. ... Image File history File links Flag_of_Egypt. ... Image File history File links Flag_of_Indonesia. ... Image File history File links Flag_of_Iraq. ... Image File history File links Flag_of_Laos. ... Image File history File links Flag_of_Nigeria. ... Image File history File links Flag_of_Thailand. ... Image File history File links Flag_of_Turkey. ... Image File history File links Flag_of_Vietnam. ... The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ...

Symptoms in humans

Further information: Pneumonia

Avian influenza hemagglutinin bind alpha 2-3 sialic acid receptors while human influenza hemagglutinin bind alpha 2-6 sialic acid receptors. Usually other differences also exist. There is as yet no human form of H5N1, so all humans who have caught it so far have caught avian H5N1. Pneumonia is an illness of the lungs and respiratory system in which the alveoli (microscopic air-filled sacs of the lung responsible for absorbing oxygen from the atmosphere) become inflamed and flooded with fluid. ... Hemagglutinin, as depicted in a simplified molecular model. ... Sialic acid Sialic acid is a derivative of a nine-carbon monosaccharide, named from the Greek σιαλοσ (sialos) saliva. It is the negative charge of this chemical that is responsible for the slippery feel of saliva and mucins coating the body’s organs. ... Hemagglutinin, as depicted in a simplified molecular model. ...

In general, humans who catch a humanized Influenza A virus (a human flu virus of type A) usually have symptoms that include fever, cough, sore throat, muscle aches, conjunctivitis and, in severe cases, breathing problems and pneumonia that may be fatal. The severity of the infection depends to a large part on the state of the infected person's immune system and whether the victim has been exposed to the strain before (in which case they would be partially immune). No one knows if these or other symptoms will be the symptoms of a humanized H5N1 flu. Genera Influenzavirus A Influenzavirus B Influenzavirus C Isavirus Thogotovirus Influenzavirus A is a genus of the family of viruses called Orthomyxoviridae in virus classification. ... Human Flu refers to a subset of Orthomyxoviridae that create influenza in humans and are endemic in humans. ... This article needs additional references or sources for verification. ... This article does not cite any references or sources. ... Myalgia means muscle pain and is a symptom of many diseases and disorders. ... Pneumonia is an illness of the lungs and respiratory system in which the alveoli (microscopic air-filled sacs of the lung responsible for absorbing oxygen from the atmosphere) become inflamed and flooded with fluid. ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ... The transmission and infection of H5N1 is a concern due to the global spread of H5N1 that constitutes a pandemic threat. ...

The mortality rate of highly pathogenic H5N1 avian flu in a human is high; WHO data indicates that 60% of cases classified as H5N1 resulted in death. In one case, a boy with H5N1 experienced diarrhea followed rapidly by a coma without developing respiratory or flu-like symptoms.^[34] There have been studies of the levels of cytokines in humans infected by the H5N1 flu virus. Of particular concern is elevated levels of tumor necrosis factor-alpha, a protein that is associated with tissue destruction at sites of infection and increased production of other cytokines. Flu virus-induced increases in the level of cytokines is also associated with flu symptoms including fever, chills, vomiting and headache. Tissue damage associated with pathogenic flu virus infection can ultimately result in death.^[3] The inflammatory cascade triggered by H5N1 has been called a 'cytokine storm' by some, because of what seems to be a positive feedback process of damage to the body resulting from immune system stimulation. H5N1 induces higher levels of cytokines than the more common flu virus types.^[35] See Epidemiology of WHO-confirmed human cases of avian influenza A(H5N1) infection. ... For the current concern about the transmission of an avian flu to humans see Transmission and infection of H5N1. ... The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ... Types 5-7 on the Bristol Stool Chart are often associated with diarrhea Diarrhea (in American English) or diarrhoea (in British English) is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause... In medicine, a coma (from the Greek koma, meaning deep sleep) is a profound state of unconsciousness. ... Cytokines are a group of proteins and peptides that are used in organisms as signaling compounds. ... In medicine, tumor necrosis factor alpha (TNFα, cachexin or cachectin) is an important cytokine involved in systemic inflammation and the acute phase response. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... A cytokine storm is a potentially fatal immune reaction consisting of a positive feedback loop between cytokines and immune cells. ... Positive feedback is a feedback system in which the system responds to the perturbation in the same direction as the perturbation (It is sometimes referred to as cumulative causation). ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ...

Treatment and prevention for humans

Flu

Flu Flu season Flu vaccine Flu treatment Avian flu H5N1 flu Flu research Genome project

Further information: Flu research

There is no highly effective treatment for H5N1 flu, but oseltamivir (commercially marketed by Roche as Tamiflu), can sometimes inhibit the influenza virus from spreading inside the user's body. This drug has become a focus for some governments and organizations trying to be seen as making preparations for a possible H5N1 pandemic.^[36] On April 20, 2006, Roche AG announced that a stockpile of three million treatment courses of Tamiflu is waiting at the disposal of the World Health Organization to be used in case of a flu pandemic; separately Roche donated two million courses to the WHO for use in developing nations that may be affected by such a pandemic but lack the ability to purchase large quantities of the drug.^[37] 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). ... 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. ... Model of Influenza Virus from NIH The flu vaccine is a vaccine to protect against the highly variable influenza virus. ... 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. ... For the current concern about the transmission of an avian flu to humans see Transmission and infection of H5N1. ... See Epidemiology of WHO-confirmed human cases of avian influenza A(H5N1) infection. ... Flu research includes molecular virology, pathogenesis, host immune responses, and epidemiology. ... 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. ... Flu research includes molecular virology, pathogenesis, host immune responses, and epidemiology. ... The transmission and infection of H5N1 is a concern due to the global spread of H5N1 that constitutes a pandemic threat. ... Oseltamivir (INN) (IPA: ) is an antiviral drug that is used in the treatment and prophylaxis of both Influenzavirus A and Influenzavirus B. Like zanamivir, oseltamivir is a neuraminidase inhibitor. ... Hoffmann-La Roche, Ltd. ... A stockpile is a pile or storage location for various material materials or commodities. ... The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ... A developing country is a country with low average income compared to the world average. ...

However, WHO expert Hassan al-Bushra has said:

"Even now, we remain unsure about Tamiflu's real effectiveness. As for a vaccine, work cannot start on it until the emergence of a new virus, and we predict it would take six to nine months to develop it. For the moment, we cannot by any means count on a potential vaccine to prevent the spread of a contagious influenza virus, whose various precedents in the past 90 years have been highly pathogenic".^[38]

There are several H5N1 vaccines for several of the avian H5N1 varieties, but the continual mutation of H5N1 renders them of limited use to date: while vaccines can sometimes provide 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".^[39] 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.^[40][41][42] 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. A vaccine is an antigenic preparation used to establish immunity to a disease. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... Georgetown University is an elite private research university located in Georgetown, Washington, D.C., United States. ... This article is about large epidemics. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ...

Animal and lab studies suggest that Relenza (zanamivir), which is in the same class of drugs as Tamiflu, may also be effective against H5N1. In a study performed on mice in 2000, "zanamivir was shown to be efficacious in treating avian influenza viruses H9N2, H6N1, and H5N1 transmissible to mammals".^[43] While no one knows if zanamivir will be useful or not on a yet to exist pandemic strain of H5N1, it might be useful to stockpile zanamivir as well as oseltamivir in the event of an H5N1 influenza pandemic. Neither oseltamivir nor zanamivir can currently be manufactured in quantities that would be meaningful once efficient human transmission starts.^[44] Zanamivir is a neuraminidase inhibitor used in the treatment of and prophylaxis of both influenza A and influenza B. Zanamivir was the first neuraminidase inhibitor commercially developed. ...

In September, 2006, a WHO scientist announced that studies had confirmed cases of strains resistant to Tamiflu and Amantadine.^[45]

Preparations for pandemic

Main article: Influenza pandemic

Cumulate Human Cases of and Deaths from H5N1
As of April 11, 2007

Notes: An influenza pandemic is a large scale epidemic of the influenza virus, such as the 1918 Spanish flu. ... is the 101st day of the year (102nd in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... Image File history File links H5n1_spread_(with_regression). ...

• 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. If this pattern continues, an upsurge in cases could be anticipated starting in late 2006 or early 2007." Avian influenza – epidemiology of human H5N1 cases reported to WHO
• The regression curve for deaths is y = a + e^k x, and is shown extended through the end of April, 2007.

"The United States is collaborating closely with eight international organizations, including the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (OIE), and 88 foreign governments to address the situation through planning, greater monitoring, and full transparency in reporting and investigating avian influenza occurrences. The United States and these international partners have led global efforts to encourage countries to heighten surveillance for outbreaks in poultry and significant numbers of deaths in migratory birds and to rapidly introduce containment measures. The U.S. Agency for International Development (USAID) and the U.S. Department of State, the U.S. Department of Health and Human Services (HHS), and Agriculture (USDA) are coordinating future international response measures on behalf of the White House with departments and agencies across the federal government".^[46] The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ... Generally, regression is related to moving backwards, and the opposite of progression. ... Look up who in Wiktionary, the free dictionary. ... Possible meanings: Faro Airport (Portugal) Federation of Astrobiology Organizations Financial Aid Office Food and Agriculture Organization This page expands a three-character combination which might be any or all of: an abbreviation, an acronym, an initialism, a word in English, or a word in another language. ... The Office International de Epizooties (OIE, World Organisation for Animal Health) is an international intergovernmental organisation founded in 1924. ... The United States Agency for International Development (or USAID) is the US government organization responsible for most non-military foreign aid. ... The United States Department of State, often referred to as the State Department, is the Cabinet-level foreign affairs agency of the United States government, equivalent to foreign ministries in other countries. ... 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. ...

Together steps are being taken to "minimize the risk of further spread in animal populations", "reduce the risk of human infections", and "further support pandemic planning and preparedness".^[46]

Ongoing detailed mutually coordinated onsite surveillance and analysis of human and animal H5N1 avian flu outbreaks are being conducted and reported by the USGS National Wildlife Health Center, the Centers for Disease Control and Prevention, the World Health Organization, the European Commission, and others.^[47] The United States Geological Survey (USGS) is a scientific agency of the United States government. ... 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. ... The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ... The Commission seat in Brussels The European Commission (formally the Commission of the European Communities) is the executive body of the European Union. ...

Impact on human society

Main article: Social impact of H5N1

There has been a huge impact of H5N1 on human society; especially the financial, political, social and personal responses to both actual and predicted deaths in birds, humans, and other animals. 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. ... This article is about modern humans. ... Young people interacting within an ethnically diverse society. ... FINANCIAL is the weekly English-language newspaper with offices in Tbilisi, Georgia and Kiev, Ukraine. ... Politics is the process by which decisions are made within groups. ... Although the term social is a crucial category in social science and often used in public discourse, its meaning is often vague, suggesting that it is a fuzzy concept. ... personal could refer to personal identity; a personal advertisement; an persons ego or self image, interests or goals; a personal problem; personal involvement; a trademark belonging to Sony. ... This article or section does not adequately cite its references or sources. ... For other uses, see Bird (disambiguation). ... This article is about modern humans. ... For other uses, see Animal (disambiguation). ...

Billions of U.S. dollars are being raised and spent to research H5N1 and prepare for a potential avian flu pandemic. Over ten billion dollars have been lost and over two hundred million birds have been killed to try to contain H5N1. The United States dollar is the official currency of the United States. ... For the current concern about the transmission of an avian flu to humans see Transmission and infection of H5N1. ... This article is about large epidemics. ...

People have reacted by buying less chicken causing poultry sales and prices to fall.^[48] Many individuals have stockpiled supplies for a possible flu pandemic. One of the best known experts on H5N1, Dr. Robert Webster, told ABC News he had a three month supply of food and water in his house as he prepared for what he considered a reasonably likely occurrence of a major pandemic.

See also

Wikimedia Commons has media related to:

H5N1

Wikinews has related news:

Avian Flu

• Antigenic shift
• Flu research
• Fujian flu
• Global spread of H5N1
• H5N1 clinical trials
• ICEID
• National Influenza Centers
• Reporting disease cases
• Zoonosis

Image File history File links Commons-logo. ... Image File history File links WikiNews-Logo. ... Wikinews is a free-content news source and a project of the Wikimedia Foundation. ... Antigenic shift is the process by which two different strains of influenza combine to form a new subtype having a mixture of the surface antigens of the two original strains. ... Flu research includes molecular virology, pathogenesis, host immune responses, and epidemiology. ... See H5N1 flu and Flu for details about the illnesses and H5N1 and H3N2 for details about the causitive agents. ... The global spread of H5N1 in birds is considered a significant pandemic threat. ... H5N1 clinical trials are clinical trials concerning H5N1 vaccine; which is to say they are investigations concerning H5N1 vaccine in humans intended to discover pharmacological effects and identify any adverse reactions. ... The ICEID or International Conference on Emerging Infectious Diseases was first convened in 1998; ICEID 2006 marks its fifth occurence. ... 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. ... Reporting disease cases refers to modern international human infectious disease surveillance. ... Zoonosis (pronounced ) is any infectious disease that may be transmitted from other animals, both wild and domestic, to humans or from humans to animals (the latter is sometimes called reverse zoonosis). ...

Sources and notes

The International Committee on Taxonomy of Viruses (ICTV) is a committee which authorizes and organizes the taxonomic classification of viruses. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 107th day of the year (108th in leap years) in the Gregorian calendar. ... 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. ... 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. ... The foundation of the U.N. The United Nations (UN) is an international organization whose stated aims are to facilitate co-operation in international law, international security, economic development, social progress and human rights issues. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 272nd day of the year (273rd in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 107th day of the year (108th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... March 16 is the 75th day of the year (76th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 107th day of the year (108th in leap years) in the Gregorian calendar. ... Washington Avenue Bridge at night The University of Minnesota, Twin Cities, almost always abbreviated U of M, and sometimes referred to as The U by locals, is the oldest and largest part of the University of Minnesota system. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 34th day of the year in the Gregorian calendar. ... Forbes magazine is an American business and financial magazine founded in 1917 by B.C. Forbes. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 81st day of the year (82nd in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... January 19 is the 19th day of the year in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... The European Food Safety Authority (EFSA), an agency of the European Union, began operating in 2002. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 94th day of the year (95th in leap years) in the Gregorian calendar. ... PDF is an abbreviation with several meanings: Portable Document Format Post-doctoral fellowship Probability density function There also is an electronic design automation company named PDF Solutions. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... Hemagglutinin, as depicted in a simplified molecular model. ... The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 301st day of the year (302nd in leap years) in the Gregorian calendar. ... PDF is an abbreviation with several meanings: Portable Document Format Post-doctoral fellowship Probability density function There also is an electronic design automation company named PDF Solutions. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 105th day of the year (106th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 12th day of the year in the Gregorian calendar. ... 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. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... The Associated Press, or AP, is an American news agency, the worlds largest such organization. ... The Wall Street Journal (WSJ) is an international daily newspaper published by Dow Jones & Company in New York City, New York, USA, with Asian and European editions, and a worldwide daily circulation of more than 2 million as of 2006, with 931,000 paying online subscribers. ... Integrated Regional Information Networks, commonly known as IRIN, is a project of the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) tasked with providing information relevant to those responding to and affected by complex emergencies, such a conflict-induced forced migration, and natural disasters, such as hurricanes and... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 92nd day of the year (93rd in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... Front of UPI Headquarters, Washington, D.C. “UPI” redirects here. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 332nd day of the year (333rd in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th 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 224th day of the year (225th in leap years) in the Gregorian calendar. ... 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 (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 27th day of the year in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 288th day of the year (289th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 288th day of the year (289th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 288th day of the year (289th in leap years) in the Gregorian calendar. ... USAID logo The United States Agency for International Development (or USAID) is the U.S. government organization responsible for most non-military foreign aid. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th 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. ... Year 2006 (MMVI) was a common year starting on Sunday (link displays full 2006 calendar) of the Gregorian calendar. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ...

Further reading

Official - international

• UN United Nations
  • WHO World Health Organization
    • The United Nation's World Health Organization's Avian Flu Facts Sheet for 2006
    • Epidemic and Pandemic Alert and Response Guide to WHO's H5N1 pages
    • Avian Influenza Resources (updated) - tracks human cases and deaths
    • National Influenza Pandemic Plans
    • WHO Collaborating Centres and Reference Laboratories Centers, names, locations, and phone numbers
  • FAO Avian Influenza portal Information resources, animations, videos, photos
    • FAO Food and Agriculture Organisation - Bi-weekly Avian Influenza Maps - tracks animal cases and deaths
    • FAO Bird Flu disease card
    • FAO Socio-Economic impact of AI Projects, Information resources
• OIE World Organisation for Animal Health - tracks animal cases and deaths
  • Official outbreak reports by country
  • Official outbreak reports by week
  • Chart of outbreaks by country

Official - United States

• PandemicFlu.Gov U.S. Government's avian flu information site
• USAID U.S. Agency for International Development - Avian Influenza Response
• CDC Centers for Disease Control - responsible agency for avian influenza in humans in US - Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus
• USGS - NWHC National Wildlife Health Center - responsible agency for avian influenza in animals in US
• HHS U.S. Department of Health & Human Services - Pandemic Influenza Plan

Official - United Kingdom

• Exotic Animal Disease Generic Contingency Plan — DEFRA generic contingency plan for controlling and eradicating an outbreak of an exotic animal disease. PDF hosted by BBC (a government entity).
• UK Influenza Pandemic Contingency Plan — NHS (a government entity). Contingency planning for an influenza pandemic. PDF hosted by BBC

Technical

External links dealing with technical aspects can be found here. The foundation of the U.N. The United Nations (UN) is an international organization whose stated aims are to facilitate co-operation in international law, international security, economic development, social progress and human rights issues. ... The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ... The Office International des Épizooties (OIE, World Organisation for Animal Health) is an international intergovernmental organisation founded in 1924. ... The Department for Environment, Food and Rural Affairs (Defra) is the United Kingdom government department responsible for environmental protection, food production and standards, agriculture, fisheries and rural communities. ... PDF is an abbreviation with several meanings: Portable Document Format Post-doctoral fellowship Probability density function There also is an electronic design automation company named PDF Solutions. ... The British Broadcasting Corporation, which is usually known as the BBC, is the largest broadcasting corporation in the world in terms of audience numbers, employing 26,000 staff in the United Kingdom alone and with a budget of more than GB£4 billion. ... The National Health Service (NHS) is the publicly-funded healthcare system of the United Kingdom. ... PDF is an abbreviation with several meanings: Portable Document Format Post-doctoral fellowship Probability density function There also is an electronic design automation company named PDF Solutions. ... The British Broadcasting Corporation, which is usually known as the BBC, is the largest broadcasting corporation in the world in terms of audience numbers, employing 26,000 staff in the United Kingdom alone and with a budget of more than GB£4 billion. ... H5N1 genetic structure refers to the molecular structure of the H5N1 viruss RNA. H5N1 is an Influenza A virus subtype. ...

News and General information

External links dealing with news and general information can be found here. The global spread of H5N1 in birds is considered a significant pandemic threat. ...