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**Flu**

For the current concern about the transmission of an avian flu to humans see Transmission and infection of H5N1.

Avian flu (also "bird flu", "avian influenza", "bird influenza"), means "flu from viruses adapted to birds", but is sometimes mistakenly used to refer to both other flu subsets (such as H5N1 flu) or the viruses that cause them (such as H5N1).^[1] ^[2] ^[3] ^[4] ^[5] ^[6] ^[7]

"Bird flu" is a phrase similar to "Pig flu", "Dog flu", "Horse flu", or "Human flu" in that it refers to an illness caused by any of many different strains of flu viruses such that the strain in question has adapted to the host. "Avian flu" differs in being named after an entire vertebrate class with 8,800–10,200 species. All known avian flu viruses belong to the species of virus called Influenza A virus. All subtypes (but not all strains of all subtypes) of Influenza A virus are adapted to birds, which is why for many purposes avian flu virus is the Influenza A virus (note that the "A" does not stand for "avian").

Adaptation is sometimes partial or multiple so a flu virus strain can be partially adapted to a species or adapted to more than one species. Flu pandemic viruses are human adapted and also bird adapted. Being adapted to one species does not mean another species can not catch it; nor does it mean it can not adapt to another species.

Genetic factors in distinguishing between "human flu viruses" and "avian flu viruses" include:

PB2: (RNA polymerase): Amino acid (or residue) position 627 in the PB2 protein encoded by the PB2 RNA gene. Until H5N1, all known avian influenza viruses had a Glu at position 627, while all human influenza viruses had a lysine.

HA: (hemagglutinin): Avian influenza HA bind alpha 2-3 sialic acid receptors while human influenza HA bind alpha 2-6 sialic acid receptors. Swine influenza viruses have the ability to bind both types of sialic acid receptors.

The HA changes have not yet occurred in any sequenced H5N1 virus - even ones from humans that died from it and the PB2 changes don't stop it from being a flu virus adapted to birds (the definition of "avian flu virus").

Pandemic flu viruses have some avian flu virus genes and usually some human flu virus genes. Both the H2N2 and H3N2 pandemic strains contained genes from avian influenza viruses. The new subtypes arose in pigs coinfected with avian and human viruses and were soon transferred to humans. Swine were considered the original "intermediate host" for influenza, because they supported reassortment of divergent subtypes. However, other hosts appear capable of similar coinfection (e.g., many poultry species), and direct transmission of avian viruses to humans is possible. The Spanish flu virus strain may have been transmitted directly from birds to humans. ^[8]

In spite of their pandemic connection, avian flu viruses are noninfectious for most species. When they are infectious they are usually asymptomatic, so the carrier does not have any disease from it. Thus while infected with an avian flu virus, the animal doesn't have a "flu". Typically, when illness (called "flu") from an avian flu virus does occur, it is the result of an avian flu virus strain adapted to one species spreading to another species (usually from one bird species to another bird species). So far as is known, the most common result of this is an illness so minor as to be not worth noticing (and thus little studied). But with the domestication of chickens and turkeys, humans have created species subtypes (domesticated poultry) that can catch an avian flu virus adapted to waterfowl and have it rapidly mutate into a form that kills in days over 90% of an entire flock and spread to other flocks and kill 90% of them and can only be stopped by killing every domestic bird in the area. Until H5N1 infected humans in the 1990s, this was all that was considered important about avian flu (outside of the poultry industry). Since then, avian flu viruses have been intensively studied; resulting in changes in what is believed about flu pandemics, changes in poultry farming, changes in flu vaccination research, and changes in flu pandemic planning.

H5N1 has evolved into a flu virus strain that inflects more species than any previously known flu virus strain, is deadlier than any previously known flu virus strain, and continues to evolve becoming both more widespread and more deadly causing the world's number one expert on avian flu to publish an article titled "The world is teetering on the edge of a pandemic that could kill a large fraction of the human population" in American Scientist. He called for adequate resources to fight what he sees as a major world threat to possibly billions of lives.^[9] Since the article was written, the world community has spent billions of dollars fighting this threat with limited success. It is a race between an exceptionally fast mutating virus and modern scientific research capabilities, with the winner of the race still in doubt.

**Cumulate Human Cases of and Deaths from H5N1**
As of October 31, 2006

Notes:

Source WHO Confirmed Human Cases of H5N1
"[T]he incidence of human cases peaked, in each of the three years in which cases have occurred, during the period roughly corresponding to winter and spring in the northern hemisphere. If this pattern continues, an upsurge in cases could be anticipated starting in late 2006 or early 2007." Avian influenza – epidemiology of human H5N1 cases reported to WHO
The regression curve for deaths is y = a + e^k x, and is shown extended through the end of November, 2006.

1 H5N1
2 Illustrative examples of correct usage
3 Illustrative examples of imprecise usage
4 See also
5 Sources and notes
6 Further reading

H5N1

As of 2006, "avian flu" is being commonly used to refer to infection from a particular subtype of Influenza A virus, H5N1, which can cause severe illness in humans who are infected. Currently, this strain is transmitted by contact with infected birds, and has been transmitted from one person to another only in a few cases. H5N1 flu is therefore not pandemic now and is not currently capable of causing a pandemic. Only if H5N1 mutates into a form that can be readily transmitted from one person to another could it cause a pandemic.

Illustrative examples of correct usage

**H5N1**

WHO pandemic phases Low risk New virus Self limiting Person to person Epidemic exists Pandemic exists

Swans can carry highly pathogenic avian H5N1 and other avian flu viruses

In technical contexts, correct usage of terms is necessary because precise distinctions are the essence of the communication.

"Avian influenza strains are those well adapted to birds" ^[1]
"An outbreak of influenza A (H5N1), also known as 'avian flu' or 'bird flu,' has been reported in several countries throughout Asia." ^[10]
"Avian influenza virus usually refers to influenza A viruses found chiefly in birds, but infections can occur in humans."^[11]
"Of the few avian influenza viruses that have crossed the species barrier to infect humans, H5N1 has caused the largest number of cases of severe disease and death in humans. Unlike normal seasonal influenza, where infection causes only mild respiratory symptoms in most people, the disease caused by H5N1 follows an unusually aggressive clinical course, with rapid deterioration and high fatality." Seasonal influenza is human flu.^[12]
"avian influenza HA bind alpha 2-3 sialic acid receptors while human influenza HA bind alpha 2-6 sialic acid receptors. Swine influenza viruses have the ability to bind both types of sialic acid receptors." ^[13]
Sometimes a virus contains both avian adapted genes and human adapted genes. Both the H2N2 and H3N2 pandemic strains contained avian flu virus RNA segments. "While the pandemic human influenza viruses of 1957 (H2N2) and 1968 (H3N2) clearly arose through reassortment between human and avian viruses, the influenza virus causing the 'Spanish flu' in 1918 appears to be entirely derived from an avian source (Belshe 2005)." ^[2]

Illustrative examples of imprecise usage

In nontechnical contexts, imprecise usage of terms is typical when discussing complex things.

"A 1,000 square mile quarantine zone to combat an outbreak of bird flu was lifted in Scotland today - despite the spread of a similar disease south of the border." Here "bird flu" is used to mean "Asian lineage HPAI A(H5N1) flu" (which is a bird flu) and contrasted with flu from an avian adapted strain of H7N3 (which is also a bird flu).^[14]

Sources and notes

^ ^a ^b "Avian influenza strains are those well adapted to birds"EUROPEAN CENTRE FOR DISEASE PREVENTION AND CONTROL.
^ ^a ^b Chapter Two : Avian Influenza by Timm C. Harder and Ortrud Werner from excellent free on-line Book called Influenza Report 2006 which is a medical textbook that provides a comprehensive overview of epidemic and pandemic influenza.
^ Large-scale sequencing of human influenza reveals the dynamic nature of viral genome evolution Nature magazine presents a summary of what has been discovered in the Influenza Genome Sequencing Project.
^ Full HTML text of Avian Influenza A (H5N1) Infection in Humans by The Writing Committee of the World Health Organization (WHO) Consultation on Human Influenza A/H5 in the September 29, 2005 New England Journal of Medicine
^ The Threat of Pandemic Influenza: Are We Ready? Workshop Summary (2005) Full text of online book by INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES
^ Here is the tree showing evolution by antigenic drift since 2002 that created dozens of highly pathogenic varieties of the Z genotype of avian flu virus H5N1, some of which are increasingly adapted to mammals.
^ Evolutionary characterization of the six internal genes of H5N1 human influenza A virus
^ Chapter Two : Avian Influenza by Timm C. Harder and Ortrud Werner from excellent free on-line Book called Influenza Report 2006 which is a medical textbook that provides a comprehensive overview of epidemic and pandemic influenza.
^ Webster, R. G. and Walker, E. J. (2003). "The world is teetering on the edge of a pandemic that could kill a large fraction of the human population". American Scientist 91 (2): 122. DOI:10.1511/2003.2.122.
^ OSHA
^ CDC Avian Influenza (Bird Flu)
^ WHO Avian influenza frequently asked questions
^ Greninger Paper (PDF)
^ News Avian flu quarantine zone lifted published May 1, 2006.

Birds Guide

Avian flu

Contents

H5N1

Illustrative examples of correct usage

Illustrative examples of imprecise usage

See also

Sources and notes

Further reading


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