четверг, 30 июня 2011 г.

UK Authorities Do Not Recommend Poultry Housing Requirement

Despite H5N1 being confirmed in Scotland, Scottish and UK Chief Veterinary Officers have concluded that a national poultry housing requirement would be disproportionate.


In a joint statement, they said that Scottish and UK officials are undertaking an urgent veterinary risk assessment and are liaising with ornithological experts to determine the level of any risk it may pose to livestock (poultry) and other kept birds.


Apart from measures already taking place in the Protection and Surveillance Zones (a radius of 10km around where the dead bird was found), authorities are still considering whether there is a need for any additional regional measures. Defra said that as soon as the full veterinary assessment is complete further advice will be available.


(Defra = Department for Environment, Food and Rural Affairs)


The two Chief Veterinary Officers stressed that Bird Flu (Avian Influenza) is a disease of birds and there is no reason for public health concern. For humans to become infected extremely close contact with infected birds, especially faeces, is required.


Department for Environment, Food and Rural Affairs



Written by:





среда, 29 июня 2011 г.

Novartis Obtains CHMP Positive Opinion For Its Investigational Pre-pandemic Influenza Vaccine Aflunov® To Help Protect Against (H5N1)

Novartis announced that the European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) has issued a positive opinion for Aflunov®, an investigational pre-pandemic avian influenza vaccine. The CHMP is endorsing the approval of Aflunov for active immunization against H5N1 subtype of Influenza A virus in adults 18 years of age and older. H5N1 (commonly referred to as avian or bird flu) accounts for most avian influenza outbreaks globally and is a serious health concern given its potential to evolve into a deadly pandemic strain at any time[6].


The CHMP recommendation serves as the basis for a European Commission licensing Decision. Based on the CHMP recommendation, a marketing authorization for Aflunov could be granted in all the European Union and EEA countries. The marketing authorization is expected to be granted before year-end.


"Upon approval, we expect Aflunov to be an important addition to our portfolio of pandemic preparedness solutions," said Andrin Oswald, Head of Novartis Vaccines and Diagnostics Division. "The onset of a pandemic can be very rapid, leaving little or no time to prepare. Vaccinating in advance may prevent the potential devastation of a pandemic outbreak."


H5N1 is presently the virus of greatest concern among all avian influenza viruses[7]. H5N1 is currently circulating in birds, poultry and many other animal species around the world and has already infected humans that have been in contact with infected animals[7],[8]. While human infections are continuing to rise, ability of the virus to spread from human to human has not been demonstrated yet[7]. To date, there have been more than 500 cases of serious illness and more than 300 deaths[5]. H5N1 morbidity and mortality rates remain significantly higher than those associated with seasonal influenza and any recent pandemic[4],[9],[10]. According to the World Health Organization (WHO), H5N1 has met all prerequisites for starting a pandemic except for the ability to spread efficiently and sustainably among humans[7].


Vaccines are considered the first line of defense against pandemic influenza[11]. Transmission of influenza virus during a pandemic can be rapid, leaving little or no time to prepare. Thus, proactive pre-pandemic vaccination to prime populations at risk or vaccine stockpiling may be a more adequate way to help protect those at risk of H5N1 infection[12], those who would form the first line of response during a potential pandemic, such as healthcare and emergency workers, and those critical to maintaining business and economic continuity.


In clinical trials, two doses of Aflunov demonstrated antibody titers considered protective in more than 85% of vaccinated individuals (homologous seroprotection rate)[13]. Aflunov was also shown to elicit cross-reactive antibodies against many of the H5 strains that have caused human disease[14]. Additionally, a single vaccination with Aflunov (H5N1, A/Vietnam/1194/2004) induced high and rapid serological response in subjects primed 6-8 years previously with two doses of a different surrogate H5 vaccine, having same formulation and including the same MF59 adjuvant as Aflunov but using the strain H5N3.















The EU regulatory filing for Aflunov will form the basis for further filings in other parts of the world including Asia, where H5N1 has been reported in many countries[7].


About Aflunov


Aflunov is an investigational influenza vaccine for the active immunization against H5N1 subtype of Influenza A virus. H5N1 is commonly referred as avian or bird flu. Aflunov contains the MF59 adjuvant and is intended for use before or upon declaration of a H5N1 avian influenza pandemic. In clinical trials Aflunov has demonstrated a broad and durable immune response[1],[2],[3], with tolerability comparable to seasonal adjuvanted vaccines[15]. It can be stockpiled for future use with sufficient shelf life.


Disclaimer


The foregoing release contains forward-looking statements that can be identified by terminology such as "may," "endorsing," "potential," "expect," "potentially," "recommendation," "can," "expected," "will," "could" or similar expressions, or by express or implied discussions regarding potential additional marketing approvals for Aflunov or regarding potential future revenues from Aflunov. You should not place undue reliance on these statements. Such forward-looking statements reflect the current views of management regarding future events, and involve known and unknown risks, uncertainties and other factors that may cause actual results with Aflunov to be materially different from any future results, performance or achievements expressed or implied by such statements. There can be no guarantee that Aflunov will be approved for sale in any additional market. Nor can there be any guarantee that Aflunov will achieve any particular levels of revenue in the future. In particular, management's expectations regarding Aflunov could be affected by, among other things, unexpected regulatory actions or delays or government regulation generally; unexpected clinical trial results, including unexpected new clinical data and unexpected additional analysis of existing clinical data; unexpected world flu or other disease patterns; the company's ability to obtain or maintain patent or other proprietary intellectual property protection; competition in general; government, industry and general public pricing pressures; the impact that the foregoing factors could have on the values attributed to the Novartis Group's assets and liabilities as recorded in the Group's consolidated balance sheet, and other risks and factors referred to in Novartis AG's current Form 20-F on file with the US Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those anticipated, believed, estimated or expected. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of new information, future events or otherwise.


References


[1] Galli, G et al. (2009). Adjuvanted H5N1 vaccine induces early CD4 T cell response that predicts long-term persistence of protective antibody levels. Proceedings of the National Academy of Sciences; 106(10): 3877-3882.


[2] Stephenson I, et al. (2008). Antigenically Distinct MF59-Adjuvanted Vaccine to Boost Immunity to H5N1. New England Journal of Medicine; 359:1631-1633.


[3] Novartis Data on File [V87P3].


[4] Centers for Disease Control and Prevention. (2008).


[5] World Health Organization. Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO.


[6] Centers for Disease Control and Prevention. (2007). Key Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus.


[7] World Health Organization. (2006). Avian influenza (" bird flu").


[8] Centers for Disease Control and Prevention. (2008). Questions and Answers About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus.


[9] World Health Organization. (2009). Fact sheet no. 211. Influenza (Seasonal).


[10] Vaillant L, La Ruche G, Tarantola A, Barboza P, for the Epidemic Intelligence team at InVS. Epidemiology of fatal cases associated with pandemic H1N1 influenza 2009. Euro Surveill. 2009; 14(33): pii=19309.


[11] World Health Organization. Responding to the avian influenza pandemic threat. Recommended strategic actions.


[12] Jennings LC, Monto AS, Chan PK, Szucs T, Nicholson KG(2008) Stockpiling influenza vaccines: A cornerstone of pandemic plans. The Lancet Infectious Diseases 8:650-658.


[13] Banzhoff, A. et al. (2009). MF59®-Adjuvanted H5N1 Vaccine Induces Immunologic Memory and Heterotypic Antibody Responses in Non-Elderly and Elderly Adults. PLoS ONE 4(2): e4384.


[14] Banzhoff, A. et al. (2008). MF59-adjuvanted vaccines for seasonal and pandemic influenza prophylaxis. Influenza and Other Respiratory Viruses, 2:243-249.


[15] Novartis Data on File [V87P13].


Source: Novartis

вторник, 28 июня 2011 г.

Google Battles Bugs & Viruses - Announces More Than $14 Million In Grants To Partners Working To Predict And Prevent The Next Pandemic

Google, the philanthropic arm of Google (NASDAQ:GOOG), has announced grants of more than $14 million to support partners working in Southeast Asia and Africa to prevent the next pandemic. Google's Predict and Prevent initiative is supporting efforts to identify hot spots where diseases may emerge, detect new pathogens circulating in animal and human populations, and respond to outbreaks before they become global crises. Several new lethal infectious diseases crop up every year. Examples include the well-known killers, HIV/AIDS, bird flu, and SARS, as well as drug-resistant strains of ancient scourges malaria and tuberculosis. Three-quarters of new diseases are zoonoses, meaning they've jumped from animals to humans.


"Business as usual won't prevent the next AIDS or SARS. The teams we're funding today are on the frontiers of digital and genetic early detection technology. We hope that their work, with partners across environmental, animal, and human health boundaries, will help solve centuries-old problems and save millions of lives," said Dr. Larry Brilliant, Executive Director, Google.


Identifying hot spots


Knowing where to look is critical to disease surveillance. Climate change and deforestation increase human-animal contact, and with it, disease spreads. "The holy grail is to predict disease outbreaks before they happen. For Rift Valley fever and malaria, long-term weather forecasts and deforestation maps can show us where to look for outbreaks, up to six months in advance," said Frank Rijsberman, Program Director, Google.


- The Woods Hole Research Center - $2 million multi-year grant to support high-resolution satellite mapping of forests to enhance monitoring of forest loss and settlement expansion in tropical countries. WHRC will create information to share with environmental and human experts so they can better anticipate the emergence of infectious diseases. For more information, please visit whrc/.


- Columbia University International Research Institute for Climate and Society (IRI) - $900,000 multi-year grant to improve the use of forecasts, rainfall data and other climate information in East Africa, and link weather and climate experts to health specialists so they can better predict outbreaks of infectious diseases. For more information, please visit portal.iri.columbia/portal/server.pt.















- University Corporation for Atmospheric Research - $900,000 multi-year grant to build and implement a system that will use weather projections to inform and target response to disease threats in West Africa. For more information, please visit ucar/.


Detecting diseases earlier


Genetic detection filters viral information in DNA to uncover deadly new pathogens, and digital detection mines online data to reveal early signals of possible epidemics. "We want to stop viruses dead in their tracks - their animal tracks - before they jump to humans," noted Dr. Mark Smolinski, Google's Threat Detective.


- Global Viral Forecasting Initiative (GVFI) - $5.5 million multi-year grant (with equal funding from the Skoll Foundation) to support the collection and analysis of blood samples of humans and animals in hot spots within Cameroon, Democratic Republic of Congo, China, Malaysia, Lao PDR and Madagascar. The GVFI team, headed by Dr. Nathan Wolfe, has demonstrated that potentially pathogenic animal viruses jump more frequently to humans than previously believed and will work to detect early evidence of future pandemics. For more information, please visit gvfi/index.html.


- Columbia University Mailman School of Public Health - $2.5 million multi-year grant to support research to accelerate the discovery of new pathogens, and to enable rapid, regional response to outbreaks by establishing molecular diagnostics in hot spot countries including Sierra Leone and Bangladesh. Dr. Ian Lipkin and colleagues have discovered more than 75 viruses to date, established critical links between infection and the development of acute and chronic diseases, including pneumonia, meningitis/encephalitis, cancer, and mental illness. For more information, please visit cii.columbia/.


- Children's Hospital Corporation supporting Healthmap and ProMED-mail - $3M multi-year grant to combine HealthMap's digital detection efforts with ProMED-mail's global network of human, animal, and ecosystem health specialists. Together, these programs will assess current emerging disease reporting systems, expand regional networks in Africa and Southeast Asia, and develop new tools to improve the detection and reporting of outbreaks. For more information please visit childrenshospital/, healthmap/en, and promedmail/pls/otn/f?p=2400:1000.


"On every continent, viruses move from animals into people. GVFI's mission is to monitor this viral exchange. Working in animal markets, with restaurant workers, and with hunters at the end of the road, we sort through this traffic to try to stop deadly diseases before they spread," said Dr. Nathan Wolfe, Founder and Director, Global Viral Forecasting Initiative.


For more information and a Google Earth Layer highlighting the grantees, please visit google/predict.html.


About Google Inc.


Google's innovative search technologies connect millions of people around the world with information every day. Founded in 1998 by Stanford Ph.D. students Larry Page and Sergey Brin, Google today is a top web property in all major global markets. Google's targeted advertising program provides businesses of all sizes with measurable results, while enhancing the overall web experience for users. Google is headquartered in Silicon Valley with offices throughout the Americas, Europe and Asia. For more information, please visit google.


About Google


Google, the philanthropic arm of Google, uses the power of information to help people better their lives. We develop and invest in tools and partnerships that can help bring shared knowledge to bear on the world's most pressing challenges in the areas of climate change, economic development and global health. For more information, visit google.


Source

Katy Bacon

Google

понедельник, 27 июня 2011 г.

Government Tests Human Influenza Plan

The Government's response to a human flu pandemic was tested in Exercise Winter Willow on Monday 19th and Tuesday 20th February.



The exercise fully tested the UK's ability to manage the effects of an influenza pandemic by playing out the decision-making process at national, regional and local levels, when there are widespread cases across the country. A human flu pandemic would occur when a new flu virus, to which people had little or no natural immunity, emerged.



The biggest exercise of its kind to study the response of the NHS, local authorities and Government Departments to pandemic flu - it was an excellent opportunity to evaluate the planning presumptions, policy and operational procedures across Government and the NHS. The findings of Exercise Winter Willow will then be fed into the overall pandemic flu preparedness plan.



Chief Medical Officer for England, Sir Liam Donaldson, said of the exercise:



"When a 'flu pandemic hits the country the top priority for the Government is to protect the public. The World Health Organization has said that the UK is at the forefront of preparations internationally, but it is always necessary to test our responses and improve them where required. This exercise is another part of the continual testing, refining, and developing of our plans.



"The NHS is ready to implement its well-rehearsed plan."



For further information please go to:
UK Department of Health

воскресенье, 26 июня 2011 г.

Bird Flu Vaccines Lose Their Strength

The initial doses of bird flu vaccines that were stockpiled by US authorities are less effective now - they lose their strength over time. As the vaccines have a shorter 'shelf-life' than was first expected, it is possible that the US stockpile would now cover one million fewer people than previously thought.


In other words - as the vaccines have a shorter shelf-life than we had previously thought, many of the first ones that were bought may now not be so good.

(Shelf life = How long a drug can be kept/stored before it has to be thrown away. A bit like 'expiry date' on foods. If a drug has a two-year shelf life and was made on 1 January, 2007, it must be discarded by the end of 2008.)


Authorities may have to re-think their contingency plans. It was first thought that by having large stocks of H5N1 vaccines, a nation would be better prepared against a possible pandemic by vaccinating health workers, key personnel and other high-risk groups.


Even so, authorities stressed that the loss of strength is gradual, not total. It does not mean that the strength of the oldest vaccines in stock have gone down from 100 to zero.


Novartis Wins Contract To Top Up USA H5N1 Vaccine Stockpile


Novartis has been awarded a $40.95 million contract to top up the USA's bird flu vaccine stockpile. US authorities aim to have enough vaccines to cover 20 million people. Last year Novartis was awarded a $62.5 million contract.


The pre-pandemic egg-based vaccine will be manufactured by Novartis in 2007 in Liverpool, UK.


Written by:





суббота, 25 июня 2011 г.

Avian Influenza Virus In Manitoba Confirmed To Be Low Pathogenic, Canada

The Canadian Food Inspection Agency (CFIA) has confirmed that the virus detected in a commercial poultry operation in the Rural Municipality of Rockwood, Manitoba is low pathogenic H5N2 avian influenza.


Pathogenicity refers to the severity of the illness caused in birds.


The infected farm remains under quarantine, and all birds in the operation will be humanely destroyed within days. As a precautionary measure, the CFIA has also quarantined a local hatchery and two poultry farms that had significant contact with the infected farm.


Avian influenza viruses do not pose risks to food safety when poultry and poultry products are properly handled and cooked. Avian influenza rarely affects humans, unless they are of specific types and there has been close contact with infected birds.


Animal health and public health authorities from the Province of Manitoba, local poultry specialists and industry are actively collaborating on the response to avian influenza in the Manitoba poultry operation, and in supporting the producer.


For information on safe food handling, please visit here.


Source:

Canadian Food Inspection Agency

пятница, 24 июня 2011 г.

West Nile Virus Threat Reduced By Diversity Among Bird Populations In Surrounding Area

A more diverse bird population can help lower the incidence of West
Nile virus in the surrounding human population, in a process called the
"dilution effect," according to an article released in the open access
journal PLoS ONE on June 25, 2008.



West Nile Virus, usually infecting birds but also affecting humans, is
often passed through mosquitoes. Part of the Japanese encephalitis
family of viruses, it's symptoms have three phases, but include fever,
chills, and diaphoresis.



In the dilution effect, an increased level of biodiversity in wildlife
results in a lower risk for humans to be infected by animal diseases.
This was first reported in Lyme disease, but this new study, it has
been demonstrated in a vector with an avian host. This effect, relating
biodiversity of birds to West Nile Virus, is the largest application
thusfar of the dilution effect, and may also apply to other infectious
diseases such as avian flu or bubonic plague, according to the authors.




John P. Swaddle and Stavros E. Calos worked with the National Center
for Ecological Analysis and Synthesis (NCEAS) at the Univeristy of
California, Santa Barbara, synthesizing existing data to make
inferences for management and policy applications. "We don't yet know
the precise mechanism that drives this pattern, but
it's likely to be due to diverse areas having relatively few of the
bird species that are particularly competent hosts and reservoirs for
the virus," Swaddle said.A set of qualities that makes a species best
able to contract a particular disease is known as host competence. The
highest levels of host competence for West Nile Virus are found in
rows, jays, thrushes and sparrows, which also happen to thrive when
avian biodiversity is lowest.



This research has many implications, according to Swaddlepoints: by
attracting more land species, land management policies could increase
biodiversity and thus decrease the number of human infection rates in
an outbreak of West Nile Virus. "Biodiversity is giving us a public
health service that people have rarely considered and the value of this
service should be considered when developing land and managing bird
populations in the future," Swaddle said.



About the National Center for Ecological Analysis and Synthesis:




The National Center for Ecological Analysis and Synthesis (NCEAS) was
established in 1995. The organization has hosted more than 3,500
scientists from

over 50 countries, and supported more than 430 collaborative projects
in ecology and related fields. NCEAS scientists develop new
techniques in

informatics, and apply general knowledge of ecological systems to
specific issues such as the loss of biotic diversity, global change, and

sustainability of marine ecosystems. NCEAS is among the top 1 % of
38,000 institutions evaluated for scientific impact in environmental
research.

NCEAS is funded by the National Science Foundation, the State of
California, the University of California, and numerous other donors.



About PLoS ONE



All works published in PLoS
ONE
are open-access. Everything is immediately available - to read, download,
redistribute, include in databases and otherwise use - without cost to
anyone, anywhere, subject only to the condition that the original
authorship and source are properly attributed. Copyright is retained by
the authors. The Public Library of Science uses the Creative Commons
Attribution License.



PLoS ONE is
the first journal of primary research from all areas of science to
employ both pre- and post-publication peer review to maximize the
impact of every report it publishes. PLoS ONE
is published by the Public Library of Science (PLoS), the Open-access
publisher whose goal is to make the world's scientific and medical
literature a public resource.



Increased Avian Diversity Is Associated with Lower Incidence
of Human West Nile Infection: Observation of the Dilution Effect.

Swaddle JP, Calos SE

PLoS ONE 3(6): e2488.

doi:10.1371/journal.pone.0002488

Click
Here For Full Length Article



Written by Anna Sophia McKenney




четверг, 23 июня 2011 г.

Trust For America's Health On New HHS Influenza Pandemic Draft Guidance

Trust for America's Health (TFAH) issued the following statement on the release of The U.S. Department of Health and Human Services (HHS) Draft Guidances to Assist in Preparation for an Influenza Pandemic, emphasizing that the federal government must do all it can to ensure it protects every American from a potential pandemic flu outbreak, especially those who are employed by smaller businesses that may not have the ability or resources to fully prepare.


"Asking employers and families to take tangible steps to prepare in advance for a pandemic influenza outbreak is step in the right direction. However, the federal government must assure that all Americans have access to the protections HHS recommends," said Jeff Levi, Director of the Trust for America's Health. "An employee of a small to mid-size company should not be penalized because the enterprise can not afford the costs of acquiring, storing and dispensing antiviral medications during a flu pandemic.


"Nor is it reasonable for every American family to stockpile the recommended 20 respirator masks per household or the up to 100 facemasks per family at a cost of $35.00 - $70.00. Even for the families that can afford to stockpile masks, children would likely be left unprotected. There is still no Federal Drug Administration-approved respirator mask for kids, despite the warning by the Centers for Disease Control and Prevention that children can be more susceptible than adults to infection, and compared to adults, children usually shed more influenza virus for a longer period of time.


"In the event of a pandemic outbreak, leaving the massive costs and logistical responsibilities to businesses and individuals, without the assurance of equal access to key prevention strategies, like antivirals and respirator masks, is not an option. The government must assure all Americans are protected, regardless of where they live or work."


Trust for America's Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.


Trust for America's Health

среда, 22 июня 2011 г.

Bird Flu Could Strike Again In India, FAO Warns

India is to be commended for its successful efforts to control the recent worst-ever outbreak of highly pathogenic avian influenza in the state of West Bengal, FAO said. The agency warned, however, that intensive surveillance should continue in high-risk areas as the possibility of new outbreaks remains high.



"Intensive culling in the predominantly backyard poultry sector appears to have stopped the disease in its tracks," said FAO veterinary expert Mohinder Oberoi after a recent field trip to the affected areas.



"The political and financial commitment from the government of India and the state of Bengal to stamp out the disease was instrumental in this success. Public awareness campaigns, a strong command chain from districts to villages, compensation payments and an effective collaboration between animal and human health departments at field level, have been the key factors for the success," Oberoi said.



No new disease outbreaks have been discovered since 2 February 2008.



FAO's Chief Veterinary Officer Joseph Domenech urged to maintain intensive surveillance in high risk areas as the possibility of new outbreaks remains high. "The virus could still be present in the environment despite heavy slaughtering and extensive disinfection of affected areas, or it could be reintroduced from other countries," he said.



In order to achieve rapid control, prevent virus spread to other states and to avoid the risk of human infection the government of India had to cull over 3.9 million chickens and ducks, mainly belonging to poor backyard poultry farmers.



The socio-economic impact of this control campaign should be urgently assessed in order to better define and apply the necessary mitigation measures regarding the negative impacts of massive culling on poor small holders, FAO said. Live bird markets, migration of wild birds and transportation routes of birds and poultry products should be mapped to better understand and control the spread of the disease.



Public awareness campaigns should continue over the next months introducing rural communities to safe poultry production and basic biosecurity measures with the ultimate goal of reducing the risk of human infections.



The recent outbreak of avian influenza in West Bengal, and the ongoing spread of the disease in Bangladesh require close collaboration between affected countries, FAO said. FAO, in collaboration with the World Organisation for Animal Health (OIE), has invited India, Bangladesh, Nepal, Bhutan and Myanmar to participate in a regional meeting to better coordinate avian influenza control campaigns. The Government of Nepal has agreed to host the meeting in Kathmandu.





fao

вторник, 21 июня 2011 г.

"No-Evacuation Required During A Bird Flu Outbreak" Breakthrough Technology To Be Presented At The 5th International Bird Flu Summit, USA

The worldwide fear against the pandemic threat of the avian flu is soon to be allayed at the 5th International Bird Flu Summit organized by New-Fields Exhibition Inc., as Dr. Norio Ogata of the Japanese Taiko Pharmaceutical Co., Ltd. presents, for the first time in an international conference, the company's experimental data and practical applications of chlorine dioxide against pandemic influenza. The product to be launched uses chlorine dioxide gas to create virus-free living spaces. With this breakthrough method in infection control, "It isn't necessary to evacuate people from workplaces", explains Dr. Ogata.


Together with this Taiko launching, the 5th В International Bird Flu Summit slated on September 27 and 28 in Las Vegas Nevada will also cover discussions on pandemic prevention, preparedness, response, and recovery and will feature public and private sector leaders addressing the threat of a Bird Flu pandemic and a possible human-to-human transmission. Participants will include distinguished scientists, public health officials, law enforcers, first responders and other experts.


The summit draws on the successes of the four previous summits held in Washington andВ  Geneva, Switzerland. Like in the past summits, attendees will also have a unique chance to come face-to-face with doctors who have treated fatal human cases of bird flu such as Dr. Sardikin Giripatro, of the Indonesian Investigation and Verification Team for Avian Influenza Outbreaks.


The summit will host public health officials and bird flu experts from more than 30 countries. This global event is open to all interested businesses and organizations from all countries.


About Taiko Pharmaceutical Co., Ltd.


Taiko Pharmaceutical Co., Ltd. of Japan is known for gastrointestinal pharmaceuticals since its founding in 1940.В  В 


Taiko's chlorine dioxide product has three forms, one is a precisely controlled chlorine dioxide gas generating machine. The machine is installed adjacent to an air-conditioner of a building and the gas generated is introduced in the duct of the air-conditioner to disinfect air of a large room. Another form is a desktop-type small gas generating gel. The "gel" is used on top of a desk or table or stuck to a wall of a room to disinfect air in a relatively small room.В  The third is chlorine dioxide solution used as a spray to disinfect an object's surface. seirogan.co.jp/english


About New-Fields


New Fields Exhibitions, Inc. is a leading emerging markets and business information provider, producing trade shows that produce results for companies worldwide. With offices in the Asia Pacific Region and Washington, DC, the company provides marketing services in the areas of construction, energy, oil & gas, telecommunications and health care.

new-fields

понедельник, 20 июня 2011 г.

Bird Flu And Developing Countries - A New Resource

The Science and Development Network (SciDev) today launches a new online BIRD FLU DOSSIER designed to keep readers up-to-date on the latest information on bird flu and developing nations.


Since originating in Asia, the H5N1 bird flu virus has spread widely and is causing problems in many developing countries. The human flu pandemic that the virus could trigger will also hit these countries hardest.


There is urgent need for policymakers to make informed decisions, for scientists to share their findings, and for the media to communicate the pandemic threat in a measured and accurate manner.


SciDev's dossier aims to support these groups by providing authoritative and comprehensive coverage on the spread of H5N1 and efforts to prepare for a human flu pandemic.


The dossier also contains the internet's most comprehensive bird flu glossary and links to relevant reports, articles, websites and organisations. This includes free access to the latest relevant research papers appearing in the journals Science and Nature.


The Science and Development Network


The Science and Development Network (SciDev) seeks to help individuals and organisations in the developing world make informed decisions on science and technology related issues that impact on social and economic development.


It does this by providing reliable and authoritative information through a free-access website containing news, views and analysis about science and technology in the developing world.


In addition, SciDev builds regional networks of individuals and institutions who share its commitment to improving science and technology communication, and organises workshops and other events in the developing world to build capacity in this field.


SciDev is supported by the journals Nature and Science, as well as the Academy of Sciences for the Developing World


Funders


SciDev is funded by the UK Department for International Development, the Swedish International Development Cooperation Agency, the Canadian International Development Research Centre and the Rockefeller Foundation.



scidev/birdflu


About the SCIDEV


SciDev is a free-access, internet-based network devoted to reporting on and discussing those aspects of modern science and technology that are relevant to sustainable development and the needs of developing countries


SCIDEV

11 Rathbone Place,

London ,

W1T 1HR,


scidev

воскресенье, 19 июня 2011 г.

Needle-Free Injector Gaining More Acceptances In Many Countries

Medical International Technology Inc. is pleased to announce the sale of 12 units
of the AGRO-JET MIT II P to "Jennie O", one of the largest Turkey farms in the USA. MIT, a
developer and manufacturer of patented low pressure needle free jet injectors for human and
animal inoculation, is also undergoing trials with Cargil (turkey breeders), Tyson Food (the pork
division) and Seaboard Foods (one of the largest pork producers in the USA).


MIT sold other units of AGRO-JET in the USA to Merial USA for vaccination of chicken, to Turner
Enterprises Inc. for vaccination of Bison and to Kraft food for lab testing.
Customers in other countries like Canada, New Zealand, China and Malaysia have purchased
AGRO-JET for the vaccination of Pork, Mink and cattle.


At the present time, the world's Animal industry (Poultry, Pork, Cattle etc.) commonly uses a
needle/syringe to vaccinate. The current method for vaccination requires that the needle be
changed after a few hundred birds in Poultry; between 20 and 35 in Pork and few Cattle's have
been injected. This method poses a major problem as cross contamination may occur and more
importantly, increases the risk of infecting the person vaccinating, with an accidental needlesticks
and Sharps Injuries.


"Medical International Technology Inc. is pleased to be able to continue providing a safer, low
pressure needle-free injection solution to the Global Animal industry," With the use of "MIT"
AGRO-JET, we can safely vaccinate all Animals and help prevent the spread of deadly disease to
Animals and Humans.


About Medical International Technology, Inc.


MIT CANADA, with offices in Montreal, is a
subsidiary of Denver, Colorado-based Medical International Technology, Inc. (MIT USA), which
specializes in the development, production, marketing and sale of needle-free injectors both for
humans and animals, for individual and mass vaccinations


The statements which are not historical facts contained in this press release are forward-looking
statements that involve certain risks and uncertainties, including but not limited to risks
associated with the uncertainty of future financial results, additional financing requirements,
development and acquisition of new product lines and services, government approval processes,
the impact of competitive products or pricing a technological changes, the effect of economic
conditions and other uncertainties, and the risk factors set forth from time to time in the
Company's SEC reports, including but not limited to its annual report on Form 10-KSB; its
quarterly reports on Forms 10-QSB; and any reports on Form 8-K. Medical International
Technology Inc. takes no obligation to update or correct forward-looking statements.


mitcanada.ca

mitinvest.ca

суббота, 18 июня 2011 г.

Avian Influenza Strain Primes Brain For Parkinson's Disease

At least one strain of the H5N1 avian influenza virus leaves survivors at significantly increased risk for Parkinson's disease and possibly other neurological problems later in life, according to new research from St. Jude Children's Research Hospital.


In the August 10 online early edition of the Proceedings of the National Academy of Sciences, researchers reported that mice which survived infection with an H5N1 flu strain were more likely than uninfected mice to develop brain changes associated with neurological disorders like Parkinson's and Alzheimer's diseases. Parkinson's and Alzheimer's involve loss of brain cells crucial to a variety of tasks, including movement, memory and intellectual functioning. The study revealed the H5N1 flu strain caused a 17 percent loss of the same neurons lost in Parkinson's as well as accumulation in certain brain cells of a protein implicated in both diseases.


"This avian flu strain does not directly cause Parkinson's disease, but it does make you more susceptible," said Richard Smeyne, Ph.D., associate member in St. Jude Developmental Neurobiology. Smeyne is the paper's senior author.


"Around age 40, people start to get a decline in brain cells. Most people die before they lose enough neurons to get Parkinson's. But we believe this H5N1 infection changes the curve. It makes the brain more sensitive to another hit, possibly involving other environmental toxins," Smeyne explained.


Smeyne noted the work involved a single strain of the H5N1 flu virus, the A/Vietnam/1203/04 strain. The threat posed by other viruses, including the current H1N1 pandemic flu virus, is still being studied.


Early indications are that the H1N1 pandemic strain carries a low neurologic risk, said Richard Webby, Ph.D., director of the World Health Organization Collaborating Center for Studies on the Ecology of Influenza in Animals and Birds, which is based at St. Jude. Webby, who is also an associate member of the St. Jude Department of Infectious Diseases, was not involved in the H5N1 study led by Smeyne.


This study also supports the theory that a hit-and-run mechanism is at work in Parkinson's disease. The investigators believe the H5N1 infection sparks an immune response that persists long after the initial threat is gone, setting patients up for further devastating losses from a second hit, possibly from another infection, drug or environmental toxin. In this case, researchers believe the flu virus is the first hit that sets up development of Parkinson's at a later time.


An estimated 4.1 million Americans, including 1 to 2 percent age 55 and older, have Parkinson's. Many suspect both genetic and environmental factors play a role in its development. The disease is linked to the death of dopamine-secreting cells in an area of the midbrain known as the substantia nigra pars compacta (SNpc). Dopamine is a neurotransmitter responsible for stimulating the motor neurons that control movement. Parkinson's is usually diagnosed after individuals lose 70 to 80 percent of the dopamine-producing cells. Treatment is available, but there is no cure.















Flu is primarily a respiratory disease, but indirect evidence dating back to 1385 links it to neurological problems, including the brain inflammation known as encephalitis. The association between flu and brain disorders like Parkinson's was strengthened by an outbreak of encephalitic lethargic, also known as von Economo's encephalopathy, following the 1918 Spanish flu pandemic. Some of those patients developed Parkinson's symptoms.


St. Jude researchers launched this study nearly three years ago in response to the threat posed by avian flu. Smeyne said there was concern about possible long-term neurological risks facing H5N1 survivors.


Previous studies had isolated H5N1 in the nervous system. But this is the first to show the path the virus takes to enter the brain as well as the aftermath of the infection. Smeyne said the virus' path from the stomach through the nervous system and into the brain is reminiscent of how Parkinson's unfolds.


In this study, mice were infected with an H5N1 flu strain isolated in 2004 from a patient in Vietnam. Robert Webster, Ph.D., said the strain remains the most virulent of the avian flu viruses. Webster, a co-author of the study, holds the Rose Marie Thomas Chair in Infectious Diseases at St. Jude.


About two-thirds of the mice developed flu symptoms, primarily weight loss. After three weeks there was no evidence of H5N1 in the nervous systems of the mice that survived.


But the inflammation the infection triggered within the brain continued for months. It was similar to inflammation associated with inherited forms of Parkinson's. Although the tremor and movement problems disappeared as flu symptoms eased, investigators reported that 60 days later mice had lost roughly 17 percent of dopamine-producing cells in SNpc, a structure found in the midbrain.


Researchers also found evidence that the avian flu infection led to over-production of a protein found in the brain cells of individuals with both Alzheimer's and Parkinson's diseases. The protein, alpha-synuclein, collected in H5N1-infected cells throughout the brain, including the midbrain where key dopamine-producing cells are located. There was little protein accumulation in the brain cells of uninfected mice.


The study marks the first time scientists were able to naturally trigger the protein build-up in an experimental Parkinson's system. "The virus activates this protein," Smeyne explained.


Other authors in this paper include Haeman Jang, David Boltz and Yun Jiao (St. Jude); and Katharine Sturm-Ramirez and Kennie Shephard (formerly of St. Jude).


This work was supported in part by the National Institute of Allergy and Infectious Diseases, National Parkinson's Foundation, Michael J. Fox Foundation, National Institutes of Health and ALSAC.


St. Jude Children's Research Hospital


St. Jude Children's Research Hospital is internationally recognized for its pioneering work in finding cures and saving children with cancer and other catastrophic diseases. Founded by late entertainer Danny Thomas and based in Memphis, Tenn., St. Jude freely shares its discoveries with scientific and medical communities around the world. No family ever pays for treatments not covered by insurance, and families without insurance are never asked to pay. St. Jude is financially supported by ALSAC, its fundraising organization.


Source: St. Jude Children's Research Hospital

пятница, 17 июня 2011 г.

Influenza Epidemics Due To Hybrid Viruses

A recent article published in the open-access journal PLoS
Pathogens maintains that over its evolutionary history,
reassortment of the influenza A virus happens often.



Genetic reassortment is when genetic material mixes from two similar
viruses that are infecting the same cell. Influenza virus A is a
species of virus that causes influenza in birds, humans, pigs, and
horses; it has often given rise to human influenza pandemics.



A team of researchers from both Pennsylvania State University and the
National Institutes of Health (NIH) looked at influenza viruses from
1918 to 2005. They focused on viruses that cause seasonal epidemics in
humans, especially ones that were associated with high mortality.



The severe influenza epidemics of 1947 and 1951, according to the
researchers, were the result of genetic reassortment events. Two human
influenza viruses from the same H1N1 strained switched genetic
material, and thus produced two new hybrid viruses.



It has been unknown as to exactly why very severe influenza epidemics
occur periodically and lead to unusually high illness and mortality
levels - like the ones in 1947 and 1951. The normal model of human
influenza virus evolution argues that major pandemics (of which 1918
was the largest) are due to genetic reassortment of human and avian
(bird) influenza viruses. However, the seasonal influenza epidemics
that occur each winter in the United States are thought to arise
without genetic reassortment.



The new research findings add a layer of complexity to the evolution of
seasonal influenza than was previously believed. That is, within a
single population, multiple
forms of the same strain co-circulate and re-assort. These
quickly-generating, novel viruses are capable of starting major
epidemics.



The authors believe that vaccine design can be helped if intensive
surveillance can capture the full extent of how genetically diverse the
influenza virus is that is co-circulating at a given time.



Multiple Reassortment Events in the Evolutionary History of H1N1 Influenza A Virus Since 1918

Nelson MI, Viboud C, Simonsen L, Bennett RT, Griesemer SB, et al.

PLoS Pathogens 4(2): e1000012. (2008).

doi:10.1371/journal.ppat.1000012

Click
Here to View Journal Website



Written by: Peter M Crosta




четверг, 16 июня 2011 г.

Bird Flu Pandemic Would Require Multi-Drug Approach, UK

Scientists have uncovered a change in the H5N1 bird flu virus which makes it resistant to the anti-viral drug Tamiflu. The mutation in the N1 component was found in human cases of the disease and suggests that a single drug approach is likely to be ineffective in case of a bird flu pandemic in humans. The findings by a team at the Medical Research Council's National Institute for Medical Research are published in Nature.


The research looked at the structure of the flu neuraminidase (N1) which is the target for both Tamiflu and Relenza, the two existing flu drugs. Both drugs aim to inhibit the N1 which is responsible for the release of the virus from infected human cells and thus allows the disease to spread.


Using a method called X-ray crystallography the scientists looked at a mutation in the structure of N1 neuraminidase that has been observed in human cases of H5N1 and in seasonal flu. They found that when this mutation occurred, the virus became resistant to Tamiflu, while still remaining susceptible to Relenza.


Viruses have a high rate of mutation often adapting to the treatments devised to tackle them. It had previously been thought that this mutation in N1 made it less virulent, but recent research from the United States has shown that the mutation does not reduce the infectiousness of the virus.


The team led by Dr Steven Gamblin also looked at samples from the seasonal flu H1N1 and found that samples showing this mutation were also resistant to Tamiflu. While the proportion of seasonal flu samples showing this resistance varies widely across Europe and is relatively low in the UK, there is no telling how the seasonal virus will evolve next year.


Dr Steve Gamblin said: "What this research shows is that stockpiling any one drug to prepare for a potential H5N1 pandemic is unlikely to provide adequate cover. In order not to be outflanked by the virus, it will be necessary to have stocks of both existing drugs. We understand this is something the Government is already exploring. There is also a huge imperative to develop further drugs that could help disable this protein on the virus surface. It is likely a future pandemic will need to be tackled using a three- or four-pronged approach, much as we tackle HIV today."


References:


Crystal structures of oseltamivir-resistant influenza virus neuraminidase mutants
Collins et. al. is published online at nature


1. Yen et al Neuraminidase inhibitor-resistant recombinant A/Vietnam/1203/04 (H5N1) influenza viruses retain their replication efficiency and pathogenicity in vitro and in vivo. J Virol 81, 12418-12426 (2007).

Medical Research Council


View drug information on Relenza; Tamiflu capsule.

среда, 15 июня 2011 г.

Roche Statement Regarding Tamiflu U.S. Label Revision

Roche has informed healthcare
professionals that the prescribing information for Tamiflu (oseltamivir
phosphate) has been updated to reflect recommendations made by the FDA
Pediatric Advisory Committee at a November 27, 2007 meeting regarding
neuropsychiatric events. The revision is an update to a label change made
in November of 2006 and includes information that influenza itself has been
associated with a variety of neuropsychiatric events and that these reports
appear to be uncommon.


The changes to the label reflect observations from a growing body of
data, which shows no evidence of a causal relationship between Tamiflu and
the reported events. The data shows that these neuropsychiatric adverse
events also occurred in flu patients who were not taking Tamiflu. In fact,
emerging evidence suggests that influenza itself may cause neuropsychiatric
adverse events. In addition to clinical trials conducted prior to the
approval of Tamiflu by the FDA, extensive post-marketing studies have been
conducted and additional research is underway by Roche, Chugai and the
Japanese health authority.



Roche agrees that it is important that healthcare professionals and
patients know that all children with flu should be monitored, regardless of
whether they are taking an antiviral medication. If any sign of unusual
behavior is observed, a healthcare professional should be contacted
immediately.



Antivirals like Tamiflu play an important role in the prevention and
treatment of influenza. Tamiflu has been used by more than 48 million
people worldwide, including nearly 21 million children, since its approval
in 1999. Tamiflu is approved for the treatment and prevention of influenza
in patients over one year of age and is one of two antiviral medications
recommended by the CDC for the 2007-2008 influenza season.



Roche is committed to ensuring safe and appropriate use of our
medications and will continue to conduct appropriate post-marketing
monitoring and research.



For full U.S. prescribing information, please visit tamiflu.


Roche

Roche


View drug information on Tamiflu capsule.

вторник, 14 июня 2011 г.

AID agencies ask for help as bird flu appears in China

International health and food safety agencies have appealed to donors for money to help stop the rapid spread of bird flu in Asia.



The appeal comes as Thailand prepares to host an international conference on ways to contain the virus and reports that the virus has spread to China.



Nearly a dozen governments including China and the United States, along with the European Union, will take part in the meeting hosted by Thailand.



The meeting will hear the latest assessment of the crisis from the World Health Organisation (WHO) and the United Nations Food and Agriculture Organisation.



Experts warn bird flu could mutate with the flu and become a global pandemic if affected countries cannot bring the virus under control.



Authorities across the region are continuing a mass slaughter of suspect chicken.



It is estimated more than 24 million birds have been culled.



But the WHO says the operation needs to be sped up if Asian governments are to stop bird flu spreading further.



Meanwhile, the Chinese government last night confirmed there has been an outbreak of the lethal strain of bird flu among ducks in a south-western province.



Fourteen thousand ducks have already been slaughtered and quarantine measures put in place.



But initial testing also indicates that the country has two other outbreaks, in ducks and chickens.


The WHO has warned that a Chinese outbreak would be serious, as it increases the risk of the virus mutating.

понедельник, 13 июня 2011 г.

Three New Human Cases Of Bird Flu Infection, All Children, Egypt

Egyptian Ministry of Health and Population officials have confirmed three new human cases of bird flu infection with the A(H5N1) virus strain. Both the US Naval Medical Research Unit Number 3 (NAMRU-3) and the Central Public Health Lab (Egypt) have confirmed.


The three cases include:


-- A 4-year-old boy, brother to a 6-year-old girl who was recently infected. He is from Qena Governate. He developed bird flu like symptoms on March 26th and was hospitalized three days later.


-- A 7-year-old boy from Sohag Governate. He became ill on March 26th and was hospitalized three days later.


-- A 4-year-old girl from Qalubiea Governate. She became ill on March 29th and was hospitalized the following day.


Hospital spokespeople say that all three children are in a 'stable condition'. Investigations so far indicate that all three children had been in contact with dead (probably infected) birds. All relatives and close contacts of these children seem to be healthy.


So far 32 humans have become infected with bird flu (H5N1) in Egypt, of which 13 have died.


-- Bird Flu = Avian Flu

-- H5N1 is the virulent avian flu virus strain (the one everyone is worried about)


Written by:





воскресенье, 12 июня 2011 г.

Ethics in a Pandemic

Coping effectively with a predicted influenza pandemic that threatens to affect the health of millions worldwide, hobble economies and overwhelm health care systems will require more than new drugs and good infection control.


An international medical ethics think-tank says that all-important public cooperation and the coordination of public officials at all levels requires open and ethical decision making.


The Influenza Pandemic Working Group at the University of Toronto Joint Centre for Bioethics today recommended a 15-point ethical guide for pandemic planning, based in part on experiences and study of the Severe Acute Respiratory Syndrome (SARS) crisis of 2003.


The report says plans to deal with a flu pandemic need to be founded on commonly held ethical values. People need to subscribe in advance to the rationale behind such choices as: the priority recipients of resources, including hospital services and medicines; how much risk front line health care workers should take; and support given to people under restrictions such as quarantine. Decision makers and the public need to be engaged so plans reflect what most people will accept as fair and good for public health.


"A shared set of ethical values is the glue that can hold us together during an intense crisis," says Peter Singer, M.D., Director of the University of Toronto Joint Centre for Bioethics (JCB), which undertook the advisory report. "A key lesson from the SARS outbreak is that fairness becomes more important during a time of crisis and confusion. And the time to consider these questions and processes in relation to a threatened major pandemic is now."


The report concludes that flu pandemic plans universally need an ethical component that address four key issues:


1. Health workers' duty to provide care during a communicable disease outbreak.


2. Restricting liberty in the interest of public health by measures such as quarantine;


3. Priority setting, including the allocation of scarce resources such as medicines;


4. Global governance implications, such as travel advisories.


Health care workers duty to care


The SARS crisis exposed health care systems to hard ethical choices that rapidly arose. Dozens of health care workers, for example, were infected through their work and some died. Other failed to report for duty to treat SARS patients out of fear for their own health or that of their family. A flu pandemic, where there may be no absolute protection or cure, would put far greater pressures on health care systems around the world.


"Workers will face competing obligations, such as their duty to care for patients and to protect their own health and that of families and friends," says JCB member Ross Upshur, M.D., Director, Primary Care Research Unit, Sunnybrook and Women's College Health Sciences Centre. "Medical codes of ethics in various countries provide little specific guidance on how to cope with this very real dilemma. Professional colleges and associations need to provide this kind of particular guidance in advance of an infectious disease outbreak crisis."















Governments and hospitals also need to provide for the health and safety of workers, and for the care of those who fall ill on duty. This might include an insurance fund for life and disability to cover health care workers who become sick or die as they place themselves in harm's way.


The Human Costs of Restrictive Measures


Officials need to provide support for those in quarantine, cut off from family, friends, work, shopping and possibly medical care for other aliments, the report says. The public should also be made aware of the need for quarantine and the consequences of non-compliance.


"The decision to use restrictive measures need to be made in an open, fair and legitimate manner. The public has a right to know the compelling public health reasons for curtailing rights and restricting normal activities. If quarantines are used, those affected need adequate care and job protection. Preventing financial hardship is important to obtaining full compliance from the public," says Dr. Upshur.


Measures to protect against stigmatization and to safeguard the privacy of individuals and/or communities affected by quarantine also should be part of pandemic preparedness plans the report recommends.


Allocating Scarce Resources, Medicines


All countries will face scarcities of medicines, equipment and health care workers during a pandemic, according to the group. Governments, hospitals and health regions should publicize a clear rationale for giving priority access to anti-viral medicines and vaccines to particular groups (e.g., front line health workers, children, decision-makers).


Advance planning ought to include criteria for resource allocation decisions, created in consultation with the general public.


Travel Bans


The World Health Organization (WHO) has warned that if the H5N1 strain of bird flu mutates and infects people it could reach all continents in less than three months. The WHO would likely impose regional travel restrictions in hopes of slowing the spread of the disease.


However such decisions can have major economic impacts. Canada, and Toronto in particular, suffered millions in economic losses when the WHO advised international travelers against all nonessential travel because of SARS.


Decisions about travel restrictions need to be clearly justified and the process must be transparent the report says.


At the same time, the WHO relies on individual countries for reporting disease outbreaks. Such surveillance may be beyond the capacity of many developing countries. The developed world should continue to invest in the surveillance capacity and the overall public health infrastructures of developing countries.


The WHO recommends that ethical issues be a consideration in the planning process for an influenza pandemic. Canada's province of Ontario has incorporated this framework into its plan.


"Other jurisdictions and nations should assess their pandemic plan against this ethical framework and these recommendations," says Dr. Singer.


"Looking ahead, we can say that if the pandemic strikes it will cause great hardship, but societies will struggle through. They will be better able to do so if they have general agreement on an ethical approach. Afterwards, history will judge today's leaders on how well they took decision on the ethical challenges they faced in the midst of the crisis."


Ten substantive values to guide ethical decision-making for a pandemic influenza outbreak


Individual liberty


In a public health crisis, restrictions to individual liberty may be necessary to protect the public from serious harm. Restrictions to individual liberty should:


- - Be proportional, necessary and relevant.


- - Employ the least restrictive means.


- - Be applied equitably.


Protection of the public from harm


To protect the public from harm, health care organizations and public health authorities may be required to take actions that impinge on individual liberty. Decision makers should:


- - Weigh the imperative for compliance.


- - Provide reasons for public health measures to encourage compliance.


- - Establish mechanisms to review decisions.


Proportionality


Proportionality requires that restrictions to individual liberty and measures taken to protect the public from harm should not exceed what is necessary to address the actual level of risk to or critical needs of the community.


Privacy


Individuals have a right to privacy in health care. In a public health crisis, it may be necessary to override this right to protect the public from serious harm.


Duty to provide care


Inherent to all codes of ethics for health care professionals is the duty to provide care and to respond to suffering. Health care providers will have to weigh demands of their professional roles against other competing obligations to their own health, and to family and friends. Moreover, health care workers will face significant challenges related to resource allocation, scope of practice, professional liability and workplace conditions.


Reciprocity


Reciprocity requires that society support those who face a disproportionate burden in protecting the public good, and take steps to minimize burdens as much as possible. Measures to protect the public good are likely to impose a disproportionate burden on health care workers, patients and their families.


Equity


All patients have an equal claim to receive the health care they need under normal conditions. During a pandemic, difficult decisions will need to be made about which health services to maintain and which to defer. Depending on the severity of the health crisis, this could curtail not only elective surgeries, but could also limit the provision of emergency or necessary services.


Trust


Trust is an essential component of the relationships among clinicians and patients, staff and their organizations, the public and health care providers or organizations, and among organizations within a health system. Decision makers will be confronted with the challenge of maintaining stakeholder trust while simultaneously implementing various control measures during an evolving health crisis. Trust is enhanced by upholding such process values as transparency.


Solidarity


As the world learned from SARS, a pandemic influenza outbreak, will require a new vision of global solidarity and a vision of solidarity among nations. A pandemic can challenge conventional ideas of national sovereignty, security or territoriality. It also requires solidarity within and among health care institutions. It calls for collaborative approaches that set aside traditional values of self-interest or territoriality among health care professionals, services or institutions.


Stewardship


Those entrusted with governance roles should be guided by the notion of stewardship. Inherent in stewardship are the notions of trust, ethical behaviour and good decision-making. This implies that decisions regarding resources are intended to achieve the best patient health and public health outcomes given the unique circumstances of the influenza crisis.



Five procedural values to guide ethical decision-making for a pandemic influenza outbreak


Reasonable


Decisions should be based on reasons (i.e., evidence, principles and values) that stakeholders can agree are relevant to meeting health needs in a pandemic influenza crisis. The decisions should be made by people who are credible and accountable.


Open and transparent


The process by which decisions are made must be open to scrutiny, and the basis upon which decisions are made should be publicly accessible.


Inclusive


Decisions should be made explicitly with stakeholder views in mind, and there should be opportunities to engage stakeholders in the decision-making process.


Responsive


There should be opportunities to revisit and revise decisions as new information emerges throughout the crisis. There should be mechanisms to address disputes and complaints.


Accountable


There should be mechanisms in place to ensure that decision makers are answerable for their actions and inactions. Defence of actions and inactions should be grounded in the 14 other ethical values proposed above.



Summary of Recommendations


An ethical guide for pandemic planning


1. National, provincial/state/territorial, and municipal governments, as well as the health care sector, should ensure that their pandemic plans include an ethical component.


2. National, provincial/state/territorial, and municipal governments, as well as the health care sector, should consider incorporating both substantive and procedural values in the ethical component of their pandemic plans.


Four key ethical issues


Issue 1: Health workers' duty to provide care during a communicable disease outbreak


1. Professional colleges and associations should provide, by way of their codes of ethics, clear guidance to members in advance of a major communicable disease outbreak, such as pandemic flu. Existing mechanisms should be identified, or means should be developed, to inform college members as to expectations and obligations regarding the duty to provide care during a communicable disease outbreak.


2. Governments and the health care sector should ensure that:
a. care providers' safety is protected at all times, and providers are able to discharge duties and receive sufficient support throughout a period of extraordinary demands; and
b. disability insurance and death benefits are available to staff and their families adversely affected while performing their duties.


3. Governments, hospitals and health regions should develop human resource strategies for communicable disease outbreaks that cover the diverse occupational roles, that are transparent in how individuals are assigned to roles in the management of an outbreak, and that are equitable with respect to the distribution of risk among individuals and occupational categories.


Issue 2: Restricting liberty in the interest of public health by measures such as quarantine


1. Governments and the health care sector should ensure that pandemic influenza response plans include a comprehensive and transparent protocol for the implementation of restrictive measures. The protocol should be founded upon the principles of proportionality and least restrictive means, should balance individual liberties with protection of public from harm and should build in safeguards such as the right of appeal.


2. Governments and the health care sector should ensure that the public is aware of:

a. the rationale for restrictive measures;

b. the benefits of compliance; and

c. the consequences of non-compliance.


3. Governments and the health care sector should include measures in their pandemic influenza preparedness plans to protect against stigmatization and to safeguard the privacy of individuals and/or communities affected by quarantine or other restrictive measures.


4. Governments and the health care sector should institute measures and processes to guarantee provisions and support services to individuals and/or communities affected by restrictive measures, such as quarantine orders, implemented during a pandemic influenza emergency. Plans should state in advance what backup support will be available to help those who are quarantined (e.g., who will do their shopping, pay the bills and provide financial support in lieu of lost income). Governments should have public discussions of appropriate levels of compensation in advance, including who is responsible for compensation.


Issue 3: Priority setting, including the allocation of scarce resources, such as vaccines and antiviral medicines


1. Governments and the health care sector should publicize a clear rationale for giving priority access to health care services, including antivirals and vaccines, to particular groups, such as front line health workers and those in emergency services. The decision makers should initiate and facilitate constructive public discussion about these choices.


2. Governments and the health care sector should engage stakeholders (including staff, the public and partners) in determining what criteria should be used to make resource allocation decisions (e.g., access to ventilators during the crisis, and access to health services for other illnesses), should ensure that clear rationales for allocation decisions are publicly accessible and should provide a justification for any deviation from the pre-determined criteria.


3. Governments and the health care sector should ensure that there are formal mechanisms in place for stakeholders to bring forward new information, to appeal or raise concerns about particular allocation decisions and to resolve disputes.


Issue 4: Global governance implications, such as travel advisories


1. The World Health Organization should remain aware of the impact of travel recommendations on affected countries, and should make every effort to be as transparent and equitable as possible when issuing such recommendations.


2. Federal countries should utilize whatever mechanisms are available within their system of government to ensure that relationships within the country are adequate to ensure compliance with the new International Health Regulations.


3. The developed world should continue to invest in the surveillance capacity of developing countries, and should also make investments to further improve the overall public health infrastructure of developing countries.


University of Toronto Joint Centre for Bioethics


Innovative. Interdisciplinary. International. Improving health care through bioethics.


The JCB is a partnership among the University of Toronto and 15 health care organizations. It provides leadership in bioethics research, education, and clinical activities. Its vision is to be a model of interdisciplinary collaboration in order to create new knowledge and improve practices with respect to bioethics. The JCB does not advocate positions on specific issues, although its individual members may do so.


JCB Members: Ross E.G. Upshur, Karen Faith, Jennifer L. Gibson, Alison K. Thompson, C. Shawn Tracy, Kumanan Wilson, Peter A. Singer


For more information:
utoronto.ca/jcb

суббота, 11 июня 2011 г.

Bird Flu Outbreak Near Islamabad, Pakistan

A bird flu (avian flu) outbreak has occurred at a chicken farm in Sihala, near Islamabad, say Pakistani authorities. Laboratory tests have confirmed the presence of the virulent H5N1 strain.


Health officials say they have destroyed 3,600 chickens at the farm. So far, no human cases of infection have been reported in or near the infected area.


This is the third outbreak of bird flu in Pakistan since the beginning of last month.


Written by:





пятница, 10 июня 2011 г.

Potential Human Vaccine Against Bird Flu

A vaccine to protect humans from a bird flu pandemic is within reach after a new discovery by researchers at the University of Melbourne, Australia



The discovery, published in the prestigious Proceedings of the National Academy of Sciences, reveals how boosting T cell immunity could better protect humans from a bird flu pandemic.



The continued spread of the highly virulent "bird flu" virus has experts worried that we are facing a new potential influenza pandemic which could transfer between humans. Furthermore, given the bird flu is new, there is no pre-existing immunity in the population and current vaccine formulations would be useless.



"The 'Killer T cell' is the hit-man of the immune system. It is able to locate and destroy virus-infected cells in our body helping rid us of infection," said A/Prof Stephen Turner, from the Department of Microbiology and Immunology at the University of Melbourne who is a lead author on the paper.



"Unfortunately, current influenza vaccines are poor at inducing killer T cell immunity. Therefore, we wanted to see if we could improve the current vaccine formulation to induce killer T cells after vaccination," he said.



"We added a compound, known to increase immunity, to the flu vaccine in an animal model. The addition of this compound promoted significant generation of potent killer T cell immunity and provided protection from infection.



"The significance of these findings is that rather than having to design a new vaccine altogether, we can improve current flu vaccines by adding this potent immune modulator.



"With appropriate clinical testing, we could see improvements to current vaccines within the next five years."



Dr Turner said the key to vaccine effectiveness was ensuring a match between the vaccine and the current circulating flu strain. However, the spike proteins varied over the course of a flu season rendering the current vaccine ineffective. As such, the vaccine needs to be updated every year to match the likely strain for that winter.



"It is a different situation for influenza pandemics. Pandemics arise due to the introduction of a new influenza virus into human circulation. As such, there is little or no pre-existing immunity to the bird flu virus enabling it to spread rapidly."



"'Killer' T cells recognise components that are conserved between different influenza viruses. Therefore, a vaccine strategy that induced killer T cells pre-emptively would provide protection from a potential pandemic."



Source: Rebecca Scott


University of Melbourne

четверг, 9 июня 2011 г.

Lab-Made Proteins That Neutralize Multiple Strains Of Seasonal And Pandemic Flu Identified By Scientists

Scientists have identified a small family of lab-made proteins that neutralize a broad range of influenza A viruses, including the H5N1 avian virus, the 1918 pandemic influenza virus and seasonal H1N1 flu viruses. These human monoclonal antibodies, identical infection-fighting proteins derived from the same cell lineage, also were found to protect mice from illness caused by H5N1 and other influenza A viruses. Because large quantities of monoclonal antibodies can be made relatively quickly, after more testing, these influenza-specific monoclonal antibodies potentially could be used in combination with antiviral drugs to prevent or treat the flu during an influenza outbreak or pandemic.



A report describing the research, supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health as well as the Centers for Disease Control and Prevention, appears online in Nature Structural & Molecular Biology. Wayne Marasco, M.D., Ph.D., associate professor of medicine at the Dana-Farber Cancer Institute and Harvard Medical School in Boston led the research team, which included collaborators from the Burnham Institute for Medical Research in La Jolla, Calif., and the CDC in Atlanta.



"This is an elegant research finding that holds considerable promise for further development into a medical tool to treat and prevent seasonal as well as pandemic influenza," notes NIAID Director Anthony S. Fauci, M.D. "In the event of an influenza pandemic, human monoclonal antibodies could be an important adjunct to antiviral drugs to contain the outbreak until a vaccine becomes available."



Using standard methods of production, initial doses of a new influenza vaccine to fight pandemic influenza would be expected to take four to six months to produce.



Key to their research, Dr. Marasco and his colleagues discovered and described the atomic structure of an obscure but genetically stable region of the influenza virus to which their monoclonal antibodies bind. The hidden part of the influenza virus is in the neck below the peanut-shaped head of the hemagglutinin (HA) protein. HA and neuraminidase are the two main surface proteins on the influenza virus.



The scientists also identified a new mechanism of antibody action against influenza: Once the antibody binds, the virus cannot change its shape, a step required before it can fuse with and enter the cell it is attempting to infect.



Dr. Marasco, Jianhua Sui, M.D., Ph.D., and other Dana-Farber colleagues began their study with avian flu viruses. They scanned tens of billions of monoclonal antibodies produced in bacterial viruses, or bacteriophages, and found 10 antibodies active against the four major strains of H5N1 avian influenza viruses. Encouraged by these findings, they collaborated with Ruben O. Donis, Ph.D., of the CDC Influenza Division, and found that three of these monoclonal antibodies had broader neutralization capabilities when tested in cell cultures and in mice against representative strains of other known influenza A viruses.
















Influenza A viruses can include any one of the 16 known subtypes of HA proteins, which fall into two groups, Group 1 and Group 2. Their monoclonal antibodies neutralized all testable viruses containing the 10 Group 1 HAs--which include the seasonal H1 viruses, the H1 virus that caused the 1918 pandemic and the highly pathogenic avian H5 subtypes--but none of the viruses containing the six Group 2 HAs.



Simultaneously, Dr. Marasco's group teamed up with Robert C. Liddington, Ph.D., professor and chair of the Infectious and Inflammatory Disease Center at Burnham, to determine the atomic structure of one of their monoclonal antibodies bound to the H5N1 HA. Their detailed picture shows one arm of the antibody inserted into a genetically stable pocket in the neck of the HA protein, an interaction that blocks the shape change required for membrane fusion and virus entry into the cell.



When they surveyed more than 6,000 available HA genetic sequences of the 16 HA subtypes, they found the pockets to be very similar within each Group but to be significantly different between the two Groups. The genetically stable pockets, they note, may be a result of evolutionary constraints that enable virus-cell fusion. This could also explain why they did not detect so-called escape mutants, viruses that elude the monoclonal antibodies through genetic mutation.



"One of the most remarkable findings of our work is that we identified a highly conserved region in the neck of the influenza hemagglutinin protein to which humans rarely make antibodies," says Dr. Marasco. "We believe this is because the head of the hemagglutinin protein acts as a decoy by constantly undergoing mutation and thereby attracting the immune system to produce antibodies against it rather than against the pocket in the neck of the protein."



Their findings could also assist vaccine developers. Current influenza vaccines target the constantly mutating head of the HA protein and do not readily generate antibodies against the conserved region in the neck.



"An important goal is to redirect the immune response of vaccines to this invariable region of the hemagglutinin to try to obtain durable lifelong immunity," Dr. Marasco states.



The monoclonal antibodies identified in their paper are very well-characterized, Dr. Marasco notes, and he is optimistic about their further clinical development. "These are fully human monoclonal antibodies that are ready for advanced preclinical testing," he says. He currently is arranging to use NIAID research resources to take the next steps: first, testing the antibodies in ferrets, the gold standard animal model for influenza, and then developing a clinical grade version of one antibody that could enter human clinical trials as soon as 18 months from when the development program begins. Should the antibodies prove safe and effective in humans, it could take several years to develop a licensed product.



Despite the availability of influenza drugs and vaccines, seasonal influenza still kills more than 250,000 people worldwide each year. During seasonal flu outbreaks, monoclonal antibodies could be used to treat individuals with impaired immunity due to pre-existing medical conditions or advanced age. In the event of an influenza pandemic, these individuals plus others at risk--for example, first responders and medical personnel and exposed family members and coworkers--could also benefit from this type of therapy.







For more information on influenza see www3.niaid.nih/news/focuson/flu and cdc/flu. Also visit PandemicFlu for one-stop access to U.S. Government information on avian and pandemic flu.



NIAID conducts and supports research--at NIH, throughout the United States, and worldwide--to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at niaid.nih.



The National Institutes of Health (NIH)--The Nation's Medical Research Agency--includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments and cures for both common and rare diseases. For more information about NIH and its programs, visit nih.



Reference: J Sui et al. Structural and functional bases for broad-spectrum neutralization of avian and human influenza A viruses. Nature Structural & Molecular Biology DOI: 10.1038/nsmb.1566 (2009).



News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at niaid.nih/.



Source: Laurie K. Doepel


NIH/National Institute of Allergy and Infectious Diseases

среда, 8 июня 2011 г.

Funds Needed To Scale Up Global Efforts To Control Avian Influenza

Global control efforts--and the funds to support them--need to be scaled up now to address the current failures in halting avian influenza, states an editorial in this week's issue of The Lancet.


The spread of the virus in Turkey indicates that the efforts to control avian influenza in birds are not working as well as hoped. Donors at the International Pledging Conference on Avian and Human Influenza in Beijing, Jan 17-18, need to acknowledge that funds for global control efforts should be scaled up to address this failure. Experts estimate that $1.2 billion to $1.4 billion is needed to boost global efforts to stop the spread of avian influenza and ward off a human pandemic.


The Lancet comments: "Although Turkey's plight is unlikely to have held much sway in the deliberations among big donors, for other delegates [in Beijing] it should reinforce the necessity of a strong global response. A restatement of rich nations' commitment to helping poorer countries is especially important now since global momentum at the end of last year was in danger of waning after some commentators took the scarcity of human infections as an indication that warnings of mass casualties were an overreaction…Turkey's experience should also remind all nations that the status of preparations to protect human health remains an immediate, and serious, concern."
Joe Santangelo

j.santangeloelsevier

Lancet

thelancet

вторник, 7 июня 2011 г.

Scientists Still Can't Identify Species Of Dead Infected Swan In Scotland

A week-and-a-half after finding the dead, H5N1 infected swan in Fife, Scotland, scientists are still not able to identify what type of swan it was. Epidemiologists need to know what type of swan it is so that they can have a better idea how the virus entered the UK.


If it was a native, non-migratory, British swan, then another bird brought the bird flu in. This means other birds could be infected. The other bird could have infected several British birds, depending on how long ago it arrived.


Scientists are carrying out DNA tests to try to identify the type of swan.


The bird was so decomposed and torn open when found that a visual identification is impossible. According to Defra, the bird was found in an advanced state of decay, with its head missing.


Ornithologists say swans are identified by their heads. Identifying a headless swan is difficult - a very decomposed headless swan is extremely complicated.


Experts say that poor identification of some infected birds in other parts of the world led to wrong conclusions about the H5N1's spread. Identifying this one correctly is vital.


Written by:

понедельник, 6 июня 2011 г.

Two New Human Cases Of Avian Influenza, Egypt

The Egyptian Central Public Health Laboratory and the US Naval Medical Research Unit Number 3 (NAMRU-3) have confirmed that two more people have become infected with the avian influenza A(H5N1) virus.


-- A girl, aged 6, was hospitalized on March 25th with bird-flu-like symptoms. She is from Qena Governorate.


-- A boy, aged 5, was hospitalized with bird-flu-like symptoms, also on March 25th. He is from Menia Governate.


Authorities say that both the boy and the girl are in a stable condition. Both children had been exposed to infected poultry.


So far, 29 humans have become infected with bird flu in Egypt, of which 13 have died.


Experts fear the H5N1 bird flu virus strain will eventually mutate and become easily human transmissible. This has not happened yet. It is still very difficult for a bird to infect a human - it is even harder for a human to infect another human.


Written by:





воскресенье, 5 июня 2011 г.

Avian Influenza On People's Minds

Researchers at the Food Policy Institute at the Rutgers New Jersey Agricultural Experiment Station have conducted a nationwide survey of public knowledge, attitudes, intentions and behaviors related to the threat of highly pathogenic avian influenza. The researchers conducted a total of 1200 telephone interviews on the topic between May 3 and June 5, 2006.



The results suggest that avian influenza is on the national agenda. Most Americans have heard about it and have talked about it, but don't know much about it. Most are aware of the presence of highly pathogenic H5N1 avian influenza in people, birds, and poultry globally, but many are unaware that there have been no cases in humans or animals in the United States.



Despite this, Americans see their current risk of infection with avian influenza as low and are not particularly worried about it. They see the current supply of chicken products as relatively safe, and they continue to eat it. However, most see the risks of infection from avian influenza as much greater for other people than for themselves.



"This tendency to believe that others are at greater risk may be a problem in getting messages across, in influencing perceived susceptibility, and in persuading people to adopt appropriate behaviors," says Sarah C. Condry, the lead author of the study.



The study focused on what American consumers would likely do if highly pathogenic H5N1 avian influenza were found in poultry in the United States. According to the United States Department of Agriculture (USDA), in such a scenario, "The chance of infected poultry or eggs entering the food chain would be extremely low because of the rapid onset of symptoms in poultry as well as the safeguards in place, which include testing of flocks and Federal inspection programs." Moreover, the USDA states, "Cooking poultry, eggs, and other poultry products to the proper temperature and preventing cross-contamination between raw and cooked food is the key to safety."



However, according to William K. Hallman, director of the Food Policy Institute, "The results of the study suggest that much of the American public does not yet have the information they need to make informed choices about purchasing, preparing, and consuming poultry products, should avian influenza emerge in the United States."



Hallman points out that U.S. farming methods for raising poultry drastically reduce the risk of an outbreak of avian influenza within our food supply. "Our poultry is typically farmed in tightly controlled environments," he said. "The poultry industry is well aware of the dangers of avian influenza and is working closely with the USDA to take appropriate precautions to prevent an outbreak." Yet, according to the study, only about two-thirds of Americans seem aware that the majority of chicken sold in the United States is produced domestically and that poultry products from countries with reported outbreaks of avian influenza are banned from import. In addition, while a variety of clinical symptoms makes it relatively easy to identify domestic poultry infected with avian influenza, few Americans believe that live chickens infected with avian influenza are easily distinguishable from healthy birds.
















According to the U.S. Centers for Disease Control and Prevention, however, a more significant fact is that "there is no evidence that people have been infected with bird flu by eating safely handled and properly cooked poultry or eggs." Yet, less than half of Americans believe that cooking chicken to the recommended temperature kills the avian influenza virus and only four-in-ten believe that the avian influenza virus is not transmissible to humans from eating fully cooked chicken or eggs.



"The methods for destroying avian influenza during the cooking process are the same as for destroying salmonella," said Hallman. "If poultry contaminated with avian influenza is cooked properly, a person cannot get sick from eating the finished product." According to the USDA, poultry and egg products should be cooked to the minimum safe internal temperature of 165 °F.



However, even if consumers can be convinced that proper cooking kills the avian influenza virus, getting them to act on this information to reduce the risk of infection may be difficult. Surveys by the Food and Drug Administration suggest that fewer than 60 percent of Americans own a meat thermometer and only 12 percent always use it when they cook chicken or chicken parts.



Instead, suggests Condry, "Consumers are likely to try to eliminate the risk entirely by avoiding consumption of poultry altogether." In fact, the study found that if highly pathogenic avian influenza were found in chickens in the United States, nearly 40 percent of Americans say they would stop eating chicken products altogether. The study also suggests that even after receiving reassurances that it is safe to eat chicken, it would take an average of nearly five months for most Americans to begin eating it again.



The USDA reports that Americans purchase an average of 86 pounds of chicken a year; nearly 26 billion pounds a year in total. A substantial drop in domestic consumer demand would result in significant economic losses.



According to Hallman, the social and nutritional costs would also likely be significant. "Chicken serves as a popular, low-cost source of protein for many American families." Indeed, the USDA estimates that the per capita consumption of chicken in the United States has more than doubled since 1970. Loss of confidence in the safety of poultry would likely result in increases in the prices of alternative sources of animal protein resulting from higher consumer demands for substitutes for chicken products. "As a result, the costs of feeding the average American family would likely rise."







The authors of the survey were Sarah C. Condry, William K. Hallman, Miranda Vata, and Cara L. Cuite. The survey project was funded through a National Integrated Food Safety Initiative grant awarded by the USDA Cooperative State Research, Education, and Extension Service and the New Jersey Agricultural Experiment Station at Rutgers, The State University of New Jersey.



The Food Policy Institute is a research unit of the Rutgers New Jersey Agricultural Experiment Station that addresses food and health policy issues. The institute supports public and private decision makers who shape aspects of the food system within which government, agriculture, industry and the consumer interact. Copies of the report are available at: foodpolicyinstitute/.



Contact: Michele Hujber


Rutgers, the State University of New Jersey

суббота, 4 июня 2011 г.

Tamiflu Predicted To Halve The Pandemic Influenza Death Toll Versus No Intervention

Treatment with the oral antiviral Tamiflu (oseltamivir) and prophylaxis for people exposed to infected patients could be one of the most cost-effective strategies for reducing illness and death during an influenza pandemic. According to modelling research presented by Beate Sander, University of Toronto, Canada, a stockpile of Tamiflu sufficient to cover 65% of a country's population could cut deaths by approximately half. This study was announced at the leading influenza conference, Options for the Control of Influenza VI, in Toronto.1



The reality is that country stockpiles of Tamiflu are limited and are targeted at treatment only rather than treatment and prevention.2 However, some governments are now planning for sufficient antiviral stockpiles that will allow them to provide Tamiflu preventatively to close contacts of infected individuals.



The disease modelling research analysed for the first time the cost-effectiveness of strategies to reduce the spread of pandemic influenza using Tamiflu prophylactically. It was predicted that this preventative approach is likely to be more cost-effective than treating symptomatic patients alone and may be an effective and cost-saving measure for reducing the impact of pandemic influenza.1 This research is supported by an earlier analysis that indicates that a prevention strategy using Tamiflu may help contain a pandemic outbreak.3



The study also predicts that if the stockpile is increased so that there is an unlimited supply of Tamiflu for treating symptomatic patients and for preventing infection in people exposed to these patients (household contacts and school/work contacts), illness attack rates and deaths could potentially be reduced by more than half when compared to no intervention. This equates to a cost saving of $70,000 per 1,000 population which would save $21 billion in the US alone versus no intervention. Adding other strategies such as school closures further reduces the attack and death rate and provides a health benefit at a reasonable cost. The research also showed that pre-pandemic vaccination programmes would play an important role but their effectiveness would be dependent upon how well the vaccine was matched to the virus.1



"The World Health Organisation provides a strong recommendation for the use of Tamiflu for the prevention of avian flu in people who have been in contact with someone who is known, or suspected of being infected with the virus," commented Professor Ira Longini, Professor of Biostatistics and Mathematics at the University of Washington, Seattle, USA. "This research suggests that a similar approach may also be an effective strategy in the event of an actual pandemic outbreak, especially as it is unlikely that a vaccine fully matched to the strain will be available in the initial wave of a pandemic."
















Prophylaxis with antivirals or vaccines



Vaccination is the primary means of preventing influenza. However, at the beginning of a pandemic, supplies of vaccines which are fully matched to the pandemic strain will be limited or non-existent. This is because vaccine production can only start once the specific pandemic virus has been determined. The first doses of a matched vaccine are unlikely to become available within the early months of the pandemic, making prophylaxis and treatment with antivirals a crucial part in the efforts to reduce the burden of pandemic influenza.4



"In an environment full of uncertainties, it is best to have a comprehensive plan in place," said Arnold Monto, professor of epidemiology and influenza expert at the University of Michigan. "Tamiflu is active against all types of influenza virus and will be immediately available during a pandemic if stockpiles are adequate. The big question is, should we be stockpiling for treatment only or for both treatment and prophylaxis""






About the study



The objective of the study was to project the potential impact of pandemic influenza mitigation strategies on health outcomes, cost and cost effectiveness from a societal perspective in the US. The population was based on 1,632,000 people of approximate household size distributions from the 2000 US census. The analysis compared no intervention with 16 single and combination strategies including antiviral post-exposure prophylaxis (PEP) with Tamiflu; treatment with Tamiflu; pre-vaccination before the outbreak of the pandemic with a partially active vaccine; and school closure. It was assumed that Tamiflu stockpiles of varying quantities were available from the start of the pandemic, ranging from covering 25% of the population to unlimited stockpile. The model was based upon assumptions regarding the efficacy of Tamiflu and of vaccines in reducing mortality and morbidity during a pandemic. Illness attack rate was reduced from 500 cases per 1000 population with no intervention to 230 cases per 1000 population in the Tamiflu PEP group. Deaths were reduced from 13 deaths per 1,000 population to 5 deaths per 1,000 population. This study was supported by an unrestricted educational grant from Roche.



About pandemic influenza



An influenza pandemic occurs when a new strain of influenza A virus appears, against which the human population has no immunity resulting in several, simultaneous epidemics worldwide with enormous numbers of deaths and illness. The most severe influenza pandemics to date include: 'Spanish flu' A (H1N1): 1918 caused in excess of 30 million deaths worldwide, 'Asian flu' A (H2N2): 1958 caused 1 million deaths worldwide, 'Hong Kong flu' A (H3N2): 1968 caused 800,000 deaths worldwide in six weeks. The WHO believes that we are as close to the next pandemic as we have been any time in the past 37 years, with two of the three widely-recognised prerequisites for a human pandemic met to date in the avian influenza outbreak in East Asia. Firstly, a new influenza virus strain has emerged (H5N1), and secondly, the virus has spread to humans. The final barrier will be the transmission of the virus from human to human.



About Tamiflu



Tamiflu is designed to be active against all clinically relevant influenza viruses and works by blocking the action of the neuraminidase (NA) enzyme on the surface of the virus. When neuraminidase is inhibited, the spread of the virus to other cells in the body is inhibited. It is licensed for the treatment and prophylaxis of influenza in children aged one year and above and in adults.



Roche and Gilead



Tamiflu was invented by Gilead Sciences and licensed to Roche in 1996. Roche and Gilead partnered on clinical development, with Roche leading efforts to produce, register and bring the product to the markets. Under the terms of the companies' agreement, amended in November 2005, Gilead participates with Roche in the consideration of sub-licenses for the pandemic supply of Tamiflu in resource-limited countries. To ensure broader access to Tamiflu for all patients in need, Gilead has agreed to waive its right to full royalty payments for product sold under these sub-licenses.



About Roche



Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As the world's biggest biotech company and an innovator of products and services for the early detection, prevention, diagnosis and treatment of diseases, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is the world leader in in-vitro diagnostics and drugs for cancer and transplantation, a market leader in virology and active in other major therapeutic areas such as autoimmune diseases, inflammation, metabolism and central nervous system.



Additional information



* Roche Health Kiosk, Influenza: health-kiosk.ch/start_grip.htm


* About Tamiflu: roche/med_mbtamiflu05e.pdf


* About influenza: roche/med_mbinfluenza05e.pdf


* WHO: Global influenza programme: who.int/csr/disease/influenza/en/


* WHO: Avian flu: who.int/mediacentre/factsheets/avian_influenza/en/



References



1. B Sander et al. Economic Evaluation of Influenza Pandemic Mitigation Strategies in the US Using a Stochastic Microsimulation Influenza Model. Data presented at OPTIONS VI 2007. (Abstract Tracking Number O82)


2. Public pandemic plans and media reporting


3. Germann TC et al. Mitigation strategies for pandemic influenza in the United States, PNAS 2006; 103:5935-5940


4. Department of Communicable Disease Surveillance and Response, World Health Organisation, WHO Guidelines on the Use of Vaccines and Antivirals during Influenza Pandemics, who.int/csr/resources/publications/influenza/11_29_01_A.pdf, Accessed 25 May, 2007


Contact: Lucy Rispin


Ketchum



View drug information on Tamiflu capsule.