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Questions & Answers on Influenza

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Questions & Answers on Influenza 101 Questions & Answers on Influenza101 101 Questions & Answers Prof. Dr. A.D.M.E. (Ab) Osterhaus is David De Pooter is working at Link Inc on professor of virology at Erasmus Medical since 2003, the Antwerp (Belgium) based Centre Rotterdam, and professor of communication consultancy agency, Environmental Virology at the Utrecht specialised in strategic communication University. Fascinated by the ingenious and social marketing. Link Inc is working ways viruses circumvent the immune with the European Scientific working Influenza system of their hosts to multiply and Group on Influenza (ESWI) since 1998 and spread, Osterhaus started his quest at the is taking care of the positioning of the interface of virology and immunology. He group, the strategy and the implementa­ Ab Osterhaus quickly translated new insights in this tion of the strategy by developing complex field to applications in animal and targeted communication tools. In this human vaccinology. In addition, he started capacity, David De Pooter is a professional David De Pooter his work on virus discovery, not only writer on medical topics and a communi­ focussing on the identification of a series cation manager of ESWI. As such he has of animal viruses, but also of new human established a fruitful and long standing viruses. collaboration with Prof Ab Osterhaus. (www.linkinc.be) 101 Questions & Answers on Influenza 101 101 Questions & Answers on Influenza Ab Osterhaus David De Pooter Elsevier, Maarssen © Elsevier, Maarssen 2009 Design: Studio Bassa, Culemborg Elsevier is an imprint of Reed Business bv, PO Box 1110, 3600 BC Maarssen, The Netherlands. To order: Elsevier Gezondheidszorg, Marketing dept., Antwoordnummer 2594 (freepost), 3600 VB Maarssen, The Netherlands. Phone: +31-314-358358; fax: +31-346-577950; e-mail: [email protected]. We have endeavored to trace the ownership of all copyrighted material and to secure permission from copyright holders when required. In the event of any question arising as to the use of any material, we will be pleased to make the necessary corrections in future printings. All rights reserved (including those of translation into foreign languages). No part of this book may be reproduced in any form — by photoprint, microfilm, or any other means — or transmitted or translated into a machine language without written permission from the publisher. ISBN 978 90 352 3091 0 NUR 870 5 Table of content Foreword 11 Preface 13 I All you need to know about influenza 1 What is a virus? 16 2 What are the differences between viruses, bacteria and parasites? 18 3 How are viruses classified? 20 4 How do viruses replicate? 21 5 What do viruses look like? 22 6 What do influenza viruses look like? 23 7 Which organisms can be infected with viruses? 24 8 Which scientific disciplines study viruses? 25 9 What are the existing types, subtypes and clades of influenza viruses? 26 10 Which animals are the natural hosts of influenza A viruses? 27 11 What other species can be infected with influenza A viruses? 28 II All about influenza viruses and the disease influenza 12 Where does the word ‘influenza’ come from? 32 13 What are the different forms of human influenza? 33 14 How do influenza viruses change? 35 15 How and where do influenza viruses enter the human body? 37 16 How does the body combat influenza? 39 17 What are possible complications of seasonal influenza? 41 18 Who belongs to the special risk groups for influenza? 42 6 ALL YOU NEED TO KNOW ABOUT INFLUENZA III How influenza viruses spread 19 How are influenza viruses transmitted from human to human? 44 20 How are influenza viruses transmitted from animals to humans? 45 21 What are the most important factors that determine influenza virus transmission to humans? 46 IV How to recognize influenza 22 What is the difference between influenza and a common cold? 48 23 What is the difference between clinical and lab-confirmed diagnosis? 49 24 When is a lab-confirmed diagnosis appropriate? 50 V All about seasonal influenza 25 What is seasonal influenza? 52 26 How many people get ill or even die from influenza each year? 53 27 What is the social and societal impact of seasonal influenza? 54 28 What is the economic impact of seasonal influenza? 55 29 How to prevent seasonal influenza? 56 30 How to treat seasonal influenza? 57 TABLE OF CONTENT 7 VI All about avian influenza 31 What is avian influenza? 60 32 What is the difference between low pathogenic avian influenza (LPAI) and highly pathogenic avian influenza (HPAI)? 61 33 How dangerous is HPAI-H5N1 virus infection for animals? 62 34 How dangerous is avian influenza for humans? 63 35 How does avian influenza spread among animals? 65 36 Can birds be vaccinated to stop the spread of avian influenza? 66 37 What else can be done to stop the spread of avian influenza? 68 38 How can I personally prevent infection with the HPAI-H5N1 virus? 69 39 Is it safe to eat poultry and poultry products? 71 VII All about pandemic influenza 40 What is pandemic influenza? 74 41 What are the pandemics which have occurred in the past century? 76 42 What is the origin of influenza pandemics? 78 43 Will there be other influenza pandemics in the future? 79 44 What is the expected impact of future pandemics? 80 45 What are the basic elements of pandemic planning? 81 46 Who is responsible for influenza pandemic preparedness plans? 83 47 Are we prepared for the current pandemic? 84 48 Will the ‘Mexican flu’ virus cause the first influenza pandemic of thest 21 century? 88 8 ALL YOU NEED TO KNOW ABOUT INFLUENZA VIII All about influenza vaccines 49 What are the medicinal intervention options for influenza? 91 50 What is the difference between vaccines, antiviral drugs and antibiotics? 93 51 Are over-the-counter products effective against influenza? 94 52 How do influenza vaccines work? 95 53 What types of seasonal influenza vaccines exist? 97 54 How are viruses chosen for the vaccine each year? 98 55 How are vaccines produced in chicken eggs? 99 56 How are vaccines produced in cultured cells? 100 57 How effective are influenza vaccines? 101 58 Is influenza vaccination cost-effective? 102 59 Who should be vaccinated annually? 103 60 Should seasonal flu vaccination be repeated every year? 104 61 When should the vaccine be given? 105 62 Should healthy people be vaccinated? 106 63 Should children be vaccinated? 107 64 Should healthcare workers be vaccinated? 108 65 Does influenza vaccination also protect against other diseases like the common cold? 110 66 Does vaccination cause side effects? 111 67 Can you get influenza from the vaccine? 112 68 How many people are vaccinated annually? 113 69 Where can I get the seasonal influenza vaccine? 115 70 What is the role of family doctors in influenza vaccination? 116 71 What is the role of pharmacists in influenza vaccination? 117 72 What are the drivers for influenza vaccination? 118 73 What are the barriers for influenza vaccination? 120 74 Does the seasonal influenza vaccine protect against pandemic influenza? 121 75 What is a pandemic influenza vaccine? 122 76 What is an adjuvant? 123 TABLE OF CONTENT 9 77 What is pre-pandemic influenza vaccination? 124 78 Can we be vaccinated against pandemic influenza now? 125 79 Will there be enough pandemic vaccine? 127 80 Who should be vaccinated first during a pandemic? 128 81 What are pneumococcal vaccines and should they be stockpiled for pandemic influenza? 130 82 What are the most common misconceptions about flu and flu vaccines? 131 IX All about antiviral drugs 83 What are antiviral drugs against influenza? 134 84 When should antiviral drugs against influenza be used? 136 85 How effective are antiviral drugs against seasonal, avian, and pandemic flu? 137 86 Should we stockpile antiviral drugs against pandemic influenza? 139 87 Should antibiotics be used against influenza? 140 88 Should antibiotics be stockpiled for pandemic influenza? 141 X How to prepare for an influenza pandemic 89 What is an influenza pandemic preparedness plan? 144 90 What are pandemic alert phases? 145 91 What is the role of international health organizations in pandemic preparedness? 147 92 What is the role of your government in pandemic preparedness? 149 93 What is the role of healthcare workers during an influenza pandemic? 151 94 What is the role of pharmaceutical companies before and during an influenza pandemic? 152 95 What can you do personally to prepare for an influenza pandemic? 153 96 Will schools and workplaces be closed during an influenza pandemic? 154 10 ALL YOU NEED TO KNOW ABOUT INFLUENZA XI Who monitors influenza spread and why? 97 What is the role of the World Health Organization in influenza surveillance? 158 98 What other international organizations play a role in influenza surveillance? 160 99 What about animal influenza surveillance? 161 XII What’s more? 10 0 What aspects of epidemic and pandemic preparedness need further research? 164 101 Where can I find the most essential flu info on the Web? 166 Biography 167 Acknowledgements 168 11 Foreword Flu, flu epidemics and why primary care matters more than ever Not that long ago, epidemics were considered a the president of the World Organization of Fam- public health problem of the past in developed ily Doctors, Wonca, I congratulate ESWI with this societies; it was a nostalgic past for that matter, excellent publication, and I would like to take the full of reminiscences of practitioners and health opportunity to summarize the role and position of officers who sometimes imposed, from their limited primary care and family doctors, in the orchestra- understanding of the patho-physiology of infec- tion of societies’ response to flu epidemics.
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