Influenza
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REVIEW ARTICLE
Influenza Dhanya Dharmapalan 1 Received: 11 August 2019 / Accepted: 24 January 2020 # Dr. K C Chaudhuri Foundation 2020
Abstract Influenza continues to baffle humans by its constantly changing nature. The twenty-first century has witnessed considerable advances in the understanding of the influenza viral pathogenesis, its synergy with bacterial infections and diagnostic methods. However, challenges continue: to find a less expensive and more reliable point-of-care test for use in developing countries, to produce more efficacious antiviral drugs, to explore ways to combat emerging antiviral resistance and to develop vaccines that can either be produced in a shorter production time or can overcome the need for annual matching with the circulating influenza strains. Most importantly for India, as a nation that suffered the highest mortality in the influenza pandemic 1918, there is an urgent need to gear up our existing preparedness for the next pandemic which is capable to hit at any moment in time. Keywords Influenza . Pandemic . Hemagglutinin . Neuraminidase . Influenza vaccines . Oseltamivir
Introduction A century has elapsed since the most fatal epidemic known in mankind which killed over 50 million people – the Spanish influenza pandemic of 1918. India was the focal point of this pandemic in terms of mortality with deaths between 10 and 20 million (about 8% of the population at that time). The epidemic in India originated in Bombay in September 1918 where the troops infected with influenza returned from the First World War [1]. Several pandemics have followed with lower mortality and morbidity in the years 1957 (Asian flu), 1968 (Hongkong flu) and 2009 (Swine flu) [2]. Despite the advances in diagnostics, antiviral drugs and vaccines the threat of a severe pandemic like 1918 looms large as the novel Influenza Aviruses of avian or swine origin continue to infect the humans. Sporadic cases of Influenza occur throughout the year. Transmission of the virus depends on two important environmental factors – temperature and humidity. Epidemics in temperate zones generally occur in dry and cold winters as the influenza virus is known to be more stable in cold with greatest transmission at 5 °C and least above 30 °C [3]. * Dhanya Dharmapalan [email protected] 1
Department of Pediatric Infectious Diseases, Apollo Hospitals, CBD Belapur, Navi Mumbai, India
However these transmission dynamics cannot be applied to tropical countries where the average humidity and temperatures are higher and epidemics are observed during the monsoons. Diurnal variations in humidity and temperature and household exposures have been postulated as possible mechanisms in these regions though the exact reasons for monsoon peaks in tropics remain elusive [4]. As of 14th July 2019, the data from National Centre of Disease Control reported over 26,000 cases and 1000 deaths due to influenza since the beginning of this year even when the peak season had just begun [5]. Influenza surveillance studies from India have identified t
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