Avian Influenza (AI)

In two years between 1918 and 1919, A pandemic of influenza swept mercilessly over the planet, killing millions which stood in its path. Miraculously, the exact origin of the pandemic is unclear. What is exceedingly clear, however, is that often the actions of man aided in the spread of the virus, whether due to inadvertent endangerment, close quarters, religious principles, or failure to recognize the true threat that influenza posed.

Every year, millions of people start talking about the influenza virus and getting their vaccines as the flu season approaches, which starts around the October-November period and reaches its peak between December and March. Therefore, public health officials around the world- and in the U.S in particular- are constantly challenged by properly preparing for the annual influenza dilemma, given that this viruses, and other respiratory viruses, are a serious health threat to the U.S population and the world as a whole. Furthermore, what makes the influenza virus even more challenging to control is that it can mutate rapidly and reassort to form new strains, having the ability to reside in multiple animal hosts. In fact, many scientists and researchers have been doing in-depth intensive research so as to understand the mechanism behind this unique characteristic of the virus, try to find new ways to control it, and explore different areas of protection and vaccination.

People are dying every second to a variety of reasons, some that could be prevented others where that is not the case. However, experts agree that influenza and influenza related deaths could be significantly prevented if people took the influenza vaccine annually. The influenza virus is a deadly virus that has been killing people since the 1900s; in 1918 the first recorded epidemic of a strain of influenza known as the Spanish flu killed approximately 50 million people ("Pandemic Flu History"). Because people did not know what the virus was or how to fight against it, it spread very fast. However, after the vaccine was made, later epidemics such as the 1957, 1968, and 2009 epidemics were not as fatal, killing approximately one million people worldwide. Vaccines played a large role in human history in fighting and preventing diseases from annihilating human beings. This paper will discuss the economic aspects of whether it should be mandatory for hospital health care workers to take the flu vaccine.

The seasonal influenza vaccine has been in existence for a numerous amount of decades, therefore so has the gradual implementation of the vaccination. Through recent studies, the break through knowledge of the importance of enforcing the requirement of this vaccine for children has acquired increasing acceptance statistics. During the many outbreaks of different classified strands of avian influenza, the health care community has been unable to retain the virus and alleviate patients efficiently. However current tallies have shown that the system for controlling these outbreaks have improved lowering the mortality rate profoundly. (BioScience Trends, 2013).

The first alternative, to such a policy includes immediate dismissal of any staff that refuse to comply regardless of being directed that it is a requirement (Brady, 2013). According to Brady et al. (2013), policies that dismiss staff who do not comply usually have higher rates of compliance. The second alternative, includes work restrictions for the unvaccinated workers during Influenza season and an overall increase in insurance premiums (Vaughan & Arsneault, 2014). This option would deter the spread of the virus in the infected to the uninfected because of the limited point of exposures to the source. The unvaccinated healthcare worker would therefore, be subjected to working fewer hours and face higher

Influenza remains as a significant global threat to public health. In United States alone, a typical influenza epidemic results in over 25 million infections, 300,000 hospitalizations and 13,000 deaths every year (1). The virus evolves antigenically from one year to the next, requiring annual reformulation of the vaccine and leading to variable vaccine efficacy. Exacerbating this natural antigenic evolution, adaptation to the chicken eggs may occur during the manufacture of virus used to produce the inactivated vaccine (2). This year such adaptation has reduced the vaccine efficacy against H3N2 strain (3). Low vaccine efficacy is expected to generate higher attack rates, as has already occured in Australia (3, 4). Compounding the effects of low vaccine efficacy, public perception following the widespread media attention may depress vaccine uptake for a given year. The combination of low vaccine efficacy and low coverage has the potential to reduce herd immunity, putting the population at risk of elevated infection incidence and ultimately high rates of infections and mortality. Consequently, optimizing epidemiological effectiveness of vaccination given vaccine efficacy is imperative to minimize the annual mortality and morbidity of influenza.

Flu season is upon us and influenza has hit our area particularly hard this year. The flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs that spread from person to person through sneezing and coughing. The flu can also be spread surfaces when infected people touch surfaces such as door knobs, shopping carts, computer keyboards, countertops, etc. Symptoms of the flu include fever, cough, sore throat, body aches, headache, chills and fatigue. Though it can be difficult to avoid the flu entirely, there are things you can do to protect yourself and your household from getting the flu by following these steps at home. Continue these steps daily throughout the flu season.

Wild aquatic fowl, ducks in particular, serve as a reservoir for the Influenza virus to transmit into poultry and then to humans. Infected birds shed flu viruses in their saliva, nasal secretions, and feces (CDC, 2004). The current virus seen in Asia is denoted as H5N1 and was first seen in terns in South Africa in 1961 (CDC, 2004). The first human seen infection of the avian H5N1 viruses was in 1997 in Hong Kong in a three- year old boy (Ruben, 2005). The outbreak involved 18 cases and killed 6, one third of the confirmed infected population (Rueben, 2005). In three days 1.5 million birds were killed in order to prevent further spread. A new pandemic is now on the horizon with recent outbreaks in poultry in the eight Asian countries of Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand, and Vietnam since 2004 (CDC, 2005). As of July 5, 2005, there have been 108 reported human cases of the H5N1 virus with 54 deaths (CDC, 2004). In wake of a

Once there was a virus named Birdie. This virus was a Bird Flu, or Avian Influenza, virus of the subtype H5N1, the first strain of Avian Influenza having the ability to infect humans (Normandin and Solan). Birdie looked like a microscopic pomander, a fragrant orange with cloves stuck in it. Inside, she had eight pieces of single stranded ribonucleic acid or ssRNA. Birdie was deadly to humans, but was not able to spread from one human to another. She could only spread from birds to humans ("Bird Flu"). Birdie started out inside a chicken named Cluck, where she was formed. A little while later, Cluck's farmer Mark, sold his Cluck, to Joe, another poultry farmer because Mark did not realize that Cluck had H5N1. After a few months of Cluck living

I think many can testify to being guilty of brushing off symptoms like a stuffy nose, and the feeling of fatigue as the common cold, treatable by over the counter drugs. We tend to ignore these minor signs of what could possibly be a very dangerous and severe viral infection, this respiratory infection being the influenza virus. Flu activity most often appears between the months of February and May, leading many to believe their symptoms might be caused by allergies. Although symptoms are very similar, the flu can cause epidemics with the deadly outcomes, as the common cold is just a nuisance for us.

Influenza strikes this country in pandemic proportions every year. Although there are many factors contributing to morbidity and mortality, the mortality rate varies from year to year. According to the Centers for Disease Control and Prevention, in the thirty year range from 1976 to 2006, saw death rates from a low of 3000 to a high of 49000 (Centers for Disease Control and Prevention, 2016). So far this season, there have been 3697 deaths from influenza related illness (CDC, 2016). In 2009, the virulent H1N1 strain, with a 20% risk of death, also brought the difficulties of lack of research based clinical evidence for treatments (Cook, et al., 2010). The lack of research conducted during pandemics stems from the delay caused by the often

Around 5 million people worldwide are affected annually by the influenza A virus (IAV), with infection resulting in severe morbidity and sometimes death. Although effective IAV vaccines exist, annual influenza epidemics occur due to its ability to quickly evolve new strains. Therefore, IAV remains a serious public health threat as evidenced by the recent pandemics involving swine H1N1 and avian H7N9. Thus, there is a vital need to develop more effective vaccines against influenza. Normally, vaccines function by priming the immune system to recognize a pathogen so that the body can more easily identify and eliminate it upon a second encounter. This protective immunity relies on receptors in the innate immune system such as the pattern recognition receptors (PRRs) Toll-like receptors (TLRs) and retinoic acid inducible gene I (RIG-I). In contrast, Nod-like receptors (NLRs) sense cellular damage as a result of infection and engage the inflammasome. Inflammasomes are multiprotein complexes that stimulate the secretion of inflammatory cytokines. Recent work by Pang et al. examined the relevance of host recognition of viral PAMPs versus virus-inflicted damage in linking innate recognition of IAV to adaptive immunity. Mediation of adaptive immunity to IAV is attributed to production of interleukin-1α (IL-1α) and IL-1β, cleavage products of the inflammatory cytokine IL-1. Pang et al. provided evidence that induction of an adaptive CD8+ T cell response did not depend on PRRs

Influenza is one of the major causes for illness around the globe and vaccination is the best way for controlling it The best way for reducing the impact of influenza infection and resulting morbidity and mortality in the human population lies in immunization against influenza (Palese & Garcia.,2002) ] . Two types of vaccines are currently licensed for prevention of yearly epidemic influenza: trivalent inactivated influenza vaccine (TIV) and live attenuated influenza vaccine (LAIV) .There are The annual vaccination (either with the intramuscular inactivated Influenza vaccine (IIV)or the intranasal live attenuated vaccine (LAIV)) continues to be the keystone of prophylactic treatment for infection associated with Influenza in humans (Pica N.

Avian influenza A (H7N9) is thought to have arisen from gene reassortment of multiple avian virus lineages. Hemagglutinin (HA) gene segments from H7 influenza viruses were determined to come from migratory wild ducks along the East Asian flyway encompassing Eastern China, South Korea and Japan [19]. Between 2009 and 2010, H7 virus strains were found in domesticated duck farms in Jiangxi province, China and then subsequently in market birds (chickens). The strain persisted for less than two years within market birds prior to the 2013 outbreak of H7N9 [20].

There are two types of influenza vaccinations, live-attenuated and inactivated. Currently, most common type of influenza vaccine is the inactivated type which is grown in chicken eggs. The egg-based production method has its advantages, but its many drawbacks are leading to a shift towards the live-attenuated vaccine which is produced in cell cultures. Both vaccination types protect against the influenza virus by triggering an immune response in the body that releases antibodies to fight off the virus. In the inactivated vaccine, the influenza virus is killed so that it cannot infect the person, but the antigens that trigger the immune response are still present. In the live-attenuated vaccine, the influenza virus is still alive but weakened so that it cannot infect the host. The weakened virus also carries the antigens that trigger the release of antibodies by the immune system. Both vaccines have proved to be effective in protecting against and preventing the spread of the influenza virus.