الفهرس 
Influenza VirusOnly 14 pages are availabe for public view
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Abstract
I
nfluenza, commonly known as ”flu”, is an infectious disease of birds and mammals caused by RNA viruses of the family Orthomyxoviridae.
There are three types of influenza viruses: A, B and C. Human influenza A and B viruses cause seasonal epidemics almost every winter. The emergence of a new and very different influenza virus can lead to an influenza pandemic. Influenza type C infections cause a mild respiratory illness and are not thought to cause epidemics.
Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: the hemagglutinin (H) and the neuraminidase (N). Current subtypes of influenza A viruses found in human are influenza A (H1N1) and influenza A (H3N2) viruses. In the spring of 2009, a new influenza A (pdm H1N1 09) virus emerged to cause illness in people. This virus was very different from regular human influenza A (H1N1) viruses. That virus also called “pdm H1N1 09” has now mostly replaced the H1N1 virus that was previously circulating in humans.
Avian influenza virus H5N1 originated in poultry and has been occasionally transmitted to humans resulting in high mortality. There have been no reports thus far to indicate that H5N1 readily transmissible from human to human.
Typically, influenza is transmitted through the air by coughs or sneezes. Influenza can also be transmitted by direct contact with nasal secretions, or through contact with contaminated surfaces, avian influenza ”H5N1” transmitted by direct contact with bird droppings. Airborne aerosols have been thought to cause most infections.
The most common symptoms are chills, fever, runny nose, sore throat, muscle pains, headache (often severe), coughing, weakness/fatigue and general discomfort. Although it is often confused with other influenza-like illnesses, especially the common cold, influenza is a more severe disease caused by a different type of virus. Influenza can occasionally lead to pneumonia, either direct viral pneumonia or complicated by secondary bacterial infection , even for persons who are usually very healthy.
Molecular diagnostic techniques as the real-time reverse transcription polymerase chain reaction (rRT-PCR) are rapid and sensitive methods for the detection and identification of influenza viruses.
The present study aimed to determine the prevalence of common influenza viruses. Flu A (pdm H1N1 09, H3N2, H5N1) and Flu B In different governorates in Egypt.
The present study present study was carried out at the Central Public Health Laboratory, Virology department, Ministry of Health and divided into two duration: Retrospective through collection of data from June 2013 to May 2014 and Prospective analysis from June 2014 to August 2014.
The present study included 7403 mixed nasopharyngeal & oropharyngeal swabs were submitted to the laboratory for routine influenza virus testing, from different governorates in Egypt. 279 samples are rejected so 7124 swabs were tested for the presence of influenza virus infection by real time reverse transcriptase PCR.
Patient age, sex and underlying conditions (pregnancy, chronic respiratory disease, chronic heart disease, diabetes mellitus, chronic liver failure, chronic renal failure) were the basic data collected from the request form.
The results of sputum Gram staining and bacteriological culture of (1331) out of 7124 cases were collected from Bacteriology unit.
A Real-time reverse transcription polymerase chain reaction (rRT-PCR) for influenza viruses, Flu A (pdm H1N1 09, H3N2, H5N1) and Flu B were done for every swab.
In the present study, Concerning examined samples the youngest age group was (6) months and the oldest was (96) years with mean age (39.5) years. Concerning sex there were 3756 (52.7%) males & 3368 females (47.3%). They were distributed among different governorates where the largest number of cases was from Cairo 2019(28.34%), while the least number were from Marsa Matrouh 1 (0.01%). The largest number of examined samples were in Winter 2014 (December-February 2014) 3426 case (48.1%) while the least number was in Summer 2013 (June- August 2013) 246 case (3.5%).
The influenza virus were not detected by real time PCR in 5400 cases (75.8%) out of 7124 examined cases, There was a small number of cases with mixed infection (more than one agent) 0.22%.
Per agent pdm H1N1 09 was the most frequent virus detected in 1101/7140 cases (15.4%), while H3 was detected in 211/7140 case (2.96%), Flu B was detected in 425/7140 cases (6%) and the least frequent virus was H5 which detected in 3/7140 cases (0.04%).
In the present study, the highest percentage of influenza infection is prevalent among age group 46-60 (579/1724) 33.6%, followed by 31-45 age group (363/1724) 21.1%, >60(347/1724) 20.1%, 16-30(274/1724)15.9% and the lowest was ≤15 (161/1724)9.34%.
Among positive cases (1724) there were (16.5%) of cases with underlying diseases (risk factors of severity). DM was the most frequent risk factor (6.6%).
Sputum samples were available from some cases 1331 cases (17.98%) for Bacteriological examination. where 159 (11.9%) were positive for bacteriological growth while 1172 (88.1%) were negative .Among examined cases Staph. aureus infection was the most frequent 47/1331 cases (3.5%).
We recommend, continuing the surveillance for influenza viruses to monitor influenza activity, as an early warning system for outbreaks and pandemics. Intensified Public orientation especially at start of winter about good personal health and hygiene habits to limit spread of influenza infection. Influenza vaccine should be given every year especially to high risk group and this should be directed to most prevalent strain in our country. Finally Egyptian veterinary authorities should carry strict measure to control spread of avian influenza among poultry including household poultry to control the growing number of human infections of H5N1 influenza in our country.