Smoking is another risk factor associated with more serious disease and increased mortality from influenza.  The influenza A virus can be subdivided into different serotypes based on the antibody response to these viruses. , Frequent hand washing reduces the risk of viral spread, as does wearing a surgical mask.  One method of calculating influenza mortality produced an estimate of 41,400 average deaths per year in the United States between 1979 and 2001.  After the hemagglutinin is cleaved by a protease, the cell imports the virus by endocytosis. , 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; frequent hand washing (with soap and water, or with alcohol-based hand rubs); covering coughs and sneezes with a tissue or sleeve; avoiding close contact with sick people; and staying home when sick. Army. The inactivated vaccine seemed to lower the risk of getting flu for the season from 30% to 11%.  "Well documented descriptions from medical observers" who witnessed the effects of the pandemic as it spread through populations have been reviewed by numerous medical historians in the centuries since.  Outbreaks were particularly severe in communities suffering from food scarcity. , The most famous and lethal outbreak was the 1918 flu pandemic (Spanish flu) (type A influenza, H1N1 subtype), which lasted into 1920. , There are a number of rapid tests for the flu.  However, as many other infections can increase the risk of this disease, influenza may only be an important cause during epidemics. Influenza remained endemic in Europe and England, where it returned in waves over the following years. , An avian-adapted, highly pathogenic strain of H5N1 (called HPAI A(H5N1), for "highly pathogenic avian influenza virus of type A of subtype H5N1") causes H5N1 flu, commonly known as "avian influenza" or simply "bird flu", and is endemic in many bird populations, especially in Southeast Asia.  Another factor is that cold temperatures lead to drier air, which may dehydrate mucus particles. The most common symptoms include: high fever, runny nose, sore throat, muscle and joint pain, headache, coughing, and feeling tired. Birds are thought to be the main animal reservoirs of influenza viruses. , It can be difficult to distinguish between the common cold and influenza in the early stages of these infections.  How long influenza survives in airborne droplets seems to be influenced by the levels of humidity and UV radiation, with low humidity and a lack of sunlight in winter aiding its survival; ideal conditions can allow it to live for an hour in the atmosphere.  The virus particle (also called the virion) is 80–120 nanometers in diameter such that the smallest virions adopt an elliptical shape. According to a European chronicler surnamed Fonseca who wrote Disputat.  Influenza infection and replication is a multi-step process: First, the virus has to bind to and enter the cell, then deliver its genome to a site where it can produce new copies of viral proteins and RNA, assemble these components into new viral particles, and, last, exit the host cell. Avoiding spitting is also recommended. It is a pain in their heads that have it, and a soreness in their stomachs, with a great cough, that remaineth with some longer with other short time, as it findeth apt bodies for the nature of the disease...There was not an appearance of danger, nor manie that died of the disease, except some old folks. , In some cases, an autoimmune response to an influenza infection may contribute to the development of Guillain–Barré syndrome. , "Flu" and "Grippe" redirect here. , For instance, part of the process that allows influenza viruses to invade cells is the cleavage of the viral hemagglutinin protein by any one of several human proteases. An epidemic of a flu-like illness is recorded for September 1557 in Portuguese Goa.. The resulting rapid change in viral genetics produces antigenic shifts, which are sudden changes from one antigen to another.  Most influenza strains are believed to have originated after humans began their intensive domestication of animals about 10,000 years ago. , The sequencing of the influenza genome and recombinant DNA technology may accelerate the generation of new vaccine strains by allowing scientists to substitute new antigens into a previously developed vaccine strain.  Another unusual feature of this pandemic was that it mostly killed young adults, with 99% of pandemic influenza deaths occurring in people under 65, and more than half in young adults 20 to 40 years old.  In Russia, umifenovir is sold for treatment of influenza and in the first quarter of 2020 had a 16 percent share in the antiviral market. The epidemics of fevers and respiratory illness eventually became referred to as the New Sickness in England, New Acquaintance in Scotland, and coqueluche or simply catarrh by medical historians in the rest of Europe. , People with the flu are advised to get plenty of rest, drink plenty of liquids, avoid using alcohol and tobacco and, if necessary, take medications such as acetaminophen (paracetamol) to relieve the fever and muscle aches associated with the flu.  They are inactivated by heating to 56 °C (133 °F) for a minimum of 60 minutes, as well as by acids (at pH <2).  Most of those who died from the disease did so on the fourth day, but some succumbed up to 11 days after first symptoms.  Forestus himself became sick with the flu and related that it "...began with a slight fever like a common catarrh, and showed its great malignancy only by degrees. , A 2018 Cochrane review of children in good general health found that the live immunization seemed to lower the risk of getting influenza for the season from 18% to 4%.  The disease may have spread from Europe to the Americas as early as the European colonization of the Americas, since almost the entire indigenous population of the Antilles was killed by an epidemic resembling influenza that broke out in 1493, after the arrival of Christopher Columbus.
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