When writing about influenza, it can be difficult to report on cutting-edge research. One has to carefully apply terms like “breakthrough.” One also has to avoid terms like “miracle cure.”

A universal flu vaccine, that can provide extended protection across a variety of recombitant influenza viruses represents the pinnacle for microbiological research in this area. While this goal remains years away, there are some promising lines of approach.

Current influenza vaccines essentially are aimed at narrow range of viruses that are currently in circulation. “Frequent minor changes in flu viruses involve two surface proteins, hemagglutinin and neuraminidase, represented by the H and N in virus names.”

The hemagglutanin (HA) surface protein is a “mushroom-shaped structure helps the virus attach to the cells it infects” The problem arises when the HA attack surface changes due to antigenic drift, requiring annual updates to the seasonal flu vaccine. Hence, some modern lines of research toward a universal vaccine try to take aim at those sections of HA portion of the virus that are relatively static over time and are consistent over several strains.

Researchers at Mount Sinai School of Medicine in New York developed
a proof-of-concept designed to help the immune system develop antibodies that target a headless hemagglutanin (HA) molecule. Thus far trials have proven successful in mice.

Other lines of research over recent years have taken aim at “M2″, a relatively stable protein found in Influenza A viruses.

Other molecular research has not centered on influenza virus itself but rather on finding human host factors and classes of natural flu fighting proteins that inhibit virus replication.

CIDRAP: Acambis launches human trial of ‘universal’ flu vaccine
CIDRAP: Firm says ‘universal’ flu vaccine passed early test
mBio: Influenza Virus Vaccine Based on the Conserved Hemagglutinin Stalk Domain
Reuters: Researchers take step to ‘universal’ flu vaccine

The most significant failure in the global public health response to pandemic H1N1 was the lack of sufficient vaccine supplies in time for the second wave of H1N1.

According to reporting from the World Health Organization (WHO) H1N1 Influenza Vaccine Task Force, global influenza vaccine production continues to fall well short of WHO’s desired production targets owing to a variety of factors.

In 2006, WHO set a goal of having vaccine supplies sufficient for two billion persons within six months of the provision of a pandemic strain to industry. H1N1 vaccine production fell well short of this goal, amounting to only 534 million doses within the six-month milestone, which was reached in December 2009.

Reasons for this trace to lower-than-expected production yields associated with egg-based production methods (H1N1 vaccine yields were two-thirds lower than their seasonal vaccine counterparts). WHO researchers also noted reluctance among some regulatory bodies to approve vaccines with adjuvants (immune system enancing additives) to stretch vaccine doses. Declining H1N1 vaccine demand and requirements for seasonal vaccine production were additional factors.

Flu vaccine production still remains mostly concentrated within a few developed countries and “among seven large manufacturers that are located in the USA, Canada, Australia, western Europe, Russia, China, and Japan.” However, overall vaccine production capacity is expanding. In 2006, vaccine production was centered in nine industrialized countries. At present, influenza vaccine production “is currently available or is being established in 25 countries.”

Within the USA, the President’s Council of Advisors on Science and Technology (PCAST) recently presented a series of recommendations to improve pandemic vaccine production. In the short term, key recommendations included shifting vaccine production from egg-based methods to cell-cultures, improved seed strains and testing as well as larger and more modernized facilities.

Among the longer-term recommendations were support for adjuvenated vaccines, capacity to test and develop vaccines against at least pandemic virus threats, research toward a universal vaccine, and improved guidance from the U.S. Food and Drug and Administration to streamline approvals of new vaccines.

CIDRAP: President’s advisory group looks to speed up flu vaccine
CIDRAP: WHO: Pandemic showed limits of vaccine production capacity

With the passage of time, H1N1 has been quiet in the USA. No states have reported widespread or regional flu activity for five consecutive weeks. Doctor visits for Influenza-like Illness (ILI) are below baseline across all ten CDC regions.

On the international front, H1N1 has receded across much of the world. The World Health Organization (WHO) reports the most active areas of pandemic influenza virus transmission “currently are in parts of the Caribbean and Southeast Asia.” The need to monitor winter influenza developments in the southern hemispere explains the WHO decision to delay consideration of a reduction in pandemic level.

As pandemic H1N1 apparently ebbs, some questions remain for future public health preparedness. Medical research continues to further our understanding of H1N1. The virus itself continues to evolve.

In the USA, public health reponse to H1N1 was a measured success. Public interest in H1N1 remained generally high and receptive to public health messages; the public largely adopted H1N1 prevention recommendations. H1N1 vaccination clincs were erected in “non-traditional venues such as shopping malls, airports, subway stations, and sporting events.” Rates of uptake of seasonal and H1N1 vaccines were impressive. As many as 81 million Americans (up to 27% of the population) were vaccinated against pandemic H1N1.

However, there were vaccine production bottlenecks, due to lower-than-expected vaccine yields, resulting in insufficient vaccine supplies during peak demand in November, 2009, at a time when the pandemic was intensifying. Public health planners can find little comfort in persistent negative perceptions of vaccine safety across large segments of the population. H1N1 resistance to antiviral medications, while still isolated and sporadic, must be closely monitored over time.

In short, the news on H1N1 continues. The focus of this influenza archive going forward, will be on what we have learned, and what we will continue to learn.

Editor’s Note: Apologies to Market@Flu-Monitor readers for the lengthy hiatus.

CDC: Updated CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States, April 2009 – April 10, 2010
CIDRAP: H1N1 LESSONS LEARNED: Vaccination campaign weathered rough road, paid dividends
NEJM: The Public’s Response to the 2009 H1N1 Influenza Pandemic
Reuters: WHO panel to review H1N1 pandemic status in coming weeks
WHO: Pandemic (H1N1) 2009 – update 101

Buy 1 Sundown vitamin at the regular price & get the 2nd Free at drugstore.com. Offer ends 06.30.2010.

Spend $25 on Burt’s Bees and get a free all in one wash! ($5.19 value) at drugstore.com. While supplies last.

Free shipping AND a $25 Restaurant.com gift certificate with your $25 order!

Get 10% your Easter order with code EASTER10 at Chocolate.com

Save 10% this Easter at Chocolate.com

From CDC’s most recent influenza surveillance report, week ending 20 March:

“Elevated ILI was seen in Regions 4, 7 and 9. Region 4 is comprised of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. Region 7 is Iowa, Kansas, Missouri and Nebraska. And Region 9 is Arizona, California, Hawaii and Nevada. (Last week, only region 4 had elevated ILI.)“

2009 H1N1 Flu: Situation Update – March 26, 2010, 5:30 PM

CDC is reporting ELEVATED influenza-like illness (ILI) activity in Region Four, which includes: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. “Region 4 led the nation at the beginning of the fall wave, which largely followed school openings.” Region 4 also had a higher number of case counts of ILI on college and university campuses than other regions.

Regional influenza activity was reported by three states (Alabama, Georgia, and Mississippi). Local influenza activity has been reported across southern and southeastern states in CDC Regions Four and Five. Recent reports on H1N1 activity from CDC Regions 4 and 5 include:

ATLANTA – Health officials say swine flu hospitalizations in Georgia are up to their highest level since the fall. About 70 to 80 hospitalizations were reported in each of the past two weeks – the most since September, when a large wave of illnesses was hitting the South. (AP – 24 Mar) NOTE: Georgia’s Dept of Community health officially reported 80 and 38 hospitalizations respectively for weeks ending 9 March and 2 March.

MONTGOMERY – Activity reported for last week (March 7-13, 2010) shows the percentage of visits attributed to ILI continues to be elevated in Alabama (7.1%). The baseline set by CDC, above which defines significant influenza activity, in Alabama is 2.0% for the 2009-10 Influenza Season. (ADPH – 18 Mar)

BATON ROUGE – State Health Officer Jimmy Guidry, M.D. announced today that parish health units statewide will host open walk-in H1N1 vaccination clinics this week, as DHH is receiving reports from across that state that hospitals and physician offices have seen an increase in flu-like illnesses in the past few weeks. (DHH – 22 Mar)

Comment: Pandemic H1N1 continues to reach where it can.

ACHA: ACHA Pandemic Influenza Surveillance: Influenza Like Illness (ILI) in Colleges and Universities: Week Ending March 19. 2010
AP: Swine flu hospitalizations up in GA
AL DPH: Influenza Surveillance in Alabama
GA DCH: H1N1 Hospitalizations and Deaths in Georgia
LA DHH: DHH Launches H1N1 Open Clinic Campaign This Week
MS DH: Influenza-Like Illness Report for 2010, Week 10
Recombinomics: US Wave 3 Start Confirmed By H1N1 Increases in Region 4 Recombinomics Commentary 23:03

Leafy Love
Natural Products Marketplace | Mar. 04, 2010

Organic is also a growing trend in the tea market. “Organic specialty teas are one of the bright spots in our economy,” said Eric Ring, head of purchasing and production for Choice Organic Teas. “This section of the food market is growing, and indications are this is not a temporary trend.

Tea can be broken down into four main types: black, green, oolong and white. Interestingly, all tea comes from the Camellia sinensis, an evergreen shrub that can grow up to 60 feet in the wild.” Two other major varietals of tea are yellow and puerh, named after Pu’er County, which is near Simao, Yunnan, China.

Roobios, often referred to as red tea, comes from South Africa and contains no Camellia sinensis. Although not a “tea,” the tea-like beverage yerba maté is made from the leaves and stems of a rainforest tree.

“There are several studies on green and black teas showing they reduce the risk of heart disease, increase metabolism, boost the immune system and aid in rheumatoid arthritis,” said Reem Rahim, co-founder and creative director of Numi Puerh Tea.

“The latest studies on puerh tea show it reduces cholesterol as effectively as cholesterol-reducing drugs, breaks down blood lipids and helps with weight management. Various herbs can assist with various benefits. Ginger and mint aid in digestion; rooibos, an anti-spasmodic, can fight allergies and help with stress. Chamomile also relaxes the body. Yerba maté is a stimulant and lemon myrtle aids with arthritic relief.” …….Full article

Leafy Love

Healthy Monday: We’ve Got Garlic
the green fork | Feb. 22, 2010

Wellness guru Dr. Andrew Weil calls garlic “one of the best general tonics for the healing system”.

Those pungent, spicy little cloves reportedly have the ability to lower cholesterol levels and blood sugar, fight cardiovascular disease, enhance your immune system, and protect your liver and brain cells from degeneration.

It contains a natural antibiotic called allicin, which fights viral and bacterial infections and acts as a decongestant. The allicin is released when you crush garlic.

So if you’re suffering from a cold or the flu this winter, it’s a no-brainer; skip the chicken soup and go for the true culinary cure: a vegetarian roasted garlic soup.…….Full article

Healthy Monday: We’ve Got Garlic

National Nutrition Month® is a nutrition education and information campaign created annually in March by the American Dietetic Association.
American Dietetic Association

The campaign focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits. The theme for March 2010 is “Nutrition From the Ground Up.”

Registered Dietitian Day, also celebrated in March, increases awareness of registered dietitians as the indispensable providers of food and nutrition services and recognizes RDs for their commitment to helping people enjoy healthy lives.

NNM also promotes ADA and its members to the public and the media as the most valuable and credible source of timely, scientifically based food and nutrition information..Full article

.
If its March… It’s National Nutrition Month