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     Flu, or "influenza" is an acute infectious disease, characterized by a sudden onset, fever and generalized aches and pains, which usually occurs in epidemics and pandemics.

Cause The disease is caused by a virus of the influenza group. There are at least three types of influenza virus, known respectively as A, B and C. One of their most characteristic features is that infection with one type provides no protection against another type. Equally important is the case with which the influenza virus can change its character. These two characteristics explain why one attack of influenza provides little, if any, protection against a subsequent attack, and why it is so difficult to prepare an effective vaccine against the disease.
    Epidemics of influenza due to virus A occur in Britain at two- to four-year intervals, and outbreaks of virus B influenza in less frequent cycles. Virus A influenza, for instance, was the prevalent infection in 1949, 1951, 1955 and 1956, whilst virus B influenza was epidemic in 1946, 1950, 1954 and, along with virus A, in 1958-59. The pandemic of 1957, which swept most of the world, though fortunately not in a severe form, was due to a new variant of virus A - the so-called Asian virus - and it has been suggested that it was this variant that was responsible for the pandemics of 1889 and 1918. Since 1957, variants of virus A have been the predominating causes of influenza accompanied on occasions by virus B. In 1997 an outbreak of Chinese avian influenza caused alarm. The influenza virus had apparently jumped species to infect some people in Hong Kong and, because no vaccine was available, some experts feared it might start an epidemic. Happily, it did not.

Symptoms The incubation period of influenza A and B is two to three days and the disease is characterized by a sudden onset. Usually this is followed by a short, sharp febrile illness of two to four days' duration, associated with headache, prostration, generalized aching and respiratory symptoms. Typically the respiratory symptoms are restricted to the upper respiratory tract, and consist of signs of irritation of the nose, pharynx and larynx. There may be nosebleeds, and a dry hacking cough is often a prominent and troublesome symptom. The fever is usually remittent and the temperature seldom exceeds 39.4 degrees C (103 degrees F), tending to fluctuate between 38.3 and 39.4 degrees C (101 and 103 degrees F).
    The most serious complication is infection of the lungs. This infection is usually due to organisms other than the influenza virus. It is a complication which can have serious results in elderly people.
    The very severe form which tends to occur during pandemics - and which was so common during the 1918-19 pandemic - is characterized by the rapid onset of broncho-pneumonia and severe prostration. Because of the toxic effect on the heart there is a particularly marked form of cyanosis, known as heliotrope cyanosis.
    Convalescence following influenza tends to be prolonged. Even after an attack of average severity there tends to be a period of weakness and depression.


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