This is an informative post. An ABC for those who "ignore" the fundamental characteristics of an influenza pandemic.
So an ABC for the population?
No.
So is ABC for a medical?
No.
Then an ABC for whom?
This is an ABC to the director of a scientific journal which has declared the pandemic in Italy . The medical knowledge is vast, so too i direttori possono aver perso qualche ABC. Questo post è dunque dedicato alla sua alfabetizzazione: frasi semplici, pochi concetti essenziali, qualche grafico esplicativo, niente di complicato come nei nostri post precedenti che erano destinati a un target diverso.
ABC
1) Nei virus influenzali le mutazioni puntiformi da errori di copiatura in uno dei cinque siti antigenici maggiori della H e/o in uno dei siti della N possono verificarsi nella fase di replicazione del genoma in ogni infezione cellulare. Gli anticorpi (e le cellule T citotossiche) presenti già nel nostro organismo neutralizzano in modo poco efficiente il nuovo virus. These variations of the virus are called antigenic drift and are responsible for seasonal flu. Different is the source of the shift, very rare events, occurring for reassortment of individual genes making up the genome of the influenza virus and are responsible for the emergence of a new pandemic. (Continued explanatory figure: Figure 1)
Figure 1
(Click on image to enlarge)
2) During a The pandemic influenza virus may continue to "live" and infect because proteins H and N are three-dimensional configurations so different from those submitted by other influenza viruses of the past seasons that it is not in any way blocked by antibodies present in the population.
3) The AIDS pandemic will continue until most of the population will not make antibodies and cytotoxic T cells against the virus H1N1swl, that acquire specific immunity after infection or vaccination. It will then be inevitable immunological selection of a virus a little 'different, the new virus-derived seasonal influenza pandemic (new antigenic drift)
4) Grafico esplicativo (Figura 2). Notare l'asse delle x, che indica anni (non giorni).
Figura 2
(Click sull'immagine per ingrandire)
(tratta da Mandell et al: Principles and Practice of Infectious Diseases, 6th ed. 2005)
5) Ci sono pandemie "fast" e pandemie "slow". L'ultima pandemia iniziata nel 1968 ha interessato due stagioni (si veda Figura 3). Non sono ancora note pandemie a diffusione superfast.
Figura 3
(Click sull'immagine per ingrandire)
tratta da Viboud C et al. Multinational Impact of the 1968 Hong Kong InfluenzaPandemic Evidence for a Smoldering Pandemic The Journal of Infec Dis 2005;192(2):233-248
6) Quali sono le nuove ipotesi biologiche che possono giustificare una così anticipata conclusione della pandemia in Italia rispetto al resto del mondo? No, but I am sure that soon we will explain under what 'evidence' has made such an innovative theory.
7) I will not dwell epidemiological analysis: useful, however, go a little 'beyond the usual readings, for example, can be opened (at least) windows of the house looking for evidence ...
8) The flow-chart below (Figure 4) will enable our choosing the more appropriate title which arise in the future, to his readers.
Figure 4
(Click on image to enlarge)
Taken from Wellington Grey 2007
8) While some studies are now confident that the readers of the magazine appreciate the letter we sent (several weeks) . Letter that certainly there will be time to answer: the distance that separates Eminences and is known to mere mortals too big.
Salvo Fedele
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