Influenza Virus Net is the web resource for anyone interested in influenza and flu pandemics. The objectives of Influenza Virus Net are to be the public and professional information resource for influenza and to serve as a network in the exchange of information and news related to influenza.

Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae (the influenza viruses), that affects humans, birds and other mammals. The virus spreads easily from person to person. Influenza circulates worldwide and can affect anybody in any age group. Influenza causes annual epidemics that peak during winter in temperate regions. Influenza is a serious public health problem that causes severe illnesses and deaths for higher risk populations. The most common symptoms of the disease are chills, fever, sore throat, muscle pains, severe headache, coughing, weakness/fatigue and general discomfort. Sore throat, fever and coughs are the most frequent symptoms. In more serious cases, influenza causes pneumonia, which can be fatal, particularly for the young and the elderly. An influenza epidemic can take an economic toll through lost workforce productivity, and strain health services. Vaccination is the most effective way to prevent infection.

• Pregnant woman target of flu jab campaign - TVNZ
  Tue, 11 Mar 2014 20:13:
• New Bird Flu Outbreak in Korea; 500000 Chickens Culled - Food Poisoning Bulletin
  Tue, 11 Mar 2014 18:44:
• Local Flu Cases Lowest Since December - OzarksFirst.com
  Tue, 11 Mar 2014 18:29:
• Flu cases rise slightly in Erie County - GoErie.com
  Tue, 11 Mar 2014 18:06:
• H7N9 bird flu comes home to roost in China - Kuwait Times
  Tue, 11 Mar 2014 18:06:
• Scientists complete first global inventory of viral wild bird flu strains - Vaccine News Daily
  Tue, 11 Mar 2014 17:35:
• Cambodia Ministry of Health releases details on new H5N1 avian influenza cases - The Global Dispatch
  Tue, 11 Mar 2014 16:48:
• CHAFEA - How prioritize Public Health Interventions against Human Influenza? - DeHavilland (press release) (subscription)
  Tue, 11 Mar 2014 16:13:
• Romark Laboratories Selects DSG for Influenza Study - PharmiWeb.com (press release)
  Tue, 11 Mar 2014 16:11:
• Reader questions flu shot safety - Mountain Mail Newspaper
  Tue, 11 Mar 2014 16:03:

• PRO/AH/EDR> Avian influenza, human (83): Cambodia (KG, KN) H5N1, RFI
  Mon, 10 Mar 2014 20:32:25
  Avian Influenza H5N1 -- Cambodia
  Following the death of a 3-year-old due to avian flu on [2 Mar 2014], an 11-year-old boy died in Phnom Penh's Kantha Bopha Hospital on Friday [7 Mar 2014], a hospital representative said yesterday [9 Mar 2014].
  The boy, from Kampong Chhnang province, was one of 2 admitted to the hospital last week [week of 3 Mar 2014] suffering from H5N1 [avian influenza], according to Dr Denis Laurent.
  "The good news is that the 8-year-old boy from Kandal province is in stable condition," Laurent


• PRO/AH/EDR> Avian influenza, human (83): Cambodia (KG, KN) H5N1, RFI
  Mon, 10 Mar 2014 20:32:25
  Avian Influenza H5N1 -- Kampong Chhnang, Cambodia
  Following the death of a 3-year-old due to avian flu on [2 Mar 2014], an 11-year-old boy died in Phnom Penh's Kantha Bopha Hospital on Friday [7 Mar 2014], a hospital representative said yesterday [9 Mar 2014].
  The boy, from Kampong Chhnang province, was one of 2 admitted to the hospital last week [week of 3 Mar 2014] suffering from H5N1 [avian influenza], according to Dr Denis Laurent.
  "The good news is that the 8-year-old boy from Kandal province is in stable condition," Laurent


• PRO/AH/EDR> Avian influenza, human (83): Cambodia (KG, KN) H5N1, RFI
  Mon, 10 Mar 2014 20:32:25
  Avian Influenza H5N1 -- Kandal, Cambodia
  Following the death of a 3-year-old due to avian flu on [2 Mar 2014], an 11-year-old boy died in Phnom Penh's Kantha Bopha Hospital on Friday [7 Mar 2014], a hospital representative said yesterday [9 Mar 2014].
  The boy, from Kampong Chhnang province, was one of 2 admitted to the hospital last week [week of 3 Mar 2014] suffering from H5N1 [avian influenza], according to Dr Denis Laurent.
  "The good news is that the 8-year-old boy from Kandal province is in stable condition," Laurent


• PRO/AH/EDR> Avian influenza (37): China, LPAI H7N9, poultry, epidemiology, vaccine, RFI
  Mon, 10 Mar 2014 02:23:56
  Avian Influenza H7N9 -- China
  Information received on 07 Mar 2014 from Dr Zhang Zhongqui, Director General , China Animal Disease Control Centre, Veterinary Bureau, Ministry of Agriculture, Beijing, China (People's Rep. of)
  
  Summary
  Report type: Follow-up report No. 14
  Date of start of the event: 04 Apr 2013
  Date of pre-confirmation of the event: 04 Apr 2013
  Report date 07 Mar 2014
  Date submitted to OIE: 07 Mar 2014
  Reason for notification: New strain of a listed disease
  Manifestation of disease:

• A live attenuated H5N1 vaccine induces long-term immunity in the absence of a primary antibody response.
  Talaat KR, Luke CJ, Khurana S, et al. A live attenuated H5N1 vaccine induces long-term immunity in the absence of a primary antibody response. [JOURNAL ARTICLE]J Infect Dis 2014 Mar 5.AbstractPublisher Full TextBackground. Highly pathogenic avian influenza H5N1 viruses cause severe infections in humans. We generated two H5N1 pandemic (p) live attenuated influenza vaccines (LAIV) but they failed to elicit a primary immune response. Our objective was to determine whether the vaccines primed or established long lasting immunity that could be detected by administration of inactivated H5N1 influenza vaccine (ISIV).Methods. The following groups were invited to participate in the study: persons who previously received H5N1 pLAIV; persons who previously received an irrelevant H7N3 pLAIV, and H5N1- and LAIV-naïve community members. LAIV experienced subjects received a single 45 µg dose of H5N1 ISIV. H5N1-and LAIV-naïve subjects received either one or two doses of ISIV.Results. In subjects who had previously received antigenically matched H5N1 pLAIV followed by one dose of ISIV compared with H5N1-and LAIV-naïve two dose ISIV recipients, we observed an increased frequency (82% vs. 50%) and significantly higher titer (112 vs. 76) hemagglutination inhibition antibody response (p=0·04). The affinity of antibody and breadth of cross-clade neutralization was also enhanced in H5N1 pLAIV-primed subjects.Conclusions. ISIV administration unmasked long lasting immunity in H5N1 pLAIV recipients with a rapid, high titer, high quality antibody response that was broadly cross-reactive across several H5N1 clades.Clinicaltrials gov number. NCT01109329.


• Priming for Pandemic Influenza: Thanks for the Memories.
  Falsey AR Priming for Pandemic Influenza: Thanks for the Memories. [JOURNAL ARTICLE]J Infect Dis 2014 Mar 5.Publisher Full Text


• Vaccines for preventing influenza in people with cystic fibrosis.
  Dharmaraj P, Smyth RL Vaccines for preventing influenza in people with cystic fibrosis. [JOURNAL ARTICLE]Cochrane Database Syst Rev 2014 Mar 6.:CD001753.AbstractPublisher Full TextViral respiratory tract infections in people with cystic fibrosis have a deteriorating effect on their lung function and disease progression. Annual influenza vaccination is therefore commonly recommended for people with cystic fibrosis.To assess the effectiveness of influenza vaccination for people with cystic fibrosis.We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises of references identified from comprehensive electronic database searches and handsearching of relevant journals and abstract books of conference proceedings. We also contacted the companies which market the influenza vaccines used in the trials to obtain further information about randomised controlled trials.Date of the most recent search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Cystic Fibrosis Trials Register: 08 July 2013.All randomised and quasi-randomised trials (published or unpublished) comparing any influenza vaccine with a placebo or with another type of influenza vaccine.Two authors independently assessed study quality and extracted data. Additional information was obtained by contacting the investigators when it was indicated.Four studies enrolling a total of 179 participants with cystic fibrosis (143 (80%) were children aged 1 to 16 years) were included in this review. There was no study comparing a vaccine to a placebo or a whole virus vaccine to a subunit or split virus vaccine. Two studies compared an intranasal applied live vaccine to an intramuscular inactivated vaccine and the other two studies compared a split virus to a subunit vaccine and a virosome to a subunit vaccine (all intramuscular). The incidence of all reported adverse events was high depending on the type of influenza vaccine. The total adverse event rate ranged from 48 out of 201 participants (24%) for the intranasal live vaccine to 13 out of 30 participants (43%) for the split virus vaccine. With the limitation of a statistical low power there was no significant difference between the study vaccinations. None of the events were severe. All study influenza vaccinations generated a satisfactory serological antibody response. No study reported other clinically important benefits.There is currently no evidence from randomised studies that influenza vaccine given to people with cystic fibrosis is of benefit to them. There remains a need for a well-constructed clinical study, that assesses the effectiveness of influenza vaccination on important clinical outcome measures.


• Common genetic variants modulate pathogen-sensing responses in human dendritic cells.
  Lee MN, Ye C, Villani AC, et al. Common genetic variants modulate pathogen-sensing responses in human dendritic cells. [Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't]Science 2014 Mar 7; 343(6175):1246980.AbstractPublisher Full TextLittle is known about how human genetic variation affects the responses to environmental stimuli in the context of complex diseases. Experimental and computational approaches were applied to determine the effects of genetic variation on the induction of pathogen-responsive genes in human dendritic cells. We identified 121 common genetic variants associated in cis with variation in expression responses to Escherichia coli lipopolysaccharide, influenza, or interferon-β (IFN-β). We localized and validated causal variants to binding sites of pathogen-activated STAT (signal transducer and activator of transcription) and IRF (IFN-regulatory factor) transcription factors. We also identified a common variant in IRF7 that is associated in trans with type I IFN induction in response to influenza infection. Our results reveal common alleles that explain interindividual variation in pathogen sensing and provide functional annotation for genetic variants that alter susceptibility to inflammatory diseases.


• Populations at Risk for Severe or Complicated Avian Influenza H5N1: A Systematic Review and Meta-Analysis.
  Mertz D, Kim TH, Johnstone J, et al. Populations at Risk for Severe or Complicated Avian Influenza H5N1: A Systematic Review and Meta-Analysis. [Journal Article]PLoS One 2014; 9(3):e89697.AbstractPublisher Full TextLittle is known about risk factors for severe outcomes in patients infected with H5N1 and no systematic review has been conducted. Understanding risk factors is an important step for prioritizing prophylaxis or treatment in the event of a pandemic.To systematically evaluate risk factors for severe outcomes in patients with avian influenza H5N1 infection.MEDLINE, EMBASE, CINAHL, GlobalHealth, and CENTRAL through March 2011.Observational studies of any design published in English, French, Spanish, German or Korean that reported on risk factor-outcome combinations of interest in participants with confirmed H5N1 infections. Outcomes considered included death, ventilator support, hospital and ICU admission, pneumonia, and composite outcomes.Risk of bias was assessed using the Newcastle-Ottawa scale (NOS).We identified 20 studies reporting on 999 patients infected with H5N1. The majority of studies (n = 14, 70%) were at intermediate risk of bias, i.e. 4-6 points on the NOS. Females were at increased risk of death (OR 1.75, 95% CI 1.27-2.44), while young age, in particular <5 years of age (OR 0.44, 95% CI 0.25-0.79 for death), was protective. Data on traditional risk factors was scarce and requires further studies. Another major limitation in the published literature was lack of adjustment for confounders.Females were at increased risk for complications following H5N1 infection while young age protected against severe outcomes. Research on traditional risk factors was limited and is required.


• Influenza a virus assembly intermediates fuse in the cytoplasm.
  Lakdawala SS, Wu Y, Wawrzusin P, et al. Influenza a virus assembly intermediates fuse in the cytoplasm. [Journal Article]PLoS Pathog 2014 Mar; 10(3):e1003971.AbstractPublisher Full TextReassortment of influenza viral RNA (vRNA) segments in co-infected cells can lead to the emergence of viruses with pandemic potential. Replication of influenza vRNA occurs in the nucleus of infected cells, while progeny virions bud from the plasma membrane. However, the intracellular mechanics of vRNA assembly into progeny virions is not well understood. Here we used recent advances in microscopy to explore vRNA assembly and transport during a productive infection. We visualized four distinct vRNA segments within a single cell using fluorescent in situ hybridization (FISH) and observed that foci containing more than one vRNA segment were found at the external nuclear periphery, suggesting that vRNA segments are not exported to the cytoplasm individually. Although many cytoplasmic foci contain multiple vRNA segments, not all vRNA species are present in every focus, indicating that assembly of all eight vRNA segments does not occur prior to export from the nucleus. To extend the observations made in fixed cells, we used a virus that encodes GFP fused to the viral polymerase acidic (PA) protein (WSN PA-GFP) to explore the dynamics of vRNA assembly in live cells during a productive infection. Since WSN PA-GFP colocalizes with viral nucleoprotein and influenza vRNA segments, we used it as a surrogate for visualizing vRNA transport in 3D and at high speed by inverted selective-plane illumination microscopy. We observed cytoplasmic PA-GFP foci colocalizing and traveling together en route to the plasma membrane. Our data strongly support a model in which vRNA segments are exported from the nucleus as complexes that assemble en route to the plasma membrane through dynamic colocalization events in the cytoplasm.


• Electrophoresis-enhanced detection of deoxyribonucleic acids on a membrane-based lateral flow strip using avian influenza h5 genetic sequence as the model.
  Wu JC, Chen CH, Fu JW, et al. Electrophoresis-enhanced detection of deoxyribonucleic acids on a membrane-based lateral flow strip using avian influenza h5 genetic sequence as the model. [Journal Article]Sensors (Basel) 2014; 14(3):4399-415.AbstractPublisher Full TextThis study reports a simple strategy to detect a deoxyribonucleic acid (DNA) on a membrane-based lateral flow (MBLF) strip without tedious gel preparation, gel electrophoresis, and EtBr-staining processes. The method also enhances the detection signal of the genetic sample. A direct electric field was applied over two ends of the MBLF strips to induce an electrophoresis of DNAs through the strips. The signal enhancement was demonstrated by the detection of the H5 subtype of avian influenza virus (H5 AIV). This approach showed an excellent selectivity of H5 AIV from other two control species, Arabidopsis thaliana and human PSMA5. It also showed an effective signal repeatability and sensitivity over a series of analyte concentrations. Its detection limit could be enhanced, from 40 ng to 0.1 ng by applying 12 V. The nano-gold particles for the color development were labeled on the capture antibody, and UV-VIS and TEM were used to check if the labeling was successful. This detection strategy could be further developed to apply on the detection of drug-allergic genes at clinics or detection of infectious substances at incident sites by a simple manipulation with an aid of a mini-PCR machine and auxiliary kits.


• Swiss Quality and Outcomes Framework: Quality Indicators for Diabetes Management in Swiss Primary Care Based on Electronic Medical Records.
  Djalali S, Frei A, Tandjung R, et al. Swiss Quality and Outcomes Framework: Quality Indicators for Diabetes Management in Swiss Primary Care Based on Electronic Medical Records. [JOURNAL ARTICLE]Gerontology 2014 Feb 28.AbstractPublisher Full TextBackground: Most industrialized countries are faced with a growing population of patients with chronic diseases and multimorbidity. Evidence performance gaps have been recognized in the treatment of this vulnerable patient group. In England, the Quality and Outcomes Framework (QOF) - based on incentivized quality indicators - has been established to narrow the gap. Objective: We evaluated to what extent clinical data, extracted from electronic medical records (EMRs) of Swiss general practitioners, can be used as quality indicators in terms of a Swiss Quality and Outcomes Framework (SQOF) for diabetes care adopted from the QOF of the UK National Health Service (NHS). Methods: We searched the FIRE database (Family Medicine ICPC Research Using Electronic Medical Records) for patients suffering from diabetes type 1 or type 2. Eligible data were matched with the diabetes indicator set of the NHS QOF and compared with the results in England. Results: A total of 11 out of 17 diabetes indicators could be adopted for the SQOF; 46 practices with 1,781 diabetes patients were included. The practices fulfilled the SQOF diabetes indicator set with 46.9% overall, with highest compliance for blood pressure measurements (97.8% of all practices) and lowest compliance for influenza immunization (45.7%). Our study practices showed higher variation across all indicators and between practices compared to England, but lacking structured data limited calculation of scores and comparability. Conclusions: Our results show that it is technically feasible to establish a diabetes QOF in Swiss primary care based on EMRs. However, a high amount of missing data made it impossible to evaluate the actual quality of care. For a nationwide introduction, standards for electronic medical documentation and EMR use need to be set. It should also be acknowledged that important dimensions of suffering from one or more chronic diseases such as health-related quality of life are not reflected within a system focusing only on somatic aspects of a disease. © 2014 S. Karger AG, Basel.


• Influenza vaccination coverage among medical residents: An Italian multicenter survey.
  Costantino C, Mazzucco W, Vitale F, et al. Influenza vaccination coverage among medical residents: An Italian multicenter survey. [JOURNAL ARTICLE]Hum Vaccin Immunother 2014 Mar 6; 10(5)AbstractPublisher Full TextAlthough influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011-2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the two previous seasons (P<0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011-2012 season (P<0.001). "To avoid spreading influenza among patients" was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination. And they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future.


• Impact of 2009 pandemic influenza among Vietnamese children based on a population-based prospective surveillance from 2007 to 2011.
  Le MN, Yoshida LM, Suzuki M, et al. Impact of 2009 pandemic influenza among Vietnamese children based on a population-based prospective surveillance from 2007 to 2011. [JOURNAL ARTICLE]Influenza Other Respir Viruses 2014 Mar 7.Influenza virus is one of the major viral pathogens causing pediatric acute respiratory infection (ARI). The spread of pandemic influenza A (A(H1N1)pdm09) in 2009 around the globe had a huge impact on global health.To investigate the impact of A(H1N1)pdm09 on pediatric ARI in Vietnam.An ongoing population-based prospective surveillance in central Vietnam was used. All children aged <15 years residing in Nha Trang city, enrolled to the ARI surveillance in Khanh Hoa General Hospital, from February 2007 through March 2011 were studied. Clinical data and nasopharyngeal swab samples were collected. Influenza A was detected and genotyped by multiplex polymerase chain reaction assays and sequencing.Among enrolled 2736 hospitalized ARI cases, 354 (13%) were positive for influenza A. Genotyping results revealed that seasonal H3N2 and H1N1 (sea-H1N1) viruses were cocirculating before A(H1N1)pdm09 appeared in July 2009. The A(H1N1)pdm09 replaced the sea-H1N1 after the pandemic. The majority of influenza A cases (90%) were aged <5 years with incidence rate of 537 (387-775) per 100 000 population. Annual incidence rates of hospitalized influenza cases for pre-, initial and post-pandemic periods among children aged <5 year were 474, 452, and 387 per 100 000, respectively. Children with A(H1N1)pdm09 were elder, visited the hospital earlier, less frequently had severe signs, and were less frequently associated with viral coinfection compared with seasonal influenza cases.The A(H1N1)pdm09 did not increase the influenza annual hospitalization incidence or disease severity compared with seasonal influenza among pediatric ARI cases in central Vietnam.