Talk:Influenza/Archive 1

Stomach flu -- myth?
The web suggests that the "stomach flu" is an actual disease, though the terminology is obviously unfortunate and not precise. The common distinction seems to lie between "upper respiratory flu" and "intestinal flu". The first one is influenza the second one is not. However, both terms exist and stomach flu does neither just refer to side effects of influenza, nor is it a general description of the symptoms given in the article. Yet, it seems that it is sometimes used to label a group of viral infections rather than a specific disease. However these problems have a common general treatment and so they may even deserve a new article. I am no expert and have no reliable sources, so I won't edit here. Though I generally would not trust the web, here are some links that give a hint at this possible alternative meaning:
 * http://scc.uchicago.edu/stomachflu.htm
 * http://www.parents.com/articles/health/5172.jsp
 * Quote from this page:
 * "Although everyone refers to vomiting and diarrhea as stomach flu, these problems are usually caused by a gastrointestinal virus (a true "flu" is influenza, a respiratory infection). Rotavirus is the most common culprit in young children;"

Even if stomach flu is considered too unclear or improper terminology, one should have pointers to diseases that would commonly be labeled this way. --Markus Krötzsch 20:51, 20 Jul 2004 (UTC)
 * http://www.the-health-pages.com/education/stomache_flu.html

I added the top-of-article Dab for "Influenza", and the distinct Dab page Flu, for related reasons. They each have to do with one of two related confusions: Further discussion of this (which has not yet changed my opinion that both are needed) is at Talk:Flu; i suggest there be single discussion there. --Jerzy(t) 07:10, 2005 Feb 24 (UTC)
 * 1) One is the  misleading standard usage of flu as a synonym for both "stomach flu" and "influenza";
 * 2) the other is the understandable but mistaken use of "influenza" as a synonym for "stomach flu", by people who correctly deduce that "flu" is derived from "influenza" but don't realize that "influenza" is no longer a more formal name for "stomach flu".

what's the name
What's the name of the company that was supposed to produce a huge quantity of flu shots for the british and the north american market, but had to redraw most of there million flu shots due to unhygienic production processes? it happened in the season 2004 / 2005.

thanks, --Abdull 16:04, 2 Jan 2005 (UTC)


 * I believe the company's name is "Chiron Corporation." Joyous 17:16, Jan 2, 2005 (UTC)

Avian influenza update needed
According to the latest update by WHO, avian influenza is most likely contracted by contact with duck blood and not communicable from human to human, and this is why we did not see a larger outbreak of the virus.

Does anybody else think this should be added to the main page? I'd update it myself if I wasn't sick at home concerned that I might have the flu... - Christophernicus 06:24, 26 Jan 2005 (UTC)


 * In accordance with updates from the WHO, I'm removing the Recent Development section. Avian influenza is transmitted to humans by migratory waterfowl and human-to-human contact has only been confirmed in one unusual case so far.  Although a new pandemic is expected sometime, it will not come from avian influenza. - Christophernicus 09:17, 20 Feb 2005 (UTC)

i agree that there should be updates about future bossible epidemics but they shouldent be on the first phargraph there are newspapers for that

With growing Media attention and governments around the world preparing for a pandemic we need more information. 70.127.34.109 18:48, 6 June 2006 (UTC)

Why Influenza is a seasonal epidemic?
The information here regarding influenza is very well done as to what it is and how it spreads, etc. But the my question to the medical community is why does it "appear" every winter? It is so seasonal now, that we can almost estimate its "time of arrival". But, how does a virus perform such an action. What causes it to become so seasonal? Is it the actual season or position of the sun? If anyone out there knows why this happens, please place it here on Wikipedia.


 * Cold preserves flu virus so it travels mouth to hand to whatever to hand to another's mouth without dying. heat over time destroys it. genetic drift caused it to mutate enough over one year so one can be reinfected in the next winter. the southern hemishere's flu season is in their winter which is the northern hemisphere's summer. WAS 4.250 14:25, 16 January 2006 (UTC)

(Response) Hi, influenza epidemics are seasonal only because in the winter the population tends to be more vulnerable to viruses, particularly the elderly and immunosuppressed. Thus the virus has a larger pool of susceptible individuals, and is able to spread. However influenza infections do still occur outside of the winter season, but at a much lower frequency.

(Response) The statement that "influenza epidemics are seasonal only because in the winter the population tends to be more vulnerable to viruses, particularly the elderly and immunosuppressed" is incorrect. The "seasonal" variation is also documented in the Southeast Asian populations in the current H5N1 situation.
 * The weather in South-East Asian countries follow a cyclic season of drier weather and then a monsoon season during the winter months (Nov-Jan). Since flu viruses are usually transmitted via moisture, I would say that weather is one of the factors that causes the seasonal variations. So the statement above is correct, but it just doesnt explain what happens in countries without winters. --Av01d 07:37, 21 June 2006 (UTC)

A further, related question: why do the yearly flu strains seem to "die out"? Particularly, why did the 1918 Spanish Flu eventually disappear? You would think that isolated pockets would persist. And if the strains are so fragile that they tend to die out after about a year, then why doesn't the avian flu (in birds) die out after some period?


 * flu viruses are RNA. RNA CAN'T be stable. it mutates. Avian flu in birds is normally without symptoms - so the virus stays in birds but not in the same strains. the strains are always mutating. there is nothing to keep them from mutating AGAIN into the 1918 strain. WAS 4.250 14:25, 16 January 2006 (UTC)

(Response) It is likely that yearly flu strains seem to "die out" due to Antigenic shift/drift < http://en.wikipedia.org/wiki/Antigenic_shift >.

Antigenic shift is the process by which two different strains of influenza combine to form a new subtype having a mixture of the surface antigens of the two original strains. The term antigenic shift is specific to the influenza literature; in other viral systems, the same process is called reassortment or viral shift.

Antigenic shift is contrasted with antigenic drift, which is the natural mutation over time of known strains of influenza (or other things, in a more general sense) to evade the immune system. Antigenic drift occurs in all types of influenza including influenza A, B and C. Antigenic shift, however, occurs only in influenza A because it infects more than just humans. Affected species include other mammals and birds, giving influenza A the opportunity for a major reorganization of surface antigens. Influenza B and C only infect humans, minimizing the chance to mutate drastically.


 * Flu species B and C also infect more than just humans but B and C have only one subtype (or no subtypes if you want to look at it that way) so there are no two subtypes to swap genes with. Species A flu virus has 16 subtypes and antigenic drift is swaping major gene segments (or entire RNA stands) between subtypes. WAS 4.250 14:25, 16 January 2006 (UTC)

Question is still not answered. The information on antigenic shift is interesting, but it seems to mainly explain how the virus gets from animals to humans. I don't see how it answers the question: "why did the 1918 Spanish Flu eventually disappear? [suddenly, after 18 months]" Are you saying that the Spanish flu eventually combined with older "ordinary" strains (in humans) and lost some of its lethality in the process?


 * RNA is unstable. It doesn't "breed true". Antigenic drift, not just shift, reflects this instability. It is ALWAYS mutating, like a river is always making incremental changes to its course. See for an example of reassortment (shift) that caused prior variations to go extinct, leaving variation Z as the only known current existing in nature (the wild) variation of highly pathogenic H5N1 (although low pathogenic varieties still exist in North America). See  for an illustration of the mutations from drift and shift in one avian flu virus gene and note how it adapts to each of three host species (birds, pigs, humans). The rest of this online book is also very interesting and highly recommended. Finally, see  for a summary of the initial results from the Influenza Genome Sequencing Project. WAS 4.250 15:46, 27 January 2006 (UTC)


 * It is a seasonal epidemic due to antigenic drift (as has been mentioned) of haemagglutinin and neuraminidase, with small changes, enough however to make some of the population susceptible. The occasional pandemics, such as with Spanish flu and the one to come are due to antigenic shift, picking up a new H/N from elsewhere.


 * The reason for old variants dissappearing is development of herd immunity through generation of neutralising IgA antibodies, meaning it must mutate to survive. The fact that RNA mutates often is not the important factor in elimination of old strains, as if they were still effective variation would be selected against and they would still exist. |→ Spaully°τ 20:54, 11 March 2006 (GMT)


 * To the best of my knowledge the neccessary gene sequencing to be sure this is true has never been done. I'm aware of mathematical models (that I disbelieve in) that could conclude such a thing. Can you point me to whatever evidence you are relying on in the making of that statement on a talk page? Thanks. WAS 4.250 02:26, 12 March 2006 (UTC) (copied from Spaully's user talk page by WAS...)


 * I don't have any papers I can link to, my understanding of the process is through lectures, essays, papers and tutorials. But I must admit I have never read this directly in any primary literature.  That's the main reason I've not talked about it in the text. However if you consider that the periodic epidemics are caused by antigenic shift, presumably this has the effect of changing the virion antigens sufficiently that it can infect a significant proportion of the population.  Given neutralising IgA is the way immunity in conferred for flu, it seems fair to assume this is the important factor in preventing spread. As for this being the reason for instability in flu strains, imagine a situation where a flu virus hits the jackpot - an antigen that for whatever reason the immune system could not produce antibodies against, there would be significant selective pressures to remain unaltered. Anyway, it is more of a personal view, and I don't plan to write about it in the article anytime soon. Although if I do look into it at some point, I'll let you know if I find anything to back up my claims. Thanks, |→ Spaully°τ 09:35, 12 March 2006 (GMT) (copied from Spaully's user talk page by WAS...)

A Different take on the same topic

The storage of brewing yeast via "freeze drying" is strongly discouraged, as it has been shown to mutate yeast, affecting fermentations, and changing the flavour of the finished fermented product. Is it possible this same affect (of daily freeze / thaw cycling) is contributing to the "winter-production" of flu? (JSK 25th April))

You would think any process like antigenic shift would be accelerated by high temperatures. . . . like a chemical reaction, or any cell multiplication, and therefore more likely to occur in summer. . . . Also, is it possible that some other organisms which are known to mutate at low temps, (fungi) are involved, perhaps as vectors in the process ? (JSK 25th April)
 * No. Organisms need a certain band of temperate to perform cellular activities. Temperatures outside this band will disable various kinases and other proteins in the organism and these activities will stop. Flu virus becomes inactivated by heat, radiation and even lack of moisture. --Av01d 07:37, 21 June 2006 (UTC)

Antigenic drift and Seasonal Variations
When a certain serotype of influenza virus is predominant in a population, more and more people get that type of flu and become immune (you also get herd immunity from others who have had the virus) to it. When the body is faced with a viral insult, B-cells start to generate antibodies (mostly IgG) to neutralise these virions. At the same time, cytotoxic T-cells start to attack cells that have been infected, thus wiping out the presence of the flu virus in the body. These cells generate memory cells which helps to quickly eliminate the same virus if it ever becomes present in the body leading to immunity.

These B and T cells work by recognising the various patterns of antigens on the surface of the flu virion, mainly Hemagglutinin and Neuraminidase which is what the H and N in H5N1 stands for. Because of the highly active antigenic drift present in RNA viruses (BTW, antigenic drift is different from antigenic shift and they are completely different mechanisms), the hemagglutinin, neuraminidase and other surface molecules undergo subtle changes. This allows the virus to evade the previously protective population of B and T cells. Hence a previously immune person becomes susceptible to this new serotype of the same virus.
 * i.e. H1N1 serotype 100 (immune) ---antigenic drift---> H1N1 serotype 101 (susceptible)

The above is what antigenic drift does, antigenic shift is a completely different story involving the gaining of new species specific antigens that allows cross-species infection. Usually when a cross-species jump occurs an epidemic results (such as HIV, which jumped from monkeys to humans). In the example below, a previously deadly strain of porcine flu gains surface proteins (from the mild human flu) that enable it to infect humans.
 * i.e. pig only flu (deadly) + human only flu (mild) ---antigenic shift---> human flu (deadly)

So how does this antigenic drift tie in with seasonal variation? Firstly, a new virus serotype which the population has no prior immunity to, becomes circulated in the environment. Then it waits for a period such as winter or the monsoon season (seen in all South-East Asian countries) where the general immunity of the population is weaker. Once the virus takes a foothold in a given population, it spreads rapidly to generate a large number of influenza cases from the same virus serotype.

The only good news is that once a person has recovered from the virus, he is immune to that serotype for a long long time. The bad news is that antigenic drift happens quite fast in flu virus. This is why vaccines against polio, rubella, varicella are so effective; while there seems to be a new flu vaccine out every year. --Av01d 07:23, 21 June 2006 (UTC)

I would like to suggest that we stop using the terms "antigenic shift" and "antigenic drift." They are falling rapidly out of favor in the flu community because they have little biological basis. Extensive reassortment (including the formation of new subtypes, e.g. H1N2) need not be accompanied by substantial changes in antigenicity (that's why we haven't had a H1N2 pandemic), and we have few simple metrics for antigenic divergence. "Antigenic drift" implies neutrality and/or a continuous process. Antigenically drifted viruses are obviously fitter because they have more susceptibles available to them. We have also learned recently that the antigenic changes in H3N2 are not steady--there are abrupt changes in some years and not in others. In other words, the dominant strain is not replaced every year--sometimes it persists for a few (H3N2 is so successful that it allows fewer spatial "pockets" of different strains than, say influenza B). Finally, it is clear that strains circulate globally, and are passed between the hemispheres. It is important to stress that we do not understand what causes influenza's seasonality. Seasonal changes in host susceptibility might play a role. That we can occasionally see a seasonal signature in subtropical areas (e.g., Hong Kong, and it's very weak; cf. Singapore) could result from diffusion of stronger epidemics in higher latitudes. It does not invalidate the hypothesis. Asseverator 05:14, 17 August 2006 (UTC)

Mechanism of infection
Can i request for a section which will talk about the mechanism this virus uses in infection. Also, if anyone is talented enough, can we have a Flash movie about how the virus infect the cels and then spread?? --LowLifer 02:36, 14 October 2005 (UTC)

Canine Influenza
This subject has been in the news the past few weeks and I imagine that many dog owner are as concerned as I am.

Perhaps someone more learned than I can write a section on this subject? Elipongo 02:26, 21 October 2005 (UTC)

Treatment
Treatment of the symptoms people. Please! --JohnO 16:51, 4 November 2005 (UTC)
 * Symptomatic Treatment
 * How 'bout subsections on symptomatic and unconventional treatments? Just because OTC remedies are heavily marketed and fail to directly fight the virus doesn't mean they shouldn't be mentioned (i.e. described as such)!  The encyclopedia should inform. I see homeopathic and other remedies that fail to meet the standards of evidence-based medicine heavily marketed at my local health food store and drugstore. Proposed sections: (I started with the current contents.) -Elvey

Proposed sections moved from this talk page to Flu treatment.

This article is already too long to signifiantly expand any sections, but each section can be expanded in a related article and linked as appropriate. i have done this for Flu treatment. Please feel free to add to Flu treatment. WAS 4.250 18:15, 3 April 2006 (UTC)


 * That was a good idea, but let's get rid of the duplicate info! I'm purging some stuff from the main article and adding my new stuff to Flu treatment (moving it from here).

I bet How H5N1 kills can be deleted/moved; it belongs on the avian flu pages. Agree?

Verifyability, understandability, relevance concerns
Because of concerns ranging from verifyability to understandability I moved the following from the article to here:
 * Preclinical research with Morpholino antisense oligos has shown efficacy of the antisense against influenzavirus in cell cultures (Ge Q, Stein D, Kroeker A, Iversen P, Chen J. Inhibition of influenza A virus production in vero cells with morpholino oligomers. Program and abstracts of the 44th Interscience Conference of Antimicrobial Agents and Chemotherapy; October 30-November 2, 2004; Washington, DC. Abstract V-1268.). WAS 4.250 23:52, 20 January 2006 (UTC)


 * Followup: AVI Biopharma, the company providing the Morpholino oligos for the research cited above, has now reported preclinical efficacy against influenzavirus in collaborations with four different outside laboratories. To date, no research report addressing these tests has been published in a peer-reviewed journal. Jon  24 January 2006


 * Second followup: I notice that someone else has posted information about Morpholinos against flu in the "Spanish flu" article, last paragraph. In that instance, they did not provide a scientific citation to the flu work, relying instead on press releases. Jon  24 March 2006


 * (copied here from my user talk page)Verifiability of the citation is straightforward, as I cited a published work from the American Society for Microbiology. This information will allow interested folks to follow up on the Morpholino antisense technique for inhibiting viral replication. Research employing this technique for Influenza knockdown is ongoing in several labs. The Morpholino technique for gene knockdown is cited in well over 1000 peer-reviewed publications. I suggest that the comment you removed should be returned to the posted influenza article. Jon (WAS 4.250 21:58, 24 March 2006 (UTC))


 * Please significantly expand the paragraph so people like me understand what you are saying, why it is important, and why it is here in this article rather than in one of wikipedia's other million articles. The problem of verifyable will, I'm sure, disappear when you increase the paragraph so it belongs in an encyclopedia article rather than a research paper's footnotes. And once expanded, if it belongs elsewhere, we can move part or all of it (or copy it and have it in both places). linking by various means can also be done once expanded. As it stands, without expansion, it doesn't fit into this article. So please expand it and teach me something. WAS 4.250 22:12, 24 March 2006 (UTC)

I thought "why wait for him to teach me" so I read Morpholino and thought its connection to influenza rather weak, so the possibility of spamming a special interest occured to me, so i went to your user page, saw you were trying to blank it, looked at it history, and saw that your first uer page said:

Jon D. Moulton, Ph.D.    GENE TOOLS, LLC www.gene-tools.com (541) 929-7840 x1201

so I went to www.gene-tools.com and it says:
 * Gene Tools is the sole commercial supplier for research quantities of Morpholino antisense oligos world-wide. Our Morpholino oligos are the premier tools for gene knockdown in developmental biology labs and are the best gene-silencing reagents for cells in culture.

All of which makes me believe you can usefully help out wikipedia but the influenza article may not be the best place for it. It has the unfortunate appearance of helping yourself more than helping the encyclopedia. Best of luck making money. WAS 4.250 22:34, 24 March 2006 (UTC)

(copied here from my talk page) Thank you for your good wishes for making money. I do intend to feed and educate my daughters. The company I work for, Gene Tools LLC, cannot market Morpholinos as therapeutics; that is the IP domain of another company, AVI BioPharma Inc. However, I am an advocate for the technology, which holds the promise of broad antiviral applications, anticancer applications and soon-to-begin clinical trials for Duchenne's Muscular Dystrophy.

Details of Morpholino antisense are in the Morpholino article; I originally only posted information directly relevant to influenza and verifiable in the scientific literature. Per your request, I offer more support here for efficacy of Morpholinos against influenza. I originally hesitated to bring in sources such as conference reviews or company press releases, as I prefer to rely on more traditional scientific citations. I think a shorter mention of the studies with pointers to articles with more information is more appropriate. However, the following expanded discussion does present a clearer view of the potential of this technology specifically as an influenza therapeutic.

Preclinical research with Morpholino antisense oligos has shown efficacy of the antisense against influenzavirus in cell cultures. Cultures of African green monkey kidney cells (vero cells) were pretreated with Morpholino antisense oligos conjugated with arginine-rich peptides to enhance penetration of the oligos into the cytosol. Targeting translation-blocking Morpholinos against the nucleoprotein 1 mRNA or one of the polymerase protein mRNAs caused 2-3 log10 reductions in influenzavirus titer three days post-infection. When Morpholinos were administered post-infection, less antiviral activity was measured. (Frederick G. Hayden, MD, Influenza in the United States and Around the World, http://www.medscape.com/viewarticle/495517, see "novel therapeutics" section)(Ge Q, Stein D, Kroeker A, Iversen P, Chen J. Inhibition of influenza A virus production in vero cells with morpholino oligomers. Program and abstracts of the 44th Interscience Conference of Antimicrobial Agents and Chemotherapy; October 30-November 2, 2004; Washington, DC. Abstract V-1268.) AVI BioPharma reports that when tested against several influenza strains by several independant laboratories, Morpholino oligos have suppressed viral replication and in one cse both replication and transcription were repressed. Co-administration of several Morpholino sequences caused as much as eightfold improvement in antiviral activity (http://www.avibio.com/pr/pr277.html). Jon 24 March 2006 (copy here from WAS talk page WAS 4.250 23:19, 24 March 2006 (UTC))

You aren't spamming this stuff all over, the data seems real, you seem honest;so, I would love to help you get the relevant data in the relevant articles. My career before I retire was a little in physics and a lot in computer science, reading lots of everything over the decades in numerous firlds. Lately, I've read everything I could about H5N1. This is the sort of thing that I find fun reading, just so I don't turn my retirement into a job :) Any sugestion for how we deal with all this can go either here or on my talk page. But since this is your area of expertise why don't you set up a work space at your user page where sources, quotes from sources, explantions of the quote, articles to put the data can be worked on. you can supply the expertise and others can actually add it to articles making sure you are not talking over over heads for one and providing a conflict of interst buffer to avoid the appearance of impropriety? (I'm hoping others can join over time in such an enterprise) I'm sure you are aware we don't do original research, so no matter how true it is we can't use it without an unbiased verifyable source. And companies that own intellectual property are biased towards that property, as you well know, mening reseach by exxon on why exxon should rule the world can't be used no matter how true it is :) WAS 4.250 23:19, 24 March 2006 (UTC)

With regard to "the following expanded discussion"; give me 24 hours to digest it. WAS 4.250 23:25, 24 March 2006 (UTC)

Very good. I won't post directly to Influenza; that has been my behavior since you originally removed the link and I will continue to limit my influenza posts to the discussion here. I think it is wise, "providing a conflict of interst buffer to avoid the appearance of impropriety". You have all I have as far as links to sources in the expanded article. I am happy to help with interpretation. I'll check back Monday. Jon 24 March 2006

Well. I've done sundry things you can check out with the "User contributions" link at the far left on my user talk page; but as far as the above is concerned, I can't figure out any way to justify putting it in influenza. It is very technical reseach that needs to go in a technical article or an article like spanish flu that is short enough a little research data doesn't hurt. The H5N1 doesn't really go here except people are confusing human and bird influenza and we don't have a bird influenza article, so we make do... the key trouble with putting Morpholinos here is that it isn't even (yet) a noteable example of influenza reseach. Get your bosses to get a newspaper to claim it is a noteable example of influenza reseach (backed with data not just a free lunch) and a short influenza research subsection here could mention Morpholinos. This article does need a short section on influenza reseach and if you were to write it not giving undo emphasis to your favorite topic, it could work - but I see no evidence any mention of Morpholinos in a short section trying to cover all influenza research would not be giving it undue emphasis. So were does it fit? How about Cell culture? I'll see what I can do about putting Morpholinos cell culture research data there. After you look at it tell me what you think. WAS 4.250 04:05, 25 March 2006 (UTC)

Putting influenza knockdown information into the cell culture article isn't a good fit, since there are hundreds of cell culture papers in the primary literature using Morpholino oligos against a broad range of cellular genes as well as some viral targets -- mentioning one of these hundreds of reported knockdown targets in the cell culture article is not a balanced presentation of the use of Morpholino technology in cell culture. If you don't feel that influenza gene knockdown information is a good fit in the influenza article I won't keep arguing for that. As you suggest, wait for the newspapers. Jon 28 March 2006


 * The problem with the cell culture article here at wikipedia is that it has too little data. Please feel free to add to the article. We are all vilunteer and have to take what we can get. The solution to a small unbalanced article is to add to it. A larger more filled article like influenza needs to spin off subarticles to remain balanced. When cell culture gets big enough, whatever is unbalancing it can be spun off into a seperate article. Meanwhile, the article is better with the section than without it. Again, please feel free to add to cell culture. It needs all the help it can get. Thanks for helping Wikipedia create a great free encyclopedia for every person on this planet (our goal). WAS 4.250 17:48, 28 March 2006 (UTC)

(GEN Morpholino influenza article no longer on GEN website, so I removed the link - JDM 10 Apr 06)

Origin
This article doesn't say where epidemic flu strains originate. I've heard that they originate in poultry in Southeast Asia, but I don't know for sure, and I'd like to know more. --Smack (talk) 02:13, 10 February 2006 (UTC)

"Avain flu virus" aka Influenzavirus A is a species of virus. The genotype H5N1 has been known for decades. The current pandemic threat strain of H5N1 emerged through reassortment in 2002 from earlier highly pathogenic genotypes of H5N1 that first appeared in China in 1996 in birds and in Hong Kong in 1997 in humans. WAS 4.250 05:29, 10 February 2006 (UTC)


 * Yes, the article tells me all I ever wanted to know about H5N1. However, I'm wondering about the garden-variety flu that comes around every year. --Smack (talk) 05:35, 10 February 2006 (UTC)


 * The "garden variety flu that comes around every year" is caused by flu virus species A, B, or C. The species A varieties that yearly attack humans are called "human flu virus" which is to say it is a variety of the species "avian flu virus" (species A) that has made genetic changes to adopt to its human hosts. It passes from human to human ALL YEAR ROUND and never goes away completely. When it is cold (winter in the north, summer in the south part of the world) infection from "human flu" increases something like ten fold or more. Different strains of avian flu virus circulate in different years as it is constantly mutating. The flu vaccine this year contains proteins from the coat of two subtypes of species A and from species B. Species B and C don't have subtypes. I think I'll and this to Flu season. WAS 4.250 17:38, 10 February 2006 (UTC)


 * Yes, I know that it's a different strain every year. I was wondering where this strain originates. --Smack (talk) 06:17, 15 February 2006 (UTC)


 * As near as I can tell, I've answered your question. Let's try this a different way. Phrase your question in a yes/no or multiple-choice way and maybe you can make progress in seeing i have answered your question and/or I can make progress in understanding what you are asking that has not been answered. Surely you aren't expecting an answer like "the species B flu virus dominant strain on December 1, 2005 resulted from genetic drift in a prior strain in June 2005 in Ms. Sally Smith of Chicago." While that level of detail is unknown, if we knew enough, that would be the actual specific answer to one strain of the many strains of the three species of flu virus. WAS 4.250 13:00, 15 February 2006 (UTC)


 * You answered my question very clearly with regard to the "current pandemic threat strain of H5N1." I'll try yes-or-no questions, as you suggest: (1) Are the origins of epidemic flu strains usually known?; (2) if so, do these strains originate in some contexts more often than in others? --Smack (talk) 04:51, 16 February 2006 (UTC)

1.Are the origins of epidemic flu strains usually known? No. Decades ago, sometimes flu would be worse someplaces than others or the flu season would start earlier someplaces and people assumes the bug started "there". In the "Spanish flu" the world was at War (WWI), most nations including the US had significant press censorship; Spain did not have press censorship; so the first nation to widely publish facts about a pandemic was Spain, so many assumed it came from "there". In fact it started in America. The bottom line is that before we were able to genetically sequence the virus people just guessed and believed what made them feel good: it came from them over there. Today with modern gene sequencing we can figure out the specific strains and their relationships to prior strains but no one knows in which individual or on what day the strains mutated into the latest strain. Its just not knowable. None the less, people guess and believe what makes them happy. The Chinese government wants to believe the latest H5N1 deadly strain did not come from China. The evidence is that it originated in south China in the late 1990s in chickens. Even if true futher pinning it down is next to impossible as to either date or place. WAS 4.250 15:56, 16 February 2006 (UTC)

2.if so, do these strains originate in some contexts more often than in others? Strains that are the garden variety yearly human flu "originate" in humans; being passed human to human, always geneticly drifting (like asking where wind originates). Pandemic versions usually result from reassortment in either humans or pigs. H5N1 was the first time we became aware of the possibility genetic drift in birds could produce a pandemic strain. This was a suprise both because it was assume drift wasn't enough, it had to be genetic shift to be a pandemic. And it was a surprise because it was considered a fact that a virus endemic in wild birds had to first become pathogenic in chickens, then spread to pigs and reassort with human flu strains in pigs (swine flu) in order to create a flu pandemic. This can do it; but now we know there are other paths to a flu pandemic. With this new knowledge scientists reviewed data on the spanish flu virus and have decided they don't know where it came from - not the species (human, pig, bird, or unknown other all have their proponets) nor whether it was a reassortment or not (before, it was assumed to be a reassortment; probably in a pig). WAS 4.250 15:56, 16 February 2006 (UTC)


 * Thanks. That makes sense.  Sorry about the misunderstanding. --Smack (talk) 06:23, 17 February 2006 (UTC)

Death and desease, a disaster for corporations
Perhaps the following citation is factually correct, but I find stating this as one of the main problems created by flu somewhat disturbing:
 * "It rapidly spreads around the world in seasonal epidemics, imposing considerable economic burden, in the form of health care costs and lost productivity." No mention of death or human suffering yet, this damn disease makes people loose money!" - unsigned comment by 84.102.180.235


 * You are right. I changed the intro to emphasize lives over money. (My original comment (now deleted), was based on the misconception we were talking about H5N1). 4.250.198.154 01:44, 1 March 2006 (UTC)

Disease not virus
The disease is caused by the viurus so it seems odd not to have any discussion of the causative agent. There isn't even a short summary or any easy links to an explanation of the virus. In fact I've been looking through other pages and have found no explanation of the life cycle of the virus, very little of what the virions are.

If I was wanting to find information about influenza, I would find it very hard to find out about the virus itself.

I am going to reinstate my addition, with some tweaking to respect the article is predominantly about the disease. |→ Spaully°τ 09:56, 12 March 2006 (GMT)


 * I've looked at some of your edits so I know you are neither stupid nor ignorant. So I am left wondering what you are talking about. go to the top of the article in question: Influenza The first sentence reads Influenza, commonly known as the flu or the grippe, is a contagious disease of the upper airways and the lungs, caused by an RNA virus of the orthomyxoviridae family.. Notice the linked item described as the causative virus? Click on it. That IS the "hard to find" virus information. See the box on the right marked "Flu"? The last item is labeled "Phylogenetics" which links to the same article. Orthomyxoviridae in turn links to Influenzaviruses A, B, and C. A is the one your contribution is about and it is also prominately linked as Avian flu is the flu box. Please don't edit war until you get your facts straight. (And even then, talking rather than edit waring is better) As it is clear you don't know what you are talking about when you say "If I was wanting to find information about influenza, I would find it very hard to find out about the virus itself" I am going to revert you. Please read Influenzavirus A and H5N1 before reverting me. Thank you. WAS 4.250 17:58, 12 March 2006 (UTC)


 * I have read these pages, and I feel the information on the virus is not summarised at any point concisely, as I was attempting to do. If the consensus is that that is innapropriate on this page, then it should be elsewhere - nowhere through the other pages is the lifecycle explained, nor are there any simple summaries of the components of the virion.  Given the pages are supposed to be readable to people without science degrees, something needs to change.
 * A few points - how are people supposed to tell from the 'flu' box that "Avian flu" applies to the virus and not the infection of birds? Why is a section on H5N1 present in this article?
 * I'll not revert anything, and the previous reversion was trying to take your comments into account. There was perhaps some irritation at the section being deleted without so much as an explanation on talk (which you'll notice I did when I reverted the first time, you did not ). Never mind, I'll check back another time, |→ Spaully°τ 18:16, 12 March 2006 (GMT)


 * "I feel the information on the virus is not summarised at any point concisely, as I was attempting to do." The article is on the disease, please feel free to expand on that. Whole books are written on the disease. Whole books are written on the viruses. Wikipedia articles are necessarily of limited size. There is not room here for more than links to the multiple articles on the viruses giving humans and animals the disease called influenza. This article will probably break into flu the human disease and flu the animal diease at some point.
 * "nowhere through the other pages is the lifecycle explained, nor are there any simple summaries of the components of the virion." What you added the first time was factually inaccurate. What you added the second time was better said and better referenced elsewhere (Virus, Orthomyxoviridae, Influenzavirus A, H5N1).
 * "how are people supposed to tell from the 'flu' box that "Avian flu" applies to the virus and not the infection of birds?" See the subsection Avian influenza. I get the impression your eyes scaned but your mind did not read. People are not supposed to understand everything before they read the article. The box only presents links. The article explains the links.
 * "Why is a section on H5N1 present in this article?" Because it is what most people coming to this article are looking for.
 * See the below (H5N1 virus structure) copied from the first part of one subsection of the H5N1 article and the first part of Global spread of H5N1. WAS 4.250 19:06, 12 March 2006 (UTC)

H5N1 virus structure
A virus is one type of microscopic parasite that infects cells in biological organisms.
 * Virus

The Orthomyxoviridae are a family of RNA viruses which infect vertebrates. It includes those viruses which cause influenza. Viruses of this family contain 7 to 8 segments of linear negative-sense single stranded RNA.
 * Orthomyxoviridae

"Influenza virus" refers to a subset of Orthomyxoviridae that create influenza. This is not a phylogenetics based taxonomic category.
 * Influenza virus

Avian influenza viruses have 10 genes on eight separate RNA molecules (called: PB2, PB1, PA, HA, NP, NA, M, and NS). HA, NA, and M specify the structure of proteins that are most medically relevant as targets for antiviral drugs and antibodies. This segmentation of the influenza genome facilitates genetic recombination by segment reassortment in hosts who are infected with two different influenza viruses at the same time. Avian influenza viruses compose the Influenzavirus A genus of the Orthomyxoviridae family and are negative sense, single-stranded, segmented RNA viruses. WAS 4.250 19:06, 12 March 2006 (UTC)
 * Avian influenza virus

(first part of) Global spread of H5N1
H5N1 is the identifier for a subtype of avian influenza virus. At the moment, the global spread of H5N1 in birds is considered a significant pandemic threat.

While prior H5N1 strains have been known, they were significantly different from the current H5N1 strain on a genetic level, making the global spread of this new strain unprecedented. The current H5N1 strain is a fast-mutating, highly pathogenic avian influenza virus (HPAI) found in multiple bird species. It is both epizootic (an epidemic in nonhumans) and panzootic (a disease affecting animals of many species especially over a wide area). Unless otherwise indicated, "H5N1" in this article refers to the recent highly pathogenic strain of H5N1.

"Since 1997, studies of H5N1 indicate that these viruses continue to evolve, with changes in antigenicity and internal gene constellations; an expanded host range in avian species and the ability to infect felids; enhanced pathogenicity in experimentally infected mice and ferrets, in which they cause systemic infections; and increased environmental stability."

Tens of millions of birds have died of H5N1 influenza and hundreds of millions of birds have been slaughtered and disposed of to limit the spread of H5N1. Countries that have reported one or more major H5N1 outbreaks in birds (causing at least thousands but in some cases millions of dead birds) are (in order of first outbreak occurrence): Korea, Vietnam, Japan, Thailand, Cambodia, Laos, Indonesia, China, Malaysia, Russia, Kazakhstan, Mongolia, Turkey, Romania, Croatia, Ukraine, Cyprus, Iraq, Nigeria, Egypt, India, France, Niger, Bosnia, Azerbaijan, and Albania. H5N1 has been found in birds in the wild in numerous other countries such as Austria, Bulgaria, Ethiopia, Germany, Greece, Hungary, Iran, Italy, Kuwait, Serbia and Montenegro, Slovakia, Slovenia, Sweden, Switzerland, and Poland. There have been, so far, no outbreaks in any non-bird species.

H5N1 has low pathogenic varieties endemic in birds in North America. H5N1 has a highly pathogenic variety that is endemic in dozens of species of birds throughout south Asia and is threatening to become endemic in birds in west Asia and Africa. So far, it is very difficult for humans to become infected with H5N1. The presence of highly pathogenic (deadly) H5N1 around the world in both birds in the wild (swans, magpies, ducks, geese, pigeons, eagles, etc.) and in chickens and turkeys on farms has been demonstrated in millions of cases with the virus isolate actually sequenced in hundreds of cases yielding definitive proof of the evolution of this strain of this subtype of the species Influenzavirus A (bird flu virus).

H5N1 caused flu outbreaks in 1959 and in 1991 but these strains were very different from the current highly pathogenic strain of H5N1. Evolution from 1999 to 2002 created the Z genotype which became the dominant strain of highly pathogenic H5N1 in 2004.

In January 2004 a major new outbreak of H5N1 surfaced in Vietnam and Thailand's poultry industry, and within weeks spread to ten countries and regions in Asia, including Indonesia, South Korea, Japan and China. In October 2004 researchers discovered H5N1 is far more dangerous than previously believed because waterfowl were directly spreading the highly pathogenic strain of H5N1 to chickens, crows, pigeons, and other birds and that it was increasing its ability to infect mammals as well. From this point on, avian flu experts increasingly refer to containment as a strategy that can delay but not prevent a future avian flu pandemic.

In January 2005 an outbreak of avian influenza affected thirty three out of sixty four cities and provinces in Vietnam, leading to the forced killing of nearly 1.2 million poultry. Up to 140 million birds are believed to have died or been killed because of the outbreak. In April 2005 there begins an unprecedented die-off of over 6,000 migratory birds at Qinghai Lake in central China over three months. This strain of H5N1 is the same strain as is spread west by migratory birds over at least the next ten months. In August 2005 H5N1 spread to Kazakhstan, Mongolia and Russia. On September 29 2005, David Nabarro, the newly appointed Senior United Nations System Coordinator for Avian and Human Influenza, warned the world that an outbreak of avian influenza could kill 5 to 150 million people. Also, due to a bipartisan effort of the United States Senate, $4 billion dollars was appropriated to develop vaccines and treatments for Avian influenza. David Nabarro stated that as the virus had spread to migratory birds, an outbreak could start in Africa or the Middle East. Later in 2005 H5N1 spread to Turkey, Romania, Croatia and Kuwait.

In the first two months of 2006 H5N1 spread to Africa and Europe in wild bird populations possibly signaling the beginning of H5N1 being endemic in wild migratory bird populations on multiple continents for decades, permanently changing the way poultry are farmed. WAS 4.250 19:13, 12 March 2006 (UTC)

further discussion
I'm not going to get drawn into an argument over this article, and for the benefit of future editors I suggest you adopt a less confrontational style of discussion. The fact is these articles are not logically separated or cross-linked. Hopefully at some point someone will be allowed to change that. I apologise for stepping on anyones toes. |→ Spaully°τ 20:46, 12 March 2006 (GMT)


 * You critisized me when I avoided arguing with you by giving my reason in the edit summary rather than the talk page and you misrepresented that by saying:"There was perhaps some irritation at the section being deleted without so much as an explanation on talk (which you'll notice I did when I reverted the first time, you did not)."
 * Now you critisize me by misrepresenting a full and substantive response as "confrontational". Your emotional response to simple evidence provided by me does not consitute evidence of anything wrong done by me.
 * You change the subject when you sneer: "The fact is these articles are not logically separated or cross-linked. Hopefully at some point someone will be allowed to change that." insinuating falsely that any such thing has occurred. In fact, I have reverted data contributed by you to this article that was completely unreferenced, partly false, and wholly neither new nor appropriate for this article and your response is to become upset, lie about my behavior and change the subject. If anyone wishes to help, I warmly welcome their help. These articles can use a lot of help. You did not help. That you added data that was "not logically separated" and then complain that's an area that needs improvement and critisize me for trying to keep the article from becomeing  more "not logically separated" by reverting you ... well, the mendacity boggles the mind. WAS 4.250 21:52, 12 March 2006 (UTC)


 * Given refactoring this discussion was resisted, I have struck the comments I made which were innapropriate. |→ Spaully°τ 23:08, 23 March 2006 (GMT)

Large sections of quotations
I notice there are a couple of large quotations from sources such as the Merck manual, most notably the old version of the first paragraph and much of the Symptoms section. To start with this is generally not considered WP style, to include large quotes in place of summary style writing; but more importantly I checked the online version of the Merck manual which is being quoted, and this use is probably a breach of their copyright, unless someone has sought permission? |→ Spaully°τ 11:48, 3 May 2006 (GMT)


 * Our only permission for quoting Merck is Fair use. Debating how much we can use is a waste of time better spent in trimming quotes and rewriting quotes. Feel free to tirm and rewrite. WAS 4.250 16:02, 3 May 2006 (UTC)


 * I agree completely, however notice that despite this comment you have reinsated the Merck quote, albeit with better attribution. I would suggest that my edited lead section is better and more in keeping with WP style than using the Merck quote. However, it is unlikely we are going to agree on this point so it would be great if others could state their opinions. Anyway, we'll see. |→ Spaully°τ 00:34, 4 May 2006 (GMT)


 * NOTE: You cannot claim the use of the current passages under fair use, from WP:CP:
 * What about fair use? Under fair use guideline, brief selections of copyrighted text may be used, but only with full attribution and only when the purpose is to comment on or criticize the text quoted.
 * The uses from the Merck manual that were included were not there to comment or criticise on the quoted text, as are some of the other quotes included. |→ Spaully°τ 23:23, 4 May 2006 (GMT)

Brief, attributed quotations of copyrighted text used to illustrate a point, establish context, or attribute a point of view or idea may be used under fair use. from Fair use. WAS 4.250 00:04, 5 May 2006 (UTC)


 * If you scroll down to the policy part of the same page, the use of the large Merck quotes falls down on both points 1 and 2. |→ Spaully°τ 16:34, 5 May 2006 (GMT)


 * Anyone agree? It seems clear cut to me, but would like some support before removing the quote again. To clarify I have copied the important parts of each policy point:
 * 1. If unfree material can be transformed into free material, it should be done instead of using a "fair use" defense. For example, the information in a newspaper article can easily be used as a basis of an original article and then cited as a reference.
 * 2. The material should not be used in a manner that would likely replace the original market role of the original copyrighted media
 * → Spaully°τ 09:43, 6 May 2006 (GMT)


 * No objections either? I think I'm going to remove it again based on my points here, but will give it another couple of hours. |→ Spaully°τ 10:25, 7 May 2006 (GMT)


 * You ask "Anyone agree?" and when no one agrees you say "No objections either?". I object. I recommend you take your talents to a different article. You are not helping here. Maybe you can get User talk:Silence to help. I respect his opinion on lots of stuff. WAS 4.250 17:16, 7 May 2006 (UTC)


 * And left it 14 hours before considering touching the article? Clearly I am forcing the issue. Maybe I was being quaint but having posted as to why it violated policy, which requires action, I thought anyone who objects might voice them. Do you have any specific objections based on the policies? |→ Spaully°τ 22:38, 7 May 2006 (GMT)


 * I find conversation between us to be to no good end; I suggest the use of intermediaries. WAS 4.250 01:59, 8 May 2006 (UTC)


 * Unfortunately I agree. Although I would still be interested to hear your responses to my arguments on points 1 and 2 of the free use policy. |→ Spaully°τ 11:06, 8 May 2006 (GMT)

WAS 4.250, what exactly is the purpose of the direct quotes from the Merck Manual? Regardless of whether it's fair use or not, it doesn't seem to be necessary. Do the quotes actually add anything to the article? -Techelf 08:29, 8 May 2006 (UTC)


 * Only a quote establishes exactly what the authority called the "Merck Manual" did or did not say. This is especially important in an anybody-can-edit encyclopedia. Modification of the exact quote by lesser authorities (us!) can inadvertaly change the meaning. "Content without context is merely pretext" goes one old saying, so it helps to keep as much context as possible, making for a larger quote. Unfortunately, there is a current Wikipedia predjudice against quotes, so I am willing to trim quotes to fit in with accepted practice at wikipedia. Removing quotes altogether that establish exactly what someone said is, however, unacceptable for serious work. WAS 4.250 13:21, 8 May 2006 (UTC)


 * I do get where you're coming from, but as you allude, current Wikipedia practice discourages this narrative style. The simplest explanation that I can offer is that interspersing direct quotes is not the scientific writing style found in encyclopaedias or in most reference texts. If people want to know exactly what The Merck Manual has to say on a subject, it's freely accessible online and they can look it up themselves. On a Wikipedia article on influenza, however, it would perhaps be better to follow scientific writing convention (minimal use of direct quotes) and cite reference sources for facts that are not commonly known and/or differ from the mainstream view, etc. -Techelf 08:41, 9 May 2006 (UTC)


 * I would agree with Techelf, and also point out that establishing exactly what someone said is no doubt necessary in some circumstances, perhaps where they are the subject of the article; however it is not common practice in any form of scientific writing I have encountered, and certainly is not necessary when careful summarising will not lose or corrupt information and where there are many sources for a particular fact. I would argue that removing quotes from this article is acceptable and necessary, as long as the remaining summarised information is sourced. |→ Spaully°τ 10:01, 9 May 2006 (GMT)


 * I will presume I am wrong in this case and I will not revert your improvment of the article in accordance with this discussion. If some fourth party wishes to do so; then we can revisit this discussion. So for now, I will be the one who focuses on other articles. Thank you for finding a third party. Thank you both for a reasoned discussion. WAS 4.250 14:13, 9 May 2006 (UTC)

Reverting changes without explanation
WAS 4.250 you have twice reverted changes I have made to the article with no explanation (referring here to the changes beside removal of the Merck quote):
 * First time - Some of my changes reinstated by you after this, but by no means all of them.
 * Second time - Nothing restored, despite only trying to explain the reinstatement of the Merck quote in talk.

Could you please explain these reverts rather than provoke a war. |→ Spaully°τ 16:29, 5 May 2006 (GMT)

Among other things, my edit properly sources a definition of "influenza" while your edit adds back an error. WAS 4.250 16:48, 5 May 2006 (UTC)


 * As I mentioned, I am asking you to explain the changes made to the article other than those regarding the Merck quote. For example in this edit you remove the edits to the rest of the intro, cleaning up the paragraphs; and you remove the more correct and informative reference for the Merck quote. This is also the case for your first revert. |→ Spaully°τ 17:21, 5 May 2006 (GMT)


 * If you want to make progress, please identify right here the one most important factual addition to the article you wish to add that you think I reverted; because I'm not following you at all. We obviously are not communicationg, so forget the past, start anew, and right here be clear specific and short about the one most important thing you are talking about. As near as I can tell I reverted nothing that was a change for the better. WAS 4.250 19:24, 5 May 2006 (UTC)


 * Why should I have to make changes 3 times and then explain them in detail in talk to get anything done here?
 * In your second revert you return to a version of the Merck reference with poor explanation of what it is - 'Merck' - and linking to a version that highlights the word 'flu'.
 * In both versions you reverted changes I made to the lead section reducing the paragraph number and bringing together concise information.
 * I don't plan to do this for everything I try to change on WP, so please in future look more carefully at the dif. page before hitting that revert button. |→ Spaully°τ

definition of "flu"
The article says "of the upper airways and the lungs that infects". Is this true? Who says so? Do they take into account the fact that a causitive agent Influenzavirus A is endemic in bird guts and subtypes can cause illness in bird species that don't normally harbor that subtype? Does it take into account the multiple organ infection of H5N1? Does it take into account the fact that humans can become infected from H5N1 by ingesting the virus and have it first infect the intestines causing diarrhea? Is the definition of "flu" changing? If you die from H5N1 from gut infection causing a cytokine storm and pneumonia, did you also have "flu"? Do definitions prior to current knowledge about H5N1 count? WAS 4.250 14:27, 9 May 2006 (UTC)


 * The source is the Merck manual, which you were previously holding up as the closest to an authoritative definition. However I agree that it is somewhat of a simplistic definition. While I generally don't like 'weasel words' perhaps a "primarily" would sort this out, as it is undoubtedly primarily an infection of the respiratory system. |→ Spaully°τ 11:28, 10 May 2006 (GMT)


 * a "primarily" would sort this out, as it is undoubtedly primarily an infection of the respiratory system. (in the context of humans) Excellent suggestion. Agree whole-heartedly. WAS 4.250 14:25, 10 May 2006 (UTC)

picture
one of the things that occasionally bothers me about wikipedia is the excessive use of unimportant pictures. (this does not happen everywhere, so don't everyone yell at me about this!) ive been trying to leave comments regarding this on some of the wikipedia pages... on this particular page there is a picture of a doctor examining a child who doesn't seem to have any symptoms of flu whatsoever. Should the picture be removed?

What is the Mortality per Annum??
Does anyone here know how many die each year in the US from flu? The article says: An average of about 36,000 people per year in the United States die from influenza, and I have seen this number many times before. I have also seen it as referring to influenza and pneumonia. Call me simple-minded but I consider this to be a big difference, since dozens of things cause pneumonia (eg strep. pneumoniae). I would think a death from flu would need confirmation from the lab as to the antigens present in in the viral coat, and I think 100 'Mericans popping off each day would make the headlines in every major city year round. I doubt the 36,000 number, and I am never happier than when I am wrong so make me eat my words!!!regford 17:42, 13 June 2006 (UTC)


 * A CDC press release on January 7, 2003 said: "Using new and improved statistical models, CDC scientists estimate that an average of 36,000 people (up from 20,000 in previous estimates) die from influenza-related complications each year in the United States."CDC Press release January 7, 2003 WAS 4.250 12:45, 19 June 2006 (UTC)

surely its just as important to know how many people are dying world wide not just in america? anyway from the who website (http://www.who.int/vaccine_research/diseases/ari/en/index.html) "The burden of influenza in the USA is currently estimated to be 25–50 million cases per year, leading to 150 000 hospitalizations and 30 000–40 000 deaths. If these figures are extrapolated to the rest of the world, the average global burden of inter-pandemic influenza may be on the order of ~1 billion cases of flu, ~3–5 million cases of severe illness and 300 000–500 000 deaths annually" the proable reason pneumonia is included is beaucse pneumonia can be the cause of death as a secondary infection as result of flu infection, and some cases of influenza are not clinically verified.

Reorganization (needed)
When an article requires an overhaul, it should be done boldly, as the Wikipedia Wikipedia:Be_bold guidelines state. There is no way to reorganize an article without making an apparently large number of changes. I will reorganize as previously, but please note that I am not changing content substantially. Wipfeln 19:52, 4 August 2006 (UTC)

Your last change (that I reverted)
 * unneccessarily changed too much all at once; breaking it down in pieces helps me be sure errors don't creep in; don't make this harder for me
 * incorrectly moved Etymology content out of its subsection
 * incorrectly changed "history" to "Influenza pandemics and flu history"
 * and I'm going to stop looking at the diff now.

A previous change you made caused me to give you further reading on your user talk page because you showed a lack of knowledge concerning the terminology used.

You do not show evidence that massive changes by you should be trusted.

Make one change at a time, and I'll revert or not based on whether it is objectively wrong or not; I rarely revert style changes; I'm about substance and accuracy and verifyability. Others have better style judgements than I do. WAS 4.250 20:46, 4 August 2006 (UTC)

I had the etomology thing backwards and I fixed that. About style ... we don't need a subsection every frickin paragraph. Try using a semi colon instead of a subsection when you feel the need for a title within a sebsection. WAS 4.250 21:21, 4 August 2006 (UTC)
 * like this

Etymology
Slightly edited "Etymology" sub section, second paragraph merged into first to reduce redundancy. -JDM

GA Review

 * GA review (see here for criteria)


 * 1) It is reasonably well written.
 * a (prose): b (MoS):
 * 1) It is factually accurate and verifiable.
 * a (references): b (citations to reliable sources):  c (OR):
 * 1) It is broad in its coverage.
 * a (major aspects): b (focused):
 * 1) It follows the neutral point of view policy.
 * a (fair representation): b (all significant views):
 * 1) It is stable.
 * 2) It contains images, where possible, to illustrate the topic.
 * a (tagged and captioned): b lack of images (does not in itself exclude GA):  c (non-free images have fair use rationales):
 * 1) Overall:
 * a Pass/Fail:
 * First of all, a minor thing that must be fixed, the section "Microbiology" does not contain any reference to RNA, but it's sub-section "Influenza A" have all usage of RNA an mRNA linked. (an easy fix)
 * Seccond, more critical, that have a easy fix or a more difficult fix. The sections "Prevention", "Treatment", and "Research" is in violation of MoS, it contains howto sections, is talking to the reader, using words like "us" etc. Either do a major rewrite of those sections, or remove them all together for the time beeing.
 * "Prevention", talking to the reader WP:MOS
 * "Treatment", only a HOWTO.
 * "Research", NPOV ("will help us") and WP:MOS
 * "Research", NPOV ("will help us") and WP:MOS

Onhold. → A z a  Toth 19:17, 15 October 2006 (UTC)

GA Review Review

 * 1) Glad to see the pluses but putting a minus in front of a word or two is unhelpful. Specificity is necessary unless the goal is being insulting or comparing this article with another. If it is the second case, then it doesn't belong on this page but back on the page where the several articles are being compared against each other.
 * 2) Apparently you wanted RNA to replace RNA. Done.
 * 3) WP:MOS is good advice. Done.
 * 4) "only a HOWTO": Provide an alternative editcopy that is not longer, not harder to read, and is just as informative to the reader. Otherwise it is just blindly applying an inappropriate formula. WAS 4.250 21:06, 15 October 2006 (UTC)

Question
In the "Microbiology" section, I haven't heard of viral RNAs being inserted into host mRNAs, is this what you meant to say? I added a note and cite tag. TimVickers 05:46, 18 October 2006 (UTC)


 * Some else wrote that without a source. Please delete whatever you find worthy of doubt concerning what you just asked. But is Horizontal gene transfer helpful?WAS 4.250 06:31, 18 October 2006 (UTC)

Suggestion
Fewer examples from the US/CDC would give this article a more worldwide view. TimVickers 05:46, 18 October 2006 (UTC)


 * No. More examples from outside the US would help. Deleting is not helpful. WAS 4.250 06:31, 18 October 2006 (UTC)

Errors?
I'm sorry if I introduced any errors when I was trying to improve this article. However, rather than reverting all of these changes (some of which are supported by references to peer-reviewed journals), could you explain here which are errors or correct them individually? Thank you. TimVickers 15:30, 18 October 2006 (UTC)


 * Sure. The initial revert was a bit of a knee jerk response to what seems to me to be errors. But a quick look at your user page and contributions suggests you may very well know more about this than I do (I just know what I read in the sources at the flu and H5N1 pages and other web pages that I ran across while looking for sources. My background is physics and computer science). So I'll give you enough time and tomorrow I'll respond individually to anything I still see a a problem. But it might save time if I made a few comments right now. The first change seems to change the point from flu to flu pandemic which is a related but separate article and issue.
 * So "Its" referred to flu pandemics in general rather that particular flu pandemic? This wasn't clear and I clarified in the wrong direction. Reworded.

Second change: Cause was. Causes were. No?
 * Orthomyxoviridae is a group of viruses, therefore they are a cause (plural).

Next change. "Outbreak" unmodified by "most known" is too undefined. Perhaps it should be changed to flu pandemics which is what I believe you and the original author meant. In any case flu pandemics is supported by the evidence and I think any other interpretation of "outbreaks" would render the sentence false.
 * I agree, good point. Changed back to "Outbreaks are..."

What's wrong with "Neuraminidase facilitates"? I thought that was accurate. "Neuraminidase is involved in" is so vague as to be worthless. Water is also "involved".
 * The problem was word repetition of "facilitates", added a precise ref to activity of this enzyme.

You change the subject from RNA to the proteins they create. Those are two separate yet related things. I don't mind you adding the data on the proteins, but deleting the data on the RNA is wrong.
 * Viral RNAs cannot be targets either drugs or antibodies, these only interact with the proteins they encode. The classification might involve silent nucleotide substitutions, so I changed this to "Their gene sequences are used.."

"World Health Organization co-ordinates the contents" is more accurate.
 * Good point, reworded.

Read Flu vaccine (or just the source where a US agency decides what the US formulation will be). The items you asked for a source on have sources in the FLU and H5N1 articles somewhere - I'll see if I can find them (the 1918 fact I'm not sure about). WAS 4.250 16:52, 18 October 2006 (UTC)


 * Thank you WAS. I am a molecular microbiologist, but I'm not a virologist. I mainly work on protozoal pathogens so not all this is familiar. I'll try to concentrate on the scientific pieces and bring these up to FA standard. If you are worried about my willingness to work with other editors, have a look at the Tuberculosis edit history as I've just finished bringing that page through Featured article review. Hopefully we can get this page up to a similar level a bit more rapidly, since it of excellent quality already. TimVickers 18:26, 18 October 2006 (UTC)


 * Seeing you fix stuff insisted on by previous editors puts me in a mind to congratulate you and tell myself that too many cooks spoil the broth. You want to take it to FA status? Go for for it and I'll get out of your way. WAS 4.250 04:58, 19 October 2006 (UTC)


 * Thanks for your confidence. However, single-editor FAs are more difficult then they need to be. Please don't stop contributing since really good articles are produced by teams, not single users. TimVickers 05:11, 19 October 2006 (UTC)

GA Rereview
My first review might have been a bit thin, that I'm sorry for, lets try to do this again say?

Things in need to be adressed:


 * List in "History" should be converted to inline text. (Embedded list)
 * Converted to table.


 * List in "Microbiology" should be converted to inline text. same list is not referenced, including previous paragraph.
 * "Influenza's effects are much more severe than those of the "cold", and last longer. Recovery takes about one to two weeks. Influenza can be deadly, especially for the weak, old or chronically ill. Some flu pandemics have killed millions of people." unrefernced.
 * Added ref and moved to merge with sentence at beginning of section.


 * "Influenza reaches peak prevalence in winter, and because the Northern and Southern Hemisphere have winter at different times of the year, there are actually two flu seasons each year. Therefore, the World Health Organization (assisted by the National Influenza Centers) makes two vaccine formulations every year; one for the Northern, and one for the Southern Hemisphere." should have a reference.
 * Added ref.


 * "Vaccination against influenza with a flu vaccine is possible and in many cases recommended. The 2006-2007 season is the first in which the U.S. CDC has recommended that children (<59 months) receive the annual flu vaccine." should also have a reference.
 * Added ref


 * "Personal health and hygiene are important in avoiding and minimizing influenza. Young children in particular are thought to be a major force of infection within communities." lacks references.
 * I can find no reference to a particularly important role of children in influenza's spread, reworded and added ref.


 * First part of "Research" lacks references.
 * Res added and section reformatted.


 * The list in "Flu in nonhumans" should be converted to inline list. (I think the list is to short to be able to apply for §2)
 * Done


 * "Flu in nonhumans" first part lacks references.
 * Refs added.

Suggestions (things to think about):
 * The list in section "Symptoms", is a borderline of §2 in Embedded list, perhaps it could look better as an inlined list.
 * I shrank the list by combining some entries.


 * The section adress specially "Influenza A", is type B ad C not notable enough to have place ther also?
 * Added some disscussion of these serotypes. TimVickers 04:13, 20 October 2006 (UTC)

I would like you to adress these points before GA-status can be added. → A z a  Toth 15:29, 19 October 2006 (UTC)

Plan of action for FA process
I intend to bring this article to FA quality and take it through the FA process. As part of this we will need to ensure it conforms to WP:LAYOUT and WP:MEDMOS, and uses the highest quality sources specific to the subject area,. Any changes I may make that seem not to improve the article, but just put it in a different format, will probably be due to me trying to re-arrange things to fit these guidelines. TimVickers 22:59, 20 October 2006 (UTC)

Making article applicable worldwide
The WHO (which is an apolitical scientific organisation, not a political organisation) gathers information from the WHO Global Influenza Surveillance Network and issues recommendations for the formulation of flu vaccines. State-specific organisations such as the CDC then use this information in issuing guidance for their countries. In quoting what these formulations are, we should therefore use a reference to the people who issue this guidance, not just one of the hundreds of organisations that use it.

It is not correct to say "the flu vaccine" since there are multiple different types (live, subunit or inactivated) that are used at different frequencies in different countries.

More importantly, in writing Wikipedia we should aim to make our articles relevant worldwide, not just one country. Consequently sources from global organisations are to be preferred over organisations that only deal with one country. Have a look at WikiProject Countering systemic bias TimVickers 22:22, 22 October 2006 (UTC)


 * The UN is a political organization. WHO is a political organization and not a scientific organization. For example it does not release data unless allowed to by the government of the country involved. To the extent that ir is scientific and apolitical is entirely due to western influences. CDC is entirely controlled by the most liberal constitution in the western world and has first ammendment rights to free speech and a history of science trumping politics. WHO is the opposite.


 * WHO relies on data from state institutions and not the other way around.


 * WHO recommends two yearly formulations (north and south hemisphere) based mostly on US supplied data and naturally the US normally (always? I don't know) agrees.


 * In the introduction we need not involve ourselves with the billions of yearly animal flu vaccine shots in chickens, the millions of research flu vaccine shots created in preparation for a possible flu pandemic, or the numerically insignificant nontrivalent flu shots created. Nor need we, in the intro, concern ourselves with variations from the standard yearly flu shot without evidence of its significance (have you evidence of its significance?).


 * Yes. We wish the article to not just be about American white male humans; but to also include nonAmericans, nonwhites, nonmales, and nonhumans. CDC is not predjudiced against any of these. WHO is not a better scientific source on the subject of vaccines. (But it is the source for human H5N1 deaths.) WAS 4.250 03:11, 23 October 2006 (UTC)

I am not convinced that the main agency dealing with disease at a global level is not the best source for a global picture of disease. However, I am sure we can both agree that scientific papers are the best way to conform to our need to use the highest quality sources specific to the subject area. So our disagreement about the reliability of WHO data is not really significant, since we can easily go back to the primary literature. In this literature, you can find use of subunit, inactivated and live vaccines, as well as recombinant and DNA vaccines in development and testing. This diversity was why I altered the brief mention of "a flu vaccine" to give a more general statement.

Do you have any resources on diagnosis? There is very little in the article on this topic, do you think it is important enough for its own section, or do you think we should include it elsewhare? TimVickers 04:19, 23 October 2006 (UTC)

secondary infections
Hi Tim, i scanned it quickly. One thing I noticed might be missing is the issue of secondary infections. i believe the primary reason for the 1918 pandemic was the deaths from the secondary infections. The 1957 Asian Flu, while bad, was not nearly as leathal due to the availability of antibiotics to control the secondary infections. This may well explian why the spanish flu was misdiagnosed, as stated in the text. David D. (Talk) 16:32, 24 October 2006 (UTC)
 * Good catch. Now added to history section. Already mentioned in Treatment section. TimVickers 16:49, 24 October 2006 (UTC)

Non living
I was surprised to see you add the non-living reference. I have always regarded viruses as living. Is there really a consensus for non living among scientists? David D. (Talk) 16:38, 24 October 2006 (UTC)
 * As I said, it depends on your definition. However any definition that classes viruses as living also classes prions as living. I think the link was needed so people can explore this themselves. TimVickers 16:51, 24 October 2006 (UTC)
 * [cauaght in edit clash with Tim, and i had already mentioned prions ;) i guess i anticipated your reply] I just read the section on the life debate in wiki and i have to disagree with the premises made. Viruses are parasites so there is no reason to assume they need to fullfill all the requirements of the arbitrary life definition. In fact, one could argue they are the ultimate life form since they can exist with a minimal genome. There are plenty of gut bacteria that are currently shedding as many genes as possible too. Their genomes are so reduced that they are completely dependent on their host organisms. Of course they are still cellular, but why is that a requirement for life? One argument made is that by defining viruses as life this is the slippery slope to opening the door for prions.  Here i have to disagree since prions have no genome and do not replicate but catalyse conformation changes.  Anyway enough pontificating. In summary, i think the use of non life might be a little too strong in this article since it implies this is accepted, while in reality it is quite controversial.  The former, more neutral version seemed better to me. David D. (Talk) 16:58, 24 October 2006 (UTC)
 * I'll try to find a more intermediate form of words. How is "non-cellular" as a description? TimVickers 22:07, 25 October 2006 (UTC)


 * Do we really need the Wendell Stanley sentence? Keeping both "non-cellular" and WS seems a little strange because, if I understand correctly, TMV was shown to be non-bacterial/non-cellular by the ceramic filtration studies of Dimitri Iwanowski (1892) and Martinus Beijerinick (1898); at least, TMV was >10-fold smaller than any known cell.  If I recall correctly, those filtration studies were quickly followed up by others on foot-and-mouth disease and poliomyelitis, probably before 1910 (well before the 1930's and WS).  Maybe we can just delete the WS sentence altogether?  Anyway, just a thought, Willow 22:34, 25 October 2006 (UTC)

I put it in since there are several references in old literature to an "influenza bacillus" and I wanted to make it clear that the people working on influenza at the time knew this was a filterable agent, but didn't really know what these agents were! TimVickers 05:25, 26 October 2006 (UTC)

Disease vs virus
Flu is a disease. Perhaps this article goes into the causative agent a bit too much when there are wikipedia articles about those viruses. Also this article and the article Infuenzavirus B differ on the question of why B doesn't cause pandemics and A does (cause Tim and I apparently read the sources differently - I think the sources indicates it is due to "host diversity" - basically type A can spread from birds to humans and cause a pandemic but B is basically only in humans so it never has a strain unknown to the human immune system to reassort with). Maybe someone can look into these things. 4.250.168.165 04:49, 26 October 2006 (UTC) (WAS 4.250)
 * Excellent point, added a note on the dual roles of limited antigenic drift and shift in preventing pandemics of influenza B. TimVickers 05:22, 26 October 2006 (UTC)

1918 W curve
Please take a look at the famous 1918 W curve here. I feel flu is inadequately communicating this. Thanks. 4.250.168.165 05:32, 26 October 2006 (UTC) (WAS 4.250)
 * At the moment we have:
 * "Another unusual feature of this pandemic was that it mostly killed young adults, with 99% of pandemic influenza deaths occurring in people under 65 and more than half in young adults 20 to 40 years old.[16] This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70)."
 * Do you want a figure for this? TimVickers 14:42, 26 October 2006 (UTC)
 * If by "figure" you mean number then i don't know which number you are asking about; but if you mean graph or image of the w curve, then yes that would be helpful. The way it reads now, it sounds like the mortality rate for 20 year olds was greater than that for 2 or 72 year olds and that is not the case. WAS 4.250 15:13, 26 October 2006 (UTC)

The way I understand it, the number of pandemic deaths were higher for the adult part of the population, as when you subtract normal mortality from the young/old populations to get "excess deaths" the adult number is higher. A graph might indeed explain this better. I'll get on to it. TimVickers 15:54, 26 October 2006 (UTC)
 * Graph added. TimVickers 16:11, 26 October 2006 (UTC)

Flu vaccine for nonhumans (I have no idea how much of this should go in this article)
Horses with horse flu can run a fever, have a dry hacking cough, have a runny nose, and become depressed and reluctant to eat or drink for several days but usually recover in 2 to 3 weeks. "Vaccination schedules generally require a primary course of 2 doses, 3-6 weeks apart, followed by boosters at 6-12 month intervals. It is generally recognised that in many cases such schedules may not maintain protective levels of antibody and more frequent administration is advised in high-risk situations." "[P]oultry vaccines, made on the cheap, are not filtered and purified [like human vaccines] to remove bits of bacteria or other viruses. They usually contain whole virus, not just the hemagglutin spike that attaches to cells. Purification is far more expensive than the work in eggs, Dr. Stöhr said; a modest factory for human vaccine costs $100 million, and no veterinary manufacturer is ready to build one. Also, poultry vaccines are "adjuvated" — boosted — with mineral oil, which induces a strong immune reaction but can cause inflammation and abscesses. Chicken vaccinators who have accidentally jabbed themselves have developed painful swollen fingers or even lost thumbs, doctors said. Effectiveness may also be limited. Chicken vaccines are often only vaguely similar to circulating flu strains — some contain an H5N2 strain isolated in Mexico years ago. 'With a chicken, if you use a vaccine that's only 85 percent related, you'll get protection,' Dr. Cardona said. 'In humans, you can get a single point mutation, and a vaccine that's 99.99 percent related won't protect you.' And they are weaker [than human vaccines]. 'Chickens are smaller and you only need to protect them for six weeks, because that's how long they live till you eat them,' said Dr. John J. Treanor, a vaccine expert at the University of Rochester. Human seasonal flu vaccines contain about 45 micrograms of antigen, while an experimental A(H5N1) vaccine contains 180. Chicken vaccines may contain less than 1 microgram. 'You have to be careful about extrapolating data from poultry to humans,' warned Dr. David E. Swayne, director of the agriculture department's Southeast Poultry Research Laboratory. 'Birds are more closely related to dinosaurs.'" Researchers, led by Nicholas Savill of the University of Edinburgh in Scotland, used mathematical models to simulate the spread of H5N1 and concluded that "at least 95 per cent of birds need to be protected to prevent the virus spreading silently. In practice, it is difficult to protect more than 90 per cent of a flock; protection levels achieved by a vaccine are usually much lower than this." 4.250.168.165 05:32, 26 October 2006 (UTC)

Also
"The FEI requires all horses competing in FEI competition to provide evidence of sufficient vaccination against equine influenza. This involves regular six monthly booster vaccinations following a primary vaccination course, as from January 2005. All horses and ponies for which an FEI Passport or a National Passport approved by the FEI has been issued must have the vaccination section completed and endorsed by a veterinarian, stating that it has received two injections for primary vaccination against equine influenza, given between 1 and 3 months apart. In addition, a booster vaccination must be administered within each succeeding 6 months (± 21 days) following the second vaccination of the primary course. None of these injections must have been given within the preceding 7 days including the day of the competition or of entry into the competition stables." 4.250.168.165 05:32, 26 October 2006 (UTC)

And
Poultry farming practices have changed due to H5N1:
 * killing millions of poultry
 * vaccinating poultry against bird flu
 * vaccinating poultry workers against human flu
 * limiting travel in areas where H5N1 is found
 * increasing farm hygiene
 * reducing contact between livestock and wild birds
 * reducing open-air wet markets
 * limiting workers contact with cock fighting
 * reducing purchases of live fowl
 * improving veterinary vaccine availability and cost.

For example, after nearly two years of using mainly culling to control the virus, the Vietnam government in 2005 adopted a combination of mass poultry vaccination, disinfecting, culling, information campaigns and bans on live poultry in cities. 4.250.168.165 05:32, 26 October 2006 (UTC)

also
According to the CDC article H5N1 Outbreaks and Enzootic Influenza by Robert G. Webster et. al.:"Transmission of highly pathogenic H5N1 from domestic poultry back to migratory waterfowl in western China has increased the geographic spread. The spread of H5N1 and its likely reintroduction to domestic poultry increase the need for good agricultural vaccines. In fact, the root cause of the continuing H5N1 pandemic threat may be the way the pathogenicity of H5N1 viruses is masked by cocirculating influenza viruses or bad agricultural vaccines." Dr. Robert Webster explains: "If you use a good vaccine you can prevent the transmission within poultry and to humans. But if they have been using vaccines now [in China] for several years, why is there so much bird flu? There is bad vaccine that stops the disease in the bird but the bird goes on pooping out virus and maintaining it and changing it. And I think this is what is going on in China. It has to be. Either there is not enough vaccine being used or there is substandard vaccine being used. Probably both. It’s not just China. We can’t blame China for substandard vaccines. I think there are substandard vaccines for influenza in poultry all over the world." In response to the same concerns, Reuters reports Hong Kong infectious disease expert Lo Wing-lok saying, "The issue of vaccines has to take top priority," and Julie Hall, in charge of the WHO's outbreak response in China, saying China's vaccinations might be masking the virus." The BBC reported that Dr Wendy Barclay, a virologist at the University of Reading, UK said: "The Chinese have made a vaccine based on reverse genetics made with H5N1 antigens, and they have been using it. There has been a lot of criticism of what they have done, because they have protected their chickens against death from this virus but the chickens still get infected; and then you get drift - the virus mutates in response to the antibodies - and now we have a situation where we have five or six 'flavours' of H5N1 out there." 4.250.168.165 05:32, 26 October 2006 (UTC)

From the type A article
Someone asked about this data. Should it also go in this article?
 * Weren't they wanting information on mammals? This article is pushing 60 kB as it is, some of these details certainly belong in the related articles, but I'm not sure how much more to add, what do other people think? TimVickers 17:53, 26 October 2006 (UTC)
 * I added the mammal data located at Influenzavirus A below. Frankly, that oughta be here and the details of flu virus replication within cells oughta be there or at Orthomyxoviridae. But whatever ...  WAS 4.250 19:20, 26 October 2006 (UTC)
 * Sorry, I wasn't clear. In the peer review Birgitte§β asked for data on flu infection in mammals apart from humans. I added the data on infection in pigs and seals to the Animal infections section in response. We probably have enough on birds as it is, but I'm keen to hear other people's opinions on this. I'm hesitant to make any radical changes since altering an article after multiple editors have reviewed it and voted in FA will invalidate their votes, since they did not see the new version. Perhaps we can reach a consensus on this after the FA process has been completed? Should only take a few more days (crosses fingers). TimVickers 19:39, 26 October 2006 (UTC)
 * Sure. No problem. The data already exists in other articles, so I really don't care that much if it is also here or not. WAS 4.250 20:25, 26 October 2006 (UTC)


 * Known outbreaks of highly pathogenic flu in poultry 1959-2003

WAS 4.250 16:29, 26 October 2006 (UTC)

Mammal data asked for ? ok?


 * Swine flu


 * Swine flu (or "pig influenza") refers to a subset of Orthomyxoviridae that create influenza in pigs and are endemic in pigs. The species of Orthomyxoviridae that can cause flu in pigs are Influenza A virus and Influenza C virus but not all genotypes of these two species infect pigs. The known subtypes of Influenza A virus that create influenza in pigs and are endemic in pigs are H1N1, H1N2 and H3N2.


 * Horse flu


 * Horse flu (or "Equine influenza") refers to varieties of Influenza A virus that affect horses. Horse 'flu viruses were only isolated in 1956. There are two main types of virus called equine-1 (H7N7) which commonly affects horse heart muscle and equine-2 (H3N8) which is usually more severe.


 * Dog flu


 * Dog flu (or "canine influenza") refers to varieties of Influenza A virus that affect dogs. The equine influenza virus H3N8 was found to infect and kill greyhound race dogs that had died from a respiratory illness at a Florida racetrack in January 2004.


 * H3N8


 * H3N8 is now endemic in birds, horses and dogs.

WAS 4.250 19:20, 26 October 2006 (UTC)

Mortality in 1918
If 2.5% of those infected with the Spanish flu were killed, and the spanish flu killed 2.5-5% of the world population, does it mean that 100-200% of the world population were infected with the spanish flu?? Yuvalkatz 01:36, 26 November 2006 (UTC)


 * The mortality should be quoted as "over 2.5%" so I changed this. Looking again at the figures in the second reference, with a 1918 population of 1,800,000 the 50-100 million mortality estimate comes out as 2.5-5% of the total. I suspect this uncertainty comes from the widely-differeng estimates of mortality, depending on which source you consult. The only direct quote of infection rate I've found is in Tannenberger et al. who say approximately 50% had clinical infection. TimVickers 18:54, 18 November 2006 (UTC)


 * "The case mortality rate varied widely. An overall figure is impossible to obtain, or even estimate reliably, because no solid information about total cases exists. In U.S. Army camps where reasonably reliable statistics were kept, case mortality often exceeded 5 percent, and in some circumstances exceeded 10 percent. In the British Army in India, case mortality for white troops was 9.6 percent, for Indian troops 21.9 percent. In isolated human populations, the virus killed at even higher rates. In the Fiji islands, it killed 14 percent of the entire population in 16 days. In Labrador and Alaska, it killed at least one-third of the entire native population (Jordan, 1927; Rice, 1988). But perhaps most disturbing and most relevant for today is the fact that a significant minority—and in some subgroups of the population a majority—of deaths came directly from the virus, not from secondary bacterial pneumonias." National Academy of Sciences WAS 4.250 22:37, 18 November 2006 (UTC)

Thanks WAS, I've put that highest estimate of mortality in as well, to give an idea of the range of estimates. I think that solves the problem. TimVickers 22:54, 18 November 2006 (UTC)

What happens during the recovery ?
What happens to the infected cells when you recover from the flu? Are they destroyed/"disinfected"/"quarantined" ... anything else? - unsigned


 * A cell that is successfully infected by a virus is converted into viruses and an evicerated sorry ass corpse of a cell. Think of a cell exploding and all that remains is debris and thousands of new viruses unleashed to seek out and destoy new victims by turning them also into virus factories. Recovering from the flu ends this cycle of destruction like the end of a war ends the bombing of enemy factories. The cells in the case of the flu, and the factories in the case of a war, must be rebuilt. In the case of a cell though, dead is dead and it can be replaced but not restored. WAS 4.250 19:38, 23 November 2006 (UTC)


 * Each cell, infected with the virus (any virus for that matter, not only the flu), that has been spotted and recognized by the immune system, goes under a controlled destruction process (Apoptosis). Virus infection does not always lead to a 'cell explosion' as WAS described, but often change it's metabolism, and cause it to create and release undesired proteins (some could be harmfull). In any case, Apoptosis is the only way for our body to fight those cells, and so 'disinfection' or 'quarantine' never take place. Often, a virus infection is so successful, that it is our own immune system (with it's controlled apoptosis) that kills us (incase of a massive tissue destruction). When you recover from the flu, the body sends nutrients to reconstruct those damaged cells or tissue, killed during that 'battle'. Yuvalkatz 01:35, 26 November 2006 (UTC)


 * Also, as indicated in H5N1 genetic structure: Influenza A viruses have 10 genes on eight separate RNA molecules (called: PB2, PB1, PA, HA, NP, NA, M, and NS) and PB1 codes for the PB1 protein and the PB1-F2 protein and the PB1-F2 protein interacts with 2 components of the mitochondrial permeability transition pore complex, ANT3 and VDCA1, sensitizing cells to apoptosis so that PB1-F2 contributes to viral pathogenicity and has an important role in determining the severity of a pandemic influenza, according to the article A novel influenza A virus mitochondrial protein that induces cell death. WAS 4.250 06:19, 26 November 2006 (UTC)

Treatment formating
There is an issue with the box at the end of this section. While there seems to be no real need for this partition of information, if it is going to stay then the text needs to be adjusted so that it does not extend beyond the box. --too lazy to sign in (user: bomb chelle)

[[

'Question:'
]] If scientists are too lazy to creat a cure for influenza, why do we have to pay them? What good does that do to us?

Archived discussions
Old discussions have been moved to archive 1. TimVickers 05:58, 3 December 2006 (UTC)