WHO report calls H5N1 vaccine stockpiling premature

first_imgNov 2, 2006 (CIDRAP News) – A group of influenza experts convened by the World Health Organization cautioned today that governments shouldn’t stockpile “pre-pandemic” H5N1 influenza vaccines now, because too little is known about the requirements for an effective vaccine.The group of 22 scientists, who met for 2 days in September, “agreed that governments should not rush to place orders for pre-pandemic vaccines when so many fundamental scientific questions are still outstanding,” says their report.The United States and some other countries have been stockpiling H5N1 vaccines, despite lack of assurance that they would be effective against a pandemic strain. Switzerland recently announced plans to buy enough vaccine for the entire Swiss population.The 16-page report, titled “Influenza Research at the Human and Animal Interface,” emphasizes the continuing seriousness of the threat posed by the H5N1 virus. The meetings on which it was based involved many of the world’s leading experts on influenza.The experts agreed that “the seriousness of the present situation, including the risk that a pandemic virus might emerge, is not likely to diminish in the near future,” the document states.The report also warns that if the H5N1 virus becomes a pandemic strain, it could remain as lethal for humans as it is now, depending on how it acquires the ability to spread from person to person. The current case-fatality rate, with 256 cases and 152 deaths, is about 59%.If the virus becomes more transmissible by acquiring genes from a human-adapted flu virus, its deadliness “would most likely be reduced.” But if it remains “a wholly avian virus” that adapts to humans through a series of mutations, it could remain as deadly as it is now, the experts say.The report says that vaccine development results so far “have not been promising,” in part because H5N1 viruses have branched off into a number of diverse subgroups, and vaccines that seem to work against one clade, or group, don’t work well against others.Many fundamental questions about vaccine development remain to be answered, the group concluded. For example, scientists need to determine which adjuvant (general immune system stimulant) works best and to define what kind of observed immune response indicates an adequate level of protection against the actual virus.The experts say the idea of intradermal injection (injecting vaccine just under the skin instead of into muscle) as a way to stretch vaccine supplies “does not look promising and is not likely to be suitable for worldwide use.”The document cites an urgent need for international standards for evaluating the efficacy of pandemic vaccines. “On such an important matter, it is unwise to leave assessments of appropriate vaccines to competing manufacturers,” it states.The report describes human H5N1 disease as “fundamentally different” from ordinary flu, marked as it typically is by progressive viral pneumonia, acute respiratory distress, and sometimes diarrhea and liver dysfunction. The disease’s severity may be a result of the “cytokine storm,” or flood of chemical messengers causing intense inflammation in the lungs, but it is not clear whether the cytokine storm is the cause or the result of extensive tissue damage and disease.Some other observations and recommendations in the wide-ranging report are as follows:A simple, rapid, and reliable diagnostic test for use in the field and at the patient’s bedside is urgently needed.Research is needed to determine what makes children and young adults especially vulnerable to infection.Recent serologic studies have shown very little evidence of asymptomatic or mild H5N1 infections in humans. All healthcare workers studied in Thailand tested negative, and samples submitted from Djibouti, Nigeria, Kazakhstan, and Mongolia for testing at the US Centers for Disease Control and Prevention were all negative. However, some family members of patients in Vietnam tested positive.Studies are needed to determine if a genetic predisposition increases the risk of human infection or of human-to-human transmission among blood relatives.Resistance to the first-choice antiviral drug, oseltamivir, has been seen in a few patients, but studies show a low rate of oseltamivir-resistance mutations in H5N1 viruses in birds. Resistance to amantadine, the second-choice antiviral, varies among H5N1 strains.Mallard ducks are now seen as the leading vectors in the geographic spread of H5N1; mute swans are highly susceptible to the disease but probably don’t spread it.Regarding poultry outbreaks in China, “the situation is severe and not yet fully under control,” and vaccination of the entire poultry population is needed.To control H5N1 disease in poultry, vaccination, coupled with appropriate monitoring, should be used when culling is impracticable.Scientists who track the disease in ducks should adjust their sampling procedures to reflect that ducks now shed more virus in their respiratory secretions than in feces.The experts’ warning against stockpiling of H5N1 vaccines was hailed by infectious disease expert Michael T. Osterholm, PhD, MPH, as appropriate advice in view of the virus’s genetic variability.”I think this report will result in a pause in what I think has been a recent epidemic of vaccine results by press release,” said Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of the CIDRAP Web site.He also said the report makes clear that the risk of a severe pandemic like that of 1918 still exists. “Some have suggested that talking about any kind of pandemic other than [the moderate pandemic of] 1957 or 1968 was tantamount to scaremongering,” but the report makes clear that from a virologic standpoint, the H5N1 virus could remain highly deadly while evolving into a pandemic strain, he said.”This is a really thoughtful report, and it adds a tremendous amount to the ongoing discussion,” Osterholm said.See also:Nov 2 WHO report “Influenza Research at the Human and Animal Interface”last_img read more

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Wyoming rolls over Georgia State 38-17 in Arizona Bowl

first_img SUBSCRIBE TO US WATCH US LIVE First Published: 1st January, 2020 15:54 IST Written By Xazavian Valladay ran for 204 yards and scored two touchdowns, quarterback Levi Williams accounted for four scores and Wyoming rolled over Georgia State 38-17 in the Arizona Bowl on Saturday. Wyoming (8-5) started slow before scoring two quick touchdowns late in the first quarter and early in the second. The Cowboys built a 14-point lead by halftime and racked up 524 total yards to win a bowl game after being left out of the postseason last year.Williams made his first career start after Tyler Vander Waal entered the transfer portal but remained with the team for bowl practices. The freshman was poised under the bowl spotlight, throwing for three touchdowns and running for another. Valladay had three catches for 91 yards and a touchdowns.Georgia State (7-6) jumped to a 10-0 lead in the first quarter but had a hard time stopping the big-play Cowboys. The Panthers twice turned the ball over on downs deep in Wyoming’s end in the second half.Dan Ellington, who played with a torn right ACL, threw for 156 yards and a TD, adding 70 yards and a score rushing.The Panthers got off to a fast start, marching quickly forThe Cowboys took over from there, scoring two touchdowns in less than two minutes. Williams threw an 18-yard TD to Austin Conway and, following an interception thrown by Ellington, he found Valladay onEarly in the second quarter, Williams had an interception deep in Georgia State’s end on an ill-advised back-foot throw. He made a similar throw just before halftime, but that one turned intoThe Cowboys led 24-10 at halftime.Williams and Valladay connected on a 63-yard pass to open the second half and Valladay scored onGeorgia State responded quickly, pulling within 31-17 when Ellington hit Cornelius McCoy onWyoming kept gouging the Panthers’ defense, though. Valladay broke two tackles on a 62-yard run, setting up Williams’THE TAKEAWAYEllington put in a valiant effort while playing injured, but Georgia State’s defense gave up too many big-chunk plays.Wyoming had a huge offensive day to cap a disappointing finish — 1-3 over its final four regular season games.UP NEXTWyoming loses four starters to graduation on offense and five on defense. Williams is a freshman and Valladay is a sophomore, giving the Cowboys two key skill players coming back.Georgia State loses just two starters on offense and one on defense, so the Panthers should be in good shape to possibly set another school record for wins. COMMENTcenter_img Last Updated: 1st January, 2020 15:54 IST Wyoming Rolls Over Georgia State 38-17 In Arizona Bowl Xazavian Valladay ran for 204 yards and scored two touchdowns, quarterback Levi Williams accounted for four scores and Wyoming rolled over Georgia State 38-17 in the Arizona Bowl on Saturday. LIVE TV FOLLOW US Associated Press Television News last_img read more

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