Changes in the surface antigens of a virus (the H & N) result in a constantly changing flu virus. This can occur in 2 ways:
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Antigenic drift: refers to minor changes (natural mutations) in genes of flu viruses that occur gradually over time to a point where the body’s immune system and antibodies may no longer recognise the antigen and can no longer provide protection from this new version of the virus.
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Antigenic shift: This is the combination of two or more different strains of virus. This abrupt, major change results in a new subtype. Previous exposure may not give protection against this new subtype and can potentially lead to an epidemic or pandemic.
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The World Health Organization (WHO) monitors flu epidemiology throughout the world. Each year WHO make recommendations of which strains of influenza A and B should be included in the vaccine for the coming flu season. These recommendations are based on the predicted circulating strains, in a particular region, in the forthcoming winter.