Showing posts with label Branswell. Show all posts

Showing posts with label Branswell. Show all posts

Branswell On Flu Vaccine Matches

Photo Credit – CDC

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Last Friday, in FluView Week 1 & MMWR Vaccine Effectiveness Report, we looked at the first estimate of this year’s flu vaccine’s effectiveness, and early numbers suggest it to be around 62%.

An estimate that is very close to what the 2011 study by Michael Osterholm and his team at CIDRAP - A Comprehensive Flu Vaccine Effectiveness Meta-Analysis - found; that most years the flu vaccine was `moderately’ protective.

Unfortunately for the elderly and for those with immune problems – the people most at risk of complications from the flu – the flu vaccine’s effectiveness is often even lower (see Study: Flu Vaccines And The Elderly).

Today the inimitable Helen Branswell, ace health reporter for The Canadian Press gives us a terrific look at the vaccine effectiveness issue, with interviews of Dr. Michael Osterholm of CIDRAP, Dr. Nancy Cox at the CDC, and Dr. Danuta Skowronski of the B.C. Centre for Disease Control, and Dr. Edward Belongia of the Marshfield Clinic in Marshfield, Wisconsin.

At this point, I’ll just step out of the way and invite you to read:

Flu studies suggest vaccine `match' not super predictor of effectiveness

Helen Branswell,

Sunday, January 13, 2013 7:55 PM

Highly Recommended.

mBio: Coronavirus Has An Affinity For Multiple Hosts

Coronavirus

Photo Credit NIAID

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Most of the infectious diseases that afflict mankind today began in a different animal species, but jumped to humans and then adapted to our physiology.

The scourge of Tuberculosis, which now infects 1/3rd of humanity, likely jumped species when man began to corral and raise its traditional hosts; goats and cattle.
Measles appears to have evolved from canine distemper and/or the Rinderpest virus of cattle.
Influenza, as most of you know, is native to aquatic birds – but jumped species thousands of years ago and many strains have adapted to humans, pigs, and other species.

The list of zoonotic diseases (those shared between humans and animals) is long and continually expanding, and includes: SARS, Babesiosis, Borrelia (Lyme), Nipah, Hendra, Malaria, Hantavirus, Ebola, Bartonella, Leptospirosis, Q-Fever, bird flu and many, many others

Most viruses are fairly selective about the type of cells they will invade, what organ systems they will attack, and even what species they will infect.

Horse viruses generally attack equines, and not say, cats and dogs. Cat viruses tend to attack felines, and not birds. Bird viruses usually only infect avian species.

But some viruses are more promiscuous than others.

Rabies can infect nearly all warm-blooded animals, and we’ve seen the H5N1 `avian flu’ virus infect a wide range of mammals, including humans, dogs, cats, and pigs.

Later today, mBio®, the online open-access journal of the American Society for Microbiology, will publish a study that looks at the host range of the newly discovered coronavirus (hCoV-EMC) in the Middle East.

Although researchers are still looking for the receptor cell that allows entry of the virus into the host’s cells, they have found that the hCoV-EMC virus can infect a number of bat species, along with pigs, and of course, humans.

We’ll have to wait a few hours to see the study, but the ASM has a press release with some of the details, and we also have an excellent write up by Helen Branswell of the Canadian Press.

First, excerpts from the press Release

Public release date: 11-Dec-2012

New coronavirus has many potential hosts, could pass from animals to humans repeatedly

The SARS epidemic of 2002-2003 was short-lived, but a novel type of human coronavirus that is alarming public health authorities can infect cells from humans and bats alike, a fact that could make the animals a continuing source of infection, according to a study to be published in in mBio®, the online open-access journal of the American Society for Microbiology, on December 11. The new coronavirus, called hCoV-EMC, is blamed for five deaths and several other cases of severe disease originating in countries in the Middle East.

According to the new results, hCoV-EMC uses a different receptor in the human body than the SARS virus, and can infect cells from a wide range of bat species and pigs, indicating there may be little to keep the virus from passing from animals to humans over and over again.

First identified in a patient in Saudi Arabia in June, nine laboratory-confirmed cases of hCoV-EMC infection have now been identified, five of whom have died. Although the virus does not apparently pass from person-to-person very readily, the case fatality rate and the fact that the source of the virus has not been identified have caused concern among global public health authorities. Cases of hCoV-EMC infection are marked by severe pneumonia and often by kidney failure.

"This virus is closely related to the SARS virus, and looking at the clinical picture, it causes the same pattern of disease," says Christian Drosten of the University of Bonn Medical Centre in German, a lead author of the study.

Given the similarities, Drosten and his colleagues wanted to know whether hCoV-EMC and SARS might use the same receptor, a sort of molecular "dock" on human cells that the virus latches onto to gain entry to the cell. The SARS receptor, called ACE2, is found mostly on pneumocytes deep within the human lung, so an individual must breathe in many, many SARS viruses for a sufficient number of them to reach this susceptible area and cause an infection. Drosten says this simple fact helped ensure the SARS outbreak didn't spread like wildfire and was mostly limited to healthcare workers and residents of overcrowded housing in Hong Kong. Also, once a person was infected with SARS in the deep part of their lungs, he or she felt sick almost immediately and therefore was not active in the community and infecting others, another aspect of the receptor that helped curb the outbreak.

Does hCoV-EMC use the same receptor? If so, the means of controlling this new virus might become clearer.

"The answer is a clear no," says Drosten. "This virus does not use ACE2." This leaves open the possiblity that hCoV-EMC could use a receptor in the human lung that is easier to access and could make the virus more infectious than SARS, but it is still not known what receptor the virus does use.

To help identify how hCoV-EMC might have originated and moved between humans and animals, the second part of the study focused on the animal species the virus can infect. SARS is closely related to viruses from bats, but Drosten says the virus changed in the transition from bats to civet cats to humans and could no longer infect bats, so SARS was not present in the wild and did not pass repeatedly from bats to humans like a classical zoonotic disease. "So the [SARS] virus lost its old host and gained a new one," says Drosten.

Like SARS, hCoV-EMC is most closely related to coronaviruses from bats, but unlike SARS, this study found that hCoV-EMC can still infect cells from many different species of bats. "This was a big surprise," says Drosten. "It's completely unusual for any coronavirus to be able to do that – to go back to its original reservoir." The virus is also able to infect cells from pigs, indicating that it uses a receptor structure that all these animals have in common. If that receptor is present in mucosal surfaces, like the lining of the lung, it is possible the virus could pass from animals to humans and back again, making animals an ongoing source of the virus that would be difficult or impossible to eliminate.

(Continue . . . )

The study should be published online at http://mbio.asm.org/ later today.

Meanwhile, Helen Branswell has the following report.

Study finds puzzling behaviour of new coronavirus, may hint at pattern of spread

By Helen Branswell, The Canadian Press | Associated Press – 7 hrs ago

TORONTO - A new study reveals that the new SARS-like virus which has been causing infections in the Middle East behaves unusually in laboratory testing

(Continue . . . )

Branswell On Expanded Surveillance For The Coronavirus

Coronavirus – Credit CDC PHIL

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Helen Branswell, ace health reporter for The Canadian Press, has an excellent look this morning at the reasons behind the World Health Organization’s request for enhanced global surveillance for the novel coronavirus recently detected in the Middle East.

Rather than detract from what is already a concise and informative report, I’ll simply step aside and invite you to read:

The Canadian Press - ONLINE EDITION

New coronavirus cases suggest source may be more widespread, WHO says

By: Helen Branswell, The Canadian Press

Posted: 3:02 AM |

Clues gleaned from the most recent infections with the new coronavirus are behind the World Health Organization's decision to warn countries to broaden their surveillance for cases, an expert with the agency says.

The Geneva-based global health body now believes the risk of exposure to the new virus may exist beyond Saudi Arabia and Qatar, so telling countries they need only look for sick people with travel or residency links to those countries may be misleading and counterproductive.

(Continue . . . )

Novartis Fluad And Agriflu Vaccines Suspended In Canada

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Over the past several days Italy, Germany, France, and Switzerland have all temporarily suspended the use of two Novartis seasonal flu vaccines (Fluad & Agriflu) due to reports of `clumping of proteins’ observed in one batch produced at their facility in Italy.

Both flu shots are distributed in single-dose, thimerosal free, pre-loaded syringes.

Fluad, an adjuvanted vaccine, is not marketed in the United States. Agriflu is listed on the CDC’s Flu Vaccine Supply for the U.S. 2012-2013 as being approved for sale in the U.S..

Yesterday Canada announced that they would join with a number of other European nations in suspending the use of these two vaccines until a proper safety review could be completed.

Here is the Health Canada statement.

Novartis Suspends Distribution of Seasonal Flu Vaccines Agriflu and Fluad in Canada as a Precaution

Information Update
2012-162
October 26, 2012
For immediate release

OTTAWA - Health Canada would like to provide further information to Canadians about its assessment of the voluntary suspension of use in Europe of the seasonal flu vaccines Agriflu and Fluad.

Agriflu and Fluad are two of the seasonal flu vaccines produced by Novartis that have been pulled from use in several European countries pending further examination of white floating material discovered clumping in the vaccines.

Health Canada rigorously reviewed Agriflu and Fluad for safety and effectiveness before it was authorized for use in Canada.

Clumping of the kind noted in Europe is common in vaccines. Health Canada has previously seen such particles before in other vaccines and has observed no impact on their safety or effectiveness. The Public Health Agency of Canada monitors for adverse events following immunization. To date it has received no reports of serious or unexpected adverse events related to these vaccines.

As a precautionary step, Health Canada asked Novartis to suspend distribution of the vaccines in Canada until a full review of the situation is completed. Novartis has agreed. The Public Health Agency of Canada is also recommending that health care professionals in possession of these vaccines refrain from using them until the review is complete.

The Public Health Agency of Canada and Health Canada will continue to work with the company to monitor the safety and effectiveness of the vaccine used here in Canada. Should a safety concern be identified, immediate and appropriate action will be taken.

Novartis reports that well over a million shots have already been administered in Europe, with no signs of increased adverse effects.

This statement appeared on their website yesterday.

October 26, 2012

To date, data from the ongoing seasonal vaccination campaign have shown no unexpected adverse events.

Novartis is confident in the safety and efficacy of its seasonal influenza vaccines Agrippal^® and Fluad^® manufactured in Italy. Patient safety is of the highest priority to Novartis. Novartis internal assessments and the clinical data gathered during the 2012-2013 seasonal influenza studies required for European licensure of Agrippal and Fluad demonstrate a safety and immunogenicity profile similar to that of prior years.

The protein aggregates observed in the one batch that led to precautionary measures in some markets can occur in the normal vaccine manufacturing process and have no impact on the safety or efficacy of the vaccines.

The company is proactively engaging with local health authorities to answer remaining open questions and is fully committed to providing high quality vaccines to patients.

For more on this story we turn to Helen Branswell of The Canadian Press, who has the following report.

Canada suspends dispersal of Novartis flu shots following similar move in Europe

Helen Branswell, Friday, October 26, 2012 9:21 PM

Given that we’ve seen this sort of protein clumping in the past with no ill effect, these suspensions may eventually be lifted.

But given the nightmare surrounding contaminated steroid injections in the United States in recent months – a proactive stance by public health officials – even if there is only a hint of a problem, is not unreasonable.

SARS Virus Placed On Select Agents List

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A story this morning from Helen Branswell of the Canadian Press on new regulations for working with the SARS virus, but first, a little background.

In May of 1995 a lab technician from Lancaster, Ohio – using a credit card and and a fake letterhead – ordered a quantity of Yersinia pestis (the bacteria that causes plague) from a mail order biomedical supply firm in Maryland.

Although 3 vials were shipped to him, the company grew suspicious and alerted federal authorities. He was eventually convicted of mail fraud – and placed on 18 months probation - since he misrepresented himself as working for a government laboratory.

Around the same time, halfway around the world, a Japanese cult called Aum Shinrikyo unleashed a Sarin gas attack on five subway trains in Tokyo. In all - 13 people were killed, another 54 serious injured – while hundreds more were affected.

When the cult’s headquarters was raided, police reported finding explosives, along with chemical and biological agents, including anthrax and Ebola cultures.

Suddenly, the threat of homegrown biological terrorism had grown very real. In response, Congress passed Section 511 of the Antiterrorism and Effective Death Penalty of 1996.

This legislation was the first step on the road to creating the CDC’s Select Agent Program, which today `oversees the activities of possession of biological agents and toxins that have the potential to pose a severe threat to public, animal or plant health, or to animal or plant products’

For more, we go to the CDC’s Select Agent Program Brochure.

This Act directed the U.S. Department of Health and Human Services (HHS) to establish a list of biological agents and toxins that could threaten public health and safety, procedures for governing the transfer of those agents, and training requirements for entities working with these “select agents.”

HHS delegated the authority to implement this Act to the Centers for Disease Control and Prevention (CDC), which then established the CDC Select Agent Program. The Division of Select Agents and Toxins in the CDC Office of Public Health Preparedness and Response oversees this program.

9/11 and increased regulation of select agents

Following the anthrax attacks of 2001, Congress significantly strengthened oversight of select agents by passing the following acts:

USA PATRIOT Act (Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism Act of 2001; Public Law 107-56): Restricted access to select agents

Bioterrorism Act (Public Health Security and Bioterrorism Preparedness and Response Act of 2002; Public Law 107-188): Increased safeguards and security measures as well as oversight of the possession and use of select agents

Essentially, in order to be able to acquire or work with certain toxins and biological agents, you had to be registered and approved entity by the HHS.

Fast forward to this past week – when by chance, a SARS-like coronavirus detected in two patients from the Middle East was making big news – and two years after it was first requested by the CDC, the SARS virus was added to the Select Agents list.

Here is the story from Helen Branswell, that also has details on how Canada deals with these types of biological materials, and some quotes from Michael Osterholm of CIDRAP.

U.S. government names SARS a select agent, restricting labs that work on virus

Friday, 05 October 2012 02:15 Helen Branswell, The Canadian Press

The Centers for Disease Control has added SARS to the list of select agents in the United States, a move designed to try to ensure the virus stays within the confines of highly regulated laboratories.

The addition, which the CDC first proposed over two years ago, was given legal status this week when the revised select agent list was published in the U.S. Federal Registry.

The timing of the move is both ironic and co-incidental.

(Continue . . .)

Although the SARS epidemic of 2002-2003 was eventually brought under control, the virus infected roughly 8,000 people, killing nearly 800.

Since then, while there have been no recurrences from the wild, three separate lab accidents in 2003 and 2004 resulted in the infection of at least 13 people.

SARS, or a variation on the SARS-Coronavirus, could wreak havoc were it to emerge once more from the wild, or be accidentally (or intentionally) released.

And many worry that - with the technology of today – cheaper, faster, and more capable than anything that could be imagined back in 1995, the ability of malevolent bio-hackers working out of their basements to create new, and dangerous organisms has never been greater.

While once we only had to worry about nature serving up an occasional biological curve ball, increasingly that ability – by design or by error - is becoming available to human hands all around the world.

Which makes the regulation and control of the most dangerous of these toxins and biological organisms a top priority of many governments around the world.

Branswell Updates The Novel Coronavirus Story

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At the end of what has been a busy infectious disease news day (see here, here, here & here), Helen Branswell of The Canadian Press has put together a comprehensive overview on what we now know about a pair of recent novel coronavirus infections reported out of the Middle East.

As Helen is arguably the best health reporter in the business, I’ll do the smart thing and simply step aside and invite you to read:

Outbreak of new coronavirus - same family as SARS - has WHO on alert

Helen Branswell, Sunday, September 23, 2012 5:16 PM

Meanwhile, after posting a notice on their Global Alert and Response (GAR) earlier today, the World Health Organization has been posting updates via their twitter account: @WHO

I would expect that the ECDC will weigh in on all of this in the next day or two as well.

Osterholm: Time To Close The Pig Barns

Credit Wikipedia

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While the CDC has yet to find evidence of sustained and efficient human-to-human transmission of the emerging H3N2v flu virus, more than 200 human cases reported over the past couple of weeks have made it pretty apparent that this virus jumps readily from pigs to humans.

The CDC – citing the lack of H2H transmission and the relative mildness of infections – has advised county fairs and animal exhibits to screen pigs for signs of illness and urge better hygiene among visitors, but has stopped short of recommending the closing of pig barns to the public.

Complicating matters, last week we saw a study that showed pigs often carry flu viruses asymptomatically (see EID Journal: Flu In Healthy-Looking Pigs), which makes the advice to identify and isolate sick pigs problematic.

This morning, Helen Branswell has a long interview with well known flu expert and CIDRAP director Michael Osterholm, who believes the time has come to close the pig exhibits at county fairs.

Osterholm stresses that we don’t yet know where this virus is going, or how much of a public threat it poses, but that the level of transmission at these venues is sufficient to warrant stronger measures.

A link to Helen’s article, then I’ll return with a postscript.

August 21, 2012 | 7:00 am

Time to close the pig barns, flu expert says

By Helen Branswell The Canadian Press

TORONTO – It’s been found in pigs and-or people in more than 10 U.S. states and counting. In less than a month, more than 200 people — most young children — have been infected by an unwanted visitor to many of the state and county fairs that are held at this time of year.

A new swine flu virus is infecting a growing number of people in the United States. But the official response to this outbreak is substantially different from the one that greeted the swine H1N1 virus that emerged in 2009.

(Continue . . .)

As I’ve pointed out before, every time this virus jumps from a pig to a human it gets another chance to better adapt to human physiology. Given enough chances, it could evolve into a greater public health threat.

So far, we’ve been lucky enough not to have seen a child’s death, or serious illness from this virus.

But when we do, you can be sure some aspects of the media a will have a field day excoriating the county fair, local officials, and health department that `let it happen’.

Admittedly, the suggestion to close the pig exhibits to the public will not be popular in the farm belt, or among pork producers (who have gone to great lengths to distance themselves from any connection to `swine flu’).

But whether the industry likes to admit it or not, pigs are highly susceptible to the influenza virus - and can even serve as `mixing vessels’ - allowing viruses to reassort into new hybrid strains.

The pandemic virus that emerged in the spring of 2009 was the end product of several influenza strains that had kicked around the world’s swine population for many years, trading bits of genetic material back and forth, until they produced a version capable of jumping to humans.

The H3N2v virus is likewise a reassortant virus; swine H3N2 combined with the M (matrix) gene from the 2009 H1N1 virus. While the odds of seeing a pandemic emerge from this H3N2v virus appear low right now, they are not zero.

Whatever negative publicity the pork industry might suffer from temporarily shuttering pig exhibits would pale in comparison to the backlash they would see should another swine-origin flu virus take off in a big way in the human population.

Nevertheless, the proposal to shutter pig barns is bound to be a sensitive one. It is going to be interesting to see how public health departments, fair officials, and the pork lobby react to Dr. Osterholm’s suggestion in the coming days.

For more on the flu risks from swine reassortments, I’d heartily recommend Helen Branswell’s terrific piece in SciAm from late 2010 called Flu Factories.

Flu Factories

The next pandemic virus may be circulating on U.S. pig farms, but health officials are struggling to see past the front gate

By Helen Branswell | December 27, 2010 |

And for some of my earlier looks at swine influenza, you may wish to revisit:

H3N2v: When Pigs Flu

You Say You Want An Evolution?

The (Swine) Influenza Reassortment Puzzle

Branswell On Lifting The H5N1 Research Moratorium

BSL-4 Lab Worker - Photo Credit –USAMRIID

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Six months ago, in response to the rising chorus of concern over the biosecurity aspects of conducting H5N1 research, a 60 day moratorium was announced by a group of 39 leading scientists (see Scientists Announce 60 Day Moratorium On Some H5N1 Research).

While the research papers that originally sparked this controversy have now been published, the self-imposed moratorium remains in place.

Next week a meeting will be held in New York City of members of the Centers of Excellence for Influenza Research and Surveillance (CEIRS), and the subject of what to do about these research restrictions is expected to be part of their talks.

The inimitable Helen Branswell of the Canadian Press brings us the inside details on the difficult and controversial path ahead to undoing the H5N1 research moratorium:

As key flu scientists meet, question looms: When will bird flu studies resume?

By Helen Branswell, The Canadian Press | The Canadian Press – 42 minutes ago

Six months after leading influenza scientists announced they would voluntarily halt research into what it takes to make bird flu viruses transmit among mammals, it's still not clear when and how the cease-work order will be lifted.

(Continue . . .)

Highly recommended.

Pediatrics: Low Uptake Of Flu Vaccine Among Toddlers In Ontario

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Despite a universal vaccination program that began in the year 2000, a study published today in the journal Pediatrics indicates that flu vaccination rates among young children (aged 6 mos- 23 mos) in Ontario, Canada (analyzed between 2002 and 2008) never exceeded 10%.

This in spite of a SARS outbreak in 2003, and a high publicized serious flu season in 2003-04. This study did not extend into the 2009-10 pandemic flu season.

The authors suggest that `vaccine fatigue’ among parents may be a major factor in this low uptake, but acknowledge that several other Canadian provinces are doing a better job at getting kids vaccinated.

With the large number vaccines recommended for young children - and unfounded fears among some parents (popularly spread in the media and online) that too many inoculations, too soon, can cause serious health problems – some doctors are having to decide which vaccines to promote to parents as being the most important.

First the journal article, then a link to Helen Branswell’s coverage of this story.

Low Rates of Influenza Immunization in Young Children Under Ontario’s Universal Influenza Immunization Program

Michael A. Campitelli, MPH, Miho Inoue, MD, MSc, Andrew J. Calzavara, MSc, Jeffrey C. Kwong, MD, MSc, and Astrid Guttmann, MDCM, MSc

Abstract

OBJECTIVES: To determine physician-administered influenza vaccine coverage for children aged 6 to 23 months in a jurisdiction with a universal influenza immunization program during 2002–2009 and to describe predictors of vaccination.

<SNIP>

CONCLUSIONS: Influenza vaccine coverage among children aged 6 to 23 months in Ontario is low, despite a universal vaccination program and high primary care visit rates. Interventions to improve coverage should target both physicians and families.

Helen Branswell of the Canadian Press has more on all of this in her article:

May 14, 2012 Updated: May 14, 2012 | 6:52 am

Flu shot program misses children under two in Ontario: study

While far from perfect, flu vaccines remain our best protection against influenza, seasonal or otherwise. They have an enviable safety record, and most years they provide a moderate level of protection against currently circulating flu strains (see A Comprehensive Flu Vaccine Effectiveness Meta-Analysis).

Unfortunately, a combination of bad press from anti-vaccine activists, memories of the ill-fated 1976 H1N1 vaccination campaign (see Deja Flu, Once Again), and the mistaken belief that influenza is a mild illness all lead to many in the public to avoid getting the flu vaccine each year.

Our most recent mild flu season notwithstanding, most years influenza claims tens of thousands of lives in North America, including those of hundreds of children.

Convincing the public of the wisdom of getting the shot every year, however, remains a difficult task.

NSABB Clears H5N1 Studies For Publication

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From Helen Branswell this evening, a report that the NSABB – after reviewing new data submitted by flu researcher Ron Fouchier – has cleared the way for the publication of both his, and Yoshihiro Kawaoka’s work on ferret transmissible H5N1.

The vote to publish Karaoka’s paper was unanimous, while the vote for Fourchier’s was 12 to 6.

The NSABB serves in an advisory capacity only, and it will be up to the United States government to either accept or reject their recommendations.

Follow the link below for the story by Helen Branswell.

US biosecurity panel clears publication path for controversial bird flu studies

By Helen Branswell, The Canadian Press |

For more on what the future of U.S. government sponsored life sciences research will look like, you may wish to revisit yesterday’s blog on U.S. Issues New DURC Oversight Rules.

NSABB To Re-examine H5N1 Research Risks

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Today and tomorrow the NSABB (National Science Advisory Board for Biosecurity) will reconvene to re-examine the issues surrounding the publication of controversial H5N1 research that produced a ferret-transmissible strain of bird flu.

Last September, Ron Fouchier from the Netherlands (and almost simultaneously Professor Yoshihiro Kawaoka from Wisconsin) announced success in creating enhanced strains of the avian flu virus in the laboratory, which subsequently unleashed a firestorm of controversy.

For some background, see Katherine Harmon’s Sci-Am article , New Scientist: Five Easy Mutations, & NPR: Bio-Terrorism Concerns Over Bird Flu Research.

Over the ensuing six months we’ve seen a steady stream of opinion pieces from both sides of this debate (see H5N1 Research: A Plethora Of Positions), including side forays into the lethality of the H5N1 virus (see The Great CFR Divide).

This week we’ve seen the release of additional dueling commentaries, three of which Lisa Schnirring of CIDRAP NEWS highlighted last night in her article:

Scientists volley ahead of more dual-use H5N1 debate

Lisa Schnirring Staff Writer

Mar 28, 2012 (CIDRAP News) – As researchers from both sides of the debate over two controversial H5N1 studies weighed in yesterday on full publication versus a more cautionary approach, two US journals said they are developing policies to address any future such instances.

(Continue . . .)

The NSABB serves strictly in an advisory role, and any policy decisions must come from the United States government. Nonetheless, all eyes will be on the NSABB as they consider this issue.

And I can think of no one better than Helen Branswell of the Canadian Press to preview this meeting for us:

Biosecurity panel reconvenes to reexamine controversial bird flu studies

3-28-12 6:31 PM EDT By Helen Branswell

A bid from some quarters in the U.S. to resolve the ongoing controversy over two unpublished bird flu studies will begin to play out over the next two days as government biosecurity advisers reconvene to reconsider the issue.

The National Science Advisory Board for Biosecurity will meet Thursday and Friday in Washington, D.C., to go over revised versions of the two studies and hear about the work from their principal authors, noted flu virologists Ron Fouchier of Erasmus Medical Centre in Rotterdam, the Netherlands, and Yoshihiro Kawaoka of the University of Wisconsin-Madison.

(Continue . . . )

Branswell: WHO Hopes H5N1 Studies Can Be Published By Summer

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Helen Branswell has details this afternoon on the hopes, expressed by Dr. Keiji Fukuda – the World Health Organization’s lead official on influenza – that the two controversial H5N1 studies by Ron Fouchier and Yoshihiro Kawaoka can be published by summer.

Since I’m still nursing an injured wrist, I’ll just get out of the way and invite you to read:

The Canadian Press - ONLINE EDITION

WHO hopes controversial bird flu studies will be published by summer

By: Helen Branswell, The Canadian Press

Branswell On The Transmissibility Of The H3N2v Virus

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Helen Branswell has the details this evening on a study just published in PNAS that looks at the transmissibility of the Swine H3N2v virus, that was detected among a dozen people across five states during the second half of 2011.

Although this virus has yet to take off in the human population, researchers believe it has at least some potential to spread.

Follow the link to read:

Ferret study suggests new swine flu virus may have pandemic potential

By: Helen Branswell, The Canadian Press

20/02/2012 2:15 PM

For more background on this H3N2 swine flu variant, you way wish to revisit.

CDC/Medscape Video: Expert Guidance On The H3N2v Virus

WHO/FAO/OIE: Call It A(H3N2)v

WHO Comment: Testing For Novel Flu Viruses

Branswell On The New trH3N2 Flu Virus

CIDRAP: New Details In The trH3N2 Story

CDC Update On Iowa trH3N2 Cases

Branswell On the CFR Of H5N1

Credit CDC PHIL - BSL-4 Lab Worker

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Yesterday we saw an article in Nature by Declan Butler that looked at the evidence (for and against) a high CFR (case fatality ratio) for the H5N1 virus (see Declan Butler On the CFR Of H5N1).

This, as you probably know, has been a major topic of debate in recent weeks as the controversy over H5N1 research in ferrets roils on. Some researchers maintain that the virus is not nearly as dangerous as others have portrayed.

Helen Branswell weighs in with her own highly informative piece, which appears in Scientific American today.

Follow the link to read:

Dread Reckoning: H5N1 Bird Flu May Be Less Deadly to Humans Than Previously Thought--or Not

Are fears of human-to-human transmitted bird flu overblown or does it make sense, based on current fatality rates, to anticipate a worst-case scenario for a future outbreak of H5N1 flu?

By Helen Branswell | February 14, 2012

Eurosurveillance: Older People May Be Susceptible To The H3N2v Virus

H1N1v virus

# 6104

The detection of a new swine H3N2v virus among a handful of people across five states in recent months has sparked concerns that a new influenza virus might be trying to establish a foothold in the human population.

Since the infections reported in the 2nd half of 2011 were predominantly among young children, there has been some speculation that those over the age of 20 might have some limited immunity to this strain.

The CDC, in their January 6th MMWR Update: Influenza A (H3N2)v Transmission and Guidelines — Five States, 2011, writes:

Limited serologic studies conducted to date indicate that young children have little preexisting immunity to influenza A (H3N2)v viruses. Because the hemagglutinin genes of these viruses are related to human influenza A (H3N2) viruses that circulated in the 1990s, older children and adults might have limited immunity against these viruses

Yesterday the Journal Eurosurveillance printed an article called:

Cross-reactive antibody to swine influenza A(H3N2) subtype virus in children and adults before and after immunisation with 2010/11 trivalent inactivated influenza vaccine in Canada, August to November 2010

by DM Skowronski, G De Serres, NZ Janjua, JL Gardy, V Gilca, M Dionne, ME Hamelin, C Rhéaume, G Boivin

As the title might suggest, this isn’t exactly `light’ reading.

Luckily we’ve the talented Helen Branswell to lead us through this medical morass, in her report for the Canadian Press. As with any Branswell article, you would be well served to follow the link and read the whole thing.

Older adults may also be vulnerable to new swine influenza virus, study suggests

By: Helen Branswell, The Canadian Press

Briefly, the Eurosurveillance study finds indications that acquired immunity carried by adults from exposure to similar viruses that were circulating prior to 1990 may wear off as adults age.

Since years when the H3N2 seasonal flu dominates often result in a more severe flu season, any decline in immunity among the elderly elicits concern.

Right now, the H3N2v virus hasn’t shown the ability to spread efficiently in the human population, although some human-to-human transmission has occurred.

But over time, it may acquire that ability.

Which is why the CDC is working on a vaccine (see H3N2v Vaccine Trials) for this new strain should the need arise.

Meanwhile, with the exception of reports out of Mexico where they are seeing a large number of H1N1 cases, influenza reports in North America and Europe remain well below average for this time of year.

WHO: Will Host H5N1 Talks In Geneva

# 6094

On Friday a coalition of H5N1 researchers offered a 60 day moratorium on controversial bird flu research in order to `allow time for international discussion’ (see Scientists Announce 60 Day Moratorium On Some H5N1 Research).

Late yesterday the World Health Organization announced that they will host talks in Geneva among a small group of scientists next month. As you might expect, @HelenBranswell of the Canadian Press is all over this story.

Follow the link to read her coverage:

Meeting to address bird flu research impasse: WHO

The Canadian Press

Date: Saturday Jan. 21, 2012 5:39 PM ET

A small -- in relative terms -- group of technical experts will be invited to Geneva in mid-February to begin the difficult task of trying to break an impasse arising from the proposed publication of controversial bird flu research, the World Health Organization revealed Saturday.

(Continue . . .)

With both sides seemingly solidly entrenched,we’ll have to wait to see whether any substantial compromises can be forged during this relatively short 60 day time-out.

Branswell On The Research Moratorium

# 6089

Tonight Helen Branswell provides us with context and comments from no less than Ron Fouchier, Dr. Anthony Fauci, and Michael Osterholm on the big flu story of the day; the 60 day moratorium being offered on conducting certain types of bird flu research.

At this point I’m going to do the sensible thing; step aside and invite you to follow the link below to read the whole story.

Flu scientists halt research on lab-made viruses for 60 days to foster talks

Helen Branswell, Friday, January 20, 2012 8:4 PM

Branswell: WHO on H5N1 Research Controversy

# 6051

Note: I’ve been otherwise occupied today, dealing with unexpected family matters and haven’t had an opportunity to post.

So I’m happy to report that Crof over at Crofsblog has posted a number of stories, including one from Helen Branswell on the World Health Organization, and the incredibly complex and controversial issues they must consider regarding bird flu research projects around the world.

As always with a Branswell story, you’ll want to follow the link and read it in its entirety.

Controversial bird flu studies raise complex problem, defy easy solutions: WHO

Helen Branswell, Wednesday, January 04, 2012 2:49 PM

Read it on Global News: Global Calgary | Controversial bird flu studies raise complex problem, defy easy solutions: WHO

I hope to be back blogging regularly tomorrow, but in the meantime check Crof, Arkanoid Legent, and A Times Memory – along with FluTrackers and the Flu Wiki – for breaking flu & infectious disease news.

Publish or Perish The Thought?

# 6039

This morning Helen Branswell of the Canadian Press brings us the debate on the possibility that the NSABB may request a temporary moratorium on the publication of sensitive bird flu research projects until a new policy on such matters can be established.

You’ll find comments by a virtual who’s who of influenza virology, including Paul Keim of the NSABB, Malik Peiris of the University of Hong Kong, Richard Webby from the WHO reference laboratory at St Judes Children's Hospital in Memphis, Tenn., Dr. Anthony Fauci director of NIAID, and Michael Osterholm, director of CIDRAP.

As with any story from Helen, the only sensible thing for this blogger to do is to step aside and invite you read the entire story at the link below.

Bird flu study controversy could lead to research chill

12/27/2011 | Helen Branswell, The Canadian Press

Three Would Make For A Crowded Viral Field

Will we have to add another Influenza A strain to this chart?

# 6034

Although our knowledge of what influenza viruses were in circulation prior to 1918 is very limited, we do know that from 1918 to 1977 only one influenza A virus seemed to circulate in humans at a time.

In 1918, the H1N1 virus appeared (although it wasn’t isolated until the 1930s), replacing whatever had been in circulation before it. And H1N1 reigned supreme for nearly 40 years, until a new upstart virus – called H2N2 – appeared with the pandemic of 1957, driving H1N1 into obscurity.

Eleven years later, another pandemic virus – called H3N2 – arrived with the Hong Kong Flu of 1968, and H2N2 followed H1N1 into the viral dustbin.

So naturally scientists assumed that the natural order of things was to have only one influenza A virus dominant at a time. True, there might be small isolated outbreaks of differing strains, but it appeared that only one could be king of the viral mountain.

Then in 1977, the H1N1 virus mysteriously reappeared after an absence of 20 years (possibly escaping from a Russian or Chinese research lab) . . . and this time, it did not drive out the currently circulating H3N2 virus.

Since those over the age of 20 had some immunity to the H1N1 virus, it mainly affected children. Some scientists believed that this left a substantial reservoir of adults susceptible to the H3N2 virus, allowing its survival.

Suddenly we had two influenza A viruses (H1N1 & H3N2) co-circulating - along with a couple of B strains - and that status quo continued until the spring of 2009 when a new H1N1 swine flu virus arrived on the scene.

While the new H1N1 virus supplanted the old seasonal H1N1 virus, it did not displace the H3N2 virus, which again left us with two co-circulating influenza A viruses.

Fast forward a couple of years, and today we are seeing some new variants of both H3N2 and H1N1 swine viruses popping up, apparently the result of the 2009 pandemic virus re-entering the swine population and reassorting with other swine flu viruses to produce hybrids.

While the number of human infections with these novel flu viruses remains small, the concern is that one (or perhaps more) of these variant viruses could end up adapting well enough to humans to begin to spread efficiently.

Most researchers are downplaying the pandemic potential for these variant viruses – at least in their present form – since there is probably a fair amount of community immunity to them, particularly among adults.

While the future of these variant viruses is impossible to see, the possibility exists that we could end up seeing three influenza A viruses co-circulating.

Helen Branswell of the Canadian Press brings us more on this possibility in her report from last night. As always with a Branswell story, you should follow the link and read it in its entirety.

U.S. finds new human infection with swine H3N2 flu

Updated: Fri Dec. 23 2011 17:16:22
The Canadian Press

U.S. public health officials have found another case of human infection with a swine-origin H3N2 virus, this time in a child from West Virginia. And they also reported finding a human infection with a new swine influenza virus never before seen in humans, in a person in Wisconsin who had contact with pigs.

(Continue . . . )

Yesterday the CDC prepared and released a small avalanche of guidance documents on these emerging variant viruses.

Yesterday I linked to Guidance For People Involved In Raising Swine and the early release MMWR on H3N2v Transmission and Guidelines.

Today, you’ll find links to interim guidance documents designed for Healthcare professionals.

Prevention Strategies for Seasonal and Influenza A(H3N2)v in Health Care Settings

Interim Guidance for Influenza Surveillance: Additional specimen collection for detection of Influenza A(H3N2)v Virus infections

Interim Guidance on Specimen Collection, Processing, and Testing for Patients with Suspect Influenza A(H3N2)v Virus Infection

Interim Guidance on Case Definitions to be Used For Investigations of Influenza A(H3N2)v Virus Cases

The public health risk from these variant viruses appears low at this time, but the CDC reminds us:

While there is no evidence that sustained human to human transmission is occurring, all influenza viruses have the capacity to change and it's possible that this virus may become widespread.

Which makes maintaining good flu hygiene this winter (washing/sanitizing your hands, covering coughs & sneezes, staying home when sick), and getting your seasonal flu shot, your best strategies to avoid getting sick during holiday season.

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