PROBLEM OF PANDEMIC INFLUENZA A/H1N1
DOI:
https://doi.org/10.11603/1681-2727.2019.2.10326Keywords:
influenza A/H1N1 (California, hemagglutinin, neuraminidase, virus reassortants, neuraminidase inhibitors, immunoprophylaxisAbstract
The aim – to provide basic information of the literature on etiology, epidemiological features, clinical manifestations and laboratory diagnosis of influenza A/H1N1 (California), and to provide the main recommendations of WHO and CDC due to it’s prevention and treatment.
The data on etiology, specific antigens, mechanisms of pandemic strains origin, reassortants, the possibility of new strains emergence that will have the ability to cause pandemics are generalized. It is shown that the genetic structure of new A/H1N1 virus is complex and includes genes of the swine flu virus that affects pigs in America, Europe and Asia; avian influenza virus genes and human influenza virus genes. The genes of the new virus come from four different sources. The history of this virus emergence is described, the data of WHO report on the pandemic 2009–2010 are presented. Epidemiological features of this virus spreading are observed in humans and among animals, including pigs. The current data of the viral antigens properties – hemagglutinin and neuraminidase and the processes of the cytokine storm at the influenza are analyzed. The clinical features of the pandemic influenza A/H1N1 are presented: the disease begins suddenly, with chills, the body temperature rises sharply to 38-40 °C, appear the headache, pain in the throat and muscles, nasal congestion, cough. Possible signs of gastrointestinal damage: abdominal pain, nausea, vomiting, diarrhea. Often the disease runs easily; in the absence of complications, the patients recover within 7-9 days. It has been shown that during a severe course of the disease pneumonia with the rapid development of respiratory failure and respiratory distress syndrome in adults is possible. In spite of artificial ventilation of the lungs, in the next 1-2 weeks, patients may die. The diagnostic criteria are given, a number of laboratory methods for confirming the diagnosis are listed and described.
Particular attention is paid to treatment. Three groups of influenza drugs with proven clinical efficacy are described: M2 channel blockers (amantadine, remantadine), viral neuraminidase inhibitors (zanamivir, oseltamivir), and synthetic nucleosides (ribavirin). Oseltamivir (tamiflu) and zanamivir (relenza) are most commonly used. The newest medicine is mentioned – Xofluza (Xofluza, baloxavir marboxium), approved so far only in the USA and Japan. The preventive measures for the population and medical staff are provided. Separate attention is paid to the achievements and challenges of immunoprophylaxis.
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