STOP THE NEXT SURGE
THE WEEK|December 06, 2020
We were not prepared for Covid-19, but we can be for an influenza pandemic. Here is all you need to know about influenza
RENUKA JOSEPH

Covid-19 reminded us of the threat of respiratory viruses. It is not the first pandemic to be caused by a respiratory virus and it is not likely to be the last. Influenza viruses are thought to have the potential to cause pandemics in the future.

According to the World Health Organization, 2.9 lakh to 6.5 lakh deaths occur during every flu season. As such, strategies preventing and treating influenza virus infections have become a major area of research.

There are four influenza viruses—A, B, C and D. Only A, B and C infect humans. C infections in humans are infrequent and mild. A and B infections can be severe, making them a public health problem.

Influenza viruses have a single-stranded segmented RNA genome. Influenza A and B have eight genes, each encoding for a different protein essential for the virus’s ability to infect and reproduce in humans. Out of these eight proteins, hemagglutinin (HA) and neuraminidase (NA) are on the surface of the virus.

HA is responsible for entry of the virus into our respiratory system. After replication, the new viral particles are released from the infected cell with the help of NA. Our immune system clears the infection by making antibodies. However, these antibodies are specific to the HA or NA and will either provide only partial protection or no protection against an influenza virus with different HA or NA.

Influenza A viruses cause both pandemics and seasonal influenza virus epidemics. Influenza A viruses are categorised into subtypes based on what HA and NA they have. There are 18 distinct HAs and 11 NAs found in nature, and, theoretically, viruses with any combinations of these are possible. For example, Influenza A H1N1 has type 1 HA and type 1 NA.

Only two influenza A subtypes—H1N1 and H3N2— cause seasonal influenza. The other subtypes are found in birds, poultry, swine and other mammals, and these subtypes occasionally infect humans causing severe disease. Subtypes are further divided into strains, which means there are many strains of H1N1 influenza A virus, each different from the other. This is based on differences in their HA. It is significant to note that all influenza virus pandemics till date have been caused by the influenza A subtype H1N1.

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