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المستخلص
The highly pathogenic avian influenza virus subtype H5N1 is already panzootic in poultry, with attendant economic consequences. It continues to cross species barriers to infect humans and other mammals, often with fatal outcomes. Therefore, H5N1 virus has rightly received attention as a potential pandemic threat.Infected birds have been the primary source of influenza A (H5N1) infections in humans. Transmission between humans is very limited at present, but continued monitoring is required to identify any increase in viral adaptation to human hosts. Avian influenza A (H5N1) in humans differs in multiple ways from influenza due to human viruses, including the routes of transmission, clinical severity, pathogenesis, and perhaps, response to treatment.
The pathogenesis of avian influenza H5N1 viruses is likely to be multifactorial in nature, involving increased viral replication competence, viral dissemination, differences in tissue tropism, and differential gene expression responses in infected host cells. While some of these mechanisms can be blocked by efficient antiviral therapy, a better understanding of the mechanisms underlying differential activation of host genes may permit specifically directed immunomodulation to contribute to therapy of this disease. Many factors should be considered in deciding which tests to use. Sensitivity, specificity, turn-around-time, repeatability, ease of performance and costs should all be taken into account. RT-PCR is generally more sensitive than serology and culture and the combination of RT-PCR with serology more sensitive than the combination of any other two methods.