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Pathogenesis and Epidemiology of Orthomyxoviruses

February 3, 2012 Leave a comment

Pathogenesis and Immunity

Influenza initially establishes a local upper respiratory tract infection. To do so, the virus first targets and kills mucus-secreting, ciliated, and other epithelial cells, causing the loss of this primary defense system. NA facilitates the development of the infection by cleaving sialic acid residues of the mucus, thereby providing access to tissue. Preferential release of the virus at the apical surface of epithelial cells and into the lung promotes cell-to-cell spread and transmission to other hosts. If the virus spreads to the lower respiratory tract, the infection can cause severe desquamation (shedding) of bronchial or alveolar epithelium down to a single-cell basal layer or to the basement membrane.

In addition to compromising the natural defenses of the respiratory tract, influenza infection promotes bacterial adhesion to the epithelial cells. Pneumonia may result from a viral pathogenesis or from a secondary bacterial infection. Influenza may also cause a transient or low-level viremia but rarely involves tissues other than the lung.

Histologically, influenza infection leads to an inflammatory cell response of the mucosal membrane, which consists primarily of monocytes and lymphocytes and few neutrophils. Submucosal edema is present. Lung tissue may reveal hyaline membrane disease, alveolar emphysema, and necrosis of the alveolar walls

Interferon and cytokine responses peak at almost the same time as virus in nasal washes and are concomitant with the febrile phase of disease. T-cell responses are important for effecting recovery and immunopathogenesis. However, influenza infection depresses macrophage and T-cell function, hindering immune resolution. Interestingly, recovery often precedes detection of antibody in serum or secretions.

Protection against reinfection is primarily associated with the development of antibodies to HA, but antibodies to NA are also protective. The antibody response is specific for each strain of influenza, but the cell-mediated immune response is more general and is capable of reacting to influenza strains of the same type (influenza A or B virus). Antigenic targets for T-cell responses include peptides from HA but also from the nucleocapsid proteins (NP, PB2) and M1 protein. The NP, PB2, and M1 proteins differ considerably for influenza A and B but not between strains of these viruses; hence T-cell memory may provide future protection against infection by different strains of either influenza A or B.

The symptoms and time course of the disease are determined by interferon and T-cell responses and the extent of epithelial tissue loss. Influenza is normally a self-limited disease that rarely involves organs other than the lung.Many of the classic “flu” symptoms (e.g., fever, malaise, headache, and myalgia) are associated with interferon induction. Repair of the compromised tissue is initiated within 3 to 5 days of the start of symptoms but may take as long as a month or more, especially for elderly people.

To read more click on this link to the full article: Pathogenesis and Epidemiology of Orthomyxoviruses

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Structure and Replication of Orthomyxoviruses

January 31, 2012 1 comment

Introduction

Influenza A, B, and C viruses are the only members of the Orthomyxoviridae family, and only influenza A and B viruses cause significant human disease. The orthomyxoviruses are enveloped and have a segmented negative-sense RNA genome. The segmented genome of these viruses facilitates the development of new strains through the mutation and reassortment of the gene segments among different human and animal (influenza A) strains of virus. This genetic instability is responsible for the annual epidemics (mutation: drift) and periodic pandemics (reassortment: shift) of influenza infection worldwide.

Influenza is one of the most prevalent and significant viral infections. There are even descriptions of influenza epidemics (local dissemination) that occurred in ancient times. Probably the most famous influenza pandemic (worldwide) is the Spanish influenza that swept the world in 1918 to 1919, killing 20 to 40 million people. In fact, more people died of influenza during that time than in the battles of World War I. Pandemics caused by novel influenza viruses occurred in 1918, 1947, 1957, 1968, and 1977, but fortunately none have occurred since. New virus strains have been detected since the last pandemic, including an outbreak of avian influenza first noted in Hong Kong in 1997, which has caused some human disease and fatalities. Fortunately, prophylaxis in the form of vaccines and antiviral drugs is now available for people at risk for serious outcomes.

To read more click on this link to the full article: Structure and Replication of Orthomyxoviruses.