title: Avian influenza: the threat of the 21st century.
abstract: This study aimed to review the literature on infection with the H5N1 subtype of avian influenza A virus, taking into consideration the fact that, in the event of a pandemic, children might become a major risk group. Searches were limited to the past ten years and were carried out using the following electronic databases: Medline, MD Consult, HighWire and Medscape. Children and young adults account for a significant proportion of the susceptible population. We found that more than half of the individuals infected were under 20 years of age and that one quarter was under the age of 10. The incubation period ranged from 2 to 5 days. Initial clinical manifestations are nonspecific, which hinders the diagnosis. Most of the infected individuals presented severe pneumonia, which evolved to respiratory insufficiency within an average of 4 days. Chest X-rays can reveal diffuse multifocal/ interstitial infiltrates or segmental/lobar consolidation with air bronchogram. The pathogenic potential is high, with mortality rates up to 63%, indicating that the pandemic virus might present high pathogenicity and high mortality. Knowledge of the risk of a pandemic and of the measures to be taken in suspect cases constitutes an important step toward controlling a potential pandemic.
authors: Faculdade de Ciências Médicas, Universidade de Alfenas, Belo Horizonte, MG, Brasil.
authors: Cláudia Ribeiro de
authors: CR
authors: Andrade
authors: Cássio da Cunha
authors: Cda C
authors: Ibiapina
authors: Natália Silva
authors: NS
authors: Champs
authors: Antonio Carlos Castro de
authors: AC
authors: Toledo Junior
authors: Isabela Furtado de Mendonça
authors: IF
authors: Picinin
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype / Q000472:pathogenicity*; D007251:Influenza, Human / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy / Q000821:virology*; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult