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Acta Medica Medianae
Correspondence to:
Medicinski fakultet Bulevar dr Zorana Đinđića 82 18000 Niš, Srbija E-mail: nico7711@hotmail.com
Copyright 2007 by Faculty of Medicine, University of Nis |
AVIAN INFLUENZA A/H5N1
Milena Veselinovic
Medicinski fakultet u Nišu
The World Health Organization (WHO) regards avian influenza A/H5N1 as a global public health threat with pandemic potential. Between 2003 and October 12, 2007, WHO registered 331 laboratory-confirmed cases (202 fatal) of human H5N1 infection. Human-to-human transmission has not been recorded yet. In the possible future, H5N1 pandemic, primary viral pneumonia would be the dominant clinical feature. Compli-cations include the development of acute respiratory distress syndrome, renal and multiorgan failure. The characteristic laboratory findings are lymphopenia, with the alteration of CD4+/CD8+ index, thrombocytopenia and ’’cytokine storm’’. Specimens for laboratory diagnosis include pharyngeal swabs, nasal swabs, tracheal aspirate (or bronchoalveolar lavage) and serum (acute and convalescent). Virus isolation by cell culture is considered the "gold standard" of influenza diagnostics. Identification of infected cells is performed by direct or indirect immunofluorescence (DFA, IFA), enzyme-linked immunoassays (EIA) or PCR-based methods. Mchip, a microarray which enables the detection and subtypisation based on M gene segment, is the recent breakthrough in H5N1 diagnostics. WHO Rapid Advice Guideline Panel on avian influenza, formed in 2006, defined the guidelines for chemoprophylaxis and therapy of human H5N1 infection. The most promissing primary treatment is oseltamivir. Vigorous antiviral activity against all subtypes of both A and B influenca viruses has been confirmed by in vitro studies. WHO has identified the antigenic and genetic characteristics of the viruses suitable for the development of the vaccine. More than 40 clinical trials have already been carried out or are ongoing. In spite of the promissing results, WHO is expressing concern regarding inadequate global capacity for the vaccine production. Acta Medica Medianae 2007;46(3): 44-51.
Key words: avian influenza A/H5N1
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