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Tracking the next pandemic: Avian Flu Talk

Good News on a Possible Vaccine

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    Posted: October 02 2008 at 12:15am
 
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  • Thursday, October 02, 2008

    Stopping Pandemic Bird Flu

    A broad-acting vaccine might be key.

    By Lauren Gravitz

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    Bird flu: The H5N1 virus, seen here in an electron micrograph, is mainly a problem among chickens and other birds. But the virus mutates quickly and has made the jump to humans--often with fatal results. A new vaccine elicits broad immunity in animal tests and could prove effective against as-yet-unknown strains of avian flu.
    Credit: Cynthia Goldsmith

    Bird flu tops the list of the world's next "potential pandemic"--virulent influenza strains that spread rapidly across the globe--but figuring out how to fight it has been far less clear-cut. So far, the U.S. Food and Drug Administration has approved a few vaccines that may be able to fend off the virus, but all of those are grown in chicken eggs, take up to six months to produce, and are each effective against only one strain of the virus. A brand-new DNA vaccine, which scientists hope to soon test in humans, may provide much broader protection.

    Avian influenza, caused by a variant of the H5N1 virus, has afflicted hundreds of millions of birds worldwide. The virus mutates quickly: some of the mutations, upon making the jump to humans, have proved fatal. So far, bird flu has killed at least 250 people.

    "Everyone fears that the virus only needs to make a few mutations to become virulent and transmissible human to human, so this is certainly one of the biggest pandemic threats that we face," says David Ho, a professor at Rockefeller University and the scientific director of the Aaron Diamond AIDS Research Center, in New York. "It obviously continues to be a threat, even though it's no longer on everyone's radar screen."

    The bird flu's rapid mutations are precisely what make the virus so difficult to fight. The few vaccines that are currently approved to treat it were created using existing viruses, and therefore, each immunizes against only a single virulent mutation. To develop a more broadly acting vaccine, Ho and his colleagues at Taiwan's Academia Sinica took a DNA-based approach. DNA-based vaccines are made up of DNA that's been genetically modified to elicit a specific immune response and thus allow a greater level of control over design than do traditional vaccines.

    Ho and his colleagues focused on the gene for hemagglutinin, which produces the virus's outer protein and the one against which human immune systems respond. They created a DNA sequence for the gene that produces hemagglutinin, using pieces of the gene that are shared among different strains of H5N1, rather than a sequence obtained from a single strain of the virus.

    DNA vaccines have many benefits: they are long-lived, stable, require no refrigeration, can be hastily modified, and can be cheaply and quickly manufactured. But they do have one drawback: injections into muscle tissue result in very inefficient DNA uptake. To address this, Ho and his collaborators turned to a technique called electroporation, a method that has shown promise in preliminary studies. In electroporation, the vaccine is combined with small electrical stimuli at the injection site; the resulting electrical field enhances DNA uptake by the muscle cells.

    The study results, published in a recent edition of the Proceedings of the National Academy of Sciences, "show that when you use the consensus sequence to immunize mice, the mice will mount an antibody response that's pretty broadly neutralizing for viruses in different branches of the H5N1 tree," Ho says. And when the researchers exposed the mice to different strains of the virus, they found that the protection had breadth as well.

    "This is a very interesting, imaginative, and novel approach," says virologist Peter Palese, head of the microbiology department at the Mount Sinai School of Medicine, in New York. "It takes advantage of several technological advances, and should be given a chance to be tested in humans."

    Part of what makes the approach so appealing, he notes, is the vaccine's ability to stimulate immunity to multiple virus strains. "The present vaccines are very limited to a particular variant, and if the circulating variant is very different, then we have a problem," says Palese. "The new vaccine will cover more variants around the original strain."

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote abcdefg Quote  Post ReplyReply Direct Link To This Post Posted: October 02 2008 at 12:16am
    so perhaps if this works, we will only have to worry about  no money and no food, due to a financial meltdown. If the bailout works maybe we will only have to worry about a terrorist strike after Ramadan or any other day. Sorry to be skeptical, I was glad to see any at all progress towards something that may help.
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: October 02 2008 at 1:54am

    FDA approves CDC's new rapid flu test

    Lisa Schnirring * Staff Writer

    Oct 1, 2008 (CIDRAP News) – The US Food and Drug Administration (FDA) yesterday approved a new diagnostic test developed by the Centers for Disease Control and Prevention (CDC) that can quickly distinguish seasonal influenza strains from an evolving virus that might have pandemic potential in hours rather than days.

    The test, called the Human Influenza Virus Real-Time RT-PCR Detection and Characterization Panel (rRT-PCR Flu Panel), can detect flu viruses and differentiate between seasonal and novel influenza strains, according to a statement released yesterday by the US Department of Health and Human Services (HHS).

    The device isolates and amplifies viral genetic material from patients' nose and throat samples. Then it labels the viral genetic material with fluorescent molecules.

    The FDA also cleared a diagnostic instrument called the Applied Biosystems 7500 Fast Dx that detects and analyzes the fluorescent-labeled viral genetic material, the HHS statement said.

    The test panel and diagnostic system can detect and characterize commonly circulating human influenza viruses, avian influenza A viruses such as H5N1, and novel viruses within 4 hours rather than the days it takes for conventional tests. Also, the system can test multiple samples simultaneously.

    Mike Leavitt, HHS Secretary, said in the statement that the new diagnostic test represents a significant achievement for public health surveillance. "The test allows us to better support laboratories on the front line of influenza testing in the United States and abroad," he said.

    Julie Gerberding, MD, MPH, the CDC's director, said in the statement that the test provides another tool to fight seasonal influenza. "We'll now be able to detect influenza in the community faster, which allows us to take steps more quickly to protect and save lives," she said.

    Three groups collaborated on the development of the new test: the CDC, Applied Biosystems, based in Foster City, Calif., and the Association of Public Health Laboratories (APHL). State public health laboratories in Virginia, Iowa, California, Massachusetts, Wisconsin, and Washington conducted clinical evaluations of the new flu panel.

    CDC-qualified labs will be able to use the new diagnostic test this fall, and some facilities will be able to receive free reagents, the HHS said, adding that the test should ensure the accuracy of influenza testing results among the different sites that perform subtype testing.

    Rosemary Humes, the APHL's senior advisor for scientific affairs, told CIDRAP News that labs have been using polymerase chain reaction (PCR) testing to analyze influenza viruses for a while, but they've never had standardized reagents until now. "The speed and accuracy is a great asset," she said, adding that the APHL helped develop the test and conducted validity testing.

    If a lab detects a novel strain with the new diagnostic testing system, the results will be more credible, Humes said.

    Leavitt said the test's ability to identify emerging influenza viruses is especially important. "This breakthrough allows for a more timely detection of a pandemic virus, which helps in determining when to begin broad control strategies as well as life-saving mitigation measures, such as closing schools, cancelling social gatherings, and informing businesses to begin work-at-home policies," he said in the statement.

    See also:

    Sep 30 HHS press release
    http://www.hhs.gov/news/press/2008pres/09/20080930a.html

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 02 2008 at 6:46am
    The vaccine could take 7-10 years to bring to market.    I would be happy with a  50% or better match with seasonal flu vaccines at this poiont. 
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: October 02 2008 at 3:55pm

    WHO seeks to ease worry over upcoming flu season

    Lisa Schnirring * Staff Writer

    Oct 2, 2008 (CIDRAP News) – A top influenza expert with the World Health Organization today sought to allay fears that the upcoming flu season in the northern hemisphere will be unusually severe.

    In a news teleconference, Keiji Fukuda, MD, MPH, coordinator of the WHO's global influenza program, said northern hemisphere locations are reporting only sporadic influenza cases. "There's no real indication on how this season is going to evolve yet," he said.

    Fukuda said he's not sure why rumors are circulating that the northern hemisphere is in for a severe flu season. He said some people might be interpreting the presence of three new strains in the northern hemisphere's influenza vaccine as a sign that the season might be severe. However, he said, "Change itself does not mean that the season is going to be severe."

    Recent reports in the British media described fears about the likely arrival of the Brisbane strain of influenza A/H3N2 in the United Kingdom during the upcoming season. That strain circulated at the end of Australia's 2007 flu season, then unexpectedly circulated in the United States during its 2007-08 season. The latest vaccine recommendations for both hemispheres include the Brisbane strain of H3N2.

    The southern hemisphere's 2008 flu season has tailed off, and it appears that its vaccine was a good match with circulating influenza strains, Fukuda said. WHO officials are in frequent close contact with health authorities in Australia.

    "The season in Australia was pretty mild," he said. "This is something that we can confirm."

    Fukuda promised that WHO will monitor the season closely through its Global Influenza Surveillance Network, consisting of 122 labs that span 94 countries. The labs process thousands clinical specimens each year from patients who have seasonal influenza infections.

    Apprehension in advance of the upcoming flu season is normal, but the best thing people can do is get their influenza vaccine, Fukuda said. "The key message is that this is the single most important thing you can do to protect yourself, the people around you, and the people you care most about," he said.

    The best time to get immunized is before the season starts, which for people in the northern hemisphere is now, Fukuda said.

    He said he worries that awareness regarding seasonal flu might be dropping off, because it seems to be overshadowed by H5N1 and pandemic flu concerns. "But this is the most common form of flu and the most preventable," he said, adding that the disease can affect people of any age or health status and spreads very easily. "If you breathe you are susceptible to getting influenza."

    On Sep 22, the WHO issued its recommendation for the southern hemisphere's 2009 influenza season. It advised that the vaccine be based on the same three viral strains as this year's vaccine: for the A/H1N1 component, a strain similar to A/Brisbane/59/2007; for the A/H3N2 component, a strain similar to A/Brisbane/10/2007, and for the B component, a strain similar to B/Florida/4/2006. The recommendation also mirrors its guidance for the northern hemisphere's 2008-09 flu season.

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: October 07 2008 at 7:20am
    ........................................................

    The Lancet, Volume 372, Issue 9640, 30 August 2008-5 September 2008, Pages 696-697
    Sheila M Bird, Jeremy Farrar

    References and further reading may be available for this article. To view references and further reading you must purchase this article.

    Summary

    Background

    Indonesia has had the most human cases of highly pathogenic avian influenza A (previous termH5N1)next term and one of the highest case-fatality rates worldwide. We described the factors associated with previous termH5N1next term case-fatality in Indonesia.
    Methods

    Between June, 2005, and February, previous term2008,next term there were 127 confirmed previous termH5N1next term infections. Investigation teams were deployed to investigate and manage each confirmed case; they obtained epidemiological and clinical data from case-investigation reports when possible and through interviews with patients, family members, and key individuals.

    Findings

    ...Of the 127 patients with confirmed previous termH5N1next term infections, 103 (81%) died. Median time to hospitalisation was 6 days (range 1–16). Of the 122 hospitalised patients for whom data were available, 121 (99%) had fever, 107 (88%) cough, and 103 (84%) dyspnoea on reaching hospital. However, for the first 2 days after onset, most had non-specific symptoms; only 31 had both fever and cough, and nine had fever and dyspnoea. Median time from onset to oseltamivir treatment was 7 days (range 0–21 days); treatment started within 2 days for one patient who survived, four (36·4%) of 11 receiving treatment within 2–4 days survived, six (37·5%) of 16 receiving treatment within 5–6 days survived, and ten (18·5%) of 44 receiving treatment at 7 days or later survived (p=0·03). Initiation of treatment within 2 days was associated with significantly lower mortality than was initiation at 5–6 days or later than 7 days (p<0·0001). Mortality was lower in clustered than unclustered cases (odds ratio 33·3, 95% CI 3·13–273). Treatment started at a median of 5 days (range 0–13 days) from onset in secondary cases in clusters compared with 8 days (range 4–16) for primary cases (p=0·04).

    Interpretation

    Development of better diagnostic methods and improved case management might improve identification of patients with previous termH5N1next term influenza, which could decrease mortality by allowing for earlier treatment with oseltamivir.


    Source
    -
    http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1B-4T70C3P-1&_user=10&_coverDate=09%2F05%2F2008&_alid=801767344&_rdoc=1&_fmt=high&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_ct=3&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=94b9507458e17794566aaac5f9de95ef
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: October 09 2008 at 2:50pm
    We kept hearing that there is no vaccine to protect from H5N1 until the real thing hits.

    the folks in the UK hear this...

    Pushing The Vaccines
    ...................................

    Do you want to be Primed?




    source-
    http://news.avian-influenza.info/latest_bird_flu_news.html

    Vaccinate NOW to beat bird flu pandemic, researchers warn (Daily Mail)

    Found on 09 Oct 2008 13:11 GMT


    excerpt-

    Dr John Wood, from the National Institute for Biological Standards and Control, a government funded body which helps in the production and testing of vaccines for emerging flu strains, backed the study.

    He told the BBC: 'The fact that they seem to have this protection after eight years is really interesting.'

    'If governments are thinking about stockpiling vaccine, you could actually be stockpiling it in people's arms.'

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Kilt2 Quote  Post ReplyReply Direct Link To This Post Posted: October 09 2008 at 9:19pm
    a vaccine is good news - but - and it a big but - they have to make enough for everyone - and that cannot be done
    And I looked, and behold a pale horse: and his name that sat on him was Death, and Hell followed with him.
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