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Name	Influenza
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Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae (the influenza viruses), that affects birds and mammals. The most common symptoms of the disease are chills, fever, sore throat, muscle pains, severe headache, coughing, weakness/fatigue and general discomfort. Although it is often confused with other influenza-like illnesses, especially the common cold, influenza is a more severe disease than the common cold and is caused by a different type of virus. Influenza may produce nausea and vomiting, particularly in children, but these symptoms are more common in the unrelated gastroenteritis, which is sometimes called inaccurately "stomach flu." Flu can occasionally cause either direct viral pneumonia or secondary bacterial pneumonia.

Typically, influenza is transmitted through the air by coughs or sneezes, creating aerosols containing the virus. Influenza can also be transmitted by direct contact with bird droppings or nasal secretions, or through contact with contaminated surfaces. Airborne aerosols have been thought to cause most infections, although which means of transmission is most important is not absolutely clear. Influenza viruses can be inactivated by sunlight, disinfectants and detergents. As the virus can be inactivated by soap, frequent hand washing reduces the risk of infection.

Influenza spreads around the world in seasonal epidemics, resulting in the deaths of between and people every year, up to millions in some pandemic years. On average 41,400 people died each year in the United States between 1979 and 2001 from influenza. In 2010 the Centers for Disease Control and Prevention (CDC) in the United States changed the way it reports the 30 year estimates for deaths. Now they are reported as a range from a low of about 3,300 deaths to a high of 49,000 per year.

Three influenza pandemics occurred in the 20th century and killed tens of millions of people, with each of these pandemics being caused by the appearance of a new strain of the virus in humans. Often, these new strains appear when an existing flu virus spreads to humans from other animal species, or when an existing human strain picks up new genes from a virus that usually infects birds or pigs. An avian strain named H5N1 raised the concern of a new influenza pandemic, after it emerged in Asia in the 1990s, but it has not evolved to a form that spreads easily between people. In April 2009 a novel flu strain evolved that combined genes from human, pig, and bird flu, initially dubbed "swine flu" and also known as influenza A/H1N1, emerged in Mexico, the United States, and several other nations. The World Health Organization officially declared the outbreak to be a pandemic on June 11, 2009 (see 2009 flu pandemic). The WHO's declaration of a pandemic level 6 was an indication of spread, not severity, the strain actually having a lower mortality rate than common flu outbreaks.

Vaccinations against influenza are usually made available to people in developed countries Farmed poultry is often vaccinated to avoid decimation of the flocks. The most common human vaccine is the trivalent influenza vaccine (TIV) that contains purified and inactivated antigens against three viral strains. Typically, this vaccine includes material from two influenza A virus subtypes and one influenza B virus strain. The TIV carries no risk of transmitting the disease, and it has very low reactivity. A vaccine formulated for one year may be ineffective in the following year, since the influenza virus evolves rapidly, and new strains quickly replace the older ones. Antiviral drugs can be used to treat influenza, with neuraminidase inhibitors (such as Tamiflu or Relenza) being particularly effective.

Classification

Types of virus

In virus classification influenza viruses are RNA viruses that make up three of the five genera of the family Orthomyxoviridae:

Influenzavirus A

Influenzavirus B

Influenzavirus C

These viruses are only distantly related to the human parainfluenza viruses, which are RNA viruses belonging to the paramyxovirus family that are a common cause of respiratory infections in children such as croup, but can also cause a disease similar to influenza in adults.

Influenzavirus A

This genus has one species, influenza A virus. Wild aquatic birds are the natural hosts for a large variety of influenza A. Occasionally, viruses are transmitted to other species and may then cause devastating outbreaks in domestic poultry or give rise to human influenza pandemics. The type A viruses are the most virulent human pathogens among the three influenza types and cause the most severe disease. The influenza A virus can be subdivided into different serotypes based on the antibody response to these viruses. The serotypes that have been confirmed in humans, ordered by the number of known human pandemic deaths, are:

H1N1, which caused Spanish Flu in 1918, and Swine Flu in 2009

H2N2, which caused Asian Flu in 1957

H3N2, which caused Hong Kong Flu in 1968

H5N1, which caused Bird Flu in 2004

H7N7, which has unusual zoonotic potential

H1N2, endemic in humans, pigs and birds

H9N2

H7N2

H7N3

H10N7

Influenzavirus B

This genus has one species, influenza B virus. Influenza B almost exclusively infects humans and is less common than influenza A. The only other animals known to be susceptible to influenza B infection are the seal and the ferret. This type of influenza mutates at a rate 2–3 times slower than type A and consequently is less genetically diverse, with only one influenza B serotype. As a result of this lack of antigenic diversity, a degree of immunity to influenza B is usually acquired at an early age. However, influenza B mutates enough that lasting immunity is not possible. This reduced rate of antigenic change, combined with its limited host range (inhibiting cross species antigenic shift), ensures that pandemics of influenza B do not occur.

Influenzavirus C

This genus has one species, influenza C virus, which infects humans, dogs and pigs, sometimes causing both severe illness and local epidemics. However, influenza C is less common than the other types and usually only causes mild disease in children.

Structure, properties, and subtype nomenclature

Influenzaviruses A, B and C are very similar in overall structure. The virus particle is 80–120 nanometers in diameter and usually roughly spherical, although filamentous forms can occur. These filamentous forms are more common in influenza C, which can form cordlike structures up to 500 micrometers long on the surfaces of infected cells. However, despite these varied shapes, the viral particles of all influenza viruses are similar in composition. These are made of a viral envelope containing two main types of glycoproteins, wrapped around a central core. The central core contains the viral RNA genome and other viral proteins that package and protect this RNA. RNA tends to be single stranded but in special cases it is double. Unusually for a virus, its genome is not a single piece of nucleic acid; instead, it contains seven or eight pieces of segmented negative-sense RNA, each piece of RNA containing either one or two genes. For example, the influenza A genome contains 11 genes on eight pieces of RNA, encoding for 11 proteins: hemagglutinin (HA), neuraminidase (NA), nucleoprotein (NP), M1, M2, NS1, NS2(NEP: nuclear export protein), PA, PB1 (polymerase basic 1), PB1-F2 and PB2.

Hemagglutinin (HA) and neuraminidase (NA) are the two large glycoproteins on the outside of the viral particles. HA is a lectin that mediates binding of the virus to target cells and entry of the viral genome into the target cell, while NA is involved in the release of progeny virus from infected cells, by cleaving sugars that bind the mature viral particles. Thus, these proteins are targets for antiviral drugs. Furthermore, they are antigens to which antibodies can be raised. Influenza A viruses are classified into subtypes based on antibody responses to HA and NA. These different types of HA and NA form the basis of the ''H'' and ''N'' distinctions in, for example, ''H5N1''. There are 16 H and 9 N subtypes known, but only H 1, 2 and 3, and N 1 and 2 are commonly found in humans.

Replication

Viruses can replicate only in living cells. 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.

Influenza viruses bind through hemagglutinin onto sialic acid sugars on the surfaces of epithelial cells, typically in the nose, throat, and lungs of mammals, and intestines of birds (Stage 1 in infection figure). After the hemagglutinin is cleaved by a protease, the cell imports the virus by endocytosis.

Once inside the cell, the acidic conditions in the endosome cause two events to happen: First, part of the hemagglutinin protein fuses the viral envelope with the vacuole's membrane, then the M2 ion channel allows protons to move through the viral envelope and acidify the core of the virus, which causes the core to dissemble and release the viral RNA and core proteins. The viral RNA (vRNA) molecules, accessory proteins and RNA-dependent RNA polymerase are then released into the cytoplasm (Stage 2). The M2 ion channel is blocked by amantadine drugs, preventing infection.

These core proteins and vRNA form a complex that is transported into the cell nucleus, where the RNA-dependent RNA polymerase begins transcribing complementary positive-sense vRNA (Steps 3a and b). The vRNA either is exported into the cytoplasm and translated (step 4) or remains in the nucleus. Newly synthesized viral proteins are either secreted through the Golgi apparatus onto the cell surface (in the case of neuraminidase and hemagglutinin, step 5b) or transported back into the nucleus to bind vRNA and form new viral genome particles (step 5a). Other viral proteins have multiple actions in the host cell, including degrading cellular mRNA and using the released nucleotides for vRNA synthesis and also inhibiting translation of host-cell mRNAs.

Negative-sense vRNAs that form the genomes of future viruses, RNA-dependent RNA polymerase, and other viral proteins are assembled into a virion. Hemagglutinin and neuraminidase molecules cluster into a bulge in the cell membrane. The vRNA and viral core proteins leave the nucleus and enter this membrane protrusion (step 6). The mature virus buds off from the cell in a sphere of host phospholipid membrane, acquiring hemagglutinin and neuraminidase with this membrane coat (step 7). As before, the viruses adhere to the cell through hemagglutinin; the mature viruses detach once their neuraminidase has cleaved sialic acid residues from the host cell. Drugs that inhibit neuraminidase, such as oseltamivir, therefore, prevent the release of new infectious viruses and halt viral replication. After the release of new influenza viruses, the host cell dies.

Because of the absence of RNA proofreading enzymes, the RNA-dependent RNA polymerase that copies the viral genome makes an error roughly every 10 thousand nucleotides, which is the approximate length of the influenza vRNA. Hence, the majority of newly manufactured influenza viruses are mutants; this causes antigenic drift, which is a slow change in the antigens on the viral surface over time. The separation of the genome into eight separate segments of vRNA allows mixing or reassortment of vRNAs if more than one type of influenza virus infects a single cell. The resulting rapid change in viral genetics produces antigenic shifts, which are sudden changes from one antigen to another. These sudden large changes allow the virus to infect new host species and quickly overcome protective immunity. This is important in the emergence of pandemics, as discussed below in the section on Epidemiology.

Signs and symptoms

	Symptom: !! sensitivity (tests)	sensitivity !! specificity
! Fever	68–86%	25–73%
Cough	84–98%	7–29%
Nasal congestion	68–91%	19–41%
			* All three findings, especially fever, were less sensitive in patients over 60 years of age.

Symptoms of influenza can start quite suddenly one to two days after infection. Usually the first symptoms are chills or a chilly sensation, but fever is also common early in the infection, with body temperatures ranging from 38-39 °C (approximately 100-103 °F). Many people are so ill that they are confined to bed for several days, with aches and pains throughout their bodies, which are worse in their backs and legs. Symptoms of influenza may include:

Fever and extreme coldness (chills shivering, shaking (rigor))

Cough

Nasal congestion

Body aches, especially joints and throat

Fatigue

Headache

Irritated, watering eyes

Reddened eyes, skin (especially face), mouth, throat and nose

Petechial Rash In children, gastrointestinal symptoms such as diarrhea and abdominal pain, (may be severe in children with influenza B)

It can be difficult to distinguish between the common cold and influenza in the early stages of these infections, but a flu can be identified by a high fever with a sudden onset and extreme fatigue. Diarrhea is not normally a symptom of influenza in adults, although it has been seen in some human cases of the H5N1 "bird flu" and can be a symptom in children. The symptoms most reliably seen in influenza are shown in the table to the right.

Since antiviral drugs are effective in treating influenza if given early (see treatment section, below), it can be important to identify cases early. Of the symptoms listed above, the combinations of fever with cough, sore throat and/or nasal congestion can improve diagnostic accuracy. Two decision analysis studies suggest that ''during local outbreaks'' of influenza, the prevalence will be over 70%, and thus patients with any of these combinations of symptoms may be treated with neuraminidase inhibitors without testing. Even in the absence of a local outbreak, treatment may be justified in the elderly during the influenza season as long as the prevalence is over 15%.

The available laboratory tests for influenza continue to improve. The United States Centers for Disease Control and Prevention (CDC) maintains an up-to-date summary of available laboratory tests. According to the CDC, rapid diagnostic tests have a sensitivity of 70–75% and specificity of 90–95% when compared with viral culture. These tests may be especially useful during the influenza season (prevalence=25%) but in the absence of a local outbreak, or peri-influenza season (prevalence=10%).

Mechanism

Transmission

Influenza virus shedding (the time during which a person might be infectious to another person) begins the day before symptoms appear and virus is then released for between 5 to 7 days, although some people may shed virus for longer periods. People who contract influenza are most infective between the second and third days after infection. The amount of virus shed appears to correlate with fever, with higher amounts of virus shed when temperatures are highest. Children are much more infectious than adults and shed virus from just before they develop symptoms until two weeks after infection. The transmission of influenza can be modeled mathematically, which helps predict how the virus will spread in a population.

Influenza can be spread in three main ways: by direct transmission (when an infected person sneezes mucus directly into the eyes, nose or mouth of another person); the airborne route (when someone inhales the aerosols produced by an infected person coughing, sneezing or spitting) and through hand-to-eye, hand-to-nose, or hand-to-mouth transmission, either from contaminated surfaces or from direct personal contact such as a hand-shake. The relative importance of these three modes of transmission is unclear, and they may all contribute to the spread of the virus. In the airborne route, the droplets that are small enough for people to inhale are 0.5 to 5 µm in diameter and inhaling just one droplet might be enough to cause an infection. Although a single sneeze releases up to 40,000 droplets, most of these droplets are quite large and will quickly settle out of the air. 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.

As the influenza virus can persist outside of the body, it can also be transmitted by contaminated surfaces such as banknotes, doorknobs, light switches and other household items. The length of time the virus will persist on a surface varies, with the virus surviving for one to two days on hard, non-porous surfaces such as plastic or metal, for about fifteen minutes from dry paper tissues, and only five minutes on skin. However, if the virus is present in mucus, this can protect it for longer periods (up to 17 days on banknotes). Avian influenza viruses can survive indefinitely when frozen. They are inactivated by heating to 56 °C (133 °F) for a minimum of 60 minutes, as well as by acids (at pH <2).

Pathophysiology

The mechanisms by which influenza infection causes symptoms in humans have been studied intensively. One of the mechanisms is believed to be the inhibition of adrenocorticotropic hormone (ACTH) resulting in lowered cortisol levels. Knowing which genes are carried by a particular strain can help predict how well it will infect humans and how severe this infection will be (that is, predict the strain's pathophysiology).

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. In mild and avirulent viruses, the structure of the hemagglutinin means that it can only be cleaved by proteases found in the throat and lungs, so these viruses cannot infect other tissues. However, in highly virulent strains, such as H5N1, the hemagglutinin can be cleaved by a wide variety of proteases, allowing the virus to spread throughout the body.

The viral hemagglutinin protein is responsible for determining both which species a strain can infect and where in the human respiratory tract a strain of influenza will bind. Strains that are easily transmitted between people have hemagglutinin proteins that bind to receptors in the upper part of the respiratory tract, such as in the nose, throat and mouth. In contrast, the highly lethal H5N1 strain binds to receptors that are mostly found deep in the lungs. This difference in the site of infection may be part of the reason why the H5N1 strain causes severe viral pneumonia in the lungs, but is not easily transmitted by people coughing and sneezing.

Common symptoms of the flu such as fever, headaches, and fatigue are the result of the huge amounts of proinflammatory cytokines and chemokines (such as interferon or tumor necrosis factor) produced from influenza-infected cells. In contrast to the rhinovirus that causes the common cold, influenza does cause tissue damage, so symptoms are not entirely due to the inflammatory response. This massive immune response might produce a life-threatening cytokine storm. This effect has been proposed to be the cause of the unusual lethality of both the H5N1 avian influenza, and the 1918 pandemic strain. However, another possibility is that these large amounts of cytokines are just a result of the massive levels of viral replication produced by these strains, and the immune response does not itself contribute to the disease.

Prevention

Vaccination

Vaccination against influenza with an influenza vaccine is often recommended for high-risk groups, such as children and the elderly, or in people who have asthma, diabetes, heart disease, or are immuno-compromised. Influenza vaccines can be produced in several ways; the most common method is to grow the virus in fertilized hen eggs. After purification, the virus is inactivated (for example, by treatment with detergent) to produce an inactivated-virus vaccine. Alternatively, the virus can be grown in eggs until it loses virulence and the avirulent virus given as a live vaccine. The effectiveness of these influenza vaccines are variable. Due to the high mutation rate of the virus, a particular influenza vaccine usually confers protection for no more than a few years. Every year, the World Health Organization predicts which strains of the virus are most likely to be circulating in the next year, allowing pharmaceutical companies to develop vaccines that will provide the best immunity against these strains. Vaccines have also been developed to protect poultry from avian influenza. These vaccines can be effective against multiple strains and are used either as part of a preventative strategy, or combined with culling in attempts to eradicate outbreaks.

It is possible to get vaccinated and still get influenza. The vaccine is reformulated each season for a few specific flu strains but cannot possibly include all the strains actively infecting people in the world for that season. It takes about six months for the manufacturers to formulate and produce the millions of doses required to deal with the seasonal epidemics; occasionally, a new or overlooked strain becomes prominent during that time and infects people although they have been vaccinated (as by the H3N2 Fujian flu in the 2003–2004 flu season). It is also possible to get infected just before vaccination and get sick with the very strain that the vaccine is supposed to prevent, as the vaccine takes about two weeks to become effective.

The 2006–2007 season was the first in which the CDC had recommended that children younger than 59 months receive the annual influenza vaccine. Vaccines can cause the immune system to react as if the body were actually being infected, and general infection symptoms (many cold and flu symptoms are just general infection symptoms) can appear, though these symptoms are usually not as severe or long-lasting as influenza. The most dangerous side effect is a severe allergic reaction to either the virus material itself or residues from the hen eggs used to grow the influenza; however, these reactions are extremely rare.

In addition to vaccination against seasonal influenza, researchers are working to develop a vaccine against a possible influenza pandemic. The rapid development, production, and distribution of pandemic influenza vaccines could potentially save millions of lives during an influenza pandemic. Due to the short time frame between identification of a pandemic strain and need for vaccination, researchers are looking at non-egg-based options for vaccine production. Live attenuated (egg-based or cell-based) technology and recombinant technologies (proteins and virus-like particles) could provide better "real-time" access and be produced more affordably, thereby increasing access for people living in low- and moderate-income countries, where an influenza pandemic may likely originate. As of July 2009, more than 70 known clinical trials have been completed or are ongoing for pandemic influenza vaccines. In September 2009, the US Food and Drug Administration approved four vaccines against the 2009 H1N1 influenza virus (the current pandemic strain), and expect the initial vaccine lots to be available within the following month.

In 2011, there has been some research success towards a “universal flu vaccine” that produces antibodies against proteins on the viral coat which mutate less rapidly, and thus a single shot could potentially provide longer-lasting protection.

Infection control

Reasonably effective ways to reduce the transmission of influenza include good personal health and hygiene habits such as: not touching your eyes, nose or mouth; frequent hand washing (with soap and water, or with alcohol-based hand rubs); covering coughs and sneezes; avoiding close contact with sick people; and staying home yourself if you are sick. Avoiding spitting is also recommended. Although face masks might help prevent transmission when caring for the sick, there is mixed evidence on beneficial effects in the community. Smoking raises the risk of contracting influenza, as well as producing more severe disease symptoms.

Since influenza spreads through both aerosols and contact with contaminated surfaces, surface sanitizing may help prevent some infections. Alcohol is an effective sanitizer against influenza viruses, while quaternary ammonium compounds can be used with alcohol so that the sanitizing effect lasts for longer. In hospitals, quaternary ammonium compounds and bleach are used to sanitize rooms or equipment that have been occupied by patients with influenza symptoms. At home, this can be done effectively with a diluted chlorine bleach.

During past pandemics, closing schools, churches and theaters slowed the spread of the virus but did not have a large effect on the overall death rate. It is uncertain if reducing public gatherings, by for example closing schools and workplaces, will reduce transmission since people with influenza may just be moved from one area to another; such measures would also be difficult to enforce and might be unpopular. When small numbers of people are infected, isolating the sick might reduce the risk of transmission.

Treatment

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. Children and teenagers with flu symptoms (particularly fever) should avoid taking aspirin during an influenza infection (especially influenza type B), because doing so can lead to Reye's syndrome, a rare but potentially fatal disease of the liver. Since influenza is caused by a virus, antibiotics have no effect on the infection; unless prescribed for secondary infections such as bacterial pneumonia. Antiviral medication can be effective, but some strains of influenza can show resistance to the standard antiviral drugs.

The two classes of antiviral drugs used against influenza are neuraminidase inhibitors and M2 protein inhibitors (adamantane derivatives). Neuraminidase inhibitors are currently preferred for flu virus infections since they are less toxic and more effective. The CDC recommended against using M2 inhibitors during the 2005–06 influenza season due to high levels of drug resistance. As pregnant women seem to be more severely affected than the general population by the 2009 H1N1 influenza virus, prompt treatment with anti-influenza drugs has been recommended. In a November 2009 press conference, the World Health Organization recommended that persons in high risk groups, including pregnant women, children under two, and persons with respiratory problems, begin taking antivirals as soon as they start experiencing flu symptoms. Antivirals include oseltamivir (Tamiflu) and zanamivir (Relenza).

Neuraminidase inhibitors

Antiviral drugs such as oseltamivir (trade name Tamiflu) and zanamivir (trade name Relenza) are neuraminidase inhibitors that are designed to halt the spread of the virus in the body. These drugs are often effective against both influenza A and B. The Cochrane Collaboration reviewed these drugs and concluded that they reduce symptoms and complications. Different strains of influenza viruses have differing degrees of resistance against these antivirals, and it is impossible to predict what degree of resistance a future pandemic strain might have.

M2 inhibitors (adamantanes)

The antiviral drugs amantadine and rimantadine block a viral ion channel (M2 protein) and prevent the virus from infecting cells. These drugs are sometimes effective against influenza A if given early in the infection but are always ineffective against influenza B because B viruses do not possess M2 molecules. Measured resistance to amantadine and rimantadine in American isolates of H3N2 has increased to 91% in 2005. This high level of resistance may be due to the easy availability of amantadines as part of over-the-counter cold remedies in countries such as China and Russia, and their use to prevent outbreaks of influenza in farmed poultry.

Prognosis

Influenza's effects are much more severe and last longer than those of the common cold. Most people will recover completely in about one to two weeks, but others will develop life-threatening complications (such as pneumonia). Influenza, thus, can be deadly, especially for the weak, young and old, or chronically ill. People with a weak immune system, such as people with advanced HIV infection or transplant patients (whose immune systems are medically suppressed to prevent transplant organ rejection), suffer from particularly severe disease. Other high-risk groups include pregnant women and young children.

The flu can worsen chronic health problems. People with emphysema, chronic bronchitis or asthma may experience shortness of breath while they have the flu, and influenza may cause worsening of coronary heart disease or congestive heart failure. Smoking is another risk factor associated with more serious disease and increased mortality from influenza.

According to the World Health Organization: "Every winter, tens of millions of people get the flu. Most are only ill and out of work for a week, yet the elderly are at a higher risk of death from the illness. We know the worldwide death toll exceeds a few hundred thousand people a year, but even in developed countries the numbers are uncertain, because medical authorities don't usually verify who actually died of influenza and who died of a flu-like illness." Even healthy people can be affected, and serious problems from influenza can happen at any age. People over 50 years old, very young children and people of any age with chronic medical conditions are more likely to get complications from influenza, such as pneumonia, bronchitis, sinus, and ear infections.

In some cases, an autoimmune response to an influenza infection may contribute to the development of Guillain-Barré syndrome. However, as many other infections can increase the risk of this disease, influenza may only be an important cause during epidemics. This syndrome has been believed to also be a rare side effect of influenza vaccines. Although one review gives an incidence of about one case per million vaccinations, a large study in China, reported in the NEJM covering close to 100 million doses of vaccine against the 2009 H1N1 "swine" flu found only eleven cases of Guillain-Barre syndrome, (0.1%) total incidence in persons vaccinated, actually lower than the normal rate of the disease in China, and no other notable side effects; "The risk-benefit ratio, which is what vaccines and everything in medicine is about, is overwhelmingly in favor of vaccination." Getting infected by influenza itself increases both the risk of death (up to 1 in 10,000) and increases the risk of developing GBS to a much higher level than the highest level of suspected vaccine involvement (approx. 10 times higher by recent estimates).

Epidemiology

Seasonal variations

Influenza reaches peak prevalence in winter, and because the Northern and Southern Hemispheres have winter at different times of the year, there are actually two different flu seasons each year. This is why the World Health Organization (assisted by the National Influenza Centers) makes recommendations for two different vaccine formulations every year; one for the Northern, and one for the Southern Hemisphere.

A long-standing puzzle has been why outbreaks of the flu occur seasonally rather than uniformly throughout the year. One possible explanation is that, because people are indoors more often during the winter, they are in close contact more often, and this promotes transmission from person to person. Increased travel due to the Northern Hemisphere winter holiday season may also play a role. Another factor is that cold temperatures lead to drier air, which may dehydrate mucus, preventing the body from effectively expelling virus particles. The virus also survives longer on surfaces at colder temperatures and aerosol transmission of the virus is highest in cold environments (less than 5 °C) with low relative humidity. Indeed, the lower air humidity in winter seems to be the main cause of seasonal influenza transmission in temperate regions.

However, seasonal changes in infection rates also occur in tropical regions, and in some countries these peaks of infection are seen mainly during the rainy season. Seasonal changes in contact rates from school terms, which are a major factor in other childhood diseases such as measles and pertussis, may also play a role in the flu. A combination of these small seasonal effects may be amplified by dynamical resonance with the endogenous disease cycles. H5N1 exhibits seasonality in both humans and birds.

An alternative hypothesis to explain seasonality in influenza infections is an effect of vitamin D levels on immunity to the virus. This idea was first proposed by Robert Edgar Hope-Simpson in 1965. He proposed that the cause of influenza epidemics during winter may be connected to seasonal fluctuations of vitamin D, which is produced in the skin under the influence of solar (or artificial) UV radiation. This could explain why influenza occurs mostly in winter and during the tropical rainy season, when people stay indoors, away from the sun, and their vitamin D levels fall.

Epidemic and pandemic spread

As influenza is caused by a variety of species and strains of viruses, in any given year some strains can die out while others create epidemics, while yet another strain can cause a pandemic. Typically, in a year's normal two flu seasons (one per hemisphere), there are between three and five million cases of severe illness and up to 500,000 deaths worldwide, which by some definitions is a yearly influenza epidemic. Although the incidence of influenza can vary widely between years, approximately 36,000 deaths and more than 200,000 hospitalizations are directly associated with influenza every year in the United States. Roughly three times per century, a pandemic occurs, which infects a large proportion of the world's population and can kill tens of millions of people (see history section). Indeed, one study estimated that if a strain with similar virulence to the 1918 influenza emerged today, it could kill between 50 and 80 million people.

New influenza viruses are constantly evolving by mutation or by reassortment. Mutations can cause small changes in the hemagglutinin and neuraminidase antigens on the surface of the virus. This is called antigenic drift, which slowly creates an increasing variety of strains until one evolves that can infect people who are immune to the pre-existing strains. This new variant then replaces the older strains as it rapidly sweeps through the human population—often causing an epidemic. However, since the strains produced by drift will still be reasonably similar to the older strains, some people will still be immune to them. In contrast, when influenza viruses reassort, they acquire completely new antigens—for example by reassortment between avian strains and human strains; this is called antigenic shift. If a human influenza virus is produced that has entirely new antigens, everybody will be susceptible, and the novel influenza will spread uncontrollably, causing a pandemic. In contrast to this model of pandemics based on antigenic drift and shift, an alternative approach has been proposed where the periodic pandemics are produced by interactions of a fixed set of viral strains with a human population with a constantly changing set of immunities to different viral strains.

History

Etymology

The word ''Influenza'' comes from the Italian language meaning "influence" and refers to the cause of the disease; initially, this ascribed illness to unfavorable astrological influences. Changes in medical thought led to its modification to ''influenza del freddo'', meaning "influence of the cold". The word ''influenza'' was first used in English to refer to the disease we know today in 1703 by J. Hugger of the University of Edinburgh in his thesis ''De Catarrho epidemio, vel Influenza, prout in India occidentali sese ostendit''. Archaic terms for influenza include ''epidemic catarrh'', ''grippe'' (from the French, first used by Molyneaux in 1694 ), ''sweating sickness'', and ''Spanish fever'' (particularly for the 1918 flu pandemic strain).

Pandemics

The symptoms of human influenza were clearly described by Hippocrates roughly 2,400 years ago. Although the virus seems to have caused epidemics throughout human history, historical data on influenza are difficult to interpret, because the symptoms can be similar to those of other respiratory diseases. 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.

The first convincing record of an influenza pandemic was of an outbreak in 1580, which began in Russia and spread to Europe via Africa. In Rome, over 8,000 people were killed, and several Spanish cities were almost wiped out. Pandemics continued sporadically throughout the 17th and 18th centuries, with the pandemic of 1830–1833 being particularly widespread; it infected approximately a quarter of the people exposed.

The most famous and lethal outbreak was the 1918 flu pandemic (Spanish flu pandemic) (type A influenza, H1N1 subtype), which lasted from 1918 to 1919. It is not known exactly how many it killed, but estimates range from 20 to 100 million people. This pandemic has been described as "the greatest medical holocaust in history" and may have killed as many people as the Black Death. This huge death toll was caused by an extremely high infection rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms. Indeed, symptoms in 1918 were so unusual that initially influenza was misdiagnosed as dengue, cholera, or typhoid. One observer wrote, "One of the most striking of the complications was hemorrhage from mucous membranes, especially from the nose, stomach, and intestine. Bleeding from the ears and petechial hemorrhages in the skin also occurred." The majority of deaths were from bacterial pneumonia, a secondary infection caused by influenza, but the virus also killed people directly, causing massive hemorrhages and edema in the lung.

The 1918 flu pandemic (Spanish flu pandemic) was truly global, spreading even to the Arctic and remote Pacific islands. The unusually severe disease killed between 2 and 20% of those infected, as opposed to the more usual flu epidemic mortality rate of 0.1%. 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. This is unusual since influenza is normally most deadly to the very young (under age 2) and the very old (over age 70). The total mortality of the 1918–1919 pandemic is not known, but it is estimated that 2.5% to 5% of the world's population was killed. As many as 25 million may have been killed in the first 25 weeks; in contrast, HIV/AIDS has killed 25 million in its first 25 years.

Later flu pandemics were not so devastating. They included the 1957 Asian Flu (type A, H2N2 strain) and the 1968 Hong Kong Flu (type A, H3N2 strain), but even these smaller outbreaks killed millions of people. In later pandemics antibiotics were available to control secondary infections and this may have helped reduce mortality compared to the Spanish Flu of 1918.

{|class="wikitable" style="text-align:center" |+ Known flu pandemics ! Name of pandemic !! Date !! Deaths !! Case fatality rate !! Subtype involved !! Pandemic Severity Index |- ! Asiatic (Russian) Flu |1889–1890 ||1 million ||0.15% ||possibly H3N8 ||NA |- ! 1918 flu pandemic(Spanish flu) |1918–1920 ||20 to 100 million ||2%||H1N1 ||5 |- ! Asian Flu |1957–1958 ||1 to 1.5 million ||0.13%||H2N2 ||2 |- ! Hong Kong Flu |1968–1969 ||0.75 to 1 million ||<0.1%||H3N2 ||2 |- ! 2009 flu pandemic |2009–2010 ||18,000 ||0.03%||H1N1 ||NA |}

The first influenza virus to be isolated was from poultry, when in 1901 the agent causing a disease called "fowl plague" was passed through Chamberland filters, which have pores that are too small for bacteria to pass through. The etiological cause of influenza, the Orthomyxoviridae family of viruses, was first discovered in pigs by Richard Shope in 1931. This discovery was shortly followed by the isolation of the virus from humans by a group headed by Patrick Laidlaw at the Medical Research Council of the United Kingdom in 1933. However, it was not until Wendell Stanley first crystallized tobacco mosaic virus in 1935 that the non-cellular nature of viruses was appreciated.

The first significant step towards preventing influenza was the development in 1944 of a killed-virus vaccine for influenza by Thomas Francis, Jr.. This built on work by Australian Frank Macfarlane Burnet, who showed that the virus lost virulence when it was cultured in fertilized hen's eggs. Application of this observation by Francis allowed his group of researchers at the University of Michigan to develop the first influenza vaccine, with support from the U.S. Army. The Army was deeply involved in this research due to its experience of influenza in World War I, when thousands of troops were killed by the virus in a matter of months. In comparison to vaccines, the development of anti-influenza drugs has been slower, with amantadine being licensed in 1966 and, almost thirty years later, the next class of drugs (the neuraminidase inhibitors) being developed.

Society and culture

Influenza produces direct costs due to lost productivity and associated medical treatment, as well as indirect costs of preventative measures. In the United States, influenza is responsible for a total cost of over $10 billion per year, while it has been estimated that a future pandemic could cause hundreds of billions of dollars in direct and indirect costs. However, the economic impacts of past pandemics have not been intensively studied, and some authors have suggested that the Spanish influenza actually had a positive long-term effect on per-capita income growth, despite a large reduction in the working population and severe short-term depressive effects. Other studies have attempted to predict the costs of a pandemic as serious as the 1918 Spanish flu on the U.S. economy, where 30% of all workers became ill, and 2.5% were killed. A 30% sickness rate and a three-week length of illness would decrease the gross domestic product by 5%. Additional costs would come from medical treatment of 18 million to 45 million people, and total economic costs would be approximately $700 billion.

Preventative costs are also high. Governments worldwide have spent billions of U.S. dollars preparing and planning for a potential H5N1 avian influenza pandemic, with costs associated with purchasing drugs and vaccines as well as developing disaster drills and strategies for improved border controls. On 1 November 2005, United States President George W. Bush unveiled the National Strategy to Safeguard Against the Danger of Pandemic Influenza backed by a request to Congress for $7.1 billion to begin implementing the plan. Internationally, on 18 January 2006, donor nations pledged US$2 billion to combat bird flu at the two-day International Pledging Conference on Avian and Human Influenza held in China.

In an assessment of the 2009 H1N1 pandemic on selected countries in the Southern Hemisphere, data suggest that all countries experienced some time-limited and/or geographically isolated socio/economic effects and a temporary decrease in tourism most likely due to fear of 2009 H1N1 disease. It is still too early to determine whether the H1N1 pandemic has caused any long-term economic impacts.

Research

Research on influenza includes studies on molecular virology, how the virus produces disease (pathogenesis), host immune responses, viral genomics, and how the virus spreads (epidemiology). These studies help in developing influenza countermeasures; for example, a better understanding of the body's immune system response helps vaccine development, and a detailed picture of how influenza invades cells aids the development of antiviral drugs. One important basic research program is the Influenza Genome Sequencing Project, which is creating a library of influenza sequences; this library should help clarify which factors make one strain more lethal than another, which genes most affect immunogenicity, and how the virus evolves over time.

Research into new vaccines is particularly important, as current vaccines are very slow and expensive to produce and must be reformulated every year. 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. New technologies are also being developed to grow viruses in cell culture, which promises higher yields, less cost, better quality and surge capacity. Research on a universal influenza A vaccine, targeted against the external domain of the transmembrane viral M2 protein (M2e), is being done at the University of Ghent by Walter Fiers, Xavier Saelens and their team and has now successfully concluded Phase I clinical trials.

A number of biologics, therapeutic vaccines and immunobiologics are also being investigated for treatment of infection caused by viruses. Therapeutic biologics are designed to activate the immune response to virus or antigens. Typically, biologics do not target metabolic pathways like anti-viral drugs, but stimulate immune cells such as lymphocytes, macrophages, and/or antigen presenting cells, in an effort to drive an immune response towards a cytotoxic effect against the virus. Infuenza models, such as murine influenza, are convenient models to test the effects of prophylactic and therapeutic biologics. For example, Lymphocyte T-Cell Immune Modulator inhibits viral growth in the murine model of influenza.

Infection in other animals

Influenza infects many animal species, and transfer of viral strains between species can occur. Birds are thought to be the main animal reservoirs of influenza viruses. Sixteen forms of hemagglutinin and nine forms of neuraminidase have been identified. All known subtypes (HxNy) are found in birds, but many subtypes are endemic in humans, dogs, horses, and pigs; populations of camels, ferrets, cats, seals, mink, and whales also show evidence of prior infection or exposure to influenza. Variants of flu virus are sometimes named according to the species the strain is endemic in or adapted to. The main variants named using this convention are: Bird Flu, Human Flu, Swine Flu, Horse Flu and Dog Flu. (Cat flu generally refers to Feline viral rhinotracheitis or Feline calicivirus and not infection from an influenza virus.) In pigs, horses and dogs, influenza symptoms are similar to humans, with cough, fever and loss of appetite. The frequency of animal diseases are not as well-studied as human infection, but an outbreak of influenza in harbor seals caused approximately 500 seal deaths off the New England coast in 1979–1980. On the other hand, outbreaks in pigs are common and do not cause severe mortality.

Bird flu

Flu symptoms in birds are variable and can be unspecific. The symptoms following infection with low-pathogenicity avian influenza may be as mild as ruffled feathers, a small reduction in egg production, or weight loss combined with minor respiratory disease. Since these mild symptoms can make diagnosis in the field difficult, tracking the spread of avian influenza requires laboratory testing of samples from infected birds. Some strains such as Asian H9N2 are highly virulent to poultry and may cause more extreme symptoms and significant mortality. In its most highly pathogenic form, influenza in chickens and turkeys produces a sudden appearance of severe symptoms and almost 100% mortality within two days. As the virus spreads rapidly in the crowded conditions seen in the intensive farming of chickens and turkeys, these outbreaks can cause large economic losses to poultry farmers.

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. This Asian lineage strain of HPAI A(H5N1) is spreading globally. It is epizootic (an epidemic in non-humans) and panzootic (a disease affecting animals of many species, especially over a wide area), killing tens of millions of birds and spurring the culling of hundreds of millions of other birds in an attempt to control its spread. Most references in the media to "bird flu" and most references to H5N1 are about this specific strain.

At present, HPAI A(H5N1) is an avian disease, and there is no evidence suggesting efficient human-to-human transmission of HPAI A(H5N1). In almost all cases, those infected have had extensive physical contact with infected birds. In the future, H5N1 may mutate or reassort into a strain capable of efficient human-to-human transmission. The exact changes that are required for this to happen are not well understood. However, due to the high lethality and virulence of H5N1, its endemic presence, and its large and increasing biological host reservoir, the H5N1 virus was the world's pandemic threat in the 2006–07 flu season, and billions of dollars are being raised and spent researching H5N1 and preparing for a potential influenza pandemic.

Swine flu

In pigs swine influenza produces fever, lethargy, sneezing, coughing, difficulty breathing and decreased appetite. In some cases the infection can cause abortion. Although mortality is usually low, the virus can produce weight loss and poor growth, causing economic loss to farmers. Infected pigs can lose up to 12 pounds of body weight over a 3 to 4 week period. Direct transmission of an influenza virus from pigs to humans is occasionally possible (this is called zoonotic swine flu). In all, 50 human cases are known to have occurred since the virus was identified in the mid-20th century, which have resulted in six deaths.

In 2009, a swine-origin H1N1 virus strain commonly referred to as "swine flu" caused the 2009 flu pandemic, but there is no evidence that it is endemic to pigs (i.e. actually a swine flu) or of transmission from pigs to people, instead the virus is spreading from person to person. This strain is a reassortment of several strains of H1N1 that are usually found separately, in humans, birds, and pigs.

See also

List of epidemics

List of viruses

Vitamin D and influenza

;Information concerning flu research can be found at:

References

Further reading

General

Bernd Sebastian Kamps, Christian Hoffmann and Wolfgang Preiser (Eds.) Influenza Report, 225 pp, PDF, free download. Flying Publisher 2006

ISBN 978-3-211-80892-4 The Influenza Viruses Hoyle L 1968 Springer Verlag

History

Microbiology

Pathogenesis

Epidemiology

Epidemiology of WHO-confirmed human cases of avian influenza A(H5N1) infection

Treatment and prevention

Research

WHO (PDF) contains latest Evolutionary "Tree of Life" for H5N1 article ''Antigenic and genetic characteristics of H5N1 viruses and candidate H5N1 vaccine viruses developed for potential use as pre-pandemic vaccines'' published 18 August 2006

WHO's assessment of Flu Research as of November 2006.

External links

ERS Online Course on Influenza

Swine and Seasonal Flu, Institute for Good Medicine at the Pennsylvania Medical Society

Info on influenza at CDC

Summary of the disease at the NYTimes.

10 Genes, Furiously Evolving NYTimes May 2009

Outbreak Alerts United States based communicable disease notification website

Influenza (Mayo Clinic)

Fact Sheet Overview of influenza at World Health Organization

The Multinational Influenza Seasonal Mortality Study (MISMS) Fogarty International Center

Influenza Virus Resource from the NCBI

European Influenza Surveillance Scheme

Flu Trends – flu activity across the U.S.

Cold and flu advice (NHS Direct)

Online video discussing influenza outbreaks and spread of other infectious diseases (Vega Science Trust)

Flu.gov: Know What To Do About the Flu

PATH Vaccine Resource Library influenza resources

Influenza Research Database – Database of influenza genomic sequences, serotypes, polymorphisms, structures, epitopes, drugs and related tools.

Recombinomics - What's New : Up to date details of circulating strains.

Category:Animal diseases Category:Italian loanwords Category:Respiratory diseases

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Coordinates	38°37′38″N90°11′52″N
Width	200
Position	Shooting guard / Small forward
Height ft	6|height_in 6
Weight lbs	216
Number	23, 45, 9, 12
Birth date	February 17, 1963
Birth place	Brooklyn, New York
High school	Emsley A. Laney
League
Career start	1984
Career end	2003
Draftyear	1984
Draftround	1
Draftpick	3
Draftteam	Chicago Bulls
College	North Carolina (1981–1984)
Years1	–, – |team1 Chicago Bulls
Years2	– |team2 Washington Wizards
Stat1label	Points
Stat1value	32,292 (30.1 ppg)
Stat2label	Rebounds
Stat2value	6,672 (6.2 rpg)
Stat3label	Assists
Stat3value	5,633 (5.3 apg)
Letter	j
Bbr	jordami01
Highlights	6× NBA Champion (–, –) 5× NBA Most Valuable Player (, –, , ) 14× NBA All-Star (–, –, –) 6× NBA Finals MVP (–, –) 10× NBA scoring champion (–, –) 3× NBA steals champion (, , ) NBA Defensive Player of the Year () 10× All-NBA First Team (–, –) All-NBA Second Team () 9× NBA All-Defensive First Team (–, –) NBA Rookie of the Year () NBA All-Rookie First Team () 3× NBA All-Star Game MVP (, , ) 2× NBA Slam Dunk Contest champion (–) NBA's 50th Anniversary All-Time Team #23 Retired by Chicago Bulls and Miami Heat NCAA Champion (1982) 2× Consensus NCAA All-American First Team (1983–1984) ACC Player of the Year (1984) Oscar Robertson Trophy (1984) Naismith College Player of the Year (1984) John R. Wooden Award (1984) Adolph Rupp Trophy (1984)
Hof player	michael-jordan }}

Michael Jeffrey Jordan (born February 17, 1963) is a former American professional basketball player, active businessman, and majority owner of the Charlotte Bobcats. His biography on the National Basketball Association (NBA) website states, "By acclamation, Michael Jordan is the greatest basketball player of all time." Jordan was one of the most effectively marketed athletes of his generation and was instrumental in popularizing the NBA around the world in the 1980s and 1990s.

After a standout career at the University of North Carolina at Chapel Hill, where he was a member of the Tar Heels' National Championship team in 1982, Jordan joined the NBA's Chicago Bulls in 1984. He quickly emerged as a league star, entertaining crowds with his prolific scoring. His leaping ability, illustrated by performing slam dunks from the free throw line in slam dunk contests, earned him the nicknames "Air Jordan" and "His Airness". He also gained a reputation for being one of the best defensive players in basketball. In 1991, he won his first NBA championship with the Bulls, and followed that achievement with titles in 1992 and 1993, securing a "three-peat". Although Jordan abruptly retired from basketball at the beginning of the 1993–94 NBA season to pursue a career in baseball, he rejoined the Bulls in 1995 and led them to three additional championships (1996, 1997, and 1998) as well as an NBA-record 72 regular-season wins in the 1995–96 NBA season. Jordan retired for a second time in 1999, but returned for two more NBA seasons from 2001 to 2003 as a member of the Washington Wizards.

Jordan's individual accolades and accomplishments include five MVP awards, ten All-NBA First Team designations, nine All-Defensive First Team honors, fourteen NBA All-Star Game appearances, three All-Star Game MVP awards, ten scoring titles, three steals titles, six NBA Finals MVP awards, and the 1988 NBA Defensive Player of the Year Award. He holds the NBA records for highest career regular season scoring average (30.12 points per game) and highest career playoff scoring average (33.45 points per game). In 1999, he was named the greatest North American athlete of the 20th century by ESPN, and was second to Babe Ruth on the Associated Press's list of athletes of the century. He was inducted into the Basketball Hall of Fame in 2009.

Jordan is also noted for his product endorsements. He fueled the success of Nike's Air Jordan sneakers, which were introduced in 1985 and remain popular today. Jordan also starred in the 1996 feature film ''Space Jam'' as himself. He is the majority owner and head of basketball operations for the NBA's Charlotte Bobcats, having won a bidding war to buy controlling interest in the team from founding owner Robert L. Johnson.

Early years

Jordan was born in Brooklyn, New York, the son of Deloris (née Peoples), who worked in banking, and James R. Jordan, Sr., an equipment supervisor. His family moved to Wilmington, North Carolina, when he was a toddler. Jordan attended Emsley A. Laney High School in Wilmington, where he anchored his athletic career by playing baseball, football, and basketball. He tried out for the varsity basketball team during his sophomore year, but at 5'11" (1.80 m), he was deemed too short to play at that level. His taller friend, Harvest Leroy Smith, was the only sophomore to make the team.

Motivated to prove his worth, Jordan became the star of Laney's junior varsity squad, and tallied several 40 point games. The following summer, he grew four inches (10 cm) and trained rigorously. Upon earning a spot on the varsity roster, Jordan averaged about 20 points per game over his final two seasons of high school play. As a senior, he was selected to the McDonald's All-American Team During his three seasons at North Carolina, he averaged 17.7 ppg on 54.0% shooting, and added 5.0 rebounds per game (rpg). He was selected by consensus to the NCAA All-American First Team in both his sophomore (1983) and junior (1984) seasons. After winning the Naismith and the Wooden College Player of the Year awards in 1984, Jordan left North Carolina one year before his scheduled graduation to enter the 1984 NBA Draft. The Chicago Bulls selected Jordan with the third overall pick, after Hakeem Olajuwon (Houston Rockets) and Sam Bowie (Portland Trail Blazers). Jordan returned to North Carolina to complete his degree in 1986.

Professional career

During his first season in the NBA, Jordan averaged 28.2 ppg on 51.5% shooting. He quickly became a fan favorite even in opposing arenas, and appeared on the cover of ''Sports Illustrated'' with the heading "A Star is Born" just over a month into his professional career. Jordan was also voted in as an All-Star starter by the fans in his rookie season. Controversy arose before the All-Star game when word surfaced that several veteran players, led by Isiah Thomas, were upset by the amount of attention Jordan was receiving. This led to a so called "freeze-out" on Jordan, where players refused to pass him the ball throughout the game. The controversy left Jordan relatively unaffected when he returned to regular season play, and he would go on to be voted Rookie of the Year. The Bulls finished the season 38–44, and lost in the first round of the playoffs in four games to the Milwaukee Bucks.

Jordan's second season was cut short by a broken foot which caused him to miss 64 games. Despite Jordan's injury and a 30–52 record, the Bulls made the playoffs. Jordan recovered in time to participate in the playoffs and performed well upon his return. Against a 1985–86 Boston Celtics team that is often considered one of the greatest in NBA history, Jordan set the still-unbroken record for points in a playoff game with 63 in Game 2. The Celtics, however, managed to sweep the series.

Jordan had recovered completely by the 1986–87 season, and had one of the most prolific scoring seasons in NBA history. He became the only player other than Wilt Chamberlain to score 3,000 points in a season, averaging a league high 37.1 points on 48.2% shooting. In addition, Jordan demonstrated his defensive prowess, as he became the first player in NBA history to record 200 steals and 100 blocks in a season. Despite Jordan's success, Magic Johnson won the league's Most Valuable Player Award. The Bulls reached 40 wins, and advanced to the playoffs for the third consecutive year. However, they were again swept by the Celtics.

Mid-career: Pistons roadblock

Jordan led the league in scoring again in the 1987–88 season, averaging 35.0 ppg on 53.5% shooting and won his first league MVP award. He was also named the Defensive Player of the Year, as he had averaged 1.6 blocks and a league high 3.16 steals per game. The Bulls finished 50–32, and made it out of the first round of the playoffs for the first time in Jordan's career, as they defeated the Cleveland Cavaliers in five games. However, the Bulls then lost in five games to the more experienced Detroit Pistons, who were led by Isiah Thomas and a group of physical players known as the "Bad Boys".

In the 1988–89 season, Jordan again led the league in scoring, averaging 32.5 ppg on 53.8% shooting from the field, along with 8 rpg and 8 assists per game (apg). The Bulls finished with a 47–35 record, and advanced to the Eastern Conference Finals, defeating the Cleveland Cavaliers and New York Knicks along the way. The Cavaliers series included a career highlight for Jordan when he hit a series-winning shot over Craig Ehlo in the closing moments of the deciding fifth game of the series. However, the Pistons again defeated the Bulls, this time in six games, by utilizing their "Jordan Rules" method of guarding Jordan, which consisted of double and triple teaming him every time he touched the ball.

The Bulls entered the 1989–90 season as a team on the rise, with their core group of Jordan and young improving players like Scottie Pippen and Horace Grant, and under the guidance of new coach Phil Jackson. Jordan averaged a league leading 33.6 ppg on 52.6% shooting, to go with 6.9 rpg and 6.3 apg in leading the Bulls to a 55–27 record. They again advanced to the Eastern Conference Finals beating the Bucks and Philadelphia 76ers en route. However, despite pushing the series to seven games, the Bulls lost to the Pistons for the third consecutive season.

First three-peat

In the 1990–91 season, Jordan won his second MVP award after averaging 31.5 ppg on 53.9% shooting, 6.0 rpg, and 5.5 apg for the regular season. The Bulls finished in first place in their division for the first time in 16 years and set a franchise record with 61 wins in the regular season. With Scottie Pippen developing into an All-Star, the Bulls had elevated their play. The Bulls defeated the New York Knicks and the Philadelphia 76ers in the opening two rounds of the playoffs. They advanced to the Eastern Conference Finals where their rival, the Detroit Pistons, awaited them. However, this time the Bulls beat the Pistons in a surprising sweep. In an unusual ending to the fourth and final game, Isiah Thomas led his team off the court before the final minute had concluded. Most of the Pistons went directly to their locker room instead of shaking hands with the Bulls.

The Bulls compiled an outstanding 15–2 record during the playoffs, and advanced to the NBA Finals for the first time in franchise history, where they beat the Los Angeles Lakers four games to one. Perhaps the best known moment of the series came in Game 2 when, attempting a dunk, Jordan avoided a potential Sam Perkins block by switching the ball from his right hand to his left in mid-air to lay the shot in. In his first Finals appearance, Jordan posted per game averages of 31.2 points on 56% shooting from the field, 11.4 assists, 6.6 rebounds, 2.8 steals and 1.4 blocks. Jordan won his first NBA Finals MVP award, and he cried while holding the NBA Finals trophy.

Jordan and the Bulls continued their dominance in the 1991–92 season, establishing a 67–15 record, topping their franchise record from 1990 to 91. Jordan won his second consecutive MVP award with averages of 30.1 points, 6.4 rebounds and 6.1 assists per game on 52% shooting. After winning a physical 7-game series over the New York Knicks in the second round of the playoffs and finishing off the Cleveland Cavaliers in the Conference Finals in 6 games, the Bulls met Clyde Drexler and the Portland Trail Blazers in the Finals. The media, hoping to recreate a Magic-Bird rivalry, highlighted the similarities between "Air" Jordan and Clyde "The Glide" during the pre-Finals hype. In the first game, Jordan scored a Finals-record 35 points in the first half, including a record-setting six three-point field goals. After the sixth three-pointer, he jogged down the court shrugging as he looked courtside. Marv Albert, who broadcast the game, later stated that it was as if Jordan was saying, "I can't believe I'm doing this." The Bulls went on to win Game 1, and defeat the Blazers in six games. Jordan was named Finals MVP for the second year in a row and finished the series averaging 35.8 ppg, 4.8 rpg, and 6.5 apg, while shooting 53% from the floor.

In 1992–93, despite a 32.6 ppg, 6.7 rpg and 5.5 apg campaign, Jordan's streak of consecutive MVP seasons ended as he lost the award to his friend Charles Barkley. Coincidentally, Jordan and the Bulls met Barkley and his Phoenix Suns in the 1993 NBA Finals. The Bulls captured their third consecutive NBA championship on a game-winning shot by John Paxson and a last-second block by Horace Grant, but Jordan was once again Chicago's catalyst. He averaged a Finals-record 41.0 ppg during the six-game series, and became the first player in NBA history to win three straight Finals MVP awards. He scored more than 30 points in every game of the series, including 40 or more points in 4 consecutive games. With his third Finals triumph, Jordan capped off a seven-year run where he attained seven scoring titles and three championships, but there were signs that Jordan was tiring of his massive celebrity and all of the non-basketball hassles in his life.

Gambling controversy

During the Bulls' playoff run in 1993, controversy arose when Jordan was seen gambling in Atlantic City, New Jersey the night before a game against the New York Knicks. In that same year, he admitted to having to cover $57,000 in gambling losses, and author Richard Esquinas wrote a book claiming he had won $1.25 million from Jordan on the golf course. In 2005, Jordan talked to Ed Bradley of the CBS evening show ''60 Minutes'' about his gambling and admitted that he made some reckless decisions. Jordan stated, "Yeah, I've gotten myself into situations where I would not walk away and I've pushed the envelope. Is that compulsive? Yeah, it depends on how you look at it. If you're willing to jeopardize your livelihood and your family, then yeah." When Bradley asked him if his gambling ever got to the level where it jeopardized his livelihood or family, Jordan replied, "No."

First retirement and baseball career

On October 6, 1993, Jordan announced his retirement, citing a loss of desire to play the game. Jordan later stated that the murder of his father earlier in the year shaped his decision. James R. Jordan, Sr. was murdered on July 23, 1993, at a highway rest area in Lumberton, North Carolina, by two teenagers, Daniel Green and Larry Martin Demery. The assailants were traced from calls they made on James Jordan's cellular phone, caught, convicted, and sentenced to life in prison. Jordan was close to his father; as a child he had imitated his father's proclivity to stick out his tongue while absorbed in work. He later adopted it as his own signature, displaying it each time he drove to the basket. In 1996 he founded a Chicago area Boys & Girls Club and dedicated it to his father.

In his 1998 autobiography ''For the Love of the Game'', Jordan wrote that he had been preparing for retirement as early as the summer of 1992. The added exhaustion due to the Dream Team run in the 1992 Olympics solidified Jordan's feelings about the game and his ever-growing celebrity status. Jordan's announcement sent shock waves throughout the NBA and appeared on the front pages of newspapers around the world.

Jordan then further surprised the sports world by signing a minor league baseball contract with the Chicago White Sox. He reported to spring training and was assigned to the team's minor league system on March 31, 1994. Jordan has stated this decision was made to pursue the dream of his late father, who had always envisioned his son as a Major League Baseball player. The White Sox were another team owned by Bulls owner Jerry Reinsdorf, who continued to honor Jordan's basketball contract during the years he played baseball. In 1994, Jordan played for the Birmingham Barons, a Double-A minor league affiliate of the Chicago White Sox, batting .202 with three home runs, 51 runs batted in, 30 stolen bases, and 11 errors. He also appeared for the Scottsdale Scorpions in the 1994 Arizona Fall League, batting .252 against the top prospects in baseball.

"I'm back": Return to the NBA

In the 1993–94 season, the Bulls, without Jordan, achieved a 55–27 record, and lost to the New York Knicks in the second round of the playoffs. But the 1994–95 version of the Bulls was a shell of the championship squad of just two years earlier. Struggling at mid-season to ensure a spot in the playoffs, Chicago was 31–31 at one point in mid-March. The team received a lift, however, when Jordan decided to return to the NBA for the Bulls.

On March 18, 1995, Jordan announced his return to the NBA through a pithy press release: "I'm back." The next day, Jordan donned jersey number 45 (his number with the Barons), as his familiar 23 had been retired in his honor following his first retirement. He took to the court with the Bulls to face the Indiana Pacers in Indianapolis, scoring 19 points. The game had the highest Nielsen rating of a regular season NBA game since 1975.

Although he had not played in an NBA game in a year and a half, Jordan played well upon his return, making a game-winning jump shot against Atlanta in his fourth game back. He then scored 55 points in his fifth game back against the Knicks at Madison Square Garden on March 28, 1995 (his first appearance at Madison Square Garden since retiring). Boosted by Jordan's comeback, the Bulls went 13-4 to make the playoffs and advanced to the Eastern Conference Semifinals against the Orlando Magic. At the end of the first game of the series, though, Orlando's Nick Anderson would strip Jordan from behind, leading to the game-winning basket for the Magic; he would later comment that Jordan "didn't look like the old Michael Jordan", after which Jordan returned to wearing his old number (23). Jordan averaged 31 points per game in that series, but Orlando prevailed in six games.

Second three-peat

Freshly motivated by the playoff defeat, Jordan trained aggressively for the 1995–96 season. Strengthened by the addition of rebound specialist Dennis Rodman, the Bulls dominated the league, starting the season 41–3, and eventually finishing with the best regular season record in NBA history: 72–10. Jordan led the league in scoring with 30.4 ppg, and won the league's regular season and All-Star Game MVP awards. In the playoffs, the Bulls lost only three games in four series, defeating the Seattle SuperSonics in the NBA Finals to win the championship. Jordan was named Finals MVP for a record fourth time, surpassing Magic Johnson's three Finals MVP awards. He also achieved only the second sweep of the MVP Awards in the All-Star Game, regular season and NBA Finals, Willis Reed having achieved the first, during the 1969–70 season. Because this was Jordan's first championship since his father's death, and it was won on Father's Day, Jordan reacted very emotionally upon winning the title, including a memorable scene of him sobbing on the locker room floor with the game ball.

In the 1996–97 season, the Bulls started out 69–11, but narrowly missed out on a second consecutive 70-win season by losing their final two games to finish 69–13. However, this year Jordan was beaten for the NBA MVP Award by Karl Malone. The team again advanced to the Finals, where they faced Malone and the Utah Jazz. The series against the Jazz featured two of the more memorable clutch moments of Jordan's career. He won Game 1 for the Bulls with a buzzer-beating jump shot. In Game 5, with the series tied 2–2, Jordan played despite being feverish and dehydrated from a stomach virus. In what is known as the "flu game", Jordan scored 38 points including the game-deciding three-pointer with less than a minute remaining. The Bulls won 90–88 and went on to win the series in six games. For the fifth time in as many Finals appearances, Jordan received the Finals MVP award. During the 1997 NBA All-Star Game, Jordan posted the first triple double in All-Star Game history in a victorious effort; however, he did not receive the MVP award.

Jordan and the Bulls compiled a 62–20 record in the 1997–98 season. Jordan led the league with 28.7 points per game, securing his fifth regular-season MVP award, plus honors for All-NBA First Team, First Defensive Team and the All-Star Game MVP. The Bulls captured the Eastern Conference Championship for a third straight season, including surviving a grueling seven-game series with Reggie Miller's Indiana Pacers in the Eastern Conference Finals; it was the first time Jordan had played in a Game 7 since the 1992 series with the Knicks. After prevailing, they moved on for a rematch with the Jazz in the Finals.

The Bulls returned to Utah for Game 6 on June 14, 1998 leading the series 3–2. Jordan executed a series of plays, considered to be one of the greatest clutch performances in NBA Finals history. With the Bulls trailing 86–83 with 40 seconds remaining, coach Jackson called a timeout. When play resumed, Jordan received the inbound pass, drove to the basket, and hit a layup over several Jazz defenders. The Jazz brought the ball upcourt and passed the ball to forward Karl Malone, who was set up in the low post and was being guarded by Rodman. Malone jostled with Rodman and caught the pass, but Jordan cut behind him and swatted the ball out of his hands for a steal. Jordan then slowly dribbled upcourt and paused at the top of the key, eyeing his defender, Jazz guard Bryon Russell. With fewer than 10 seconds remaining, Jordan started to dribble right, then crossed over to his left, possibly pushing off Russell, although the officials did not call a foul. Jordan then made what would become the climactic shot of his career. After a desperation three-point shot by John Stockton missed, Jordan and the Bulls claimed their sixth NBA championship, and secured a second three-peat. Once again, Jordan was voted the Finals MVP, having led all scorers by averaging 33.5 points per game, including 45 in the deciding Game 6. Jordan's six Finals MVPs is a record; Shaquille O'Neal, Magic Johnson, and Tim Duncan are tied for second place with three apiece. The 1998 Finals holds the highest television rating of any Finals series in history, and Game 6 holds the highest television rating of any game in NBA history.

Second retirement

With Phil Jackson's contract expiring, the pending departures of Scottie Pippen (who stated his desire to be traded during the season) and Dennis Rodman (who would sign with the Los Angeles Lakers as a free agent) looming, and being in the latter stages of an owner-induced lockout of NBA players, Jordan retired for the second time on January 13, 1999.

On January 19, 2000, Jordan returned to the NBA not as a player, but as part owner and President of Basketball Operations for the Washington Wizards. Jordan's responsibilities with the Wizards were comprehensive. He controlled all aspects of the Wizards' basketball operations, and had the final say in all personnel matters. Opinions of Jordan as a basketball executive were mixed. He managed to purge the team of several highly paid, unpopular players (such as forward Juwan Howard and point guard Rod Strickland), but used the first pick in the 2001 NBA Draft to select high schooler Kwame Brown, who did not live up to expectations and was traded away after four seasons.

Despite his January 1999 claim that he was "99.9% certain" that he would never play another NBA game, in the summer of 2001 Jordan expressed interest in making another comeback, this time with his new team. Inspired by the NHL comeback of his friend Mario Lemieux the previous winter, Jordan spent much of the spring and summer of 2001 in training, holding several invitation-only camps for NBA players in Chicago. In addition, Jordan hired his old Chicago Bulls head coach, Doug Collins, as Washington's coach for the upcoming season, a decision that many saw as foreshadowing another Jordan return.

Washington Wizards comeback

On September 25, 2001 Jordan announced his return to professional play with the Wizards, indicating his intention to donate his salary as a player to a relief effort for the victims of the September 11, 2001 attacks. In an injury-plagued 2001–02 season, he led the team in scoring (22.9 ppg), assists (5.2 apg), and steals (1.42 spg). However, torn cartilage in his right knee ended Jordan's season after only 60 games, the fewest he had played in a regular season since playing 17 games after returning from his first retirement during the 1994–95 season.

Playing in his 14th and final NBA All-Star Game in 2003, Jordan passed Kareem Abdul-Jabbar as the all-time leading scorer in All-Star game history. That year, Jordan was the only Washington player to play in all 82 games, starting in 67 of them. He averaged 20.0 points, 6.1 rebounds, 3.8 assists, and 1.5 steals per game. He also shot 45% from the field, and 82% from the free throw line. Even though he turned 40 during the season, he scored 20 or more points 42 times, 30 or more points nine times, and 40 or more points three times. On February 21, 2003, Jordan became the first 40-year-old to tally 43 points in an NBA game. During his stint with the Wizards, all of Jordan's home games at the MCI Center were sold out, and the Wizards were the second most-watched team in the NBA, averaging 20,172 fans a game at home and 19,311 on the road. However, neither of Jordan's final two seasons resulted in a playoff appearance for the Wizards, and Jordan was often unsatisfied with the play of those around him. At several points he openly criticized his teammates to the media, citing their lack of focus and intensity, notably that of the number one draft pick in the 2001 NBA Draft, Kwame Brown.

With the recognition that 2002–03 would be Jordan's final season, tributes were paid to him throughout the NBA. In his final game at his old home court, the United Center in Chicago, Jordan received a four-minute standing ovation. The Miami Heat retired the number 23 jersey on April 11, 2003, even though Jordan had never played for the team. At the 2003 All-Star Game, Jordan was offered a starting spot from Tracy McGrady and Allen Iverson, but refused both; in the end, however, he accepted the spot of Vince Carter, who decided to give it up under great public pressure.

Jordan's final NBA game was on April 16, 2003 in Philadelphia. After scoring only 13 points in the game, Jordan went to the bench with 4 minutes and 13 seconds remaining in the third quarter and with his team trailing the Philadelphia 76ers, 75–56. Just after the start of the fourth quarter, the First Union Center crowd began chanting "We want Mike!". After much encouragement from coach Doug Collins, Jordan finally rose from the bench and re-entered the game for Larry Hughes with 2:35 remaining. At 1:45, Jordan was intentionally fouled by the 76ers' Eric Snow, and stepped to the line to make both free throws. After the second foul shot, the 76ers in-bounded the ball to rookie John Salmons, who in turn was intentionally fouled by Bobby Simmons one second later, stopping time so that Jordan could return to the bench. Jordan received a three-minute standing ovation from his teammates, his opponents, the officials and a crowd of 21,257 fans.

Olympic career

Jordan played on two Olympic gold medal-winning American basketball teams. As a college player he participated, and won the gold, in the 1984 Summer Olympics. Jordan led the team in scoring averaging 17.1 ppg for the tournament.

In the 1992 Summer Olympics he was a member of the star-studded squad that included Magic Johnson, Larry Bird, and David Robinson and was dubbed the "Dream Team". Playing limited minutes due to the frequent blowouts, Jordan averaged 12.7 ppg, finishing fourth on the team in scoring. Jordan, Patrick Ewing, and fellow Dream Team member Chris Mullin are the only American men's basketball players to win Olympic gold as amateurs (all in 1984) and professionals.

In addition, Jordan and fellow Dream Team member (and Bulls teammate) Scottie Pippen are the only players to have won both NBA championship and Olympic gold medal in the same year (1992).

After retiring as a player

After his third retirement, Jordan assumed that he would be able to return to his front office position of Director of Basketball Operations with the Wizards. However, his previous tenure in the Wizards' front office had produced the aforementioned mixed results and may have also influenced the trade of Richard "Rip" Hamilton for Jerry Stackhouse (although Jordan was not technically Director of Basketball Operations in 2002). On May 7, 2003, Wizards owner Abe Pollin fired Jordan as Washington's President of Basketball Operations. Jordan later stated that he felt betrayed, and that if he knew he would be fired upon retiring he never would have come back to play for the Wizards.

Jordan kept busy over the next few years by staying in shape, playing golf in celebrity charity tournaments, spending time with his family in Chicago, promoting his Jordan Brand clothing line, and riding motorcycles. Since 2004, Jordan has owned Michael Jordan Motorsports, a professional closed-course motorcycle road racing team that competes with two Suzukis in the premier Superbike class sanctioned by the American Motorcyclist Association (AMA). Jordan and his then-wife Juanita pledged $5 million to Chicago's Hales Franciscan High School in 2006, and the Jordan Brand has made donations to Habitat for Humanity and a Louisiana branch of the Boys & Girls Clubs of America. On June 15, 2006, Jordan bought a minority stake in the Charlotte Bobcats, becoming the team's second-largest shareholder behind majority owner Robert L. Johnson. As part of the deal, Jordan was named "Managing Member of Basketball Operations," with full control over the basketball side of the operation. Despite Jordan's previous success as an endorser, he has made an effort not to be included in Charlotte's marketing campaigns.

In February 2010, it was reported that Jordan was seeking majority ownership of the Bobcats. As February wore on, it emerged that the leading contenders for the team were Jordan and former Houston Rockets president George Postolos. On February 27, the Bobcats announced that Johnson had reached an agreement with Jordan and his group, MJ Basketball Holdings, to buy the team pending NBA approval. On March 17, the NBA Board of Governors unanimously approved Jordan's purchase, making him the first former NBA player ever to become the majority owner of a league franchise.

Player profile

Jordan was a shooting guard who was also capable of playing small forward (the position he would primarily play during his second return to professional basketball with the Washington Wizards). Jordan was known throughout his career for being a strong clutch performer. He decided numerous games with last-second plays (e.g., The Shot) and performed at a high level even under adverse circumstances (e.g., Flu Game). His competitiveness was visible in his prolific trash-talk and well-known work ethic.

Jordan had a versatile offensive game. He was capable of aggressively driving to the basket, as well as drawing fouls from his opponents at a high rate; his 8,772 free throw attempts are the ninth highest total of all time. As his career progressed, Jordan also developed the ability to post up his opponents and score with his trademark fadeaway jump shot, using his leaping ability to "fade away" from block attempts. According to Hubie Brown, this move alone made him nearly unstoppable. Despite media criticism as a "selfish" player early in his career, Jordan's 5.3 assists per game also indicate his willingness to defer to his teammates. In later years, the NBA shortened its three-point line to 22 feet (from 23 feet, 9 inches), which coupled with Jordan's extended shooting range to make him a long-range threat as well—his 3-point stroke developed from a low 9 / 52 rate (.173) in his rookie year into a stellar 111 / 260 (.427) shooter in the 1995–96 season. For a guard, Jordan was also a good rebounder (6.2 per game).

In 1988, Jordan was honored with the NBA's Defensive Player of the Year Award and became the first NBA player to win both the Defensive Player of the Year and MVP awards in a career (since equaled by Hakeem Olajuwon, David Robinson, and Kevin Garnett; Olajuwon is the only player other than Jordan to win both during the same season). In addition he set both seasonal and career records for blocked shots by a guard, and combined this with his ball-thieving ability to become a standout defensive player. His 2,514 steals are the second highest total of all-time behind John Stockton, while his steals per game average is third all-time. Jerry West often stated that he was more impressed with Jordan's defensive contributions than his offensive ones.

Legacy

Jordan's basketball talent was clear from his rookie season. In his first game in Madison Square Garden against the New York Knicks, Jordan received a prolonged standing ovation, a rarity for an opposing player. After Jordan scored a playoff record 63 points against the Boston Celtics in 1986, Celtics star Larry Bird described him as "God disguised as Michael Jordan."

Jordan led the NBA in scoring in 10 seasons (NBA record) and tied Wilt Chamberlain's record of seven consecutive scoring titles. He was also a fixture on the NBA All-Defensive First Team, making the roster nine times (NBA record shared with Gary Payton). Jordan also holds the top career regular season and playoff scoring averages of 30.1 and 33.4 points per game, respectively. By 1998, the season of his Finals-winning shot against the Jazz, he was well known throughout the league as a clutch performer. In the regular season, Jordan was the Bulls' primary threat in the final seconds of a close game and in the playoffs, Jordan would always demand the ball at crunch time. Jordan's total of 5,987 points in the playoffs is the highest in NBA history. He retired with 32,292 points in regular season play, placing him third on the NBA's all-time scoring list behind Kareem Abdul-Jabbar and Karl Malone.

With five regular-season MVPs (tied for second place with Bill Russell; only Kareem Abdul-Jabbar has won more, six), six Finals MVPs (NBA record), and three All-Star MVPs, Jordan is the most decorated player ever to play in the NBA. Jordan finished among the top three in regular-season MVP voting a record 10 times, and was named one of the 50 Greatest Players in NBA History in 1996.

Many of Jordan's contemporaries label Jordan as the greatest basketball player of all time. An ESPN survey of journalists, athletes and other sports figures ranked Jordan the greatest North American athlete of the 20th century, above icons such as Babe Ruth and Muhammad Ali. Jordan placed second to Babe Ruth in the Associated Press's list of 20th century athletes. In addition, the Associated Press voted him as the basketball player of the 20th century. Jordan has also appeared on the front cover of ''Sports Illustrated'' a record 49 times. In the September 1996 issue of ''Sport'', which was the publication's 50th anniversary issue, Jordan was named the greatest athlete of the past 50 years.

Jordan's athletic leaping ability, highlighted in his back-to-back slam dunk contest championships in 1987 and 1988, is credited by many with having influenced a generation of young players. Several current NBA All-Stars have stated that they considered Jordan their role model while growing up, including LeBron James and Dwyane Wade. In addition, commentators have dubbed a number of next-generation players "the next Michael Jordan" upon their entry to the NBA, including Anfernee "Penny" Hardaway, Grant Hill, Allen Iverson, Kobe Bryant, LeBron James, Vince Carter, and Dwyane Wade. Although Jordan was a well-rounded player, his "Air Jordan" image is also often credited with inadvertently decreasing the jump shooting skills, defense, and fundamentals of young players, a fact which Jordan himself has lamented. Although Jordan has done much to increase the status of the game, some of his impact on the game's popularity in America appears to be fleeting. Television ratings in particular increased only during his time in the league and have subsequently lowered each time he left the game.

In August 2009, the Basketball Hall of Fame in Springfield, Massachusetts, opened a Michael Jordan exhibit containing items from his college and NBA careers, as well as from the 1992 "Dream Team". The exhibit also has a batting glove to signify Jordan's short career in baseball. He was inducted into the Hall of Fame in September 2009, with former Bulls teammates Scottie Pippen, Dennis Rodman, Charles Oakley, Ron Harper, Steve Kerr, and Toni Kukoc in attendance.

Personal life

Jordan is the fourth of five children. He has two older brothers, Larry Jordan and James R. Jordan, Jr., one older sister, Deloris, and a younger sister, Roslyn. Jordan's brother James retired in 2006 as the Command Sergeant Major of the 35th Signal Brigade of the XVIII Airborne Corps in the U.S. Army.

He married Juanita Vanoy in September 1989, and they have two sons, Jeffrey Michael and Marcus James, and a daughter, Jasmine. Jordan and Vanoy filed for divorce on January 4, 2002, citing irreconcilable differences, but reconciled shortly thereafter. They again filed for divorce and were granted a final decree of dissolution of marriage on December 29, 2006, commenting that the decision was made "mutually and amicably". It is reported that Juanita received a $168 million settlement, making it the largest celebrity divorce settlement in history at the time on public record.

On July 21, 2006, a Cook County, Illinois judge determined that Jordan did not owe his alleged former lover Karla Knafel $5 million. Jordan had allegedly paid Knafel $250,000 to keep their relationship a secret. Knafel claimed Jordan promised her $5 million for remaining silent and agreeing not to file a paternity suit after Knafel learned she was pregnant in 1991. A DNA test showed Jordan was not the father of the child.

As of 2007, Jordan lived in Highland Park, Illinois, and both of his sons attended Loyola Academy, a private Roman Catholic high school located in Wilmette, Illinois. Jeffrey graduated as a member of the 2007 graduating class and played his first collegiate basketball game on November 11, 2007, for the University of Illinois. After two seasons, Jeffrey left the Illinois basketball team in 2009. He later rejoined the team for a third season, then received a release to transfer to the University of Central Florida, where Marcus was attending. Marcus transferred to Whitney Young High School after his sophomore year and graduated in 2009. He began attending UCF in the fall of 2009.

Media figure and business interests

Jordan is one of the most marketed sports figures in history. He has been a major spokesman for such brands as Nike, Coca-Cola, Chevrolet, Gatorade, McDonald's, Ball Park Franks, Rayovac, Wheaties, Hanes, and MCI. Jordan has had a long relationship with Gatorade, appearing in over 20 commercials for the company since 1991, including the "Like Mike" commercials in which a song was sung by children wishing to be like Jordan.

Nike created a signature shoe for him, called the ''Air Jordan''. One of Jordan's more popular commercials for the shoe involved Spike Lee playing the part of Mars Blackmon. In the commercials Lee, as Blackmon, attempted to find the source of Jordan's abilities and became convinced that "it's gotta be the shoes". The hype and demand for the shoes even brought on a spate of "shoe-jackings" where people were robbed of their sneakers at gunpoint. Subsequently Nike spun off the Jordan line into its own division named the "Jordan Brand". The company features an impressive list of athletes and celebrities as endorsers. The brand has also sponsored college sports programs such as those of North Carolina, Cincinnati, Cal, St. John's, Georgetown, and North Carolina A&T;.

Jordan also has been associated with the Looney Tunes cartoon characters. A Nike commercial shown during the 1993 Super Bowl XXVII featured Jordan and Bugs Bunny playing basketball against a group of Martian characters. The Super Bowl commercial inspired the 1996 live action/animated movie ''Space Jam'', which starred Jordan and Bugs in a fictional story set during his first retirement. They have subsequently appeared together in several commercials for MCI.

Jordan's yearly income from the endorsements is estimated to be over forty million dollars. In addition, when Jordan's power at the ticket gates was at its highest point the Bulls regularly sold out every game they played in, whether home or away. Due to this, Jordan set records in player salary by signing annual contracts worth in excess of $30 million US$ per season. An academic study found that Jordan’s first NBA comeback resulted in an increase in the market capitalization of his client firms of more than $1 billion.

Most of Jordan's endorsement deals, including the first deal with Nike, were engineered by his agent, David Falk. Jordan has said of Falk that "he's the best at what he does", and that "marketing-wise, he's great. He's the one who came up with the concept of 'Air Jordan.'"

In June 2010, Jordan was ranked by Forbes Magazine as the 20th most powerful celebrity in the world with $55 million earned between June 2009 and June 2010. According to the Forbes article, Brand Jordan generates $1 billion in sales for Nike.

Honors and awards

Jordan won numerous awards and set many records during his career. The following are some of his achievements:

Naismith Memorial Basketball Hall of Fame Class of 2009

2 Olympic Gold Medals – 1984, 1992

6-time NBA Champion

6-time NBA Finals MVP

5-time NBA MVP

10 NBA Scoring Titles

3-time steals leader

3-time minutes leader

14 NBA All-Star Selections

3-time NBA All-Star Game MVP

11 All-NBA Selections

9 All-Defensive First Team Selections

2-time NBA Slam Dunk Contest Champion – 1987, 1988

NBA Rookie of the Year – NBA Defensive Player of the Year –

NCAA National Championship – University of North Carolina at Chapel Hill: 1981–82

ACC Freshman of the Year – 1981–82

2-time Consensus NCAA All-American First Team – 1982–83, 1983–84

ACC Men's Basketball Player of the Year – 1983–84

USBWA College Player of the Year – 1983–84

Naismith College Player of the Year – 1983–84

John R. Wooden Award – 1983–84

Adolph Rupp Trophy – 1983–84

''Sports Illustrated'' Sportsman of the Year – 1991

Named one of the 50 Greatest Players in NBA History in 1996

Ranked No.1 by SLAM Magazine's Top 50 Players of All-Time

Ranked No.1 by ESPN Sportscentury's Top 100 Athletes of the 20th century

Elected to North Carolina Sports Hall of Fame

See also

Michael Jordan Steakhouse

Michael Jordan's Restaurant

''Michael Jordan: Chaos in the Windy City''

''Michael Jordan in Flight''

''NBA 2K11''

References

Further reading

External links

Michael Jordan biography at NBA Encyclopedia

Michael Jordan player profile at NBA.com

Michael Jordan Motorsports

Category:1963 births Category:ACC Athlete of the Year Category:African American basketball players Category:African American sports executives Category:Naismith Memorial Basketball Hall of Fame inductees Category:Basketball players at the 1983 Pan American Games Category:Basketball players at the 1984 Summer Olympics Category:Basketball players at the 1992 Summer Olympics Category:Basketball players from North Carolina Category:Birmingham Barons players Category:Charlotte Bobcats executives Category:Charlotte Bobcats owners Category:Chicago Bulls draft picks Category:Chicago Bulls players Category:Living people Category:McDonald's High School All-Americans Category:Minor league baseball players Category:National Basketball Association executives Category:National Basketball Association owners Category:NBA Defensive Player of the Year Award winners Category:NBA Finals MVP Award winners Category:NBA Slam Dunk Contest champions Category:North Carolina Tar Heels men's basketball players Category:National Basketball Association players with retired numbers Category:Olympic basketball players of the United States Category:Olympic gold medalists for the United States Category:Parade High School All-Americans (boys' basketball) Category:Sportspeople from Brooklyn Category:Sportspeople from Chicago, Illinois Category:People from Highland Park, Illinois Category:People from Wilmington, North Carolina Category:Shooting guards Category:Basketball players from New York Category:Sportspeople of multiple sports Category:United States men's national basketball team members Category:Washington Wizards executives Category:Washington Wizards players Category:Olympic medalists in basketball

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