What Strain Of Flu Is Going Around – Infectious disease specialists have been concerned about HIV/AIDS, Ebola, and Zika in recent decades. But one disease scares them more than any other – the flu. That’s right, a cold.
Although many people ignore and misunderstand it, everything from a cold to a stomach bug is called a “cold,” but between 12,000 and 56,000 people die from the flu in the United States each year. they give. And it’s the usual flu season.
What Strain Of Flu Is Going Around
There are frequent epidemics of influenza. At this stage, a new strain emerges to which humans are not immune and is very different from what was previously circulating. A century ago, the 1918 H1N1 pandemic infected about a third of the world’s population and killed 50 to 100 million people. Since then, three other epidemics have occurred in 1957, 1968 and 2009.
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“We’ve come a long way, but we’re still vulnerable,” said Ruth Berkelman, director emeritus of the Center for Public Health Research and Preparedness at the Rollins School of Public Health. “Influenza spreads quickly. It mutates quickly. It’s also ecologically persistent. I think it’s one of the biggest catastrophic threats we face.”
But we have vaccines to prevent infections, antiviral drugs to shorten colds, and antibiotics to fight the bacterial infections that often follow the flu. We’re safer than ever, right?
No really. The flu is a tricky enemy. Because the disease hides from its host for about a day before it becomes known, an infected person can unknowingly spread the germ through their daily activities at school, work, grocery shopping, and physical activity. Many people move. The virus is contagious and spreads mainly through droplets produced when infected people sneeze, cough or talk. Flu germs can jump up to 6 feet to other people and remain on hard surfaces for up to 24 hours.
“There’s a lot you can do to prepare, but at the end of the day, the flu seems to find a way around everything you do,” says Lynette Brammer, who leads the CDC’s domestic flu surveillance team.
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“There’s a saying that when you’ve seen one, you’ve seen one. I know less about the flu today than I did 10 years ago.” Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota
Consider the 2009 pandemic. Flu watchers were convinced that the next pandemic would come from a strain of bird flu that originated in Asia, but the 2009 outbreak was H1N1 (a variant of the strain that caused the 1918 pandemic) that spread among pigs and originated in Mexico. Was. . The outbreak began in April, when flu is not normally seen in the Northern Hemisphere.
“It started in such a strange place, at such a strange time of year, and it took everyone by surprise,” said Alison Chamberlain, assistant professor of epidemiology and director of the Center for Public Health Research and Preparedness at Rollins. “This shows how difficult it is to prevent the flu.”
Flu facts video with Dr. G. Marshall Lyon, a member of the Emory Critical Infectious Disease Unit (SCDU) team.
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That fall, Emory’s Office of Emergency Preparedness and Response (CEPAR), led by emergency physician Alex Isakov, organized a university-wide response to the outbreak. CEPAR has worked with Emory faculty and other partners to develop the “Strategy for Out-of-Site Rapid Diagnosis” (SORT), which allows people to be treated in the most appropriate location by assessing disease severity and risk factors. Convalescent home or clinic/ED for further evaluation and care. This includes a voluntary “round-the-clock quarantine” for Emory students with suspected or suspected swine flu.
“South Thurman residents get free meals, skip school and drive to the pharmacy in the Flying Pig van. Sheets are changed daily. A staff member carries grocery bags containing Tamiflu, granola bars, sports drinks, soup, and a thermometer. The goal is to prevent infected people from sniffling and becoming infected, wrote Robbie Brown, a journalism graduate student at Emory College.
In February, the US Food and Drug Administration will decide which three to four strains will be included in the US flu vaccine for the next flu season, based on recommendations from the World Health Organization.
But during the six months or more it takes to develop and distribute a new vaccine, the virus may mutate in a way different from the original vaccine, rendering the vaccine ineffective. That’s exactly what happened last year, according to infectious disease physician Marshall Lyon, a member of Emory’s Infectious Disease Intensive Care Unit (SCDU). SCDU is required by the federal government to care for patients with specific pathogens better than any other medical facility in the United States.
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Emory has used this expertise to conduct research, validate clinical practices and technologies, and translate discoveries into educational and training programs for healthcare providers, thereby improving patient care outcomes and employee safety, according to Colleen Craft, SCDU assistant medical director. improves Outbreaks of colds or other infectious diseases.
“If I vaccinate myself and people around me refuse the vaccine, I’m at greater risk,” says Walter Orenstein, director of Emory’s program on vaccine policy and development. Therefore, the general immunity threshold for influenza is thought to be 50%.
This means that unless at least 50% of the population is immune, the flu cannot gain enough ground to cause a pandemic. If a vaccine is 60% effective, 85% of the population must be vaccinated to reach the herd immunity threshold.
Last year’s flu season was the deadliest in 40 years, killing an estimated 80,000 Americans, including 180 children. The severity of the epidemic highlighted other potential shortcomings. Demand for hospital beds and services quickly outstripped supply. Grady Memorial Hospital converted waiting rooms into inpatient units, rented a “mobile emergency room” in its parking lot and required staff to work overtime.
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The best protection against an influenza pandemic is a universal vaccine, one that is effective against strains of influenza that persist for years, if not for life.
Researchers say such a vaccine is years away, but important work is underway at Emory University, one of the top five Centers for Influenza Research and Surveillance (CEIRS). These five centers are responsible for the US government’s pandemic planning.
The two main types of influenza virus that infect humans are A and B. Both are associated with seasonal epidemics, but only type A causes epidemics.
Influenza A virus is cleaved by two surface proteins, hemagglutinin (HA) and neuraminidase (NA). These proteins on the surface of the cell are like recognition fingerprints unique to the virus. A small mutation in one of these proteins creates a new subtype, so the flu vaccine must be updated every year. Larger mutations can create strains that humans haven’t encountered before, so they’re not immune. And it can lead to an epidemic.
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Most notably, the HA molecule is tree-shaped, with a large head and a small stem or stalk. The head is the part that connects the virus to the cells and changes from year to year. The flu vaccine usually targets the head of the flu.
Rafi Ahmed, director of Emory’s Vaccine Center, is working on a vaccine that targets the stem of the HA molecule. Because this region does not change from strain to strain, a vaccine that inactivates the virus by attacking the stem will be effective against many strains of influenza A.
Ahmed and his team started down this path after the 2009 pandemic and were surprised to find that people infected with the H1N1 strain produced antibodies in the stem rather than the head. This opened the door to the development of a similar vaccine.
“We were able to identify many antibodies that bind to the stem region and some protected areas of the head,” Ahmed said. We are working with Mount Sinai to develop a vaccine, but it is still early days.
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Ahmed’s lab is investigating what can be done to make the vaccine last longer, such as adding another compound, changing the design, or using a different delivery method.
In another Emory lab, Emory/UGA CEIRS researcher Ioanna Skuntzou, an associate professor of microbiology and immunology in the School of Medicine, is pursuing a novel approach to targeting the viral NA molecule, which is less variable than HA.
He also uses a method that does not reproduce live viruses from eggs. Instead, he uses virus-like particles (VLPs). VLPs are man-made decoys of non-infectious natural viruses that are safe to produce and less likely to cause side effects. The Skountzou lab produced VLPs that expressed NA on their surface
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