#Comparing #SARS-CoV-2 with SARS-CoV and #influenza #pandemics (Lancet Infect Dis., abstract)

[Source: Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Comparing SARS-CoV-2 with SARS-CoV and influenza pandemics

Prof Eskild Petersen, MD, Prof Marion Koopmans, DVM, Unyeong Go, MD, Davidson H Hamer, MD, Nicola Petrosillo, MD, Prof Francesco Castelli, MD et al.

Published: July 03, 2020 | DOI: https://doi.org/10.1016/S1473-3099(20)30484-9



The objective of this Personal View is to compare transmissibility, hospitalisation, and mortality rates for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with those of other epidemic coronaviruses, such as severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), and pandemic influenza viruses. The basic reproductive rate (R0) for SARS-CoV-2 is estimated to be 2·5 (range 1·8–3·6) compared with 2·0–3·0 for SARS-CoV and the 1918 influenza pandemic, 0·9 for MERS-CoV, and 1·5 for the 2009 influenza pandemic. SARS-CoV-2 causes mild or asymptomatic disease in most cases; however, severe to critical illness occurs in a small proportion of infected individuals, with the highest rate seen in people older than 70 years. The measured case fatality rate varies between countries, probably because of differences in testing strategies. Population-based mortality estimates vary widely across Europe, ranging from zero to high. Numbers from the first affected region in Italy, Lombardy, show an all age mortality rate of 154 per 100 000 population. Differences are most likely due to varying demographic structures, among other factors. However, this new virus has a focal dissemination; therefore, some areas have a higher disease burden and are affected more than others for reasons that are still not understood. Nevertheless, early introduction of strict physical distancing and hygiene measures have proven effective in sharply reducing R0 and associated mortality and could in part explain the geographical differences.

Keywords: SARS-CoV-2; COVID-19; SARS-CoV; MERS-CoV; Pandemic Influenza.


#COVID19: can we learn from #encephalitis lethargica? (Lancet Neurol., summary)

[Source: Lancet Neurology, full page: (LINK). Summary, edited.]

COVID-19: can we learn from encephalitis lethargica?

Antonino Giordano, Ghil Schwarz, Laura Cacciaguerra, Federica Esposito, Massimo Filippi

Published: July, 2020 | DOI: https://doi.org/10.1016/S1474-4422(20)30189-7


In 1918, influenza caused one of the most severe pandemics in history. Encephalitis lethargica emerged at around the same time and affected more than one million individuals. It had a nonspecific prodromal phase, with influenza-like symptoms, and an acute phase, characterised by fever, sleepiness, ocular motility disturbances, and movement disorders. Months to years later, patients experienced subtle chronic neurological manifestations, mainly postencephalitic parkinsonism.1


Keywords: SARS-CoV-2; COVID-19; Pandemic Influenza; Encephalitis lethargica.


#Pandemic #Influenza #Vaccines: What did We Learn from the 2009 Pandemic and are We Better Prepared Now? (Vaccines, abstract)

[Source: Vaccines, full page: (LINK). Abstract, edited.]

Pandemic Influenza Vaccines: What did We Learn from the 2009 Pandemic and are We Better Prepared Now?

by  Steven Rockman 1,2, Karen Laurie 1,2 and Ian Barr 2,3,*

1 Seqirus, 63 Poplar Road, Parkville, VIC 3052, Australia; 2 Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute of Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia; 3 WHO Collaborating Centre for Reference and Research on Influenza, at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000,  Australia

*Author to whom correspondence should be addressed.

Vaccines 2020, 8(2), 211; https://doi.org/10.3390/vaccines8020211 (registering DOI)

Received: 4 April 2020 / Revised: 1 May 2020 / Accepted: 6 May 2020 / Published: 7 May 2020

(This article belongs to the Special Issue Influenza Virus and Vaccine Development)



In 2009, a novel A(H1N1) influenza virus emerged with rapid human-to-human spread and caused the first pandemic of the 21st century. Although this pandemic was considered mild compared to the previous pandemics of the 20th century, there was still extensive disease and death. This virus replaced the previous A(H1N1) and continues to circulate today as a seasonal virus. It is well established that vaccines are the most effective method to alleviate the mortality and morbidity associated with influenza virus infections, but the 2009 A(H1N1) influenza pandemic, like all significant infectious disease outbreaks, presented its own unique set of problems with vaccine supply and demand. This manuscript describes the issues that confronted governments, international agencies and industries in developing a well-matched vaccine in 2009, and identifies the key improvements and remaining challenges facing the world as the next influenza pandemic inevitably approaches.

Keywords: influenza vaccine; pandemic; pandemic  preparedness; influenza; A(H1N1)pdm09; seasonal influenza vaccine; pandemic influenza vaccine; pandemic vaccine

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Keywords: Influenza A; Pandemic Influenza; Pandemic Preparedness, Vaccines.


#Priorities for the #US #Health #Community Responding to #COVID19 (JAMA, summary)

[Source: JAMA, full page: (LINK). Summary, edited.]

Priorities for the US Health Community Responding to COVID-19

Amesh A. Adalja, MD1; Eric Toner, MD1; Thomas V. Inglesby, MD1

Author Affiliations: 1 Johns Hopkins Center for Health Security and the Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

JAMA. Published online March 3, 2020. doi:10.1001/jama.2020.3413


In late December 2019, a cluster of unexplained cases of viral pneumonia occurred in Wuhan, China.1 This initial cluster of patients with what soon became known as coronavirus disease 2019 (COVID-19) heralded the arrival of a new pandemic caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To date, close to 90 000 cases have occurred in more than 60 countries with approximately 3000 deaths. The World Health Organization (WHO) has declared these events a Public Health Emergency of International Concern.




Corresponding Author: Thomas V. Inglesby, MD, Johns Hopkins Bloomberg School of Public Health, 621 E Pratt St, Ste 210, Baltimore, MD 21202 (tinglesby@jhu.edu).

Published Online: March 3, 2020. doi:10.1001/jama.2020.3413

Conflict of Interest Disclosures: Dr Adalja reports being a shareholder or investor in Luminex, Roche, Evolent, UPMC, Merck, and Ativa Medical and receiving fees from Merck. No other disclosures were reported.

Keywords: SARS-COV-2; COVID-19; USA.


The 1918 #Influenza #Pandemic and Its #Legacy (Cold Spring Harb Perspect Med., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Cold Spring Harb Perspect Med. 2019 Dec 23. pii: a038695. doi: 10.1101/cshperspect.a038695. [Epub ahead of print]

The 1918 Influenza Pandemic and Its Legacy.

Taubenberger JK1, Morens DM2.

Author information: 1 Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA. 2 Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.



Just over a century ago in 1918-1919, the “Spanish” influenza pandemic appeared nearly simultaneously around the world and caused extraordinary mortality-estimated at 50-100 million fatalities-associated with unexpected clinical and epidemiological features. The pandemic’s sudden appearance and high fatality rate were unprecedented, and 100 years later still serve as a stark reminder of the continual threat influenza poses. Sequencing and reconstruction of the 1918 virus have allowed scientists to answer many questions about its origin and pathogenicity, although many questions remain. Several of the unusual features of the 1918-1919 pandemic, including age-specific mortality patterns and the high frequency of severe pneumonias, are still not fully understood. The 1918 pandemic virus initiated a pandemic era still ongoing. The descendants of the 1918 virus remain today as annually circulating and evolving influenza viruses causing significant mortality each year. This review summarizes key findings and unanswered questions about this deadliest of human events.

Copyright © 2019 Cold Spring Harbor Laboratory Press; all rights reserved.

PMID: 31871232 DOI: 10.1101/cshperspect.a038695

Keywords: Influenza A; H1N1; Pandemic Influenza; Spanish Flu.


The #matrix segment of the “#Spanishflu” virus originated from intragenic #recombination between #avian and #human #influenza A viruses (Transbound Emerg Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Transbound Emerg Dis. 2019 Sep;66(5):2188-2195. doi: 10.1111/tbed.13282. Epub 2019 Jul 15.

The matrix segment of the “Spanish flu” virus originated from intragenic recombination between avian and human influenza A viruses.

He CQ1, He M1, He HB1, Wang HM1, Ding NZ1.

Author information: 1 The Key Laboratory of Animal Resistant Biology of Shandong, College of Life Science, Shandong Normal University, Jinan, China.



The 1918 Spanish flu virus has claimed more than 50 million lives. However, the mechanism of its high pathogenicity remains elusive; and the origin of the virus is controversial. The matrix (M) segment regulates the replication of influenza A virus, thereby affecting its virulence and pathogenicity. This study found that the M segment of the Spanish flu virus is a recombinant chimera originating from avian influenza virus and human influenza virus. The unique mosaic M segment might confer the virus high replication capacity, showing that the recombination might play an important role in inducing high pathogenicity of the virus. In addition, this study also suggested that the NA and NS segments of the virus were generated by reassortment between mammalian and avian viruses. Direct phylogenetic evidence was also provided for its avian origin.

© 2019 Blackwell Verlag GmbH.

PMID: 31241237 DOI: 10.1111/tbed.13282 [Indexed for MEDLINE]

Keywords: Avian Influenza; Pandemic Influenza; Reassortant strain; H1N1; Spanish Flu.


#Biochemistry and computer generated graph comparison of the #structural and nonstructural #proteins of #spanish-1918 #Influenza, pandemic-2009, and #birdflu viruses (Acta Biochem Pol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Acta Biochim Pol. 2019 Jul 24;66(3):329-336. doi: 10.18388/abp.2019_2795.

Biochemistry and computer generated graph comparison of the structural and nonstructural proteins of spanish-1918 Influenza, pandemic-2009, and bird flu viruses.

Mahardika GN1, Suartha NI2, Kencana GAY1, Suardana IBK1, Mahardika WW3, Budayanti NS4.

Author information: 1 Virology Laboratory, Faculty of Veterinary Medicine Udayana University, Denpasar, Bali, Indonesia. 2 Animal Hospital, Faculty of Veterinary Medicine Udayana University, Denpasar, Bali, Indonesia. 3 Faculty of Visual Communication Design of Bina Nusantara University, Tanggerang-Banten, Indonesia. 4 Microbiology Department, Faculty of Medicine Udayana University, Denpasar, Bali, Indonesia.



The potential emergence of deadly pandemic influenza viruses is unpredictable and most have emerged with no forewarning. The distinct epidemiological and pathological patterns of the Spanish (H1N1), pandemic-2009 (H1N1), and avian influenza (H5N1), known as bird flu, viruses may allow us to develop a ‘template’ for possible emergence of devastating pandemic strains. Here, we provide a detailed molecular dissection of the structural and nonstructural proteins of this triad of viruses. GenBank data for three representative strains were analyzed to determine the polymorphic amino acids, genetic distances, and isoelectric points, hydrophobicity plot, and protein modeling of various proteins. We propose that the most devastating pandemic strains may have full-length PB1-F2 protein with unique residues, highly cleavable HA, and a basic NS1. Any newly emerging strain should be compared with these three strains, so that resources can be directed appropriately.

PMID: 31531422 DOI: 10.18388/abp.2019_2795 [Indexed for MEDLINE] Free full text

Keywords: Avian Influenza; Influenza A; Pandemic Influenza; H1N1; H1N1pdm09; H5N1.


Selective induction of #antibody effector functional responses using #MF59-adjuvanted #vaccination (J Clin Invest., abstract)

[Source: Journal of Clinical Investigation, full page: (LINK). Abstract, edited.]

Research Article / Immunology / Vaccines / Free access | DOI: 10.1172/JCI129520

Selective induction of antibody effector functional responses using MF59-adjuvanted vaccination

Carolyn M. Boudreau,1,2 Wen-Han Yu,1 Todd J. Suscovich,1 H. Keipp Talbot,3,4 Kathryn M. Edwards,5 and Galit Alter1

First published December 17, 2019



Seasonal and pandemic influenza infection remains a major public health concern worldwide. Driving robust humoral immunity has been a challenge given preexisting, often cross-reactive, immunity and in particular, poorly immunogenic avian antigens. To overcome immune barriers, the adjuvant MF59 has been used in seasonal influenza vaccines to increase antibody titers and improve neutralizing activity, translating to a moderate increase in protection in vulnerable populations. However, its effects on stimulating antibody effector functions, including NK cell activation, monocyte phagocytosis, and complement activity, all of which have been implicated in protection against influenza, have yet to be defined. Using systems serology, we assessed changes in antibody functional profiles in individuals who received H5N1 avian influenza vaccine administered with MF59, with alum, or delivered unadjuvanted. MF59 elicited antibody responses that stimulated robust neutrophil phagocytosis and complement activity. Conversely, vaccination with MF59 recruited NK cells poorly and drove moderate monocyte phagocytic activity, both likely compromised because of the induction of antibodies that did not bind FCGR3A. Collectively, defining the humoral antibody functions induced by distinct adjuvants may provide a path to designing next-generation vaccines that can selectively leverage the humoral immune functions, beyond binding and neutralization, resulting in better protection from infection.

Keywords: Influenza A; Seasonal Influenza; Pandemic Influenza; Vaccines; Immunology; MF59.


#Planning for the next #pandemic: a call for new #guidance (Lancet Resp Med., summary)

[Source: The Lancet Respiratory Medicine, full page: (LINK). Summary, edited.]

Planning for the next pandemic: a call for new guidance

Joe Brierley, Stephen Playfor, Samiran Ray

Published: December 16, 2019 / DOI: https://doi.org/10.1016/S2213-2600(19)30357-1


Collaborative working, regional spare capacity, and goodwill maintain paediatric intensive care unit (PICU) function during sudden local or regional surges of demand, such as those observed after the Manchester bombing or the Grenfell Tower fire in the UK. Surges due to pandemics are less forgiving but are inevitable, and we also face an increasing number of unpredictable threats from environmental catastrophes and terrorism. Given recent substantial changes in the PICU case-mix, it seems clear that existing guidance for resource allocation during times of overwhelming need, such as during pandemics, requires urgent revision.


Keywords: Pandemic Influenza; Pandemic Preparedness; Emerging diseases; Intensive Care; Pediatrics.


#PanStop: a decade of rapid #containment #exercises for #pandemic #preparedness in the #WHO Western #Pacific Region (Western Pac Surveill Response J., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Western Pac Surveill Response J. 2018 Winter; 9(5 Suppl 1): 71–74. Published online 2018 Dec 18. doi: 10.5365/wpsar.2018.9.5.012 | PMCID: PMC6902655

PanStop: a decade of rapid containment exercises for pandemic preparedness in the WHO Western Pacific Region

Edna Moturi,a Katherine Horton,a Leila Bell,a Lucy Breakwell,a and Erica Dueger a,b

Author information: {a} WHO Regional Office for the Western Pacific, Manila, Philippines. {b} Influenza Division, Centers for Disease Control and Prevention, Atlanta, United States of America.

Correspondence to Erica Dueger (email: tni.ohw@raspw)

Copyright (c) 2018 The authors; licensee World Health Organization.

This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article’s original URL.



Rapid containment (RC) is one of the five priority interventions of the World Health Organization (WHO) Strategic Action Plan for Pandemic Influenza; (1) it relies on the concept that mass prophylactic administration of antiviral drugs, combined with quarantine and social distancing measures, could contain or delay the international spread of an emerging influenza virus. (2, 3) During a RC operation, mass antiviral prophylaxis treatment and non-pharmaceutical interventions are rapidly implemented within a containment zone surrounding the initial cases; active surveillance and additional activities are extended to a broader buffer zone where cases are most likely to appear based on the movements of cases and contacts. (2, 4) The strategy is dependent on the rapid (within three to five days) detection, investigation and reporting of initial cases; the efficacy and availability of antivirals and vaccines; and timely risk assessment and decision-making. In the Western Pacific Region, a stockpile of antiviral medication and personal protective equipment acquired through donations from the Government of Japan is warehoused in Singapore under the auspices of the Association of South-eastern Asian Nations (ASEAN), (5) and is managed under contract by the Japan International Cooperation System (JICS). (5) These supplies are reserved for early intervention when initial signs of increased human-to-human transmission of a highly contagious influenza virus occur.


Keywords: Pandemic Influenza; Pandemic Preparedness; Antivirals; Asia Region; WHO.