18/08/09

Swine flu science update: 18 August 2009

Most researchers don't think a more dangerous strain of H1N1 will emerge Copyright: Flickr: A Hermida

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A poll of influenza researchers, epidemiologists and public health officials in several countries conducted by New Scientist last week (12 August) has revealed that most do not think a more dangerous strain of swine flu — influenza A(H1N1) — is likely to emerge.

But more than half said they were very or extremely concerned that their local health services would be unable to deal with a virulent wave of swine flu, with one health official in Africa saying her nation was "totally relying on the grace of God".

John Oxford, a professor of virology at Queen Mary, University of London in the United Kingdom, said those fearing increased virulence were harking back to the flu pandemic of 1918 which killed millions. "But it’s different now. In 1918 it was like a missile into a virgin community, where everyone was susceptible … I don’t envisage, at all, a 1918-type scenario," Oxford said.

And an analysis of 14 global or regional flu epidemics in the past 500 years has cast doubt on the widely-held view that the 1918 pandemic was characterised by increasingly virulent waves.

The review, published last week (12 August) in the Journal of the American Medical Association, found insufficient evidence of a milder initial wave followed by increased severity. It also found no pattern of wave-like surges in the disease across the 14 epidemics.

The authors stress that the A(H1N1) pandemic should be closely monitored, paraphrasing the Danish philosopher Soren Kierkegaard to say that "influenza epidemics are lived forward and understood backward".

An influenza A(H1N1) vaccine made in China is effective after a single dose, trials on over 1,500 people have shown, according to Bloomberg. The Chinese government has ordered four million doses which will be delivered by the end of September, said vaccine manufacturer Sinovac.

The country’s health minister, Chen Zhu, was photographed last week (12 August) receiving a second dose of one of the vaccines under production by ten manufacturers in the country.

The future of the international, open access database of information on influenza, EpiFlu, could be in jeopardy because the two organisations responsible for its creation have become mired in a legal dispute.

The Global Initiative on Sharing Avian Influenza Data (GISAID) and the Swiss Institute of Bioinformatics are involved in legal proceedings over a row about funding.

While researchers can still access the database, officials are worried about the implications of the dispute in the longer term. Before the creation of GISAID, some countries, such as Indonesia, refused to share information on influenza.

Brazil has temporarily banned advertising on over-the-counter flu medicine in an effort to force people to see their doctors if they have flu symptoms, AFP reported last week (15 August).

The ban was ordered by the National Health Vigilance Agency, which said that to ensure accurate disease surveillance people must not self-medicate.