Avian influenza: a new pandemic threat?
In December 2003, the largest outbreak of highly pathogenic avian influenza H5N1 occurred among poultry in 8 Asian countries. A limited number of human H5N1 infections have been reported from Vietnam and Thailand, with a mortality rate approaching 70%. Deaths have occurred in otherwise healthy young individuals, which is reminiscent of the 1918 Spanish influenza pandemic. The main presenting features were fever, pneumonitis, lymphopenia, and diarrhea. Notably, sore throat, conjunctivitis, and coryza were absent. The H5N1 strains are resistant to amantadine and rimantadine but are susceptible to neuraminidase inhibitors, which can be used for treatment and prophylaxis. The widespread epidemic of avian influenza in domestic birds increases the likelihood for mutational events and genetic reassortment. The threat of a future pandemic from avian influenza is real. Adequate surveillance, development of vaccines, outbreak preparedness, and pandemic influenza planning are important. This article summarizes the current knowledge on avian influenza, including the virology, epidemiology, diagnosis, and management of this emerging disease.
Trampuz
Andrej
A
Division of Infectious Diseases and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA. andrejtrampuz@aol.com
Prabhu
Rajesh M
RM
Smith
Thomas F
TF
Baddour
Larry M
LM
D000547:Amantadine / Q000627:therapeutic use; D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D001208:Asia / Q000453:epidemiology; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D024921:Drug Resistance, Multiple, Viral; D005191:Family Characteristics; D005544:Forecasting; D014943:Global Health; D006801:Humans; D009980:Influenza A virus / Q000235:genetics / Q000472:pathogenicity; D005585:Influenza in Birds / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D009154:Mutation / Q000235:genetics; D009439:Neuraminidase / Q000037:antagonists & inhibitors; D010356:Patient Isolation; D011159:Population Surveillance; D011200:Poultry; D011201:Poultry Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D011995:Recombination, Genetic / Q000235:genetics; D012299:Rimantadine / Q000627:therapeutic use; D014611:Vaccination; D015047:Zoonoses / Q000453:epidemiology / Q000821:virology
D000998:Antiviral Agents; D012299:Rimantadine; D000547:Amantadine; D009439:Neuraminidase