Showing posts with label John Oxford. Show all posts
Showing posts with label John Oxford. Show all posts

Another Yank From Oxford

 

 

 

 

# 5863

 

 

The 2010-2011 flu season across much of the northern hemisphere was unremarkable, but there were a few notable exceptions. The UK saw a dramatic resurgence of the 2009 H1N1 virus in December of 2010, stressing hospital ICUs across Britain.

 

According to the HPA’s figures . . . with the exception of the swine flu pandemic of 2009 . . .  last year’s flu epidemic in Great Britain was the worst in nearly a decade.

 

image

These, and many other flu graphics, are available from HPA Weekly National Influenza Graphs (PDF, 687 KB).

 

North America in contrast, which was dominated by the H3N2 virus, saw a relatively mild flu epidemic last year.  Despite that, flu claimed thousands of American lives last year.

 

Giving further evidence that influenza is notoriously unpredictable. Even during the same year, the strains and severity can vary widely across the globe.

 

Still, this time of year many scientists look towards the slowly waning flu season south of the equator for clues as to how the northern hemisphere will fare this year.

 

As you might expect, the picture is mixed.  The following graphic comes from the World Health Organization’s  latest influenza surveillance report.

 

image

 

Influenza activity in South Africa and much of South America peaked early in their season and is on the decline (influenza B, however, is still circulating in parts of Africa at significant levels).

 

Australia and New Zealand are reporting continued, and relatively heavy, influenza activity.

 

The following graph comes from the latest Australian Influenza Surveillance report, and the pattern is similar to the one we saw in the first graphic from the HPA. 

image

Influenza activity this year (with the exception of the 2009 pandemic) is the highest they’ve recorded in recent years.  According to this report, so far:

 

. . .  in 2011, 14,222 (71%) cases were reported as influenza A (35% influenza A (untyped), 31%
pandemic (H1N1) 2009
and 5% A/H3N2) and 5,620 (28%) were influenza B.

 

All of which serves as prelude to a report today in the UK Express Newspaper, featuring interviews with several noted virologists including John Oxford - Scientific Director of Retroscreen Virology Ltd. and a Professor of Virology at St Bartholomew’s and the Royal London Hospital.

 

In the UK, when the press wants a quote or opinion on influenza or pandemic issues, you’ll find it often comes from Professor Oxford. 

 

At the start of the influenza pandemic of 2009 Oxford was publicly insisting that the real number of infected from the H1N1 virus in the UK was many times greater than the British government was saying (see A Yank From Oxford).

 

As it turned out, he was right. 

 

Today we have:

 

KILLER FLU TO GRIP BRITAIN

Many Britons have little immunity after two years of relatively limited outbreaks

Monday September 26,2011

 

Hyperbolic headlines aside (a `killer flu’ hits Britain every year. It’s really just a matter of degree), Professor Oxford is quoted as saying:

 

“No one is sure why our patterns of flu tend to follow what happens in the southern hemisphere during the summer but it does.

 

Unfortunately in Australia there has been a sharp outbreak with higher than normal numbers of flu strains A and B.

 

The chances are the same will happen here.”

 

He qualifies his statement later by saying that they really won’t know how the UK will fare until later in the year.

 

But even without the elevated flu levels reported in Australia, Oxford is concerned over a resurgence of Influenza B which as been overshadowed the past couple of years by the A/H1N1 strain.  

 

Community immunity to the B strain may be declining, and the virus can cause serious illness, particularly in the very young and very old.

 

 

Other scientists interviewed in this article are less willing to predict how the upcoming flu season will evolve, although all admit a heavy flu season is possible.

 

All of this comes amid controversy over the UK government’s decision not to publicly push their “Catch it. Kill it. Bin it” flu hygiene advertising campaign, or run PSAs encouraging vaccination.

 

Instead, the NHS is relying on a targeted flu vaccination plan for `at-risk’ populations through their network of GPs.

 

Another controversy is that only about a third of Health Care Workers (HCWs) in Britain voluntarily accepted the flu vaccine last year.

 

Professor Lindsey Davies, president of the UK Faculty of Public Health, calls that a “complete dereliction of duty” and warns that it could endanger the lives of `at-risk patients such as babies, the elderly, pregnant women and those with breathing trouble.’

 

Flu apathy, particularly in the wake of a pandemic that failed to live up to some people’s expectations, runs high in the UK and around the world.

 

Last year’s flu headlines (see The Pandemic Is Ended (But The Malady Lingers On) are all-but-forgotten, replaced by the latest crisis of the week.  It is hard for most people to worry about a flu that may come later this winter when the economy already appears to have pneumonia.

 

And so we find ourselves on the cusp of another flu season, peering ahead, but without much of a clue as to how it will pan out. 

 

The only certainty is that the flu will arrive – more or less on schedule – and even if it isn’t severe, it will sicken millions, hospitalize hundreds of thousands, and kill tens of thousands around the world.

 

Influenza can kill you, even in a `light’ flu season.

 

Reason enough to get a flu vaccine every year, and to practice good flu hygiene (covering coughs, sneezes, washing hands, staying home when sick, etc.) year round.

 

No, they are not guaranteed protection.  But they can give you a decided edge against a serious virus.

 

For more on influenza, vaccines, and prevention, I would invite you to visit:

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Robert Webster on The Bird Flu Threat

 

 


# 5848

 

 

I know Crof already posted excerpts last night, but the interview and bird flu backgrounder with Dr. Robert G. Webster that appeared yesterday in The Guardian is certainly worthy of further mention. 

 

Webster, as most of you know, is one of the world’s most acclaimed virologists, and is the head of the virology department of St Jude Children's Research Hospital in Memphis.

 

 

Robert Webster: 'We ignore bird flu at our peril'

With the UN issuing renewed warnings and a Hollywood disaster movie stoking our fears, bird flu is back in the news. We meet the man who first warned of a pandemic 50 years ago – and who is worried again now

 


Like many flu observers, Webster finds the evolution of the H5N1 virus in Egypt of particular concern.

 

Egypt has reported the greatest number of human infections over the past couple of years, and the virus has shown signs it may be slowly adapting more towards human physiology (see PLoS: Human-Type H5N1 Receptor Binding In Egypt).

 

While Webster’s greatest concern is with the H5N1 bird flu virus – mostly due to its high lethality - he acknowledges that other pandemic flu threats exist, and mentions the H9N2 avian virus which is widespread across much of Asia.

 

Earlier this summer (see PNAS: Reassortment Potential Of Avian H9N2) we looked at some of the ways that this avian virus could reassort into a more easily transmitted pathogen.

 

Last week, another virologist with impeccable credentials – Professor John Oxford, Scientific Director of Retroscreen Virology Ltd. and a Professor of Virology at St Bartholomew’s and the Royal London Hospital – expressed his own pandemic concerns in a online webinar (see Webinar: John Oxford On Pandemic Preparedness).

 

And 3 weeks ago, in Professor Peter Doherty On Bird Flu, we looked at his worries on the possibility that the H5N1 virus might one day swap genes (reassort) with the H1N1 virus and produce an easily transmitted, highly virulent flu strain.

 

And indeed, just last Friday we saw research (see Study: Reassorted H1N1-H5N1 Produced Virulent Strain) where a laboratory-created reassortant virus with genes taken from the H5N1 and H1N1 virus produced a highly transmissible and virulent strain.

 

Of course, while the world was waiting for bird flu, in 2009 a Swine flu virus unexpectedly sparked a global pandemic. We were fortunate that it wasn’t any more severe than it was, but it illustrates that there are many ways a pandemic can evolve.

 

 Zoonotic Jump

 

Detections of  trH3N2 swine flu viruses in Pennsylvania and Indiana over the past month are a fresh reminder of the need for establishing better global surveillance of humans, and of farm animals, in order to detect the next emerging influenza virus before it can spread widely.

 

There is a chance, albeit it small, that a limited outbreak could be stopped if detected early enough. 

 

That was done successfully in Hong Kong in 1997 when the H5N1 virus first emerged.

 

While it is always possible that the next pandemic will spring directly from the wild, the odds favor that it will come from a farm – where large numbers of animals intermingle, swap viruses, and come in daily contact with humans.

 

For more on the reassortment potential of avian, swine, and human flu viruses, you can’t do better than  Helen Branswell’s excellent Scientific American article from last December called Flu Factories, or her SciAm Podcast interview.

 

And for good measure, a sampling of a few of my earlier blogs on reassortment:

 

Review: Evolution & Adaptation Of The 2009 pdmH1N1 Virus

You Say You Want An Evolution?

EID Journal: Co-Infection By Influenza Strains

EID Journal: Swine Flu Reassortants In Pigs

If You’ve Seen One Triple Reassortant Swine Flu Virus . . .

 

 

Although we could get lucky and go years - or even decades - before the next pandemic emerges, another one could just as easily start tomorrow.

 

As Dr. Webster points out, we ignore these risks at our own peril.

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Webinar: John Oxford On Pandemic Preparedness

 

 

 

# 5825

 

With heightened pandemic awareness due to recent reports on the bird flu virus, a small number of novel swine flu cases showing up in Pennsylvania and Indiana, and the release of the movie Contagion this weekend, pandemic preparedness is once again ripe for discussion.

 

Professor John Oxford - Scientific Director of Retroscreen Virology Ltd. and a Professor of Virology at St Bartholomew’s and the Royal London Hospital, co-author of two standard medical texts, and author of more than 250 scientific papers – is often sought out for his expertise on pandemic influenza.

 

In the UK, when the BBC wants a quote or opinion on influenza or pandemic issues, you’ll find it often comes from Professor Oxford. 

 

At the start of the influenza pandemic of 2009 Oxford was publicly insisting that the real number of infected from the H1N1 virus in the UK was many times greater than the British government was saying (see A Yank From Oxford).

 

As it turned out, he was right. 

 


Later today (Sept 9th), Professor Oxford will take part in an online Webinar hosted by International SOS - a private sector healthcare, medical assistance, and security services company - where he will discuss last week’s announcement (see FAO Warns On Bird Flu) of an emerging new clade of the H5N1 virus, and pandemic preparedness issues for businesses and organizations. 

 

According to the Press Release, topics to be covered will include:

 

  • What is the real risk of another influenza pandemic? Has it increased?
  • When might the pandemic occur?
  • How severe might a bird flu H5N1 influenza pandemic be?
  • How prepared are we as a nation, and internationally, for a deadly virus?
  • What extra precautions should travelers and expatriates take when visiting / living in affected countries?

Following the discussion, webinar attendees are invited to participate in a Q&A session with the keynote speakers listed above.

WHEN:

Friday, Sept. 9, 2011

11 a.m. EDT

HOW:

Follow this link to join the webinar.

If you are unable to attend, use this link to request a recording, to be emailed no later than three business days after the webinar.

WHO: Human resources, security, risk and safety, travel, medical and business continuity professionals will benefit from this webinar.

 

 

Access to this webinar requires advance registration, after which you will receive instructions on how to attend via email.

 

Professor Oxford is never shy about sharing his views, and so this webinar ought to make for interesting viewing.

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UK: 2010 Flu Vaccine Policy Debated

 

 

 

# 5182

 

 

With the UK on the cusp of what may turn into the first major flu epidemic in a decade, difficult questions are being raised about this year’s flu vaccination policies. 

 

The NHS provides free influenza vaccines to groups deemed to be at high risk from the virus, and this year that includes:

 

It is recommended you have a flu jab if you:

  • are 65 or over
  • are pregnant (see below)
  • have a serious medical condition (see box)
  • live in a residential or nursing home
  • are the main carer for an elderly or disabled person whose welfare may be at risk if you fall ill
  • are a healthcare or social care professional directly involved in patient care
  • work with poultry (see below)

 

This is essentially a return to the pre-pandemic recommendations, based on the long standing determination that those over-65, and those with chronic health conditions, are most at risk from the influenza virus.

 

Children under the age of 5 were included (a carry over from last year’s pandemic) until The Independent Joint Committee on Vaccination and Immunisation dropped that recommendation last July.

 

Now . . .  with the HPA reporting (as of Dec. 24th) 460 people in intensive care, and 27 flu-related fatalities, this year’s vaccination policy has turned into a heated medical, scientific, and political debate.

 

The novel H1N1 virus – which since it emerged has shown a predilection for those under 65 – is once again the predominant strain of influenza in the UK (but not globally . . . go figure).

 

As a result, 89% of those in Intensive care units are under the age of 65.

 

There are now accusations being made in the media, and by some Shadow Ministers (members of Her Majesty's Loyal Opposition) that the exclusion of otherwise healthy under-5’s from the high-risk list was a cost cutting move, and ill advised.

 

It should be noted that by far, the most heavily impacted age group (based on ICU admissions) are those between the ages of 16-64 (79%).

 

Under-5’s made up about 6% of the total ICU admissions (n=26).

 

Details on how many of each group had pre-existing conditions, and would have been eligible for (or actually received) the jab, have not been made available.

 

 

Health Secretary Andrew Lansley is defending the decision, stating that their vaccination program was based based on age and risk factors and was continually under review.

 

 

This morning, a report from the BBC which includes statements by John Oxford, Professor of Virology at St Bartholomew’s and the Royal London Hospital, on our need to adapt to the changing threat from influenza.

 

 

28 December 2010 Last updated at 05:48 ET

Flu vaccine policy for children defended
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John Oxford On Pandemic H1N1

 

 

# 4631

 

 

Not being a virologist – or a scientist of any stripe –  I haven’t attempted to offer any personal opinions about how the pandemic H1N1 virus would play out. 

 

Frankly, I’ve no idea what happens next.

 

About the best I can do is to offer my readers the opinions of reputable scientists from around the world, and whenever possible, try to add a little context of my own.

 


One well respected scientist who remains vocal about the threat of H1N1 is Professor John Oxford, Scientific Director of Retroscreen Virology Ltd.  and a Professor of Virology at St Bartholomew’s and the Royal London Hospital, Queen Mary’s School of Medicine and Dentistry.

 

A little over a year ago Oxford was publicly insisting that the real number of infected from the H1N1 virus in the UK was many times greater than the British government was saying (see A Yank From Oxford).  

 

As it turned out, he was right. 

 

Oxford is concerned that the return of H1N1 in the fall could bring with it another bad flu season.  That we aren’t out of the woods just yet.

 

Oxford has suggested in the past that mutations in the H1N1 virus are less likely to occur until a certain amount of herd immunity is achieved. There have been studies that indicate that vaccination pressure may drive antigenic drift in flu viruses.

 

As the the supply of easily infected hosts dwindles, the virus must either learn to evade this acquired immunity or die off.

 

Oxford is extensively quoted in the Irish Times today concerning his views about the future of the H1N1 virus.   I’ve just excerpted the `money quote’ below. 

 

Follow the link to read the article in its entirety.  A hat tip to Roehl_JC on FluTrackers for this link.

 

 

I think that swine flu is still going to cause trouble, says virology professor

(EXCERPT)

“I think swine flu is still going to cause trouble,” says John Oxford, professor of virology at St Bartholomew’s and the Royal London Hospital, and scientific director at Retroscreen Virology, a contract research organisation that conducts trials on anti-viral drugs and vaccines.

 

“Great viruses start small and go big rather quickly, so we have to be careful,” he says. “Pandemic H1N1 is a virus with a sting in its tail and I think that’s what we have to contend with. It’s too early to do a postmortem. We will see what lies ahead, but viruses don’t go easily into this dark night.”

(Continue . . . )

 

 

Obviously, we’ll have to wait to see what happens this fall.  As I said, I’m not in the prediction business.

 

My advice today remains pretty much the same as what I gave thirteen months ago, before the pandemic was declared (see An Appropriate Level Of Concern).

 

Specifically, I suggested that everyone should :

  1. have a good family and business emergency plan
  2. acquire and maintain a 2-week stockpile of emergency supplies
  3. routinely practice good flu hygiene
  4. get the appropriate vaccines when they are available
  5. have and be a flu buddy
  6. look out for your neighbors and greater community

 

Last October, during the peak of the outbreak,  I stated:

 

I see no need to hunker down at home, or to live in fear over this virus.  This is a serious situation, of course. And tragically, this virus will claim thousands of lives over the next few months.

 

It certainly deserves your attention, vigilance, and respect.

 

But not your fear.

 

The same holds true today. 

 

Whatever should come this fall or winter, a little preparedness on your part will go a long way towards blunting its impact. And at the same time, you’ll be in pretty good stead to deal with any other crisis, like an earthquake, tornado, blizzard, or hurricane.

 

Which sounds like a win-win proposition to me.

 

For more preparedness information, go to:

 

FEMA http://www.fema.gov/index.shtm

 

READY.GOV http://www.ready.gov/

 

AMERICAN RED CROSS http://www.redcross.org/

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