الفهرس 
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Abstract
Influenza, commonly known as the flu, is a contagious respiratory illness caused by influenza viruses. These viruses belong to the Orthomyxoviridae family and are classified into types A, B, C, and occasionally D.
Influenza spreads through respiratory droplets. Clinical picture includes fever, cough, sore throat, body aches, fatigue, and respiratory distress. In severe cases, it can lead to pneumonia or exacerbate existing health conditions.
Influenza exhibits seasonal patterns, with increased activity during colder months. This seasonality is attributed to factors such as environmental conditions and human behavior.
Influenza viruses undergo genetic changes known as antigenic drift (minor changes in surface proteins) and antigenic shift (major changes through reassortment).
Influenza characterized by seasonal variations, genetic changes, and the potential for severe complications. Vaccination and early antiviral treatment play crucial roles in preventing and managing the impact of influenza.
Influenza A viruses are further categorized based on their surface proteins, hemagglutinin (H) and neuraminidase (N).
Haemagglutinins (H) are glycoproteins found on the surface of influenza viruses. Haemagglutinins play a crucial role in the infection process by facilitating the entry of the virus into host cells.
Influenza viruses exhibit different subtypes of haemagglutinins H1 to H18. Variability in haemagglutinins contributes to the classification of influenza A subtypes.
Major changes in haemagglutinins, known as antigenic shift, can lead to the emergence of new influenza subtypes with pandemic potential. This occurs when there is reassortment of genetic material between different influenza viruses.
Understanding the structure and variability of haemagglutinins is crucial for monitoring and responding to influenza outbreaks, designing effective vaccines, and comprehending the potential for the emergence of novel influenza strains with pandemic implications.
This study was carried out in the Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University and Suez general hospital, Suez Governorate at a time period from November 2019- April 2021.
One hundred and Sixty patients with Influenza like illness for 3-10 days were enrolled in this study.
Two nasopharyngeal swabs were collected from all patients according to standard sampling protocol. One was used for antigen detection by Rapid Influenza antigen detection test and the other was used for confirmation and subtyping of influenza A virus by real time PCR. In addition, two Serum samples were collected from influenza A patients: 1st serum sample on the first day of enrollment in the study and 2nd serum sample twenty-one to twenty-eight days later for detection of the anti-haemagglutinins antibodies response.
The following results were obtained:
• The total number of cases with symptoms resembling common influenza in our study was one hundred and sixty. Fifteen cases (9.4%) tested positive for Influenza A virus, and seven cases (4.3%) were positive for Influenza B virus. Meanwhile, one hundred and thirty-eight cases (86.3%) tested negative for both Influenza A and B viruses.
• The cases were collected over two consecutive seasons, 2019-2020 and 2020-2021, with a total of fourteen and eight influenza cases, respectively. An equal number of cases for Influenza A and B (seven cases each) were identified in the first season, while only Influenza A was diagnosed in the second season.
• The results were influenced by the concurrent COVID-19 pandemic