Glossary of terms

This glossary of words, commonly associated with influenza and its treatment, is arranged alphabetically with each term catalogued by first letter.

A-D

Antibodies	A group of glycoproteins (immunoglobulins) which are formed by lymphocytes and plasma cells in the immune systemafter contact with antigens from white blood cells of the immune system (so-called B-lymphocytes) and plasma cells and which react exclusively with the corresponding antigen (antigen-antibody reaction). Antibodies may bind to both foreign antigens, such as microorganisms which cause disease, and to native antigens, such as tumour cells.
Antigen	An antigen is a substance which is recognised as foreign by an organism and which evokes a specific immune response, with the formation of antibodies, where the word "specific" means that the response is only against this antigen. Bacteria, viruses, other microorganisms and foreign proteins can all act as antigens. Cf. Influenza virus.
Antigenic Drift	Gradual changes over the years in an antigen, which are mostly only slight. As a result of this,antibodies which are formed in the human body during immunisation against the original antigen can lose their protective activity. For example, new variants of the subtype of the influenza virus arises by changes (mutations) in the genes which bear the information for the virus antigens haemagglutinin and neuraminidases. Cf. antigenic shift
Antigenic Shift	A sudden and usually considerable change in the properties of an antigen of a microorganism (particularly a virus), as a result of which new subtypes may arise. For example, an antigenic shift is caused in the influenza virus (type A) by exchange of genetic material between two subtypes. This usually leads to a new pandemic, as the antibodies which are present in man are no longer active against the new subtype of the influenza virus. Cf.antigenic drift.
Antiserum	Designation for a blood serum which contains antibodies to one or more defined antigens. Antisera are isolated from animals or people who have either been specially immunised for this purpose or who have suffered from a certain disease and who have therefore produced these antibodies. Because of the many ways in which the reactions of immune defence may occur, the antiserum contains different antibodies to the antigen. Antisera are used, for example, for the identification of pathogens. Cf. Serogroup, Serotype.
Ascorbic Acid	see Vitamin C
Bacteria	Bacteria are living creatures with a single cell which has no real nucleus. They may be shaped like balls (cocci), rods (bacilli) or screws (spirochaetes). Bacteria reproduce by cell division, which gives two identical cells. In unfavourable conditions, some bacteria can produce so-called spores (permanent stages), which makes them resistant to, for example, extreme temperatures. Many bacteria cause infections, while others are important components of the flora in the human skin and intestine.
Blood Poisoning	see sepsis
Bronchitis, acute	Acute inflammatory infection of the lower respiratory tract (cf. bronchus), mostly as a consequence of viral infection. Bacterial bronchitis is relatively rare. Symptoms Cough, thick sputum, increase in body temperature, pain in the chest. Treatment Fluid intake, measures to stop the mucous membranes from swelling, antiviral therapy (virostatic drugs) only in exceptional cases. Antibiotics only for bacterial infection (e.g. from haemophilus influenzae), perhaps drugs to lower temperature. Natural medicines include drugs to dissolve phlegm, for example as teas to protect the mucous membrane; ethereal oils increase secretion, dissolve phlegm and have antibacterial activity. They can be used externally as medicinal baths, embrocations or for inhalation. Moist chest compresses are thought to soothe, to inhibit cough and to alleviate pain.
Bronchus	Lower respiratory tracts; continuation of the trachea (windpipe). Before the 4th thoracic vertebra, the bronchus divides into the right and left main bronchi. The main bronchi then branch into the lobes of the lung, with three lobe bronchi on the right and two on the left. These then branch into segmental bronchi, corresponding to the number of lung segments. The wall of the bronchi is covered with a ciliated epithelium. In the wall of the ciliated epithelium there are beaker cells which secrete mucus, which is transported in the direction of the throat by the cilia. In this way, foreign particles are transported out of the bronchi. Bronchial musculature is smooth and circular and forms helixes in the smaller bronchi. Cf. bronchioles.
Catarrh	see rhinitis
Cold, Russian	The so-called "Russian cold" was a large wave of influenza in the years 1889-1892. Cf. pandemic.
Colds	Inflammation of the respiratory tract and middle ear which often occurs after chilling. Not to be confused with influenza! Causes Mostly virus infection, (particularly with rhinovirus) after a drop in local perfusion and immune defence. Treatment Drug treatment: symptomatic: 1. Nose drops; 2. Inhalation with camomile extract, brine (mineral water containing salt) or ethereal oils; 3. With children, cold ointments can be rubbed in; 4. Antibiotic treatment for otitis media or paranasal sinus inflammation. Traditional treatments: 1. With acute symptoms like flu, rest, including bed rest; 2. Little food, or food which is easy to digest and which contains much carbohydrate; 3. Regular bowel movements, perhaps with laxatives; 4. The effect of fever is in principle positive. If necessary, temperature can be reduced with wet packs; 5. Cold baths with plant additives can soothe, relax and support sleep; 6. Treatment of inflamed mucous membranes with ethereal oils, depending on the localisation, steam inhalation for the head, rinsing of the mouth or gargling; also local warmth, e.g. with infrared or short wave radiation. Prevention Avoidance of overheated rooms, dry air, and stress; adequate supply of vitamins, particularly of vitamin C (ascorbic acid). Comments Never treat with nose drops for more than 14 days, because of the danger of chronic rhinopathy (narrowing of the nose, with restriction to breathing, damage to the mucous membrane, problems in smelling, calcification of the blood vessels).
Combination Vaccines	Also known as multiple vaccines Vaccine (see vaccines) for the simultaneous immunisation against several infectious diseases, to make the recommended protective vaccination easier, e.g. measles, mumps, German measles vaccine. Cf. vaccine, polyvalent.
Cough	Forced breathing out, against the vocal chords in the larynx, which are initially closed and then suddenly opened. Cough is an essential protective reflex, which is released by the irritation of receptors in the windpipe and bronchi. Forms 1. Productive cough in which mucus is transported out; 2. Unproductive, dry cough, so-called hacking cough. Treatment 1. In principle, the treatment of cough is the treatment of the underlying disease (e.g. influenza); 2. In addition, drugs to suppress cough should be used for unproductive and exhausting cough; 3. Traditional medicine offers a variety of herbs; cold compresses are a home remedy and have a soothing and suppressive effect. Comment A further diagnostic investigation must be carried out if the cough continues, or if the sputum contains pus or is bloody.

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E-H

Endemic Disease	Permanent occurrence of a disease in a restricted area. Cf. epidemic, pandemic.
Epidemic	Very frequent occurrence of a disease, particularly an infectious disease, in a restricted area and time. Explosive epidemics exhibit a rapid increase and decrease in the number of patients (water and milk epidemics); with tardive epidemics, the number of patients rise and fall slowly (contact epidemics). Cf. endemic disease, pandemic.
Fever	Increase in body temperature as a result of a disturbance in thermal regulation. In contrast to hyperthermia, in which the body is overheated without the so-called target value being shifted, in fever the target value for the body temperature is shifted upwards. Fever can support the body's defensive mechanisms, partly by acceleration of biochemical reactions. These advantageous effects of moderate fever must be balanced against subjective complaints (feeling of illness, loss of appetite, headache) and objective disadvantages ( protein degradation). Classification: Up to 38 °C subfebrile temperature, up to 38.5 °C moderate fever, above 39 °C high fever. Fever rarely rises above 41 °C. Symptoms When fever develops during infections, babies and small children can react with fever seizures. With older children, the rise in fever is accompanied by shivering, cool limbs and centralisation of the circulation. Adults with fever usually suffer from chills. After the peak of the fever has been reached, there may be loss of consciousness or perception. The fever may drop slowly in the course of days or rapidly in the course of hours. Treatment Treatment of the causes (e.g. treatment of infection); treatment of the symptoms, balancing the advantages and disadvantages (physically by improving the release of heat, or by giving drugs which lower fever). Traditional medicine prescribes calf compresses, juice or tea fasts or a variety of plant extracts (e.g. red currants, traditional barberry, common wood sorrel and others).
Flu	see influenza
Flu Virus	see influenza virus
Flu, Asiatic	Asiatic flu was a large wave of influenza in the years 1957-1958. Cf. pandemic.
Flu, Hong Kong	Hong Kong flu was a large wave of influenza in the years 1968-1969. Cf. pandemic.
Flu, Spanish	Wave of influenza 1918-1920, from which 500 million people fell ill and 22 million people died.
Haemagglutins	Name for substances which cause the agglomeration of blood cells (haemagglutination), e.g. the surface antigens of certain viruses, such as the measles, mumps, German measles and influenza viruses.
Haemophilus influenzae	also known as Influenza Bacteria Bacterium, that used to be thought to be the cause of influenza. It is now regarded as the cause of secondary diseases after respiratory viral infections, e.g. when influenza caused by influenza viruses is already present. Haemophilus influenzae type b in babies and small children is the primary cause of inflammation of the cerebral membrane (meningitis) and of the larynx, more rarely of pneumonia, sepsis, inflammation of the paranasal sinuses or otitis media. Prevention Protective vaccination against Haemophilus influenzae type b for babies and small children.

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I-L

Immune Defence	Ability of the immune system of an organism to react specifically against antigens with the help of specific antibodies (humoral immunity) or of T-lymphocytes, which can destroy cells which are foreign to the body (cell-mediated immunity).
Immune System	Complex functional system (in vertebrates) to maintain health by repelling substances which are foreign to the body (antigens) and the continuous elimination of abnormal body cells, in which the organs of the lymphatic system participate. Cells which are distributed throughout the organism play a role, particularly white blood cells and antibodies.
Immunity	Lack of susceptibility of an organism for an infection with pathogenic microorganisms, or protection from poisonous metabolic products or plant or animal poisons. Immunity is based on one or more specific defence mechanisms. Less specific immunity is a result of various protective mechanisms, particularly the so-called skin-mucous membrane barrier and, for example, from the natural resistance (lack of susceptibility) of man to certain pathogens (e.g. canine distemper). Specific immunity includes, for example, the formation of antibodies as the immune response to antigens.
Infection	Transmission, adherence and penetration of microorganisms (viruses, bacteria, fungi and other) into a so-called host (plant, animal, man), followed by reproduction in the host. An infection is the precondition for the development of an infectious disease and is essentially determined by the infectious properties of the microorganism, such as transmissibility, adherence, ability to penetrate and ability to reproduce. The emergence and course of an infectious disease also depend on the susceptibility or lack of susceptibility of the host and from the defences of the host (immunity). Influenza is the result of a viral infection.
Infection, influenzal	Unspecific collective term for generalised feverish illness from different causes, mostly with more or less marked participation of the upper respiratory tract or (more rarely) of the gastrointestinal tract. See colds, influenza.
Inflammation of the Middle Ear	see otitis media
Influenza	Definition Also known as viral influenza or flu Influenza is an acute endemic, epidemic or pandemic infection of the respiratory tract. (Cf. endemic disease, epidemic, pandemic). Causes Pathogen Influenza is caused by the so-called influenza virus. Influenza or flu viruses are of types A, B and C. Type A influenza virus is responsible for the intense waves of influenza,as it is highly variable (see antigenic drift, antigenic shift). The viruses are transmitted by droplet infection (sneezing and coughing), but also by speaking and direct contact. After an infection, they destroy the uppermost layer of the mucous membrane from the nose to the bronchi. As a result, secondary bacterial infections can arise, particularly with Haemophilus influenzae, staphylococci and streptococci. Cf. viruses. Symptoms Influenza begins suddenly with high fever, chills, throat problems, and pain in the head, limbs, muscles and lower back. Additional symptoms are hoarseness and dry cough and sometimes vomiting and abdominal pain. Any organ or organ system can be toxically damaged, which can lead to the occurrence of different symptoms: excessively low blood pressure, slow heart rate, swelling of the liver, nose bleeds, coughing blood and influenza exanthema. If the course is uncomplicated, the symptoms regress after 4-8 days. Total recovery can last longer. Complications Complications may develop, particularly in older people and when there are secondary bacterial infections. These include: 1. Acute bronchitis and pneumonia, which is regarded as the cause of 80-100 % of influenza deaths. Secondary infections with staphylococci may lead to accumulation of pus in the pleura. 2. Paranasal sinusitis and otitis media. 3. Circulatory failure as a result of infectious and toxic inflammation of the heart muscle or damage to the smallest blood vessels (capillaries). 4. Involvement of the nervous system (inflammation of the nerves, meningitis). Diagnosis Diagnosis is carried out on the basis of the symptoms. Additional diagnostic tests can include the blood count, demonstration of the virus in secretions in the throat or in the stool and measurement of antibodies. Influenza should be differentiated from other viral infections, particularly adeno- and Coxsackie viruses, and also ornithosis, which is an infectious bacterial disease transmitted by birds, sepsis, Typhus abdominalis and miliary tuberculosis. Therapy As a first step, the symptoms are combated with drugs to reduce the fever and inflammation. If the course of the disease is threatening, treatment follows with a vaccine which contains the corresponding antibody and with virostatic drugs antibiotics are used for secondary bacterial infections. In cases free of complications the prognosis is favourable. Prevention protective vaccination to influenza can be carried out as prophylaxis against infection. Vaccination is particularly important for individuals aged over 60, those who are at increased risk because of an underlying disease and for people who are at increased risk because of their work, e.g. if they work in hospitals or have much contact with the public. It is best to use the antigen combination which is currently recommended by the WHO. If at all possible, the vaccination should be carried out in autumn before the start of the influenza season. It is best to inject the vaccine into the upper arm. Revaccination should be carried out every year, as vaccination only protects for a maximum of one year. During a pandemic caused by a change in the pathogenic influenza virus (cf. antigenic shift), vaccination with broad activity is requisite. This can be of great value for the health of the population. The use of the protective vaccine depends on the epidemic situation.
Influenza Enanthema	Inflammatory changes in the mucous membrane in connection with influenza; small blisters in the frontal arch of the palate, very small point-like areas of bleeding from the small blood vessels, particularly on the mucous membrane of the cheeks, or small yellow-white specks (flu points) on the mucous membrane of the cheeks, at the border between the red of the lips and the lip mucous membrane. Cf. influenza exanthema.
Influenza Exanthema	Inflammatory changes in the skin (resembles measles) in the context of influenza more frequent in children than in adults. Influenza exanthema arises on the first day of the illness and remains for one to two days. Cf. influenza enanthema.
Influenza Virus	also known as flu virus Virus which causes (see influenza). Divided into types A, B and C on the basis of an antigenically active protein. Type A influenza viruses are further divided into subtypes on the basis of differences in the surface antigens localised in the virus coat, (see neuraminidase) (N) and (see haemagglutinin) (H) and are characterised by considerable antigenic variability (see antigenic drift),(see antigenic shift). They occur in man and also in pigs, birds and horses. 14 Different haemagglutinins and 9 different neuraminidases have been described. Haemagglutinins H1, H2 and H3 and neuraminidases N1 and N2 are of particular importance in the influenza viruses which are infective to man. For example, the (see Spanish flu) was caused by influenza virus A of the subtype H1N1. However, in May 1997 the influenza virus A of subtype H5N1 was found in Hong Kong in a deceased child; previously only some species of bird had been infected with this virus. This led to intensive monitoring of this subtype till the end of 1997 and to the discovery of a further 15 cases of death in Hong Kong. It is presumed that the virus infection was caused by contact between humans and infected birds. As a result of this marked antigenic variability, (see antibodies) formed against the influenza virus in the course of a previous immunisation can lose their specificity for the antigen and hence their protective activity. The antigenic variability also hinders the development of a constant standard vaccine which is generally active. The virus is transmitted by droplet infection. (see Protective vaccination to influenza) may be performed as a preventive measure. (see protective vaccination), (see viruses)
Inoculation	see vaccine

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M-O

Neuraminidase Inhibitors	Inhibitors of the neuraminidase of the influenza virus types A and B. The release of newly formed viruses from the infected cell is blocked. Cf. virostatic drugs.
Neuraminidases	Enzyme that occurs in certain viruses and bacteria, in plasma and in lysosomes (cell organelles). Neuraminidase is a surface antigen of the influenza virus. Mucoproteins are slime substances which are secreted by the skin and mucous membranes for protective purposes. The virus can attack these with the help of neuraminidase.
Oseltamivir	Virostatic drug (neuraminidase inhibitor) for the early treatment of influenza (influenza virus types A and B). Cf virostatic drugs. Side-effects of the Drug Nausea, vomiting, heartburn, headache
OTC Drugs	OTC is an abbreviation for "over the counter" OTC drugs are drugs which may be obtained without medical prescription. The supply of freely available drugs can be very different in different countries.
Otitis media	Inflammation of the middle ear Infection of the middle ear, which mostly develops in the context of an infection of the rhinopharynx, by transmission through the auditory tube. Viruses or bacteria may cause acute otitis media, e.g. Haemophilus influenzae. Otitis media can have a mild course, with a feeling of pressure, moderate pain and loss of hearing. Severe infections are characterised by intense general symptoms, sometimes accompanied by fever and chills. The treatment includes the causative infection of the upper respiratory tract (see colds), and also perhaps treatment with warmth (red light). If the auditory tube is not cleared within 1-2 weeks of when the infection subsides, treatment of the tube should then follow. Severe cases should always be treated with antibiotics and perhaps with surgery.

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P-R

Pandemic	Spreading of an infectious disease over countries and continents, e.g. influenza pandemic. Cf. endemic disease, epidemic.
Parainfluenza Virus	Group of RNA viruses for which 15 serotypes are distinguished in man, cows, sheep, monkeys, dogs and mice. Four serotypes which cause disease are known in man. The distribution is throughout the world. Sporadic disease and small epidemics of different severity, particularly in winter, may occur. Inflammation in the throat, rhinitis, acute bronchitis and pneumonia may develop. Children and older people are mainly affected. The course of the disease may be severe on first infection and in babies. Subsequent infections either cause only mild symptoms or none at all.
Paranasal Sinusitis	see sinusitis
Protective Vaccination	Production of immunity to prevent infectious diseases. Forms 1. Active immunisation: The antigen is administered and the body is intended to produce the corresponding antibodies. One example is the artificial production of a weakened or low-level disease. The viruses or bacteria which are administered to the subject can reproduce, but can cause only very mild disease. The aim is stable immunity to the disease; 2. Passive immunisation: Injection of specific antibodies or serum from actively immunised humans or animals. Non-infectious or non-poisonous antibodies are used for the prevention or direct treatment of infectious diseases. The antibodies must not be first formed by the body; 3. Simultaneous vaccination is a combination of active and passive immunisation, i.e. antigen and antibody are administered at the same time. This is meant to bridge the unprotected gap between infection and antibody production. Examples of this are the vaccinations to tetanus, rabies and hepatitis B. Cf.vaccine, polyvalent, combination vaccine, vaccination complication.
Reagent	Test substance; Substance which makes the presence of another substance recognisable by its chemical effect.
Recombination	Formation of a new gene combination from genetically different genomes (total genetic material in a cell or organisms).
Replication	Identical duplication of genetic material (DNA or RNA); with double-stranded DNA, replication usually occurs before cell division. A daughter strand is formed on each of the two original strands, which serve as matrixes. This leads to two identical double strands.
Rhinitis	Also known as coryza or nasal catarrh Superficial inflammation of the nasal mucous membrane, which often occurs without the temperature being raised. Acute rhinitis is often the first symptom of other infectious diseases such as influenza and whooping cough. "Chronic" means chronic inflammation of the nasal mucous membrane, which leads to an increase in the volume of the mucous membrane, particularly in the area of the nasal muscles, which can hinder breathing through the nose. Possible cause for this include recurrent inflammation, chemical or physical irritation or hormonal disturbance. Cause of the disease (pathogens) Mostly rhinoviruses, but also numerous other viruses. Symptoms There is a dry first stage with a general feeling of illness, burning and tickling in the nose and throat and the urge to sneeze. This is followed by acute rhinitis, with watery secretion, which then becomes viscous and contains pus. Treatment Catarrh drops or sprays, which reduce the swelling in the nasal mucous membrane. Comment Nose drops should never be used for more than 14 days, because of the danger of excessive perfusion of the blood vessels of the nasal mucous membrane, with chronic rhinopathy (narrowing of the nose, which hinders breathing, damage to the mucous membrane, disturbances in smelling, calcification of the blood vessels).
Rhinovirus	Genus of small RNA viruses from the family of the Picornaviridae; up to now more than 115 serotypes have been recognised. These are classified as belonging to the Rhinovirus major group or the Rhinovirus minor group, depending on the cellular receptor. Rhinoviruses mostly occur in the nasopharynx and are the most frequent cause of rhinitis. Cf. colds.

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S-T

Sepsis	also known as septicaemia or blood poisoning General infection with symptoms of illness, in which microorganisms (mostly bacteria, more rarely fungi, viruses or parasites) reach the circulation from a so-called focus. Possible focuses of infection include the navel (for new born babies), often the urogenital tract (e.g. infections of the urinary tract or infections after birth), the skin (e.g. infections from wounds), ENT (e.g. inflammation of the tonsils, of the frontal sinuses or of the middle ear), the lungs (e.g. pneumonia) or the intestine (e.g. inflammation of the diaphragm). Promoting Factors Include treatment which suppresses the immune response, preceding operation, implant or indwelling catheter (e.g. in bladder or vein), diabetes mellitus. Symptoms Typically, high fever, chills, clearly impaired general feeling of wellbeing, which may extend to confusion, often grey-pale skin, later (soft) spleen and liver enlargement and infectious and toxic damage to internal organs (kidneys, lungs, heart). Pathogens established in the body can cause inflammation of the cerebral membrane (meningitis), brain abscess, lung abscess, arthritis or inflammation of the bone marrow. Treatment Immediate treatment with antibiotics. Prognosis In spite of intensive medical care, the prognosis is serious (mortality ca. 50%), and is particularly unfavourable if the treatment starts late, if the focus of infection cannot be localised, in cancer patients, or if there is multiorgan failure in the course of the treatment.
Septicaemia	see sepsis
Serogroup	A closely related group of microorganisms, identified with a specific antiserum, which reacts with common structural elements in the antigens of the serogroup.
Serotype	Microorganisms which belong to a serogroup and which are identifiable by a certain pattern of antigens with the help of a specific antiserum.
Sinusitis	Paranasal sinus inflammation Acute or chronic inflammation of one or several paranasal sinuses (maxillary sinus, frontal sinus, sphenoid sinus, ethmoid cells). In adults the maxillary sinuses are most often affected. Causes Infections transmitted from the nasal cavity, particularly viruses (e.g. the influenza virus) or bacteria (e.g. Haemophilus influenzae, streptococci, staphylococci). Symptoms General feeling of being washed out, pain in the face and head, problems with breathing through the nose. Chronic sinusitis often exhibits few symptoms. Treatment Nose drops to reduce swelling, camomile steam bath, warmth, possibly antibiotics, rinsing of the paranasal sinuses, possibly operation. Complications Very rare rupture into the external soft tissue, into the eyes or cranial cavity, causing for example meningitis.
Strain	Microbiology is the branch of science which deals with the conditions in which microorganisms live, including bacteria and viruses. Within microbiology, the strain is the systematic subunit of the species.
System, lymphatic	Name for cells (e.g. lymphocytes) which participate in the immune system. Lymphocytes are formed in the bone marrow and thymus; the reaction between lymphocytes and antigens takes place in the spleen and in the lymph nodes.
Type	Also known as variety Concept in biological systematics to describe the system of strain development and the relationships within living nature. The type or variety is a classification within the species, used for organisms which exhibit slight, but largely constant, differences.

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U-Z

Vaccination	see protective vaccination
Vaccination Calendar	Fixed sequence for the recommended vaccinations for babies, children and young people, with the aim of achieving resistance (immunity) to important infectious diseases. Supported in Switzerland by the Swiss Committee for Vaccination Questions (Abbreviation SKIF), in Germany by the Standing Committee on Vaccination of the Robert Koch Institute (Abbreviation STIKO) and in Austria by the Upper Health Committee (Vaccination Committee). There are special recommendations for refresher and first vaccinations for adults and for specific groups (for instance, treatment before travel or for groups at risk). Cf. protective vaccination.
Vaccination Complications	Illness from a vaccination which goes beyond the normal reaction to vaccination and which may need treatment. In rare cases permanent damage may result. Vaccination complications may be caused by the vaccination antigen itself or by the helper substances in the vaccine. For example, the oral vaccine to poliomyelitis uses a weakened vaccine material which contains live viruses which can reproduce (Sabin). This can cause vaccine poliomyelitis or contact vaccine poliomyelitis in individuals who have been in close contact with someone who has been vaccinated. It is therefore recommended only to use the Salk inactivated polio vaccine (IPV). Cf. protective vaccination.
Vaccine, polyvalent	Vaccine consisting of a mixture of different vaccination antigens of the types of a pathogen (e.g. influenza virus, poliomyelitis virus). Cf. combination vaccine, protective vaccine.
Vaccines	A substance used for inoculation, consisting either of live pathogens with reduced toxicity, inactivated pathogens, or inactivated toxins or fragments of pathogens. Cf.protective immunisation.
Viral Influenza	see influenza
Virologist	Biologist who has specialised in viruses.
Virostatic Drugs	Virostatic drugs are chemical compounds for the treatment of virus infections (cf. infection). Possible Modes of Action 1. The penetration of viral genetic material and its release are hindered; 2. The replication of the viral genetic material is hindered, e.g. by inhibition of the necessary enzymes in the virus; 3. The maturation of the virus and its release are inhibited. Use As a result of drug side-effects and differences between individual viruses, the use of virostatic drugs has as yet been restricted to selected groups of viruses; e.g. Herpes simplex virus, influenza virus, hepatitis viruses. Contraindications Pregnancy, breast feeding, kidney failure, allergies and other. Drug Side-effects Depending on the drug, e.g. kidney damage, damage to the system which forms new blood cells (haematopoesis), or to the nervous system. Also disturbances in the digestive tract, local reactions at the site of infusion, such as thrombosis of superficial veins and inflammation of the blood vessel wall, hypersensitivity reactions.
Virus	see viruses
Virus Classification	Viruses can be classified according to various points of view, e.g. according to the type of nucleic acid (DNA, RNA), according to size, according to structure, according to the host organism in which they cause disease, or on the basis of their adaptation to distinct tissue types or organ systems (e.g. whether they infect the nervous system, the lungs or the liver). The modern classification according to consistent rules succeeded on the basis of exact chemical, physical and genetic analyses and includes an international designation, the virus family with the ending "-idae"; as a group of genera with similar structure, genus with ending "-virus", etc..
Viruses	Collective name for the biological structures, which in the known cases mostly cause disease, and which have the following common characteristics: 1. The genetic information is only either DNA or RNA; 2. They do not possess the enzymes which are necessary for growth and reproduction, but require for this purpose host cells which are usually specific and which may be plant cells or certain animal or human cells, in which they often cause disease. Viruses which only attack bacteria are called bacteriophages.The modern classification of viruses is mostly based on their structure and genetic similarity and only exceptionally on clinical or epidemiological characteristics. Structure (Morphology) Infectious viruses (so-called virions) measure 20-300 nm in length or diameter and consist of: 1. strand of nucleic acid (DNA or RNA); 2. protein coat (core, capsid; capsid and nucleic acid together are referred to as the nucleocapsid); 3. complex virions are surrounded by a coat. Nucleocapsids mostly have simple geometrical forms. The viral coat partially originates from the host cell membrane, with glycoproteins from the virus itself protruding out of it (so-called spikes). These play an important role in the virulence of the virions and in the immunological reaction of the host. 1. Viruses are always cell parasites. The virion is first bound to certain receptor structures on the cell membrane of the host cell. 2. The virus coat either merges with the membrane of the host cell or the virus is taken up into the host cell by means of invaginations in the host cell, i.e. it is surrounded by the cell membrane and forced into the inside of the cell. The membrane is then dissolved by enzymes inside the cell. 3. Multiplication of the genetic material takes place in the host cell, using the host cell's molecular equipment. 4. The nucleic acids and polypeptides produced in the host cell are assembles to make infectious virions, which then leave the host cell. The coat of a virion is derived from the cell membrane of the host cell, after the virion has left the cell through a bud-like projection and constriction of the membrane.
Vitamin C	also called ascorbic acid Water soluble vitamin which is readily oxidised. Biochemical Function Radical trap; serves as redox system is hydroxylation reactions, participates in electron transport, increases iron absorption, inhibits formation of nitrosamines and may influence the immune system. Occurrence Vitamin C occurs widely in foods from both plants and animals, as higher plants and most animals can produce vitamin C from glucose. There are particularly high levels of vitamin C in fruit (e.g. common sea buckthorn, blackcurrants, kiwis and citrus fruits), vegetables (parsley, paprika, kale, broccoli, potatoes) and liver. An adult requires 75 mg/day; for smokers this should be increased by 40 mg/day. Symptoms of Deficiency False or deficient nutrition (e.g. single older people, extreme diets, alcoholism), increased requirements (e.g. pregnancy, dialysis, smoking) or disturbances in intestinal absorption can lead to vitamin C deficiency (scurvy), with reduced physical energy, tiredness, irritability and pain in the limbs and joints. Subsequently, bleeding in the skin, mucous membrane and musculature, spongy gums, tooth loss, poor wound healing and susceptibility to infection can develop. Diseases from overdosage with vitamin C are unknown, neither from high uptake in food nor from the therapeutic use of high doses. This is because vitamin C which is not needed is excreted in the urine.
Wave of Influenza	Concentrated occurrence of influenza infections. It is a characteristic of flu that it occurs more frequently at certain times in certain areas, so that an increase in influenza cases each year in the winter months can be expected. Spreading of the disease over several countries or continents (pandemic) is observed at intervals of decades. Pandemic waves of influenza included the "Russian Cold", the "Spanish Flu", the "Asiatic Flu" and the "Hong Kong Flu". At the centres of an epidemic, the probability of disease is ca. 30 %; in pandemic areas it is higher.
World Health Organization	Abbreviation for the World Health Organisation; International Federation with headquarters in Geneva, for collaboration related to health services, in particular in the prevention and combating of widespread diseases and epidemics and in vaccine production.

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Influenza references

A list of Influenza World references and links to abstracts are provided here

"I would describe flu as something that makes you feel very, very ill. You get a headache, aching bones, and are generally fed up"

"When I get flu symptoms I feel like a train has run over me"

"I felt very sick and, during the first week, I had high temperature. Flu was very different to a cold. I went back to work after two and a half weeks. Then I suffered a setback for another week"

"I run a guesthouse; flu would be a real pest for me. I couldn’t cook, I shouldn’t cook, and I wouldn’t cook, so I would need to get a lot of extra help in. It would cost me a lot more money. So flu’s a real problem, a right downturn"

"I work on my own and when I can’t work, I have to try not to infect my little children, so they avoid getting the flu as well"

"I feel a little numb, like I’m in another dimension. Because in general I have sore throat, headache, I feel all clogged-up. Usually a sensation like I’m floating in the air"

"Shivers, sweats, makes you ache. Last time I had flu I was off for two weeks"

"I think that I would probably be concerned that I would pass flu onto my children, who might not be able to deal with it as well as I would"

"Flu makes you feel like you’ve been hit over the head with a baseball bat. You don’t feel like you can get yourself out of bed as all your energy is drawn from you"

"I was incapable of working. It just wasn’t possible at all… and my flu dragged on for more than a week"

"I have no strength. It annoys me because I can do nothing, it seems like I’m wasting my time"

"Flu’s like being hit by a truck because you feel completely gone. There is no energy left in your body. You are suffering from high temperature. You’re sweating a lot and you feel really unwell"

"First of all infinite tiredness, then I feel like sleeping and don’t want to eat"

"I felt really miserable because my muscles and my bones were aching. Well, I can hardly describe it, I just felt really awful, absolutely miserable"

"It’s like there’s something huge treading on your head, like a deafening noise that destroys the eardrums"

"The fever was constantly rising – I immediately measured my temperature as soon as I got home. It was 41°C and it kept rising and I was wondering what’s going on. I was really scared! Everything was hurting and it all happened so fast. Flu came out of the blue"

"I always feel like my limbs have iron weights tied to them and I’m going to fall over any minute, a really stuffy runny nose and feel antisocial"

"I was totally dependent on others! I was incapable of doing anything at all"

"The real flu knocks you for six – you just don’t want to move or do anything. It’s not very nice"

"Not being able to go to work. Not being able to do the things I have to do at home and the commitments that I have day by day"