C O N T E N T S
The influenza virus may be the most dangerous virus in the world. Several times in past history, this virus has been responsible for killing huge numbers of people within a 1 to 2 year period. As an example, the "Spanish Flu" /type A(H1N1) of 1918-19 killed about 500,000 people in the United States and at least 20 million people worldwide. In 1957-58, the "Asian Flu" /type A(H2N2) resulted in 70,000 deaths in the United States and in 1968-69, the "Hong-Kong Flu" /type (A(H3N2) killed 34,000 in the United States.
Epidemic influenza is divided into type A and type B. The most common presentation of influenza includes a fever (usually 100-103 degrees F in adults), respiratory symptoms (such as cough, sore throat, runny or stuffy nose), headache, muscle aches, and often extreme fatigue.
In an average year, influenza is associated with about 20,000 deaths, especially for the elderly, immuno-compromised, or those who have an existing condition, such as asthma, diabetes or heart disease.
Currently there are three main variants circulating, two type "A" and one type "B". The type A variants are the "Hong Kong" /type A(H3N2) virus and its relatives, responsible for about 400,000 deaths in the United States since 1968 and distant relatives of the "Spanish Flu", type A(H1N1). There is considerable concern that the Avian Flu (H5N1) could cross species and cause a worlwdie pandemic.
The "H" and "N" refer to viral proteins called haemagglutinin and the neuraminidase.
The influenza viruses are able to mutate or change over time, allowing them to reinfect year after year. Usually this is a slow and very gradual process; both type A and B influenza virus can change in this manner. However, every once in a while, the type A strains will have a dramatic and abrupt change to either its haemagglutinin and/or neuraminidase proteins. This results in a new strain of the virus.
Blood groups and influenza
Quite a few different researchers have investigated blood group and influenza.
After exposure to the influenza virus, an immune process termed "seroconversion" takes place in which the immune system attempts to produce antibodies to the virus.. Researchers have found that after circulation of influenza A (type (H1N1) and (H3N2))(1) and influenza B viruses, the immune response (as measured in a rise in antihaemagglutinin antibodies against the virus) differ between the blood groups.(2)
Blood group characteristics to seroconversion
Some researchers have hypothesized that one explanation for the typical emergence of the new epidemic strains of influenza in Asia is connected to blood group and the relatively high proportion of group blood found in Asia. It would appear that blood group B has a genetic predisposition to latent (chronic) persistence of influenza A virus (especially A(H3N2) "Hong Kong" variants). Often, the influenza virus antigen can still be found in healthy group B individuals as long as 5 months after infection.(7)
People with blood group B (and AB) can expect to be much more susceptible to infection during times when new antigenic variants and serotypes of influenza virus appear. This is actually particularly bad news since this is the type of influenza A virus change that results in widespread flu pandemics. Blood group O individuals tend to be susceptible to influenza infection at the period of the circulation of virulent strains (so in years when the flu is making people feel really sick, type O will be hit the hardest). Blood group A has a generalized susceptibility to the less virulent strains of influenza A.(8)
Overall, influenza is probably most problematic year to year for blood group AB. In general, they are more sensitive to infection by both influenza A and B than the other blood groups. They are affected by these viruses earlier and more severely than those with the other blood groups.
Research shows is that all blood groups will have similar seroconversion frequencies to both the live attenuated and killed subunit vaccines after the administration of two doses. But after only one dose of the live vaccine, blood group A is much more likely than the other blood groups to seroconvert. so must be given by inhalation. Its use might also be limited by its cost. So far, researchers claim that resistance of the virus to the drug has been only rarely observed (but remains a possible area of concern).(9)
C O N T E N T S
Inhibitory activity of blood group antigens M and N in inhibition of virus influenza hemagglutination
Med Pregl. 2000 Jan-Feb;53(1-2):7-14.
1. Mackenzie JS, Wetherall JD, Fimmel PJ, et al. Host factors and susceptibility to influenza A infection: the effect of ABO blood groups and HL-A antigens. Dev Biol Stand 1977 Jun 1-3;39:355-62
2. Naikhin AN, Katorgina LG, Tsaritsyna IM, et al. Indicators of collective immunity to influenza depending on the blood group and sex of the population. Vopr Virusol 1989 Jul-Aug;34(4):419-23
3. Aho K, Pyhala R, Visakorpi R. ABO associated genetic determinant in H1N1 influenza. Tissue Antigens 1980 Oct;16(4):310-3
4. Fedorova GI, Slepushkin AN, Popova NS, et al. Correlations of the antigenic specificity of human blood with the levels of antihemagglutinins to influenza viruses. Vopr Virusol 1983 Jan-Feb;28(1):54-7
5. Frolov VK, Sokhin AA, Sotnik AY, et al. Polymorphism of human blood groups and incidence of influenza A/Hong Kong (H3N2). Acta Virol 1975 Sep;19(5):406-12
6. Sominina AA, Tsubalova LM, Karpova LS, et al. Genetic predisposition to latent influenza A virus in children with blood group B(III) as a possible cause of new epidemiologic strains in the countries of South-Eastern Asia. Vestn Ross Akad Med Nauk 1994;(9):21-4
7. Karpova LS, Popova TL, Oleinikova EV, et al. Significance of persons with different blood groups in the influenza type A epidemic process. Zh Mikrobiol Epidemiol Immunobiol 1982;(11):86-91
8. Lebiush M, Rannon L, Kark JD. The relationship between epidemic influenza (A(H1N1) and ABO blood group. J Hyg (Lond) 1981 Aug;87(1):139-46
9. Mackenzie JS, Fimmel PJ. The effect of ABO blood groups on the incidence of epidemic influenza and on the response to live attenuated and detergent split influenza virus vaccines. J Hyg (Lond) 1978 Feb;80(1):21-30
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