#Influenza #Cataclysm, 1918 (N Engl J Med., summary)

[Source: The New England Journal of Medicine, full page: (LINK). Summary, edited.]

Influenza Cataclysm, 1918

David M. Morens, M.D., and Jeffery K. Taubenberger, M.D., Ph.D.

December 13, 2018 / N Engl J Med 2018; 379:2285-2287 / DOI: 10.1056/NEJMp1814447

 

Audio Interview

Interview with Dr. David Morens on lessons from the 1918 influenza pandemic and the threat of a similar global health disaster. 

This year marks the centennial of an influenza pandemic that killed 50 million to 100 million people globally — arguably the single deadliest event in recorded human history. Evidence suggests that another pandemic at least as severe may occur one day.

___

Disclosure forms provided by the authors are available at NEJM.org.

Author Affiliations: From the Office of the Director (D.M.M.) and the Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases (J.K.T.), National Institute of Allergy and Infectious Diseases, Bethesda, MD.

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

——

Advertisements

#Epidemic #preparedness: why is there a need to accelerate the #development of #diagnostics? (Lancet Infect Dis., summary)

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

Epidemic preparedness: why is there a need to accelerate the development of diagnostics?

Prof Rosanna W Peeling, PhD, Maurine Murtagh, PhD, Piero L Olliaro, MD

Published: December 11, 2018 / DOI: https://doi.org/10.1016/S1473-3099(18)30594-2

 

Summary

Global epidemics of infectious diseases are increasing in frequency and severity. Diagnostics are needed for rapid identification of the cause of the epidemic to facilitate effective control and prevention. Lessons learned from the recent Ebola virus and Zika virus epidemics are that delay in developing the right diagnostic for the right population at the right time has been a costly barrier to disease control and prevention. We believe that it is possible to accelerate and optimise diagnostic development through a five-pronged strategy: by doing a global landscape analysis of diagnostic availability worldwide; through strategic partnerships for accelerating test development, in particular with vaccine companies to identify novel diagnostic targets; by creating and sharing repositories of data, reagents, and well characterised specimens for advancing the development process; by involving key public and private stakeholders, including appropriate regulatory bodies and policy makers, to ensure rapid access for researchers to diagnostics; and last, by fostering an enabling environment for research and access to diagnostics in the countries that need them. The need is great, but not insurmountable and innovative and faster development pathways are urgently required to address current shortfalls.

Keywords: Emerging Diseases; Infectious Diseases; Pandemic preparedness; Diagnostic tests.

——

#Preclinical evaluation of the efficacy of an #H5N8 #vaccine candidate (IDCDC-RG43A) in mouse and ferret models for #pandemic preparedness (Vaccine, abstract)

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

Vaccine. 2018 Nov 27. pii: S0264-410X(18)31589-5. doi: 10.1016/j.vaccine.2018.11.064. [Epub ahead of print]

Preclinical evaluation of the efficacy of an H5N8 vaccine candidate (IDCDC-RG43A) in mouse and ferret models for pandemic preparedness.

Jeong JH1, Kim EH1, Lloren KKS1, Kwon JJ1, Kwon HI1, Ahn SJ1, Kim YI1, Choi WS1, Si YJ1, Lee OJ1, Han HJ2, Baek YH1, Song MS3, Choi YK4, Kim CJ5.

Author information: 1 Department of Microbiology, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Republic of Korea. 2 Department of Microbiology, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Republic of Korea; Research & Development Center, Green Cross Corporation, Yongin, Republic of Korea; Research & Development Center, Green Cross Wellbeing Corporation, Seongnam, Republic of Korea. 3 Department of Microbiology, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Republic of Korea. Electronic address: songminsuk@chungbuk.ac.kr. 4 Department of Microbiology, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Republic of Korea. Electronic address: choiki55@chungbuk.ac.kr. 5 College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea. Electronic address: cjkim@cnu.ac.kr.

 

Abstract

Because H5N1 influenza viruses continuously threaten the public health, the WHO has prepared various clades of H5N1 mock-up vaccines as one of the measures for pandemic preparedness. The recent worldwide outbreak of H5Nx virus which belongs to clade 2.3.4.4 and of which H5N6 subtype belongs and already caused human infection also increases the need of pandemic vaccine for such novel emerging viruses. In this study, we evaluated the protective efficacy and immunogenicity of an egg-based and inactivated whole-virus H5N8 (IDCDC-RG43A) developed by CDC containing HA and NA gene of the parent virus A/gyrfalcon/Washington/41088-6/2014. Mice vaccinated two times elicited low to moderate antibody titer in varying amount of antigen doses against the homologous H5N8 vaccine virus and heterologous intra-clade 2.3.4.4 H5N6 (A/Sichuan/26221/2014) virus. Mice immunized with at least 3.0 µg/dose of IDCDC-RG43A with aluminum hydroxide adjuvant were completely protected from lethal challenge with the mouse-adapted H5N8 (A/Environment/Korea/ma468/2015, maH5N8) as well as cleared the viral replication in tissues including lung, brain, spleen, and kidney. Vaccinated ferrets induced high antibody titers against clade 2.3.4.4 H5N8/H5N6 viruses and the antibody showed high cross-reactivity to clade 2.2 H5N1 but not to clade 1 and 2.3.4 viruses as measured by hemagglutinin inhibition and serum neutralization assays. Furthermore, administration of the vaccine in ferrets resulted in attenuation of clinical disease signs and virus spread to peripheral organs including lung, spleen, and kidney from high dose challenge with maH5N8 virus. The protective and immunogenic characteristic of the candidate vaccine are essential attributes to be considered for further clinical trials as a pre-pandemic vaccine for a potential pandemic virus.

KEYWORDS: H5N8 pre-pandemic vaccine; Immunogenicity; Preclinical evaluation; Protective efficacy

PMID: 30502069 DOI: 10.1016/j.vaccine.2018.11.064

Keywords: Avian Influenza; Pandemic Influenza; Pandemic Preparedness; Vaccines; H5N1; H5N6; H5N8.

——

1818, 1918, 2018: Two #Centuries of #Pandemics (Health Secur., abstract)

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

Health Secur. 2018 Dec 4. doi: 10.1089/hs.2018.0083. [Epub ahead of print]

1818, 1918, 2018: Two Centuries of Pandemics.

Snyder MR1,2, Ravi SJ1,2.

Author information: 1 Michael R. Snyder, MALD, is an Analyst, and Sanjana J. Ravi, MPH, is a Senior Analyst, both at the Johns Hopkins Center for Health Security. 2 Both are Research Associates at the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

 

Abstract

2018 marks the centennial of the 1918 influenza pandemic, widely acknowledged as one of the deadliest infectious disease crises in human history. As public health and medical communities of practice reflect on the aftermath of the influenza pandemic and the ways in which it has altered the trajectory of history and informed current practices in health security, it is worth noting that the Spanish flu was preceded by a very different 100-year threat: the first Asiatic cholera pandemic of 1817 to 1824. In this commentary, we offer a historical analysis of the common socioeconomic, political, and environmental factors underlying both pandemics, consider the roles of cholera and Spanish flu in shaping global health norms and modern public health practices, and examine how strategic applications of soft power and broadening the focus of health security to include sustainable development could help the world prepare for pandemics of the future.

PMID: 30511884 DOI: 10.1089/hs.2018.0083

Keywords: Pandemics; Pandemic preparedness; Influenza A; Cholera; Society.

——

#Politics and #Pandemics (N Engl J Med., summary)

[Source: The New England Journal of Medicine, full page: (LINK). Summary, edited.]

Perspective

Politics and Pandemics

Ron Klain, J.D.

December 6, 2018 / N Engl J Med 2018; 379:2191-2193 / DOI: 10.1056/NEJMp1813905

____

This year marks the 100th anniversary of the deadliest event in U.S. history: the Spanish influenza epidemic of 1918, which killed more Americans than World Wars I and II combined. Although science and technology have advanced tremendously over the past century, the pandemic peril remains: a recent exercise at the Johns Hopkins Center for Health Security showed that an epidemic of an influenza-like virus could kill 15 million Americans in a single year.

(…)

___

Disclosure forms provided by the author are available at NEJM.org.

This article was published on November 7, 2018, at NEJM.org.

Author Affiliations: From Harvard Law School, Cambridge, MA. Mr. Klain was the White House Ebola Response Coordinator from 2014 to 2015.

Keywords: Pandemic Preparedness.

——

The #Angolan #Pandemic #RRT: An #Assessment, Improvement, and #Development Analysis of the First Self-sufficient African National Response Team Curriculum (Disaster Med Public Health Prep., abstract)

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

Disaster Med Public Health Prep. 2018 Nov 27:1-5. doi: 10.1017/dmp.2018.122. [Epub ahead of print]

The Angolan Pandemic Rapid Response Team: An Assessment, Improvement, and Development Analysis of the First Self-sufficient African National Response Team Curriculum.

Owens MD1, Rice J2.

Author information: 1 Naval Medical Center,Portsmouth,Virginia. 2 Navy Environmental and Preventive Medicine Unit 7,Rota,Spain.

 

Abstract

OBJECTIVE:

The purpose of this study was to assess, through participant self-assessment, the effectiveness of a rapid response team curriculum based on the World Health Organization (WHO) Ebola Virus Disease Consolidated Preparedness Checklist, Revision 1.

METHODS:

A pre-and-post survey for the purpose of process improvement assessment involving 44 individuals was conducted in Angola. The survey was conducted before and after a 6-day training workshop held in Luanda, Angola, in December 2017. A paired t-test was used to identify any significant change on six 7-point Likert scale questions with α <.05 (95% CI).

RESULTS:

Two of the 6 questions, “I feel confident the team can effectively work together to accomplish its assigned goals and objectives during a suspected contagious hemorrhagic fever disease outbreak” and “I understand basic pandemic response concepts” changed significantly from the presurvey to the postsurvey. The 4 remaining questions had near statistical significant change or an upward trend.

CONCLUSION:

This Angolan rapid response team training curriculum based on WHO guidelines, After Action Reports, and internationally accepted standard operating procedures provides the nation of Angola with the confidence to rapidly respond at the national level to a highly infectious contagion in the region.

(Disaster Med Public Health Preparedness. 2018;page 1 of 5).

KEYWORDS: Ebola; hemorrhagic fever; public health emergencies of international concern; rapid response teams

PMID: 30479245 DOI: 10.1017/dmp.2018.122

Keywords: Pandemic Preparedness; Ebola; Angola.

——

#Fogarty International Center collaborative #networks in #infectious disease modeling: Lessons learnt in research and capacity building (Epidemics, abstract)

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

Epidemics. 2018 Oct 23. pii: S1755-4365(18)30029-X. doi: 10.1016/j.epidem.2018.10.004. [Epub ahead of print]

Fogarty International Center collaborative networks in infectious disease modeling: Lessons learnt in research and capacity building.

Nelson MI1, Lloyd-Smith JO2, Simonsen L3, Rambaut A4, Holmes EC5, Chowell G6, Miller MA1, Spiro DJ1, Grenfell B7, Viboud C8.

Author information: 1 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA. 2 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA; Department of Ecology & Evolutionary Biology, University of California, Los Angeles CA, USA. 3 Department of Science and Environment, Roskilde University, Roskilde, Denmark. 4 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA; Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, Scotland. 5 Marie Bashir Institute for Infectious Diseases and Biosecurity, Charles Perkins Centre, School of Life and Environmental Sciences and Sydney Medical School, The University of Sydney, Sydney NSW, Australia. 6 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA; Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta GA, USA. 7 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA; Department of Ecology and Evolutionary Biology, Princeton University, Princeton NJ, USA. 8 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA. Electronic address: viboudc@mail.nih.gov.

 

Abstract

Due to a combination of ecological, political, and demographic factors, the emergence of novel pathogens has been increasingly observed in animals and humans in recent decades. Enhancing global capacity to study and interpret infectious disease surveillance data, and to develop data-driven computational models to guide policy, represents one of the most cost-effective, and yet overlooked, ways to prepare for the next pandemic. Epidemiological and behavioral data from recent pandemics and historic scourges have provided rich opportunities for validation of computational models, while new sequencing technologies and the ‘big data’ revolution present new tools for studying the epidemiology of outbreaks in real time. For the past two decades, the Division of International Epidemiology and Population Studies (DIEPS) of the NIH Fogarty International Center has spearheaded two synergistic programs to better understand and devise control strategies for global infectious disease threats. The Multinational Influenza Seasonal Mortality Study (MISMS) has strengthened global capacity to study the epidemiology and evolutionary dynamics of influenza viruses in 80 countries by organizing international research activities and training workshops. The Research and Policy in Infectious Disease Dynamics (RAPIDD) program and its precursor activities has established a network of global experts in infectious disease modeling operating at the research-policy interface, with collaborators in 78 countries. These activities have provided evidence-based recommendations for disease control, including during large-scale outbreaks of pandemic influenza, Ebola and Zika virus. Together, these programs have coordinated international collaborative networks to advance the study of emerging disease threats and the field of computational epidemic modeling. A global community of researchers and policy-makers have used the tools and trainings developed by these programs to interpret infectious disease patterns in their countries, understand modeling concepts, and inform control policies. Here we reflect on the scientific achievements and lessons learnt from these programs (h-index = 106 for RAPIDD and 79 for MISMS), including the identification of outstanding researchers and fellows; funding flexibility for timely research workshops and working groups (particularly relative to more traditional investigator-based grant programs); emphasis on group activities such as large-scale modeling reviews, model comparisons, forecasting challenges and special journal issues; strong quality control with a light touch on outputs; and prominence of training, data-sharing, and joint publications.

KEYWORDS: Capacity building; Computational models; Control; Emerging disease threats; Infectious diseases; Influenza; Pathogen evolution; Policy; Transmission models

PMID: 30446431 DOI: 10.1016/j.epidem.2018.10.004

Keywords: Infectious Diseases; Emerging Diseases; Pandemic Preparedness; International Cooperation; Mathermatical Models.

——