Swine Flu (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Swine flu (H1N1 influenza virus) facts
- What is the swine flu (novel H1N1 influenza A swine flu)?
- What causes swine flu (H1N1)?
- Why is swine flu (H1N1) now infecting humans?
- What are the symptoms of swine flu (H1N1)?
- How is swine flu (H1N1) diagnosed?
- What is the treatment for swine flu (H1N1)?
- What is the history of swine flu (H1N1)?
- What are the risk factors for swine flu (H1N1)?
- Can novel H1N1 swine flu be prevented with a vaccine?
- Can H1N1 be prevented if the H1N1 flu vaccine (or other flu strain vaccine) is not readily available?
- Is swine flu (H1N1) a cause of an epidemic or pandemic in the 2009-2010 flu season?
- What is the prognosis (outlook) and complications for patients who get swine flu (H1N1)?
- Where can I find more information about swine flu (H1N1)?
- Swine Flu (H1N1) FAQ Slideshow Pictures
- Pictures of Strep or Sore Throat - Slideshow
- Flu Fighter Foods Slideshow Pictures
What causes swine flu (H1N1)?
The cause of swine flu is an influenza A virus type designated as H1N1. It has this designation or name because of the two major antigens (H and N) detectable on its surface by immunological techniques (H or hemagglutinin and N or neuraminidase). In 2011, a new swine flu virus was detected. The new strain is named influenza A (H3N2)v. Only a few people (mainly children) have been infected, but the U.S. Department of Health and Human Services (HHS) is developing a vaccine against this virus. A separate article discusses some of the details about this new flu strain. In general, all of the influenza A viruses have a structure similar to the H1N1 virus; each type has a somewhat different H and/or N structure.
Why is swine flu (H1N1) now infecting humans?
Many researchers now consider that two main series of events can lead to swine flu (and also avian or bird flu) becoming a major cause for influenza illness in humans.
First, the influenza viruses (types A, B, C) are enveloped RNA viruses with a segmented genome; this means the viral RNA genetic code is not a single strand of RNA but exists as eight different RNA segments in the influenza viruses. A human (or bird) influenza virus can infect a pig respiratory cell at the same time as a swine influenza virus; some of the replicating RNA strands from the human virus can get mistakenly enclosed inside the enveloped swine influenza virus. For example, one cell could contain eight swine flu and eight human flu RNA segments. The total number of RNA types in one cell would be 16; four swine and four human flu RNA segments could be incorporated into one particle, making a viable eight RNA-segmented flu virus from the 16 available segment types. Various combinations of RNA segments can result in a new subtype of virus (this process is known as antigenic shift) that may have the ability to preferentially infect humans but still show characteristics unique to the swine influenza virus (see Figure 1). It is even possible to include RNA strands from birds, swine, and human influenza viruses into one virus if a single cell becomes infected with all three types of influenza (for example, two bird flu, three swine flu, and three human flu RNA segments to produce a viable eight-segment new type of flu viral genome). Formation of a new viral type is considered to be antigenic shift; small changes within an individual RNA segment in flu viruses are termed antigenic drift and result in minor changes in the virus. However, these can accumulate over time to produce enough minor changes that cumulatively change the virus' antigenic makeup over time (usually years).
Second, pigs can play a unique role as an intermediary host to new flu types because pig respiratory cells can be infected directly with bird, human, and other mammalian flu viruses. Consequently, pig respiratory cells are able to be infected with many types of flu and can function as a "mixing pot" for flu RNA segments (see Figure 1). Bird flu viruses, which usually infect the gastrointestinal cells of many bird species, are shed in bird feces. Pigs can pick these viruses up from the environment, and this seems to be the major way that bird flu virus RNA segments enter the mammalian flu virus population.
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