Influenza Pandemics

Question 1

Which flu occurred in 1918?

Answer 1

Spanish flu

Question 2

Spanish flu subtype?

Answer 2

H1N1

Question 3

Which flu occurred in 1957?

Answer 3

Asian flu

Question 4

Asian flu subtype?

Answer 4

H2N2

Question 5

Which flu occurred in 1968?

Answer 5

Hong Kong flu

Question 6

Hong Kong flus subtype?

Answer 6

H3N2

Question 7

Which flu threat occurred in 1997?

Answer 7

Avian bird flu threat H5N1

Question 8

Which flu occurred in 2009?

Answer 8

Swine flu

Question 9

Swine flu subtype?

Answer 9

H1N1

Question 10

Which flu threat occurred in 2012?

Answer 10

Avian bird flu threat H7N9

Question 11

Why is H7N9 so concerning?

Answer 11

Dual receptor binding affinity
In February 2017 noticed HPAI - was causing chickens do die
PB2 627K mutation has been observed in the virus infecting humans

Question 12

Where did Spanish flu start?

Answer 12

Kansas

Question 13

Why was Spanish flu so severe?

Answer 13

Caused cytokine degranulation

Caused a cytokine storm to occur

Question 14

Spanish flu killed an estimated?

Answer 14

20 to 50 million individuals

Question 15

Why was it thought that the Hong Kong flu was not so severe?

Answer 15

Was H3N2
Has the same neuraminidase as the flu virus from the 1957 Asian flu threat: H2N2
May have had some cross-reactive immunity due to the shared neuraminidase

Question 16

The Gain of Function research looked at which influenza in particular?

Answer 16

H5N1

Question 17

Gain of Function research aimed to?

Answer 17

Establish which mutations would be required to make H5N1 transmissible between humans and to evaluate the likelihood of this occurring in nature

Question 18

Gain of function research allowed the spread of H5N1 between?

Answer 18

Ferrets

Question 19

What are the benefits of gain of function research?

Answer 19

• Allows us to establish what mutations are required for transmission between humans
• Allows us to evaluate which influenza viruses are the most likely to cause pandemics
• Allows governments to make informed decisions about which vaccines they would like to stockpile
• Has given us an insight into what is needed for bird flu to spread in humans e.g. PB2 mutation
• Aids in drug development

Question 20

What are the disadvantages of gain of function research?

Answer 20

• Threat to biosafety and biosecurity
• Could be used in bioterrorism if we make the information readily available to all
• There is a threat of release, accidental release may occur

Question 21

What are the alternatives to gain of function research?

Answer 21

IRAT
Influenza Risk Analysis Tool
Created by the WHO and industry experts
States that the virus most likely to cause the next pandemic is H7N9

Question 22

Swine flu has now become?

Answer 22

Seasonal flu

Question 23

Where did swine flu first appear?

Answer 23

First appeared in Mexico

Question 24

Swine flu originated in?

Answer 24

Pigs

Question 25

What is H3N2v?

Answer 25

Influenza variant virus

Question 26

H3N2v originated in?

Answer 26

Pigs

Question 27

How can H3N2v spread to humans?

Answer 27

When humans are in close proximity to pigs e.g. at agricultural fairs

Question 28

Why might it be worth creating a vaccine/stockpiling drugs against H3N2v?

Answer 28

Does not seem to be changing | Antigenically stable

Question 29

Why is H3N2v not evolving and developing mutations?

Answer 29

Pigs do not live long enough (slaughter) to become re-infected. This means there is no selection pressure from the immune system to cause the virus to drift.

Question 30

H3N2v can be described as evolutionarily?

Answer 30

Static

Question 31

When did H7N9 cause its first human death?

Answer 31

2013

Question 32

What happened to h7N9 in February 2017?

Answer 32

Was seen to kill chickens | Became HPAI

Question 33

HPAI?

Answer 33

Highly pathogenic avian influenza

Question 34

H7N9 human mortality rate?

Answer 34

Extremely high | 40%

Question 35

Why is H7N9 so concerning?

Answer 35

Shows dual receptor binding ability Has been shown to undergo the PB2 627K mutation in infected humans High mortality rate in humans: 40%

Question 36

What was the Chinese government's response to H7N9?

Answer 36

Began vaccinating chickens against H7N9 in 2017

Question 37

What is a cheap cost-effective way of identifying if a person is infected with influenza?

Answer 37

Influenza hemagglutinin assay

Question 38

What is a way of identifying the subtype someone is infected with?

Answer 38

Agglutination inhibition If you are able to prevent agglutination by using antibodies against a specific subtype of influenza hemagglutinin you can confirm the hemagglutinin subtype an individual is infected with