A Role for Extracorporeal Treatment in Severe Influenza?

Authors: Nausherwan K. Burki, MD, PhD


Influenza occurs worldwide as a seasonal infection. The influenza virus is enclosed in an envelope containing the glycoproteins hemagglutinin and neuraminidase. It has been known for many decades that the virus mutates to form new subtypes and strains, which are named according to the antigenic types of hemagglutinin and neuraminidase, thus influenza A (H3N2), etc. A gradual change (antigenic drift) in the antigenic properties produces new strains; influenza vaccines are reformulated every year to take this antigenic drift into account. A more abrupt change (antigenic shift) may produce a new subtype. Usually, these mutations do not produce any significant change in virulence. Occasionally the mutated virus may be devastating in terms of morbidity and mortality, as was seen in the great flu pandemic of 1918–1919, caused by an influenza A (H1N1) virus, when nearly 20 million people are believed to have died worldwide. A second pandemic of influenza A (H2N2) occurred in 1957–1958, accounting for nearly 70,000 deaths in the US, followed by a third pandemic of influenza A (H3N2) in 1968.1

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