Influenza Virus Mashup

Via the Public Health Agency of Canada: Biosafety Advisory: Efficiently Transmissible Engineered Influenza A H5N1 Viruses. Excerpt:

Influenza A H5N1 is a highly pathogenic avian influenza virus that emerged as a human pathogen in 1997 when it was transmitted from avian populations to humans in Hong Kong. Since then, various countries around the world have reported human infections, particularly in Southeast Asia, the Middle East, and Africa. From 2003 to 2011, 574 human cases and 337 deaths have been confirmed by the World Health Organization; this correlates to a mortality rate of 59%. H5N1 can cause death in healthy individuals with no pre-existing medical conditions. 

In November 2011, three independent studies on H5N1 transmission in ferrets were either published online or submitted for publication. These studies have received a significant amount of attention due to their relative success in producing engineered H5N1 viruses capable of efficient transmission in ferrets, including via the air. Ferrets are considered a good model for studying human influenza viruses. The engineered transmissible H5N1 viruses are not currently in circulation, but it is widely agreed that if released, the clinical and economic impact could be devastating.

The advisory goes on to specify CL4 as minimum containment levels for any experiments involving efficient H2H transmission of H5N1.

Via The Guardian: Brazil takes steps to deal with influx of Haitian migrants. Excerpt: 

The Brazilian government is to give aid to two states in the north-west that have seen a recent increase in the number of Haitian migrants. This week, the ministry for social development announced it was to give around US$520,000 to the states of Acre and Amazonas. The first tranche of funds is expected to become available over the next month. 

The continued hardship in Haiti after the devastating earthquake in January 2010 has forced thousands of people to flee to other Latin American countries in search of a better life. 

The bulk of the money – around $300,000 – will support programmes in Amazonas, which has recorded more than 4,600 Haitians in the state. 

Acre has around 1,400 migrants. The government had already granted the state $750,000 to support its overloaded health service. 

The new money will be used to implement a series of programmes through local government bodies. These will provide food and accommodation to Haitians, as well as access to a special health service that will work independently from the national system, to meet the specific needs of the migrants. Some Haitians arrive in Brazil suffering from diseases such as cholera. Brazil's health ministry is anxious to ensure these don't spread to the local population. 

Other programmes will tackle education and skills. Portuguese language classes will be offered to immigrants who wish to work.

This is an act of remarkable political decency. It's also smart public-health policy. It ought to shame the US, which routinely turns back Haitians willing to risk their lives in search of work and safety.

Via the Public Health Agency of Canada: Biosafety Advisory: Efficiently Transmissible Engineered Influenza A H5N1 Viruses. Excerpt:

Influenza A H5N1 is a highly pathogenic avian influenza virus that emerged as a human pathogen in 1997 when it was transmitted from avian populations to humans in Hong Kong. Since then, various countries around the world have reported human infections, particularly in Southeast Asia, the Middle East, and Africa. From 2003 to 2011, 574 human cases and 337 deaths have been confirmed by the World Health Organization; this correlates to a mortality rate of 59%. H5N1 can cause death in healthy individuals with no pre-existing medical conditions. 

In November 2011, three independent studies on H5N1 transmission in ferrets were either published online or submitted for publication. These studies have received a significant amount of attention due to their relative success in producing engineered H5N1 viruses capable of efficient transmission in ferrets, including via the air. Ferrets are considered a good model for studying human influenza viruses. The engineered transmissible H5N1 viruses are not currently in circulation, but it is widely agreed that if released, the clinical and economic impact could be devastating.

The advisory goes on to specify CL4 as minimum containment levels for any experiments involving efficient H2H transmission of H5N1.

Thanks to A Time's Memory for posting this: Mysterious infection kills 1 soldier; 19 in quarantine (Colombia Reports, February 1 2012). I did some digging and found a report in El Colombiano. Without doing a word-for-word translation, the story says the soldier, Óscar Vela, died of pneumonia after contracting H1N1. Other soldiers also fell ill with flu but have been under close medical observation and are recovering.

Via CIDRAP, Lisa Schnirring reports: Study finds influenza B may be more severe than thought. Excerpt:

An autopsy study involving influenza B infections revealed how histologically similar the disease is to fatal influenza A and how quickly it can kill, challenging the notion that it is milder than influenza A. 

The investigators, from the US Centers for Disease Control and Prevention (CDC), also found a high level of cardiac injury with fatal influenza B infections, especially in younger patients. 

The research group said that comprehensive studies of influenza B deaths involving large series of patients and comparing those with and without bacterial pneumonia are lacking. Their findings appeared yesterday in the Journal of Infectious Diseases. 

Scientists know more about influenza A, because they keep close watch for unpredictable antigenic changes and the virus is found in a wide range of birds and mammals. 

In contrast, only two influenza B lineages circulate in humans. Though influenza B doesn't often dominate during flu seasons, mortality in epidemics involving the strain are typically somewhere in the middle for seasonal strains—more than for H1N1, but less than for H3N2. 

Influenza B is more fatal in children, though the disease can cause a substantial number of seasonal flu infections in adults, including some deaths, according to the researchers. 

The researchers obtained autopsy tissue samples submitted to the CDC from May 2000 until February 2010. They noted that supplemental clinical data were better for samples collected after 2003, when fatal pediatric flu infections became a nationally notifiable condition. 

Histopathological examinations assessed airway, lung, cardiac, and lymph node tissue for evidence of influenza B. For lung tissue samples that had intraalveolar inflammatory cell infiltrates, researchers looked for evidence of bacterial coinfection. They examined cardiac tissue samples for signs of acute monocyte injury. 

RNA extracted from tissue samples was evaluated with reverse-transcriptase polymerase chain reaction (rRT-PCR) tests to detect influenza B hemagglutinin gene segments, and lineage-specific probes were used to identify Victoria-like and Yamagata-like viruses. 

Of the 45 case-patients, 29 were female and 16 male. The median age at death was 11 years, and 34 (76%) were younger than 18. For patients with available data, illnesses occurred between December and April, and preexisting medical conditions were present in 13 (43%). Of 35 patients with available information, 24 (69%) died within 4 days of illness onset. 

Seventeen (38%) had evidence of bacterial pneumonia, which was more common in patients older than 18. 

The most common pathologic finding, found in nearly all cases, was tracheal and bronchial inflammation. In 17 patients who had bacterial pneumonia, Staphylococcus aureus was found in 13 (76%), of whom 7 had genetic markers for methicillin resistance and 11 showed evidence of increased virulence.

Thanks to Helen Branswell for tweeting the link to this New York Times op-ed by Professor Howard Markel, a historian of medicine: Censorship Hinders Influenza Research. Excerpt:

The censorship of influenza research will do little to prevent its misuse by evildoers — and it may well hinder our ability to stop influenza outbreaks, whether natural or otherwise, when they do occur. 

In this case, censorship is too little, too late. The data generated by one of the research teams was already presented at a conference in Malta in September, where copies of the paper were distributed. But even if the data weren’t already available, the key details could likely be inferred from other information that is already available. 

I recently spoke with several prominent influenza scientists, all of whom agreed that, based on the knowledge that certain mutations can make H5N1 highly transmissible in ferrets, they could consult previously published literature and probably figure out what those mutations are. 

A terrorist-generated pandemic is a worrisome threat, but there are reasons not to be overly preoccupied with the prospect. Even if terrorists got their hands on the new data, it’s not certain they could weaponize the virus: no one knows for certain that the virus’s transmissibility and virulence in ferrets means transmissibility and virulence in humans. 

In any event, the influenza virus, highly variable in its power and spread, is not an optimal terrorist weapon, not least because no one would know for sure if it was unleashed by a terrorist or natural forces. 

A naturally occurring influenza pandemic is a far graver threat. And censorship of influenza research makes it harder to predict, treat and prevent such pandemics. Although modern medicine has made major advances since the deadly 1918 flu pandemic, we still know woefully little about the virus’s complex biology. 

Before the current controversy, the National Science Advisory Board for Biosecurity, which President George W. Bush created in 2004, reviewed two papers on the genetic sequencing of the 1918 influenza virus; those papers were published in 2005 without redactions — or negative consequences. 

As a result, we now know the valuable fact that the changes in the 1918 H1N1 virus that made it so effective at infecting humans were not found in the 2009 H1N1 pandemic virus (sometimes called swine flu).

Via Channel NewsAsia: Bird flu claims second victim this year in Vietnam. Excerpt:

The 26-year-old woman from Soc Trang province in the Mekong delta died on January 28. Tests on the victim after she died confirmed she had contracted the H5N1 virus, the Hanoi-based Preventive Healthcare department said. 

"The victim culled and ate sick chicken. There had also been sick and dead poultry around her residence," it said in a report.

And that's what amazes me. According to WHO, Vietnam had 120 human H5N1 cases before this one, and 60 deaths. People in Vietnam have been dying of H5N1 since 2003, and the government seems to be running a good campaign against it. Yet people are still eating sick chickens—whether out of ignorance or a misplaced sense of thrift.

(Wed, 01 Feb 2012 19:05:00 +0000)

# 6116

Crof over at Crofsblog (link Vietnam: 2012’s second H5N1 death confirmed) has picked up an English language report from TuoiTreNews.vn of a recent H5N1 fatality in Soc Trang Province.

Reportedly this involves a 26-year-old female who fell ill after slaughtering and eating `infected meat’.

Assuming a confirmation from the World Health Organization, this would make the second human case reported in Mekong Delta region of Vietnam this year (the first occurring in Kiên Giang Province).

Via the Daily News, a quick follow-up to the story posted here this morning: Chicken deaths: bird flu not suspected. Excerpt:

Investigations have confirmed that bird flu was not the cause of the large number of chicken deaths reported from the Bingiriya area on Tuesday, Animal Production and Health Department Director General, Kumar de Silva told Daily News. 

Two teams of specialists comprising of doctors from the Contagious Diseases Research Division, Health Ministry and the World Health Organisation conducted an awareness programme for the medical staff of the Bingiriya area yesterday. 

Steps were taken to provide secure medical equipment to the Chilaw and Bingiriya hospitals as a precautionary step.

(Wed, 01 Feb 2012 17:06:00 +0000)

# 6115

Among the many fascinating topics Maryn McKenna covered in her book Superbug: The Fatal Menace of MRSA was the possibility that a vaccine might someday be developed against this growing epidemic of antibiotic resistant staph.

Today, Maryn follows up with a terrific feature that appears in the prestigious Journal Nature, which focuses on Robert Daum, the founder of the University of Chicago’s MRSA Research Center, and others who are in search of this as-yet elusive goal.

Follow the link to read:

 

Vaccine development: Man vs MRSA

For decades, Robert Daum has studied the havoc wreaked by methicillin-resistant Staphylococcus aureus. Now he thinks he can stop it for good.

• Maryn McKenna

01 February 2012