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Bad Flu Season Ahead

The flu bug let us off easy last winter, but experts predict that this coming flu season will be a different story. ?We usually do not have mild years back to back,? says Dr. Kristin Nichol, an influenza researcher at the Minneapolis Veterans Medical Center. ?I can?t explain why it is biologically, but I would certainly encourage people not to expect another mild season.?

Kris Ehresmann, an epidemiologist who tracks the influenza virus for the Minnesota Department of Health, agrees. ?We are expecting more disease activity this year than what we had last year,? and adds that the flu strains expected to predominate are the type that make people the sickest.

We were lucky that 2000 was a mild flu season, since flu vaccine was in short supply. In many places it was limited to the elderly and those with suppressed immune systems. This year?s flu vaccine supply isn?t yet available in most areas, since one manufacturer was late in getting approval from the FDA. ?There will be adequate vaccine in the system,? says Ehresmann. ?People need to be patient.? A flu shot takes 10 days to two weeks to fully protect against the virus.

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A team of researchers has found that a tiny change in a flu virus can turn it from an annoyance into a killer. A change in just one of the virus? 10 genes switched a form of flu in chickens to a strain deadly to humans four years ago in Hong Kong. Authorities were forced to kill more than a million chickens to block the spread of the flu, which killed six out of the 18 humans it infected.

?What this tells you is that the avian influenza virus can become the virus that causes the disease in humans at any moment,? says Yoshihiro Kawaoka, who is part of the research team at the University of Wisconsin-Madison. ?We have found that a limited number of very tiny genetic changes in a specific gene, one called PB2, can have a big effect on how potent the influenza virus is. Because the influenza virus constantly mutates, and because only a few changes can make a nonpathogenic virus highly pathogenic, we should assume that an outbreak of any new strain or subtype is potentially dangerous to humans.?

Robert Lamb, professor of biochemistry at Northwestern University, says this report is intriguing. ?In many ways it tells us just how complicated understanding the influenza virus is, that a point mutation in one gene can confer virulence. It also tells us just how dangerous a virus influenza is.?

The Hong Kong case was the first documented instance of a flu virus jumping directly from chickens to humans, according to the National Institutes of Health. It raises worries because of the many live poultry markets around the world, including some in parts of Florida and New York.

The disease reappeared in Hong King this summer and more than a million chickens were slaughtered once again. It has long been known that animals such as pigs can harbor viruses, with major epidemics occurring when the virus jumps from the usual host to humans. AIDS is an example of an animal virus that moved on to humans, with deadly results.

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