Influenza disease, often referred to as “flu”, is caused by the influenza viruses. These viruses are most only responsible for epidemics of variable severity almost every winter but occasionally cause major pandemic outbreaks. The term “influenza” has been derived from the Italian astrologers in the mid-1300s, who thought the flu was due to the “influence” of the heavenly bodies. Yet, the aetiology of the disease and the explanation for it’s peculiar behavior remained elusive. At the turn of the 19th century, influenza was thought to be due to a bacterial infection with Haemophilus influenzae. It was not until 1931 that Richard Shope showed that the causative agent was a virus. A few years later, Smith and co-workers for the first time isolated an influenza virus from humans with respiratory illness. The burden of influenza virus for the society, not only from a clinical but also from an economic perspective, is often underestimated. This relates particularly to the recurring annual winter epidemics. Fortunately, since the virus was first discovered, efficient means to contain the infection have been developed. Vaccination is the primary method for the prevention of influenza. However, due to the continuous genetic and antigenic variation that influenza viruses undergo, a constant global surveillance is required to identify and select new variants with epidemic or pandemic potential. Therefore, improvement of vaccination strategies against epidemic influenza and development of effective vaccines against potential pandemic viruses are a public health priority. New strategies for influenza vaccines include altering the dose, site or method of delivery of inactivated vaccines, the use of adjuvants or immunomodulators to enhance immune responses, or targeting of viral proteins that may promote broader, cross protective responses.

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The publication of this thesis was financially supported by: AstraZeneca • Boeringer Ingelheim • BD Bioscience • Glaxo Smith Klein • Intervet • Jurriaanse Stichting • Novartis • Nobilon • Pfizer • Roche NL • Sanquin Reagentia • Schering- Plough • Solvay • Viroclinics • VIRGO
B.N.M. Lambrecht (Bart) , A.D.M.E. Osterhaus (Albert)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

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