Influenza: A case for an improved link between vaccine research and public health

AbstractEmerging infectious diseases (EIDs) are an increasing threat to public health on a global scale. In recent times, the most prominent outbreaks have constituted RNA viruses, spreading via droplets (COVID-19 and Influenza A H1N1), directly between humans (Ebola and Marburg), via arthropod vectors (Dengue, Zika, West Nile, Chikungunya, Crimean Congo) and zoonotically (Lassa fever, Nipah, Rift Valley fever, Hantaviruses). However, specific approved antiviral therapies and vaccine availability are scarce, and public health measures remain critical. Patients can present with a spectrum of ocular manifestations. Emerging infectious diseases should therefore be considered in the differential diagnosis of ocular inflammatory conditions in patients inhabiting or returning from endemic territories, and more general vigilance is advisable in the context of a global pandemic. Eye specialists are in a position to facilitate swift diagnosis, improve clinical outcomes, and contribute to wider public health efforts during outbreaks. This article reviews those emerging viral diseases associated with reports of ocular manifestations and summarizes details pertinent to practicing eye specialists.

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The Effects of Social Distancing Policies on non-SARS-CoV-2 Respiratory Pathogens

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab133 ◽

2021 ◽

Author(s):

Jeff Nawrocki ◽

Katherine Olin ◽

Martin C Holdrege ◽

Joel Hartsell ◽

Lindsay Meyers ◽

...

Keyword(s):

Public Health ◽

Influenza A ◽

Detection Rate ◽

Respiratory Illness ◽

Respiratory Pathogens ◽

Public Health Response ◽

Mixed Effect ◽

Detection Rates ◽

Social Distancing ◽

The Impact

Abstract Background The initial focus of the US public health response to COVID-19 was the implementation of numerous social distancing policies. While COVID-19 was the impetus for imposing these policies, it is not the only respiratory disease affected by their implementation. This study aimed to assess the impact of social distancing policies on non-SARS-CoV-2 respiratory pathogens typically circulating across multiple US states. Methods Linear mixed-effect models were implemented to explore the effects of five social distancing policies on non-SARS-CoV-2 respiratory pathogens across nine states from January 1 through May 1, 2020. The observed 2020 pathogen detection rates were compared week-by-week to historical rates to determine when the detection rates were different. Results Model results indicate that several social distancing policies were associated with a reduction in total detection rate, by nearly 15%. Policies were associated with decreases in pathogen circulation of human rhinovirus/enterovirus and human metapneumovirus, as well as influenza A, which typically decrease after winter. Parainfluenza viruses failed to circulate at historical levels during the spring. Total detection rate in April 2020 was 35% less than historical average. Many of the pathogens driving this difference fell below historical detection rate ranges within two weeks of initial policy implementation. Conclusion This analysis investigated the effect of multiple social distancing policies implemented to reduce transmission of SARS-CoV-2 on non-SARS-CoV-2 respiratory pathogens. These findings suggest that social distancing policies may be used as an impactful public health tool to reduce communicable respiratory illness.

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The Search for a Schistosomiasis Vaccine: Australia’s Contribution

Vaccines ◽

10.3390/vaccines9080872 ◽

2021 ◽

Vol 9 (8) ◽

pp. 872

Author(s):

Donald P. McManus

Keyword(s):

Public Health ◽

Drug Resistance ◽

Sub Saharan Africa ◽

Effective Vaccine ◽

Neglected Tropical Disease ◽

Vaccine Research ◽

Health Measures ◽

Leading Role ◽

Invaluable Tool ◽

Sub Saharan

Schistosomiasis, a neglected tropical disease caused by parasitic flatworms of the genus Schistosoma, results in considerable human morbidity in sub-Saharan Africa, in particular, but also parts of the Middle East, South America, and Southeast Asia. The anti-schistosome drug praziquantel is efficacious and safe against the adult parasites of all Schistosoma species infecting humans; however, it does not prevent reinfection and the development of drug resistance is a constant concern. The need to develop an effective vaccine is of great importance if the health of many in the developing world is to be improved. Indeed, vaccination, in combination with other public health measures, can provide an invaluable tool to achieve lasting control, leading to schistosomiasis elimination. Australia has played a leading role in schistosomiasis vaccine research over many years and this review presents an overview of some of the significant contributions made by Australian scientists in this important area.

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Features of the new pandemic influenza A/H1N1/2009 virus: virology, epidemiology, clinical and public health aspects

Current Opinion in Pulmonary Medicine ◽

10.1097/mcp.0b013e3283375727 ◽

2010 ◽

Vol 16 (3) ◽

pp. 235-241 ◽

Cited By ~ 25

Author(s):

Julian W Tang ◽

Nandini Shetty ◽

Tommy Tsan-Yuk Lam

Keyword(s):

Public Health ◽

Pandemic Influenza ◽

Influenza A ◽

Influenza A H1n1

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Rapid disappearance of influenza following the implementation of COVID-19 mitigation measures in Hamilton, Ontario

Canada Communicable Disease Report ◽

10.14745/ccdr.v47i04a04 ◽

2021 ◽

Vol 47 (04) ◽

pp. 202-208

Author(s):

Kevin Zhang ◽

Avika Misra ◽

Patrick J Kim ◽

Seyed M Moghadas ◽

Joanne M Langley ◽

...

Keyword(s):

Public Health ◽

Influenza A ◽

Respiratory Virus ◽

Respiratory Viruses ◽

Mitigation Measures ◽

Nasopharyngeal Swab ◽

Health Measures ◽

Bayesian Linear Regression ◽

Syncytial Virus ◽

The Impact

Background: Public health measures, such as physical distancing and closure of schools and non-essential services, were rapidly implemented in Canada to interrupt the spread of the coronavirus disease 2019 (COVID-19). We sought to investigate the impact of mitigation measures during the spring wave of COVID-19 on the incidence of other laboratory-confirmed respiratory viruses in Hamilton, Ontario. Methods: All nasopharyngeal swab specimens (n=57,503) submitted for routine respiratory virus testing at a regional laboratory serving all acute-care hospitals in Hamilton between January 2010 and June 2020 were reviewed. Testing for influenza A and B, respiratory syncytial virus, human metapneumovirus, parainfluenza I–III, adenovirus, and rhinovirus/enterovirus was done routinely using a laboratory-developed polymerase chain reaction multiplex respiratory viral panel. A Bayesian linear regression model was used to determine the trend of positivity rates of all influenza samples for the first 26 weeks of each year from 2010 to 2019. The mean positivity rate of Bayesian inference was compared with the weekly reported positivity rate of influenza samples in 2020. Results: The positivity rate of influenza in 2020 diminished sharply following the population-wide implementation of COVID-19 interventions. Weeks 12–26 reported 0% positivity for influenza, with the exception of 0.1% reported in week 13. Conclusion: Public health measures implemented during the COVID-19 pandemic were associated with a reduced incidence of other respiratory viruses and should be considered to mitigate severe seasonal influenza and other respiratory virus pandemics.

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Public health implications of influenza B outbreaks in closed settings in the United Kingdom in the 2007/08 influenza season

Eurosurveillance ◽

10.2807/ese.13.38.18986-en ◽

2008 ◽

Vol 13 (38) ◽

Author(s):

P Mook ◽

J Ellis ◽

J M Watson ◽

CI Thompson ◽

M Zambon ◽

...

Keyword(s):

Public Health ◽

United Kingdom ◽

Burden Of Disease ◽

Influenza A ◽

Health Management ◽

Influenza Season ◽

Influenza B ◽

Influenza A Viruses ◽

School Aged Children ◽

The United Kingdom

Several influenza B outbreaks occurred in closed settings late in the 2007/08 influenza season (October to mid-May) in the United Kingdom (UK), with implications for public health management. Influenza B viruses usually circulate late in the season and cause a milder disease than influenza A viruses [1]. Epidemics of influenza B usually occur every two to three years with the burden of disease falling predominantly on school-aged children [2].

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An analysis of International Health Regulations Emergency Committees and Public Health Emergency of International Concern Designations

BMJ Global Health ◽

10.1136/bmjgh-2020-002502 ◽

2020 ◽

Vol 5 (6) ◽

pp. e002502 ◽

Cited By ~ 4

Author(s):

Lucia Mullen ◽

Christina Potter ◽

Lawrence O Gostin ◽

Anita Cicero ◽

Jennifer B Nuzzo

Keyword(s):

Public Health ◽

Influenza A ◽

Ebola Virus ◽

Virus Disease ◽

International Health ◽

Public Health Emergency ◽

Director General ◽

International Health Regulations ◽

International Response ◽

Health Regulations

IntroductionNine events have been assessed for potential declaration of a Public Health Emergency of International Concern (PHEIC). A PHEIC is defined as an extraordinary event that constitutes a public health risk to other states through international spread and requires a coordinated international response. The WHO Director-General convenes Emergency Committees (ECs) to provide their advice on whether an event constitutes a PHEIC. The EC rationales have been criticised for being non-transparent and contradictory to the International Health Regulations (IHR). This first comprehensive analysis of EC rationale provides recommendations to increase clarity of EC decisions which will strengthen the IHR and WHO’s legitimacy in future outbreaks.Methods66 EC statements were reviewed from nine public health outbreaks of influenza A, Middle East respiratory syndrome coronavirus, polio, Ebola virus disease, Zika, yellow fever and coronavirus disease-2019. Statements were analysed to determine which of the three IHR criteria were noted as contributing towards the EC’s justification on whether to declare a PHEIC and what language was used to explain the decision.ResultsInterpretation of the criteria were often vague and applied inconsistently. ECs often failed to describe and justify which criteria had been satisfied.DiscussionGuidelines must be developed for the standardised interpretation of IHR core criteria. The ECs must clearly identify and justify which criteria have contributed to their rationale for or against PHEIC declaration.ConclusionStriving for more consistency and transparency in EC justifications would benefit future deliberations and provide more understanding and support for the process.

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Rethinking Vaccine Development as an Integral Part of Preparedness in the European Health Union

European Journal of Risk Regulation ◽

10.1017/err.2020.95 ◽

2020 ◽

Vol 11 (4) ◽

pp. 821-830

Author(s):

Marco RIZZI

Keyword(s):

Public Health ◽

Risk Management ◽

Research And Development ◽

Paradigm Shift ◽

Vaccine Development ◽

Recent Past ◽

Vaccine Research ◽

Regulatory Frameworks ◽

European Health ◽

Epidemic Diseases

This opinion piece puts forward a critique of the policy and regulatory frameworks governing vaccines, understood as tools to confront pandemic and epidemic diseases (PEDs). Vaccines being the universally recognised prime method of prevention, immunisation campaigns and vaccine research and development (R&D) could reasonably be expected to feature prominently in any policy and/or strategic document addressing emerging health threats. Yet, vaccination occupies a relatively subsidiary role, with a prevalent focus on risk management mechanisms. This piece outlines the main characteristics of preparedness frameworks and looks at vaccine development in the course of PED outbreaks in the recent past, concluding that the COVID-19 pandemic calls for a paradigm shift in vaccine R&D, which should become integral to public health preparedness.

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Structural and Molecular Characterization of the Hemagglutinin from the Fifth-Epidemic-Wave A(H7N9) Influenza Viruses

Journal of Virology ◽

10.1128/jvi.00375-18 ◽

2018 ◽

Vol 92 (16) ◽

Cited By ~ 14

Author(s):

Hua Yang ◽

Paul J. Carney ◽

Jessie C. Chang ◽

Zhu Guo ◽

James Stevens

Keyword(s):

Public Health ◽

Avian Influenza ◽

Influenza A ◽

Human Infection ◽

Influenza Viruses ◽

Surface Proteins ◽

Health Concern ◽

Public Health Concern ◽

H7n9 Influenza ◽

Epidemic Wave

ABSTRACTThe avian influenza A(H7N9) virus continues to cause human infections in China and is a major ongoing public health concern. Five epidemic waves of A(H7N9) infection have occurred since 2013, and the recent fifth epidemic wave saw the emergence of two distinct lineages with elevated numbers of human infection cases and broader geographic distribution of viral diseases compared to the first four epidemic waves. Moreover, highly pathogenic avian influenza (HPAI) A(H7N9) viruses were also isolated during the fifth epidemic wave. Here, we present a detailed structural and biochemical analysis of the surface hemagglutinin (HA) antigen from viruses isolated during this recent epidemic wave. Results highlight that, compared to the 2013 virus HAs, the fifth-wave virus HAs remained a weak binder to human glycan receptor analogs. We also studied three mutations, V177K-K184T-G219S, that were recently reported to switch a 2013 A(H7N9) HA to human-type receptor specificity. Our results indicate that these mutations could also switch the H7 HA receptor preference to a predominantly human binding specificity for both fifth-wave H7 HAs analyzed in this study.IMPORTANCEThe A(H7N9) viruses circulating in China are of great public health concern. Here, we report a molecular and structural study of the major surface proteins from several recent A(H7N9) influenza viruses. Our results improve the understanding of these evolving viruses and provide important information on their receptor preference that is central to ongoing pandemic risk assessment.

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