H5N1

More on the NSABB H5N1 decision

Via Nature News & Comment, a report by Declan Butler and Heidi Ledford: US biosecurity board moves towards publication of revised mutant flu studies. Excerpt:

The US National Science Advisory Board for Biosecurity (NSABB) today recommended the publication of two controversial avian flu papers. 

In December 2011, the board said that experimental details of the two studies should be redacted from any publications, because of concerns that the information could be used in a bioterror attack. The board also feared that publishing the details would prompt more laboratories to work on the viruses, making an accidental release more likely. 

Today, after a two-day meeting, the board decided to revise its earlier decision. The NSABB unanimously recommended full publication of one of the two disputed papers, a manuscript submitted to Nature by Yoshihiro Kawaoka of the University of Wisconsin and his colleagues. 

“We at Nature are delighted,” said Nature’s editor-in-chief, Philip Campbell. “Subject to any outstanding regulatory or legal issues, we intend to proceed with publication as soon as possible.” 

But in a 12 to 6 vote, the board advised only the publication of the data, methods, and conclusions of a second manuscript, submitted to Science by Ron Fouchier of Erasmus Medical Center in the Netherlands. 

Kawaoka says he believes that the board’s revised decision was influenced by a better understanding of the public health implications of the work, which described the changes in a key viral protein called hemagglutinin that could make avian flu more transmissible among mammals. “We were able to explain that very few mutations are needed for the hemagglutinin of the currently circulating H5N1 viruses to become a hemagglutinin that supports respiratory droplet transmission in ferrets.” he says 

The revised NSABB opinion brings the board closer in line with the World Health Organization, which last month advised full publication of both papers. The NSABB is only an independent advisory board, and the US government has yet to weigh in with any official decision on the new NSABB recommendations. 

Publication of the manuscripts may also be impacted by export controls in various countries. Such controls can be used to regulate the dissemination of restricted information.

Dr. Vincent Racaniello, who has been very involved in this debate, has also posted some comments on his Virology Blog.

Branswell: US biosecurity panel clears publication path for controversial bird flu studies

Via The Winnipeg Free Press, Helen Branswell of The Canadian Press writes: US biosecurity panel clears publication path for controversial bird flu studies. Excerpt:

A panel of U.S. biosecurity experts has withdrawn its objection to the publication of two controversial bird flu studies, clearing the way for the work to be disseminated by leading scientific journals. 

The National Science Advisory Board for Biosecurity said Friday that after reviewing revised versions of the studies it is recommending they can be published in full. 

The decision came at the end of a two-day meeting during which the authors explained their work and took questions from the board members. As well, the group was presented with unpublished data showing the mutations used in the studies are cropping up in H5N1 viruses in the wild. 

The board voted unanimously to clear the path to publication for work done by virologist Yoshihiro Kawaoka of the University of Wisconsin-Madison. But it voted 12 to six on a second paper by Dutch virologist Ron Fouchier from Erasmus Medical Centre in Rotterdam. 

"Of course we are very much relieved," Fouchier told The Canadian Press in an interview. He said he didn't know why Kawaoka's work was cleared by a unanimous vote and his was not. 

"Yoshi got a straight A. I just got a B," he said. "It would have been nice if we would have got a unanimous decision on our paper also. But if this it the way it is, this is the way it is. 

"I'm still happy."

H5N1: Bungling dual-use governance

Via The Bulletin of the Atomic Scientists, an article by Alexander Kelle: H5N1: Bungling dual-use governance. Here's the first of his three objections (the other two are lack of US governance and hijacked global governance):

1. Weird science. Clearly, in the two unpublished papers submitted to Science and Nature, the arguments and the methods used to arrive at the conclusions -- that H5N1 is highly adaptable, transmissible, and deadly -- must have been strong, coherent, and unambiguous; otherwise, the papers would not have been accepted for publication by these top journals. 

However, after the board recommendation to publish only redacted versions of the papers by the teams led by Fouchier and Kawaoka, the scientific narrative began to change and can currently at best be described as a moving target. 

A January 25 article in the US journal PNAS (Proceedings of the National Academy of Sciences) claims that the case fatality rate for H5N1 has been misrepresented by the World Health Organization (WHO) and is "likely orders of magnitude too high" and "fear needs to be put to rest." In plain speak, according to the PNAS article, H5N1 is apparently a much less dangerous virus than everybody up to now thought and therefore is unsuitable as a bioterrorism agent. 

However, as John Treanor, an expert on influenza vaccines at the University of Rochester, puts it: If that is actually the case and "H5 infections are no more serious than the regular flu," it raises a question -- "Why are you spending all this money studying it?" So far, those trying to play down risks associated with H5N1 have not provided an answer to this question. 

Meanwhile, an article in the American Society for Microbiology's mBio journal asserts that ferrets are not good models for transmissibility among humans. Thus, even though transmissibility among ferrets has been demonstrated in the experiments conducted by Fouchier and Kawaoka, this does not mean that, if humans were exposed to the genetically modified strains, a pandemic would result. 

Yet this argument is also puzzling: Fouchier and Kawaoka are respected scientists; obviously they thought that H5N1 studies in ferrets would provide some reliable information that could be extrapolated to a human population. Otherwise, there was no point in using the ferret model to study the virus in the first place (unless one is deeply concerned with the plight of ferrets).

Even if one accepts that the H5N1 case fatality rate is overestimated, that ferrets are poor models of study, and that scientific uncertainty in this case exists, it would seem that the very same uncertainty also means that a pandemic cannot be excluded. As Lisa Murillo from Los Alamos National Laboratory argues, "The consequences of underestimating these viruses' pathogenicity or propensity for transmission among humans are simply too great."

Canadian budget hits basic science

Via Nature News & Comment: Canadian budget hits basic science. Excerpt and then a comment and link:

Canada's latest budget will slash spending on the environment and push for more collaboration between basic researchers and industry. The changes are aimed at stimulating the economy and balancing the budget by 2015, but researchers fear that they will undermine the country's long-term competitiveness. The budget is the first since the Conservative party gained a majority in parliament last year. 

“This is disastrous,” says James Turk, executive director of the Canadian Association of University Teachers in Ottawa, Ontario. “The government has no understanding of how scientific advancement is made. No appreciation of blue-sky research.” 

Like many nations in the West, Canada has been under pressure to cut spending, balance its budget, and stimulate its sluggish economy. The 500-page budget will ease the environmental review of major projects and cut 12,000 government jobs, while boosting investment in industrial research and natural-resources development. 

Losers and winners 

To balance its budget in three years, the government introduced a cost-cutting exercise to its 68 departments and agencies, asking each to envisage scenarios of 5–10% reductions in their bottom lines. 

Under the resulting cuts, funding to the environment portfolio will drop by 8.3%. Environment Canda will lose Can$13.3 million (US$13.3 million) from its Can$1.1 billion budget this year, and Can$31.5 million and Can$53.8 million in the following two years. The announced cuts could mean more job losses at the agency, which announced in August that 700 positions might change or disappear by 2014 (see 'Canadian ozone network faces axe'). 

The budget also eliminates a federal advisory panel on the environment. The National Round Table on the Environment and the Economy, an independent agency established in the 1990s, studied questions of climate, water, energy, biodiversity and governance, and offered advice to the Canadian prime minister. 

But its reports frequently challenged the government’s views, says Andrew Weaver, a climate modeller at the University of Victoria in British Columbia. Combined with the announced cuts at Environment Canada, it is clear that “the environment is a huge loser in this budget,” he says.  

To enhance partnerships between industry and academia, the budget includes a Can$37-million annual boost to the country’s three main granting agencies — the Canadian Institutes for Health Research (CIHR), the Natural Sciences and Engineering Research Council (NSERC), and the Social Sciences and Humanities Research Council. 

But the money will have to come from savings generated within each council. The NSERC and the CIHR have each planned savings of Can$15 million to their approximately Can$1-billion budgets in 2012–13, increasing to Can$30 million for each of the next two years.

We've been aware for years of the Harper government's hostility to science, but couldn't understand it. Last week The Tyee published an article that may explain its roots in religion. It's not just a political problem; it's ultimately a public-health issue. As I keep quoting Virchow: "Politics is nothing but the practice of medicine on a large scale." Or in the case of our present government, malpractice.

Ireland: Low-path avian flu in County Cork

Via RTE News: Outbreak of bird flu reported in Co Cork. Excerpt:

There has been an outbreak of avian flu in a small flock of pheasants in Co Cork.

The preliminary test results show that while it is what is called the H5 strain, it is not the most pathogenic H5N1 strain of the virus. Further tests are being carried out to establish the precise strain. 

As a purely precautionary measure, the 100 birds on the affected premises are being slaughtered and all necessary biosecurity measures have been put in place. 

The Department of Agriculture says additional laboratory test results will be available early next week and it will review the measures being announced today on the basis of those results. 

In line with established procedures and in accordance with EU regulations, as a further precautionary measure a 1km temporary restriction zone has been put in place around the premises. 

Within this zone, additional surveillance is being undertaken and the movement of poultry, other birds and their products and other animals on poultry holdings is prohibited, except under license from the Regional Veterinary Office. 

It is important to note that there is no concerns relating to the consumption of poultry meat or poultry meat products and there are no restrictions on poultry movements outside the zone.

China: Surging hand-foot-mouth disease in Hunan

Via Xinhua: Surging hand-foot-mouth disease in Hunan. Excerpt:

Central China's Hunan province has witnessed a surge in cases of hand-foot-mouth disease since the beginning of this month, local health authorities said Friday. 

More than 1,000 cases have been reported in the province over the past week, according to the provincial disease control and prevention center. 

The center said Hunan had already recorded more patients suffering with the disease this year than in the same period of 2011, and the epidemic would become severer in April, when it reaches its peak. 

Children under three years old are especially susceptible to break-outs of hand-foot-mouth. The virus is usually transmitted through digestive and respiratory systems or through intimate contact. 

The infectious disease starts with a slight fever followed by blisters and ulcers in the mouth and rashes on the hands and feet. 

The Hunan provincial disease control and prevention center has since ordered measures to closely monitor and prevent cases of the disease, especially at primary schools and kindergartens.

Nigeria: H5N1 risk raised by biosecurity failures

Via The Poultry Site: Bird Flu Risk Raised by Biosecurity Failures in Nigeria. Excerpt:

Biosecurity failures were revealed in a survey of poultry farming in Kogi state, according to new research at Ahmadu Bello University, raising the risk of the introduction and spread of highly pathogenic avian influenza (HPAI) in the area. Better knowledge and understanding by stakeholders would help reduce the risks, say the researchers. 

Kogi state did not report Highly Pathogenic Avian Influenza (HPAI) during the 2006-2008 outbreaks in Nigeria despite the presence of favourable factors for the occurrence of the disease, according to researchers at Ahmadu Bello University in Zaria. 

In a paper published in International Journal of Poultry Science, O.N. Ameji and colleagues describe a survey conducted among stakeholders using structured questionnaires to determine the level of awareness, knowledge and readiness to report outbreak of HPAI and biosecurity practices in Kogi state. 

Awareness was 100 per cent but knowledge of HPAI was low at just 9.1 per cent. Readiness to report HPAI outbreak to relevant authorities was high at 75.3 per cent but about 20 per cent of respondents were not prepared to report to any authority. 

Biosecurity practices evaluated by the presence of movement control was 38.8 per cent; presence of footbath was rare (11.8 per cent); handling of sick birds by isolation and treatment was 40 per cent; improper disposal of dead birds in refuse dump was high (85.9 per cent) and extensive management system was high (60.76 per cent).

Moving towards a universal flu vaccine

Via Nature News & Comment: Moving towards a universal flu vaccine. Excerpt:

Multimeric-001, an influenza vaccine now in clinical trials, boosts immunity in elderly people when given as a supplement to the seasonal shot. But supplementation is just a short-term goal: eventually the drug’s maker, BiondVax Pharmaceuticals of Ness Ziona, Israel, believes that Multimeric-001 alone could protect against all strains of flu. 

The company will present the results from its second phase II trial of the shot on 3 April at the Second Annual Vaccines Congress in London. The 90 people aged 65 and older who got the pair of shots, compared to 30 who received only the annual vaccine, mounted a stronger immune response to the three seasonal flu strains, as well as to a few other strains not in the seasonal vaccine. 

For most infectious agents, one exposure teaches the body’s immune system to recognize and destroy the virus or bacterium. The standard flu vaccine teaches the body to recognize the virus's outer coating. But influenza is constantly changing its stripes, mutating from year to year and forcing scientists to guess which three strains to include in the seasonal vaccine. 

“This is crazy,” says Vincent Racaniello, a virologist at Columbia University in New York, who is not involved with the Biondvax trials. If there were one vaccine that worked for any kind of flu, no matter how it mutated its coat, the costs of protection would drop and pandemics could disappear, he says. 

The Multimeric-001 vaccine comprises nine linked sections from three flu proteins from different parts of the virus. These represent a “common denominator” shared by more than 10,000 flu strains since 1940, says the company’s chief scientist Tamar Ben-Yedidia. Racaniello says that, in theory, this combination or proteins should be universal, because every strain of flu would have them. 

In a study published in February in the Journal of Clinical Immunology, BiondVax reported that its Multimeric-001 vaccine was safe and conferred immunity on its own. However, BiondVax thinks that a universal flu vaccine would be a tough sell to regulatory agencies. Part of the challenge is that the standard test for a vaccine’s efficacy is based on the presence of antibodies to the ever-changing parts of the haemagglutinin protein on the outside of the virus in a vaccinated person's blood. It’s a test their universal vaccine is designed to fail, because Multimeric-001 does not confer immunity to these proteins. 

Instead, the company hopes to obtain approval for Multimeric-001 as a supplement to the three-strain annual vaccine, then track the first recipients of the shot to see if they suffer from fewer flu infections. The company is focusing on people aged 65 and older, who tend not to get much benefit from the regular shot — Ben-Yedidia says that only 30% of older people achieve immunity after the seasonal vaccine, and they account for 90% of flu deaths.

Epidemiologist uses film in fight against S.Africa gold-mine TB

Via Reuters AlertNet News Blog: Epidemiologist uses film in fight against S.Africa gold-mine TB. Excerpt:

Jonathan Smith is trying to fight disease with facts, figures and – emotion. 

Smith is using data-driven research as the basis for a documentary film he hopes will raise awareness about the plight of migrant workers in South African gold mines who, according to a 2011 report published in the American Journal of Public Health, contract tuberculosis (TB) at a rate 10 times higher than the populations from which they come. 

Working conditions in the mines create a high-risk environment for TB transmission because of poor ventilation, exposure to silica dust and high HIV rates, said Smith, an epidemiology lecturer at Yale University in New Haven, Connecticut, in an interview. 

Migrant workers are sent home “to die” by the mining firms once they contract TB, spreading it into other parts of Africa already hard hit by the disease, he added. 

The conditions in South African gold mines, which also cause silicosis, a lung disease which makes people highly susceptible to tuberculosis, have inspired a class action legal case.

Dengue virus turns mosquitoes hungry

Via the Mumbai Mirror: Dengue virus turns mosquitoes hungry. Excerpt:

Scientists have shown for the first time that infection with dengue virus turns on mosquito genes that makes them hungrier and better feeders, and therefore possibly more likely to spread the disease to humans.  

Specifically, the researchers from the Johns Hopkins Bloomberg School of Public Health found that dengue virus infection of the mosquito's salivary gland triggered a response that involved genes of the insect's immune system, feeding behaviour and the mosquito's ability to sense odours.  

Dengue virus is primarily spread to people by the mosquito Aedes aegypti. Over 2.5 billion people live in areas where dengue fever is endemic. The World Health Organization estimates that there are between 50 million and 100 million dengue infections each year.  

"Our study shows that the dengue virus infects mosquito organs, the salivary glands and antennae that are essential for finding and feeding on a human host. This infection induces odorant-binding protein genes, which enable the mosquito to sense odours," George Dimopoulus, senior author of the study, said.  

"The virus may, therefore, facilitate the mosquito's host-seeking ability, and could-at least theoretically-increase transmission efficiency, although we don't fully understand the relationships between feeding efficiency and virus transmission.  

"In other words, a hungrier mosquito with a better ability to sense food is more likely to spread dengue virus," he said.