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Talk:Influenza - Wikipedia, the free encyclopedia

Talk:Influenza

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Featured article star Influenza is a featured article; it (or a previous version of it) has been identified as one of the best articles produced by the Wikipedia community. Even so, if you can update or improve it, please do.
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This article was selected on the Medicine portal as one of Wikipedia's best articles related to Medicine.

Contents

[edit] Archived discussions

Old discussions have been moved to archive 1. TimVickers 05:58, 3 December 2006 (UTC)

[edit] Diagnosis

This section was thin and I have added to it. In addition, I have added a Bayesian approach to the diagnosis that utilizes CDC data for seasonal changes in prevalence. Badgettrg 05:20, 5 December 2006 (UTC)

[edit] Prevention and treatment

I split these sections and organized the treatments. Note that the prevention section is in need of a discussion of using neuraminidase inhibitors for either prophylaxis or post-exposure prophylaxis. Badgettrg 05:23, 5 December 2006 (UTC)

It's a small thing, but I don't see any mention anywhere of how long the virus is shed by an infected person. Seems like knowing how long you're contageous for would be an important thing to know as far as preventing further spread. When do you start shedding virus, versus when you start showing symptoms, and how long does it continue? How does taking antivirals affect that, if anyone knows? Anyone looking up influenza because they have it or someone they know has it would likely want to know that. Critterkeeper 05:24, 15 March 2007 (UTC)

Added to the "Vaccination and infection control" section. TimVickers 05:43, 15 March 2007 (UTC)

[edit] Potential Edit War

Perhaps I'm mistaken, but it appears to me that an edit war is beginning to brew; like I've said, perhaps I'm mistaken, but I've seen almost 10 reverts happen in the past 2 minutes. This needs to be dealt with. BishopTutu 00:21, 1 January 2007 (UTC)

It's not an edit war, it's just the regular shitstorm of vandalism that hits every page featured in the Today's Featured Article section of the Main Page. GeeJo (t)⁄(c) • 00:32, 1 January 2007 (UTC)
Well, I don't wish to sound uptight, but shouldn't something, at least, be done about it? BishopTutu 00:37, 1 January 2007 (UTC)
Please see Wikipedia:Main Page featured article protection, and the discussion on the talk page. --Fsotrain09 01:26, 1 January 2007 (UTC)
Well, I guess that, quite frankly, I should just shut up; It'll be promptly and accordingly dealt with, I presume. BishopTutu 01:45, 1 January 2007 (UTC)
It's better that way BishopTutu. I found that given the amount of press this place gets, new users are always on here trashing the place and showing their friends how they are "1337 hax0rz". If you speak out about it, you just come off as another whining user. I tried to stop a flame war once and instead got banned for a week cause I was "not part of the solution, merely another problem". Unless you have access to dynamic IPs, proxies, and multiple accounts to get around the bans; don't bother sticking your head out... it'll only get chopped off by some over-zealous op. Ghostalker 10:14, 1 January 2007 (UTC)
I suppose it would be pointless to point out that you're contributing nothing right now, as well. Tuviya 17:18, 1 January 2007 (UTC)

[edit] Image Display Issues

I am having an issue where the Specific Death Rate graph in the history section obscures some of the text in the paragraph. This is affecting viewing for me in IE and firefox in 1024x768. Is anybody else having this issue and if so can someone with a little more expertise than myself fix it. Andystar23 02:49, 1 January 2007 (UTC)

I had the same issue as that, on Firefox (though only when I had the window at about two-thirds screen size). I think it was more an issue with the image above, and as such, I think it's fixed now (as in it's OK for me). Can you check see if it's gone for you? :-). --86.130.21.79 03:26, 1 January 2007 (UTC).
Thanks, looks fine now Andystar23 10:18, 1 January 2007 (UTC)

--82.8.58.73 04:13, 1 January 2007 (UTC)

[edit] Western medicine

Not a topic I'm pursuing, just noticed that Influenza is the featured article today, and that the slant of the entire article is about Western science and medical treatment as if it is the end-all and be-all of medical treatment. As a person who suffered brutally from the effects of antibiotics on my immune system and became chronically susceptible to flus, I was impressed when a Chinese painter (also a genuine, traditional Taoist master, trained in China) informed me that going back to the original Yellow Emperor's book on medicine, the Chinese have had medicine for treating the entire range of these complaints....ranging from the common cold through the 'ague' to full-blown influenza of most common varieties. It works by boosting the strength of the meridians related to what we call the immune system This medicine (Yin Chiao ) is very cheap ($3Canadian for 120 tablets) and usually will clear the flu in three doses of the medicine, which usually means overnight. Caveats are that according to 'chi types' (wet, dry,hot, cold etc) there are a few people who will not respond to this treatment, but the Chinese Herbalists have a tea, which is brewed up and will help not only these people, but also the more severe super-flu which has been circulating....the one that lasts for around a month. For those who cannot manage to get past the hubris and pride about western science, I would much prefer they read Bruce Holbrook's Stone Monkey than embarrass themselves by directing tackling me in efforts to insist upon the superiority of Western medicine. The simple fact is that there are some things it simply cannot do at this time, and other systems can. My interest is in what actually help sick people, not in participating in ideological debates. I have nothing invested in the faith that rationalists have in their scientific philosophy, or of defending Oriental medicine, nor of entering any debate about it.

I'm writing this simply because this medicine is one of a number remedies I've seen that work, but Western medicine would rather ignore than use in the mean time while they come up with a 'scientific' remedy.

chriss Nessmuk 08:46, 1 January 2007 (UTC)

Wikipedia is not a Soapbox, so these kind of diatribes are inappropriate. In addition to this, Wikipedia's neutral point of view policy demands that we do not give undue weight to fringe theories. The vast majority of people who know about such issues subscribe to the western medicine viewpoint. If there are a few that don't, that's bound to happen - I'm sure there are some people who think Jehovah is a goddess-figure, but you're not going to see a huge section about that here or anywhere else, because it's not a common belief. Also, I think it's sort of funny to be using a device like a computer on a framework like the internet, and then still use scare quotes around the word 'scientific'. I have never used a homeopathic computer, but maybe you have...?  :) Tuviya 17:22, 1 January 2007 (UTC)

Yes, but Wikipedia is supposed to have multiple countries... Hence the "This article is on a non-national view-point" tag. --½¹²³€½¾¡⅛£¼⅜⅝⅞™±°¿ 17:29, 1 January 2007 (UTC)

IMHO, that tag is not valid. It's not like the rest of the world treats or sees flu differently than 'the West'. They use plenty of 'western' medicine in China and the other Oriental nations as well. Tuviya 17:40, 1 January 2007 (UTC)
When I can't see because it is too dark in my home, I don't light a bunch of candles as my first resort. I do not know the ins and outs of how a lightbulb works, but I still turn one on when it gets dark. Because at some point in history, someone somewhere took the time, did the research, and invented the lightbulb. Scientists today are much like Joseph Swan and Thomas Edison( lightbulb inventors). They are looking for a cure, figuring out what works and what does not. So instead of insulting the people who are actually trying to find a cure, perhaps you could help them along by suggesting yours. Also, if "Western medicine" looked into your chinese herbalist method of dealing with influenza, perhaps they would find a 'scientific' explanation for how it works. Just because science has not proven the "how" of a particular treatment, it does not mean that people are not willing to try something new(or old). V.E. 24.247.247.186 00:22, 2 January 2007 (UTC)
The scientific method is applied worldwide, therefore using data from scientific studies does not favour any one part of the world more than another. TimVickers 01:00, 2 January 2007 (UTC)

[edit] History

I don't know how firm these dates are for the 19th century flu epidemic. St. Therese of Lisieux reported that flu devastated her convent in the winter of 1990-1, not the previous year. Three deaths, probably elderly nuns (out of maybe a dozen or so?). Nearly everyone was sick at one time. Is is possible the epidemic listed for the previous year was still ongoing? Student7 23:31, 11 January 2007 (UTC)

I think you mean 1890, don't you? The best source I can find source states "Pandemic influenza was recorded in 1830–3, 1898–1900, and four times in the 20th century (Fig. 2). It is not appropriate to detail these events in the present text, but full accounts for the latter half of the 19th century can be found in the literature (Jordan 1927; Burnet and Clark 1942; Pyle 1986; Patterson 1987).." C.W. Potter , A history of influenza. J. Appl. Microbiol. 91 (2001), pp. 572–579. link Hope this helps. TimVickers 23:48, 11 January 2007 (UTC)
Thanks Tim. I was off by a century! I was referring to the table under "History," where it explains that the flu, believed to be H2N2, struck in 1889-1890. The nun's account is supposedly a year later. It is, of course, "anecdotal." Still, it seemed pretty serious there. I like your ranges better because they are longer. Maybe the table's should be expanded? I'm not really familiar with the data. Just thought I'd throw that in. Student7 03:40, 12 January 2007 (UTC)
What's the reference? You can add the data with the reference if you want. TimVickers 05:08, 12 January 2007 (UTC)

Taubenberger thinks 1889 was H3N8, he should know, he has many unpublished pre-1918 virus-sequence segments. The Next Influenza Pandemic Can It Be Predicted? Jeffery K. Taubenberger, MD, PhD; David M. Morens, MD; Anthony S. Fauci, MD JAMA. 2007;297:2025-2027.

the 1580 outbreak has recently been assumed to have been pertussis rather than influenza: http://asclepio.revistas.csic.es/index.php/asclepio/article/viewFile/57/59 Gsgs2 (talk) 10:25, 21 December 2007 (UTC)gsgs2

[edit] Clitoris redirect

"clitoris" redirects to the influenza page. i would fix it, but i don't know how (yet...still getting my feet wet). 71.126.101.8 03:33, 2 January 2007 (UTC)

Thanks. It has been fixed. WAS 4.250 05:23, 2 January 2007 (UTC)

[edit] Taxonomy

Is there any reason that the taxonomy box is not displayed on this page? See Yellow fever for an example... -Ravedave (Adopt a State) 18:31, 25 January 2007 (UTC)

None I know of, you would be most welcome to go ahead and add the taxonomy to the infobox. TimVickers 18:35, 25 January 2007 (UTC)
This article is about the disease. We have seperate articles about the causative agents. Those articles should have taxoboxes. See the navigation box at the bottom of the article for a list of such articles. The taxobox at Yellow fever should be deleted as that article is also about the disease and not about the virus that causes the disease. I suppose one could put the taxobox at Orthomyxoviridae in the Microbiology section of Influenza. But isn't the article long enough already? WAS 4.250 19:27, 25 January 2007 (UTC)
Does Orthomyxoviridae need to be made the "main article" of the Microbiology section? There is quite a bit of confusing overlap. I believe that the taxobox belongs on this article and the Orthomyxoviridae page. The separation of the virus and the symptoms of a virus articles seems strange to me, unless the "sub article" structure is used. -Ravedave (Adopt a State) 20:07, 25 January 2007 (UTC)
Sometimes a disease and its causitive agent are so tied together they are best treated together - and sometimes they are not as when distinct seperate things can cause a single disease (like flu). But a disease is not something with an evolutionary history and a causitive agent is not something to be cured. As for what "belongs" - the answer is whatever is best for our readers. Reasoned judgement is always better than trying to find or invent some rule. WAS 4.250 05:59, 26 January 2007 (UTC)

[edit] Egyptian origin of influenza as a pandemic disease of humans?

Influenza is a disease associated with the close proximity of water fowl, pigs and humans, and its origin as a pandemic disease may be due to the development of agricultural systems that allow the mixing of these animals and their wastes.[1][2] Some of the first archaeological evidence for this agricultural system is during the Amarna period of Ancient Egypt, and the pandemic that followed this period throughout the Ancient Near East may have been the earliest recorded outbreak of influenza.[3] However, the precise nature of this Egyptian plague remains unknown and Asia has also been suggested as a possible site of origin of pandemic influenza in humans.[4][5][6]

I've asked for some help from the Ancient egypt page as I'm not sure how accurate this is. TimVickers 21:24, 21 February 2007 (UTC)
All known pandemic flu is caused by Influenzavirus A. Influenzavirus A is endemic in birds and judging by its genetics, has been since before humans existed. It is currently believed that Influenzavirus A is capable of jumping directly from birds to humans and causing a pandemic. Thus there is no logical reason to believe that flu pandemics did not occur in prehistory prior to agriculture. Well, such "pandemics" as could be supported by the human population. Agriculture allowed for dense rather than sparse populations, and the invention of writing allowed for someone to write about contagious disease. There is no reason to believe that contagious flu did not exist prior to agricultureand prior to writing. One could define "pandemic" so it can't exist prior to the human densities made possible by agriculture, but that's semantics. WAS 4.250 06:02, 22 February 2007 (UTC)
The first part of the paragraph I am happy with, as it is reasonably well-established that pigs are the most common intermediate host in the emergence of new strains of influenza. I've added another reference here and done some thorough checking. The suggestion that this co-localisation of the three hosts occurs most commonly in Asia and may have first occurred in Asia is also well supported. What I cannot find any good references for is the suggestion that this first occurred in Ancient Egypt. I propose leaving this on talk for a while and if nobody provides a reliable source for the Egyptian sentence then we cut this and replace the rest. TimVickers 17:24, 22 February 2007 (UTC)
None of this belongs in the history section and probably does not belong in this article at all. We have articles an intensive farming and on flu research and on ancient egypt. Speculation in disease in ancient egypt goes there since there is no way any claim about flu in ancient egypt is anything other than speculation. There is a great deal of concern about intensive farming's role in the creation and spread of disease (including flu) - vaccination, use of poultry shit as fish food, wet markets mixing geese and chicken and pigs, humans living in close quarters to animals in asia - but the flu article is not the place for this as there are many details and cultural practises and political issues that need to be handled right to do justice to the issue. I tried at Social impact of H5N1 to get into this a little. The section Economic impact might be able to use an additional sentence or two about farming practices, but not the history section where it is original research and speculation. "it is reasonably well-established that pigs are the most common intermediate host in the emergence of new strains of influenza" is no longer true altho it was formerly asserted prior the the latest researches due to H5N1 which have cast a considerable amount of doubt on many former theories about flu as now we know it is far more complicated than we had thought and flu has far more ability to mutate and jump species than had been thought. "that this co-localisation of the three hosts occurs most commonly in Asia and may have first occurred in Asia is also well supported" is the old theory that was commonly believed but is now believed to be but one part of a much larger puzzle that we are only beginning to get an outline of. "History of flu research" comes to mind here. WAS 4.250 19:18, 22 February 2007 (UTC)

A couple more points: What you are discussing is specific to Influenzavirus A which is but one of the three flu causing species, which adds a little to this not being the best place for it. What we know about pigs possibly being a mixing vessel for flu is that "Avian influenza HA bind alpha 2-3 sialic acid receptors while human influenza HA bind alpha 2-6 sialic acid receptors. Swine influenza viruses have the ability to bind both types of sialic acid receptors." The rest is speculation. Guesswork that was thought adequate but now is recognized as inadequate. For example, it was just recently learned that humans too have the ability to bind both types of sialic acid receptors (just not as many and not as available as they are mostly deeper in the respiratory system) so humans can be their own mixing vessel and don't need pigs for that honor. WAS 4.250 19:29, 22 February 2007 (UTC)

From a 2005 review "The participation of intermediate hosts in the process of generating influenza strains with pandemic potential is poorly understood but generally regarded as critical. Pigs have long been considered as potential “mixing vessels” that favor reassortment between human influenza strains and those from other animal species.24,25 This hypothesis is based on documented disease outbreaks in swine caused by either avian or human influenza viruses, particularly of the H1N1 and H3N2 subtypes. Further support comes from laboratory studies that show that swine are susceptible to infection by many subtypes of avian influenza.26 In recent years it has become apparent that domestic poultry can harbor AI viruses with the capacity to infect humans.27–32 Experimental data suggest that some domestic poultry act as unapparent amplifiers of influenza viruses with pandemic potential when infected without showing signs of disease. Studies in quail show that they can be efficient at spreading reassortants containing human flu genes. Ducks can carry H5 viruses that transmit to humans but also do not always exhibit signs of disease.33–35 In the light of evidence of human infection with AI, the possibility that humans may act as mixing vessels must not be overlooked. Thus, the genesis of pandemic influenza strains is likely a multistep process that may require considerable time. In some cases it may involve the exchange of genomic information among multiple influenza subtypes or strains circulating in different animal species at the same time.36" link I think you are right here, since we have no single clear model of how pandemic strains emerge, and little idea of how traditional farming practices influence these processes, the above passage is too definite for the hazy state of our knowledge.

How about

Influenza is a disease associated with the close proximity of water fowl, pigs and humans, and its historical origin as a pandemic disease may be due to the development of agriculture, which would have facilitated the mixing of these animals and their wastes.[7][8] However, the precise nature of poorly-documented plagues is impossible to determine, so defining the prevalence of influenza in the ancient world is impossible.[9] As today's new influenza strains commonly originate in Asia, this region may have been the place where the first pandemic strains originated, but conditions in the ancient world may have differed dramatically from those today.[10][11][12]

How about a direct quote from WHO or CDC? They keep up to date. WAS 4.250 00:07, 23 February 2007 (UTC)

[edit] Re. Ancient Egyptian animal agriculture

Nefermaat & Atet's mastaba shows various hunting/herding scenes
Nefermaat & Atet's mastaba shows various hunting/herding scenes

Hi Tim! Sorry for the late reply, I haven't been active on Wikipedia lately. Pigs, cattle, waterfowl and sheep were all raised in ancient Egypt and to varying degrees included in the diet. Pigs had been domesticated since the Predynastic period. There was some restriction on their consumption, but there is evidence that they were consumed at least by the poorer classes and were used in farming. Eugen Strouhal (1992) Life in Ancient Egypt is a good place to start. Strouhal is a physical anthropologist who's worked extensively on ancient Egyptian diseases and epidemics, though I can't recall if he mentions an outbreak of the flu. Also, Houlihan (1996) Animal World of the Pharaohs and AUC Egyptologist Salima Ikram are both great sources on ancient Egyptian fauna and animal domestication. Hope this helps. — Zerida 05:52, 26 February 2007 (UTC)

[edit] "change in the virus"

"change in the virus, with each of these pandemics being caused by a major genetic"

I'm dissatisfied with terminology that does not adequately indicate it is the addition of a new varient (rather than the wholesale replacement of existing varients) because there is a misunderstanding that H5N1 and other subtypes are one thing genetically and when it changes that it is all now that new genetic type; when H5N1 is in fact creating new varients that are each co-evolving and the impact of this is since it has become endemic in nonhumans, even if it does mutate into a pandemic strain, the pre-pandemic strains still exist and can mutate again and again and again ... Unless it nysteriously dies out, this is literally the evolution of something new and permanant in Influenzavirus A. There has never, so far as we know, been a highly pathogenic strain of Influenzavirus A endemic in the wild. And this one is still learning to adopt to new species. The multiple co-evolving strains of Influenzavirus A is essential to understanding Influenzavirus A. It doesn't "change" to a new strain. It adds and deletes strains from its existing arsenal of thousands(?) of antigenetically distinct strains maintained in thousands(?) of species of birds and mammals. WAS 4.250 19:23, 27 February 2007 (UTC)

Is the new version better? TimVickers 19:37, 27 February 2007 (UTC)
Yes. Great job. Thanks. By the way, congrats on becoming admin. And you also have my symphathy. It's mostly a thankless job that earns you nasty people as enemies. WAS 4.250 20:47, 27 February 2007 (UTC)
But it does mean that looking after the FAs will be a bit easier. If I can help out, just get in touch. TimVickers 20:53, 27 February 2007 (UTC)

[edit] starve the fever feed the cold

u should not lower a fever, a fever will slow down the reprodction of the virus/bacteria and it will help make more b and t cells to attack the virus/ bacteria so a fever helps you!

[edit] Image:H5n1 spread (with regression).png

Hi all. I talked with User:Waitak about the appropriateness of the regression curve in the context of WP:ATT, but he wants a general consensus between editors of Influenza articles. I think that the regression - and especially the choice of which regression to use - probably falls astray of WP:ATT since it "propose(s) unpublished ideas or arguments" or, alternatively, is "unpublished synthesis of published material". What do you guys think? —AySz88\^-^ 05:39, 13 March 2007 (UTC)

If it remains then it needs to be clarified that it is NOT a scientific projection but instead is merely something nonlinear to compare the data curve to. The curve is useful to me in indicating that the billions of dollars spent are helping to keep the number of human deaths lower than they might have been. Perhaps its meaningfulness is too uncertain to keep. Or maybe we should just say: Regression curve:uncertain meaningfulness. WAS 4.250 07:25, 13 March 2007 (UTC)

I agree this is inappropriate. Unless we have more data, the best way of presenting these figures is to join the points. That adds no additional interpretation. TimVickers 13:52, 13 March 2007 (UTC)

Curve fitting is definitely not 'original research' in any meaningful sense. Just put on the image description page what you fit to and what the parameter values are. It may be debatable whether the regression curve is useful, though. Opabinia regalis 23:40, 13 March 2007 (UTC)
The problem is, although the curve is not really meaningful, it suggests a meaning and a use that isn't there - that there is some reason to believe that the rate of deaths is exponential and will be in the future. Is there some (expert's) reason why exponential should be chosen as opposed to, say, logistic? —AySz88\^-^ 05:04, 19 March 2007 (UTC)
Yeah, choosing one curve over another is the issue. A straight line fits with most people's instinct. Yet exponential is more common in these biological type situations - until a limiting factor is reached - when the curve becomes logistic. And when there is genetic adaptation involved such as is occuring with H5N1, there can be a series of S shaped curves as it fills an ecological niche, stalls, mutates, and fills yet another niche. All in all, this is biological evolution on the fast track; doing all its tricks in months rather than millenium. Exponential is the right comparison curve yet there is a significant problem with implied meaning. WAS 4.250 05:53, 19 March 2007 (UTC)
In an unrestrained epidemic, where each case infects multiple new people, exponential growth will obviously result. However, if some of the population are immune or the rate of infection in similar to the rate of death/cure there can be a linear growth in the number of cases. Furthermore, this is the cumulative number of cases, not the actual number of cases in any one year. TimVickers 15:26, 19 March 2007 (UTC)

[edit] Pliny's silence about influenza

I've been thumbing thru this ancient antecedent of Wikipedia, & according to one of its translators (W.H.S. Jones), Pliny the Elder does not mention influenza: "The ordinary infectuous fevers -- smallpox, measles, scarlet fever, diptheria, enteric, influenza -- were apparently unknown" (Loeb trans., vol. 6, p. ix). This may not mean that Influenza was unknown to the Romans; Jones later notes that "it is curious that Pliny makes so few references to the common cold" (p. xv). Having read some lengthy chunks of his Natural History, I think it must be pointed out that Pliny sometimes reveals that he is more likely to trust what his written sources over what his own personal experience show. I'm not sure if this helps with the article. -- llywrch 02:01, 15 March 2007 (UTC)

[edit] FYI

This http://www.ganfyd.org/index.php?title=Flu has an interesting but incompatible copyright license. Right now we cover flu better, but we should keep an eye on it. 4.250.168.212 21:50, 19 March 2007 (UTC) (WAS 4.250)

[edit] Flu virus mutation

I could use some help.

I had thought that the current dominate strain of HPAI A(H5N1) sometimes called Asian lineage HPAI A(H5N1) was identical with "Genotype Z" but apparently there is a "Genotype V" which stayed endemic in China and did not die out and is now threatening to breakout and possibly play a major role.

I'm too tired to fully deal with this now, but I've gathered some sources and stuff.

related articles
Sources

WAS 4.250 07:44, 24 March 2007 (UTC)

"Experts see double threat from flu strains

Summary:Experts yesterday voiced concern over the possibility that the two different genotypes, called "sub-clades", of the H5N1 bird-flu virus found in Thailand could meet and merge into an unknown and "unpredictable" mutated form.

Chulalongkorn University has found that a virus sample from Nakhon Phanom province in the Northeast was of a strain newly observed in Thailand and more closely related to H5N1 strains that have been circulating since 2005 in southeast China. In contrast, H5N1 samples from Phichit province in the lower North region were similar to the cluster of samples isolated during 2004 and 2005 outbreaks in Thailand and Vietnam, said Professor Yong Poovorawan, author of the Chulalongkorn University study. The viruses isolated from Phichit belonged to genotype Z, whereas the virus isolated from Nakhon Phanom belonged to genotype V, he wrote in his report. The latest bird-flu outbreak, in the Northeast province of Mukdahan, has raised concerns that the genotype V virus from the Northeast could spread to meet with the genotype Z virus endemic in the lower North and Central region, said veterinarian Rakthai Ngampak, head of the Department of Livestock Development's Bird Flu Control Centre. Although the results of DNA sequencing of the virus samples taken from Mukdahan are yet to be known, it is very likely that they are the same strain found in Nakhon Phanom, given the way the virus killed poultry, Rakthai said. Yong and Rakthai agreed that the consequences of a new strain of H5N1 emerging from the mixing of the two genotypes might or might not be serious. However, Professor Pilaipan Puthavathana, a virologist at Mahidol University's Siriraj Hospital, said: "It won't be good if the two genotypes meet and mix."[1]

But it looks like they have already mixed before:

"Phylogenetic analysis also revealed that the viruses isolated from migratory ducks at Poyang Lake belonged to two different H5N1 genotypes: Z (MDk/JX/1653/05, MDk/JX/1657/05, MDk/JX/1701/05) and V (MDk/JX/2136/05, MDk/JX/2295/05, MDk/JX/2300/05). The matrix (M), nonstructural (NS), polymerase acidic (PA), polymerase basic (PB) 1, and PB2 genes of isolates from an outbreak at Qinghai Lake in central China (represented by BH goose/QH/65/05; genotype Z) clustered with those of MDk/JX/1653/05 (genotype Z), whereas the HA, NA, and NP genes of the Qinghai Lake isolates grouped with those of MDk/JX/2136/05 (genotype V), both of which were isolated from Poyang Lake in January and March 2005, respectively. Thus, all eight gene segments of viruses from the Qinghai Lake outbreak in central China can be traced to the H5N1 viruses isolated from migratory ducks at Poyang Lake in southeast China, ≈1,700 km distant, indicating that migratory birds can disseminate the virus over long distances." [2]

So long as both Z and V are endemic, they can continue to mix and each time produce new variations. I'm not sure how to write this up or where to put it. WAS 4.250 18:26, 24 March 2007 (UTC)

[edit] Spelling

Just a point about the english language; flu isn't a word, it's an abreviation. I will wait to gauge popular opinion but I would sujest that all the references to flu are changed the 'flu. MHDIV ɪŋglɪʃnɜː(r)d(Suggestion?|wanna chat?) 15:03, 19 June 2007 (UTC)

Nonsense WAS 4.250 17:13, 20 June 2007 (UTC)
The OED lists both versions as nouns. flu The version lacking the apostrophe is the one now in most common usage. TimVickers 17:25, 20 June 2007 (UTC)

[edit] Proposal for new influenza categories

Hello, I notice that the assignment of influenza related pages to categories is a little disorganized. I would like to suggest that we create additional subcategories and reorganize exisiting pages to categories. My proposal is below. Any comments? Regards—G716 <T·C> 04:16, 18 October 2007 (UTC)

[edit] Proposed new influenza categories

Here are the new categories I am suggesting, with indentation indicating a subordinate relationship between categories.

Influenza

Avian influenza
Influenza viruses
Influenza A subtypes
H5N1
Influenza treatment
Influenza vaccines
Influenza pandemics
Deaths by influenza (not shown in table below for sake of space. Would remain unchanged.)
Mammalian influenza

Existing categories that would be retired:

Category:Neuraminidase inhibitors

Here's how I think the suggested categories would be further categorized —G716 <T·C> 05:16, 18 October 2007 (UTC)

Proposed category Other superordinate categories
Influenza Category:Viral diseases
Avian influenza Category:Poultry diseases
Influenza viruses Category:Viruses
Influenza A subtypes
H5N1
Influenza treatment Category:Antivirals
Influenza vaccines Category:Vaccines
Influenza pandemics Category:Pandemics
Deaths by influenza Category:Deaths by infectious disease
Mammalian influenza Each page in this category also would be in the
appropriate species disease category. For example,
Canine influenza would be in Category:Dog diseases

[edit] Assignment of influenza topics to categories

This table shows how existing pages are assigned to categories now, and how I propose assigning them to new categories.

Proposed Influenza Categories

Page Name

Current Category

Proposed Category
Center for Biologics Evaluation and Research Influenza None
Fatal Contact: Bird Flu in America H5N1 None
Avian influenza H5N1 Avian influenza
Avian influenza Influenza Avian influenza
Bird flu in Croatia H5N1 Avian influenza
Bird flu in India H5N1 Avian influenza
International Partnership on Avian and Pandemic Influenza H5N1 Avian influenza
2007 Bernard Matthews H5N1 outbreak H5N1 H5N1
Bernard Matthews H5N1 H5N1
GISAID H5N1 H5N1
Global spread of H5N1 H5N1 H5N1
Global spread of H5N1 in 2004 H5N1 H5N1
Global spread of H5N1 in 2005 H5N1 H5N1
Global spread of H5N1 in 2006 H5N1 H5N1
H5N1 H5N1 H5N1
H5N1 clinical trials H5N1 H5N1
H5N1 genetic structure H5N1 H5N1
Human mortality from H5N1 H5N1 H5N1
Influenza Genome Sequencing Project H5N1 H5N1
OIE/FAO Network of Expertise on Avian Influenza H5N1 H5N1
Social effects of H5N1 H5N1 H5N1
Tiết canh H5N1 H5N1
Transmission and infection of H5N1 H5N1 H5N1
Antigenic drift Influenza Influenza
Antigenic shift Influenza Influenza
Flu season Influenza Influenza
Hemagglutinin Influenza Influenza
Human flu Influenza Influenza
Influenza Influenza Influenza
Influenza research Influenza Influenza
International Conference on Emerging Infectious Diseases Influenza Influenza
M1 protein Influenza Influenza
M2 protein Influenza Influenza
National Influenza Centers Influenza Influenza
NS1 Influenza Protein Influenza Influenza
OIE/FAO Network of Expertise on Avian Influenza Influenza Influenza
Reassortment Influenza Influenza
H1N1 Influenza Influenza A subtypes
H1N2 Influenza Influenza A subtypes
H2N2 Influenza Influenza A subtypes
H3N1 Influenza Influenza A subtypes
H3N2 Influenza Influenza A subtypes
H3N8 Influenza Influenza A subtypes
H5N2 Influenza Influenza A subtypes
H5N3 Influenza Influenza A subtypes
H5N8 Influenza Influenza A subtypes
H5N9 Influenza Influenza A subtypes
H7N1 Influenza Influenza A subtypes
H7N2 Influenza Influenza A subtypes
H7N3 Influenza Influenza A subtypes
H7N4 Influenza Influenza A subtypes
H7N7 Influenza Influenza A subtypes
H9N2 Influenza Influenza A subtypes
H10N7 Influenza Influenza A subtypes
Fujian flu H5N1 Influenza pandemic
Fujian flu Influenza Influenza pandemic
Influenza pandemic H5N1 Influenza pandemic
Influenza pandemic Influenza Influenza pandemic
International Conference on Emerging Infectious Diseases H5N1 Influenza pandemic
International Partnership on Avian and Pandemic Influenza Influenza Influenza pandemic
Pandemic Preparedness and Response Act H5N1 Influenza pandemic
Pandemic Preparedness and Response Act Influenza Influenza pandemic
Pandemic Severity Index Influenza Influenza pandemic
Spanish flu Influenza Influenza pandemic
Spanish flu research Influenza Influenza pandemic
Amantadine Influenza Influenza treatment
Arbidol Influenza Influenza treatment
Flu treatment Influenza Influenza treatment
Neuraminidase Influenza Influenza treatment
Neuraminidase inhibitor Neuraminidase inhibitor Influenza treatment
Oseltamivir Neuraminidase inhibitor Influenza treatment
Peramivir Neuraminidase inhibitor Influenza treatment
Rimantadine Influenza Influenza treatment
Zanamivir Neuraminidase inhibitor Influenza treatment
Flu vaccine Influenza Influenza vaccine
FluMist Influenza Influenza vaccine
Fluzone Influenza Influenza vaccine
Influenzavirus A H5N1 Influenza viruses
Influenzavirus A Influenza Influenza viruses
Influenzavirus B Influenza Influenza viruses
Influenzavirus C Influenza Influenza viruses
Orthomyxoviridae Influenza Influenza viruses
2007 Australian equine influenza outbreak Influenza Mammalian influenza
Canine influenza Influenza Mammalian influenza
Equine influenza Influenza Mammalian influenza
Swine flu Influenza Mammalian influenza

[edit] Comments

Things have multiple aspects. "Influenza" is a type of disease. It is a medical category. "H5N1" is a subtype of a species. It is a biology category. "Avian flu" is an epidemiology and a public health category as is "mammal flu" and relates both to biology and medicine (which quite naturally relate to each other). I see no value in artificially deleting categories from the bottom of article pages based on an imposed artificial hierarchy. The solution to the problem that you see is not a reduction in the number of categories at the bottom but an increase in them and and increase in the types of categories. You could create separate hierarchies for each aspect. For biology, the H5N1 category would be in the category Orthomyxoviridae. For medicine, the Flu category would be in the category Diseases of the respiratory system and so forth. WAS 4.250 13:44, 18 October 2007 (UTC)

Thank you for your thoughtful comments. I agree with all you say, especially about the need to clarify distinctions among medical, biology and epidemiology categories. However, I do want to clarify that I am not suggesting reducing the number of categories. I want to increase the number of categories by adding categories: Avian influenza, Influenza viruses (or even better: Orthomyxoviridae), Influenza A subtypes, Influenza treatment (or possibly Influenza antiviral drugs), Influenza vaccines, Influenza pandemics, Mammalian influenza. My goal here is two-fold: make the 'influenza' categories more meaningful, reduce (or eliminate) the current confusing (to me) multiple assignment of pages to categories and sub-categories, and generally make navigation around this topic easier (OK, that's threefold). Thanks again for your help, Regards—G716 <T·C> 02:57, 19 October 2007 (UTC)
Go for it. Be bold. Do it. Implement a vision. Wikipedia benefits most most from boldness. It's easy to tweak something not quite right. It is harder to create that something in the first place. Don't worry about getting it perfect. Do your best. ... Just add rather than delete. WAS 4.250 05:22, 19 October 2007 (UTC)

Looks good to me—kudos on taking it upon yourself to do this. I am, however, not really fond of "Influenza treatment"—to me, it would be more logical to keep Flu treatment in Cat:Influenza and create, say, a Cat:Anti-influenza agents. Other than that, I have no objection (why should I? :) Fvasconcellos (t·c) 16:19, 19 October 2007 (UTC)

[edit] redirect/merge this article and human flu

Please see Wikipedia:Articles for deletion/Human flu. "Human flu" is used on these pages to mean the subset of Orthomyxoviridae that create influenza in humans and are endemic in humans. It also serves to contrast with horse flu, pig flu, dog flu, cat flu, and bird flu. Each type of flu, named after what it is endemic in, has unique aspects to it. The flu article is very human-centric, but it is not the human flu article. Perhaps much of this article should be merged into the human flu article for the sake of consistancy? Or leave well enough alone? Or what? WAS 4.250 15:16, 21 October 2007 (UTC)

[edit] Wrong Magnification

These are incorrect, the original magnification of the electron micrographs was probably around 70,000 but no account has been taken for the extra magnification of the final positive print. To me, (and I have seen hundreds of electron micrographs), on my screen and when this article is printed the final magnification is more like 200,000! I would change the legends to read "approximate magnification x 200,000". GrahamColm 06:58, 1 November 2007 (UTC)

The virons are roughly 1 cm across on my screen and if we take the virion diameter to be 100 nm (makes things simpler), this corresponds to a 100,000-fold magnification. Is that about right? Tim Vickers 16:29, 1 November 2007 (UTC)

Yes Tim, I concur. I tracked down the original on the CDC site but they don't give the magnification details, which is a pity. During my time as an electron microscopist, I always wrote these details on the back of all the prints I made. The thumbnail is around 100,000 fold (which is a good number) - the original is more like 200 -250K. Best wishes User:GrahamColm

OK, article corrected to 100,000x thank you. Tim Vickers 19:14, 1 November 2007 (UTC)

You guys are making assumptions about the size of the screen that this page is being displayed on and counting on the image text being updated if the image is resized here or elsewhere (eg in a printed context). I recommend that the image text say something that remains true regardless of the size of the screen that this page is displayed on (projected on a classroom wall for example). WAS 4.250 21:27, 1 November 2007 (UTC)


This is a valid point. To remain true, there should be a scale marker embedded in the image saying something like "bar = 100nm". This is the way it is usually done. But I am reluctant to edit the original images as they are not mine. If the images are projected the teacher would have to say what the final magnification is on their screen. Or should we put an approximate 100nM bar into the the micrographs? We can do this but it would not be exact. Comments please User:GrahamColm
How about using the width of the image as the bar? Say "The width of the image is 1000 nm" or whatever it is. WAS 4.250 23:26, 1 November 2007 (UTC)

[edit] Seasonality

Viral seasonality is fascinating, complex and not restricted to Influenza virus. In the UK you can set your calender by Respiratory syncytial virus, it comes every November and stays for around four weeks. Rotavirus prefers the late winter/early spring, Enterovirus the summer as do enteric Adenovirus and Varicella zoster virus. Before we had the MMR vaccine, Measles infections had a dramatic peak every three years. None of these have been given a convincing explanation. I'm not suggesting any changes to the article; it's good that it remains a little vague about this. --GrahamColmTalk 19:37, 5 December 2007 (UTC)

Viral seasonality - it's a redlink, are you tempted Graham? Tim Vickers (talk) 19:46, 5 December 2007 (UTC)

I found a recent, open-access journal article on the seasonality of influenza at: http://pathogens.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.ppat.0030151 The work was featured in the NY Times. Besselfunctions (talk) 01:35, 6 December 2007 (UTC)

That is already in the article I'm afraid, reference number 62. Tim Vickers (talk) 02:33, 6 December 2007 (UTC)

[edit] Spanish Flu - H1N1 Article Number of Deaths Inconsistency

Just a quick note. The H1N1 article states that "50 million to 100 million people worldwide" were killed by the strand while this article says 40 million. I just thought we might want to address the inconsistency. I realize there are often different figures found depending on where you look. The H1N1 article does have a citation (although I prefer more thanone especially for statistics like this). Maybe a citation for this article might be a good idea, or both could acknowledge the varied numbers? --jenlight (talk) 14:22, 13 January 2008 (UTC)

I'm a bit confused by your question. This article states:
"The most famous and lethal outbreak was the so-called Spanish flu pandemic (type A influenza, H1N1 subtype), which lasted from 1918 to 1919. Older estimates say it killed 40–50 million people[17] while current estimates say 50 million to 100 million people worldwide were killed.[18]" Tim Vickers (talk) 23:34, 13 January 2008 (UTC)
Was it the table you were talking about? I changed this to reflect the more detailed figures given in the text. Tim Vickers (talk) 23:36, 13 January 2008 (UTC)

[edit] Article fails to link WP article on 'Influenza vaccine'

The link is in the sub-heading of the section on "Vaccination and infection control" Tim Vickers (talk) 01:08, 29 February 2008 (UTC)

[edit] Article fails to note preventive potential of vitamin D

See, e.g.,

Cannell JJ, Vieth R, Umhau JC, et al (2006). "Epidemic influenza and vitamin D". Epidemiol. Infect. 134 (6): 1129–40. doi:10.1017/S0950268806007175. PMID 16959053. —Preceding unsigned comment added by 68.166.205.54 (talk) 02:57, 11 March 2008 (UTC)

See the third paragraph of the Seasonal variations section. It even contains that exact review! :) Tim Vickers (talk) 03:19, 11 March 2008 (UTC)

[edit] Symptoms Error

To my understanding, it is a common misconception that nausea and vomiting are associated with the flu. See online articles on influenza offered by eMedicine, Medline Plus, and WHO. —Preceding unsigned comment added by 70.181.148.205 (talk) 01:45, 12 March 2008 (UTC)

http://www.cdc.gov/flu/professionals/acip/clinical.htm says "Uncomplicated influenza illness is characterized by the abrupt onset of constitutional and respiratory signs and symptoms (e.g., fever, myalgia, headache, malaise, nonproductive cough, sore throat, and rhinitis). Among children, otitis media, nausea, and vomiting also are commonly reported with influenza illness." WAS 4.250 (talk) 21:36, 12 March 2008 (UTC)

Well, PMID 16886147 doesn't mention vomiting as a symptom in children, but I found a reference that says influenza B can cause abdominal pain. Tim Vickers (talk) 22:09, 12 March 2008 (UTC)

hello, good work —Preceding unsigned comment added by 130.231.103.15 (talk) 11:48, 22 March 2008 (UTC)


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