micro sheet(corrected) # 8 - Bara2a Al5a6eeb

بسم الله الرحمن الرحيم

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micro 8.doc

___________________________
بسم الله الرحمن الرحيم

Our lec today about influenza virus
Lets start with again viral respiratory tract pathogen in relation to virus
Orthomaxovirus (influenza virus)
- Maxovirus : within these group the influenza virus is very common and imp. As causative agent as we know of upper R.t infections.
- Here we have 3 major genotype of influenza virus design as (A , B and C)
- Isolation of influenza virus as has been accomplished in 1933 where they discovered morphological structures of the virus and they have managed to know details about this virus and specially service antigen and now the virus later they have stopped by using molecular technique

- Mechanism of attachment to upper R.T mucosa and mechanism of pathogenicity how this virus might associated with clinical features of flue which preserve as we know that these antigen structure specially on the surface of any type of viruses contribute for interaction with specific receptor on the infected type of cell


- As you see in the picture in the hand out 8 RNT segment < virus contain in the nucleocapsid of 8 segment of RNA > surrounded by presence of capsid / copsomer and later associated with presences of bilyer which composed mainly of certain protein or fatty acid. And if we look exactly to these structures we will recognize 2 types of structures considers as spikes.

Spike : special projection on the surface of the envelope
These structures composed of specific type of glycoprotein, and the glycoprotein composed of 2 imp. Polypeptide and these polypeptides together form a specific antigen(HA, NA) and accordingly function of these antigen as recognize in this case.

For example, we have first antigen which known as HA(hemagglutinin) stand to
1- help agglutination (which mean this antigen function to agglutinate RBCS in the vitro to reduce accumulation of them so it called help agglutination antigen).
2- these antigen also imp. To attach to specific receptor on the mucosa of the epithelium or R.T.

Specially in relation to micin(am not sure) and in particular risk of chemical substances called N-cyclic acid where HA antigen interact and produce a bond
This bond allows the virus react to be attached firmly on the surface of mucosa.


Later the second antigen which is called NA(neuraminidase)
Neuraminidase means type of enzyme which affects a specific function during the attachment of the virus.

Unique mechanism of these viruses that one antigen (HA antigen”help agglutination”) produce the bond and the other antigen (NA antigen) begin to attack the bond.

May u say how this function??
One produce the bond and the second inhibit the bond btw virus and n-cycli acid and so allow the virus to release the envelop with the capsid and only the viron (which composed mainly of nucleic acid with endosome of infected cells.

During entrance of nucleic acid mainly as we see in the slide (8 segment of RNA begin coz this virus is (-) stranded RNA which mean can’t easily produce necessary component for production and multiplication within the cytoplasm without first to produced mRNA and this mRNA in fact due to presence of specific what we called independent polymerase (RNA polymerase) then can be use with enzyme which associated with nucleic acid called surrounded nucleic acid allow the virus to produce mRNA and later from mRNA virus begin to produce tRNA with necessary amino acid polypeptide and other components necessary for replication.

Once all components of virus have been produced in large number with help of cytoplasm of infected cell they begin to assemble to produce a new virus.

The assembly will be done not in the cytoplasm but in the nucleus of infected cell and within the nucleus it will assembly of these components and releasing of new developed virus particles.

These new virus particles later reach to cell membrane of the infected tissue and with the help of neuraminidase and again it will result destroyed connection btw HN antigen and allow virus to release by budding

During releasing and developing of new virus particles some part of cell membrane will be attach to new virus and this result of production of new virus particles in thousand

This mechanism of developing new virus always controlled by genetic apparatus or what we called genome of this virus .

Therefore presence of Hagglutinin is imp. As well as N.A imp. To produce new infective virus particles


In this connection please keep in mind that this 2 antigens not stable they can be change and in relation to segment of RNA

If there is any change in the sequence of RNA mean will be change specifically in relation to these service antigen HA and NA antigen

It has been shown that they are 15 HA antigenic structures which might be associate with a genome of virus and means we have 15 types of HA and we have 9 subtypes of NA so following any change in H and N mean new genotype of virus

In relation to human they have discovered that they are very few number of H antigen and N antigen association with developing human infection called (influenza infection)


In relation to H we have 1-3 types (H1,H2,H3)
- In relation to N we have 2 types (N1,N2)
- Combination btw ( H1N1 , H2N2 ,……….. , ets) mean we have a type separated as infectious particles which might result infection of human .

Other than 3 main types of H we have (4,5,6,………….,ets) but these types are not related to human infection , they related to animals and other types of birds , chicken ………..ets)
** in addition to these 2 imp. Antigen (HA , NA ) which control infection in human or animal there are other supported components found in relation to the envelop of virus , specially m1, m2 and these consider as m protein .

Function of these m proteins:-
M1 : support attachment and adsorption of virus particles
M2 : contribute to control surrounded pH of cell membrane. And indirectly help to keep necessary pH later to be used in enzymatic activates.
- As we know most metabolic activity within our bodies followed by neutral pH , so these contribute attachment and replication later on the virus within infected tissue.

Retain back after these virus structures to look for the following imp. Features :
-infection virus in any type specially which adapted to human ( H1-H3 ,N1 .N2) once attach to ciliated R.T columnar epithelium cell after enteric into the endosome ( by endocytosis :cell engulf )begin to replication and release virus by process of budding (this mean incubation period)
-incubation period in human it is about 2 days
-following incubation period ( 2 days) at the end we have numerous thousand million of new virus particles which associated with this infection.

**before to go in details about this topic we have to mention 2 imp. Features related what we called genetic exchange/change in the genome of this virus
-we have 2 imp terms and this term helped to understand why our bodies can’t be immune against infection with influenza virus.

-as we know most of us at least once time of year might be infected with influenza virus and despite our bodies develop humeral antibodies (like interferon..ets) still we susceptible to be infected with influenza virus
Reason of this:
-this virus often inter in 2 imp. Genetic metabolism process one called genetic drift and the other called genetic shift
Genetic drift:
Mean minor change in the sequence or RNA during replication.
Sequence or RNA is not 100% stable there will be some change (replacement one NA )
So any change in the RNA sequence mean minor these change later in the H and N antigenecity , it will be later transmitted in form of change in the sequence of amino acid within the glycoprotein of the spikes(H and N)
This change mean that our bodies specially mucosa or R.T will might not discovered and might not manage to indentify the infection by presence of specific antibodies
Because of the change in the surface of these antibodies. Therefore this change to some extend might be identifying the infection but not 100% may to 78%.

Antigenetic gene
If there is a major change (shift) in nucleotide due to major reassorment or RNA segment and this might be add to develop of a new genotype .
Antigenettic shift mean that we have new genotype of H1N1 ,H2N1 …ets
These mean that our bodies is less susceptible to be infect by this genotype, therefore antigenetic drift and antigenetic shift in fact are associated of endemic with out-brake of infective virus in form of pandemic

To give some hints in relation to developing pandemic infection:
Pandemic mean infection spread over many continent, countries or community, not related to one country or community

Out –break influenza might occurs just in one country, but if spread over many countries specially include many continent that we use pandemic out-break of infection

First out-break
-case H1N1
-studied by isolation of virus and char…. In genotype of this virus was in 1980 where swine –like

Why swine??
Swine in relation to pigs originally this type of virus found in pigs and from animals transmitted to human and produce influenza
First out-break
- result in infection or 100 million people and possibly in developed country
-death grow rang btw 20-40 million according different differences
-this type was first pandemic which has been recorded despite in fact at that time they have not isolated virus and studied exactly the morphological as we mentioned .

Second out-break
-case H2N1
-observed in 1957
-called Ischia pandemic
-2 million death coz our bodies can’t recognize easily this virus so virus at beginning was very aggressive and resulted in large infection and associated with high mortality.
Q by a student ( am didn’t hear it)
Answer : any change in genome of the vises in RNA segment of resulted in change in H and N which consider as spikes and these spikes necessary in attach to the mucosa
Change in drift is minor and our body can detect the infection by specific antibodies
Our bodies memorize the infection
If a large change -> that’s means form a new type (our bodies can’t memorize the infection because receptors are not variable on the surface of the mucosa.

Third pandemic
-observed in 1968
-change in H but N is same these compensation should be consider together ( HA , NA)
-1970 they observe that is always at least 2 types of virus genotype circulated in the world (n1n2 , h2n2) or mix of them
- in the past we have one genotype (H1N1 , H2N2) but now we have 2 types together circulate in the world.
And each year WHO have recorded between 500 to 1 billion of world population(6 billion) mean 1 of 6 population infect with this compensation it might be 1or 2 and resulted of total number of infection death (2-3) million each year
more important to mention the following < sure that all of u have heard in last few years the out-break of 2 types of influenza virus.
One in relation to birds : this birds have observed in 1997
-this type composed of H5N1 which mean we have a drift type (large change)
-spread among birds specially dogs and chicken in hong-kong ,vetman ,chania …ets) and resulting in killing of millions of birds and later to first time of infection this type also transmitted to human and result in a form of flue and result in 300 cases .
These flue similar to human flue which cause by H1N1 or H2N2
Approximately 60% of these 300 cases will die following infection due to this anew genotype (no immunity).
Similar to human flu which cause by H, N, or H2, N2
This type of flu Was found in brides and transmitted to human result in 300 cases
Always first genotype of influenza virus or any type of infected associated of high mortality coz body still not ready to produce rapidly specific antibodies and it appear later that this virus once transmit from one person to another ,during this period resulting in decrease in the pathogen of antigen (in the invasions of organism)
In another word pathoginicity will be decrease during spread of the virus in the population wither animals or humans, But the first case very sever and associated with high mortality so, slowly pathogenecity of the virus decrease with the time
these virus cant transmitted from human to human it transmit just from animals to human once it infect human it will be changed and this change can’t allow virus to continue the infectious process to another human and it will be stopped
as we said before that we have 3 genotypes of influenza virus(A,B and C) and we have m protein that control the PH in flu virus
all we talked in the previous are relation to type A virus (more common )

B influenza virus
-no animal reserve only human
-very few changes have been observed in relation to antigenic structures of the viruses
- not highly infectious and often if infect human the infection will be mild and can be to sub extend contain
- it become dangerous if this virus is in association with type A(out-break of influenza due to A and B)
- vaccine available use for protection against influenza virus composed of A and B
-WHO collect information from different parts of the world about genotypes of the influenza virus in relation to H,N to know exactly this genotype is prevalent and these information should be available in June each year , and according to these information they prepare specific types of vaccines.

Influenza virus type C
- Found in certain type of animals specially in bits and only one to two countries mainly in the china
- Rarely produce infection to the human and if it produce infection to the human it is a mild and in upper R.T
- Infection might be associated with conjunctivitis mainly in children and it is asymptomatic.
- Most imp. Type is A and less is B

Swine flu virus

-not forget these fact : swine flu virus mean the same type of H influenza virus which affect human But there is change in the compositions of genes of these virus , but it is similar in the morphological structures ,same HA ,NA antigens exactly like human.
- the change mild and this mild change still might associated to human infection
-swine flu (AH1N1) already found in swine and already produce infection, but there was no transfer no dissemination of this subtype to human.

-first case discovered in the macceco in 2009 ,suddenly they have recorded out-break of influenza virus infection related to the human exactly like other influenza viruses . Following detection and identification of the virus they have recorded that this virus must be originated from pigs and then transmitted from pigs to the human.
-RNA segment originate from 4 types of H1N1 which originate from different contents but reassorment of these RNA from different sources resulted in a new recombination and this new recombination resulted in developing a new genotype which called H1N1 and they have recognize in this type 3 gens segments originate from swine and only one gene segment from human.
-these 4 segments by double equal 8 segments of genotypes they have what we called recombination of these segments resulted in formation of new genotype which consider as swine flu type.

-new swine flu viruses spread to many countries started from Macecco to U.S and later to other countries and reach our country first in July and later the case increase.

-within 1 year WHO recorded that this virus spread in 100 countries associated 300-400 million cases and recorded in 17,000 this mean that the majority of this new flu cases mild and only 1% might lead serious illness and death.


**they have observed another features :
- Most infection has been observed in the age range in between(5-45) year specially young person are more susceptible than elderly coz this virus mild in the past and spread to humans , but it is asymptomatic (not observed) so elderly person has already developed certain immune response and so often they are not susceptible to this new virus.

- Most people who might developed complication and pain found in the relation to the following categories :

1- Pregnant women
2- Person with immune suppress problems in relation to cardio respiratory system
3- Malignancy

-in other healthy people, they manage to detect the infection without treated by antiviral drugs.

-in 2009 they were already available vaccine. In Jordan only few people accept vaccinate against this virus and this is right coz there no need to vaccinate all population.

- It is recommended that vaccine to be given only for people with high risk to disease with this infection
- In addition there is antiviral drugs available and can be given for such people with high risk to develop complication and these antiviral drugs is anew neuraminidase drug known as anti viral and relenance( am not sure) ,these 2 drugs are available in our countries they can be given within the first our incubation at the start of developing over diseases ,they help to inhibit the replication of the virus by inhibition of neuraminidase activity and virus cant penetrate the infected tissues.


THE END
Done by :baraah Alkhateeb
Lec # 8 ,27/2/2011



بسم الله الرحمن الرحيم

Our lec today about influenza virus
Lets start with again viral respiratory tract pathogen in relation to virus
Orthomaxovirus (influenza virus)
- Maxovirus : within these group the influenza virus is very common and imp. As causative agent as we know of upper R.t infections.
- Here we have 3 major genotype of influenza virus design as (A , B and C)
- Isolation of influenza virus as has been accomplished in 1933 where they discovered morphological structures of the virus and they have managed to know details about this virus and specially service antigen and now the virus later they have stopped by using molecular technique

- Mechanism of attachment to upper R.T mucosa and mechanism of pathogenicity how this virus might associated with clinical features of flue which preserve as we know that these antigen structure specially on the surface of any type of viruses contribute for interaction with specific receptor on the infected type of cell


- As you see in the picture in the hand out 8 RNT segment < virus contain in the nucleocapsid of 8 segment of RNA > surrounded by presence of capsid / copsomer and later associated with presences of bilyer which composed mainly of certain protein or fatty acid. And if we look exactly to these structures we will recognize 2 types of structures considers as spikes.

Spike : special projection on the surface of the envelope
These structures composed of specific type of glycoprotein, and the glycoprotein composed of 2 imp. Polypeptide and these polypeptides together form a specific antigen(HA, NA) and accordingly function of these antigen as recognize in this case.

For example, we have first antigen which known as HA(hemagglutinin) stand to
1- help agglutination (which mean this antigen function to agglutinate RBCS in the vitro to reduce accumulation of them so it called help agglutination antigen).
2- these antigen also imp. To attach to specific receptor on the mucosa of the epithelium or R.T.

Specially in relation to micin(am not sure) and in particular risk of chemical substances called N-cyclic acid where HA antigen interact and produce a bond
This bond allows the virus react to be attached firmly on the surface of mucosa.


Later the second antigen which is called NA(neuraminidase)
Neuraminidase means type of enzyme which affects a specific function during the attachment of the virus.

Unique mechanism of these viruses that one antigen (HA antigen”help agglutination”) produce the bond and the other antigen (NA antigen) begin to attack the bond.

May u say how this function??
One produce the bond and the second inhibit the bond btw virus and n-cycli acid and so allow the virus to release the envelop with the capsid and only the viron (which composed mainly of nucleic acid with endosome of infected cells.

During entrance of nucleic acid mainly as we see in the slide (8 segment of RNA begin coz this virus is (-) stranded RNA which mean can’t easily produce necessary component for production and multiplication within the cytoplasm without first to produced mRNA and this mRNA in fact due to presence of specific what we called independent polymerase (RNA polymerase) then can be use with enzyme which associated with nucleic acid called surrounded nucleic acid allow the virus to produce mRNA and later from mRNA virus begin to produce tRNA with necessary amino acid polypeptide and other components necessary for replication.

Once all components of virus have been produced in large number with help of cytoplasm of infected cell they begin to assemble to produce a new virus.

The assembly will be done not in the cytoplasm but in the nucleus of infected cell and within the nucleus it will assembly of these components and releasing of new developed virus particles.

These new virus particles later reach to cell membrane of the infected tissue and with the help of neuraminidase and again it will result destroyed connection btw HN antigen and allow virus to release by budding

During releasing and developing of new virus particles some part of cell membrane will be attach to new virus and this result of production of new virus particles in thousand

This mechanism of developing new virus always controlled by genetic apparatus or what we called genome of this virus .

Therefore presence of Hagglutinin is imp. As well as N.A imp. To produce new infective virus particles


In this connection please keep in mind that this 2 antigens not stable they can be change and in relation to segment of RNA

If there is any change in the sequence of RNA mean will be change specifically in relation to these service antigen HA and NA antigen

It has been shown that they are 15 HA antigenic structures which might be associate with a genome of virus and means we have 15 types of HA and we have 9 subtypes of NA so following any change in H and N mean new genotype of virus

In relation to human they have discovered that they are very few number of H antigen and N antigen association with developing human infection called (influenza infection)


In relation to H we have 1-3 types (H1,H2,H3)
- In relation to N we have 2 types (N1,N2)
- Combination btw ( H1N1 , H2N2 ,……….. , ets) mean we have a type separated as infectious particles which might result infection of human .

Other than 3 main types of H we have (4,5,6,………….,ets) but these types are not related to human infection , they related to animals and other types of birds , chicken ………..ets)
** in addition to these 2 imp. Antigen (HA , NA ) which control infection in human or animal there are other supported components found in relation to the envelop of virus , specially m1, m2 and these consider as m protein .

Function of these m proteins:-
M1 : support attachment and adsorption of virus particles
M2 : contribute to control surrounded pH of cell membrane. And indirectly help to keep necessary pH later to be used in enzymatic activates.
- As we know most metabolic activity within our bodies followed by neutral pH , so these contribute attachment and replication later on the virus within infected tissue.

Retain back after these virus structures to look for the following imp. Features :
-infection virus in any type specially which adapted to human ( H1-H3 ,N1 .N2) once attach to ciliated R.T columnar epithelium cell after enteric into the endosome ( by endocytosis :cell engulf )begin to replication and release virus by process of budding (this mean incubation period)
-incubation period in human it is about 2 days
-following incubation period ( 2 days) at the end we have numerous thousand million of new virus particles which associated with this infection.

**before to go in details about this topic we have to mention 2 imp. Features related what we called genetic exchange/change in the genome of this virus
-we have 2 imp terms and this term helped to understand why our bodies can’t be immune against infection with influenza virus.

-as we know most of us at least once time of year might be infected with influenza virus and despite our bodies develop humeral antibodies (like interferon..ets) still we susceptible to be infected with influenza virus
Reason of this:
-this virus often inter in 2 imp. Genetic metabolism process one called genetic drift and the other called genetic shift
Genetic drift:
Mean minor change in the sequence or RNA during replication.
Sequence or RNA is not 100% stable there will be some change (replacement one NA )
So any change in the RNA sequence mean minor these change later in the H and N antigenecity , it will be later transmitted in form of change in the sequence of amino acid within the glycoprotein of the spikes(H and N)
This change mean that our bodies specially mucosa or R.T will might not discovered and might not manage to indentify the infection by presence of specific antibodies
Because of the change in the surface of these antibodies. Therefore this change to some extend might be identifying the infection but not 100% may to 78%.

Antigenetic gene
If there is a major change (shift) in nucleotide due to major reassorment or RNA segment and this might be add to develop of a new genotype .
Antigenettic shift mean that we have new genotype of H1N1 ,H2N1 …ets
These mean that our bodies is less susceptible to be infect by this genotype, therefore antigenetic drift and antigenetic shift in fact are associated of endemic with out-brake of infective virus in form of pandemic

To give some hints in relation to developing pandemic infection:
Pandemic mean infection spread over many continent, countries or community, not related to one country or community

Out –break influenza might occurs just in one country, but if spread over many countries specially include many continent that we use pandemic out-break of infection

First out-break
-case H1N1
-studied by isolation of virus and char…. In genotype of this virus was in 1980 where swine –like

Why swine??
Swine in relation to pigs originally this type of virus found in pigs and from animals transmitted to human and produce influenza
First out-break
- result in infection or 100 million people and possibly in developed country
-death grow rang btw 20-40 million according different differences
-this type was first pandemic which has been recorded despite in fact at that time they have not isolated virus and studied exactly the morphological as we mentioned .

Second out-break
-case H2N1
-observed in 1957
-called Ischia pandemic
-2 million death coz our bodies can’t recognize easily this virus so virus at beginning was very aggressive and resulted in large infection and associated with high mortality.
Q by a student ( am didn’t hear it)
Answer : any change in genome of the vises in RNA segment of resulted in change in H and N which consider as spikes and these spikes necessary in attach to the mucosa
Change in drift is minor and our body can detect the infection by specific antibodies
Our bodies memorize the infection
If a large change -> that’s means form a new type (our bodies can’t memorize the infection because receptors are not variable on the surface of the mucosa.

Third pandemic
-observed in 1968
-change in H but N is same these compensation should be consider together ( HA , NA)
-1970 they observe that is always at least 2 types of virus genotype circulated in the world (n1n2 , h2n2) or mix of them
- in the past we have one genotype (H1N1 , H2N2) but now we have 2 types together circulate in the world.
And each year WHO have recorded between 500 to 1 billion of world population(6 billion) mean 1 of 6 population infect with this compensation it might be 1or 2 and resulted of total number of infection death (2-3) million each year
more important to mention the following < sure that all of u have heard in last few years the out-break of 2 types of influenza virus.
One in relation to birds : this birds have observed in 1997
-this type composed of H5N1 which mean we have a drift type (large change)
-spread among birds specially dogs and chicken in hong-kong ,vetman ,chania …ets) and resulting in killing of millions of birds and later to first time of infection this type also transmitted to human and result in a form of flue and result in 300 cases .
These flue similar to human flue which cause by H1N1 or H2N2
Approximately 60% of these 300 cases will die following infection due to this anew genotype (no immunity).
Similar to human flu which cause by H, N, or H2, N2
This type of flu Was found in brides and transmitted to human result in 300 cases
Always first genotype of influenza virus or any type of infected associated of high mortality coz body still not ready to produce rapidly specific antibodies and it appear later that this virus once transmit from one person to another ,during this period resulting in decrease in the pathogen of antigen (in the invasions of organism)
In another word pathoginicity will be decrease during spread of the virus in the population wither animals or humans, But the first case very sever and associated with high mortality so, slowly pathogenecity of the virus decrease with the time
these virus cant transmitted from human to human it transmit just from animals to human once it infect human it will be changed and this change can’t allow virus to continue the infectious process to another human and it will be stopped
as we said before that we have 3 genotypes of influenza virus(A,B and C) and we have m protein that control the PH in flu virus
all we talked in the previous are relation to type A virus (more common )

B influenza virus
-no animal reserve only human
-very few changes have been observed in relation to antigenic structures of the viruses
- not highly infectious and often if infect human the infection will be mild and can be to sub extend contain
- it become dangerous if this virus is in association with type A(out-break of influenza due to A and B)
- vaccine available use for protection against influenza virus composed of A and B
-WHO collect information from different parts of the world about genotypes of the influenza virus in relation to H,N to know exactly this genotype is prevalent and these information should be available in June each year , and according to these information they prepare specific types of vaccines.

Influenza virus type C
- Found in certain type of animals specially in bits and only one to two countries mainly in the china
- Rarely produce infection to the human and if it produce infection to the human it is a mild and in upper R.T
- Infection might be associated with conjunctivitis mainly in children and it is asymptomatic.
- Most imp. Type is A and less is B

Swine flu virus

-not forget these fact : swine flu virus mean the same type of H influenza virus which affect human But there is change in the compositions of genes of these virus , but it is similar in the morphological structures ,same HA ,NA antigens exactly like human.
- the change mild and this mild change still might associated to human infection
-swine flu (AH1N1) already found in swine and already produce infection, but there was no transfer no dissemination of this subtype to human.

-first case discovered in the macceco in 2009 ,suddenly they have recorded out-break of influenza virus infection related to the human exactly like other influenza viruses . Following detection and identification of the virus they have recorded that this virus must be originated from pigs and then transmitted from pigs to the human.
-RNA segment originate from 4 types of H1N1 which originate from different contents but reassorment of these RNA from different sources resulted in a new recombination and this new recombination resulted in developing a new genotype which called H1N1 and they have recognize in this type 3 gens segments originate from swine and only one gene segment from human.
-these 4 segments by double equal 8 segments of genotypes they have what we called recombination of these segments resulted in formation of new genotype which consider as swine flu type.

-new swine flu viruses spread to many countries started from Macecco to U.S and later to other countries and reach our country first in July and later the case increase.

-within 1 year WHO recorded that this virus spread in 100 countries associated 300-400 million cases and recorded in 17,000 this mean that the majority of this new flu cases mild and only 1% might lead serious illness and death.


**they have observed another features :
- Most infection has been observed in the age range in between(5-45) year specially young person are more susceptible than elderly coz this virus mild in the past and spread to humans , but it is asymptomatic (not observed) so elderly person has already developed certain immune response and so often they are not susceptible to this new virus.

- Most people who might developed complication and pain found in the relation to the following categories :

1- Pregnant women
2- Person with immune suppress problems in relation to cardio respiratory system
3- Malignancy

-in other healthy people, they manage to detect the infection without treated by antiviral drugs.

-in 2009 they were already available vaccine. In Jordan only few people accept vaccinate against this virus and this is right coz there no need to vaccinate all population.

- It is recommended that vaccine to be given only for people with high risk to disease with this infection
- In addition there is antiviral drugs available and can be given for such people with high risk to develop complication and these antiviral drugs is anew neuraminidase drug known as anti viral and relenance( am not sure) ,these 2 drugs are available in our countries they can be given within the first our incubation at the start of developing over diseases ,they help to inhibit the replication of the virus by inhibition of neuraminidase activity and virus cant penetrate the infected tissues.


THE END
Done by :baraah Alkhateeb
Lec # 8 ,27/2/2011

Micro sheet 8 ...... correction
Page 2 line 13 :epithelium of R.T
Line 15,28 : N-sialic
Page 4 line 14 : 15 subtypes

Page 6 line 13,14 : antigenetic not genetic
Line 15,16 : of RNA
Line 25 :antigens not antibodies
Line 22 : of R.T

Page 7 line 1 : antigenetic shift
Line 3 : of RNA
Line 20 :characterization

Page 8 line 5,2 : of 100 million
Line 10 :H2N2

Page 9 line 6 : (h,n2,h2,n2)
Line 16 : we have a shift type
Line 20,22 : flu

Page 13 line 15 : neuraminidase inhibition
and releuza

Baraah al-khateeb