Probable Person-to-Person Transmission of Avian Influenza A (H5N1)

Ungchusak, Kumnuan; Auewarakul, Prasert; Dowell, Scott F.; Kitphati, Rungrueng; Auwanit, Wattana; Puthavathana, Pilaipan; Uiprasertkul, Mongkol; Boonnak, Kobporn; Pittayawonganon, Chakrarat; Cox, Nancy J.; Zaki, Sherif R.; Thawatsupha, Pranee; Chittaganpitch, Malinee; Khontong, Rotjana; Simmerman, James Mark; Chunsutthiwat, Supamit

doi:10.1056/nejmoa044021

Cited by 793 publications

(593 citation statements)

References 19 publications

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“…Most of these were again from contact with dead or live infected poultry. The only evidence of human to human transmission was in a family cluster of 8 .The mortality rate is around 60% which is very high. Infection with H5N1 in humans has so far remained confi ned to individuals with close contact with infected birds or surfaces or objects heavily contaminated with their droppings.…”

Section: Disease Burden and Demographic Characteristicsmentioning

confidence: 99%

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Influenza A: From highly pathogenic H5N1 to pandemic 2009 H1N1. Epidemiology and clinical features

2009

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The last decade has seen the emergence of two new infl uenza A subtypes and they have become a cause of concern for the global community. These are the highly pathogenic H5N1 infl uenza A virus (H5N1) and the Pandemic 2009 infl uenza H1N1 virus. Since 2003 the H5N1 virus has caused widespread disease and death in poultry, mainly in south East Asia and Africa. In humans the number of cases infected with this virus is few but the mortality has been about 60%. Most patients have presented with severe pneumonia and acute respiratory distress syndrome. The second infl uenza virus, the pandemic H1N1 2009, emerged in Mexico in March this year. This virus acquired the ability for sustained human to human spread and within a few months spread throughout the world and infected over 4 lakh individuals. The symptoms of infection with this virus are similar to seasonal infl uenza but it currently affecting younger individuals more often. Fortunately the mortality has been low. Both these new infl uenza viruses are currently circulating and have different clinical and epidemiological characteristics.

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Section: Disease Burden and Demographic Characteristicsmentioning

confidence: 99%

“…Human-to-human transmission has only been documented in 1 case of transmission from sick child to mother and possibly 1 case of a cluster of 8 patients in a family in Indonesia in 2006 [7,8].…”

Section: Route Of Transmissionmentioning

confidence: 99%

Influenza A: From highly pathogenic H5N1 to pandemic 2009 H1N1. Epidemiology and clinical features

2009

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“…The highly pathogenic avian influenza A/H5N1 virus, first reported in China in 1996, has been responsible for severe avian influenza outbreaks 15 , 16 , 17 . The disease is now widespread among poultry and migratory birds in many parts of the world and, significantly, more than 380 humans have been infected, with approximately 240 (63%) deaths 18 .…”

Section: Introductionmentioning

confidence: 99%

MF59^®‐adjuvanted vaccines for seasonal and pandemic influenza prophylaxis

Banzhoff

Pellegrini

Giudice

et al. 2008

Influenza Resp Viruses

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Influenza is a major cause of worldwide morbidity and mortality through frequent seasonal epidemics and infrequent pandemics. Morbidity and mortality rates from seasonal influenza are highest in the most frail, such as the elderly, those with underlying chronic conditions and very young children. Antigenic mismatch between strains recommended for vaccine formulation and circulating viruses can further reduce vaccine efficacy in these populations. Seasonal influenza vaccines with enhanced, cross‐reactive immunogenicity are needed to address these problems and can confer a better immune protection, particularly in seasons were antigenic mismatch occurs. A related issue for vaccine development is the growing threat of pandemic influenza caused by H5N1 avian strains. Vaccines against strains with pandemic potential offer the best approach for reducing the potential impact of a pandemic. However, current non‐adjuvanted pre‐pandemic vaccines offer suboptimal immunogenicity against H5N1. For both seasonal and pre‐pandemic vaccines, the addition of adjuvants may be the best approach for providing enhanced cross‐reactive immunogenicity. MF59®, the first oil‐in‐water emulsion licensed as an adjuvant for human use, can enhance vaccine immune responses through multiple mechanisms. A trivalent MF59‐adjuvanted seasonal influenza vaccine (Fluad®) has shown to induce significantly higher immune responses to influenza vaccination in the elderly, compared with non‐adjuvanted vaccines, and to provide cross‐reactive immunity against divergent influenza strains. Similar results have been generated with a MF59‐adjuvanted H5N1 pre‐pandemic vaccine, which showed higher and broader immunogenicity compared with non‐adjuvanted pre‐pandemic vaccines.

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“…Aunque el virus H5N1 está apuntando a la población humana, la infección entre humanos no ha sido demostrada consistentemente y hay muchos informes probados de que esta infección no se ve transmitida entre humanos 32,33 . La controversia viene con algunos otros estudios que sugieren que el contacto cercano entre personas pueda conducir a la infección aviar de la gripe 31,34 .…”

Section: Epidemiologíaunclassified

“…Estos tres tipos se clasifican en función de las proteínas de su núcleo (NP y M) 34 . La gripe A infecta mamíferos y pájaros mientras que la B y la C se restringen a los seres humanos 36,37 .…”

Section: Virologíaunclassified

Gripe aviar: lo que un intensivista debe conocer

Casillas¹,

Fernandez²,

Varon³

2008

Medicina Intensiva

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En el siglo pasado, la humanidad ha hecho frente a tres de las mayores pandemias de infecciones por el virus de la gripe. La primera fue en 1918, y causó una cantidad significativa de muertes. Éste ha sido también capaz de cruzar la barrera de la especie y afectar a los mamíferos y, lo más preocupante, a los seres humanos. Desde entonces se han publicado varios brotes en el sudeste de Asia. Una gran cantidad de pacientes presenta un curso severo que desarrolla neumonía y disfunción, que implica al hígado, los riñones, el cerebro y los pulmones.Puesto que el virus carece de control regulador de la división genética, experimenta mutaciones constantes que conducen a nuevos subtipos y a nuevas cepas. Los únicos fármacos que han mostrado cierta protección son oseltamivir y zanamivir. Es crucial desarrollar vacunas eficaces y no costosas para prevenir la extensión del virus y la infección, no solamente en seres humanos sino también en aves. PALABRAS CLAVE: gripe aviar, fallo respiratorio agudo, virus H5N1, neuraminidasa, oseltamivir. BIRD FLU: WHAT THE INTENSIVIST MUST KNOWIn the last century, humankind has faced 3 major pandemics of influenza virus infections. The first one occurred in 1918 and caused a significant amount of deaths. It was also capable of crossing over species barrier and affecting mammals, and most worrisome, humans. Since then several outbreaks have been reported in the Southeast of Asia. Many patients with the flu-like illness have a severe course and the patient develops pneumonia and in some cases multiorgan failure involving liver, kidneys, brain and lungs.Since the virus lacks regulatory control of genetic division it undergoes constant mutations leading to new subtypes and, sometimes, new strains. The only drugs that have shown some protection are oseltamivir and zanamivir. It is crucial to develop effective and non-expensive vaccines to prevent the virus spread and infection not only in humans but in birds too.

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Probable Person-to-Person Transmission of Avian Influenza A (H5N1)

Abstract: Disease in the mother and aunt probably resulted from person-to-person transmission of this lethal avian influenzavirus during unprotected exposure to the critically ill index patient.

Cited by 793 publications

References 19 publications

Influenza A: From highly pathogenic H5N1 to pandemic 2009 H1N1. Epidemiology and clinical features

Influenza A: From highly pathogenic H5N1 to pandemic 2009 H1N1. Epidemiology and clinical features

MF59^®‐adjuvanted vaccines for seasonal and pandemic influenza prophylaxis

Gripe aviar: lo que un intensivista debe conocer

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Probable Person-to-Person Transmission of Avian Influenza A (H5N1)

Abstract: Disease in the mother and aunt probably resulted from person-to-person transmission of this lethal avian influenzavirus during unprotected exposure to the critically ill index patient.

Cited by 793 publications

References 19 publications

Influenza A: From highly pathogenic H5N1 to pandemic 2009 H1N1. Epidemiology and clinical features

Influenza A: From highly pathogenic H5N1 to pandemic 2009 H1N1. Epidemiology and clinical features

MF59®‐adjuvanted vaccines for seasonal and pandemic influenza prophylaxis

Gripe aviar: lo que un intensivista debe conocer

Contact Info

Product

Resources

About

MF59^®‐adjuvanted vaccines for seasonal and pandemic influenza prophylaxis