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<li id="toc-Types_of_virus" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Types_of_virus"> <div class="vector-toc-text"> 2.1 Types of virus </div> </a> <ul id="toc-Types_of_virus-sublist" class="vector-toc-list"> <li id="toc-Influenza_virus_nomenclature" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Influenza_virus_nomenclature"> <div class="vector-toc-text"> 2.1.1 Influenza virus nomenclature </div> </a> <ul id="toc-Influenza_virus_nomenclature-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Genome_and_structure" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Genome_and_structure"> <div class="vector-toc-text"> 2.2 Genome and structure </div> </a> <ul id="toc-Genome_and_structure-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Life_cycle" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Life_cycle"> <div class="vector-toc-text"> 2.3 Life cycle </div> </a> <ul id="toc-Life_cycle-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Antigenic_drift_and_shift" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antigenic_drift_and_shift"> <div class="vector-toc-text"> 2.4 Antigenic drift and shift </div> </a> <ul id="toc-Antigenic_drift_and_shift-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Mechanism" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Mechanism"> <div class="vector-toc-text"> 3 Mechanism </div> </a> <button aria-controls="toc-Mechanism-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Mechanism subsection </button> <ul id="toc-Mechanism-sublist" class="vector-toc-list"> <li id="toc-Transmission" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Transmission"> <div class="vector-toc-text"> 3.1 Transmission </div> </a> <ul id="toc-Transmission-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pathophysiology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pathophysiology"> <div class="vector-toc-text"> 3.2 Pathophysiology </div> </a> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Immunology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Immunology"> <div class="vector-toc-text"> 3.3 Immunology </div> </a> <ul id="toc-Immunology-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> 4 Prevention </div> </a> <button aria-controls="toc-Prevention-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Prevention subsection </button> <ul id="toc-Prevention-sublist" class="vector-toc-list"> <li id="toc-Vaccination" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Vaccination"> <div class="vector-toc-text"> 4.1 Vaccination </div> </a> <ul id="toc-Vaccination-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Antiviral_chemoprophylaxis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antiviral_chemoprophylaxis"> <div class="vector-toc-text"> 4.2 Antiviral chemoprophylaxis </div> </a> <ul id="toc-Antiviral_chemoprophylaxis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Infection_control" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Infection_control"> <div class="vector-toc-text"> 4.3 Infection control </div> </a> <ul id="toc-Infection_control-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> 5 Diagnosis </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> 6 Management </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Management subsection </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Antivirals" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antivirals"> <div class="vector-toc-text"> 6.1 Antivirals </div> </a> <ul id="toc-Antivirals-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> 7 Prognosis </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> 8 Epidemiology </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> 9 History </div> </a> <button aria-controls="toc-History-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle History subsection </button> <ul id="toc-History-sublist" class="vector-toc-list"> <li id="toc-Etymology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Etymology"> <div class="vector-toc-text"> 9.1 Etymology </div> </a> <ul id="toc-Etymology-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-In_animals" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#In_animals"> <div class="vector-toc-text"> 10 In animals </div> </a> <button aria-controls="toc-In_animals-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle In animals subsection </button> <ul id="toc-In_animals-sublist" class="vector-toc-list"> <li id="toc-Birds" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Birds"> <div class="vector-toc-text"> 10.1 Birds </div> </a> <ul id="toc-Birds-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pigs" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pigs"> <div class="vector-toc-text"> 10.2 Pigs </div> </a> <ul id="toc-Pigs-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_animals" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_animals"> <div class="vector-toc-text"> 10.3 Other animals </div> </a> <ul id="toc-Other_animals-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 11 References </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> 12 Further reading </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Influenza</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 145 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-145" aria-hidden="true" > 145 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Griep" title="Griep – Afrikaans" lang="af" hreflang="af" data-title="Griep" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target">Afrikaans</a></li><li class="interlanguage-link interwiki-als mw-list-item"><a href="https://als.wikipedia.org/wiki/Influenza" title="Influenza – Alemannic" lang="gsw" hreflang="gsw" data-title="Influenza" data-language-autonym="Alemannisch" data-language-local-name="Alemannic" class="interlanguage-link-target">Alemannisch</a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A5%D9%86%D9%81%D9%84%D9%88%D9%86%D8%B2%D8%A7" title="إنفلونزا – Arabic" lang="ar" hreflang="ar" data-title="إنفلونزا" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-an mw-list-item"><a href="https://an.wikipedia.org/wiki/Gripe" title="Gripe – Aragonese" lang="an" hreflang="an" data-title="Gripe" data-language-autonym="Aragonés" data-language-local-name="Aragonese" class="interlanguage-link-target">Aragonés</a></li><li class="interlanguage-link interwiki-roa-rup mw-list-item"><a href="https://roa-rup.wikipedia.org/wiki/Aremi" title="Aremi – Aromanian" lang="rup" hreflang="rup" data-title="Aremi" data-language-autonym="Armãneashti" data-language-local-name="Aromanian" class="interlanguage-link-target">Armãneashti</a></li><li class="interlanguage-link interwiki-frp mw-list-item"><a href="https://frp.wikipedia.org/wiki/Gripa" title="Gripa – Arpitan" lang="frp" hreflang="frp" data-title="Gripa" data-language-autonym="Arpetan" data-language-local-name="Arpitan" class="interlanguage-link-target">Arpetan</a></li><li class="interlanguage-link interwiki-as mw-list-item"><a href="https://as.wikipedia.org/wiki/%E0%A6%87%E0%A6%A8%E0%A6%AB%E0%A7%8D%E0%A6%B2%E0%A7%81%E0%A7%B1%E0%A7%87%E0%A6%9E%E0%A7%8D%E0%A6%9C%E0%A6%BE" title="ইনফ্লুৱেঞ্জা – Assamese" lang="as" hreflang="as" data-title="ইনফ্লুৱেঞ্জা" data-language-autonym="অসমীয়া" data-language-local-name="Assamese" class="interlanguage-link-target">অসমীয়া</a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Gripe" title="Gripe – Asturian" lang="ast" hreflang="ast" data-title="Gripe" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target">Asturianu</a></li><li class="interlanguage-link interwiki-awa mw-list-item"><a href="https://awa.wikipedia.org/wiki/%E0%A4%87%E0%A4%A8%E0%A4%AB%E0%A4%BC%E0%A5%8D%E0%A4%B2%E0%A5%81%E0%A4%8F%E0%A4%82%E0%A4%9C%E0%A4%BC%E0%A4%BE" title="इनफ़्लुएंज़ा – Awadhi" lang="awa" hreflang="awa" data-title="इनफ़्लुएंज़ा" data-language-autonym="अवधी" data-language-local-name="Awadhi" class="interlanguage-link-target">अवधी</a></li><li class="interlanguage-link interwiki-gn mw-list-item"><a href="https://gn.wikipedia.org/wiki/Mba%27asyparar%C3%A3" title="Mba'asypararã – Guarani" lang="gn" hreflang="gn" data-title="Mba'asypararã" data-language-autonym="Avañe'ẽ" data-language-local-name="Guarani" class="interlanguage-link-target">Avañe'ẽ</a></li><li class="interlanguage-link interwiki-ay mw-list-item"><a href="https://ay.wikipedia.org/wiki/Jurma_usu" title="Jurma usu – Aymara" lang="ay" hreflang="ay" data-title="Jurma usu" data-language-autonym="Aymar aru" data-language-local-name="Aymara" class="interlanguage-link-target">Aymar aru</a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Qrip" title="Qrip – Azerbaijani" lang="az" hreflang="az" data-title="Qrip" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target">Azərbaycanca</a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%A2%D9%86%D9%81%D9%88%D9%84%D8%A7%D9%86%D8%B2%D8%A7" title="آنفولانزا – South Azerbaijani" lang="azb" hreflang="azb" data-title="آنفولانزا" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target">تۆرکجه</a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%87%E0%A6%A8%E0%A6%AB%E0%A7%8D%E0%A6%B2%E0%A7%81%E0%A6%AF%E0%A6%BC%E0%A7%87%E0%A6%9E%E0%A7%8D%E0%A6%9C%E0%A6%BE" title="ইনফ্লুয়েঞ্জা – Bangla" lang="bn" hreflang="bn" data-title="ইনফ্লুয়েঞ্জা" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target">বাংলা</a></li><li class="interlanguage-link interwiki-zh-min-nan mw-list-item"><a href="https://zh-min-nan.wikipedia.org/wiki/Li%C3%BB-h%C3%AAng-s%C3%A8ng_k%C3%A1m-m%C5%8D%CD%98" title="Liû-hêng-sèng kám-mō͘ – Minnan" lang="nan" hreflang="nan" data-title="Liû-hêng-sèng kám-mō͘" data-language-autonym="閩南語 / Bân-lâm-gú" data-language-local-name="Minnan" class="interlanguage-link-target">閩南語 / Bân-lâm-gú</a></li><li class="interlanguage-link interwiki-map-bms mw-list-item"><a href="https://map-bms.wikipedia.org/wiki/Influenza" title="Influenza – Banyumasan" lang="jv-x-bms" hreflang="jv-x-bms" data-title="Influenza" data-language-autonym="Basa Banyumasan" data-language-local-name="Banyumasan" class="interlanguage-link-target">Basa Banyumasan</a></li><li class="interlanguage-link interwiki-ba mw-list-item"><a href="https://ba.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF%D0%BF" title="Грипп – Bashkir" lang="ba" hreflang="ba" data-title="Грипп" data-language-autonym="Башҡортса" data-language-local-name="Bashkir" class="interlanguage-link-target">Башҡортса</a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%93%D1%80%D1%8B%D0%BF" title="Грып – Belarusian" lang="be" hreflang="be" data-title="Грып" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target">Беларуская</a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%93%D1%80%D1%8B%D0%BF" title="Грып – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Грып" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target">Беларуская (тарашкевіца)</a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF" title="Грип – Bulgarian" lang="bg" hreflang="bg" data-title="Грип" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target">Български</a></li><li class="interlanguage-link interwiki-bo mw-list-item"><a href="https://bo.wikipedia.org/wiki/%E0%BD%9A%E0%BD%91%E0%BC%8B%E0%BD%A2%E0%BD%B2%E0%BD%98%E0%BD%A6%E0%BC%8D" title="ཚད་རིམས། – Tibetan" lang="bo" hreflang="bo" data-title="ཚད་རིམས།" data-language-autonym="བོད་ཡིག" data-language-local-name="Tibetan" class="interlanguage-link-target">བོད་ཡིག</a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Gripa" title="Gripa – Bosnian" lang="bs" hreflang="bs" data-title="Gripa" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target">Bosanski</a></li><li class="interlanguage-link interwiki-br mw-list-item"><a href="https://br.wikipedia.org/wiki/Grip" title="Grip – Breton" lang="br" hreflang="br" data-title="Grip" data-language-autonym="Brezhoneg" data-language-local-name="Breton" class="interlanguage-link-target">Brezhoneg</a></li><li class="interlanguage-link interwiki-bxr mw-list-item"><a href="https://bxr.wikipedia.org/wiki/%D0%A5%D1%8D%D0%B6%D1%8D%D0%B3" title="Хэжэг – Russia Buriat" lang="bxr" hreflang="bxr" data-title="Хэжэг" data-language-autonym="Буряад" data-language-local-name="Russia Buriat" class="interlanguage-link-target">Буряад</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Grip" title="Grip – Catalan" lang="ca" hreflang="ca" data-title="Grip" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Ch%C5%99ipka" title="Chřipka – Czech" lang="cs" hreflang="cs" data-title="Chřipka" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Y_ffliw" title="Y ffliw – Welsh" lang="cy" hreflang="cy" data-title="Y ffliw" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target">Cymraeg</a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Influenza" title="Influenza – Danish" lang="da" hreflang="da" data-title="Influenza" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Influenza" title="Influenza – German" lang="de" hreflang="de" data-title="Influenza" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%87%DE%A8%DE%82%DE%B0%DE%8A%DE%AA%DE%8D%DE%AA%DE%87%DE%AC%DE%82%DE%B0%DE%92%DE%A7" title="އިންފުލުއެންޒާ – Divehi" lang="dv" hreflang="dv" data-title="އިންފުލުއެންޒާ" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target">ދިވެހިބަސް</a></li><li class="interlanguage-link interwiki-nv mw-list-item"><a href="https://nv.wikipedia.org/wiki/Tahoniig%C3%A1%C3%A1h" title="Tahoniigááh – Navajo" lang="nv" hreflang="nv" data-title="Tahoniigááh" data-language-autonym="Diné bizaad" data-language-local-name="Navajo" class="interlanguage-link-target">Diné bizaad</a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Gripp" title="Gripp – Estonian" lang="et" hreflang="et" data-title="Gripp" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target">Eesti</a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%93%CF%81%CE%AF%CF%80%CE%B7" title="Γρίπη – Greek" lang="el" hreflang="el" data-title="Γρίπη" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target">Ελληνικά</a></li><li class="interlanguage-link interwiki-es badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://es.wikipedia.org/wiki/Gripe" title="Gripe – Spanish" lang="es" hreflang="es" data-title="Gripe" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Gripo" title="Gripo – Esperanto" lang="eo" hreflang="eo" data-title="Gripo" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target">Esperanto</a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Gripe" title="Gripe – Basque" lang="eu" hreflang="eu" data-title="Gripe" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target">Euskara</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A2%D9%86%D9%81%D9%84%D9%88%D8%A7%D9%86%D8%B2%D8%A7" title="آنفلوانزا – Persian" lang="fa" hreflang="fa" data-title="آنفلوانزا" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-hif mw-list-item"><a href="https://hif.wikipedia.org/wiki/Bukhaar" title="Bukhaar – Fiji Hindi" lang="hif" hreflang="hif" data-title="Bukhaar" data-language-autonym="Fiji Hindi" data-language-local-name="Fiji Hindi" class="interlanguage-link-target">Fiji Hindi</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Grippe" title="Grippe – French" lang="fr" hreflang="fr" data-title="Grippe" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-fy mw-list-item"><a href="https://fy.wikipedia.org/wiki/Gryp" title="Gryp – Western Frisian" lang="fy" hreflang="fy" data-title="Gryp" data-language-autonym="Frysk" data-language-local-name="Western Frisian" class="interlanguage-link-target">Frysk</a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Fli%C3%BA" title="Fliú – Irish" lang="ga" hreflang="ga" data-title="Fliú" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target">Gaeilge</a></li><li class="interlanguage-link interwiki-gd mw-list-item"><a href="https://gd.wikipedia.org/wiki/An_cnatan-m%C3%B2r" title="An cnatan-mòr – Scottish Gaelic" lang="gd" hreflang="gd" data-title="An cnatan-mòr" data-language-autonym="Gàidhlig" data-language-local-name="Scottish Gaelic" class="interlanguage-link-target">Gàidhlig</a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Gripe" title="Gripe – Galician" lang="gl" hreflang="gl" data-title="Gripe" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target">Galego</a></li><li class="interlanguage-link interwiki-hak mw-list-item"><a href="https://hak.wikipedia.org/wiki/Li%C3%B9-h%C3%A0ng-sin_k%C3%A1m-mo" title="Liù-hàng-sin kám-mo – Hakka Chinese" lang="hak" hreflang="hak" data-title="Liù-hàng-sin kám-mo" data-language-autonym="客家語 / Hak-kâ-ngî" data-language-local-name="Hakka Chinese" class="interlanguage-link-target">客家語 / Hak-kâ-ngî</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%9D%B8%ED%94%8C%EB%A3%A8%EC%97%94%EC%9E%90" title="인플루엔자 – Korean" lang="ko" hreflang="ko" data-title="인플루엔자" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Influenza" title="Influenza – Hausa" lang="ha" hreflang="ha" data-title="Influenza" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target">Hausa</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B3%D6%80%D5%AB%D5%BA" title="Գրիպ – Armenian" lang="hy" hreflang="hy" data-title="Գրիպ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%87%E0%A4%A8%E0%A4%AB%E0%A4%BC%E0%A5%8D%E0%A4%B2%E0%A5%81%E0%A4%8F%E0%A4%82%E0%A4%9C%E0%A4%BC%E0%A4%BE" title="इनफ़्लुएंज़ा – Hindi" lang="hi" hreflang="hi" data-title="इनफ़्लुएंज़ा" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target">हिन्दी</a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Gripa" title="Gripa – Croatian" lang="hr" hreflang="hr" data-title="Gripa" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target">Hrvatski</a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Influenzo" title="Influenzo – Ido" lang="io" hreflang="io" data-title="Influenzo" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target">Ido</a></li><li class="interlanguage-link interwiki-ilo mw-list-item"><a href="https://ilo.wikipedia.org/wiki/Trangkaso" title="Trangkaso – Iloko" lang="ilo" hreflang="ilo" data-title="Trangkaso" data-language-autonym="Ilokano" data-language-local-name="Iloko" class="interlanguage-link-target">Ilokano</a></li><li class="interlanguage-link interwiki-id badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://id.wikipedia.org/wiki/Influenza" title="Influenza – Indonesian" lang="id" hreflang="id" data-title="Influenza" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-ia mw-list-item"><a href="https://ia.wikipedia.org/wiki/Influenza" title="Influenza – Interlingua" lang="ia" hreflang="ia" data-title="Influenza" data-language-autonym="Interlingua" data-language-local-name="Interlingua" class="interlanguage-link-target">Interlingua</a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/Infl%C3%BAensa" title="Inflúensa – Icelandic" lang="is" hreflang="is" data-title="Inflúensa" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target">Íslenska</a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Influenza" title="Influenza – Italian" lang="it" hreflang="it" data-title="Influenza" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%A9%D7%A4%D7%A2%D7%AA" title="שפעת – Hebrew" lang="he" hreflang="he" data-title="שפעת" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-jv badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://jv.wikipedia.org/wiki/Influenza" title="Influenza – Javanese" lang="jv" hreflang="jv" data-title="Influenza" data-language-autonym="Jawa" data-language-local-name="Javanese" class="interlanguage-link-target">Jawa</a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%87%E0%B2%A8%E0%B3%8D%E0%B2%AB%E0%B3%8D%E0%B2%B2%E0%B3%81%E0%B2%AF%E0%B3%86%E0%B2%A8%E0%B3%8D%E0%B2%9C" title="ಇನ್ಫ್ಲುಯೆನ್ಜ – Kannada" lang="kn" hreflang="kn" data-title="ಇನ್ಫ್ಲುಯೆನ್ಜ" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target">ಕನ್ನಡ</a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%92%E1%83%A0%E1%83%98%E1%83%9E%E1%83%98" title="გრიპი – Georgian" lang="ka" hreflang="ka" data-title="გრიპი" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target">ქართული</a></li><li class="interlanguage-link interwiki-csb mw-list-item"><a href="https://csb.wikipedia.org/wiki/Gripa" title="Gripa – Kashubian" lang="csb" hreflang="csb" data-title="Gripa" data-language-autonym="Kaszëbsczi" data-language-local-name="Kashubian" class="interlanguage-link-target">Kaszëbsczi</a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%A2%D2%B1%D0%BC%D0%B0%D1%83" title="Тұмау – Kazakh" lang="kk" hreflang="kk" data-title="Тұмау" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target">Қазақша</a></li><li class="interlanguage-link interwiki-rn mw-list-item"><a href="https://rn.wikipedia.org/wiki/Infuluwanza" title="Infuluwanza – Rundi" lang="rn" hreflang="rn" data-title="Infuluwanza" data-language-autonym="Ikirundi" data-language-local-name="Rundi" class="interlanguage-link-target">Ikirundi</a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Homa_ya_mafua" title="Homa ya mafua – Swahili" lang="sw" hreflang="sw" data-title="Homa ya mafua" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target">Kiswahili</a></li><li class="interlanguage-link interwiki-ht mw-list-item"><a href="https://ht.wikipedia.org/wiki/Grip" title="Grip – Haitian Creole" lang="ht" hreflang="ht" data-title="Grip" data-language-autonym="Kreyòl ayisyen" data-language-local-name="Haitian Creole" class="interlanguage-link-target">Kreyòl ayisyen</a></li><li class="interlanguage-link interwiki-gcr mw-list-item"><a href="https://gcr.wikipedia.org/wiki/Lagrip" title="Lagrip – Guianan Creole" lang="gcr" hreflang="gcr" data-title="Lagrip" data-language-autonym="Kriyòl gwiyannen" data-language-local-name="Guianan Creole" class="interlanguage-link-target">Kriyòl gwiyannen</a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/Arsim" title="Arsim – Kurdish" lang="ku" hreflang="ku" data-title="Arsim" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target">Kurdî</a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF%D0%BF" title="Грипп – Kyrgyz" lang="ky" hreflang="ky" data-title="Грипп" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target">Кыргызча</a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Influentia" title="Influentia – Latin" lang="la" hreflang="la" data-title="Influentia" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target">Latina</a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Gripa" title="Gripa – Latvian" lang="lv" hreflang="lv" data-title="Gripa" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target">Latviešu</a></li><li class="interlanguage-link interwiki-lb mw-list-item"><a href="https://lb.wikipedia.org/wiki/Gripp" title="Gripp – Luxembourgish" lang="lb" hreflang="lb" data-title="Gripp" data-language-autonym="Lëtzebuergesch" data-language-local-name="Luxembourgish" class="interlanguage-link-target">Lëtzebuergesch</a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Gripas" title="Gripas – Lithuanian" lang="lt" hreflang="lt" data-title="Gripas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target">Lietuvių</a></li><li class="interlanguage-link interwiki-ln mw-list-item"><a href="https://ln.wikipedia.org/wiki/Mal%C3%A1li_na_m%C9%94p%C9%9Bp%C9%9B" title="Maláli na mɔpɛpɛ – Lingala" lang="ln" hreflang="ln" data-title="Maláli na mɔpɛpɛ" data-language-autonym="Lingála" data-language-local-name="Lingala" class="interlanguage-link-target">Lingála</a></li><li class="interlanguage-link interwiki-lmo mw-list-item"><a href="https://lmo.wikipedia.org/wiki/Grippa" title="Grippa – Lombard" lang="lmo" hreflang="lmo" data-title="Grippa" data-language-autonym="Lombard" data-language-local-name="Lombard" class="interlanguage-link-target">Lombard</a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Influenza" title="Influenza – Hungarian" lang="hu" hreflang="hu" data-title="Influenza" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target">Magyar</a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF" title="Грип – Macedonian" lang="mk" hreflang="mk" data-title="Грип" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target">Македонски</a></li><li class="interlanguage-link interwiki-mg mw-list-item"><a href="https://mg.wikipedia.org/wiki/Gripa" title="Gripa – Malagasy" lang="mg" hreflang="mg" data-title="Gripa" data-language-autonym="Malagasy" data-language-local-name="Malagasy" class="interlanguage-link-target">Malagasy</a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%87%E0%B5%BB%E0%B4%AB%E0%B5%8D%E0%B4%B2%E0%B5%81%E0%B4%B5%E0%B5%86%E0%B5%BB%E0%B4%B8" title="ഇൻഫ്ലുവെൻസ – Malayalam" lang="ml" hreflang="ml" data-title="ഇൻഫ്ലുവെൻസ" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target">മലയാളം</a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%87%E0%A4%A8%E0%A5%8D%E0%A4%AB%E0%A5%8D%E0%A4%B2%E0%A5%81%E0%A4%8F%E0%A4%A8%E0%A5%8D%E0%A4%9D%E0%A4%BE" title="इन्फ्लुएन्झा – Marathi" lang="mr" hreflang="mr" data-title="इन्फ्लुएन्झा" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target">मराठी</a></li><li class="interlanguage-link interwiki-xmf mw-list-item"><a href="https://xmf.wikipedia.org/wiki/%E1%83%92%E1%83%A0%E1%83%98%E1%83%9E%E1%83%98" title="გრიპი – Mingrelian" lang="xmf" hreflang="xmf" data-title="გრიპი" data-language-autonym="მარგალური" data-language-local-name="Mingrelian" class="interlanguage-link-target">მარგალური</a></li><li class="interlanguage-link interwiki-arz mw-list-item"><a href="https://arz.wikipedia.org/wiki/%D8%A7%D9%86%D9%81%D9%84%D9%88%D9%86%D8%B2%D8%A7" title="انفلونزا – Egyptian Arabic" lang="arz" hreflang="arz" data-title="انفلونزا" data-language-autonym="مصرى" data-language-local-name="Egyptian Arabic" class="interlanguage-link-target">مصرى</a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Influenza" title="Influenza – Malay" lang="ms" hreflang="ms" data-title="Influenza" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target">Bahasa Melayu</a></li><li class="interlanguage-link interwiki-min mw-list-item"><a href="https://min.wikipedia.org/wiki/Influenza" title="Influenza – Minangkabau" lang="min" hreflang="min" data-title="Influenza" data-language-autonym="Minangkabau" data-language-local-name="Minangkabau" class="interlanguage-link-target">Minangkabau</a></li><li class="interlanguage-link interwiki-cdo mw-list-item"><a href="https://cdo.wikipedia.org/wiki/Li%C3%B9-h%C3%A8ng-s%C3%A9ng_g%C4%81ng-m%C3%B4%CC%A4" title="Liù-hèng-séng gāng-mô̤ – Mindong" lang="cdo" hreflang="cdo" data-title="Liù-hèng-séng gāng-mô̤" data-language-autonym="閩東語 / Mìng-dĕ̤ng-ngṳ̄" data-language-local-name="Mindong" class="interlanguage-link-target">閩東語 / Mìng-dĕ̤ng-ngṳ̄</a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%90%E1%80%AF%E1%80%95%E1%80%BA%E1%80%80%E1%80%BD%E1%80%B1%E1%80%B8%E1%80%9B%E1%80%B1%E1%80%AC%E1%80%82%E1%80%AB" title="တုပ်ကွေးရောဂါ – Burmese" lang="my" hreflang="my" data-title="တုပ်ကွေးရောဂါ" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target">မြန်မာဘာသာ</a></li><li class="interlanguage-link interwiki-fj mw-list-item"><a href="https://fj.wikipedia.org/wiki/Influenza" title="Influenza – Fijian" lang="fj" hreflang="fj" data-title="Influenza" data-language-autonym="Na Vosa Vakaviti" data-language-local-name="Fijian" class="interlanguage-link-target">Na Vosa Vakaviti</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Griep" title="Griep – Dutch" lang="nl" hreflang="nl" data-title="Griep" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ne mw-list-item"><a href="https://ne.wikipedia.org/wiki/%E0%A4%87%E0%A4%A8%E0%A5%8D%E0%A4%AB%E0%A5%8D%E0%A4%B2%E0%A5%81%E0%A4%8F%E0%A4%A8%E0%A5%8D%E0%A4%9C%E0%A4%BE" title="इन्फ्लुएन्जा – Nepali" lang="ne" hreflang="ne" data-title="इन्फ्लुएन्जा" data-language-autonym="नेपाली" data-language-local-name="Nepali" class="interlanguage-link-target">नेपाली</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%82%A4%E3%83%B3%E3%83%95%E3%83%AB%E3%82%A8%E3%83%B3%E3%82%B6" title="インフルエンザ – Japanese" lang="ja" hreflang="ja" data-title="インフルエンザ" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-frr badge-Q70894304 mw-list-item" title=""><a href="https://frr.wikipedia.org/wiki/Influenza" title="Influenza – Northern Frisian" lang="frr" hreflang="frr" data-title="Influenza" data-language-autonym="Nordfriisk" data-language-local-name="Northern Frisian" class="interlanguage-link-target">Nordfriisk</a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Influensa" title="Influensa – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Influensa" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Influensa" title="Influensa – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Influensa" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target">Norsk nynorsk</a></li><li class="interlanguage-link interwiki-oc mw-list-item"><a href="https://oc.wikipedia.org/wiki/Gripa" title="Gripa – Occitan" lang="oc" hreflang="oc" data-title="Gripa" data-language-autonym="Occitan" data-language-local-name="Occitan" class="interlanguage-link-target">Occitan</a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%87%E0%AC%A8%E0%AD%8D%E2%80%8C%E0%AC%AB%E0%AD%8D%E0%AC%B2%E0%AD%81%E0%AC%8F%E0%AC%9E%E0%AD%8D%E0%AC%9C%E0%AC%BE" title="ଇନ୍‌ଫ୍ଲୁଏଞ୍ଜା – Odia" lang="or" hreflang="or" data-title="ଇନ୍‌ଫ୍ଲୁଏଞ୍ଜା" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target">ଓଡ଼ିଆ</a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Gripp" title="Gripp – Uzbek" lang="uz" hreflang="uz" data-title="Gripp" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target">Oʻzbekcha / ўзбекча</a></li><li class="interlanguage-link interwiki-pa mw-list-item"><a href="https://pa.wikipedia.org/wiki/%E0%A8%87%E0%A8%A8%E0%A8%AB%E0%A8%B2%E0%A9%82%E0%A8%90%E0%A8%A8%E0%A8%9C%E0%A8%BC%E0%A8%BE" title="ਇਨਫਲੂਐਨਜ਼ਾ – Punjabi" lang="pa" hreflang="pa" data-title="ਇਨਫਲੂਐਨਜ਼ਾ" data-language-autonym="ਪੰਜਾਬੀ" data-language-local-name="Punjabi" class="interlanguage-link-target">ਪੰਜਾਬੀ</a></li><li class="interlanguage-link interwiki-pnb mw-list-item"><a href="https://pnb.wikipedia.org/wiki/%D9%86%D8%B2%D9%84%DB%81" title="نزلہ – Western Punjabi" lang="pnb" hreflang="pnb" data-title="نزلہ" data-language-autonym="پنجابی" data-language-local-name="Western Punjabi" class="interlanguage-link-target">پنجابی</a></li><li class="interlanguage-link interwiki-blk mw-list-item"><a href="https://blk.wikipedia.org/wiki/%E1%80%90%E1%80%AF%E1%80%90%E1%80%BA%E1%80%80%E1%80%BD%E1%80%B1%E1%80%B8%E1%80%9B%E1%80%B1%E1%80%AC%E1%82%8F%E1%80%82%E1%80%AB%E1%82%8F" title="တုတ်ကွေးရောႏဂါႏ – Pa'O" lang="blk" hreflang="blk" data-title="တုတ်ကွေးရောႏဂါႏ" data-language-autonym="ပအိုဝ်ႏဘာႏသာႏ" data-language-local-name="Pa'O" class="interlanguage-link-target">ပအိုဝ်ႏဘာႏသာႏ</a></li><li class="interlanguage-link interwiki-pap mw-list-item"><a href="https://pap.wikipedia.org/wiki/Grip" title="Grip – Papiamento" lang="pap" hreflang="pap" data-title="Grip" data-language-autonym="Papiamentu" data-language-local-name="Papiamento" class="interlanguage-link-target">Papiamentu</a></li><li class="interlanguage-link interwiki-jam mw-list-item"><a href="https://jam.wikipedia.org/wiki/Influenza" title="Influenza – Jamaican Creole English" lang="jam" hreflang="jam" data-title="Influenza" data-language-autonym="Patois" data-language-local-name="Jamaican Creole English" class="interlanguage-link-target">Patois</a></li><li class="interlanguage-link interwiki-nds mw-list-item"><a href="https://nds.wikipedia.org/wiki/Gripp" title="Gripp – Low German" lang="nds" hreflang="nds" data-title="Gripp" data-language-autonym="Plattdüütsch" data-language-local-name="Low German" class="interlanguage-link-target">Plattdüütsch</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Grypa" title="Grypa – Polish" lang="pl" hreflang="pl" data-title="Grypa" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://pt.wikipedia.org/wiki/Gripe" title="Gripe – Portuguese" lang="pt" hreflang="pt" data-title="Gripe" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-kaa mw-list-item"><a href="https://kaa.wikipedia.org/wiki/Gripp" title="Gripp – Kara-Kalpak" lang="kaa" hreflang="kaa" data-title="Gripp" data-language-autonym="Qaraqalpaqsha" data-language-local-name="Kara-Kalpak" class="interlanguage-link-target">Qaraqalpaqsha</a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Grip%C4%83" title="Gripă – Romanian" lang="ro" hreflang="ro" data-title="Gripă" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target">Română</a></li><li class="interlanguage-link interwiki-qu mw-list-item"><a href="https://qu.wikipedia.org/wiki/Chhulli" title="Chhulli – Quechua" lang="qu" hreflang="qu" data-title="Chhulli" data-language-autonym="Runa Simi" data-language-local-name="Quechua" class="interlanguage-link-target">Runa Simi</a></li><li class="interlanguage-link interwiki-rue mw-list-item"><a href="https://rue.wikipedia.org/wiki/%D0%A5%D1%80%D0%B8%D0%BF%D0%BA%D0%B0" title="Хрипка – Rusyn" lang="rue" hreflang="rue" data-title="Хрипка" data-language-autonym="Русиньскый" data-language-local-name="Rusyn" class="interlanguage-link-target">Русиньскый</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF%D0%BF" title="Грипп – Russian" lang="ru" hreflang="ru" data-title="Грипп" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF%D0%BF" title="Грипп – Yakut" lang="sah" hreflang="sah" data-title="Грипп" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target">Саха тыла</a></li><li class="interlanguage-link interwiki-sco mw-list-item"><a href="https://sco.wikipedia.org/wiki/Haingles" title="Haingles – Scots" lang="sco" hreflang="sco" data-title="Haingles" data-language-autonym="Scots" data-language-local-name="Scots" class="interlanguage-link-target">Scots</a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Gripi" title="Gripi – Albanian" lang="sq" hreflang="sq" data-title="Gripi" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target">Shqip</a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B6%89%E0%B6%B1%E0%B7%8A%E0%B7%86%E0%B7%8A%E0%B6%BD%E0%B7%94%E0%B7%80%E0%B7%99%E0%B6%B1%E0%B7%8A%E0%B7%83%E0%B7%8F" title="ඉන්ෆ්ලුවෙන්සා – Sinhala" lang="si" hreflang="si" data-title="ඉන්ෆ්ලුවෙන්සා" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target">සිංහල</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Influenza" title="Influenza – Simple English" lang="en-simple" hreflang="en-simple" data-title="Influenza" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-sd mw-list-item"><a href="https://sd.wikipedia.org/wiki/%D9%88%D8%A8%D8%A7%D8%A6%D9%8A_%D8%B2%DA%AA%D8%A7%D9%85" title="وبائي زڪام – Sindhi" lang="sd" hreflang="sd" data-title="وبائي زڪام" data-language-autonym="سنڌي" data-language-local-name="Sindhi" class="interlanguage-link-target">سنڌي</a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Chr%C3%ADpka" title="Chrípka – Slovak" lang="sk" hreflang="sk" data-title="Chrípka" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target">Slovenčina</a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Gripa" title="Gripa – Slovenian" lang="sl" hreflang="sl" data-title="Gripa" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target">Slovenščina</a></li><li class="interlanguage-link interwiki-so mw-list-item"><a href="https://so.wikipedia.org/wiki/Hargab" title="Hargab – Somali" lang="so" hreflang="so" data-title="Hargab" data-language-autonym="Soomaaliga" data-language-local-name="Somali" class="interlanguage-link-target">Soomaaliga</a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D8%A6%DB%95%D9%86%D9%81%D9%84%DB%86%D9%86%D8%B2%D8%A7" title="ئەنفلۆنزا – Central Kurdish" lang="ckb" hreflang="ckb" data-title="ئەنفلۆنزا" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target">کوردی</a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF" title="Грип – Serbian" lang="sr" hreflang="sr" data-title="Грип" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target">Српски / srpski</a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Influenca" title="Influenca – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Influenca" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target">Srpskohrvatski / српскохрватски</a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Influenssa" title="Influenssa – Finnish" lang="fi" hreflang="fi" data-title="Influenssa" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target">Suomi</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Influensa" title="Influensa – Swedish" lang="sv" hreflang="sv" data-title="Influensa" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Trangkaso" title="Trangkaso – Tagalog" lang="tl" hreflang="tl" data-title="Trangkaso" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target">Tagalog</a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%87%E0%AE%A9%E0%AF%8D%E0%AE%83%E0%AE%AA%E0%AF%81%E0%AE%B3%E0%AF%81%E0%AE%B5%E0%AF%86%E0%AE%A9%E0%AF%8D%E0%AE%9A%E0%AE%BE" title="இன்ஃபுளுவென்சா – Tamil" lang="ta" hreflang="ta" data-title="இன்ஃபுளுவென்சா" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target">தமிழ்</a></li><li class="interlanguage-link interwiki-kab mw-list-item"><a href="https://kab.wikipedia.org/wiki/Tussit" title="Tussit – Kabyle" lang="kab" hreflang="kab" data-title="Tussit" data-language-autonym="Taqbaylit" data-language-local-name="Kabyle" class="interlanguage-link-target">Taqbaylit</a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF%D0%BF" title="Грипп – Tatar" lang="tt" hreflang="tt" data-title="Грипп" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target">Татарча / tatarça</a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%AB%E0%B1%8D%E0%B0%B2%E0%B1%82" title="ఫ్లూ – Telugu" lang="te" hreflang="te" data-title="ఫ్లూ" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target">తెలుగు</a></li><li class="interlanguage-link interwiki-th badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://th.wikipedia.org/wiki/%E0%B9%84%E0%B8%82%E0%B9%89%E0%B8%AB%E0%B8%A7%E0%B8%B1%E0%B8%94%E0%B9%83%E0%B8%AB%E0%B8%8D%E0%B9%88" title="ไข้หวัดใหญ่ – Thai" lang="th" hreflang="th" data-title="ไข้หวัดใหญ่" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target">ไทย</a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF%D0%BF" title="Грипп – Tajik" lang="tg" hreflang="tg" data-title="Грипп" data-language-autonym="Тоҷикӣ" data-language-local-name="Tajik" class="interlanguage-link-target">Тоҷикӣ</a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Grip" title="Grip – Turkish" lang="tr" hreflang="tr" data-title="Grip" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target">Türkçe</a></li><li class="interlanguage-link interwiki-tk mw-list-item"><a href="https://tk.wikipedia.org/wiki/D%C3%BCmew" title="Dümew – Turkmen" lang="tk" hreflang="tk" data-title="Dümew" data-language-autonym="Türkmençe" data-language-local-name="Turkmen" class="interlanguage-link-target">Türkmençe</a></li><li class="interlanguage-link interwiki-tyv mw-list-item"><a href="https://tyv.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF%D0%BF" title="Грипп – Tuvinian" lang="tyv" hreflang="tyv" data-title="Грипп" data-language-autonym="Тыва дыл" data-language-local-name="Tuvinian" class="interlanguage-link-target">Тыва дыл</a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%93%D1%80%D0%B8%D0%BF" title="Грип – Ukrainian" lang="uk" hreflang="uk" data-title="Грип" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target">Українська</a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%D9%86%D8%B2%D9%84%DB%81" title="نزلہ – Urdu" lang="ur" hreflang="ur" data-title="نزلہ" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target">اردو</a></li><li class="interlanguage-link interwiki-vec mw-list-item"><a href="https://vec.wikipedia.org/wiki/Influensa" title="Influensa – Venetian" lang="vec" hreflang="vec" data-title="Influensa" data-language-autonym="Vèneto" data-language-local-name="Venetian" class="interlanguage-link-target">Vèneto</a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/C%C3%BAm" title="Cúm – Vietnamese" lang="vi" hreflang="vi" data-title="Cúm" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target">Tiếng Việt</a></li><li class="interlanguage-link interwiki-wa mw-list-item"><a href="https://wa.wikipedia.org/wiki/Vir%C3%BBsse_del_gripe" title="Virûsse del gripe – Walloon" lang="wa" hreflang="wa" data-title="Virûsse del gripe" data-language-autonym="Walon" data-language-local-name="Walloon" class="interlanguage-link-target">Walon</a></li><li class="interlanguage-link interwiki-vls mw-list-item"><a href="https://vls.wikipedia.org/wiki/Griep" title="Griep – West Flemish" lang="vls" hreflang="vls" data-title="Griep" data-language-autonym="West-Vlams" data-language-local-name="West Flemish" class="interlanguage-link-target">West-Vlams</a></li><li class="interlanguage-link interwiki-war mw-list-item"><a href="https://war.wikipedia.org/wiki/Trangkaso" title="Trangkaso – Waray" lang="war" hreflang="war" data-title="Trangkaso" data-language-autonym="Winaray" data-language-local-name="Waray" class="interlanguage-link-target">Winaray</a></li><li class="interlanguage-link interwiki-wuu mw-list-item"><a href="https://wuu.wikipedia.org/wiki/%E6%B5%81%E8%A1%8C%E6%80%A7%E6%84%9F%E5%86%92" title="流行性感冒 – Wu" lang="wuu" hreflang="wuu" data-title="流行性感冒" data-language-autonym="吴语" data-language-local-name="Wu" class="interlanguage-link-target">吴语</a></li><li class="interlanguage-link interwiki-ts mw-list-item"><a href="https://ts.wikipedia.org/wiki/Mukhuhlwana" title="Mukhuhlwana – Tsonga" lang="ts" hreflang="ts" data-title="Mukhuhlwana" data-language-autonym="Xitsonga" data-language-local-name="Tsonga" class="interlanguage-link-target">Xitsonga</a></li><li class="interlanguage-link interwiki-yi mw-list-item"><a href="https://yi.wikipedia.org/wiki/%D7%92%D7%A8%D7%99%D7%A4%D7%A2" title="גריפע – Yiddish" lang="yi" hreflang="yi" data-title="גריפע" data-language-autonym="ייִדיש" data-language-local-name="Yiddish" class="interlanguage-link-target">ייִדיש</a></li><li class="interlanguage-link interwiki-yo mw-list-item"><a href="https://yo.wikipedia.org/wiki/%C3%80r%C3%B9n_g%C3%A1g%C3%A1" title="Àrùn gágá – Yoruba" lang="yo" hreflang="yo" data-title="Àrùn gágá" data-language-autonym="Yorùbá" data-language-local-name="Yoruba" class="interlanguage-link-target">Yorùbá</a></li><li class="interlanguage-link interwiki-zh-yue mw-list-item"><a href="https://zh-yue.wikipedia.org/wiki/%E6%B5%81%E8%A1%8C%E6%80%A7%E6%84%9F%E5%86%92" title="流行性感冒 – Cantonese" lang="yue" hreflang="yue" data-title="流行性感冒" data-language-autonym="粵語" data-language-local-name="Cantonese" class="interlanguage-link-target">粵語</a></li><li class="interlanguage-link interwiki-bat-smg mw-list-item"><a href="https://bat-smg.wikipedia.org/wiki/Grips" title="Grips – Samogitian" lang="sgs" hreflang="sgs" data-title="Grips" 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For other uses, see <a href="/wiki/Flu_(disambiguation)" class="mw-disambig" title="Flu (disambiguation)">Flu (disambiguation)</a>, <a href="/wiki/Grippe_(disambiguation)" class="mw-disambig" title="Grippe (disambiguation)">Grippe (disambiguation)</a>, and <a href="/wiki/Influenza_(disambiguation)" class="mw-disambig" title="Influenza (disambiguation)">Influenza (disambiguation)</a>.</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">"Flus" redirects here. For the diagnostic class of thyroid nodules, see <a href="/wiki/FLUS" class="mw-redirect" title="FLUS">FLUS</a>.</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Flue" title="Flue">Flue</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Influenza</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">flu, grippe (French for flu)</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><a href="/wiki/File:EM_of_influenza_virus.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a4/EM_of_influenza_virus.jpg/220px-EM_of_influenza_virus.jpg" decoding="async" width="220" height="234" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a4/EM_of_influenza_virus.jpg/330px-EM_of_influenza_virus.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a4/EM_of_influenza_virus.jpg/440px-EM_of_influenza_virus.jpg 2x" data-file-width="700" data-file-height="743" /></a></td></tr><tr><td colspan="2" class="infobox-full-data">Influenza virus</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Infectious_disease_(medical_specialty)" class="mw-redirect" title="Infectious disease (medical specialty)">Infectious disease</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><a href="/wiki/Fever" title="Fever">Fever</a>, <a href="/wiki/Rhinorrhea" title="Rhinorrhea">runny nose</a>, <a href="/wiki/Sore_throat" title="Sore throat">sore throat</a>, <a href="/wiki/Myalgia" title="Myalgia">muscle pain</a>, <a href="/wiki/Headache" title="Headache">headache</a>, <a href="/wiki/Cough" title="Cough">coughing</a>, <a href="/wiki/Fatigue" title="Fatigue">fatigue</a></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">1–4 days after exposure</td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">2–8 days</td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data">Influenza viruses</td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data"><a href="/wiki/Hand_washing" title="Hand washing">Hand washing</a>, <a href="/wiki/Flu_vaccine" class="mw-redirect" title="Flu vaccine">flu vaccines</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medication" title="Medication">Medication</a></th><td class="infobox-data"><a href="/wiki/Antiviral_drug" title="Antiviral drug">Antiviral drugs</a> such as <a href="/wiki/Oseltamivir" title="Oseltamivir">oseltamivir</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">3–5 million severe cases per year<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-sautto-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label">Deaths</th><td class="infobox-data">>290,000–650,000 deaths per year<a href="#cite_note-allen-3">[3]</a><a href="#cite_note-lampejo-4">[4]</a></td></tr></tbody></table> Influenza, commonly known as the flu, is an <a href="/wiki/Infectious_disease" class="mw-redirect" title="Infectious disease">infectious disease</a> caused by <a href="/wiki/Influenza_viruses" class="mw-redirect" title="Influenza viruses">influenza viruses</a>. Symptoms range from mild to severe and often include <a href="/wiki/Fever" title="Fever">fever</a>, <a href="/wiki/Rhinorrhea" title="Rhinorrhea">runny nose</a>, <a href="/wiki/Sore_throat" title="Sore throat">sore throat</a>, <a href="/wiki/Myalgia" title="Myalgia">muscle pain</a>, <a href="/wiki/Headache" title="Headache">headache</a>, <a href="/wiki/Cough" title="Cough">coughing</a>, and <a href="/wiki/Fatigue" title="Fatigue">fatigue</a>. These symptoms begin one to four (typically two) days after exposure to the virus and last for about two to eight days. <a href="/wiki/Diarrhea" title="Diarrhea">Diarrhea</a> and <a href="/wiki/Vomiting" title="Vomiting">vomiting</a> can occur, particularly in children. Influenza may progress to <a href="/wiki/Pneumonia" title="Pneumonia">pneumonia</a> from the virus or a subsequent <a href="/wiki/Bacterial_infection" class="mw-redirect" title="Bacterial infection">bacterial infection</a>. Other complications include <a href="/wiki/Acute_respiratory_distress_syndrome" title="Acute respiratory distress syndrome">acute respiratory distress syndrome</a>, <a href="/wiki/Meningitis" title="Meningitis">meningitis</a>, <a href="/wiki/Encephalitis" title="Encephalitis">encephalitis</a>, and worsening of pre-existing health problems such as <a href="/wiki/Asthma" title="Asthma">asthma</a> and <a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">cardiovascular disease</a>. There are four types of influenza virus: types A, B, C, and D. <a href="/wiki/Aquatic_bird" class="mw-redirect" title="Aquatic bird">Aquatic birds</a> are the primary source of <a href="/wiki/Influenza_A_virus" title="Influenza A virus">influenza A virus</a> (IAV), which is also widespread in various mammals, including humans and pigs. <a href="/wiki/Influenza_B_virus" title="Influenza B virus">Influenza B virus</a> (IBV) and <a href="/wiki/Influenza_C_virus" title="Influenza C virus">influenza C virus</a> (ICV) primarily infect humans, and <a href="/wiki/Influenza_D_virus" title="Influenza D virus">influenza D virus</a> (IDV) is found in cattle and pigs. Influenza A virus and influenza B virus circulate in humans and cause seasonal <a href="/wiki/Epidemic" title="Epidemic">epidemics</a>, and influenza C virus causes a mild infection, primarily in children. Influenza D virus can infect humans but is not known to cause illness. In humans, influenza viruses are primarily <a href="/wiki/Disease_transmission" class="mw-redirect" title="Disease transmission">transmitted</a> through <a href="/wiki/Respiratory_droplet" title="Respiratory droplet">respiratory droplets</a> from coughing and sneezing. Transmission through <a href="/wiki/Aerosol" title="Aerosol">aerosols</a> and surfaces contaminated by the virus also occur. Frequent <a href="/wiki/Hand_washing" title="Hand washing">hand washing</a> and covering one's mouth and nose when coughing and sneezing reduce transmission, as does wearing a mask. <a href="/wiki/Influenza_vaccination" class="mw-redirect" title="Influenza vaccination">Annual vaccination</a> can help to provide protection against influenza. Influenza viruses, particularly influenza A virus, evolve quickly, so flu vaccines are updated regularly to match which influenza strains are in circulation. Vaccines provide protection against influenza A virus subtypes <a href="/wiki/H1N1" class="mw-redirect" title="H1N1">H1N1</a> and <a href="/wiki/H3N2" class="mw-redirect" title="H3N2">H3N2</a> and one or two influenza B virus subtypes. Influenza infection is diagnosed with laboratory methods such as <a href="/wiki/Antibody" title="Antibody">antibody</a> or <a href="/wiki/Antigen" title="Antigen">antigen</a> tests and a polymerase chain reaction (<a href="/wiki/Polymerase_chain_reaction" title="Polymerase chain reaction">PCR</a>) to identify viral <a href="/wiki/Nucleic_acid" title="Nucleic acid">nucleic acid</a>. The disease can be treated with <a href="/wiki/Supportive_measures" class="mw-redirect" title="Supportive measures">supportive measures</a> and, in severe cases, with <a href="/wiki/Antiviral_drug" title="Antiviral drug">antiviral drugs</a> such as <a href="/wiki/Oseltamivir" title="Oseltamivir">oseltamivir</a>. In healthy individuals, influenza is typically <a href="/wiki/Self-limiting_(biology)" title="Self-limiting (biology)">self-limiting</a> and rarely fatal, but it can be deadly in high-risk groups. In a typical year, five to 15 percent of the population contracts influenza. There are 3 to 5 million severe cases annually, with up to 650,000 respiratory-related deaths globally each year. Deaths most commonly occur in high-risk groups, including young children, the elderly, and people with chronic health conditions. In <a href="/wiki/Temperate_region" class="mw-redirect" title="Temperate region">temperate regions</a>, the number of influenza cases peaks during winter, whereas in the <a href="/wiki/Tropics" title="Tropics">tropics</a>, influenza can occur year-round. Since the late 1800s, <a href="/wiki/Pandemic" title="Pandemic">pandemic</a> outbreaks of novel influenza strains have occurred every 10 to 50 years. Five <a href="/wiki/Influenza_pandemic" title="Influenza pandemic">flu pandemics</a> have occurred since 1900: the <a href="/wiki/Spanish_flu" title="Spanish flu">Spanish flu</a> from 1918 to 1920, which was the most severe; the <a href="/wiki/Asian_flu" class="mw-redirect" title="Asian flu">Asian flu</a> in 1957; the <a href="/wiki/Hong_Kong_flu" title="Hong Kong flu">Hong Kong flu</a> in 1968; the <a href="/wiki/1977_Russian_flu" title="1977 Russian flu">Russian flu</a> in 1977; and the <a href="/wiki/2009_swine_flu_pandemic" title="2009 swine flu pandemic">swine flu pandemic</a> in 2009. <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Symptoms_of_influenza.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/9e/Symptoms_of_influenza.svg/300px-Symptoms_of_influenza.svg.png" decoding="async" width="300" height="263" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/9e/Symptoms_of_influenza.svg/450px-Symptoms_of_influenza.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/9e/Symptoms_of_influenza.svg/600px-Symptoms_of_influenza.svg.png 2x" data-file-width="1200" data-file-height="1050" /></a><figcaption>Symptoms of influenza,<a href="#cite_note-5">[5]</a><a href="#cite_note-6">[6]</a> with fever and cough the most common symptoms<a href="#cite_note-pmid15728170-7">[7]</a></figcaption></figure> The symptoms of influenza are similar to those of a cold, although usually more severe and less likely to include a <a href="/wiki/Runny_nose" class="mw-redirect" title="Runny nose">runny nose</a>.<a href="#cite_note-CMAJ2014-8">[8]</a><a href="#cite_note-9">[9]</a> The time between exposure to the virus and development of symptoms (the <a href="/wiki/Incubation_period" title="Incubation period">incubation period</a>) is one to four days, most commonly one to two days. Many infections are asymptomatic.<a href="#cite_note-dharmapalan-10">[10]</a> The onset of symptoms is sudden, and initial symptoms are predominately non-specific, including fever, chills, headaches, <a href="/wiki/Myalgia" title="Myalgia">muscle pain</a>, <a href="/wiki/Malaise" title="Malaise">malaise</a>, <a href="/wiki/Anorexia" class="mw-redirect" title="Anorexia">loss of appetite</a>, lack of energy, and confusion. These are usually accompanied by respiratory symptoms such as a <a href="/wiki/Dry_cough" class="mw-redirect" title="Dry cough">dry cough</a>, <a href="/wiki/Pharyngitis" title="Pharyngitis">sore or dry throat</a>, <a href="/wiki/Hoarseness" class="mw-redirect" title="Hoarseness">hoarse voice</a>, and a <a href="/wiki/Nasal_congestion" title="Nasal congestion">stuffy</a> or <a href="/wiki/Rhinorrhea" title="Rhinorrhea">runny nose</a>. Coughing is the most common symptom.<a href="#cite_note-krammer-1">[1]</a> Gastrointestinal symptoms may also occur, including nausea, vomiting, diarrhea,<a href="#cite_note-ghebrehewet-11">[11]</a> and gastroenteritis,<a href="#cite_note-sederdahl-12">[12]</a> especially in children. The standard influenza symptoms typically last for two to eight days.<a href="#cite_note-peteranderl-13">[13]</a> Some studies suggest influenza can cause long-lasting symptoms in a similar way to <a href="/wiki/Long_COVID" title="Long COVID">long COVID</a>.<a href="#cite_note-14">[14]</a><a href="#cite_note-15">[15]</a><a href="#cite_note-16">[16]</a> Symptomatic infections are usually mild and limited to the <a href="/wiki/Upper_respiratory_tract" class="mw-redirect" title="Upper respiratory tract">upper respiratory tract</a>, but progression to pneumonia is relatively common. Pneumonia may be caused by the primary viral infection or a <a href="/wiki/Secondary_infection" class="mw-redirect" title="Secondary infection">secondary bacterial infection</a>. Primary pneumonia is characterized by rapid progression of fever, cough, <a href="/wiki/Dyspnea" class="mw-redirect" title="Dyspnea">labored breathing</a>, and <a href="/wiki/Hypoxia_(medical)" class="mw-redirect" title="Hypoxia (medical)">low oxygen levels</a> that cause <a href="/wiki/Cyanosis" title="Cyanosis">bluish skin</a>. It is especially common among those who have an underlying <a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">cardiovascular disease</a> such as <a href="/wiki/Rheumatic_heart_disease" class="mw-redirect" title="Rheumatic heart disease">rheumatic heart disease</a>. Secondary pneumonia typically has a period of improvement in symptoms for one to three weeks<a href="#cite_note-kalil-17">[17]</a> followed by recurrent fever, <a href="/wiki/Sputum" title="Sputum">sputum</a> production, and <a href="/wiki/Pulmonary_effusion" class="mw-redirect" title="Pulmonary effusion">fluid buildup in the lungs</a>,<a href="#cite_note-krammer-1">[1]</a> but can also occur just a few days after influenza symptoms appear.<a href="#cite_note-kalil-17">[17]</a> About a third of primary pneumonia cases are followed by secondary pneumonia, which is most frequently caused by the bacteria <a href="/wiki/Streptococcus_pneumoniae" title="Streptococcus pneumoniae">Streptococcus pneumoniae</a> and <a href="/wiki/Staphylococcus_aureus" title="Staphylococcus aureus">Staphylococcus aureus</a>.<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-krammer-1">[1]</a> <div class="mw-heading mw-heading2"><h2 id="Virology">Virology</h2></div> <div class="mw-heading mw-heading3"><h3 id="Types_of_virus">Types of virus</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Influenza_nomenclature.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/7a/Influenza_nomenclature.svg/310px-Influenza_nomenclature.svg.png" decoding="async" width="310" height="200" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/7a/Influenza_nomenclature.svg/465px-Influenza_nomenclature.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/7a/Influenza_nomenclature.svg/620px-Influenza_nomenclature.svg.png 2x" data-file-width="590" data-file-height="380" /></a><figcaption>Influenza virus <a href="/wiki/International_Committee_on_Taxonomy_of_Viruses" title="International Committee on Taxonomy of Viruses">nomenclature</a> (for a <a href="/wiki/Fujian_flu" title="Fujian flu">Fujian flu</a> virus)</figcaption></figure> Influenza viruses comprise four species, each the sole member of its own genus. The four influenza genera comprise four of the seven genera in the family <a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a>. They are:<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ictv-18">[18]</a> <ul><li><a href="/wiki/Influenza_A_virus" title="Influenza A virus">Influenza A virus</a>, genus Alphainfluenzavirus</li> <li><a href="/wiki/Influenza_B_virus" title="Influenza B virus">Influenza B virus</a>, genus Betainfluenzavirus</li> <li><a href="/wiki/Influenza_C_virus" title="Influenza C virus">Influenza C virus</a>, genus Gammainfluenzavirus</li> <li><a href="/wiki/Influenza_D_virus" title="Influenza D virus">Influenza D virus</a>, genus Deltainfluenzavirus</li></ul> Influenza A virus is responsible for most cases of severe illness as well as seasonal epidemics and occasional pandemics. It infects people of all ages but tends to disproportionately cause severe illness in the elderly, the very young, and those with chronic health issues. Birds are the primary reservoir of influenza A virus, especially aquatic birds such as ducks, geese, shorebirds, and gulls,<a href="#cite_note-li-19">[19]</a><a href="#cite_note-joseph-20">[20]</a> but the virus also circulates among mammals, including pigs, horses, and marine mammals. Subtypes of Influenza A are defined by the combination of the antigenic viral proteins <a href="/wiki/Hemagglutinin_(influenza)" title="Hemagglutinin (influenza)">haemagglutinin</a> (H) and <a href="/wiki/Neuraminidase" title="Neuraminidase">neuraminidase</a> (N) in the <a href="/wiki/Viral_envelope" title="Viral envelope">viral envelope</a>; for example, "<a href="/wiki/Influenza_A_virus_subtype_H1N1" title="Influenza A virus subtype H1N1">H1N1</a>" designates an IAV subtype that has a type-1 hemagglutinin (H) protein and a type-1 neuraminidase (N) protein.<a href="#cite_note-:112-21">[21]</a> Almost all possible combinations of H (1 thru 16) and N (1 thru 11) have been isolated from wild birds.<a href="#cite_note-22">[22]</a><a href="#cite_note-asha-23">[23]</a> In addition H17, H18, N10 and N11 have been found in bats.<a href="#cite_note-24">[24]</a><a href="#cite_note-asha-23">[23]</a> The influenza A virus subtypes in circulation among humans as of 2018<a class="external text" href="https://en.wikipedia.org/w/index.php?title=Influenza&action=edit">[update]</a> are H1N1 and H3N2.<a href="#cite_note-sautto-2">[2]</a> Influenza B virus mainly infects humans but has been identified in seals, horses, dogs, and pigs.<a href="#cite_note-asha-23">[23]</a> Influenza B virus does not have subtypes like influenza A virus but has two antigenically distinct lineages, termed the B/Victoria/2/1987-like and B/Yamagata/16/1988-like lineages,<a href="#cite_note-krammer-1">[1]</a> or simply (B/)Victoria(-like) and (B/)Yamagata(-like).<a href="#cite_note-asha-23">[23]</a><a href="#cite_note-sautto-2">[2]</a> Both lineages are in circulation in humans,<a href="#cite_note-krammer-1">[1]</a> disproportionately affecting children.<a href="#cite_note-ghebrehewet-11">[11]</a> However, the B/Yamagata lineage might have become extinct in 2020/2021 due to <a href="/wiki/COVID-19_pandemic" title="COVID-19 pandemic">COVID-19 pandemic</a> measures.<a href="#cite_note-Koutsakos2021-25">[25]</a> Influenza B viruses contribute to seasonal epidemics alongside influenza A viruses but have never been associated with a pandemic.<a href="#cite_note-asha-23">[23]</a> Influenza C virus, like influenza B virus, is primarily found in humans, though it has been detected in pigs, feral dogs, <a href="/wiki/Dromedary" title="Dromedary">dromedary</a> camels, cattle, and dogs.<a href="#cite_note-sederdahl-12">[12]</a><a href="#cite_note-asha-23">[23]</a> Influenza C virus infection primarily affects children and is usually asymptomatic<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a> or has mild cold-like symptoms, though more severe symptoms such as gastroenteritis and pneumonia can occur.<a href="#cite_note-sederdahl-12">[12]</a> Unlike influenza A virus and influenza B virus, influenza C virus has not been a major focus of research pertaining to antiviral drugs, vaccines, and other measures against influenza.<a href="#cite_note-asha-23">[23]</a> Influenza C virus is subclassified into six genetic/antigenic lineages.<a href="#cite_note-sederdahl-12">[12]</a><a href="#cite_note-su-26">[26]</a> Influenza D virus has been isolated from pigs and cattle, the latter being the natural reservoir. Infection has also been observed in humans, horses, dromedary camels, and small ruminants such as goats and sheep.<a href="#cite_note-asha-23">[23]</a><a href="#cite_note-su-26">[26]</a> Influenza D virus is distantly related to influenza C virus. While cattle workers have occasionally tested positive to prior influenza D virus infection, it is not known to cause disease in humans.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a><a href="#cite_note-sederdahl-12">[12]</a> Influenza C virus and influenza D virus experience a slower rate of antigenic evolution than influenza A virus and influenza B virus. Because of this antigenic stability, relatively few novel lineages emerge.<a href="#cite_note-su-26">[26]</a> <div class="mw-heading mw-heading4"><h4 id="Influenza_virus_nomenclature">Influenza virus nomenclature</h4></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:InfluenzaNomenclatureDiagram.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/11/InfluenzaNomenclatureDiagram.svg/220px-InfluenzaNomenclatureDiagram.svg.png" decoding="async" width="220" height="145" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/11/InfluenzaNomenclatureDiagram.svg/330px-InfluenzaNomenclatureDiagram.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/11/InfluenzaNomenclatureDiagram.svg/440px-InfluenzaNomenclatureDiagram.svg.png 2x" data-file-width="975" data-file-height="642" /></a><figcaption>Diagram of influenza nomenclature</figcaption></figure> Every year, millions of influenza virus samples are analysed to monitor changes in the virus' <a href="/wiki/Antigenic_variation" title="Antigenic variation">antigenic</a> properties, and to inform the development of vaccines.<a href="#cite_note-:022-27">[27]</a> To unambiguously describe a specific <a href="/wiki/Isolation_(microbiology)" title="Isolation (microbiology)">isolate</a> of virus, researchers use the internationally accepted influenza virus nomenclature,<a href="#cite_note-28">[28]</a> which describes, among other things, the species of animal from which the virus was isolated, and the place and year of collection. As an example – A/chicken/Nakorn-Patom/Thailand/CU-K2/04(H5N1): <ul><li>A stands for the genus of influenza (<a href="/wiki/Influenzavirus_A" class="mw-redirect" title="Influenzavirus A">A</a>, <a href="/wiki/Influenzavirus_B" class="mw-redirect" title="Influenzavirus B">B</a>, <a href="/wiki/Influenzavirus_C" class="mw-redirect" title="Influenzavirus C">C</a> or <a href="/wiki/Influenza_D_virus" title="Influenza D virus">D</a>).</li> <li>chicken is the animal species the isolate was found in (note: human isolates lack this component term and are thus identified as human isolates by default)</li> <li>Nakorn-Patom/Thailand is the place this specific virus was isolated</li> <li>CU-K2 is the laboratory reference number that identifies it from other influenza viruses isolated at the same place and year</li> <li>04 represents the year of isolation 2004</li> <li>H5 stands for the fifth of several known types of the protein <a href="/wiki/Hemagglutinin_(influenza)" title="Hemagglutinin (influenza)">hemagglutinin</a>.</li> <li>N1 stands for the first of several known types of the protein <a href="/wiki/Viral_neuraminidase" title="Viral neuraminidase">neuraminidase</a>.<a href="#cite_note-PAHO-29">[29]</a></li></ul> The nomenclature for influenza B, C and D, which are less variable, is simpler. Examples are B/Santiago/29615/2020 and C/Minnesota/10/2015.<a href="#cite_note-PAHO-29">[29]</a> <div class="mw-heading mw-heading3"><h3 id="Genome_and_structure">Genome and structure</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:3D_Influenza_virus.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3b/3D_Influenza_virus.png/310px-3D_Influenza_virus.png" decoding="async" width="310" height="230" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/3/3b/3D_Influenza_virus.png 1.5x" data-file-width="356" data-file-height="264" /></a><figcaption>Structure of the influenza <a href="https://en.wiktionary.org/wiki/virion" class="extiw" title="wikt:virion">virion</a>. The hemagglutinin (HA) and neuraminidase (NA) proteins are shown on the surface of the particle. The viral RNAs that make up the <a href="/wiki/Genome" title="Genome">genome</a> are shown as red coils inside the particle and bound to <a href="/wiki/Influenza_virus_nucleoprotein" title="Influenza virus nucleoprotein">ribonucleoproteins</a> (RNP).</figcaption></figure> Influenza viruses have a <a href="/wiki/Sense_(molecular_biology)" title="Sense (molecular biology)">negative-sense</a>, single-stranded RNA genome that is segmented. The negative sense of the genome means it can be used as a template to synthesize <a href="/wiki/Messenger_RNA" title="Messenger RNA">messenger RNA</a> (mRNA).<a href="#cite_note-dharmapalan-10">[10]</a> Influenza A virus and influenza B virus have eight genome segments that encode 10 major proteins. Influenza C virus and influenza D virus have seven genome segments that encode nine major proteins.<a href="#cite_note-sederdahl-12">[12]</a> Three segments encode three subunits of an <a href="/wiki/RNA-dependent_RNA_polymerase" title="RNA-dependent RNA polymerase">RNA-dependent RNA polymerase</a> (RdRp) complex: PB1, a transcriptase, PB2, which recognizes <a href="/wiki/Five-prime_cap" title="Five-prime cap">5' caps</a>, and PA (P3 for influenza C virus and influenza D virus), an <a href="/wiki/Endonuclease" title="Endonuclease">endonuclease</a>.<a href="#cite_note-mccauley-30">[30]</a> The <a href="/wiki/Viral_matrix_protein" title="Viral matrix protein">M1 matrix protein</a> and <a href="/wiki/M2_proton_channel" title="M2 proton channel">M2 proton channel</a> share a segment, as do the non-structural protein (NS1) and the nuclear export protein (NEP).<a href="#cite_note-krammer-1">[1]</a> For influenza A virus and influenza B virus, <a href="/wiki/Hemagglutinin_(influenza)" title="Hemagglutinin (influenza)">hemagglutinin</a> (HA) and <a href="/wiki/Neuraminidase" title="Neuraminidase">neuraminidase</a> (NA) are encoded on one segment each, whereas influenza C virus and influenza D virus encode a hemagglutinin-esterase fusion (HEF) protein on one segment that merges the functions of HA and NA. The final genome segment encodes the viral nucleoprotein (NP).<a href="#cite_note-mccauley-30">[30]</a> Influenza viruses also encode various accessory proteins, such as PB1-F2 and PA-X, that are <a href="/wiki/Gene_expression" title="Gene expression">expressed</a> through alternative <a href="/wiki/Open_reading_frame" title="Open reading frame">open reading frames</a><a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-shim-31">[31]</a> and which are important in host defense suppression, virulence, and pathogenicity.<a href="#cite_note-hao-32">[32]</a> The virus particle, called a virion, is pleomorphic and varies between being filamentous, bacilliform, or spherical in shape. Clinical isolates tend to be pleomorphic, whereas strains adapted to laboratory growth typically produce spherical virions. Filamentous virions are about 250 nanometers (nm) by 80 nm, bacilliform 120–250 by 95 nm, and spherical 120 nm in diameter.<a href="#cite_note-dadonaite-33">[33]</a> The core of the virion comprises one copy of each segment of the genome bound to NP nucleoproteins in separate ribonucleoprotein (RNP) complexes for each segment. There is a copy of the RdRp, all subunits included, bound to each RNP. The genetic material is <a href="/wiki/Capsid" title="Capsid">encapsulated</a> by a layer of M1 matrix protein which provides structural reinforcement to the outer layer, the <a href="/wiki/Viral_envelope" title="Viral envelope">viral envelope</a>.<a href="#cite_note-allen-3">[3]</a> The envelope comprises a <a href="/wiki/Lipid_bilayer" title="Lipid bilayer">lipid bilayer</a> membrane incorporating HA and NA (or HEF<a href="#cite_note-su-26">[26]</a>) proteins extending outward from its exterior surface. HA and HEF<a href="#cite_note-su-26">[26]</a> proteins have a distinct "head" and "stalk" structure. M2 proteins form <a href="/wiki/M2_proton_channel" title="M2 proton channel">proton channels</a> through the viral envelope that are required for viral entry and exit. Influenza B viruses contain a surface protein named NB that is anchored in the envelope, but its function is unknown.<a href="#cite_note-krammer-1">[1]</a> <div class="mw-heading mw-heading3"><h3 id="Life_cycle">Life cycle</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Virus_Replication_large.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a0/Virus_Replication_large.svg/310px-Virus_Replication_large.svg.png" decoding="async" width="310" height="286" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a0/Virus_Replication_large.svg/465px-Virus_Replication_large.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a0/Virus_Replication_large.svg/620px-Virus_Replication_large.svg.png 2x" data-file-width="925" data-file-height="852" /></a><figcaption>Host cell invasion and replication by the influenza virus</figcaption></figure> The viral life cycle begins by binding to a target cell. Binding is mediated by the viral HA proteins on the surface of the envelope, which bind to cells that contain <a href="/wiki/Sialic_acid" title="Sialic acid">sialic acid</a> receptors on the surface of the cell membrane.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-li-19">[19]</a><a href="#cite_note-allen-3">[3]</a> For N1 subtypes with the "G147R" mutation and N2 subtypes, the NA protein can initiate entry. Prior to binding, NA proteins promote access to target cells by degrading mucus, which helps to remove extracellular decoy receptors that would impede access to target cells.<a href="#cite_note-allen-3">[3]</a> After binding, the virus is internalized into the cell by an <a href="/wiki/Endosome" title="Endosome">endosome</a> that contains the virion inside it. The endosome is acidified by cellular vATPase<a href="#cite_note-shim-31">[31]</a> to have lower pH, which triggers a conformational change in HA that allows fusion of the viral envelope with the endosomal membrane.<a href="#cite_note-hao-32">[32]</a> At the same time, hydrogen ions diffuse into the virion through M2 ion channels, disrupting internal protein-protein interactions to release RNPs into the host cell's <a href="/wiki/Cytosol" title="Cytosol">cytosol</a>. The M1 protein shell surrounding RNPs is degraded, fully uncoating RNPs in the cytosol.<a href="#cite_note-shim-31">[31]</a><a href="#cite_note-allen-3">[3]</a> RNPs are then imported into the nucleus with the help of viral localization signals. There, the viral RNA polymerase <a href="/wiki/Transcription_(biology)" title="Transcription (biology)">transcribes</a> mRNA using the genomic negative-sense strand as a template. The polymerase <a href="/wiki/Cap_snatching" title="Cap snatching">snatches 5' caps</a> for viral mRNA from cellular RNA to prime mRNA synthesis and the 3'-end of mRNA is polyadenylated at the end of transcription.<a href="#cite_note-mccauley-30">[30]</a> Once viral mRNA is transcribed, it is exported out of the nucleus and <a href="/wiki/Translation_(biology)" title="Translation (biology)">translated</a> by host ribosomes in a cap-dependent manner to synthesize viral proteins.<a href="#cite_note-shim-31">[31]</a> RdRp also synthesizes complementary positive-sense strands of the viral genome in a complementary RNP complex which are then used as templates by viral polymerases to synthesize copies of the negative-sense genome.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-allen-3">[3]</a> During these processes, RdRps of avian influenza viruses (AIVs) function optimally at a higher temperature than mammalian influenza viruses.<a href="#cite_note-peteranderl-13">[13]</a> Newly synthesized viral polymerase subunits and NP proteins are imported to the nucleus to further increase the rate of viral replication and form RNPs.<a href="#cite_note-mccauley-30">[30]</a> HA, NA, and M2 proteins are trafficked with the aid of M1 and NEP proteins<a href="#cite_note-hao-32">[32]</a> to the cell membrane through the <a href="/wiki/Golgi_apparatus" title="Golgi apparatus">Golgi apparatus</a><a href="#cite_note-mccauley-30">[30]</a> and inserted into the cell's membrane. Viral non-structural proteins including NS1, PB1-F2, and PA-X regulate host cellular processes to disable antiviral responses.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-hao-32">[32]</a><a href="#cite_note-allen-3">[3]</a> PB1-F2 also interacts with PB1 to keep polymerases in the nucleus longer.<a href="#cite_note-joseph-20">[20]</a> M1 and NEP proteins localize to the nucleus during the later stages of infection, bind to viral RNPs and mediate their export to the cytoplasm where they migrate to the cell membrane with the aid of recycled endosomes and are bundled into the segments of the genome.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-allen-3">[3]</a> Progeny viruses leave the cell by budding from the cell membrane, which is initiated by the accumulation of M1 proteins at the cytoplasmic side of the membrane. The viral genome is incorporated inside a viral envelope derived from portions of the cell membrane that have HA, NA, and M2 proteins. At the end of budding, HA proteins remain attached to cellular sialic acid until they are cleaved by the sialidase activity of NA proteins. The virion is then released from the cell. The sialidase activity of NA also cleaves any sialic acid residues from the viral surface, which helps prevent newly assembled viruses from aggregating near the cell surface and improving infectivity.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-allen-3">[3]</a> Similar to other aspects of influenza replication, optimal NA activity is temperature- and pH-dependent.<a href="#cite_note-peteranderl-13">[13]</a> Ultimately, presence of large quantities of viral RNA in the cell triggers apoptosis (programmed cell death), which is initiated by cellular factors to restrict viral replication.<a href="#cite_note-shim-31">[31]</a> <div class="mw-heading mw-heading3"><h3 id="Antigenic_drift_and_shift">Antigenic drift and shift</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Viruses-10-00497-g003.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Viruses-10-00497-g003.png/220px-Viruses-10-00497-g003.png" decoding="async" width="220" height="154" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Viruses-10-00497-g003.png/330px-Viruses-10-00497-g003.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Viruses-10-00497-g003.png/440px-Viruses-10-00497-g003.png 2x" data-file-width="3517" data-file-height="2462" /></a><figcaption>Evolution mechanisms of IAV. (A) Antigenic Drift: Gradual accumulation of mutations in the genome of IAVs leads to emergence of new virus variants. (B) Antigenic Shift: The reassortment of genetic segments between two or more invading IAVs in a host cell can lead to emergence of an antigenically novel subtype.</figcaption></figure> Two key processes that influenza viruses evolve through are <a href="/wiki/Antigenic_drift" title="Antigenic drift">antigenic drift</a> and <a href="/wiki/Antigenic_shift" title="Antigenic shift">antigenic shift</a>. Antigenic drift is when an influenza virus' antigens change due to the gradual accumulation of mutations in the antigen's (HA or NA) gene.<a href="#cite_note-li-19">[19]</a> This can occur in response to <a href="/wiki/Evolutionary_pressure" title="Evolutionary pressure">evolutionary pressure</a> exerted by the host immune response. Antigenic drift is especially common for the HA protein, in which just a few amino acid changes in the head region can constitute antigenic drift.<a href="#cite_note-sautto-2">[2]</a><a href="#cite_note-su-26">[26]</a> The result is the production of novel strains that can evade pre-existing antibody-mediated immunity.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a> Antigenic drift occurs in all influenza species but is slower in B than A and slowest in C and D.<a href="#cite_note-su-26">[26]</a> Antigenic drift is a major cause of seasonal influenza,<a href="#cite_note-hastings-34">[34]</a> and requires that flu vaccines be updated annually. HA is the main component of inactivated vaccines, so surveillance monitors antigenic drift of this antigen among circulating strains. Antigenic evolution of influenza viruses of humans appears to be faster than in swine and equines. In wild birds, within-subtype <a href="/wiki/Antigenic_variation" title="Antigenic variation">antigenic variation</a> appears to be limited but has been observed in poultry.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a> Antigenic shift is a sudden, drastic change in an influenza virus' antigen, usually HA. During antigenic shift, antigenically different strains that infect the same cell can <a href="/wiki/Reassortment" title="Reassortment">reassort</a> genome segments with each other, producing hybrid progeny. Since all influenza viruses have segmented genomes, all are capable of reassortment.<a href="#cite_note-sederdahl-12">[12]</a><a href="#cite_note-su-26">[26]</a> Antigenic shift only occurs among influenza viruses of the same genus<a href="#cite_note-mccauley-30">[30]</a> and most commonly occurs among influenza A viruses. In particular, reassortment is very common in AIVs, creating a large diversity of influenza viruses in birds, but is uncommon in human, equine, and canine lineages.<a href="#cite_note-lycett-35">[35]</a> Pigs, bats, and quails have receptors for both mammalian and avian influenza A viruses, so they are potential "mixing vessels" for reassortment.<a href="#cite_note-asha-23">[23]</a> If an animal strain reassorts with a human strain,<a href="#cite_note-sautto-2">[2]</a> then a novel strain can emerge that is capable of human-to-human transmission. This has caused pandemics, but only a limited number, so it is difficult to predict when the next will happen.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a> The <a href="/wiki/Global_Influenza_Surveillance_and_Response_System" title="Global Influenza Surveillance and Response System">Global Influenza Surveillance and Response System</a> of the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> (GISRS) tests several millions of specimens annually to monitor the spread and evolution of influenza viruses.<a href="#cite_note-gisrs2-36">[36]</a><a href="#cite_note-Leveraging-37">[37]</a><a href="#cite_note-:022-27">[27]</a> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2></div> <div class="mw-heading mw-heading3"><h3 id="Transmission">Transmission</h3></div> People who are infected can transmit influenza viruses through breathing, talking, coughing, and sneezing, which spread <a href="/wiki/Respiratory_droplet" title="Respiratory droplet">respiratory droplets</a> and <a href="/wiki/Aerosol" title="Aerosol">aerosols</a> that contain virus particles into the air. A person susceptible to infection can contract influenza by coming into contact with these particles.<a href="#cite_note-kalil-17">[17]</a><a href="#cite_note-kutter-38">[38]</a> Respiratory droplets are relatively large and travel less than two meters before falling onto nearby surfaces. Aerosols are smaller and remain suspended in the air longer, so they take longer to settle and can travel further.<a href="#cite_note-kutter-38">[38]</a><a href="#cite_note-lampejo-4">[4]</a> Inhalation of aerosols can lead to infection,<a href="#cite_note-killingley-39">[39]</a> but most transmission is in the area about two meters around an infected person via respiratory droplets<a href="#cite_note-dharmapalan-10">[10]</a> that come into contact with mucosa of the upper respiratory tract.<a href="#cite_note-killingley-39">[39]</a> Transmission through contact with a person, bodily fluids, or intermediate objects (<a href="/wiki/Fomite" title="Fomite">fomites</a>) can also occur,<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-kutter-38">[38]</a> since influenza viruses can survive for hours on non-porous surfaces.<a href="#cite_note-lampejo-4">[4]</a> If one's hands are contaminated, then touching one's face can cause infection.<a href="#cite_note-weber-40">[40]</a> Influenza is usually transmissible from one day before the onset of symptoms to 5–7 days after.<a href="#cite_note-ghebrehewet-11">[11]</a> In healthy adults, the virus is shed for up to 3–5 days. In children and the immunocompromised, the virus may be transmissible for several weeks.<a href="#cite_note-dharmapalan-10">[10]</a> Children ages 2–17 are considered to be the primary and most efficient spreaders of influenza.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a> Children who have not had multiple prior exposures to influenza viruses shed the virus at greater quantities and for a longer duration than other children.<a href="#cite_note-krammer-1">[1]</a> People at risk of exposure to influenza include health care workers, social care workers, and those who live with or care for people vulnerable to influenza. In long-term care facilities, the flu can spread rapidly.<a href="#cite_note-ghebrehewet-11">[11]</a> A variety of factors likely encourage influenza transmission, including lower temperature, lower absolute and relative <a href="/wiki/Humidity" title="Humidity">humidity</a>, less <a href="/wiki/Ultraviolet" title="Ultraviolet">ultraviolet</a> radiation from the sun,<a href="#cite_note-killingley-39">[39]</a><a href="#cite_note-moriyama-41">[41]</a> and crowding.<a href="#cite_note-kutter-38">[38]</a> Influenza viruses that infect the upper respiratory tract like H1N1 tend to be more mild but more transmissible, whereas those that infect the lower respiratory tract like <a href="/wiki/H5N1" class="mw-redirect" title="H5N1">H5N1</a> tend to cause more severe illness but are less contagious.<a href="#cite_note-dharmapalan-10">[10]</a> <div class="mw-heading mw-heading3"><h3 id="Pathophysiology">Pathophysiology</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:H1N1_versus_H5N1_pathology.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b0/H1N1_versus_H5N1_pathology.png/310px-H1N1_versus_H5N1_pathology.png" decoding="async" width="310" height="227" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b0/H1N1_versus_H5N1_pathology.png/465px-H1N1_versus_H5N1_pathology.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b0/H1N1_versus_H5N1_pathology.png/620px-H1N1_versus_H5N1_pathology.png 2x" data-file-width="754" data-file-height="552" /></a><figcaption>How the different sites of infection (shown in red) of H1N1 and H5N1 influences their transmission and lethality<a href="#cite_note-:1-42">[42]</a></figcaption></figure> In humans, influenza viruses first cause infection by infecting epithelial cells in the respiratory tract. Illness during infection is primarily the result of lung <a href="/wiki/Inflammation" title="Inflammation">inflammation</a> and compromise caused by epithelial cell infection and death, combined with inflammation caused by the immune system's response to infection. Non-respiratory organs can become involved, but the mechanisms by which influenza is involved in these cases are unknown. Severe respiratory illness can be caused by multiple, non-exclusive mechanisms, including obstruction of the airways, loss of <a href="/wiki/Pulmonary_alveolus" title="Pulmonary alveolus">alveolar</a> structure, loss of lung epithelial integrity due to epithelial cell infection and death, and degradation of the extracellular matrix that maintains lung structure. In particular, alveolar cell infection appears to drive severe symptoms since this results in impaired gas exchange and enables viruses to infect endothelial cells, which produce large quantities of pro-inflammatory <a href="/wiki/Cytokine" title="Cytokine">cytokines</a>.<a href="#cite_note-kalil-17">[17]</a> Pneumonia caused by influenza viruses is characterized by high levels of viral replication in the lower respiratory tract, accompanied by a strong pro-inflammatory response called a <a href="/wiki/Cytokine_storm" title="Cytokine storm">cytokine storm</a>.<a href="#cite_note-krammer-1">[1]</a> Infection with H5N1 or <a href="/wiki/H7N9" class="mw-redirect" title="H7N9">H7N9</a> especially produces high levels of pro-inflammatory cytokines.<a href="#cite_note-li-19">[19]</a> In bacterial infections, early depletion of <a href="/wiki/Macrophage" title="Macrophage">macrophages</a> during influenza creates a favorable environment in the lungs for bacterial growth since these white blood cells are important in responding to bacterial infection. Host mechanisms to encourage tissue repair may inadvertently allow bacterial infection. Infection also induces production of systemic <a href="/wiki/Glucocorticoid" title="Glucocorticoid">glucocorticoids</a> that can reduce inflammation to preserve tissue integrity but allow increased bacterial growth.<a href="#cite_note-kalil-17">[17]</a> The pathophysiology of influenza is significantly influenced by which receptors influenza viruses bind to during entry into cells. Mammalian influenza viruses preferentially bind to sialic acids connected to the rest of the oligosaccharide by an α-2,6 link, most commonly found in various respiratory cells,<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-li-19">[19]</a><a href="#cite_note-allen-3">[3]</a> such as respiratory and retinal epithelial cells.<a href="#cite_note-shim-31">[31]</a> AIVs prefer sialic acids with an α-2,3 linkage, which are most common in birds in gastrointestinal epithelial cells<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-li-19">[19]</a><a href="#cite_note-allen-3">[3]</a> and in humans in the lower respiratory tract.<a href="#cite_note-shao-43">[43]</a> <a href="/wiki/Proteolysis" title="Proteolysis">Cleavage</a> of the HA protein into HA1, the binding subunit, and HA2, the fusion subunit, is performed by different proteases, affecting which cells can be infected. For mammalian influenza viruses and low pathogenic AIVs, cleavage is extracellular, which limits infection to cells that have the appropriate proteases, whereas for highly pathogenic AIVs, cleavage is intracellular and performed by ubiquitous proteases, which allows for infection of a greater variety of cells, thereby contributing to more severe disease.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-lycett-35">[35]</a><a href="#cite_note-steinhauer-44">[44]</a> <div class="mw-heading mw-heading3"><h3 id="Immunology">Immunology</h3></div> Cells possess sensors to detect viral RNA, which can then induce <a href="/wiki/Interferon" title="Interferon">interferon</a> production. Interferons mediate expression of antiviral proteins and proteins that recruit immune cells to the infection site, and they notify nearby uninfected cells of infection. Some infected cells release pro-inflammatory cytokines that recruit immune cells to the site of infection. Immune cells control viral infection by killing infected cells and <a href="/wiki/Phagocytosis" title="Phagocytosis">phagocytizing</a> viral particles and apoptotic cells. An exacerbated immune response can harm the host organism through a cytokine storm.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-peteranderl-13">[13]</a><a href="#cite_note-shim-31">[31]</a> To counter the immune response, influenza viruses encode various non-structural proteins, including NS1, NEP, PB1-F2, and PA-X, that are involved in curtailing the host immune response by suppressing interferon production and host gene expression.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-hao-32">[32]</a> <a href="/wiki/B_cell" title="B cell">B cells</a>, a type of white blood cell, produce antibodies that bind to influenza antigens HA and NA (or HEF<a href="#cite_note-su-26">[26]</a>) and other proteins to a lesser degree. Once bound to these proteins, antibodies block virions from binding to cellular receptors, <a href="/wiki/Neutralizing_antibody" title="Neutralizing antibody">neutralizing</a> the virus. In humans, a sizeable antibody response occurs about one week after viral exposure.<a href="#cite_note-45">[45]</a> This antibody response is typically robust and long-lasting, especially for influenza C virus and influenza D virus.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-su-26">[26]</a> People exposed to a certain strain in childhood still possess antibodies to that strain at a reasonable level later in life, which can provide some protection to related strains.<a href="#cite_note-krammer-1">[1]</a> There is, however, an "<a href="/wiki/Original_antigenic_sin" title="Original antigenic sin">original antigenic sin</a>", in which the first HA subtype a person is exposed to influences the antibody-based immune response to future infections and vaccines.<a href="#cite_note-sautto-2">[2]</a> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Prevention_of_influenza" title="Prevention of influenza">Prevention of influenza</a></div> <div class="mw-heading mw-heading3"><h3 id="Vaccination">Vaccination</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Influenza_vaccine" title="Influenza vaccine">Influenza vaccine</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Defense.gov_News_Photo_041028-N-9864S-021.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/9f/Defense.gov_News_Photo_041028-N-9864S-021.jpg/310px-Defense.gov_News_Photo_041028-N-9864S-021.jpg" decoding="async" width="310" height="202" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/9f/Defense.gov_News_Photo_041028-N-9864S-021.jpg/465px-Defense.gov_News_Photo_041028-N-9864S-021.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/9f/Defense.gov_News_Photo_041028-N-9864S-021.jpg/620px-Defense.gov_News_Photo_041028-N-9864S-021.jpg 2x" data-file-width="3008" data-file-height="1960" /></a><figcaption>Giving an influenza vaccination</figcaption></figure> Annual vaccination is the primary and most effective way to prevent influenza and influenza-associated complications, especially for high-risk groups.<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-chow-46">[46]</a> Vaccines against the flu are trivalent or quadrivalent, providing protection against an H1N1 strain, an H3N2 strain, and one or two influenza B virus strains corresponding to the two influenza B virus lineages.<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-sautto-2">[2]</a> Two types of vaccines are in use: inactivated vaccines that contain "killed" (i.e. inactivated) viruses and <a href="/wiki/Live_attenuated_influenza_vaccine" title="Live attenuated influenza vaccine">live attenuated influenza vaccines</a> (LAIVs) that contain weakened viruses.<a href="#cite_note-krammer-1">[1]</a> There are three types of inactivated vaccines: whole virus, split virus, in which the virus is disrupted by a detergent, and subunit, which only contains the viral antigens HA and NA.<a href="#cite_note-tregoning-47">[47]</a> Most flu vaccines are inactivated and administered via intramuscular injection. LAIVs are sprayed into the nasal cavity.<a href="#cite_note-krammer-1">[1]</a> Vaccination recommendations vary by country. Some recommend vaccination for all people above a certain age, such as 6 months,<a href="#cite_note-chow-46">[46]</a> whereas other countries limit recommendations to high-risk groups.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a> Young infants cannot receive flu vaccines for safety reasons, but they can inherit <a href="/wiki/Passive_immunity" title="Passive immunity">passive immunity</a> from their mother if vaccinated during pregnancy.<a href="#cite_note-principi-48">[48]</a> Influenza vaccination helps to reduce the probability of reassortment.<a href="#cite_note-peteranderl-13">[13]</a> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:COVID-19-Antigen-with-Influenza-A-B-Rapid-Antigen-Combo.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/45/COVID-19-Antigen-with-Influenza-A-B-Rapid-Antigen-Combo.jpg/220px-COVID-19-Antigen-with-Influenza-A-B-Rapid-Antigen-Combo.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/45/COVID-19-Antigen-with-Influenza-A-B-Rapid-Antigen-Combo.jpg/330px-COVID-19-Antigen-with-Influenza-A-B-Rapid-Antigen-Combo.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/45/COVID-19-Antigen-with-Influenza-A-B-Rapid-Antigen-Combo.jpg/440px-COVID-19-Antigen-with-Influenza-A-B-Rapid-Antigen-Combo.jpg 2x" data-file-width="4640" data-file-height="3472" /></a><figcaption>An Influenza A&B Antigen Test (bottom) showing negative results for both Influenza A and B)</figcaption></figure> In general, influenza vaccines are only effective if there is an antigenic match between vaccine strains and circulating strains.<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-sautto-2">[2]</a> Most commercially available flu vaccines are manufactured by propagation of influenza viruses in embryonated chicken eggs, taking 6–8 months.<a href="#cite_note-sautto-2">[2]</a> Flu seasons are different in the northern and southern hemisphere, so the WHO meets twice a year, once for each hemisphere, to discuss <a href="/wiki/Historical_annual_reformulations_of_the_influenza_vaccine" title="Historical annual reformulations of the influenza vaccine">which strains should be included</a> based on observation from HA inhibition assays.<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-allen-3">[3]</a> Other manufacturing methods include an <a href="/wiki/Madin-Darby_Canine_Kidney_cells" class="mw-redirect" title="Madin-Darby Canine Kidney cells">MDCK cell</a> culture-based inactivated vaccine and a recombinant subunit vaccine manufactured from <a href="/wiki/Baculovirus" class="mw-redirect" title="Baculovirus">baculovirus</a> overexpression in insect cells.<a href="#cite_note-sautto-2">[2]</a><a href="#cite_note-barr-49">[49]</a> <div class="mw-heading mw-heading3"><h3 id="Antiviral_chemoprophylaxis">Antiviral chemoprophylaxis</h3></div> Influenza can be prevented or reduced in severity by post-exposure prophylaxis with the antiviral drugs <a href="/wiki/Oseltamivir" title="Oseltamivir">oseltamivir</a>, which can be taken orally by those at least three months old, and <a href="/wiki/Zanamivir" title="Zanamivir">zanamivir</a>, which can be inhaled by those above seven years. <a href="/wiki/Chemoprophylaxis" title="Chemoprophylaxis">Chemoprophylaxis</a> is most useful for individuals at high risk for complications and those who cannot receive the flu vaccine.<a href="#cite_note-dharmapalan-10">[10]</a> Post-exposure chemoprophylaxis is only recommended if oseltamivir is taken within 48 hours of contact with a confirmed or suspected case and zanamivir within 36 hours.<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-ghebrehewet-11">[11]</a> It is recommended for people who have yet to receive a vaccine for the current flu season, who have been vaccinated less than two week since contact, if there is a significant mismatch between vaccine and circulating strains, or during an outbreak in a closed setting regardless of vaccination history.<a href="#cite_note-ghebrehewet-11">[11]</a> <div class="mw-heading mw-heading3"><h3 id="Infection_control">Infection control</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Influenza_prevention" class="mw-redirect" title="Influenza prevention">Influenza prevention</a></div> These are the main ways that influenza spreads <ul><li>by direct transmission (when an infected person sneezes mucus directly into the eyes, nose or mouth of another person);</li> <li>the airborne route (when someone inhales the <a href="/wiki/Particulate" class="mw-redirect" title="Particulate">aerosols</a> produced by an infected person coughing, sneezing or spitting);</li> <li>through hand-to-eye, hand-to-nose, or hand-to-mouth transmission, either from contaminated surfaces or from direct personal contact such as a hand-shake.</li></ul> When vaccines and antiviral medications are limited, non-pharmaceutical interventions are essential to reduce transmission and spread. The lack of <a href="/wiki/Controlled_studies" class="mw-redirect" title="Controlled studies">controlled studies</a> and rigorous evidence of the effectiveness of some measures has hampered planning decisions and recommendations. Nevertheless, strategies endorsed by experts for all phases of flu outbreaks include hand and respiratory hygiene, self-isolation by symptomatic individuals and the use of face masks by them and their caregivers, surface disinfection, rapid testing and diagnosis, and <a href="/wiki/Contact_tracing" title="Contact tracing">contact tracing</a>. In some cases, other forms of <a href="/wiki/Social_distancing" title="Social distancing">social distancing</a> including school closures and travel restrictions are recommended.<a href="#cite_note-Aledort-50">[50]</a> Reasonably effective ways to reduce the transmission of influenza include good personal health and hygiene habits such as: not touching the eyes, nose or mouth;<a href="#cite_note-CDCQA-51">[51]</a> frequent <a href="/wiki/Hand_washing" title="Hand washing">hand washing</a> (with soap and water, or with alcohol-based hand rubs);<a href="#cite_note-52">[52]</a> covering coughs and sneezes with a tissue or sleeve; avoiding close contact with sick people; and staying home when sick. Avoiding spitting is also recommended.<a href="#cite_note-Aledort-50">[50]</a> Although <a href="/wiki/Surgical_mask" title="Surgical mask">face masks</a> might help prevent transmission when caring for the sick,<a href="#cite_note-53">[53]</a><a href="#cite_note-54">[54]</a> there is mixed evidence on beneficial effects in the community.<a href="#cite_note-Aledort-50">[50]</a><a href="#cite_note-55">[55]</a> Smoking raises the risk of contracting influenza, as well as producing more severe disease symptoms.<a href="#cite_note-pmid16231688-56">[56]</a><a href="#cite_note-57">[57]</a> Since influenza spreads through both <a href="/wiki/Particulate" class="mw-redirect" title="Particulate">aerosols</a> and contact with contaminated surfaces, surface sanitizing may help prevent some infections.<a href="#cite_note-58">[58]</a> <a href="/wiki/Rubbing_alcohol" title="Rubbing alcohol">Alcohol</a> is an effective sanitizer against influenza viruses, while <a href="/wiki/Quaternary_ammonium_cation" title="Quaternary ammonium cation">quaternary ammonium compounds</a> can be used with alcohol so that the sanitizing effect lasts for longer.<a href="#cite_note-McDonnell-59">[59]</a> In hospitals, quaternary ammonium compounds and <a href="/wiki/Bleach" title="Bleach">bleach</a> are used to sanitize rooms or equipment that have been occupied by people with influenza symptoms.<a href="#cite_note-McDonnell-59">[59]</a> At home, this can be done effectively with a diluted chlorine bleach.<a href="#cite_note-60">[60]</a> Since influenza viruses circulate in animals such as birds and pigs, prevention of transmission from these animals is important. <a href="/wiki/Water_treatment" title="Water treatment">Water treatment</a>, indoor raising of animals, quarantining sick animals, vaccination, and <a href="/wiki/Biosecurity" title="Biosecurity">biosecurity</a> are the primary measures used. Placing poultry houses and piggeries on high ground away from high-density farms, backyard farms, live poultry markets, and bodies of water helps to minimize contact with wild birds.<a href="#cite_note-krammer-1">[1]</a> Closure of live poultry markets appears to the most effective measure<a href="#cite_note-li-19">[19]</a> and has shown to be effective at controlling the spread of H5N1, H7N9, and <a href="/wiki/H9N2" class="mw-redirect" title="H9N2">H9N2</a>.<a href="#cite_note-joseph-20">[20]</a> Other biosecurity measures include cleaning and disinfecting facilities and vehicles, banning visits to poultry farms, not bringing birds intended for slaughter back to farms,<a href="#cite_note-avian-61">[61]</a> changing clothes, disinfecting foot baths, and treating food and water.<a href="#cite_note-krammer-1">[1]</a> If live poultry markets are not closed, then "clean days" when unsold poultry is removed and facilities are disinfected and "no carry-over" policies to eliminate infectious material before new poultry arrive can be used to reduce the spread of influenza viruses. If a novel influenza viruses has breached the aforementioned biosecurity measures, then rapid detection to stamp it out via quarantining, decontamination, and culling may be necessary to prevent the virus from becoming endemic.<a href="#cite_note-krammer-1">[1]</a> Vaccines exist for avian H5, H7, and H9 subtypes that are used in some countries.<a href="#cite_note-li-19">[19]</a> In China, for example, vaccination of domestic birds against H7N9 successfully limited its spread, indicating that vaccination may be an effective strategy<a href="#cite_note-lycett-35">[35]</a> if used in combination with other measures to limit transmission.<a href="#cite_note-krammer-1">[1]</a> In pigs and horses, management of influenza is dependent on vaccination with biosecurity.<a href="#cite_note-krammer-1">[1]</a> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:X-ray_of_29-year-old_person_with_H1N1.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/X-ray_of_29-year-old_person_with_H1N1.jpg/310px-X-ray_of_29-year-old_person_with_H1N1.jpg" decoding="async" width="310" height="237" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/X-ray_of_29-year-old_person_with_H1N1.jpg/465px-X-ray_of_29-year-old_person_with_H1N1.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/37/X-ray_of_29-year-old_person_with_H1N1.jpg/620px-X-ray_of_29-year-old_person_with_H1N1.jpg 2x" data-file-width="632" data-file-height="483" /></a><figcaption>X-ray of 29-year-old person with H1N1</figcaption></figure> Diagnosis based on symptoms is fairly accurate in otherwise healthy people during seasonal epidemics and should be suspected in cases of pneumonia, acute respiratory distress syndrome (ARDS), <a href="/wiki/Sepsis" title="Sepsis">sepsis</a>, or if encephalitis, <a href="/wiki/Myocarditis" title="Myocarditis">myocarditis</a>, or <a href="/wiki/Rhabdomyolysis" title="Rhabdomyolysis">breakdown of muscle tissue</a> occur.<a href="#cite_note-kalil-17">[17]</a> Because influenza is similar to other viral respiratory tract illnesses, laboratory diagnosis is necessary for confirmation. Common sample collection methods for testing include nasal and throat swabs.<a href="#cite_note-krammer-1">[1]</a> Samples may be taken from the lower respiratory tract if infection has cleared the upper but not lower respiratory tract. Influenza testing is recommended for anyone hospitalized with symptoms resembling influenza during flu season or who is connected to an influenza case. For severe cases, earlier diagnosis improves patient outcome.<a href="#cite_note-chow-46">[46]</a> Diagnostic methods that can identify influenza include <a href="/wiki/Viral_culture" title="Viral culture">viral cultures</a>, antibody- and antigen-detecting tests, and nucleic acid-based tests.<a href="#cite_note-vemula-62">[62]</a> Viruses can be grown in a culture of mammalian cells or <a href="/wiki/Embryonated" title="Embryonated">embryonated</a> eggs for 3–10 days to monitor cytopathic effect. Final confirmation can then be done via antibody staining, hemadsorption using <a href="/wiki/Red_blood_cell" title="Red blood cell">red blood cells</a>, or <a href="/wiki/Immunofluorescence" title="Immunofluorescence">immunofluorescence</a> microscopy. Shell vial cultures, which can identify infection via immunostaining before a cytopathic effect appears, are more sensitive than traditional cultures with results in 1–3 days.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-chow-46">[46]</a><a href="#cite_note-vemula-62">[62]</a> Cultures can be used to characterize novel viruses, observe sensitivity to antiviral drugs, and monitor antigenic drift, but they are relatively slow and require specialized skills and equipment.<a href="#cite_note-krammer-1">[1]</a> Serological assays can be used to detect an antibody response to influenza after natural infection or vaccination. Common serological assays include hemagglutination inhibition assays that detect HA-specific antibodies, virus neutralization assays that check whether antibodies have neutralized the virus, and enzyme-linked immunoabsorbant assays. These methods tend to be relatively inexpensive and fast but are less reliable than nucleic-acid based tests.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-vemula-62">[62]</a> Direct fluorescent or immunofluorescent antibody (DFA/IFA) tests involve staining respiratory epithelial cells in samples with fluorescently-labeled influenza-specific antibodies, followed by examination under a fluorescent microscope. They can differentiate between influenza A virus and influenza B virus but can not subtype influenza A virus.<a href="#cite_note-vemula-62">[62]</a> <a href="/wiki/Rapid_influenza_diagnostic_test" title="Rapid influenza diagnostic test">Rapid influenza diagnostic tests</a> (RIDTs) are a simple way of obtaining assay results, are low cost, and produce results in less than 30 minutes, so they are commonly used, but they can not distinguish between influenza A virus and influenza B virus or between influenza A virus subtypes and are not as sensitive as nucleic-acid based tests.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-vemula-62">[62]</a> <a href="/wiki/Nucleic_acid_test" title="Nucleic acid test">Nucleic acid-based tests</a> (NATs) amplify and detect viral nucleic acid. Most of these tests take a few hours,<a href="#cite_note-vemula-62">[62]</a> but rapid molecular assays are as fast as RIDTs.<a href="#cite_note-chow-46">[46]</a> Among NATs, <a href="/wiki/Reverse_transcription_polymerase_chain_reaction" title="Reverse transcription polymerase chain reaction">reverse transcription polymerase chain reaction</a> (RT-PCR) is the most traditional and considered the gold standard for diagnosing influenza<a href="#cite_note-vemula-62">[62]</a> because it is fast and can subtype influenza A virus, but it is relatively expensive and more prone to false-positives than cultures.<a href="#cite_note-krammer-1">[1]</a> Other NATs that have been used include <a href="/wiki/Loop-mediated_isothermal_amplification" title="Loop-mediated isothermal amplification">loop-mediated isothermal amplification</a>-based assays, simple amplification-based assays, and nucleic acid sequence-based amplification. Nucleic acid sequencing methods can identify infection by obtaining the nucleic acid sequence of viral samples to identify the virus and antiviral drug resistance. The traditional method is <a href="/wiki/Sanger_sequencing" title="Sanger sequencing">Sanger sequencing</a>, but it has been largely replaced by <a href="/wiki/Massive_parallel_sequencing" title="Massive parallel sequencing">next-generation methods</a> that have greater sequencing speed and throughput.<a href="#cite_note-vemula-62">[62]</a> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Treatment_of_influenza" title="Treatment of influenza">Treatment of influenza</a></div> Treatment in cases of mild or moderate illness is supportive and includes anti-fever medications such as <a href="/wiki/Acetaminophen" class="mw-redirect" title="Acetaminophen">acetaminophen</a> and <a href="/wiki/Ibuprofen" title="Ibuprofen">ibuprofen</a>,<a href="#cite_note-MLP2010-63">[63]</a> adequate fluid intake to avoid dehydration, and rest.<a href="#cite_note-ghebrehewet-11">[11]</a> Cough drops and throat sprays may be beneficial for sore throat. It is recommended to avoid alcohol and tobacco use while ill.<a href="#cite_note-MLP2010-63">[63]</a> <a href="/wiki/Aspirin" title="Aspirin">Aspirin</a> is not recommended to treat influenza in children due to an elevated risk of developing <a href="/wiki/Reye_syndrome" title="Reye syndrome">Reye syndrome</a>.<a href="#cite_note-banday-64">[64]</a> <a href="/wiki/Corticosteroid" title="Corticosteroid">Corticosteroids</a> are not recommended except when treating <a href="/wiki/Septic_shock" title="Septic shock">septic shock</a> or an underlying medical condition, such as <a href="/wiki/Chronic_obstructive_pulmonary_disease" title="Chronic obstructive pulmonary disease">chronic obstructive pulmonary disease</a> or asthma exacerbation, since they are associated with increased mortality.<a href="#cite_note-chow-46">[46]</a> If a secondary bacterial infection occurs, then antibiotics may be necessary.<a href="#cite_note-ghebrehewet-11">[11]</a> <div class="mw-heading mw-heading3"><h3 id="Antivirals">Antivirals</h3></div> <table class="wikitable" style="text-align:center; margin-left: auto; margin-right: auto; border: none;"> <caption>Antiviral drugs<a href="#cite_note-peteranderl-13">[13]</a> </caption> <tbody><tr> <th>Drug</th> <th>Route of administration</th> <th>Approved age of use </th></tr> <tr> <td><a href="/wiki/Oseltamivir" title="Oseltamivir">Oseltamivir</a></td> <td>Oral</td> <td>At least two weeks old </td></tr> <tr> <td><a href="/wiki/Zanamivir" title="Zanamivir">Zanamivir</a></td> <td>Inhalation</td> <td>At least five years old </td></tr> <tr> <td><a href="/wiki/Peramivir" title="Peramivir">Peramivir</a></td> <td>Intravenous injection</td> <td>At least 18 years old </td></tr> <tr> <td><a href="/wiki/Laninamivir" title="Laninamivir">Laninamivir</a></td> <td>Inhalation<a href="#cite_note-krammer-1">[1]</a></td> <td>40 milligrams (mg) dose for people at least 10 years old, 20 mg for those under 10<a href="#cite_note-lanina-65">[65]</a> </td></tr> <tr> <td><a href="/wiki/Baloxavir_marboxil" title="Baloxavir marboxil">Baloxavir marboxil</a></td> <td>Oral<a href="#cite_note-lampejo-4">[4]</a></td> <td>At least 12 years old<a href="#cite_note-chow-46">[46]</a> </td></tr></tbody></table> Antiviral drugs are primarily used to treat severely ill patients, especially those with compromised immune systems. Antivirals are most effective when started in the first 48 hours after symptoms appear. Later administration may still be beneficial for those who have underlying immune defects, those with more severe symptoms, or those who have a higher risk of developing complications if these individuals are still shedding the virus. Antiviral treatment is also recommended if a person is hospitalized with suspected influenza instead of waiting for test results to return and if symptoms are worsening.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-chow-46">[46]</a> Most antiviral drugs against influenza fall into two categories: neuraminidase (NA) inhibitors and M2 inhibitors.<a href="#cite_note-peteranderl-13">[13]</a> Baloxavir marboxil is a notable exception, which targets the endonuclease activity of the viral RNA polymerase and can be used as an alternative to NA and M2 inhibitors for influenza A virus and influenza B virus.<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-li-19">[19]</a><a href="#cite_note-lampejo-4">[4]</a> NA inhibitors target the enzymatic activity of NA receptors, mimicking the binding of sialic acid in the active site of NA on influenza A virus and influenza B virus virions<a href="#cite_note-krammer-1">[1]</a> so that viral release from infected cells and the rate of viral replication are impaired.<a href="#cite_note-ghebrehewet-11">[11]</a> NA inhibitors include oseltamivir, which is consumed orally in a prodrug form and converted to its active form in the liver, and zanamivir, which is a powder that is inhaled nasally. Oseltamivir and zanamivir are effective for prophylaxis and post-exposure prophylaxis, and research overall indicates that NA inhibitors are effective at reducing rates of complications, hospitalization, and mortality<a href="#cite_note-krammer-1">[1]</a> and the duration of illness.<a href="#cite_note-peteranderl-13">[13]</a><a href="#cite_note-chow-46">[46]</a><a href="#cite_note-lampejo-4">[4]</a> Additionally, the earlier NA inhibitors are provided, the better the outcome,<a href="#cite_note-lampejo-4">[4]</a> though late administration can still be beneficial in severe cases.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-chow-46">[46]</a> Other NA inhibitors include laninamivir<a href="#cite_note-krammer-1">[1]</a> and peramivir, the latter of which can be used as an alternative to oseltamivir for people who cannot tolerate or absorb it.<a href="#cite_note-chow-46">[46]</a> The <a href="/wiki/Adamantane" title="Adamantane">adamantanes</a> <a href="/wiki/Amantadine" title="Amantadine">amantadine</a> and <a href="/wiki/Rimantadine" title="Rimantadine">rimantadine</a> are orally administered drugs that block the influenza virus' M2 ion channel,<a href="#cite_note-krammer-1">[1]</a> preventing viral uncoating.<a href="#cite_note-lampejo-4">[4]</a> These drugs are only functional against influenza A virus<a href="#cite_note-chow-46">[46]</a> but are no longer recommended for use because of widespread resistance to them among influenza A viruses.<a href="#cite_note-lampejo-4">[4]</a> Adamantane resistance first emerged in H3N2 in 2003, becoming worldwide by 2008. Oseltamivir resistance is no longer widespread because the 2009 pandemic H1N1 strain (H1N1 pdm09), which is resistant to adamantanes, seemingly replaced resistant strains in circulation. Since the 2009 pandemic, oseltamivir resistance has mainly been observed in patients undergoing therapy,<a href="#cite_note-krammer-1">[1]</a> especially the immunocompromised and young children.<a href="#cite_note-lampejo-4">[4]</a> Oseltamivir resistance is usually reported in H1N1, but has been reported in H3N2 and influenza B viruss less commonly.<a href="#cite_note-krammer-1">[1]</a> Because of this, oseltamivir is recommended as the first drug of choice for immunocompetent people, whereas for the immunocompromised, oseltamivir is recommended against H3N2 and influenza B virus and zanamivir against H1N1 pdm09. Zanamivir resistance is observed less frequently, and resistance to peramivir and baloxavir marboxil is possible.<a href="#cite_note-lampejo-4">[4]</a> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2></div> In healthy individuals, influenza infection is usually self-limiting and rarely fatal.<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-ghebrehewet-11">[11]</a> Symptoms usually last for 2–8 days.<a href="#cite_note-peteranderl-13">[13]</a> Influenza can cause people to miss work or school, and it is associated with decreased job performance and, in older adults, reduced independence. Fatigue and malaise may last for several weeks after recovery, and healthy adults may experience pulmonary abnormalities that can take several weeks to resolve. Complications and mortality primarily occur in high-risk populations and those who are hospitalized. Severe disease and mortality are usually attributable to pneumonia from the primary viral infection or a secondary bacterial infection,<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a> which can progress to ARDS.<a href="#cite_note-peteranderl-13">[13]</a> Other respiratory complications that may occur include <a href="/wiki/Sinusitis" title="Sinusitis">sinusitis</a>, <a href="/wiki/Bronchitis" title="Bronchitis">bronchitis</a>, <a href="/wiki/Bronchiolitis" title="Bronchiolitis">bronchiolitis</a>, excess fluid buildup in the lungs, and exacerbation of chronic bronchitis and asthma. <a href="/wiki/Otitis_media" title="Otitis media">Middle ear infection</a> and <a href="/wiki/Croup" title="Croup">croup</a> may occur, most commonly in children.<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-krammer-1">[1]</a> Secondary S. aureus infection has been observed, primarily in children, to cause <a href="/wiki/Toxic_shock_syndrome" title="Toxic shock syndrome">toxic shock syndrome</a> after influenza, with hypotension, fever, and reddening and peeling of the skin.<a href="#cite_note-krammer-1">[1]</a> Complications affecting the cardiovascular system are rare and include pericarditis, fulminant myocarditis with a <a href="/wiki/Arrythmia" class="mw-redirect" title="Arrythmia">fast, slow, or irregular heartbeat</a>, and exacerbation of pre-existing cardiovascular disease.<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-ghebrehewet-11">[11]</a> <a href="/wiki/Myositis" title="Myositis">Inflammation or swelling of muscles</a> accompanied by muscle tissue breaking down occurs rarely, usually in children, which presents as extreme tenderness and muscle pain in the legs and a reluctance to walk for 2–3 days.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a><a href="#cite_note-kalil-17">[17]</a> Influenza can affect pregnancy, including causing smaller neonatal size, increased risk of premature birth, and an increased risk of child death shortly before or after birth.<a href="#cite_note-ghebrehewet-11">[11]</a> Neurological complications have been associated with influenza on rare occasions, including aseptic meningitis, encephalitis, disseminated encephalomyelitis, transverse myelitis, and <a href="/wiki/Guillain%E2%80%93Barr%C3%A9_syndrome" title="Guillain–Barré syndrome">Guillain–Barré syndrome</a>.<a href="#cite_note-kalil-17">[17]</a> Additionally, febrile seizures and Reye syndrome can occur, most commonly in children.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a> Influenza-associated encephalopathy can occur directly from central nervous system infection from <a href="/wiki/Viremia" title="Viremia">the presence of the virus in blood</a> and presents as sudden onset of fever with convulsions, followed by rapid progression to coma.<a href="#cite_note-dharmapalan-10">[10]</a> An atypical form of encephalitis called encephalitis lethargica, characterized by headache, drowsiness, and coma, may rarely occur sometime after infection.<a href="#cite_note-krammer-1">[1]</a> In survivors of influenza-associated encephalopathy, neurological defects may occur.<a href="#cite_note-dharmapalan-10">[10]</a> Primarily in children, in severe cases the immune system may rarely <a href="/wiki/Hemophagocytic_lymphohistiocytosis" title="Hemophagocytic lymphohistiocytosis">dramatically overproduce white blood cells</a> that release cytokines, causing severe inflammation.<a href="#cite_note-dharmapalan-10">[10]</a> People who are at least 65 years of age,<a href="#cite_note-ghebrehewet-11">[11]</a> due to a weakened immune system from aging or a chronic illness, are a high-risk group for developing complications, as are children less than one year of age and children who have not been previously exposed to influenza viruses multiple times. Pregnant women are at an elevated risk, which increases by trimester<a href="#cite_note-krammer-1">[1]</a> and lasts up to two weeks after childbirth.<a href="#cite_note-ghebrehewet-11">[11]</a><a href="#cite_note-chow-46">[46]</a> Obesity, in particular a <a href="/wiki/Body_mass_index" title="Body mass index">body mass index</a> greater than 35–40, is associated with greater amounts of viral replication, increased severity of secondary bacterial infection, and reduced vaccination efficacy. People who have underlying health conditions are also considered at-risk, including those who have congenital or chronic heart problems or lung (e.g. asthma), kidney, liver, blood, neurological, or metabolic (e.g. <a href="/wiki/Diabetes" title="Diabetes">diabetes</a>) disorders,<a href="#cite_note-dharmapalan-10">[10]</a><a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a> as are people who are immunocompromised from chemotherapy, <a href="/wiki/Asplenia" title="Asplenia">asplenia</a>, prolonged steroid treatment, splenic dysfunction, or <a href="/wiki/HIV" title="HIV">HIV</a> infection.<a href="#cite_note-ghebrehewet-11">[11]</a> Tobacco use, including past use, places a person at risk.<a href="#cite_note-chow-46">[46]</a> The role of genetics in influenza is not well researched,<a href="#cite_note-krammer-1">[1]</a> but it may be a factor in influenza mortality.<a href="#cite_note-peteranderl-13">[13]</a> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Flu_season" title="Flu season">Flu season</a> and <a href="/wiki/Flu_pandemics" class="mw-redirect" title="Flu pandemics">Flu pandemics</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:InfluenzaCaseMortality.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/InfluenzaCaseMortality.svg/280px-InfluenzaCaseMortality.svg.png" decoding="async" width="280" height="231" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/InfluenzaCaseMortality.svg/420px-InfluenzaCaseMortality.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6f/InfluenzaCaseMortality.svg/560px-InfluenzaCaseMortality.svg.png 2x" data-file-width="300" data-file-height="248" /></a><figcaption>Influenza mortality in symptomatic cases in the US for the 2018/2019 season<a href="#cite_note-66">[66]</a></figcaption></figure> Influenza is typically characterized by seasonal epidemics and sporadic pandemics. Most of the burden of influenza is a result of flu seasons caused by influenza A virus and influenza B virus. Among influenza A virus subtypes, H1N1 and H3N2 circulate in humans and are responsible for seasonal influenza. Cases disproportionately occur in children, but most severe causes are among the elderly, the very young,<a href="#cite_note-krammer-1">[1]</a> and the immunocompromised.<a href="#cite_note-lampejo-4">[4]</a> In a typical year, influenza viruses infect 5–15% of the global population,<a href="#cite_note-allen-3">[3]</a><a href="#cite_note-vemula-62">[62]</a> causing 3–5 million cases of severe illness annually<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-sautto-2">[2]</a> and accounting for 290,000–650,000 deaths each year due to respiratory illness.<a href="#cite_note-allen-3">[3]</a><a href="#cite_note-lampejo-4">[4]</a><a href="#cite_note-67">[67]</a> 5–10% of adults and 20–30% of children contract influenza each year.<a href="#cite_note-asha-23">[23]</a> The reported number of influenza cases is usually much lower than the actual number.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-principi-48">[48]</a> During seasonal epidemics, it is estimated that about 80% of otherwise healthy people who have a cough or sore throat have the flu.<a href="#cite_note-krammer-1">[1]</a> Approximately 30–40% of people hospitalized for influenza develop pneumonia, and about 5% of all severe pneumonia cases in hospitals are due to influenza, which is also the most common cause of ARDS in adults. In children, influenza and <a href="/wiki/Respiratory_syncytial_virus" title="Respiratory syncytial virus">respiratory syncytial virus</a> are the two most common causes of ARDS.<a href="#cite_note-kalil-17">[17]</a> About 3–5% of children each year develop otitis media due to influenza.<a href="#cite_note-dharmapalan-10">[10]</a> Adults who develop organ failure from influenza and children who have PIM scores and acute renal failure have higher rates of mortality.<a href="#cite_note-kalil-17">[17]</a> During seasonal influenza, mortality is concentrated in the very young and the elderly, whereas during flu pandemics, young adults are often affected at a high rate.<a href="#cite_note-peteranderl-13">[13]</a> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Influenza_Seasonal_Risk_Areas.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/30/Influenza_Seasonal_Risk_Areas.svg/310px-Influenza_Seasonal_Risk_Areas.svg.png" decoding="async" width="310" height="159" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/30/Influenza_Seasonal_Risk_Areas.svg/465px-Influenza_Seasonal_Risk_Areas.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/30/Influenza_Seasonal_Risk_Areas.svg/620px-Influenza_Seasonal_Risk_Areas.svg.png 2x" data-file-width="863" data-file-height="443" /></a><figcaption>Seasonal risk areas for influenza: November–April (blue), April–November (red), and year-round (yellow)</figcaption></figure> In temperate regions, the number of influenza cases varies from season to season. Lower <a href="/wiki/Vitamin_D" title="Vitamin D">vitamin D</a> levels, presumably due to less sunlight,<a href="#cite_note-moriyama-41">[41]</a> lower humidity, lower temperature, and minor changes in virus proteins caused by antigenic drift contribute to annual epidemics that peak during the winter season. In the northern hemisphere, this is from October to May (more narrowly December to April<a href="#cite_note-peteranderl-13">[13]</a>), and in the southern hemisphere, this is from May to October (more narrowly June to September<a href="#cite_note-peteranderl-13">[13]</a>). There are therefore two distinct influenza seasons every year in temperate regions, one in the northern hemisphere and one in the southern hemisphere.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a><a href="#cite_note-sautto-2">[2]</a> In tropical and subtropical regions, seasonality is more complex and appears to be affected by various climatic factors such as minimum temperature, hours of sunshine, maximum rainfall, and high humidity.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-potter-68">[68]</a> Influenza may therefore occur year-round in these regions.<a href="#cite_note-peteranderl-13">[13]</a> Influenza epidemics in modern times have the tendency to start in the eastern or southern hemisphere,<a href="#cite_note-potter-68">[68]</a> with Asia being a key reservoir.<a href="#cite_note-peteranderl-13">[13]</a> Influenza A virus and influenza B virus co-circulate, so have the same patterns of transmission.<a href="#cite_note-krammer-1">[1]</a> The seasonality of influenza C virus, however, is poorly understood. Influenza C virus infection is most common in children under the age of two, and by adulthood most people have been exposed to it. Influenza C virus-associated hospitalization most commonly occurs in children under the age of three and is frequently accompanied by co-infection with another virus or a bacterium, which may increase the severity of disease. When considering all hospitalizations for respiratory illness among young children, influenza C virus appears to account for only a small percentage of such cases. Large outbreaks of influenza C virus infection can occur, so incidence varies significantly.<a href="#cite_note-sederdahl-12">[12]</a> Outbreaks of influenza caused by novel influenza viruses are common.<a href="#cite_note-mccauley-30">[30]</a> Depending on the level of pre-existing immunity in the population, novel influenza viruses can spread rapidly and cause pandemics with millions of deaths. These pandemics, in contrast to seasonal influenza, are caused by antigenic shifts involving animal influenza viruses. To date, all known flu pandemics have been caused by influenza A viruses, and they follow the same pattern of spreading from an origin point to the rest of the world over the course of multiple waves in a year.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-ghebrehewet-11">[11]</a><a href="#cite_note-chow-46">[46]</a> Pandemic strains tend to be associated with higher rates of pneumonia in otherwise healthy individuals.<a href="#cite_note-kalil-17">[17]</a> Generally after each influenza pandemic, the pandemic strain continues to circulate as the cause of seasonal influenza, replacing prior strains.<a href="#cite_note-krammer-1">[1]</a> From 1700 to 1889, influenza pandemics occurred about once every 50–60 years. Since then, pandemics have occurred about once every 10–50 years, so they may be getting more frequent over time.<a href="#cite_note-potter-68">[68]</a> <div class="mw-heading mw-heading2"><h2 id="History">History</h2></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Influenza_subtypes.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b8/Influenza_subtypes.svg/350px-Influenza_subtypes.svg.png" decoding="async" width="350" height="139" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b8/Influenza_subtypes.svg/525px-Influenza_subtypes.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b8/Influenza_subtypes.svg/700px-Influenza_subtypes.svg.png 2x" data-file-width="631" data-file-height="250" /></a><figcaption>The main types of influenza viruses in humans. Solid squares show the appearance of a new strain, causing recurring influenza pandemics. Broken lines indicate uncertain strain identifications.<a href="#cite_note-Palese-69">[69]</a></figcaption></figure> The first influenza epidemic may have occurred around 6,000 BC in China,<a href="#cite_note-mordini-70">[70]</a> and possible descriptions of influenza exist in Greek writings from the 5th century BC.<a href="#cite_note-potter-68">[68]</a><a href="#cite_note-martin-71">[71]</a> In both 1173–1174 AD and 1387 AD, epidemics occurred across Europe that were named "influenza". Whether these epidemics or others were caused by influenza is unclear since there was then no consistent naming pattern for epidemic respiratory diseases, and "influenza" did not become clearly associated with respiratory disease until centuries later.<a href="#cite_note-morens1-72">[72]</a> Influenza may have been brought to the Americas as early as 1493, when an epidemic disease resembling influenza killed most of the population of the <a href="/wiki/Antilles" title="Antilles">Antilles</a>.<a href="#cite_note-guerra1988-73">[73]</a><a href="#cite_note-guerra1993-74">[74]</a> The first convincing record of an influenza pandemic was <a href="/wiki/1510_influenza_pandemic" title="1510 influenza pandemic">in 1510</a>. It began in East Asia before spreading to North Africa and then Europe.<a href="#cite_note-morens2-75">[75]</a> Following the pandemic, seasonal influenza occurred, with subsequent pandemics in 1557 and 1580.<a href="#cite_note-morens1-72">[72]</a> The flu pandemic in 1557 was potentially the first time influenza was connected to miscarriage and death of pregnant women.<a href="#cite_note-knobler-76">[76]</a> The <a href="/wiki/1580_influenza_pandemic" title="1580 influenza pandemic">1580 influenza pandemic</a> originated in Asia during summer, spread to Africa, then Europe, and finally America.<a href="#cite_note-potter-68">[68]</a> By the end of the 16th century, influenza was beginning to become understood as a specific, recognizable disease with epidemic and endemic forms.<a href="#cite_note-morens1-72">[72]</a> In 1648, it was discovered that horses also experience influenza.<a href="#cite_note-morens2-75">[75]</a> Influenza data after 1700 is more accurate, so it is easier to identify flu pandemics after this point.<a href="#cite_note-taubenberger-77">[77]</a> The first flu pandemic of the 18th century started in 1729 in Russia in spring, spreading worldwide over the course of three years with distinct waves, the later ones being more lethal. Another flu pandemic occurred in 1781–1782, starting in China in autumn.<a href="#cite_note-potter-68">[68]</a> From this pandemic, influenza became associated with sudden outbreaks of febrile illness.<a href="#cite_note-taubenberger-77">[77]</a> The next flu pandemic was from 1830 to 1833, beginning in China in winter. This pandemic had a high attack rate, but the mortality rate was low.<a href="#cite_note-hastings-34">[34]</a><a href="#cite_note-potter-68">[68]</a> A minor influenza pandemic occurred from 1847 to 1851 at the same time as the <a href="/wiki/Third_cholera_pandemic" class="mw-redirect" title="Third cholera pandemic">third cholera pandemic</a> and was the first flu pandemic to occur with vital statistics being recorded, so influenza mortality was clearly recorded for the first time.<a href="#cite_note-taubenberger-77">[77]</a> Fowl plague (now recognised as highly pathogenic avian influenza) was recognized in 1878<a href="#cite_note-taubenberger-77">[77]</a> and was soon linked to transmission to humans.<a href="#cite_note-morens2-75">[75]</a> By the time of the <a href="/wiki/1889%E2%80%931890_pandemic" title="1889–1890 pandemic">1889 pandemic</a>, which may have been caused by an H2N2 strain,<a href="#cite_note-vijgen-78">[78]</a> the flu had become an easily recognizable disease.<a href="#cite_note-morens2-75">[75]</a> The microbial agent responsible for influenza was incorrectly identified in 1892 by <a href="/wiki/Richard_Friedrich_Johannes_Pfeiffer" title="Richard Friedrich Johannes Pfeiffer">R. F. J. Pfeiffer</a> as the bacteria species <a href="/wiki/Haemophilus_influenzae" title="Haemophilus influenzae">Haemophilus influenzae</a>, which retains "influenza" in its name.<a href="#cite_note-morens2-75">[75]</a><a href="#cite_note-taubenberger-77">[77]</a> From 1901 to 1903, Italian and Austrian researchers were able to show that avian influenza, then called "fowl plague",<a href="#cite_note-lycett-35">[35]</a> was caused by a microscopic agent smaller than bacteria by using filters with pores too small for bacteria to pass through. The fundamental differences between viruses and bacteria, however, were not yet fully understood.<a href="#cite_note-taubenberger-77">[77]</a> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:W_curve.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/70/W_curve.png/290px-W_curve.png" decoding="async" width="290" height="205" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/70/W_curve.png/435px-W_curve.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/70/W_curve.png/580px-W_curve.png 2x" data-file-width="600" data-file-height="424" /></a><figcaption>The difference between the influenza mortality age distributions of the 1918 epidemic and normal epidemics. Deaths per 100,000 persons in each age group, United States, for the interpandemic years 1911–1917 (dashed line) and the pandemic year 1918 (solid line).<a href="#cite_note-Taubenberger2-79">[79]</a></figcaption></figure> From 1918 to 1920, the <a href="/wiki/Spanish_flu" title="Spanish flu">Spanish flu</a> pandemic became the most devastating influenza pandemic and one of the deadliest pandemics in history. The pandemic, caused by an H1N1 strain of influenza A,<a href="#cite_note-taubenberger2-80">[80]</a> likely began in the United States before spreading worldwide via soldiers during and after the <a href="/wiki/First_World_War" class="mw-redirect" title="First World War">First World War</a>. The initial wave in the first half of 1918 was relatively minor and resembled past flu pandemics, but the second wave later that year had a much higher mortality rate.<a href="#cite_note-potter-68">[68]</a> A third wave with lower mortality occurred in many places a few months after the second.<a href="#cite_note-hastings-34">[34]</a> By the end of 1920, it is estimated that about a third<a href="#cite_note-peteranderl-13">[13]</a> to half of all people in the world had been infected, with tens of millions of deaths, disproportionately young adults.<a href="#cite_note-potter-68">[68]</a> During the 1918 pandemic, the respiratory route of transmission was clearly identified<a href="#cite_note-hastings-34">[34]</a> and influenza was shown to be caused by a "filter passer", not a bacterium, but there remained a lack of agreement about influenza's cause for another decade and research on influenza declined.<a href="#cite_note-taubenberger-77">[77]</a> After the pandemic, H1N1 circulated in humans in seasonal form<a href="#cite_note-krammer-1">[1]</a> until the next pandemic.<a href="#cite_note-taubenberger-77">[77]</a> In 1931, <a href="/wiki/Richard_Shope" title="Richard Shope">Richard Shope</a> published three papers identifying a virus as the cause of swine influenza, a then newly recognized disease among pigs that was characterized during the second wave of the 1918 pandemic.<a href="#cite_note-knobler-76">[76]</a><a href="#cite_note-taubenberger-77">[77]</a> Shope's research reinvigorated research on human influenza, and many advances in virology, serology, immunology, experimental animal models, vaccinology, and immunotherapy have since arisen from influenza research.<a href="#cite_note-taubenberger-77">[77]</a> Just two years after influenza viruses were discovered, in 1933, influenza A virus was identified as the agent responsible for human influenza.<a href="#cite_note-knobler-76">[76]</a><a href="#cite_note-smith-81">[81]</a> Subtypes of influenza A virus were discovered throughout the 1930s,<a href="#cite_note-taubenberger-77">[77]</a> and influenza B virus was discovered in 1940.<a href="#cite_note-asha-23">[23]</a> During the <a href="/wiki/Second_World_War" class="mw-redirect" title="Second World War">Second World War</a>, the US government worked on developing inactivated vaccines for influenza, resulting in the first influenza vaccine being licensed in 1945 in the United States.<a href="#cite_note-krammer-1">[1]</a> Influenza C virus was discovered two years later in 1947.<a href="#cite_note-asha-23">[23]</a> In 1955, avian influenza was confirmed to be caused by influenza A virus.<a href="#cite_note-lycett-35">[35]</a> Four influenza pandemics have occurred since WWII. The first of these was the <a href="/wiki/Asian_flu" class="mw-redirect" title="Asian flu">Asian flu</a> from 1957 to 1958, caused by an H2N2 strain<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-saunders-82">[82]</a> and beginning in China's <a href="/wiki/Yunnan" title="Yunnan">Yunnan</a> province. The number of deaths probably exceeded one million, mostly among the very young and very old.<a href="#cite_note-potter-68">[68]</a> This was the first flu pandemic to occur in the presence of a global surveillance system and laboratories able to study the novel influenza virus.<a href="#cite_note-hastings-34">[34]</a> After the pandemic, H2N2 was the influenza A virus subtype responsible for seasonal influenza.<a href="#cite_note-krammer-1">[1]</a> The first antiviral drug against influenza, <a href="/wiki/Amantadine" title="Amantadine">amantadine</a>, was approved in 1966, with additional antiviral drugs being used since the 1990s.<a href="#cite_note-lampejo-4">[4]</a> In 1968, H3N2 was introduced into humans through a rearrangement between an avian H3N2 strain and an H2N2 strain that was circulating in humans. The novel H3N2 strain emerged in Hong Kong and spread worldwide, causing the <a href="/wiki/Hong_Kong_flu" title="Hong Kong flu">Hong Kong flu</a> pandemic, which resulted in 500,000–2,000,000 deaths. This was the first pandemic to spread significantly by air travel.<a href="#cite_note-allen-3">[3]</a><a href="#cite_note-hastings-34">[34]</a> H2N2 and H3N2 co-circulated after the pandemic until 1971 when H2N2 waned in prevalence and was completely replaced by H3N2.<a href="#cite_note-allen-3">[3]</a> In 1977, H1N1 reemerged in humans, possibly after it was released from a freezer in a laboratory accident, and caused <a href="/wiki/1977_Russian_flu" title="1977 Russian flu">a pseudo-pandemic</a>.<a href="#cite_note-hastings-34">[34]</a><a href="#cite_note-taubenberger-77">[77]</a> This H1N1 strain was antigenically similar to the H1N1 strains that circulated prior to 1957. Since 1977, both H1N1 and H3N2 have circulated in humans as part of seasonal influenza.<a href="#cite_note-krammer-1">[1]</a> In 1980, the classification system used to subtype influenza viruses was introduced.<a href="#cite_note-heinen-83">[83]</a> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Airport_Thermographic_Camera.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1c/Airport_Thermographic_Camera.jpg/220px-Airport_Thermographic_Camera.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/1c/Airport_Thermographic_Camera.jpg/330px-Airport_Thermographic_Camera.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/1c/Airport_Thermographic_Camera.jpg/440px-Airport_Thermographic_Camera.jpg 2x" data-file-width="2560" data-file-height="1920" /></a><figcaption>Thermal imaging camera and screen, photographed in an airport terminal in <a href="/wiki/Greece" title="Greece">Greece</a> during the 2009 flu pandemic. Thermal imaging can detect elevated body temperature, one of the signs of swine flu.</figcaption></figure> At some point, influenza B virus diverged into two strains, named the B/Victoria-like and B/Yamagata-like lineages, both of which have been circulating in humans since 1983.<a href="#cite_note-asha-23">[23]</a> In 1996, a highly pathogenic H5N1 subtype of influenza A was detected in geese in <a href="/wiki/Guangdong" title="Guangdong">Guangdong</a>, China<a href="#cite_note-lycett-35">[35]</a> and a year later emerged in poultry in Hong Kong, gradually spreading worldwide from there. A small H5N1 outbreak in humans in Hong Kong occurred then,<a href="#cite_note-steinhauer-44">[44]</a> and sporadic human cases have occurred since 1997, carrying a high case fatality rate.<a href="#cite_note-li-19">[19]</a><a href="#cite_note-vemula-62">[62]</a> The most recent flu pandemic was the <a href="/wiki/2009_swine_flu_pandemic" title="2009 swine flu pandemic">2009 swine flu pandemic</a>, which originated in Mexico and resulted in hundreds of thousands of deaths.<a href="#cite_note-hastings-34">[34]</a> It was caused by a novel H1N1 strain that was a reassortment of human, swine, and avian influenza viruses.<a href="#cite_note-joseph-20">[20]</a><a href="#cite_note-lampejo-4">[4]</a> The 2009 pandemic had the effect of replacing prior H1N1 strains in circulation with the novel strain but not any other influenza viruses. Consequently, H1N1, H3N2, and both influenza B virus lineages have been in circulation in seasonal form since the 2009 pandemic.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-hastings-34">[34]</a><a href="#cite_note-lycett-35">[35]</a> In 2011, influenza D virus was discovered in pigs in Oklahoma, USA, and cattle were later identified as the primary reservoir of influenza D virus.<a href="#cite_note-sederdahl-12">[12]</a><a href="#cite_note-asha-23">[23]</a> In the same year,<a href="#cite_note-vemula-62">[62]</a> avian H7N9 was detected in China and began to cause human infections in 2013, starting in <a href="/wiki/Shanghai" title="Shanghai">Shanghai</a> and <a href="/wiki/Anhui" title="Anhui">Anhui</a> and remaining mostly in China. Highly pathogenic H7N9 emerged sometime in 2016 and has occasionally infected humans incidentally. Other avian influenza viruses have less commonly infected humans since the 1990s, including H5N1, H5N5, <a href="/wiki/H5N6" class="mw-redirect" title="H5N6">H5N6</a>, <a href="/wiki/H6N1" class="mw-redirect" title="H6N1">H5N8</a>, <a href="/wiki/H6N1" class="mw-redirect" title="H6N1">H6N1</a>, <a href="/wiki/Influenza_A_virus_subtype_H7N2" title="Influenza A virus subtype H7N2">H7N2</a>, <a href="/wiki/H7N7" class="mw-redirect" title="H7N7">H7N7</a>, and <a href="/wiki/Influenza_A_virus_subtype_H10N7" title="Influenza A virus subtype H10N7">H10N7</a>, and have begun to spread throughout much of the world since the 2010s.<a href="#cite_note-li-19">[19]</a> Future flu pandemics, which may be caused by an influenza virus of avian origin,<a href="#cite_note-lycett-35">[35]</a> are viewed as almost inevitable, and increased <a href="/wiki/Globalization" title="Globalization">globalization</a> has made it easier for a pandemic virus to spread,<a href="#cite_note-hastings-34">[34]</a> so there are continual efforts to prepare for future pandemics<a href="#cite_note-knobler-76">[76]</a> and improve the prevention and treatment of influenza.<a href="#cite_note-krammer-1">[1]</a> <div class="mw-heading mw-heading3"><h3 id="Etymology">Etymology</h3></div> The word influenza comes from the <a href="/wiki/Italian_language" title="Italian language">Italian</a> word influenza, from medieval <a href="/wiki/Latin" title="Latin">Latin</a> influentia, originally meaning 'visitation' or 'influence'. Terms such as influenza di freddo, meaning 'influence of the cold', and influenza di stelle, meaning 'influence of the stars' are attested from the 14th century. The latter referred to the disease's cause, which at the time was ascribed by some to unfavorable <a href="/wiki/Astrology" title="Astrology">astrological</a> conditions. As early as 1504, influenza began to mean a 'visitation' or 'outbreak' of any disease affecting many people in a single place at once. During an outbreak of influenza in 1743 that started in Italy and spread throughout Europe, the word reached the English language and was anglicized in pronunciation. Since the mid-1800s, influenza has also been used to refer to severe colds.<a href="#cite_note-espinosa-84">[84]</a><a href="#cite_note-etymonline-85">[85]</a><a href="#cite_note-oed-86">[86]</a> The shortened form of the word, "flu", is first attested in 1839 as flue with the spelling flu confirmed in 1893.<a href="#cite_note-etymflu-87">[87]</a> Other names that have been used for influenza include epidemic catarrh, la grippe from <a href="/wiki/French_language" title="French language">French</a>, sweating sickness, and, especially when referring to the 1918 pandemic strain, Spanish fever.<a href="#cite_note-calisher-88">[88]</a> <div class="mw-heading mw-heading2"><h2 id="In_animals">In animals</h2></div> <div class="mw-heading mw-heading3"><h3 id="Birds">Birds</h3></div> Aquatic birds such as ducks, geese, shorebirds, and gulls are the primary reservoir of influenza A viruses (IAVs).<a href="#cite_note-li-19">[19]</a><a href="#cite_note-joseph-20">[20]</a> Because of the impact of avian influenza on economically important chicken farms, a classification system was devised in 1981 which divided avian virus strains as either highly pathogenic (and therefore potentially requiring vigorous control measures) or low pathogenic. The test for this is based solely on the effect on chickens – a virus strain is highly pathogenic avian influenza (HPAI) if 75% or more of chickens die after being deliberately infected with it. The alternative classification is low pathogenic avian influenza (LPAI) which produces mild or no symptoms.<a href="#cite_note-:AA6-89">[89]</a> This classification system has since been modified to take into account the structure of the virus' haemagglutinin protein.<a href="#cite_note-90">[90]</a> At the genetic level, an AIV can be identified as an HPAI virus if it has a multibasic cleavage site in the HA protein, which contains additional residues in the HA gene.<a href="#cite_note-joseph-20">[20]</a><a href="#cite_note-lycett-35">[35]</a> Other species of birds, especially water birds, can become infected with HPAI virus without experiencing severe symptoms and can spread the infection over large distances; the exact symptoms depend on the species of bird and the strain of virus.<a href="#cite_note-:AA6-89">[89]</a> Classification of an avian virus strain as HPAI or LPAI does not predict how serious the disease might be if it infects humans or other mammals.<a href="#cite_note-:AA6-89">[89]</a><a href="#cite_note-91">[91]</a> Symptoms of HPAI infection in chickens include lack of energy and appetite, decreased egg production, soft-shelled or misshapen eggs, swelling of the head, comb, wattles, and hocks, purple discoloration of wattles, combs, and legs, nasal discharge, coughing, sneezing, incoordination, and diarrhea; birds infected with an HPAI virus may also die suddenly without any signs of infection.<a href="#cite_note-avian-61">[61]</a> Notable HPAI viruses include influenza A (H5N1) and A (H7N9). HPAI viruses have been a major disease burden in the 21st century, resulting in the death of large numbers of birds. In H7N9's case, some circulating strains were originally low pathogenic but became high pathogenic by mutating to acquire the HA multibasic cleavage site. Avian H9N2 is also of concern because although it is low pathogenic, it is a common donor of genes to H5N1 and H7N9 during reassortment.<a href="#cite_note-krammer-1">[1]</a> <a href="/wiki/Bird_migration" title="Bird migration">Migratory birds</a> can spread influenza across long distances. An example of this was when an H5N1 strain in 2005 infected birds at <a href="/wiki/Qinghai_Lake" title="Qinghai Lake">Qinghai Lake</a>, China, which is a stopover and breeding site for many migratory birds, subsequently spreading the virus to more than 20 countries across Asia, Europe, and the Middle East.<a href="#cite_note-li-19">[19]</a><a href="#cite_note-lycett-35">[35]</a> AIVs can be transmitted from wild birds to domestic free-range ducks and in turn to poultry through contaminated water, aerosols, and fomites.<a href="#cite_note-krammer-1">[1]</a> Ducks therefore act as key intermediates between wild and domestic birds.<a href="#cite_note-lycett-35">[35]</a> Transmission to poultry typically occurs in backyard farming and live animal markets where multiple species interact with each other. From there, AIVs can spread to poultry farms in the absence of adequate biosecurity. Among poultry, HPAI transmission occurs through aerosols and contaminated feces,<a href="#cite_note-krammer-1">[1]</a> cages, feed, and dead animals.<a href="#cite_note-li-19">[19]</a> Back-transmission of HPAI viruses from poultry to wild birds has occurred and is implicated in mass die-offs and intercontinental spread.<a href="#cite_note-joseph-20">[20]</a> AIVs have occasionally infected humans through aerosols, fomites, and contaminated water.<a href="#cite_note-krammer-1">[1]</a> Direction transmission from wild birds is rare.<a href="#cite_note-lycett-35">[35]</a> Instead, most transmission involves domestic poultry, mainly chickens, ducks, and geese but also a variety of other birds such as guinea fowl, partridge, pheasants, and quails.<a href="#cite_note-joseph-20">[20]</a> The primary risk factor for infection with AIVs is exposure to birds in farms and live poultry markets.<a href="#cite_note-li-19">[19]</a> Typically, infection with an AIV has an incubation period of 3–5 days but can be up to 9 days. H5N1 and H7N9 cause severe lower respiratory tract illness, whereas other AIVs such as H9N2 cause a more mild upper respiratory tract illness, commonly with conjunctivitis.<a href="#cite_note-krammer-1">[1]</a> Limited transmission of avian H2, H5-7, H9, and H10 subtypes from one person to another through respiratory droplets, aerosols, and fomites has occurred, but sustained human-to-human transmission of AIVs has not occurred.<a href="#cite_note-krammer-1">[1]</a><a href="#cite_note-sautto-2">[2]</a> <div class="mw-heading mw-heading3"><h3 id="Pigs">Pigs</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:ChineseFluInspectors.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/ChineseFluInspectors.JPG/220px-ChineseFluInspectors.JPG" decoding="async" width="220" height="221" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/ChineseFluInspectors.JPG/330px-ChineseFluInspectors.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6d/ChineseFluInspectors.JPG/440px-ChineseFluInspectors.JPG 2x" data-file-width="441" data-file-height="443" /></a><figcaption>Chinese inspectors checking airline passengers for fever, a common symptom of swine flu</figcaption></figure> Influenza in pigs is a respiratory disease similar to influenza in humans and is found worldwide. Asymptomatic infections are common. Symptoms typically appear 1–3 days after infection and include fever, lethargy, anorexia, weight loss, labored breathing, coughing, sneezing, and nasal discharge. In sows, pregnancy may be aborted. Complications include secondary infections and potentially fatal <a href="/wiki/Bronchopneumonia" title="Bronchopneumonia">bronchopneumonia</a>. Pigs become contagious within a day of infection and typically spread the virus for 7–10 days, which can spread rapidly within a herd. Pigs usually recover within 3–7 days after symptoms appear. Prevention and control measures include inactivated vaccines and culling infected herds. Influenza A virus subtypes H1N1, <a href="/wiki/H1N2" class="mw-redirect" title="H1N2">H1N2</a>, and H3N2 are usually responsible for swine flu.<a href="#cite_note-swine-92">[92]</a> Some influenza A viruses can be transmitted via aerosols from pigs to humans and vice versa.<a href="#cite_note-krammer-1">[1]</a> Pigs, along with bats and quails,<a href="#cite_note-asha-23">[23]</a> are recognized as a mixing vessel of influenza viruses because they have both α-2,3 and α-2,6 sialic acid receptors in their respiratory tract. Because of that, both avian and mammalian influenza viruses can infect pigs. If co-infection occurs, reassortment is possible.<a href="#cite_note-joseph-20">[20]</a> A notable example of this was the reassortment of a swine, avian, and human influenza virus that caused the 2009 flu pandemic.<a href="#cite_note-joseph-20">[20]</a><a href="#cite_note-lampejo-4">[4]</a> Spillover events from humans to pigs appear to be more common than from pigs to humans.<a href="#cite_note-joseph-20">[20]</a> <div class="mw-heading mw-heading3"><h3 id="Other_animals">Other animals</h3></div> Influenza viruses have been found in many other animals, including cattle, horses, dogs, cats, and marine mammals. Nearly all influenza A viruses are apparently descended from ancestral viruses in birds. The exception are bat influenza-like viruses, which have an uncertain origin. These bat viruses have HA and NA subtypes H17, H18, N10, and N11. <a href="/w/index.php?title=H17N10&action=edit&redlink=1" class="new" title="H17N10 (page does not exist)">H17N10</a> and <a href="/w/index.php?title=H18N11&action=edit&redlink=1" class="new" title="H18N11 (page does not exist)">H18N11</a> are unable to reassort with other influenza A viruses, but they are still able to replicate in other mammals.<a href="#cite_note-krammer-1">[1]</a> Equine influenza A viruses include H7N7 and two lineages<a href="#cite_note-krammer-1">[1]</a> of <a href="/wiki/H3N8" class="mw-redirect" title="H3N8">H3N8</a>. H7N7, however, has not been detected in horses since the late 1970s,<a href="#cite_note-mccauley-30">[30]</a> so it may have become extinct in horses.<a href="#cite_note-joseph-20">[20]</a> H3N8 in equines spreads via aerosols and causes respiratory illness.<a href="#cite_note-krammer-1">[1]</a> Equine H3N8 preferentially binds to α-2,3 sialic acids, so horses are usually considered dead-end hosts, but transmission to dogs and camels has occurred, raising concerns that horses may be mixing vessels for reassortment. In canines, the only influenza A viruses in circulation are equine-derived H3N8 and avian-derived H3N2. Canine H3N8 has not been observed to reassort with other subtypes. H3N2 has a much broader host range and can reassort with H1N1 and H5N1. An isolated case of H6N1, likely from a chicken, was found infecting a dog, so other AIVs may emerge in canines.<a href="#cite_note-joseph-20">[20]</a> <a href="/wiki/List_of_mammals_that_can_get_H5N1" title="List of mammals that can get H5N1">A wide range of other mammals</a> have been affected by avian influenza A viruses, generally due to eating birds which had been infected.<a href="#cite_note-93">[93]</a> There have been instances where transmission of the disease between mammals, including seals and cows, may have occurred.<a href="#cite_note-94">[94]</a><a href="#cite_note-:B22-95">[95]</a><a href="#cite_note-mccauley-30">[30]</a> Various mutations have been identified that are associated with AIVs adapting to mammals. Since HA proteins vary in which sialic acids they bind to, mutations in the HA receptor binding site can allow AIVs to infect mammals. Other mutations include mutations affecting which sialic acids NA proteins cleave and a mutation in the PB2 polymerase subunit that improves tolerance of lower temperatures in mammalian respiratory tracts and enhances RNP assembly by stabilizing NP and PB2 binding.<a href="#cite_note-joseph-20">[20]</a> Influenza B virus is mainly found in humans but has also been detected in pigs, dogs, horses, and seals.<a href="#cite_note-asha-23">[23]</a> Likewise, influenza C virus primarily infects humans but has been observed in pigs, dogs, cattle, and dromedary camels.<a href="#cite_note-sederdahl-12">[12]</a><a href="#cite_note-asha-23">[23]</a> Influenza D virus causes an influenza-like illness in pigs but its impact in its natural reservoir, cattle, is relatively unknown. It may cause respiratory disease resembling human influenza on its own, or it may be part of a <a href="/wiki/Bovine_respiratory_disease" title="Bovine respiratory disease">bovine respiratory disease</a> (BRD) complex with other pathogens during co-infection. BRD is a concern for the cattle industry, so influenza D virus' possible involvement in BRD has led to research on vaccines for cattle that can provide protection against influenza D virus.<a href="#cite_note-asha-23">[23]</a><a href="#cite_note-su-26">[26]</a> Two antigenic lineages are in circulation: D/swine/Oklahoma/1334/2011 (D/OK) and D/bovine/Oklahoma/660/2013 (D/660).<a href="#cite_note-asha-23">[23]</a> <div class="mw-heading mw-heading2"><h2 id="References">References</h2></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-krammer-1">^ <a href="#cite_ref-krammer_1-0">a</a> <a href="#cite_ref-krammer_1-1">b</a> <a href="#cite_ref-krammer_1-2">c</a> <a href="#cite_ref-krammer_1-3">d</a> <a href="#cite_ref-krammer_1-4">e</a> <a href="#cite_ref-krammer_1-5">f</a> <a href="#cite_ref-krammer_1-6">g</a> <a href="#cite_ref-krammer_1-7">h</a> <a href="#cite_ref-krammer_1-8">i</a> <a href="#cite_ref-krammer_1-9">j</a> <a href="#cite_ref-krammer_1-10">k</a> <a 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Retrieved 21 May 2024.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=www.ecdc.europa.eu&rft.atitle=Factsheet+on+A%28H5N1%29&rft.date=2017-06-15&rft_id=https%3A%2F%2Fwww.ecdc.europa.eu%2Fen%2Fzoonotic-influenza%2Ffacts%2Ffactsheet-h5n1&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInfluenza" class="Z3988"> </li> <li id="cite_note-91"><a href="#cite_ref-91">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCDC2024" class="citation web cs1">CDC (5 April 2024). <a rel="nofollow" class="external text" href="https://www.cdc.gov/flu/avianflu/inhumans.htm">"Current U.S. Bird Flu Situation in Humans"</a>. U.S. <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> (CDC). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20240522125455/https://www.cdc.gov/flu/avianflu/inhumans.htm">Archived</a> from the original on 22 May 2024. Retrieved 22 May 2024.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=U.S.+Centers+for+Disease+Control+and+Prevention+%28CDC%29&rft.atitle=Current+U.S.+Bird+Flu+Situation+in+Humans&rft.date=2024-04-05&rft.au=CDC&rft_id=https%3A%2F%2Fwww.cdc.gov%2Fflu%2Favianflu%2Finhumans.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInfluenza" class="Z3988"> </li> <li id="cite_note-swine-92"><a href="#cite_ref-swine_92-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.oie.int/en/animal-health-in-the-world/animal-diseases/Swine-influenza/">"Swine influenza"</a>. World Organisation for Animal Health. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20210304222929/https://www.oie.int/en/animal-health-in-the-world/animal-diseases/Swine-influenza/">Archived</a> from the original on 4 March 2021. Retrieved 9 March 2021.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Swine+influenza&rft.pub=World+Organisation+for+Animal+Health&rft_id=https%3A%2F%2Fwww.oie.int%2Fen%2Fanimal-health-in-the-world%2Fanimal-diseases%2FSwine-influenza%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInfluenza" class="Z3988"> </li> <li id="cite_note-93"><a href="#cite_ref-93">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://www.bbc.com/news/science-environment-64474594">"Bird flu 'spills over' to otters and foxes in UK"</a>. BBC News. 2 February 2023. Retrieved 11 June 2024.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=BBC+News&rft.atitle=Bird+flu+%27spills+over%27+to+otters+and+foxes+in+UK&rft.date=2023-02-02&rft_id=https%3A%2F%2Fwww.bbc.com%2Fnews%2Fscience-environment-64474594&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInfluenza" class="Z3988"> </li> <li id="cite_note-94"><a href="#cite_ref-94">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cidrap.umn.edu/avian-influenza-bird-flu/study-h5n1-avian-flu-seal-deaths-reveals-multiple-lineages">"Study of H5N1 avian flu seal deaths reveals multiple lineages | CIDRAP"</a>. Center for Infectious Disease Research and Policy. 15 March 2023. Retrieved 13 June 2024.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Center+for+Infectious+Disease+Research+and+Policy&rft.atitle=Study+of+H5N1+avian+flu+seal+deaths+reveals+multiple+lineages+%7C+CIDRAP&rft.date=2023-03-15&rft_id=https%3A%2F%2Fwww.cidrap.umn.edu%2Favian-influenza-bird-flu%2Fstudy-h5n1-avian-flu-seal-deaths-reveals-multiple-lineages&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInfluenza" class="Z3988"> </li> <li id="cite_note-:B22-95"><a href="#cite_ref-:B22_95-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKozlov2024" class="citation journal cs1">Kozlov M (June 2024). "Huge amounts of bird-flu virus found in raw milk of infected cows". Nature. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fd41586-024-01624-1">10.1038/d41586-024-01624-1</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/38840011">38840011</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature&rft.atitle=Huge+amounts+of+bird-flu+virus+found+in+raw+milk+of+infected+cows&rft.date=2024-06&rft_id=info%3Adoi%2F10.1038%2Fd41586-024-01624-1&rft_id=info%3Apmid%2F38840011&rft.aulast=Kozlov&rft.aufirst=M&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInfluenza" class="Z3988"> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1257001546"><table class="infobox" style="clear: right; float:right;margin:0 0 1.5em 1.5em"><tbody><tr><th colspan="2" class="infobox-above" style="font-size:115%">External videos</th></tr><tr><td colspan="2" class="infobox-full-data" style="text-align: left"><img alt="video icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Nuvola_apps_kaboodle.svg/16px-Nuvola_apps_kaboodle.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Nuvola_apps_kaboodle.svg/24px-Nuvola_apps_kaboodle.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Nuvola_apps_kaboodle.svg/32px-Nuvola_apps_kaboodle.svg.png 2x" data-file-width="128" data-file-height="128" /> <a rel="nofollow" class="external text" href="https://www.c-span.org/video/?458488-1/influenza">Presentation by Brown on Influenza, March 5, 2019</a>, <a href="/wiki/C-SPAN" title="C-SPAN">C-SPAN</a></td></tr></tbody></table> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBrown2018" class="citation book cs1">Brown J (2018). Influenza: The Hundred Year Hunt to Cure the Deadliest Disease in History. New York: Atria. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1501181245" title="Special:BookSources/978-1501181245"><bdi>978-1501181245</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Influenza%3A+The+Hundred+Year+Hunt+to+Cure+the+Deadliest+Disease+in+History&rft.place=New+York&rft.pub=Atria&rft.date=2018&rft.isbn=978-1501181245&rft.aulast=Brown&rft.aufirst=J&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInfluenza" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSt_Mouritz1921" class="citation book cs1"><a href="/wiki/Arthur_Albert_St._Mouritz" title="Arthur Albert St. Mouritz">St Mouritz AA</a> (1921). <a rel="nofollow" class="external text" href="https://collections.nlm.nih.gov/bookviewer?PID=nlm:nlmuid-101283076-bk#page/3/mode/1up/">The Flu: A Brief History of Influenza in U.S. America, Europe, Hawaii</a>. Honolulu, Hawaii, U.S. America: Advertiser Publishing Co.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+Flu%3A+A+Brief+History+of+Influenza+in+U.S.+America%2C+Europe%2C+Hawaii&rft.place=Honolulu%2C+Hawaii%2C+U.S.+America&rft.pub=Advertiser+Publishing+Co.&rft.date=1921&rft.aulast=St+Mouritz&rft.aufirst=AA&rft_id=https%3A%2F%2Fcollections.nlm.nih.gov%2Fbookviewer%3FPID%3Dnlm%3Anlmuid-101283076-bk%23page%2F3%2Fmode%2F1up%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInfluenza" class="Z3988"></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output 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li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q2840" class="extiw" title="d:Q2840">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/J10">J10</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/J11">J11</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=487">487</a></li><li><a href="/wiki/Online_Mendelian_Inheritance_in_Man" title="Online Mendelian Inheritance in Man">OMIM</a>: <a rel="nofollow" class="external text" href="https://omim.org/entry/614680">614680</a></li><li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D007251">D007251</a></li><li><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb6791.htm">6791</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000080.htm">000080</a></li><li><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/1170-overview">med/1170</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/ped/topic3006.htm#">ped/3006</a></li><li><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/influenza">Influenza</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Influenza" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Influenza" title="Template:Influenza"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Influenza" title="Template talk:Influenza"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Influenza" title="Special:EditPage/Template:Influenza"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Influenza" style="font-size:114%;margin:0 4em"><a class="mw-selflink selflink">Influenza</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">General topics</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Influenza_research" class="mw-redirect" title="Influenza research">Research</a></li> <li><a href="/wiki/Influenza_vaccine" title="Influenza vaccine">Vaccine</a></li> <li><a href="/wiki/Influenza_treatment" class="mw-redirect" title="Influenza treatment">Treatment</a></li> <li><a href="/wiki/Influenza_Genome_Sequencing_Project" title="Influenza Genome Sequencing Project">Genome sequencing</a></li> <li><a href="/wiki/Reassortment" title="Reassortment">Reassortment</a></li> <li><a href="/wiki/Superinfection" title="Superinfection">Superinfection</a></li> <li><a href="/wiki/Flu_season" title="Flu season">Flu season</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Viruses</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a></li> <li><a href="/wiki/Influenza_A_virus" title="Influenza A virus">Influenza A</a></li> <li><a href="/wiki/Influenzavirus_B" class="mw-redirect" title="Influenzavirus B">Influenza B</a></li> <li><a href="/wiki/Influenzavirus_C" class="mw-redirect" title="Influenzavirus C">Influenza C</a></li> <li><a href="/wiki/Influenzavirus_D" class="mw-redirect" title="Influenzavirus D">Influenza D</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Influenza A virus subtypes</div></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Influenza_A_virus_subtype_H1N1" title="Influenza A virus subtype H1N1">H1N1</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H1N2" title="Influenza A virus subtype H1N2">H1N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H2N2" title="Influenza A virus subtype H2N2">H2N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H2N3" title="Influenza A virus subtype H2N3">H2N3</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H3N1" title="Influenza A virus subtype H3N1">H3N1</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H3N2" title="Influenza A virus subtype H3N2">H3N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H3N8" title="Influenza A virus subtype H3N8">H3N8</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N1" title="Influenza A virus subtype H5N1">H5N1</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N2" title="Influenza A virus subtype H5N2">H5N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N3" title="Influenza A virus subtype H5N3">H5N3</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N6" title="Influenza A virus subtype H5N6">H5N6</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N8" title="Influenza A virus subtype H5N8">H5N8</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H5N9" class="mw-redirect" title="Influenza A virus subtype H5N9">H5N9</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H6N1" title="Influenza A virus subtype H6N1">H6N1</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N1" title="Influenza A virus subtype H7N1">H7N1</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N2" title="Influenza A virus subtype H7N2">H7N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N3" title="Influenza A virus subtype H7N3">H7N3</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N4" title="Influenza A virus subtype H7N4">H7N4</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N7" title="Influenza A virus subtype H7N7">H7N7</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H7N9" title="Influenza A virus subtype H7N9">H7N9</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H9N2" title="Influenza A virus subtype H9N2">H9N2</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H10N3" title="Influenza A virus subtype H10N3">H10N3</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H10N7" title="Influenza A virus subtype H10N7">H10N7</a></li> <li><a href="/wiki/Influenza_A_virus_subtype_H10N8" title="Influenza A virus subtype H10N8">H10N8</a></li> <li><a href="/w/index.php?title=Influenza_A_virus_subtype_H11N2&action=edit&redlink=1" class="new" title="Influenza A virus subtype H11N2 (page does not exist)">H11N2</a></li> <li><a href="/w/index.php?title=Influenza_A_virus_subtype_H11N9&action=edit&redlink=1" class="new" title="Influenza A virus subtype H11N9 (page does not exist)">H11N9</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Influenza_A_virus_subtype_H1N1" title="Influenza A virus subtype H1N1">H1N1</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;"><a href="/wiki/Influenza_pandemic" title="Influenza pandemic">Pandemics</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Spanish_flu" title="Spanish flu">1918 (Spanish flu)</a></li> <li><a href="/wiki/1977_Russian_flu" title="1977 Russian flu">1977 (Russian flu)</a></li> <li><a href="/wiki/2009_swine_flu_pandemic" title="2009 swine flu pandemic">2009 (Swine flu)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Science</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pandemic_H1N1/09_virus" title="Pandemic H1N1/09 virus">2009 A/H1N1</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Influenza_A_virus_subtype_H5N1" title="Influenza A virus subtype H5N1">H5N1</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Outbreaks</th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bird_flu_in_Croatia" class="mw-redirect" title="Bird flu in Croatia">Croatia (2005)</a></li> <li><a href="/wiki/2006_H5N1_outbreak_in_India" title="2006 H5N1 outbreak in India">India (2006)</a></li> <li><a href="/wiki/2007_Bernard_Matthews_H5N1_outbreak" title="2007 Bernard Matthews H5N1 outbreak">UK (2007)</a></li> <li><a href="/wiki/2008_H5N1_outbreak_in_West_Bengal" title="2008 H5N1 outbreak in West Bengal">West Bengal (2008)</a></li> <li><a href="/wiki/2020%E2%80%932024_H5N1_outbreak" title="2020–2024 H5N1 outbreak">2020s outbreak</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Science</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/H5N1_genetic_structure" title="H5N1 genetic structure">Genetic structure</a></li> <li><a href="/wiki/Transmission_and_infection_of_H5N1" title="Transmission and infection of H5N1">Transmission and infection</a></li> <li><a href="/wiki/Global_spread_of_H5N1" title="Global spread of H5N1">Global spread</a></li> <li><a href="/wiki/H5N1_vaccine" title="H5N1 vaccine">Vaccine</a> <ul><li><a href="/wiki/H5N1_clinical_trials" class="mw-redirect" title="H5N1 clinical trials">clinical trials</a></li></ul></li> <li><a href="/wiki/Human_mortality_from_H5N1" title="Human mortality from H5N1">Human mortality</a></li> <li><a href="/wiki/Social_effects_of_H5N1" title="Social effects of H5N1">Social impact</a></li> <li><a href="/wiki/Influenza_pandemic#Government_preparations_for_a_potential_H5N1_pandemic_(2003–2009)" title="Influenza pandemic">Pandemic preparation</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Influenza_A_virus_subtype_H5N8" title="Influenza A virus subtype H5N8">H5N8</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Outbreaks</th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/2020%E2%80%932022_H5N8_outbreak" class="mw-redirect" title="2020–2022 H5N8 outbreak">2020–2022</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Influenza_treatment" class="mw-redirect" title="Influenza treatment">Treatments</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;"><a href="/wiki/Antiviral_drug" title="Antiviral drug">Antiviral drugs</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adamantane" title="Adamantane">Adamantane derivatives</a> <ul><li><a href="/wiki/Amantadine" title="Amantadine">Amantadine</a></li> <li><a href="/wiki/Rimantadine" title="Rimantadine">Rimantadine</a></li></ul></li> <li><a href="/wiki/Neuraminidase_inhibitor" title="Neuraminidase inhibitor">Neuraminidase inhibitor</a> <ul><li><a href="/wiki/Oseltamivir" title="Oseltamivir">Oseltamivir</a></li> <li><a href="/wiki/Laninamivir" title="Laninamivir">Laninamivir</a></li> <li><a href="/wiki/Peramivir" title="Peramivir">Peramivir</a></li> <li><a href="/wiki/Zanamivir" title="Zanamivir">Zanamivir</a></li></ul></li> <li><a href="/wiki/Peramivir" title="Peramivir">Peramivir (experimental)</a></li> <li><a href="/wiki/Umifenovir" title="Umifenovir">Umifenovir</a></li> <li><a href="/wiki/Baloxavir_marboxil" title="Baloxavir marboxil">Baloxavir marboxil</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;"><a href="/wiki/Influenza_vaccine" title="Influenza vaccine">Vaccines</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Live_attenuated_influenza_vaccine" title="Live attenuated influenza vaccine">Live attenuated influenza vaccine</a></li> <li><a href="/wiki/Seasonal_influenza_vaccine_brands" class="mw-redirect" title="Seasonal influenza vaccine brands">Brands</a></li> <li><a href="/wiki/Pandemrix" title="Pandemrix">Pandemrix</a></li> <li><a href="/wiki/Audenz" class="mw-redirect" title="Audenz">Audenz</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Pandemics and epidemics</div></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;"><a href="/wiki/Influenza_pandemic" title="Influenza pandemic">Pandemics</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/1510_influenza_pandemic" title="1510 influenza pandemic">Influenza pandemic (1510)</a></li> <li><a href="/wiki/1557_influenza_pandemic" title="1557 influenza pandemic">Influenza pandemic (1557)</a></li> <li><a href="/wiki/1889%E2%80%931890_pandemic" title="1889–1890 pandemic">Russian flu (1889–1890)</a></li> <li><a href="/wiki/1918_flu_pandemic" class="mw-redirect" title="1918 flu pandemic">Spanish flu (1918)</a></li> <li><a href="/wiki/1957%E2%80%931958_influenza_pandemic" title="1957–1958 influenza pandemic">Asian flu (1957-1958)</a></li> <li><a href="/wiki/Hong_Kong_flu" title="Hong Kong flu">Hong Kong flu (1968)</a></li> <li><a href="/wiki/1977_Russian_flu" title="1977 Russian flu">1977 Russian flu</a></li> <li><a href="/wiki/2009_swine_flu_pandemic" title="2009 swine flu pandemic">Swine flu (2009)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;"><a href="/wiki/List_of_epidemics_and_pandemics" title="List of epidemics and pandemics">Epidemics</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fujian_flu" title="Fujian flu">Fujian flu (H3N2)</a> <ul><li><a href="/wiki/1989%E2%80%931990_flu_epidemic_in_the_United_Kingdom" title="1989–1990 flu epidemic in the United Kingdom">1989–1990 UK outbreak</a></li></ul></li> <li><a href="/wiki/2017_Central_Luzon_H5N6_outbreak" title="2017 Central Luzon H5N6 outbreak">Central Luzon H5N6 (2017)</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Non-human</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Mammals</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Canine_influenza" title="Canine influenza">Canine</a></li> <li><a href="/wiki/Cat_flu" title="Cat flu">Feline</a></li> <li><a href="/wiki/Equine_influenza" title="Equine influenza">Equine</a> <ul><li><a href="/wiki/2007_Australian_equine_influenza_outbreak" title="2007 Australian equine influenza outbreak">2007 Australian outbreak</a></li></ul></li> <li><a href="/wiki/Swine_influenza" title="Swine influenza">Swine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:6.6em;font-weight: normal;">Non-mammals</th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Avian_influenza" title="Avian influenza">Avian</a></li> <li><a href="/wiki/Fujian_flu" title="Fujian flu">Fujian (H5N1)</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acute_bronchitis" title="Acute bronchitis">Acute bronchitis</a></li> <li><a href="/wiki/Bronchiolitis" title="Bronchiolitis">Bronchiolitis</a></li> <li><a href="/wiki/Croup" title="Croup">Croup</a></li> <li><a href="/wiki/Otitis_media" title="Otitis media">Otitis media</a></li> <li><a href="/wiki/Pharyngitis" title="Pharyngitis">Pharyngitis</a></li> <li><a href="/wiki/Pneumonia" title="Pneumonia">Pneumonia</a></li> <li><a href="/wiki/Sinusitis" title="Sinusitis">Sinusitis</a></li> <li><a href="/wiki/Streptococcal_pharyngitis" title="Streptococcal pharyngitis">Strep throat</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Influenza-like_illness" title="Influenza-like illness">Influenza-like illness</a></li> <li><a href="/wiki/2017%E2%80%932018_United_States_flu_season" title="2017–2018 United States flu season">2017–2018 United States flu season</a></li> <li><a href="/wiki/US_influenza_statistics_by_flu_season" class="mw-redirect" title="US influenza statistics by flu season">US influenza statistics by flu season</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_the_respiratory_system" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Respiratory_pathology" title="Template:Respiratory pathology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Respiratory_pathology" title="Template talk:Respiratory pathology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Respiratory_pathology" title="Special:EditPage/Template:Respiratory pathology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_the_respiratory_system" style="font-size:114%;margin:0 4em"><a href="/wiki/Respiratory_disease" title="Respiratory disease">Diseases of the respiratory system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Upper_respiratory_tract_infection" title="Upper respiratory tract infection">Upper RT</a> (including <a href="/wiki/Upper_respiratory_tract_infection" title="Upper respiratory tract infection">URTIs</a>, <a href="/wiki/Common_cold" title="Common cold">common cold</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_head" title="Human head">Head</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/Paranasal_sinuses" title="Paranasal sinuses">sinuses</a></dt> <dd></dd> <dd><a href="/wiki/Sinusitis" title="Sinusitis">Sinusitis</a></dd></dl> <dl><dt><a href="/wiki/Human_nose" title="Human nose">nose</a></dt> <dd></dd> <dd><a href="/wiki/Rhinitis" title="Rhinitis">Rhinitis</a> <dl><dd><a href="/wiki/Nonallergic_rhinitis" title="Nonallergic rhinitis">Vasomotor rhinitis</a></dd> <dd><a href="/wiki/Chronic_atrophic_rhinitis" title="Chronic atrophic rhinitis">Atrophic rhinitis</a></dd> <dd><a href="/wiki/Allergic_rhinitis" title="Allergic rhinitis">Hay fever</a></dd></dl></dd> <dd><a href="/wiki/Nasal_polyp" title="Nasal polyp">Nasal polyp</a></dd> <dd><a href="/wiki/Rhinorrhea" title="Rhinorrhea">Rhinorrhea</a></dd> <dd><a href="/wiki/Nasal_septum" title="Nasal septum">nasal septum</a> <dl><dd><a href="/wiki/Nasal_septum_deviation" title="Nasal septum deviation">Nasal septum deviation</a></dd> <dd><a href="/wiki/Nasal_septum_perforation" title="Nasal septum perforation">Nasal septum perforation</a></dd> <dd><a href="/wiki/Nasal_septal_hematoma" title="Nasal septal hematoma">Nasal septal hematoma</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/Tonsil" title="Tonsil">tonsil</a></dt> <dd></dd> <dd><a href="/wiki/Tonsillitis" title="Tonsillitis">Tonsillitis</a></dd> <dd><a href="/wiki/Adenoid_hypertrophy" title="Adenoid hypertrophy">Adenoid hypertrophy</a></dd> <dd><a href="/wiki/Peritonsillar_abscess" title="Peritonsillar abscess">Peritonsillar abscess</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neck" title="Neck">Neck</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/Pharynx" title="Pharynx">pharynx</a></dt> <dd></dd> <dd><a href="/wiki/Pharyngitis" title="Pharyngitis">Pharyngitis</a> <dl><dd><a href="/wiki/Streptococcal_pharyngitis" title="Streptococcal pharyngitis">Strep throat</a></dd></dl></dd> <dd><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</dd> <dd><a href="/wiki/Retropharyngeal_abscess" title="Retropharyngeal abscess">Retropharyngeal abscess</a></dd></dl> <dl><dt><a href="/wiki/Larynx" title="Larynx">larynx</a></dt> <dd></dd> <dd><a href="/wiki/Croup" title="Croup">Croup</a></dd> <dd><a href="/wiki/Laryngomalacia" title="Laryngomalacia">Laryngomalacia</a></dd> <dd><a href="/wiki/Laryngeal_cyst" title="Laryngeal cyst">Laryngeal cyst</a></dd> <dd><a href="/wiki/Laryngitis" title="Laryngitis">Laryngitis</a></dd> <dd><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</dd> <dd><a href="/wiki/Laryngospasm" title="Laryngospasm">Laryngospasm</a></dd></dl> <dl><dt><a href="/wiki/Vocal_cords" title="Vocal cords">vocal cords</a></dt> <dd></dd> <dd><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</dd> <dd><a href="/wiki/Vocal_cord_nodule" title="Vocal cord nodule">Vocal fold nodule</a></dd> <dd><a href="/wiki/Vocal_cord_paresis" title="Vocal cord paresis">Vocal fold paresis</a></dd> <dd><a href="/wiki/Vocal_cord_dysfunction" title="Vocal cord dysfunction">Vocal cord dysfunction</a></dd></dl> <dl><dt><a href="/wiki/Epiglottis" title="Epiglottis">epiglottis</a></dt> <dd></dd> <dd><a href="/wiki/Epiglottitis" title="Epiglottitis">Epiglottitis</a></dd></dl> <dl><dt><a href="/wiki/Trachea" title="Trachea">trachea</a></dt> <dd></dd> <dd><a href="/wiki/Tracheitis" title="Tracheitis">Tracheitis</a></dd> <dd><a href="/wiki/Laryngotracheal_stenosis" title="Laryngotracheal stenosis">Laryngotracheal stenosis</a></dd></dl> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lower_respiratory_tract" class="mw-redirect" title="Lower respiratory tract">Lower RT</a>/ <a href="/wiki/Respiratory_disease" title="Respiratory disease">lung disease</a> (including <a href="/wiki/Lower_respiratory_tract_infection" title="Lower respiratory tract infection">LRTIs</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bronchus" title="Bronchus">Bronchial</a>/ <a href="/wiki/Obstructive_lung_disease" title="Obstructive lung disease">obstructive</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt>acute</dt> <dd></dd> <dd><a href="/wiki/Acute_bronchitis" title="Acute bronchitis">Acute bronchitis</a></dd></dl> <dl><dt>chronic</dt> <dd></dd> <dd><a href="/wiki/Chronic_obstructive_pulmonary_disease" title="Chronic obstructive pulmonary disease">COPD</a> <dl><dd><a href="/wiki/Bronchitis#Chronic_bronchitis" title="Bronchitis">Chronic bronchitis</a></dd> <dd><a href="/wiki/Acute_exacerbation_of_chronic_obstructive_pulmonary_disease" title="Acute exacerbation of chronic obstructive pulmonary disease">Acute exacerbation of COPD</a>)</dd> <dd><a href="/wiki/Asthma" title="Asthma">Asthma</a> (<a href="/wiki/Status_asthmaticus" class="mw-redirect" title="Status asthmaticus">Status asthmaticus</a></dd> <dd><a href="/wiki/Aspirin-exacerbated_respiratory_disease" title="Aspirin-exacerbated respiratory disease">AERD</a></dd> <dd><a href="/wiki/Exercise-induced_asthma" class="mw-redirect" title="Exercise-induced asthma">Exercise-induced</a></dd></dl></dd> <dd><a href="/wiki/Bronchiectasis" title="Bronchiectasis">Bronchiectasis</a></dd> <dd><a href="/wiki/Cystic_fibrosis" title="Cystic fibrosis">Cystic fibrosis</a></dd></dl> <dl><dt>unspecified</dt> <dd></dd> <dd><a href="/wiki/Bronchitis" title="Bronchitis">Bronchitis</a></dd> <dd><a href="/wiki/Bronchiolitis" title="Bronchiolitis">Bronchiolitis</a> <dl><dd><a href="/wiki/Bronchiolitis_obliterans" title="Bronchiolitis obliterans">Bronchiolitis obliterans</a></dd></dl></dd> <dd><a href="/wiki/Diffuse_panbronchiolitis" title="Diffuse panbronchiolitis">Diffuse panbronchiolitis</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Interstitial_lung_disease" title="Interstitial lung disease">Interstitial</a>/ <a href="/wiki/Restrictive_lung_disease" title="Restrictive lung disease">restrictive</a> (<a href="/wiki/Pulmonary_fibrosis" title="Pulmonary fibrosis">fibrosis</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">External agents/ <a href="/wiki/Occupational_disease" title="Occupational disease">occupational</a> <a href="/wiki/Occupational_lung_disease" title="Occupational lung disease">lung disease</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dd><a href="/wiki/Pneumoconiosis" title="Pneumoconiosis">Pneumoconiosis</a> <dl><dd><a href="/wiki/Aluminosis" title="Aluminosis">Aluminosis</a></dd> <dd><a href="/wiki/Asbestosis" title="Asbestosis">Asbestosis</a></dd> <dd><a href="/wiki/Baritosis" title="Baritosis">Baritosis</a></dd> <dd><a href="/wiki/Bauxite_fibrosis" title="Bauxite fibrosis">Bauxite fibrosis</a></dd> <dd><a href="/wiki/Berylliosis" title="Berylliosis">Berylliosis</a></dd> <dd><a href="/wiki/Caplan%27s_syndrome" title="Caplan's syndrome">Caplan's syndrome</a></dd> <dd><a href="/wiki/Chalicosis" title="Chalicosis">Chalicosis</a></dd> <dd><a href="/wiki/Coalworker%27s_pneumoconiosis" class="mw-redirect" title="Coalworker's pneumoconiosis">Coalworker's pneumoconiosis</a></dd> <dd><a href="/wiki/Siderosis" title="Siderosis">Siderosis</a></dd> <dd><a href="/wiki/Silicosis" title="Silicosis">Silicosis</a></dd> <dd><a href="/wiki/Pulmonary_talcosis" title="Pulmonary talcosis">Talcosis</a></dd> <dd><a href="/wiki/Byssinosis" title="Byssinosis">Byssinosis</a></dd></dl></dd></dl> <dl><dd><a href="/wiki/Hypersensitivity_pneumonitis" title="Hypersensitivity pneumonitis">Hypersensitivity pneumonitis</a> <dl><dd><a href="/wiki/Bagassosis" title="Bagassosis">Bagassosis</a></dd> <dd><a href="/wiki/Bird_fancier%27s_lung" title="Bird fancier's lung">Bird fancier's lung</a></dd> <dd><a href="/wiki/Farmer%27s_lung" title="Farmer's lung">Farmer's lung</a></dd> <dd><a href="/wiki/Lycoperdonosis" title="Lycoperdonosis">Lycoperdonosis</a></dd></dl></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acute_respiratory_distress_syndrome" title="Acute respiratory distress syndrome">ARDS</a></li> <li><a href="/wiki/Combined_pulmonary_fibrosis_and_emphysema" title="Combined pulmonary fibrosis and emphysema">Combined pulmonary fibrosis and emphysema</a></li> <li><a href="/wiki/Pulmonary_edema" title="Pulmonary edema">Pulmonary edema</a></li> <li><a href="/wiki/L%C3%B6ffler%27s_syndrome" title="Löffler's syndrome">Löffler's syndrome</a>/<a href="/wiki/Eosinophilic_pneumonia" title="Eosinophilic pneumonia">Eosinophilic pneumonia</a></li> <li><a href="/wiki/Respiratory_hypersensitivity" class="mw-redirect" title="Respiratory hypersensitivity">Respiratory hypersensitivity</a> <ul><li><a href="/wiki/Allergic_bronchopulmonary_aspergillosis" title="Allergic bronchopulmonary aspergillosis">Allergic bronchopulmonary aspergillosis</a></li></ul></li> <li><a href="/wiki/Hamman%E2%80%93Rich_syndrome" class="mw-redirect" title="Hamman–Rich syndrome">Hamman–Rich syndrome</a></li> <li><a href="/wiki/Idiopathic_pulmonary_fibrosis" title="Idiopathic pulmonary fibrosis">Idiopathic pulmonary fibrosis</a></li> <li><a href="/wiki/Sarcoidosis" title="Sarcoidosis">Sarcoidosis</a></li> <li><a href="/wiki/Vaping-associated_pulmonary_injury" title="Vaping-associated pulmonary injury">Vaping-associated pulmonary injury</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Obstructive / Restrictive</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pneumonia" title="Pneumonia">Pneumonia</a>/ <a href="/wiki/Pneumonitis" title="Pneumonitis">pneumonitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">By pathogen</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Viral_pneumonia" title="Viral pneumonia">Viral</a></li> <li><a href="/wiki/Bacterial_pneumonia" title="Bacterial pneumonia">Bacterial</a> <ul><li><a href="/wiki/Pneumococcal_infection" title="Pneumococcal infection">Pneumococcal</a></li> <li><a href="/wiki/Klebsiella_pneumoniae#Klebsiella_pneumonia" title="Klebsiella pneumoniae">Klebsiella</a></li></ul></li> <li><a href="/wiki/Atypical_pneumonia" title="Atypical pneumonia">Atypical bacterial</a> <ul><li><a href="/wiki/Mycoplasma_pneumonia" title="Mycoplasma pneumonia">Mycoplasma</a></li> <li><a href="/wiki/Legionellosis" class="mw-redirect" title="Legionellosis">Legionnaires' disease</a></li> <li><a href="/wiki/Chlamydiota" title="Chlamydiota">Chlamydiae</a></li></ul></li> <li><a href="/wiki/Fungal_pneumonia" title="Fungal pneumonia">Fungal</a> <ul><li><a href="/wiki/Pneumocystis_pneumonia" title="Pneumocystis pneumonia">Pneumocystis</a></li></ul></li> <li><a href="/wiki/Parasitic_pneumonia" title="Parasitic pneumonia">Parasitic</a></li> <li>noninfectious <ul><li><a href="/wiki/Chemical_pneumonia" class="mw-redirect" title="Chemical pneumonia">Chemical</a>/<a href="/wiki/Mendelson%27s_syndrome" title="Mendelson's syndrome">Mendelson's syndrome</a></li> <li><a href="/wiki/Aspiration_pneumonia" title="Aspiration pneumonia">Aspiration</a>/<a href="/wiki/Lipid_pneumonia" title="Lipid pneumonia">Lipid</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">By vector/route</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Community-acquired_pneumonia" title="Community-acquired pneumonia">Community-acquired</a></li> <li><a href="/wiki/Healthcare-associated_pneumonia" class="mw-redirect" title="Healthcare-associated pneumonia">Healthcare-associated</a></li> <li><a href="/wiki/Hospital-acquired_pneumonia" title="Hospital-acquired pneumonia">Hospital-acquired</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">By distribution</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bronchopneumonia" title="Bronchopneumonia">Broncho-</a></li> <li><a href="/wiki/Lobar_pneumonia" title="Lobar pneumonia">Lobar</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Idiopathic_interstitial_pneumonia" title="Idiopathic interstitial pneumonia">IIP</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Usual_interstitial_pneumonia" title="Usual interstitial pneumonia">UIP</a></li> <li><a href="/wiki/Desquamative_interstitial_pneumonia" title="Desquamative interstitial pneumonia">DIP</a></li> <li><a href="/wiki/Bronchiolitis_obliterans_organizing_pneumonia" class="mw-redirect" title="Bronchiolitis obliterans organizing pneumonia">BOOP-COP</a></li> <li><a href="/wiki/Nonspecific_interstitial_pneumonia" class="mw-redirect" title="Nonspecific interstitial pneumonia">NSIP</a></li> <li><a href="/wiki/Respiratory_bronchiolitis" title="Respiratory bronchiolitis">RB</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Atelectasis" title="Atelectasis">Atelectasis</a></li> <li>circulatory <ul><li><a href="/wiki/Pulmonary_hypertension" title="Pulmonary hypertension">Pulmonary hypertension</a></li> <li><a href="/wiki/Pulmonary_embolism" title="Pulmonary embolism">Pulmonary embolism</a></li></ul></li> <li><a href="/wiki/Lung_abscess" title="Lung abscess">Lung abscess</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pleural_cavity" title="Pleural cavity">Pleural cavity</a>/ <a href="/wiki/Mediastinum" title="Mediastinum">mediastinum</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pleural_disease" title="Pleural disease">Pleural disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pleurisy" title="Pleurisy">Pleuritis/pleurisy</a></li></ul> <ul><li><a href="/wiki/Pneumothorax" title="Pneumothorax">Pneumothorax</a>/<a href="/wiki/Hemopneumothorax" title="Hemopneumothorax">Hemopneumothorax</a></li></ul> <dl><dt><a href="/wiki/Pleural_effusion" title="Pleural effusion">Pleural effusion</a></dt> <dd></dd> <dd><a href="/wiki/Hemothorax" title="Hemothorax">Hemothorax</a></dd> <dd><a href="/wiki/Hydrothorax" title="Hydrothorax">Hydrothorax</a></dd> <dd><a href="/wiki/Chylothorax" title="Chylothorax">Chylothorax</a></dd> <dd><a href="/wiki/Pleural_empyema" title="Pleural empyema">Empyema/pyothorax</a></dd> <dd><a href="/wiki/Malignant_pleural_effusion" title="Malignant pleural effusion">Malignant</a></dd></dl> <dl><dd><a href="/wiki/Fibrothorax" title="Fibrothorax">Fibrothorax</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mediastinal_disease" class="mw-redirect" title="Mediastinal disease">Mediastinal disease</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mediastinitis" title="Mediastinitis">Mediastinitis</a></li> <li><a href="/wiki/Pneumomediastinum" title="Pneumomediastinum">Mediastinal emphysema</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other/general</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Respiratory_failure" title="Respiratory failure">Respiratory failure</a></li> <li><a class="mw-selflink selflink">Influenza</a></li> <li><a href="/wiki/Common_cold" title="Common cold">Common cold</a></li> <li><a href="/wiki/Severe_acute_respiratory_syndrome" class="mw-redirect" title="Severe acute respiratory syndrome">SARS</a></li> <li><a href="/wiki/COVID-19" title="COVID-19">COVID-19</a></li> <li><a href="/wiki/Idiopathic_pulmonary_haemosiderosis" title="Idiopathic pulmonary haemosiderosis">Idiopathic pulmonary haemosiderosis</a></li> <li><a href="/wiki/Pulmonary_alveolar_proteinosis" title="Pulmonary alveolar proteinosis">Pulmonary alveolar proteinosis</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Infectious_diseases_–_viral_systemic_diseases" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Viral_systemic_diseases" title="Template:Viral systemic diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Viral_systemic_diseases" title="Template talk:Viral systemic diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Viral_systemic_diseases" title="Special:EditPage/Template:Viral systemic diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Infectious_diseases_–_viral_systemic_diseases" style="font-size:114%;margin:0 4em"><a href="/wiki/Infection" title="Infection">Infectious diseases</a> – <a href="/wiki/Viral_disease" title="Viral disease">viral systemic diseases</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Oncovirus" title="Oncovirus">Oncovirus</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">HBV</a> <dl><dd><a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a></dd></dl></dd> <dd><a href="/wiki/Papillomaviridae" title="Papillomaviridae">HPV</a> <dl><dd><a href="/wiki/Cervical_cancer" title="Cervical cancer">Cervical cancer</a></dd> <dd><a href="/wiki/Anal_cancer" title="Anal cancer">Anal cancer</a></dd> <dd><a href="/wiki/Penile_cancer" title="Penile cancer">Penile cancer</a></dd> <dd><a href="/wiki/Vulvar_cancer" title="Vulvar cancer">Vulvar cancer</a></dd> <dd><a href="/wiki/Vaginal_cancer" title="Vaginal cancer">Vaginal cancer</a></dd> <dd><a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">Oropharyngeal cancer</a></dd></dl></dd> <dd><a href="/wiki/Kaposi%27s_sarcoma-associated_herpesvirus" title="Kaposi's sarcoma-associated herpesvirus">KSHV</a> <dl><dd><a href="/wiki/Kaposi%27s_sarcoma" title="Kaposi's sarcoma">Kaposi's sarcoma</a></dd></dl></dd> <dd><a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">EBV</a> <dl><dd><a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">Nasopharyngeal carcinoma</a></dd> <dd><a href="/wiki/Burkitt%27s_lymphoma" class="mw-redirect" title="Burkitt's lymphoma">Burkitt's lymphoma</a></dd> <dd><a href="/wiki/Hodgkin_lymphoma" title="Hodgkin lymphoma">Hodgkin lymphoma</a></dd> <dd><a href="/wiki/Follicular_dendritic_cell_sarcoma" title="Follicular dendritic cell sarcoma">Follicular dendritic cell sarcoma</a></dd> <dd><a href="/wiki/Extranodal_NK/T-cell_lymphoma,_nasal_type" title="Extranodal NK/T-cell lymphoma, nasal type">Extranodal NK/T-cell lymphoma, nasal type</a></dd></dl></dd> <dd><a href="/wiki/Merkel_cell_polyomavirus" title="Merkel cell polyomavirus">MCPyV</a> <dl><dd><a href="/wiki/Merkel-cell_carcinoma" title="Merkel-cell carcinoma">Merkel-cell carcinoma</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">HCV</a> <dl><dd><a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a></dd> <dd><a href="/wiki/Splenic_marginal_zone_lymphoma" title="Splenic marginal zone lymphoma">Splenic marginal zone lymphoma</a></dd></dl></dd> <dd><a href="/wiki/Human_T-lymphotropic_virus_1" title="Human T-lymphotropic virus 1">HTLV-I</a> <dl><dd><a href="/wiki/Adult_T-cell_leukemia/lymphoma" title="Adult T-cell leukemia/lymphoma">Adult T-cell leukemia/lymphoma</a></dd></dl></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Immune_disorder" title="Immune disorder">Immune disorders</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HIV" title="HIV">HIV</a> <ul><li><a href="/wiki/HIV/AIDS" title="HIV/AIDS">AIDS</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Central_nervous_system_viral_disease" title="Central nervous system viral disease">Central nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Viral_encephalitis" title="Viral encephalitis">Encephalitis</a>/ <a href="/wiki/Viral_meningitis" title="Viral meningitis">meningitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><a href="/wiki/Human_polyomavirus_2" title="Human polyomavirus 2">Human polyomavirus 2</a> <dl><dd><a href="/wiki/Progressive_multifocal_leukoencephalopathy" title="Progressive multifocal leukoencephalopathy">Progressive multifocal leukoencephalopathy</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><a href="/wiki/Measles_morbillivirus" class="mw-redirect" title="Measles morbillivirus">MeV</a> <dl><dd><a href="/wiki/Subacute_sclerosing_panencephalitis" title="Subacute sclerosing panencephalitis">Subacute sclerosing panencephalitis</a></dd></dl></dd> <dd><a href="/wiki/Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">LCV</a> <dl><dd><a href="/wiki/Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">Lymphocytic choriomeningitis</a></dd></dl></dd> <dd><a href="/wiki/Arbovirus_encephalitis" class="mw-redirect" title="Arbovirus encephalitis">Arbovirus encephalitis</a></dd> <dd><a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a> (probable) <dl><dd><a href="/wiki/Encephalitis_lethargica" title="Encephalitis lethargica">Encephalitis lethargica</a></dd></dl></dd> <dd><a href="/wiki/Rabies_virus" title="Rabies virus">RV</a> <dl><dd><a href="/wiki/Rabies" title="Rabies">Rabies</a></dd></dl></dd> <dd><a href="/wiki/Chandipura_vesiculovirus" title="Chandipura vesiculovirus">Chandipura vesiculovirus</a></dd> <dd><a href="/wiki/Herpesviral_meningitis" class="mw-redirect" title="Herpesviral meningitis">Herpesviral meningitis</a></dd> <dd><a href="/wiki/Ramsay_Hunt_syndrome_type_2" title="Ramsay Hunt syndrome type 2">Ramsay Hunt syndrome type 2</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Myelitis" title="Myelitis">Myelitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Poliovirus" title="Poliovirus">Poliovirus</a> <ul><li><a href="/wiki/Polio" title="Polio">Poliomyelitis</a></li> <li><a href="/wiki/Post-polio_syndrome" title="Post-polio syndrome">Post-polio syndrome</a></li></ul></li> <li><a href="/wiki/Human_T-lymphotropic_virus_1" title="Human T-lymphotropic virus 1">HTLV-I</a> <ul><li><a href="/wiki/Tropical_spastic_paraparesis" title="Tropical spastic paraparesis">Tropical spastic paraparesis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Eye_disease" title="Eye disease">Eye</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a> <ul><li><a href="/wiki/Cytomegalovirus_retinitis" title="Cytomegalovirus retinitis">Cytomegalovirus retinitis</a></li></ul></li> <li><a href="/wiki/Herpes_simplex_virus" title="Herpes simplex virus">HSV</a> <ul><li><a href="/wiki/Herpes_simplex_keratitis" title="Herpes simplex keratitis">Herpes of the eye</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a> <ul><li><a href="/wiki/Pericarditis" title="Pericarditis">Pericarditis</a></li> <li><a href="/wiki/Myocarditis" title="Myocarditis">Myocarditis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Respiratory_system" title="Respiratory system">Respiratory system</a>/ <a href="/wiki/Common_cold" title="Common cold">acute viral nasopharyngitis</a>/ <a href="/wiki/Viral_pneumonia" title="Viral pneumonia">viral pneumonia</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a> <ul><li><a href="/wiki/Epstein%E2%80%93Barr_virus_infection" title="Epstein–Barr virus infection">EBV infection</a>/<a href="/wiki/Infectious_mononucleosis" title="Infectious mononucleosis">Infectious mononucleosis</a></li></ul></li> <li><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/RNA_virus#Group_IV_–_positive-sense_ssRNA_viruses" title="RNA virus">IV</a>: <a href="/wiki/Human_coronavirus" class="mw-redirect" title="Human coronavirus">Human coronavirus</a> <a href="/wiki/Human_coronavirus_229E" title="Human coronavirus 229E">229E</a>/<a href="/wiki/Human_coronavirus_NL63" title="Human coronavirus NL63">NL63</a>/<a href="/wiki/Human_coronavirus_HKU1" title="Human coronavirus HKU1">HKU1</a>/<a href="/wiki/Human_coronavirus_OC43" title="Human coronavirus OC43">OC43</a> <ul><li><a href="/wiki/Common_cold" title="Common cold">Common cold</a></li></ul></li> <li><a href="/wiki/Middle_East_respiratory_syndrome%E2%80%93related_coronavirus" class="mw-redirect" title="Middle East respiratory syndrome–related coronavirus">MERS coronavirus</a> <ul><li><a href="/wiki/Middle_East_respiratory_syndrome" class="mw-redirect" title="Middle East respiratory syndrome">Middle East respiratory syndrome</a></li></ul></li> <li><a href="/wiki/Severe_acute_respiratory_syndrome_coronavirus" class="mw-redirect" title="Severe acute respiratory syndrome coronavirus">SARS coronavirus</a> <ul><li><a href="/wiki/Severe_acute_respiratory_syndrome" class="mw-redirect" title="Severe acute respiratory syndrome">Severe acute respiratory syndrome</a></li></ul></li> <li><a href="/wiki/SARS-CoV-2" title="SARS-CoV-2">SARS-CoV-2</a> <ul><li><a href="/wiki/COVID-19" title="COVID-19">COVID-19</a></li></ul></li></ul> <ul><li><a href="/wiki/RNA_virus#Group_V_–_negative-sense_ssRNA_viruses" title="RNA virus">V</a>, <a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a>: <a href="/wiki/Influenza_A_virus" title="Influenza A virus">Influenza virus A</a>/<a href="/wiki/Influenza_B_virus" title="Influenza B virus">B</a>/<a href="/wiki/Influenza_C_virus" title="Influenza C virus">C</a>/<a href="/wiki/Influenza_D_virus" title="Influenza D virus">D</a> <ul><li><a class="mw-selflink selflink">Influenza</a>/<a href="/wiki/Avian_influenza" title="Avian influenza">Avian influenza</a></li></ul></li></ul> <ul><li>V, <a href="/wiki/Paramyxoviridae" title="Paramyxoviridae">Paramyxoviridae</a>: <a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">Human parainfluenza viruses</a> <ul><li><a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">Parainfluenza</a></li></ul></li> <li><a href="/wiki/Human_orthopneumovirus" class="mw-redirect" title="Human orthopneumovirus">Human orthopneumovirus</a></li> <li><a href="/wiki/Human_metapneumovirus" title="Human metapneumovirus">hMPV</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_digestive_system" title="Human digestive system">Human digestive system</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pharynx" title="Pharynx">Pharynx</a>/<a href="/wiki/Esophagus" title="Esophagus">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mumps_virus" title="Mumps virus">MuV</a> <ul><li><a href="/wiki/Mumps" title="Mumps">Mumps</a></li></ul></li> <li><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a> <ul><li><a href="/wiki/Cytomegalovirus_esophagitis" title="Cytomegalovirus esophagitis">Cytomegalovirus esophagitis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastroenteritis#Viral" title="Gastroenteritis">Gastroenteritis</a>/ <a href="/wiki/Gastroenteritis#Virus" title="Gastroenteritis">diarrhea</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><a href="/wiki/Adenoviridae" title="Adenoviridae">Adenovirus</a> <dl><dd><a href="/wiki/Adenovirus_infection" title="Adenovirus infection">Adenovirus infection</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><a href="/wiki/Rotavirus" title="Rotavirus">Rotavirus</a> (<a href="/wiki/Rotaviral_gastroenteritis" class="mw-redirect" title="Rotaviral gastroenteritis">Gastroenteritis</a>)</dd> <dd><a href="/wiki/Norovirus" title="Norovirus">Norovirus</a></dd> <dd><a href="/wiki/Astrovirus" title="Astrovirus">Astrovirus</a></dd> <dd><a href="/wiki/Coronavirus" title="Coronavirus">Coronavirus</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Hepatitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">HBV</a> (<a href="/wiki/Hepatitis_B" title="Hepatitis B">B</a>)</dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></dd> <dd><a href="/wiki/Hepatitis_A#Virology" title="Hepatitis A">HAV</a> (<a href="/wiki/Hepatitis_A" title="Hepatitis A">A</a>)</dd> <dd><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">HCV</a> (<a href="/wiki/Hepatitis_C" title="Hepatitis C">C</a>)</dd> <dd><a href="/wiki/Hepatitis_D" title="Hepatitis D">HDV</a> (<a href="/wiki/Hepatitis_D" title="Hepatitis D">D</a>)</dd> <dd><a href="/wiki/Orthohepevirus_A" title="Orthohepevirus A">HEV</a> (<a href="/wiki/Hepatitis_E" title="Hepatitis E">E</a>)</dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Genitourinary_system" title="Genitourinary system">Urogenital</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/BK_virus" title="BK virus">BK virus</a></li> <li><a href="/wiki/Mumps_virus" title="Mumps virus">MuV</a> <ul><li><a href="/wiki/Mumps" title="Mumps">Mumps</a></li></ul></li></ul> </div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1130092004">.mw-parser-output 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title="Wikipedia:Contents/Portals">Portals</a>:<ul class="portal-bar-content"><li class="portal-bar-item"><img alt="icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/WHO_Rod.svg/8px-WHO_Rod.svg.png" decoding="async" width="8" height="19" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/WHO_Rod.svg/12px-WHO_Rod.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d6/WHO_Rod.svg/16px-WHO_Rod.svg.png 2x" data-file-width="107" data-file-height="250" /> <a href="/wiki/Portal:Medicine" title="Portal:Medicine">Medicine</a></li><li class="portal-bar-item"><a href="/wiki/File:Sida-aids.png" class="mw-file-description"><img alt="icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Sida-aids.png/19px-Sida-aids.png" decoding="async" width="19" height="19" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Sida-aids.png/29px-Sida-aids.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Sida-aids.png/38px-Sida-aids.png 2x" data-file-width="290" data-file-height="290" /></a> <a href="/wiki/Portal:Viruses" title="Portal:Viruses">Viruses</a></li></ul></div><style data-mw-deduplicate="TemplateStyles:r1236088147">.mw-parser-output .sister-bar{display:flex;justify-content:center;align-items:baseline;font-size:88%;background-color:#fdfdfd;border:1px solid #a2a9b1;clear:both;margin:1em 0 0;padding:0 2em}.mw-parser-output .sister-bar-header{margin:0 1em 0 0.5em;padding:0.2em 0;flex:0 0 auto;min-height:24px;line-height:22px}.mw-parser-output .sister-bar-content{display:flex;flex-flow:row wrap;flex:0 1 auto;align-items:baseline;padding:0.2em 0;column-gap:1em;margin:0;list-style:none}.mw-parser-output .sister-bar-item{display:flex;align-items:baseline;margin:0.15em 0;min-height:24px;text-align:left}.mw-parser-output .sister-bar-logo{width:22px;line-height:22px;margin:0 0.2em;text-align:right}.mw-parser-output .sister-bar-link{margin:0 0.2em;text-align:left}@media screen and (max-width:960px){.mw-parser-output .sister-bar{flex-flow:column wrap;margin:1em auto 0}.mw-parser-output .sister-bar-header{flex:0 1}.mw-parser-output .sister-bar-content{flex:1;border-top:1px solid #a2a9b1;margin:0;list-style:none}.mw-parser-output .sister-bar-item{flex:0 0 20em;min-width:20em}}.mw-parser-output .navbox+link+.sister-bar,.mw-parser-output .navbox+style+.sister-bar,.mw-parser-output .portal-bar+link+.sister-bar,.mw-parser-output .portal-bar+style+.sister-bar,.mw-parser-output .sister-bar+.navbox-styles+.navbox,.mw-parser-output .sister-bar+.navbox-styles+.portal-bar{margin-top:-1px}@media print{body.ns-0 .mw-parser-output .sister-bar{display:none!important}}</style><div class="noprint metadata sister-bar" role="navigation" aria-label="sister-projects"><div class="sister-bar-header">Influenza at Wikipedia's <a href="/wiki/Wikipedia:Wikimedia_sister_projects" title="Wikipedia:Wikimedia sister 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1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/28px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /><a href="https://commons.wikimedia.org/wiki/Category:Influenza" class="extiw" title="c:Category:Influenza">Media</a> from Commons</li><li class="sister-bar-item"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/2/24/Wikinews-logo.svg/21px-Wikinews-logo.svg.png" decoding="async" width="21" height="11" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/24/Wikinews-logo.svg/32px-Wikinews-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/24/Wikinews-logo.svg/42px-Wikinews-logo.svg.png 2x" data-file-width="759" data-file-height="415" /><a href="https://en.wikinews.org/wiki/Category:Influenza" class="extiw" title="n:Category:Influenza">News</a> from Wikinews</li><li class="sister-bar-item"><img alt="" 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