WHO gearing up response to puzzling new flu virus

[Guest guest]

here we go again.......................Sars, then Bird Flu, then Swine

Flu, now this - its another piggy one - what shall we call this

one? Piggy 2?

They won't quit until people stop buying into these fears

Sheri

The CDC asked the laboratory that makes seed strains for

vaccine companies to produce a vaccine candidate virus for

this H3N2. It is already in the hands of manufacturers. And the WHO is

looking at what it needs to do to be ready. ...

http://ottawa.ctv.ca/servlet/an/local/CTVNews/20111126/who-novel-flu-virus-response-111126/20111126/?hub=OttawaHome

WHO gearing up response to puzzling new flu virus

CTV.ca

Updated: Sat Nov. 26 2011 10:06:59 AM

The Canadian Press

The spread of an odd new flu virus that has been jumping from pigs to

people in parts of the United States has the World Health Organization

gearing up its response planning, a senior official of the agency says.

The UN health body is figuring out what needs to be done if the virus

continues to spread and a global response is required, Dr. Keiji Fukuda,

assistant director-general for health security and environment said in an

interview from Geneva.

The WHO wants to be ready to make recommendations and issue guidance to

countries if the need arises -- though Fukuda stressed at this point it

is far from certain there will be that need.

" We're very aware that we don't want to over-play or under-play.

We're trying to get that right, " says Fukuda, a leading influenza

expert.

" (We're) trying to make sure that we're ready to move quickly, if we

have to move quickly, but also trying not to raise alarm bells. "

The desire to be prepared without raising alarm is a legacy of the 2009

H1N1 pandemic. The WHO was heavily criticized in Europe for declaring

that event a pandemic when the outbreak turned out to be far milder than

originally feared.

But what exactly the agency -- and the world -- might need to prepare for

now is very unclear. With the public relations problems of the 2009

outbreak fresh in the minds of health officials, no one is using the

" p " word these days.

Yet in some respects the parallels to 2009 are striking.

A new swine-origin flu virus is causing sporadic infections in parts of

the United States. Since the new virus was first spotted in July, 10

cases have been confirmed in Maine, Indiana, Pennsylvania and Iowa. All

have been children under 10, with a lone exception -- a 58-year-old

adult. Three of the cases have required hospitalization but most of the

infections have been mild, like regular flu.

It is an influenza A virus of the H3N2 subtype, a distant cousin of H3N2

viruses that circulate in humans.

Scientists at the U.S. Centers for Disease Control say the hemagglutinin

gene, the H3, looks like that of H3N2 viruses that used to circulate in

people in the early 1990s.

It is sufficiently different from contemporary human viruses that the

H3N2 component of the seasonal flu shot is not expected to protect

against this virus, though it might boost antibody levels in those who

were exposed to the earlier H3N2 viruses.

The CDC is still doing serological work -- checking stored blood samples

for antibodies that react to this virus -- to try to figure out how much

vulnerability there is to the new virus. The current thinking is most

people over the age of 21 or so would have had exposure to similar flu

viruses and would therefore have some protection against it.

Teenagers and children might not, though even that's not 100 per cent

certain. Flu expert Malik Peiris, chair of the department of microbiology

at the University of Hong Kong, says he thinks exposure to contemporary

H3N2 viruses might provide some protection against these swine viruses.

" It is important to see the serological data to see how much

vulnerability or susceptibility there is in the human population, "

Peiris says.

Dr. Arnold Monto, a flu expert at the University of Michigan, says if a

major part of the human population has antibodies that react to the

virus, it may not be much of a threat.

" If there's a lot of immunity in the population, there probably will

not be any kind of extensive spread except maybe in these little clusters

where you have little folks who don't have much immunity to

anything, " he says.

Fukuda, on the other hand, says further spread cannot be ruled out:

" I think that certainly there's no reason why this virus, if it

continues to spread human to human couldn't move from country to country

among young people. "

The first seven infections appeared to have been instances where the

virus passed from pigs to people. But the most recent cases, in Iowa,

seem pretty clearly to have involved person-to-person spread.

There were three confirmed cases in that cluster, but it was likely

larger. Two contacts of the first confirmed case were also ill, but were

not tested. And the people in this cluster seemingly had no contact with

pigs, suggesting they caught the virus from an unidentified person.

The virus was previously isolated from pigs in the U.S. Midwest, says Dr.

, head of the CDC's influenza division, though she won't specify

where.

Canadian authorities say there are no reports of the virus in this

country. And the WHO knows of no cases other than those in the United

States, Fukuda says.

To some in the flu world, the situation is reminiscent of 1977. That year

an H1N1 virus started circling the globe, causing infections mainly in

young people. H1N1 viruses hadn't been spotted for 20 years at that

point; it is widely believed the virus was accidentally released from a

laboratory.

On some lists of pandemics, the 1977 outbreak is named. Most flu experts,

though, do not consider it a pandemic. Some, like Monto, refer to it as a

pseudo pandemic.

While the flu world doesn't want to over-react to this virus, it doesn't

feel safe ignoring it either.

The CDC asked the laboratory that makes seed strains for vaccine

companies to produce a vaccine candidate virus for this H3N2. It is

already in the hands of manufacturers.

And the WHO is looking at what it needs to do to be ready. One of the

tasks it is currently working on is trying to figure out what to call

this virus, if it should continue to spread.

Naming the pandemic virus was a nightmare for public health officials in

the start of the 2009 outbreak.

Flu experts accustomed to talking about viruses based on the animals they

normally infected -- bird flu, swine flu, dog flu, human flu -- were

caught in a political vise when powerful agricultural interests objected

to references to the virus's swine origins.

But calling the virus simply H1N1 didn't differentiate it from the human

H1N1 that was circulating before the pandemic. (It has since

disappeared.) Recently the pandemic virus was officially named H1N1

pdm09.

This swine-origin H3N2 virus poses the same naming challenges.

And this time, the WHO wants to be prepared. Fukuda says the WHO has been

in discussion with its animal health counterparts, the UN Food and

Agriculture Agency and the OIE, the World Organization for Animal Health,

to work out a possible name.

" We're pretty aware that we don't want to increase stigma, we're

pretty aware that it is always possible for people to get afraid of food

or to enact trade embargoes or things like that. So to the extent that

naming the virus in a way which minimizes those things can be done, we

think it's better, " he says.

" It's just one of those lessons that we've learned. Take a look at

those things early. So that's what we're doing. "

Still, it's all being done with the realization that there may be no need

for heightened public health responses, apart from the increased

surveillance the U.S. has mounted.

" This is one of the things that we've discussed, " Fukuda says.

" This could be the only cluster we see, " he says, referring to

the Iowa cases. " We could see some sort of stuttering picture for a

long time. Or we could see things jump. All of those things are

possible. "