This report summarizes influenza virus surveillance data from Europe between October 2015 and March 2016. It finds that influenza A viruses are predominant, with A(H1N1)pdm09 viruses more common than A(H3N2). B/Victoria-lineage viruses are also increasing. Antigenic characterization shows A(H1N1)pdm09 viruses match the vaccine strain. A(H3N2) viruses show poor recognition by antiserum for the vaccine strain. Genetic analysis finds A(H1N1)pdm09 viruses primarily belong to genetic subclade 6B.1. This report analyzes antigenic and genetic properties of influenza viruses circulating in Europe this season.
Influenza characterisation-report-february-2022paqui b
This report summarizes influenza virus surveillance data across Europe from August 2021 to February 2022. During this period, over 44,000 influenza detections were reported, a large increase from the previous season. The vast majority (97%) were influenza A viruses, with A(H3N2) dominating (93%) over A(H1N1) (7%). Influenza B accounted for 3% of detections. While influenza activity has increased, detection numbers remain lower than pre-pandemic seasons, likely due to COVID measures limiting spread. A(H3N2) viruses are recommended for inclusion in the 2022-2023 northern hemisphere vaccine.
Communicable disease-threats-report-12-mar-2022-week 10paqui b
Three cases of acute hepatitis related to rat Hepatitis E virus (HEV-C) were detected in Spain between 2018-2021, representing the first cases in Europe. While HEV-C normally circulates among rats, this finding suggests it may be an emerging infectious disease in humans. Public health authorities are monitoring the situation as HEV-C is divergent from other hepatitis E virus variants that typically infect humans.
Similarities and Differences between the New Coronavirus Infectious 2019 COVI...ijtsrd
This document compares the similarities and differences between COVID-19 and seasonal influenza. Both viruses cause respiratory illness with symptoms like fever and cough. However, COVID-19 has a longer incubation period and causes virus shedding for a longer duration than influenza. Additionally, COVID-19 spreads more easily between adults and leads to more secondary infections. In contrast, influenza has a higher transmission rate and often spreads more through children. The mortality rate of COVID-19 is also significantly higher than seasonal influenza. Currently, there are treatments and vaccines available for influenza but not yet for COVID-19.
Incorporate the visual brilliance of COVID 19 Template PowerPoint Presentation Slides to deliver a gripping presentation. Using the coronavirus PPT theme, you can display global epicenters of this pandemic on a world map diagram. With the help of this corona PowerPoint slideshow, you can spread awareness by communicating symptoms of the disease. Demonstrate the healthcare system capacity and the number of cases using the line graph given in the COVID 19 PPT template. The concise dashboard diagrams included in this 2019-nCoV disease PowerPoint presentation are appropriate to showcase key statistics of the pandemic. Novel coronavirus pneumonia PPT slideshow helps you to highlight the major pandemics of the modern era like the 1700s smallpox outbreak. Elucidate country-wise stats related to the disease using the dashboard layout in this severe pneumonia with novel pathogens PowerPoint theme. So, download this COVID-19 PPT presentation to outline the affected areas, precautionary measures, and other fundamentals. https://bit.ly/3yA9QwF
This study aimed to understand the sources and modes of transmission of SARS-CoV-2 among healthcare workers and patients at three hospitals in the Netherlands in March 2020. The researchers screened 1796 (15%) of healthcare workers for SARS-CoV-2 infection, finding 96 (5%) tested positive. Whole genome sequencing was performed on samples from 50 healthcare workers and 10 patients, finding most sequences grouped in three clusters, two showing local circulation. The patterns were consistent with multiple community introductions and local amplification, rather than widespread nosocomial transmission. While direct hospital transmission could not be ruled out, the data did not support hospitals as the primary source of infection in patients or healthcare workers early in the outbreak.
Final exam english ii reynaldi 20160700011Reynaldi18
The document summarizes the spread of COVID-19 from China to other countries in early 2020. It describes the symptoms and transmission of the virus, as well as control measures taken like travel restrictions. Analysis suggested the quarantine around Wuhan only modestly delayed spread within China. There were no specific antiviral treatments available yet. WHO is working to develop vaccines and coordinate the global response. Proper hygiene and social distancing are encouraged to slow transmission until a vaccine is found.
Correlation between Human Origin and the Severity of COVID19ijtsrd
It has been reported that the severity of coronavirus infectious disease COVID 19 is due to several factors such as age and the presence or absence of chronic disease. Furthermore, it has been reported that genetic factors affect the severity of COVID 19. A recently published study of the COVID 19 Host Genetics Initiative suggests that genetic manifolds in the region located on chromosome 3 may increase the risk of the severity of COVID 19. Takuma Hayashi | Ikuo Konishi "Correlation between Human Origin and the Severity of COVID19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33684.pdf Paper Url: https://www.ijtsrd.com/medicine/other/33684/correlation-between-human-origin-and-the-severity-of-covid19/takuma-hayashi
The COVID-19 outbreak has hit Europe hard, with Italy having the second largest number of confirmed cases after China. The rapid surge is posing a serious threat to Italy's health system due to limited intensive care capacity. While early exponential projections predicted over 30,000 cases in Italy by March 15, restrictive measures introduced on March 9 and 11 resulted in about 24,747 actual cases, suggesting the measures began reducing new cases within 3-4 days. All other European countries now appear to be in a similar situation to Italy, just a short time-lag behind. Immediate, very restrictive measures are urged to limit viral spread, ensure adequate healthcare response, and reduce mortality.
Influenza characterisation-report-february-2022paqui b
This report summarizes influenza virus surveillance data across Europe from August 2021 to February 2022. During this period, over 44,000 influenza detections were reported, a large increase from the previous season. The vast majority (97%) were influenza A viruses, with A(H3N2) dominating (93%) over A(H1N1) (7%). Influenza B accounted for 3% of detections. While influenza activity has increased, detection numbers remain lower than pre-pandemic seasons, likely due to COVID measures limiting spread. A(H3N2) viruses are recommended for inclusion in the 2022-2023 northern hemisphere vaccine.
Communicable disease-threats-report-12-mar-2022-week 10paqui b
Three cases of acute hepatitis related to rat Hepatitis E virus (HEV-C) were detected in Spain between 2018-2021, representing the first cases in Europe. While HEV-C normally circulates among rats, this finding suggests it may be an emerging infectious disease in humans. Public health authorities are monitoring the situation as HEV-C is divergent from other hepatitis E virus variants that typically infect humans.
Similarities and Differences between the New Coronavirus Infectious 2019 COVI...ijtsrd
This document compares the similarities and differences between COVID-19 and seasonal influenza. Both viruses cause respiratory illness with symptoms like fever and cough. However, COVID-19 has a longer incubation period and causes virus shedding for a longer duration than influenza. Additionally, COVID-19 spreads more easily between adults and leads to more secondary infections. In contrast, influenza has a higher transmission rate and often spreads more through children. The mortality rate of COVID-19 is also significantly higher than seasonal influenza. Currently, there are treatments and vaccines available for influenza but not yet for COVID-19.
Incorporate the visual brilliance of COVID 19 Template PowerPoint Presentation Slides to deliver a gripping presentation. Using the coronavirus PPT theme, you can display global epicenters of this pandemic on a world map diagram. With the help of this corona PowerPoint slideshow, you can spread awareness by communicating symptoms of the disease. Demonstrate the healthcare system capacity and the number of cases using the line graph given in the COVID 19 PPT template. The concise dashboard diagrams included in this 2019-nCoV disease PowerPoint presentation are appropriate to showcase key statistics of the pandemic. Novel coronavirus pneumonia PPT slideshow helps you to highlight the major pandemics of the modern era like the 1700s smallpox outbreak. Elucidate country-wise stats related to the disease using the dashboard layout in this severe pneumonia with novel pathogens PowerPoint theme. So, download this COVID-19 PPT presentation to outline the affected areas, precautionary measures, and other fundamentals. https://bit.ly/3yA9QwF
This study aimed to understand the sources and modes of transmission of SARS-CoV-2 among healthcare workers and patients at three hospitals in the Netherlands in March 2020. The researchers screened 1796 (15%) of healthcare workers for SARS-CoV-2 infection, finding 96 (5%) tested positive. Whole genome sequencing was performed on samples from 50 healthcare workers and 10 patients, finding most sequences grouped in three clusters, two showing local circulation. The patterns were consistent with multiple community introductions and local amplification, rather than widespread nosocomial transmission. While direct hospital transmission could not be ruled out, the data did not support hospitals as the primary source of infection in patients or healthcare workers early in the outbreak.
Final exam english ii reynaldi 20160700011Reynaldi18
The document summarizes the spread of COVID-19 from China to other countries in early 2020. It describes the symptoms and transmission of the virus, as well as control measures taken like travel restrictions. Analysis suggested the quarantine around Wuhan only modestly delayed spread within China. There were no specific antiviral treatments available yet. WHO is working to develop vaccines and coordinate the global response. Proper hygiene and social distancing are encouraged to slow transmission until a vaccine is found.
Correlation between Human Origin and the Severity of COVID19ijtsrd
It has been reported that the severity of coronavirus infectious disease COVID 19 is due to several factors such as age and the presence or absence of chronic disease. Furthermore, it has been reported that genetic factors affect the severity of COVID 19. A recently published study of the COVID 19 Host Genetics Initiative suggests that genetic manifolds in the region located on chromosome 3 may increase the risk of the severity of COVID 19. Takuma Hayashi | Ikuo Konishi "Correlation between Human Origin and the Severity of COVID19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33684.pdf Paper Url: https://www.ijtsrd.com/medicine/other/33684/correlation-between-human-origin-and-the-severity-of-covid19/takuma-hayashi
The COVID-19 outbreak has hit Europe hard, with Italy having the second largest number of confirmed cases after China. The rapid surge is posing a serious threat to Italy's health system due to limited intensive care capacity. While early exponential projections predicted over 30,000 cases in Italy by March 15, restrictive measures introduced on March 9 and 11 resulted in about 24,747 actual cases, suggesting the measures began reducing new cases within 3-4 days. All other European countries now appear to be in a similar situation to Italy, just a short time-lag behind. Immediate, very restrictive measures are urged to limit viral spread, ensure adequate healthcare response, and reduce mortality.
The document discusses the COVID-19 outbreak in Italy. It summarizes the increasingly strict measures the Italian government has taken to limit citizens' movement and close public spaces. As of March 16th, there were over 27,000 confirmed cases in Italy, a rate of growth that has doubled over the past week. Data on patient characteristics and outcomes is still limited. Improved collection and sharing of surveillance data across countries is needed to better inform the response.
At the end of December 2019, Chinese authorities reported an outbreak of acute respiratory syndrome in Wuhan, China caused by a novel coronavirus (SARS-CoV-2). On January 30, 2020 the WHO declared it a Public Health Emergency of International Concern and on March 11 a pandemic. There are now over 2.9 million confirmed cases globally with over 200,000 deaths across 213 countries/areas. The US has the most cases while Europe is currently the epidemic center. Risk is considered moderate for the general population but very high for elderly and healthcare systems.
This document provides an overview of measles outbreaks in several European countries in early 2014. It summarizes that 6,335 measles cases were reported in Europe in the first quarter of 2014, with over 80% of cases coming from 4 countries. It then describes in detail measles outbreaks occurring in the Czech Republic, Latvia, and Ireland, including the numbers of cases, affected age groups, genotypes identified, and control measures implemented.
Contributors are students, faculty, and alumni located in a variety of geographic locations from Yale, Tulane, and Sacred Heart Universities. It provides information gathered from situation reports, government and non-governmental organization, media reporting, and a variety of information sources, verifies and synchronizes the information and provide real-time information products to federal, state, local, nongovernmental and international response organizations.
A Meta-Analysis of COVID-19. This meta-analysis does not provide all of the answers regarding the appropriate course of action but is intended to help provide clarity assessing many of the MEDICAL considerations at play in the current pandemic. A responsible course of action addressing this pandemic must balance out a range of interconnected Medical, Economic and Social considerations.
This report specifically looks at the impact COVID-19 has had on nursing homes and the nursing home industry. Contributors are students, faculty, and alumni located in a variety of geographic locations from Yale, Tulane, and Sacred Heart Universities. It provides information gathered from situation reports, government and non-governmental organization, media reporting, and a variety of information sources, verifies and synchronizes the information and provide real-time information products to federal, state, local, nongovernmental and international response organizations.
The document discusses Sars-Cov-2 and Covid-19. It provides statistics on cases globally and in India. It describes the virus, including that it is a coronavirus similar to SARS. It discusses WHO declaring Covid-19 a public health emergency. It outlines symptoms, high risk groups, diagnosis methods, clinical management including drugs like hydroxychloroquine and remdesivir, and steps to take if experiencing symptoms.
Fact and Opinion about COVID-19 outbreak/Project Englishdanieldwi2
The document discusses the COVID-19 pandemic, caused by the SARS-CoV-2 virus. It describes how the outbreak began in Wuhan, China in December 2019 and was declared a pandemic by the WHO in March 2020. The virus spreads primarily through respiratory droplets from coughs and sneezes and can also spread by touching contaminated surfaces. Common symptoms include fever, cough and shortness of breath. There is no vaccine and treatment focuses on relieving symptoms. Preventive measures include hand washing, social distancing and self-isolation of those infected. The pandemic has caused major global socioeconomic disruptions.
The Coronavirus (COVID-19) Outbreak and Data-driven Healthcare: A Biomedical ...Jake Chen
The ongoing outbreak of coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, has led to more than 80,000 confirmed cases and nearly 3000 deaths worldwide since December 2019. There is a race in the biomedical research community to publish findings on a wide spectrum of topics, from pathogenicity, viral genome characterization, genetic epidemiology, disease management, treatment, to drug and vaccine development. I will review literature primarily from the epidemiology, genomics, computational biology, and translational bioinformatics perspectives to help us understand the basic biomedical research questions related to the COVID-19 outbreak. These questions include: what is a coronavirus, how the viral genome is organized, how it compares with SARS, what biochemical and genomic characteristics that it has to make it so virulent, and what genomics/informatics/drug discovery opportunities there are. The rapid data collection, analysis, publication, healthcare intervention, and drug development presents a promising new model for “data-driven healthcare” in response to future major disease outbreak events.
A Perspective Approach of Community Medicine in Corona Virus Disease COVID 19ijtsrd
Coronavirus disease COVID 19 is an infectious disease caused by the SARS CoV 2 coronavirus, which has spread rapidly across the world. The World Health Organization WHO proclaimed the COVID 19 outbreak a pandemic in March 2020. The pandemic has wreaked havoc on global health systems, as well as economic and social development. The rate of transmission is relatively high.As a result, regardless of vaccine history or previous infection, the CDC recommends that anyone with any signs or symptoms of COVID 19 be checked. Everyday Preventive Actions, as well as having the Covid 19 Vaccine when it is safe, will protect you and your loved ones. Prof. Dr. Anup Kumar Das | Dr. Humani Sharma | Dr. Hitarth Mehta "A Perspective Approach of Community Medicine in Corona Virus Disease (COVID 19)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd43677.pdf Paper URL: https://www.ijtsrd.comother-scientific-research-area/other/43677/a-perspective-approach-of-community-medicine-in-corona-virus-disease-covid-19/prof-dr-anup-kumar-das
Description: The COVID-19 pandemic has taken the world by storm, bringing world economies to its knees. These slides give an overview of coronaviruses, its discovery, as well as a comparison between SARS, MERS and the latest COVID-19. Slides revised to include upcoming topics.
Corona viruses are a group of RNA viruses. In late December 2019, Patients with pneumonia with unknown etiology was get admitted in health care facilities in Wuhan, China, and resulted in a pandemic disease which affected more than 200 countries and responsible for 182,989 deaths world wide. The disease is officially named as Coronavirus Disease 2019 COVID 19, by WHO on February 11, 2020 . COVID 19 is a potential zoonotic disease with low to moderate estimated 2 -5 mortality rate. Currently, there is no definite treatment for COVID 19 although some trials are under investigation. Hence, appropriate use of PPE, regular hand hygiene, Respiratory and cough etiquettes, social distancing are some key elements to prevent the spread of disease. Ms. Pabalpreet Kaur | Ms. Eenu | Ms. Pooja Jaswal | Dr. (Mrs.) Jyoti Sarin "The Outbreak of COVID-19: An Overview" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30859.pdf Paper Url :https://www.ijtsrd.com/medicine/nursing/30859/the-outbreak-of-covid19-an-overview/ms-pabalpreet-kaur
SARS-CoV-2 variants of concern and variants under investigation in EnglandSociété Tripalio
Rapport officiel du Public Health England concernant l'épidémie de coronavirus en Angleterre. Ce document montre que les vaccinés sont plus souvent malades du COVID (variant indien) que les non-vaccinés.
- The document discusses the Covid-19 pandemic, providing an overview of the virus and its spread worldwide. It notes that Covid-19 has infected over 3.7 million people globally, causing over 259,000 deaths.
- Symptoms of Covid-19 range from mild to severe and can include fever, cough, shortness of breath. Around 14% of cases progress to pneumonia and 5% are critical. The elderly and those with preexisting conditions are at higher risk.
- Covid-19 is diagnosed through PCR tests of nasal and throat swabs. Antibody tests can also detect if a person has been infected. The case fatality rate of Covid-19 is around 2.
The document summarizes information about COVID-19 (coronavirus). It begins by defining COVID-19 and describing its origins and transmission. It then discusses the global spread of the virus over time. The document outlines the virus's structure, replication cycle, and symptoms. It provides details on prevention, treatment, and experimental drug options. It concludes by discussing factors that increase risk of infection. The summary covers the key topics, causes, and timeline of the ongoing COVID-19 pandemic.
Nazi concentration camp survivors letter to ICC 20.9.2021Guy Boulianne
This letter is written by Nazi concentration camp survivors to the ICC Prosecutor in support of an investigation into COVID-19 vaccines. It argues that the vaccines do not meet the standards of informed consent as outlined in the Nuremberg Code and constitute a crime against humanity. It cites evidence of deaths and injuries reported to databases to call for an immediate halt to vaccination programs and investigation of perpetrators. The letter writers believe another atrocious crime against humanity is occurring through forced medical experimentation on a global scale.
guidelines of WHO on Coronavirus, structure of coronavirus, prevention and ongoing researches for COVID-19, what does pandemic mean, role of immune system for coronavirus and how to improve general immunity, how COVID-19 got its name, about SARS-CoV-2, when and how to use mask and dispose it off, myths related to coronavirus, studies going on in Oxford University for vaccine of COVID-19 from chimpanzee called as ChAdOx1 nCoV-19
The document summarizes information about the COVID-19 pandemic from various sources such as newspapers, social media platforms, and blogs. It discusses how the pandemic has impacted different countries and some key steps governments have taken in response. It also compares the accuracy of information provided on newspapers, social media, and blogs, concluding that newspapers and blogs generally provide more reliable information than social media.
Apvs2013 06 castellan et al.-clinical case report of h1 n1pdm in italyMerial EMEA
This document summarizes a clinical case report of an outbreak of pandemic H1N1 influenza virus (H1N1pdm) in an Italian pig farm between July 2012 and March 2013. The farm experienced increased respiratory disease and mortality in post-weaned pigs, testing confirmed the presence of H1N1pdm virus. A vaccination program was implemented using an inactivated trivalent swine influenza vaccine. Following vaccination of sows and piglets, clinical signs reduced and virus detection decreased, controlling the H1N1pdm outbreak.
Prevalence of HCV virus genotypes in Albaniatheijes
The epidemic of Hepatitis C virus infection is continuously evolving in Albania such as in Europe. Until now the intravenous drug use has become the main risk factor for the HCV transmission, prevalent infections have increased and genotype distribution has changed and diversified. Meanwhile in Eastern European countries epidemiological data are limited such as in Albania. Through this study, we furnish more information about the prevalence of HCV virus genotypes in Albania. Methods: In this study we enrolled 174 subjects HCV RNA positive during the period 2007-2015 with an median age of 38.7 years old, from the Public Health Institute and National Blood Transfusion Centre, Albania. Results: The HCV virus genotype 1b is the most frequent with 35.6% (62/174). It’s important to mention that genotype 3 and 3a is more frequent among IDU (Intravenous drug users). Conclusions: Even though limited data, we noticed that HCV virus genotype 1b is the most frequent in Albania such as in other countries of Central-South Europe. Parenteral route of transmission of different subtypes of this virus in Albania is very evident, but further epidemiological studies are required.
The document discusses the COVID-19 outbreak in Italy. It summarizes the increasingly strict measures the Italian government has taken to limit citizens' movement and close public spaces. As of March 16th, there were over 27,000 confirmed cases in Italy, a rate of growth that has doubled over the past week. Data on patient characteristics and outcomes is still limited. Improved collection and sharing of surveillance data across countries is needed to better inform the response.
At the end of December 2019, Chinese authorities reported an outbreak of acute respiratory syndrome in Wuhan, China caused by a novel coronavirus (SARS-CoV-2). On January 30, 2020 the WHO declared it a Public Health Emergency of International Concern and on March 11 a pandemic. There are now over 2.9 million confirmed cases globally with over 200,000 deaths across 213 countries/areas. The US has the most cases while Europe is currently the epidemic center. Risk is considered moderate for the general population but very high for elderly and healthcare systems.
This document provides an overview of measles outbreaks in several European countries in early 2014. It summarizes that 6,335 measles cases were reported in Europe in the first quarter of 2014, with over 80% of cases coming from 4 countries. It then describes in detail measles outbreaks occurring in the Czech Republic, Latvia, and Ireland, including the numbers of cases, affected age groups, genotypes identified, and control measures implemented.
Contributors are students, faculty, and alumni located in a variety of geographic locations from Yale, Tulane, and Sacred Heart Universities. It provides information gathered from situation reports, government and non-governmental organization, media reporting, and a variety of information sources, verifies and synchronizes the information and provide real-time information products to federal, state, local, nongovernmental and international response organizations.
A Meta-Analysis of COVID-19. This meta-analysis does not provide all of the answers regarding the appropriate course of action but is intended to help provide clarity assessing many of the MEDICAL considerations at play in the current pandemic. A responsible course of action addressing this pandemic must balance out a range of interconnected Medical, Economic and Social considerations.
This report specifically looks at the impact COVID-19 has had on nursing homes and the nursing home industry. Contributors are students, faculty, and alumni located in a variety of geographic locations from Yale, Tulane, and Sacred Heart Universities. It provides information gathered from situation reports, government and non-governmental organization, media reporting, and a variety of information sources, verifies and synchronizes the information and provide real-time information products to federal, state, local, nongovernmental and international response organizations.
The document discusses Sars-Cov-2 and Covid-19. It provides statistics on cases globally and in India. It describes the virus, including that it is a coronavirus similar to SARS. It discusses WHO declaring Covid-19 a public health emergency. It outlines symptoms, high risk groups, diagnosis methods, clinical management including drugs like hydroxychloroquine and remdesivir, and steps to take if experiencing symptoms.
Fact and Opinion about COVID-19 outbreak/Project Englishdanieldwi2
The document discusses the COVID-19 pandemic, caused by the SARS-CoV-2 virus. It describes how the outbreak began in Wuhan, China in December 2019 and was declared a pandemic by the WHO in March 2020. The virus spreads primarily through respiratory droplets from coughs and sneezes and can also spread by touching contaminated surfaces. Common symptoms include fever, cough and shortness of breath. There is no vaccine and treatment focuses on relieving symptoms. Preventive measures include hand washing, social distancing and self-isolation of those infected. The pandemic has caused major global socioeconomic disruptions.
The Coronavirus (COVID-19) Outbreak and Data-driven Healthcare: A Biomedical ...Jake Chen
The ongoing outbreak of coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, has led to more than 80,000 confirmed cases and nearly 3000 deaths worldwide since December 2019. There is a race in the biomedical research community to publish findings on a wide spectrum of topics, from pathogenicity, viral genome characterization, genetic epidemiology, disease management, treatment, to drug and vaccine development. I will review literature primarily from the epidemiology, genomics, computational biology, and translational bioinformatics perspectives to help us understand the basic biomedical research questions related to the COVID-19 outbreak. These questions include: what is a coronavirus, how the viral genome is organized, how it compares with SARS, what biochemical and genomic characteristics that it has to make it so virulent, and what genomics/informatics/drug discovery opportunities there are. The rapid data collection, analysis, publication, healthcare intervention, and drug development presents a promising new model for “data-driven healthcare” in response to future major disease outbreak events.
A Perspective Approach of Community Medicine in Corona Virus Disease COVID 19ijtsrd
Coronavirus disease COVID 19 is an infectious disease caused by the SARS CoV 2 coronavirus, which has spread rapidly across the world. The World Health Organization WHO proclaimed the COVID 19 outbreak a pandemic in March 2020. The pandemic has wreaked havoc on global health systems, as well as economic and social development. The rate of transmission is relatively high.As a result, regardless of vaccine history or previous infection, the CDC recommends that anyone with any signs or symptoms of COVID 19 be checked. Everyday Preventive Actions, as well as having the Covid 19 Vaccine when it is safe, will protect you and your loved ones. Prof. Dr. Anup Kumar Das | Dr. Humani Sharma | Dr. Hitarth Mehta "A Perspective Approach of Community Medicine in Corona Virus Disease (COVID 19)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd43677.pdf Paper URL: https://www.ijtsrd.comother-scientific-research-area/other/43677/a-perspective-approach-of-community-medicine-in-corona-virus-disease-covid-19/prof-dr-anup-kumar-das
Description: The COVID-19 pandemic has taken the world by storm, bringing world economies to its knees. These slides give an overview of coronaviruses, its discovery, as well as a comparison between SARS, MERS and the latest COVID-19. Slides revised to include upcoming topics.
Corona viruses are a group of RNA viruses. In late December 2019, Patients with pneumonia with unknown etiology was get admitted in health care facilities in Wuhan, China, and resulted in a pandemic disease which affected more than 200 countries and responsible for 182,989 deaths world wide. The disease is officially named as Coronavirus Disease 2019 COVID 19, by WHO on February 11, 2020 . COVID 19 is a potential zoonotic disease with low to moderate estimated 2 -5 mortality rate. Currently, there is no definite treatment for COVID 19 although some trials are under investigation. Hence, appropriate use of PPE, regular hand hygiene, Respiratory and cough etiquettes, social distancing are some key elements to prevent the spread of disease. Ms. Pabalpreet Kaur | Ms. Eenu | Ms. Pooja Jaswal | Dr. (Mrs.) Jyoti Sarin "The Outbreak of COVID-19: An Overview" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30859.pdf Paper Url :https://www.ijtsrd.com/medicine/nursing/30859/the-outbreak-of-covid19-an-overview/ms-pabalpreet-kaur
SARS-CoV-2 variants of concern and variants under investigation in EnglandSociété Tripalio
Rapport officiel du Public Health England concernant l'épidémie de coronavirus en Angleterre. Ce document montre que les vaccinés sont plus souvent malades du COVID (variant indien) que les non-vaccinés.
- The document discusses the Covid-19 pandemic, providing an overview of the virus and its spread worldwide. It notes that Covid-19 has infected over 3.7 million people globally, causing over 259,000 deaths.
- Symptoms of Covid-19 range from mild to severe and can include fever, cough, shortness of breath. Around 14% of cases progress to pneumonia and 5% are critical. The elderly and those with preexisting conditions are at higher risk.
- Covid-19 is diagnosed through PCR tests of nasal and throat swabs. Antibody tests can also detect if a person has been infected. The case fatality rate of Covid-19 is around 2.
The document summarizes information about COVID-19 (coronavirus). It begins by defining COVID-19 and describing its origins and transmission. It then discusses the global spread of the virus over time. The document outlines the virus's structure, replication cycle, and symptoms. It provides details on prevention, treatment, and experimental drug options. It concludes by discussing factors that increase risk of infection. The summary covers the key topics, causes, and timeline of the ongoing COVID-19 pandemic.
Nazi concentration camp survivors letter to ICC 20.9.2021Guy Boulianne
This letter is written by Nazi concentration camp survivors to the ICC Prosecutor in support of an investigation into COVID-19 vaccines. It argues that the vaccines do not meet the standards of informed consent as outlined in the Nuremberg Code and constitute a crime against humanity. It cites evidence of deaths and injuries reported to databases to call for an immediate halt to vaccination programs and investigation of perpetrators. The letter writers believe another atrocious crime against humanity is occurring through forced medical experimentation on a global scale.
guidelines of WHO on Coronavirus, structure of coronavirus, prevention and ongoing researches for COVID-19, what does pandemic mean, role of immune system for coronavirus and how to improve general immunity, how COVID-19 got its name, about SARS-CoV-2, when and how to use mask and dispose it off, myths related to coronavirus, studies going on in Oxford University for vaccine of COVID-19 from chimpanzee called as ChAdOx1 nCoV-19
The document summarizes information about the COVID-19 pandemic from various sources such as newspapers, social media platforms, and blogs. It discusses how the pandemic has impacted different countries and some key steps governments have taken in response. It also compares the accuracy of information provided on newspapers, social media, and blogs, concluding that newspapers and blogs generally provide more reliable information than social media.
Apvs2013 06 castellan et al.-clinical case report of h1 n1pdm in italyMerial EMEA
This document summarizes a clinical case report of an outbreak of pandemic H1N1 influenza virus (H1N1pdm) in an Italian pig farm between July 2012 and March 2013. The farm experienced increased respiratory disease and mortality in post-weaned pigs, testing confirmed the presence of H1N1pdm virus. A vaccination program was implemented using an inactivated trivalent swine influenza vaccine. Following vaccination of sows and piglets, clinical signs reduced and virus detection decreased, controlling the H1N1pdm outbreak.
Prevalence of HCV virus genotypes in Albaniatheijes
The epidemic of Hepatitis C virus infection is continuously evolving in Albania such as in Europe. Until now the intravenous drug use has become the main risk factor for the HCV transmission, prevalent infections have increased and genotype distribution has changed and diversified. Meanwhile in Eastern European countries epidemiological data are limited such as in Albania. Through this study, we furnish more information about the prevalence of HCV virus genotypes in Albania. Methods: In this study we enrolled 174 subjects HCV RNA positive during the period 2007-2015 with an median age of 38.7 years old, from the Public Health Institute and National Blood Transfusion Centre, Albania. Results: The HCV virus genotype 1b is the most frequent with 35.6% (62/174). It’s important to mention that genotype 3 and 3a is more frequent among IDU (Intravenous drug users). Conclusions: Even though limited data, we noticed that HCV virus genotype 1b is the most frequent in Albania such as in other countries of Central-South Europe. Parenteral route of transmission of different subtypes of this virus in Albania is very evident, but further epidemiological studies are required.
1. The study evaluated the antiviral effects of remdesivir and chloroquine against 2019-nCoV in vitro.
2. Both remdesivir and chloroquine potently blocked infection at low micromolar concentrations and showed clear dose-dependent antiviral effects.
3. Time-of-addition experiments indicated that both drugs targeted the early stages of the 2019-nCoV life cycle.
01 ....Epidemiology. Global Update..pptxRuchaBendale3
This document summarizes epidemiological information about COVID-19. It describes the origin and timeline of the outbreak in Wuhan, China. It provides details on transmission mechanisms, clinical presentation, severity, risk groups, and comparisons to SARS and MERS. Epidemic curves for China, other countries and India are shown. The response in China included lockdowns, hospitals, and information sharing. Ongoing risks include asymptomatic transmission and rising international cases, though containment is still possible with testing, contact tracing and isolation.
1. The SARS-CoV-2 pandemic continues to spread in India, with the curve not yet flattened and cases still rising. The coming month of July is predicted to see worsening of the pandemic in India.
2. As of July 14th, India has seen over 970,000 total cases and 24,929 deaths, surpassing Russia to become the third most affected country. Around 331,505 cases remain active.
3. Various diagnostic tests and their significance, classifications of COVID-19 disease severity, common radiological findings, and epidemiological data are discussed in detail in the document. Increased awareness and improved hospital facilities are needed to better tackle the pandemic in India.
This document is a weekly bulletin from the Center of Influenza and Acute Respiratory Viral Infections of the State Institution "Ukrainian Center for Control and Monitoring of Diseases" providing information and analysis on the incidence of influenza and acute respiratory viral infections (ARVI) in Ukraine for week 43. It finds that 162,689 people became ill with influenza and ARVI during the reporting week, with the highest incidence in Kiev region and lowest in Ternopil region. Virological monitoring identified parainfluenza viruses as the most common, though influenza viruses were not detected. Sanitary-educational work continued to promote prevention and vaccination.
Estudio del Instituto de Salud Carlos III sobre la transmisión del SARS-CoV-2...20minutos
- Phylogenetic analysis of the first 28 SARS-CoV-2 genomes from Spain found that most belonged to the G and S clades, with 13 sequences each, and two in the V clade.
- Eleven Spanish S clade sequences grouped in the monophyletic S-Spain cluster along with sequences from 6 other countries, suggesting dissemination from Spain.
- Six Spanish G clade sequences grouped in the G-Spain cluster, with the earliest sequence from Germany, suggesting introduction from there.
This document summarizes recent measles outbreaks and epidemiology in Europe. It finds that measles remains endemic in 6 EU countries and that vaccination coverage for the first and second dose of the MMR vaccine remains below 95% in over half of reporting countries. Outbreaks in 2017 have already exceeded case numbers for all of 2016 in some countries. The majority of recent cases are in unvaccinated individuals, especially children ages 1-4 who are the target group for routine vaccination. Several outbreaks have also affected healthcare workers. Actions are needed to strengthen routine childhood vaccination and increase vaccination rates to eliminate measles transmission.
This document discusses swine flu, also known as influenza A subtype H1N1. It provides information on the virus classification, structure, replication stages, and types including seasonal influenza, pandemic influenza, antigenic drift, and antigenic shift. It also summarizes data on swine flu cases and deaths globally and in specific regions. Clinical features, pathogenesis, and definitions of swine flu cases are outlined.
- The study monitored 10 healthy individuals for over 35 years to investigate the duration of protective immunity against reinfection from the four seasonal human coronaviruses (HCoV-NL63, HCoV-229E, HCoV-OC43, HCoV-HKU1).
- A total of 101 coronavirus infection events were detected using serum samples to measure antibody levels against the nucleocapsid protein of each coronavirus.
- Reinfections were frequently observed at around 12 months after the initial infection. Some reinfections occurred within 6-9 months, but no reinfections were seen within the first 3 months during follow-up visits.
- The study suggests that protective immunity against seasonal coronavirus reinfection is
This document summarizes a study on the isolation and identification of seasonal influenza virus subtypes (H1N1, H3N2) and type B from human samples in Al Najaf, Iraq from March 2012 to April 2013. Three methods were used to detect influenza viruses: plasma pH testing, rapid testing devices, and real-time PCR. Of the 1000 samples tested, 647 cases were positive for influenza virus. The most common subtype was H3N2 at 283 cases, followed by H1N1 at 148 cases and type B at 130 cases. Plasma pH testing identified positive cases as having pH levels lower than normal ranges. Rapid testing devices and real-time PCR were then used for confirmation and identification
1. The document summarizes the current state of knowledge about COVID-19, including its origin, pathophysiology, epidemiology, clinical presentation, diagnosis, and management.
2. Key points include that SARS-CoV-2 likely evolved through natural selection in an animal host before transferring to humans, its optimal binding to the human ACE2 receptor, and viral shedding occurring for up to 37 days including in asymptomatic cases.
3. Clinical presentation varies from mild to critical illness, with risk factors for severe disease including older age and comorbidities. Lymphopenia and elevated inflammatory markers are common lab findings.
After several years of decreasing trend, foodborne hepatitis A virus (HAV) infection has re-emerged as a public health problem in EU/EEA since 2011. Several consecutive multi-country foodborne HAV outbreaks were experienced in Europe 2012-2014.
This presentation covers the epidemiology of influenza, including H1N1 influenza. It discusses the influenza virus types and subtypes, including antigenic shift and drift. It describes the 2009 H1N1 pandemic virus and the global, regional, and national epidemiological burden. Host and environmental epidemiological determinants are examined. The modes of transmission, clinical features, diagnosis, case management, prevention and control measures, and the national response are summarized.
Mealesss Global Regional MR Elimination OverviewLourduAnthoni1
This document provides an overview of measles, rubella, and measles-rubella (MR) vaccination strategies and progress in eliminating these diseases globally and within specific countries and regions. It summarizes key facts about measles and rubella, including symptoms, complications, mortality rates, burden of congenital rubella syndrome, and the effectiveness of the MR vaccine. It also presents data on reported measles and rubella cases and outbreaks in India at the national, state, and city levels to illustrate disease distribution and vaccination progress. The overall aim is to promote MR vaccination campaigns and strategies to achieve over 95% population immunity through two doses of the vaccine to eliminate measles, rubella, and congenital rubella syndrome.
Poster presentation at the AIDS 2018 conference in Amsterdam.
By: Marieke J. van der Werf and Csaba Ködmön, European Centre for Disease Prevention and Control, ECDC.
Lecture from World Vaccine Congress, Washington 2016. This presentation provides further information about different viral challenge agents and the relative merits of two common influenza serotypes for vaccine clinical trials.
1) 58,994 TB cases were notified in 30 EU/EEA countries in 2016, with a notification rate of 11.4 per 100,000 population. The number and rate of TB cases have declined continuously between 2007-2016.
2) The highest notification rates in 2016 were among those aged 25-44, and males had higher rates than females in all groups over 14. Rates have declined annually by 2-4% in all age groups between 2007-2016.
3) 32.7% of cases in 2016 were in persons of foreign origin, an increase from 21% in 2007. The rate of cases in foreign-born persons was stable between 2007-2016.
Estimates of the severity of coronavirus disease 2019 - a model-based analysisGuy Boulianne
This study used individual-level case data and aggregate case/death counts from China, Hong Kong, Macau, and other countries to estimate key severity metrics for COVID-19, accounting for biases. The researchers estimated that the mean duration from symptom onset to death is 17.8 days, and to hospital discharge is 24.7 days. They estimated the case fatality ratio in China to be 1.38% overall but higher in older age groups, and the infection fatality ratio in China to be 0.66% with increasing risk with age. They also estimated the proportion of infections likely to require hospitalization increases with age up to 18.4% for those aged 80+.
Similar to Influenza virus-characterisation-march-2016 (20)
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
2. ECDC SURVEILLANCE REPORT Influenza virus characterisation, March 2016
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Table 1 shows a summary of influenza virus detections in the WHO European Region reported to TESSy for the
first 27 weeks (weeks 40/2015 – 13/2016) of reporting for the 2015–16 season. A total of over 120 000 detections
had been made with type A viruses prevailing over type B at a ratio of 2.8:1; this compares to a ratio of 5.8:1 to
week 7/2016, indicating a surge in influenza type B circulation over the last six weeks. So far, of the type A viruses
subtyped (n = 61 723) and the type B viruses ascribed to lineage (n = 5 846), A(H1N1)pdm09 have prevailed over
A(H3N2) and B/Victoria over B/Yamagata by ratios of 11:1 and 15:1, respectively.
Since the start of weekly reporting for the 2015–16 influenza season (week 40/2015), 44 shipments of specimens
have been received at the Crick Worldwide Influenza Centre (WIC), from 24 countries in the EU/EEA (Table 2). Of
the 472 specimens received, a mix of clinical samples and virus isolates, the majority (82.8%) were type A viruses,
and A(H1N1)pdm09 outnumbered A(H3N2) at a ratio of 4.8:1. Of the 81 type B specimens received (17.2% of the
specimens), 66 were B/Victoria-lineage and 10 B/Yamagata-lineage. A number of specimens are still in the process
of being characterised. The antigenic and genetic properties of influenza virus isolates characterised since the
February 2016 report1
are presented and discussed in this report.
Table 1. Influenza virus detections in the WHO European Region since the start of reporting for the
2015–16 season (weeks 40/2015 – 13/2016)
_____
1
European Centre for Disease Prevention and Control. Influenza virus characterisation, summary Europe, February 2016.
Stockholm: ECDC; 2016. Available from: http://ecdc.europa.eu/en/publications/Publications/influenza-virus-characterisation-
february-2016.pdf
Virus type/subtype Sentinel sources Non-sentinel sources Totals % Ratios
Influenza A 10021 81267 91288 73.7 2.8:1
A(H1N1)pdm09 8293 48102 56395 91.4 10.6:1
A(H3N2) 1253 4075 5328 8.6
A not subtyped 475 29090 29565
Influenza B 6965 25629 32594 26.3
Victoria lineage 3353 2128 5481 93.8 15.1:1
Yamagata lineage 90 275 365 6.2
Lineage not ascribed 3522 23226 26748
Total detections (total tested) 16986 (45816) 106896 (461151) 123882 (506967)
Cumulative number of detections Totals*
* Percentages are shown for total detections (types A & B, and for viruses ascribed to subtype/lineage). Ratios are given for
type A:B, A(H1N1)pdm09: A(H3N2) and Victoria:Yamagata lineages.
3. ECDC SURVEILLANCE REPORT Influenza virus characterisation, March 2016
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Table 2. Summary of clinical samples and virus isolates received from EU/EEA Member States:
packages received since the start of the 2015–16 reporting period (week 40/2015)
MONTH* TOTAL
RECEIVED
Country
2015
SEPTEMBER
Iceland 1 1 1
Poland 1 1 0 0
Spain 1 1 1
Sweden 1 1 1
United Kingdom 3 3 3 0
OCTOBER
Austria 1 1 1
Belgium 1 1 1
France 2 2 2
Germany 2 1 1 1 1
Italy 2 1 1 1 1
Latvia 1 1 1
Netherlands 1 1 1
Norway 11 8 6 2 2 0 1 1
Portugal 1 1 1
Romania 1 1 1
Slovenia 2 1 0 1 1
Spain 2 2 1
Sweden 1 1 0 1
United Kingdom 8 7 7 1 1
NOVEMBER
Austria 9 5 5 4 4 0
Belgium 11 2 1 1 0 1 6 6 2 2
Denmark 1 1 1
Estonia 3 3 0
Finland 4 2 2 2 1 1
France 5 1 1 1 1 0 3 3
Germany 14 11 11 2 0 2 1 1
Italy 2 1 1 0 1 1
Netherlands 7 5 5 2 2
Norway 11 7 6 1 1 0 1 1 2 2
Poland 1 1 0
Portugal 8 8 7
Slovenia 3 2 0 2 1 0
Spain 5 2 0 2 1 1 1 0
Sweden 11 7 7 4 4 0
United Kingdom 7 7 5
DECEMBER
Austria 3 3 2 1
Czech Republic 2 2 2
Denmark 7 7 7
Estonia 6 1 0 1 0 4 3
Finland 8 7 6 1 1 0
France 24 7 7 2 2 0 15 15
Germany 21 17 17 3 3 0 1 1
Greece 6 5 3 1 0 1
Iceland 3 1 1 1 0 1 1 1
Ireland 4 2 2 1 0 1 1 1
Italy 8 3 3 5 2 3
Latvia 4 3 3 1 in process
Netherlands 5 5 5
Norway 5 3 3 2 1 1
Poland 12 10 0 1 1 1 0
Portugal 14 10 7 3 2 1 1 1
Romania 1 1 0 1
Slovenia 5 5 1 3
Spain 14 8 7 2 0 1 4 4
United Kingdom 3 3 3
2016
JANUARY
Cyprus 15 9 in process 1 1 0 5 in process
Czech Republic 3 3 3
Estonia 3 2 0 1 1
Germany 24 11 11 3 3 0 8 8 2 2
Greece 27 27 in process
Hungary 7 4 4 3 3
Iceland 6 5 5 1 1
Ireland 10 9 9 1 1
Italy 1 1 1
Netherlands 2 2 2
Portugal 6 6 6
Romania 8 7 7 1 0 1
Slovenia 8 3 3 3 0 3 2 0
Spain 19 16 in process 1 0 1 1 in process 1 1
FEBRUARY
Cyprus 9 8 in process 1 in process
Greece 4 4 in process
Latvia 2 2 in process
Netherlands 1 1 1
Spain 17 15 in process 2 2
472 14 0 312 209 65 36 26 5 0 66 57 10 10
24 Countries
* Month indicates the months in which the clinical specimens were collected
1. Propagated to sufficient titre to perform HI assay
2. Propagated to sufficient titre to perform HI assay in presence of 20nM oseltamivir; numbers in red indicate viruses recovered but with insufficient HA titre to permit HI assay
A
82.8% 17.2%
B Yamagata lineageH1N1pdm09 H3N2 B Victoria lineage
66.1% 14.0% 2.1%
B
13.8%
Number
received
Number
propagated
Number
propagated1
Number
propagated2
Number
received
Number
received
Number
received
Number
received
Number
received
Number
propagated1
Number
propagated
Number
propagated1
4. ECDC SURVEILLANCE REPORT Influenza virus characterisation, March 2016
4
Influenza A(H1N1)pdm09 virus analyses
Haemagglutination inhibition (HI) analyses of viruses that have been performed since the February 2016 report
are shown in Tables 3-1 and 3-2. All 35 A(H1N1)pdm09 viruses from EU/EEA countries were antigenically similar
to the vaccine virus, A/California/7/2009. Generally, the test viruses were recognised by the panel of antisera at
titres within fourfold of the titres for the homologous viruses, with the exception of the antiserum raised against
A/Christchurch/16/2010. This antiserum recognised only 7/35 (20%) test viruses at a titre within fourfold of the
titre for the homologous virus. In addition, antiserum raised against A/Lviv/N6/2009 showed eightfold reduced
titres with 12 of the test viruses, compared to the homologous titre. Reference viruses carrying HA1 G155E amino
acid substitutions, A/Bayern/69/2009 and A/Lviv/N6/2009, showed reduced recognition by the antisera raised
against A/California/7/2009 and reference viruses in genetic clades 4, 5, 6, 7 and subclades 6A, 6B, 6B.1 and
6B.2.
While sequencing is still in process for the majority of test viruses indicated in Tables 3-1 and 3-2, the eight
viruses from the Netherlands all fell in subclade 6B.1 (Table 3-1). Since 2009, the HA genes have evolved, and
nine clades have been designated. For well over a year, viruses in clade 6, represented by A/St
Petersburg/27/2011 and carrying amino acid substitutions of D97N, S185T and S203T in HA1 and E47K and
S124N in HA2 compared with A/California/7/2009, have predominated worldwide with a number of subclades
emerging. All EU/EEA viruses characterised since the September 2014 report2
carry HA genes in subclade 6B,
which is characterised by additional amino acid substitutions of K163Q, A256T and K283E in HA1 and E172K
in HA2 compared with A/California/7/2009, e.g. A/South Africa/3626/2013. A number of virus clusters have
emerged within clade 6B and two of these have been designated as subclades: viruses in subclade 6B.1 are
defined by HA1 amino acid substitutions S84N, S162N (which results in the formation of a new potential
glycosylation motif at residues 162-164 of HA1) and I216T, while those in subclade 6B.2 are defined by HA1
amino acid substitutions V152T and V173I (Figure 1).
_____
2
European Centre for Disease Prevention and Control. Influenza virus characterisation, summary Europe, September 2014.
Stockholm: ECDC; 2014. Available from: http://ecdc.europa.eu/en/publications/Publications/Influenza-ERLI-Net-report-Sept-
2014.pdf
7. ECDC SURVEILLANCE REPORT Influenza virus characterisation, March 2016
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Figure 1. Phylogenetic comparison of influenza A(H1N1)pdm09 HA genes
8. ECDC SURVEILLANCE REPORT Influenza virus characterisation, March 2016
8
Influenza A(H3N2) virus analyses
As described in many previous reports3
, influenza A(H3N2) viruses continue to be difficult to characterise
antigenically by HI assay due to variable agglutination of red blood cells (RBCs) from guinea pigs, turkeys and
humans or the loss of the ability of viruses to agglutinate any of the RBCs. This is a particular problem for most
viruses that fall in genetic subgroup 3C.2a as was highlighted first in the November 2014 report4
.
Results of HI tests performed with guinea pig RBCs in the presence of 20nM oseltamivir, added to circumvent NA-
mediated binding of A(H3N2) viruses to the RBCs, are shown in Table 4. Of the six test viruses that retained
sufficient HA titre to be analysed by HI assay, four have been analysed genetically with three (from Germany)
falling in subclade 3C.3a and one in subclade 3C.2a.
The test viruses, propagated in MDCK-SIAT1 cells, reacted poorly in HI assays with the panel of post-infection
ferret antisera relative to the titres of the antisera with their respective homologous viruses (shown in red: Table
4). However, in terms of absolute titres, antisera raised against A/Stockholm/6/2014 (3C.3a: tissue culture- and
egg-propagated), tissue culture-propagated A/Hong Kong/5738/2014 (3C.2a), tissue culture-propagated
A/Georgia/532/2015 and A/Hong Kong/4801/2014 (3C.2a: tissue culture- and egg-propagated), gave consistent
reactivity with all test viruses. In terms of absolute titre, the antiserum raised against the northern hemisphere
2015–16 vaccine component, egg-propagated A/Switzerland/9715293/2013 (3C.3a) reacted with test viruses at
titres equivalent to (two viruses) or at least twofold-reduced (four viruses) compared to titres achieved with egg-
propagated A/Hong Kong/4801/2014, the virus recommended for use in vaccines for the southern hemisphere
2016 and northern hemisphere 2016–17 influenza seasons.
Since 2009, seven genetic groups based on the HA gene have been defined for A(H3N2) viruses. Phylogenetic
analysis of the HA genes of representative A(H3N2) viruses with recent collection dates is shown in Figure 2. The
HA genes fall within clade 3C. This clade has three subdivisions: 3C.1 (represented by A/Texas/50/2012, the
vaccine virus recommended for use in the 2014–15 northern hemisphere season), 3C.2 and 3C.3. Viruses in these
three subdivisions had been antigenically similar. In 2014, three new subclades emerged, one in subdivision 3C.2,
3C.2a, and two in 3C.3, 3C.3a and 3C.3b, with subclade 3C.2a viruses dominating in recent months (Figure 2).
While viruses in subclades 3C.2a and 3C.3a are antigenic drift variants, those in 3C.3b have remained antigenically
similar to previously circulating viruses in the 3C.3 subdivision. Amino acid substitutions that define these
subdivisions and subclades are:
(3C.2) N145S in HA1, and D160N in HA2, e.g. A/Hong Kong/146/2013
(3C.2a) Those in 3C.2 plus L3I, N144S (resulting in the loss of a potential glycosylation site), F159Y,
K160T (in the majority of viruses, resulting in the gain of a potential glycosylation site), N225D and
Q311H in HA1, e.g. A/Hong Kong/5738/2014
(3C.3) T128A (resulting in the loss of a potential glycosylation site), R142G and N145S in HA1, e.g.
A/Samara/73/2013
(3C.3a) those in 3C.3 plus A138S, F159S and N225D in HA1, many with K326R, e.g.
A/Switzerland/9715293/2013
(3C.3b) those in 3C.3 plus E62K, K83R, N122D (resulting in the loss of a potential glycosylation site),
L157S and R261Q in HA1 with M18K in HA2, e.g. A/Stockholm/28/2014.
Based on results available at the time of the February 2015 vaccine composition meeting showing cross-reactivity
of antisera raised against subclade 3C.3a and 3C.2a viruses, but with changes acquired on egg-adaptation of
genetic subgroup 3C.2a viruses and, at that time, the lack of a suitable 3C.2a vaccine candidate, the World Health
Organization recommendation was to use an A/Switzerland/9715293/2013-like virus as the A(H3N2) component of
vaccines for the northern hemisphere 2015–16 influenza season [1]. After February 2015, a new subclade
designated 3C.3b emerged, these three subclades being antigenically distinguishable, but subclade 3C.2a viruses
became prevalent and have remained so. While ferret antisera raised against 3C.3a and 3C.2a subclade viruses
showed some cross-reactivity with viruses in all three subclades, antisera raised against 3C.3b viruses were
subclade-specific. With the availability of new subclade 3C.2a vaccine candidates and the continued cross-
reactivity of antisera raised against viruses in subclades 3C.3a and 3C.2a viruses, the World Health Organization
recommendation for the A(H3N2) component of influenza vaccines for the southern hemisphere 2016 [2] and
northern hemisphere 2016-17 [3] influenza seasons was for an A/Hong Kong/4801/2014-like (3C.2a) virus.
_____
3
For example, the September 2013 report: European Centre for Disease Prevention and Control. Influenza virus characterisation,
summary Europe, September 2013. Stockholm: ECDC; 2013. Available from:
http://www.ecdc.europa.eu/en/publications/Publications/influenza-virus-characterisation-sep-2013.pdf
4
European Centre for Disease Prevention and Control. Influenza virus characterisation, summary Europe, November 2014.
Stockholm: ECDC; 2014. Available from: http://www.ecdc.europa.eu/en/publications/Publications/ERLI-Net report November
2014.pdf
10. ECDC SURVEILLANCE REPORT Influenza virus characterisation, March 2016
10
Figure 2. Phylogenetic comparison of influenza A(H3N2) HA genes
11. ECDC SURVEILLANCE REPORT Influenza virus characterisation, March 2016
11
Influenza B virus analyses
Eighty-one influenza type B viruses have been received from EU/EEA countries of which 76 were ascribed to a
lineage: 66 B/Victoria-lineage and 10 B/Yamagata-lineage (Table 2).
Influenza B – Victoria lineage
Since the February 2016 report, 23 viruses of this lineage from EU/EEA countries have been characterised
antigenically. HI results are shown in Table 5; as observed throughout the previous season, those test viruses for
which gene sequencing was completed carried HA genes of clade 1A.
The test viruses showed similar HI reactivity patterns to those from the 2014–15 influenza season: greater than
eightfold reductions in HI titres compared with the titre for the homologous virus with post-infection ferret antisera
raised against the recommended vaccine virus for quadrivalent live and inactivated vaccines for the northern
hemisphere 2015–16 influenza season, B/Brisbane/60/2008. Similarly, they were poorly recognised by post-
infection ferret antisera raised against the reference viruses propagated in eggs B/Malta/636714/2011,
B/Johannesburg/3964/2013 and B/South Australia/81/2012. In contrast, all but one test virus
(B/Catalonia/8514S/2016) showed reactivity within fourfold, the majority within twofold, of the titres for the
corresponding homologous viruses with antisera raised against viruses that are considered to be surrogate tissue
culture-propagated antigens representing the egg-propagated B/Brisbane/60/2008 prototype virus; these antisera
were raised against B/Paris/1762/2009, B/Odessa/3886/2010 and B/Hong Kong/514/2009.
Phylogenetic analysis of the HA gene of representative B/Victoria lineage viruses is shown in Figure 3. Worldwide,
recent viruses have HA genes that fall into the B/Brisbane/60/2008 clade (clade 1A) and remain antigenically
similar to the recommended vaccine virus, B/Brisbane/60/2008, for use in quadrivalent vaccines. The great
majority of viruses, with collection dates since October 2015, fall in a major sub-cluster defined by amino acid
substitutions N129D, V146I and I117V within clade 1A.
These results, linked with the rise in the proportion of B/Victoria-lineage viruses seen in the 2015 southern
hemisphere and 2015–16 northern hemisphere influenza seasons, support the recommendations made to include
B/Brisbane/60/2008 in trivalent influenza vaccines for the southern hemisphere 2016 [2] and northern hemisphere
2016–17 [3] influenza seasons.
Influenza B – Yamagata lineage
HI results for three B/Yamagata-lineage test viruses analysed since the February 2016 report, all of which fell in
HA genetic clade 3, are shown in Table 6.
The homologous titres of the ten post-infection ferret antisera, shown in red, ranged from 160 to 640 and the test
viruses show similar reactivity patterns though B/Italy-FVG/19/2015 was generally inhibited slightly better (Table
6). This virus carried HA1 K116R and V263M amino acid substitutions compared to the other two test viruses.
Antisera raised against egg-propagated clade 3 viruses B/Phuket/3073/2013 (the virus recommended for inclusion
in trivalent influenza vaccines for the northern hemisphere 2014–15 season) and B/Hong Kong/3417/2014
recognised all test viruses at titres within twofold of their respective homologous titres, as did that raised against
egg-propagated B/Wisconsin/1/2010 (a previous vaccine virus). However, the antisera raised against egg-
propagated B/Stockholm/12/2011 and tissue culture-propagated B/Phuket/3073/2013 showed somewhat reduced
reactivity (up to fourfold) with the test viruses. The test viruses also consistently showed fourfold reductions in HI
titres compared to the homologous titre for the antiserum raised against egg-propagated
B/Massachusetts/02/2012, the clade 2 vaccine virus recommended for use in the 2014–15 northern hemisphere
influenza season.
Figure 4 shows a phylogenetic analysis of the HA genes of representative B/Yamagata-lineage viruses. Worldwide,
the vast majority of HA genes from recently collected viruses have fallen in the B/Wisconsin/1/2010–
B/Phuket/3073/2013 clade (clade 3) with the great majority falling in a subgroup defined by L172Q amino acid
substitution in HA1. A few viruses, annotated in the phylogenetic trees, are reassortants carrying NA genes
normally associated with the B/Victoria-lineage: none was from an EU/EEA country.
Based on such results, a B/Phuket/3073/2013-like virus has been recommended for inclusion in quadrivalent
vaccines for the 2016 southern hemisphere [2] and 2016–17 northern hemisphere [3] influenza seasons.
15. ECDC SURVEILLANCE REPORT Influenza virus characterisation, March 2016
15
Figure 4. Phylogenetic comparison of influenza B/Yamagata-lineage HA genes
16. ECDC SURVEILLANCE REPORT Influenza virus characterisation, March 2016
16
Summary of genetic data submitted to TESSy
For the period covering weeks 40/2015 – 13/2016, 4 314 viruses have been characterised genetically: 3 066
A(H1N1)pdm09 clade 6B represented by A/South Africa/3626/2013 (6B.1 and 6B.2 subclade designations were not
available as reporting categories at the start of the 2015–16 influenza season); 315 A(H3N2) subclade 3C.2a
represented by A/Hong Kong/4801/2014, 132 subclade 3C.3a represented by A/Switzerland/9715293/2013, three
subclade 3C.3b represented by A/Stockholm/28/2014, and six subclade 3C.3 represented by A/Samara/73/2013;
672 B/Victoria-lineage clade 1A represented by B/Brisbane/60/2008; and 120 B/Yamagata-lineage clade 3
represented by B/Phuket/3073/2013.
Antiviral susceptibility
For weeks 40/2015 – 13/2016 of the 2015–16 influenza season, countries reported on the antiviral susceptibility of
2 041 A(H1N1)pdm09 viruses, 108 A(H3N2) viruses and 228 influenza type B viruses from sentinel and non-
sentinel sources. All but 13 showed no molecular or phenotypic evidence of reduced inhibition (RI) by
neuraminidase inhibitors. Twelve A(H1N1)pdm09 viruses carried NA H275Y amino acid substitution associated with
highly reduced inhibition (HRI) by oseltamivir and one A(H3N2) virus showed RI by oseltamivir associated with
NA-E119V amino acid substitution.
Phenotypic testing for susceptibility to oseltamivir and zanamivir has been conducted on 350 viruses at the WIC:
221 A(H1N1)pdm09, 61 A(H3N2), 58 B/Victoria-lineage and 10 B/Yamagata-lineage viruses. All showed normal
inhibition (NI) by these neuraminidase inhibitors.
Influenza A(H7N9) virus
On 1 April 2013, the World Health Organization (WHO) Global Alert and Response [4] reported that the China
Health and Family Planning Commission had notified the WHO of three cases of human infection with influenza
A(H7N9). The cases were confirmed by laboratory testing on 29 March 2013 by the Chinese CDC. A description of
the characteristics of H7N9 viruses can be found on the WHO website [5]. Increased numbers of cases were
reported over the course of the 2013–14, 2014–15 and 2015-16 seasons and cases have been reported recently
[6]. A revised Rapid Risk Assessment [7] for these A(H7N9) viruses was carried out by ECDC and published on 2
February 2015. WHO published a summary of human infection on 31 January 2014 [8], updated on 25 February
2016 [9] with 29 new cases since the report of 21 January 2016, and conducted a risk assessment on 23 February
2015 [10]. In light of the assessment, WHO advised that countries continue to strengthen influenza surveillance.
WHO last summarised the numbers of cases of human infection related to their geographic location on 14 July
2014 [11] and has provided subsequent situation updates, with the latest being on 29 March 2016 [6].
Influenza A(H5) virus
The most recent monthly risk assessment of influenza at the human–animal interface was published by WHO on
25 February 2016 [9]. Since the last WHO Influenza update on 21 January 2016, no new laboratory-confirmed
human cases of avian influenza A(H5) virus infection have been reported to WHO. ECDC published an updated
rapid risk assessment on the situation in Egypt on 13 March 2015 [12] and an epidemiological update on 10 April
2015 [13]. On 2 December 2015 ECDC published a rapid risk assessment related to the identification of highly
pathogenic H5 viruses in poultry in France [14].
WHO CC reports
A description of results generated by the WHO Collaborating Centre for Reference and Research on Influenza at
the Crick Worldwide Influenza Centre, the Francis Crick Institute, Mill Hill Laboratory and used at the WHO Vaccine
Composition Meetings held in Memphis, USA, on 21–23 September 2015 and at WHO headquarters in Geneva on
22–24 February 2016 can be found, respectively, at:
https://www.crick.ac.uk/media/273950/crick_sep2015_vcm_report_to_post.pdf and
https://www.crick.ac.uk/media/286458/crick_feb2016_vcm_report_to_post.pdf
17. ECDC SURVEILLANCE REPORT Influenza virus characterisation, March 2016
17
Note on the figures
The phylogenetic trees were constructed using RAxML, drawn using FigTree and annotated using Adobe Illustrator.
The bars indicate the proportion of nucleotide changes between sequences. Reference strains are viruses to which
post-infection ferret antisera have been raised. The colours indicate the month of sample collection. Isolates from
WHO NICs in EU/EEA countries are marked (#). Sequences for some viruses from non-EU/EEA countries were
recovered from GISAID. We gratefully acknowledge the authors, originating and submitting laboratories of the
sequences from GISAID’s EpiFlu database which were downloaded for use in the preparation of this report (all
submitters of data may be contacted directly via the GISAID website), along with all laboratories who submitted
sequences directly to the London WHO Collaborating Centre.
References
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2016 northern hemisphere influenza season. Weekly Epidemiological Record 90, 97-108.
2. World Health Organization. Recommended composition of influenza virus vaccines for use in the 2016
southern hemisphere influenza season. Weekly Epidemiological Record 90, 545-558.
3. World Health Organization. Recommended composition of influenza virus vaccines for use in the 2016–
2017 northern hemisphere influenza season. Weekly Epidemiological Record 91, 121-132.
4. World Health Organization. Global alert and response: Human infection with influenza A(H7N9) virus in
China. 1 April 2013. Available from:
http://www.who.int/csr/don/2013_04_01/en/index.html
5. World Health Organization. Avian influenza A(H7N9) virus. Available from:
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6. World Health Organization. Situation updates - avian influenza. Available from:
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influenza A(H5N1) virus, Egypt. Available from:
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March-2015.pdf
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human cases of A(H5N1) influenza, Egypt. Available from:
http://ecdc.europa.eu/en/press/news/_layouts/forms/News_DispForm.aspx?List=8db7286c-fe2d-476c-
9133-18ff4cb1b568&ID=1199
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pathogenic avian influenza virus A of H5 type. Available from:
http://ecdc.europa.eu/en/publications/Publications/highly-pathogenic-avian-influenza-virus-A-H5-rapid-
risk-assessment-2-dec-2015.pdf