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Flu season is upon us and, not surprisingly, there is no dearth of information available to the public about the seasonal and H1N1 flu vaccines. Mostly there are stories about the lack of availability of the vaccines, underreporting of deaths associated from H1N1 infections and perhaps, most importantly concerns about flu vaccine safety. Despite attempts by the CDC and a few dedicated virologists like BioCrowd co-founder Vincent Racaniello, flu vaccine manufacturing is an enigma to the lay public.

While I am a card-carrying microbiologist, my knowledge of the manufacturing of flu vaccine is admittedly lacking. With this in mind, I came across an outstanding tutorial about flu vaccine manufacturing published by the College of Agriculture at the University of Wisconsin-Madison (my alma mater). The UW tutorial is easy to understand and will shed light on and help to demystify flu vaccine production for lay people (and a few scientists like me).

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Yesterday, after giving a talk on social media to a great NYC-based PR firm called Ricochet,I decided to take an uptown trip to visit Professor Vincent Racaniello at Columbia University Medical School to talk about the new applications that we plan to introduce to BioCrowd.

When I arrived at Professor Racaniello’s office, which has an outstanding view of the Hudson River and George Washington Bridge, he was in the middle of taping this week’s This Week in Virology (TWiV) podcast with co-hosts Dick Despommier and Alan Dove. Much to my surprise, Vincent invited me to join the conversation although I am a bacteriologist not a virologist. The podcast was devoted mainly to answering questions that listeners had submitted to the show. One listener alerted us to a post at Newsweek Online entitled “Fight Flu and Falsehoods” while we didn’t agree with the author’s assertion that “that hand washing doesn’t affect the transmissibility of influenza”—it does reduce infections rates of other viruses, bacteria and parasites, so it is a good idea to continue to wash your hands—accompanying the article was an outstanding online quiz that assesses how much you really know about influenza and other viruses. 

I think it would be fun for BioJobBlog readers to take the quiz, report scores and then tabulate the results.

To take the quiz, click here and to report your score click here!  I will tabulate the results and share them in a later post if enough BioJobBlog readers and their friends take!

Until next time

Good Luck and More Luck On the Quiz!!!

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There was an interesting article in the New York Times this past week entitled“Do Women Need Such Big Flu Shot.” The gist of the article was that we would have more doses of influenza 2009 H1N1 vaccine if we accounted for the biological differences between the immune responses in men and women follow influenza vaccination (the article cites a study that contends that less vaccine is need to elicit an protective response in women as compared with men.

I was going to write a post about the article but I got distracted and thought I would revisit it when I had more time. Much to my surprise, Vincent Racaniello, a Bio-Crowd founder, virologist extraordinaire and host of the popular TWiV podcast series, had already “scooped” me. Professor Racaniello graciously allowed me to crib his entire post and let BioJobBlog readers decide for themselves whether or not there are real differences in the male and female immune responses to influenza vaccines or the results obtained by the scientists who conducted the study may be explain by strain to strain variation among influenza A isolates? Read Professor Racaniello’s post below and let me know what YOU think!

Do women need the same amount of influenza vaccine as men?

by Vincent Racaniello

“Do Women Need Such Big Flu Shots?” suggests that we would have more doses of influenza 2009 H1N1 vaccine if we accounted for the biological differences between men and women. The idea is that women generate a stronger antibody response than men, and therefore require less vaccine. Does this idea have scientific support?

The opinion is based in part on a study carried out in 2004-05, in which adults were immunized with full (15 micrograms) or half-doses of trivalent inactivated influenza vaccine. This vaccine, made by Aventis Pasteur, contains influenza H3N2, H1N1, and B strains. Serum samples obtained before immunization and 21 days later were assayed for antibody response to each strain of influenza by hemagglutination-inhibtion. I’ve taken the data on geometric mean serum HI titers according to age, sex, and dose and plotted them on a graph:

Based on the results the authors conclude that “Significantly higher geometric mean titer responses in women were identified for all ages, regardless of dose or influenza strain. Half-dose vaccination may be an effective strategy for healthy adults younger than 50 years in the setting of an influenza vaccine shortage.” But are these immune responses protective?

HI titers of 1:40 or more (which would be reported as 40 or higher in the graph) are believed to indicate levels of antibody that would protect against infection with influenza virus. By this criteria, the full and half dose of vaccine would provide protection agains the influenza H3N2 and B viruses in both men and women. The results confirm that females respond more strongly to the same dose of vaccine than men. But look at the results with the H1N1 strain – in all subjects, no matter the dose of vaccine or gender, the antibody response would not be sufficient to protect against infection. Furthermore, the response is only slightly better than in women.

In interpret these observations to mean that the antibody response to inactivated influenza virus vaccine is not universally more robust in women compared with men – it appears to depend on the virus strain. Clearly clinical studies are required to address this question. Even after spending millions of dollars to decide whether to give women less influenza vaccine, a new strain of influenza virus might come along that induces no better antibody response in women than in men.

My conclusion is that it would not be possible to determine conclusively that women could receive half the amount of inactivated influenza virus vaccine as men. I would rather spend money on developing new ways to produce as much influenza vaccine as needed as quickly as possible – such as by making virus-like particles in plants.

Engler RJ, Nelson MR, Klote MM, VanRaden MJ, Huang CY, Cox NJ, Klimov A, Keitel WA, Nichol KL, Carr WW, Treanor JJ, & Walter Reed Health Care System Influenza Vaccine Consortium (2008). Half- vs full-dose trivalent inactivated influenza vaccine (2004-2005): age, dose, and sex effects on immune responses. Archives of internal medicine, 168 (22), 2405-14 PMID: 19064822

 Until next time...

Good Luck and Good Reading!!!!!

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I regularly watch Real Time with Bill Maher and generally agree with many of the political views and ideas that he espouses. In fact, I am a fan! However, his rant two weeks ago about the H1N1 vaccines, and vaccination in general, showed me that while politically astute and incisive he has absolutely no understanding about science and modern medicine (see video below). Making matters worst, his guest, former conservative senator Bill Frist, a surgeon by training, was ill prepared to correct and refute some of Maher’s outrageous assertions regarding the differences between the two currently available H1N1 vaccines and the basic principles of vaccinology.

Maher is quick to tell people that they are stupid when they don’t agree with his ideas or political views. And, he rightfully criticized George W. Bush for routinely making decisions about important issues based on “his gut feelings” rather than facts. Ironically, this is exactly what Bill Maher does when he talks to his guests about medicine and food. Maher, who may be a vegetarian and is clearly anti-traditional medicine,  is quick to point out that Westernized medicine and food production is profit driven and consequently, any information or advice offered by the US government is little more than a ploy to keep people sick and fat. In other words, don’t trust anything that the government tells you if you believe otherwise or you heard it from a celebrity. 

I suspect that science wasn’t Bill’s “cup of tea” (he frequently calls the tea baggers who don’t trust anything that the Obama administration tells them idiots and morons) and may have never taken anything he learned about science seriously. If he had, he might have learned how vaccines work and realized that modern vaccines (the first vaccines were produced in the 1780s) protect over 95% of people who receive them from devastating childhood diseases and even cervical cancer. Instead, he cites bogus and scientifically refuted claims about vaccine safety including mercury poisoning, links to autism and the miniscule possibility of developing Guerin-Barr Syndrome (which was first observed in large number of patients following vaccination with the 1976 Swine Flu vaccine). Shockingly, despite incontrovertible evidence to the contrary he continues to spew misinformation and flat-out wrong claims about vaccines. Ironically, his wrong-headed vaccine tirades are remarkably similar to those of the Birthers —people who refuse to believe that President Obama is an American despite incontrovertible evidence to the contrary—and racists who contend that Obama is a Muslim—two groups that he is quick to bash and dismiss as crazies and morons. In other words, Maher believes that he is right even though he is clearly misinformed or wrong!

Originally, I was going to write this post after Maher’s “Real Time” tirade about vaccines almost two weeks ago on Real Time. However, I relented but couldn’t help myself after reading an article in today’s Scientist Times about a pregnant woman who lost her second child after she contracted the flu. As many of you may know, pregnant women are very susceptible to influenza which could have serous consequences for the mother and baby. This is an exchange the woman had with a physical therapist with whom she was working to regain muscle control after being hospitalized (and near death) for almost 4 months:

“Have you ever read the labels?” she (the physical therapist asked). “They’re so full of toxins.”

Asked if she realized that a shot, had it existed in June, might have saved her client and her baby, she frowned and went back to her clipboard.

Are you kidding me—full of toxins? This is exactly what Maher was trying to imply during his anti-vaccine rant on Real Time. Unfortunately, millions of people listen to him and celebrities like Oprah, Dr. Phil and Maher and many believe (and blindly follow) their recommendations and advice. While this may not be a problem when talking about hair color, books to read or weight loss it is extremely troubling and dangerous when it comes to scientific and medical advice. The problem is that a vast majority of Americans are scientifically illiterate and are either incapable or unwilling to analyze and evaluate scientific or medical information on their own. This forces many people to rely on the Internet, government agencies and sometimes healthcare professionals to do their medical and scientific thinking for them. And when things go wrong, or not as advertised, they are quick to accuse the government or the healthcare industry of withholding information and engaging in nefarious conspiracies. This is exacerbated by the fact that science and medical reporting in the US is grossly inadequate, often wrong and frequently designed to be as sensationalistic as possible. Is it any wonder why the American public is often confused and misinformed about science and medicine?

My scientific training has taught me to analyze and evaluate all available data before I draw any conclusions on a topic. And, as an infectious disease expert I believe that childhood vaccines are unequivocally safe and effective. To that end, they have substantially reduced the morbidity and mortality associated with mumps, measles, diphtheria, whooping cough, pneumonia, tetanus, almost eradicated polio and eliminated smallpox from the planet. There is no doubt that there are risks associated with vaccination and that a small number of those vaccinated may experience some side effects or serious adverse events. But, the small risks associated with modern vaccines don’t outweigh the benefits and positive effects on billions of people who may have lost their lives if they hadn’t been developed in the first place. I wonder whether or not an anti-vaccine movement would exist today if smallpox and polio were still causing as much death, disfigurement and paralysis as they had prior to development of the smallpox and polio vaccines in the mid 20^th century.

In closing, as an American, I believe that everybody is entitled to their opinions and the right to freely express them. However, I implore Bill Maher get the FACTS right before summarily bashing a topic and making recommendations to the millions of people who watch Real Time and believe what he says. Otherwise, he is no smarter or better than the ignorant, close-minded, right wingers who he regularly trashes on his show.

Until next time...

Good Luck and Good Job Hunting!!!!!!!!!!

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The Belgian chemical manufacturer Solvay announced today that it had agreed to sell its pharmaceutical business unit to Abbott Pharmaceuticals for $6.6 billion. By purchasing Solvay, Abbott gains access to emerging markets in Eastern Europe and Asia along with new therapeutic areas, including hormone therapies and vaccines. Solvay's flu vaccine Influvac will give Abbott an entrant in the burgeoning vaccines market, which is currently dominated by European pharmaceutical giants like GlaxoSmithKline and Novartis.

Abbott already holds U.S. marketing rights for Solvay's Trilipix and TriCor, drugs which raise "good" HDL cholesterol while reducing triglycerides and "bad" LDL cholesterol.

Solvay's other top-selling drugs include the Parkinson's disease treatment Duodopa and hormone therapy drugs AndroGel and Duphaston. It is not clear whether or not the Solvay purchase will affect ongoing pharmaceutical operations or staffing decision in the US. However, I suspect that there will be management changes and layoffs in Europe.

In other news, Johnson & Johnson bought an 18 percent stake in Dutch biotechnology company Crucell NV, which is trying to develop a universal flu vaccine, while competitor Merck acquired the rights to sell Australia-based CSL Ltd.'s Afluria flu vaccine in the U.S.

The Solvay deal is the latest in a string of mergers and acquisitions, as cash-rich pharmaceutical companies race to acquire new products amid looming patent expiry on blockbuster drugs. Earlier this year Swiss drugmaker Roche acquired Genentech following similar deals uniting Pfizer Inc. and Wyeth, and Merck & Co. Inc. with Schering-Plough.

Expect more M&A activity in the life sciences sector before year’s end.

Until next time...

Good Luck and Good Job Hunting!!!!!!!!

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As an iPhone user, I am constantly amazed at the applications that are developed for it. I recently downloaded a flashlight app that converts my iPhone into a flash light in case of a power outage or finding myself in the dark like I did two summers ago at Moosehead Lake in Maine. Just when I thought iphone apps couldn’t get cooler, I learned about a new app called “Outbreaks By Me.” It was developed by researchers at Children's Hospital Boston in collaboration with the MIT Media Lab, enables users to track and report outbreaks of infectious diseases, such as H1N1 (swine flu), on the ground in real time. The application can be downloaded from iTunes.

According to a press release “the application builds upon the mission and proven capability of HealthMap, an online resource that collects, filters, maps and disseminates information about emerging infectious diseases, and provides a new, contextualized view of a user's specific location – pinpointing outbreaks that have been reported in the vicinity of the user and offering the opportunity to search for additional outbreak information by location or disease.” An additional feature of Outbreaks Near Me is the ability to set alerts that will notify users via text or by e-mail when new outbreaks are reported in their proximity, or if users enter a new area of activity. It also offers an option for users to submit an outbreak report which will allow people in cities and countries around the world to interact with the HealthMap team and participate in the public health surveillance process.

What will iPhone app developers think of next— an app for swine flu vaccination?   Now that would be way cool!

Until next time....

Good Luck and Good Swine Flu Hunting!!!!!!!

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Professor Vincent Racaniello, a BioCrowd co-founder and virologist who studies the pathogenesis of polio and influenza viruses commented that there will likely be two influenza vaccines offered this fall: a trivalent vaccine consisting of seasonal H3N2 and H1N1 strains and an influenza B strain; and a monovalent one consisting of the 2009 pandemic H1N1 strain.

He posited an interesting question to BioCrowd members earlier today: "Will you be receiving a flu vaccine this fall, and if so, which one?"

To weigh in on the topic and find out which vaccines makes sense for you, check out Professor Racaniello’s influenza vaccine survey and discussion at BioCrowd!

Until next time...

Good Luck and Good Networking @ BioCrowd!

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The media frenzy surrounding the impending H1N1 swine flu pandemic has spawned a recent spate of articles and television news segments on “germs.” In the last 48 hours, articles on germs have appeared in the New York Times, my local paper (The Trenton Times via the Chicago Tribune), on news channels and most recently this morning on the Today Show on MSNBC. Most of these have focused on where “germs” are found, how they are spread and ways to minimize or prevent their transmission. For those of you who may be interested, the word germ was first coined in 1664 and is defined as a “small mass of living substance capable of developing into an organism or one of its parts” or more conventionally, as a “microorganism that causes disease.” While these media pieces are intended to inform the public about infectious agents and their transmission, most people who read or see these reports don’t understand that the word germ can encompass viruses, bacteria and fungi. And, to make matters worse, most Americans don’t know that viruses, bacteria and fungi are different microorganisms.

Unfortunately, after reading newspaper articles and seeing reports on television about so-called germs, many consumers rush out to their local groceries and purchase a variety of antibacterial soaps and detergents—erroneously believing that these products will protect their families from infection by the dreaded H1N1 virus and other pathogens. Although frequent hand washing and the appropriate use of viricidal disinfectants can help to reduce transmission of H1N1 and other viruses, antibacterial products are generally less effective (or ineffective) against viruses and overuse can result in emergence of multi-drug resistant bacteria.

To that end, I think it is high time that the news media eschew the use of the anachronistic term germ in favor of bacteria, virus or fungi when referring to causative agents of infectious diseases. Promulgating the use of the word germ will continue to keep the lay public in the dark about infectious agents and the diseases they cause and hinder people from making informed decisions about treatment and preventing their transmission.

Until next time...

Good Luck and Good Job Hunting!!!!

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The appearance of the Swine Flu aka H1N1 last spring not only created a worldwide panic, it demonstrated to Albert Osterhaus, head of virology at the Erasmus Medical Center in the Netherlands how uninformed the lay public was about viral outbreaks, epidemiology and public health. This prompted Dr. Osterhaus and his colleagues to create a free, online video game called the “The Great Flu” which challenges players to control a new viral pandemic.

As the virus has spread worldwide, countries have tried different methods to slow it down and pharmaceutical companies are now racing to produce a swine flu vaccine (sound familiar?). To fight the emerging outbreak, players use public health measures including setting up surveillance systems, stockpiling antivirals and vaccines, and closing schools and airports. Players also have a limited budget and are warned that "your actions to control the virus cost money, so keep an eye on it." In other words, while the goal is to control the pandemic, there may not be sufficient funds and resources to accomplish those goals!

A running tally of the numbers of people infected and those who have died are displayed above the budget. Newspaper stories about the deadly virus and the global response to it — like riots breaking out worldwide — pop up to help players monitor the outbreak and plan their next moves. Messages from governments mirror the difficulties faced by international agencies like WHO that are responsible for containing worldwide epidemics. For example, when players set up costly surveillance systems, sometimes participating governments will send a message "we will comply with your directions...but we must inform you that the political support for this action is low in this region. Therefore, the effectiveness of the system to control the outbreak may differ from your expectations."

The goal of the game is make the lay public aware of the difficulties that public health officials encounter during pandemics and the tight rope they sometimes must walk to insure that the virus is contained and doesn’t continue to spread. To test your skill level at controlling pandemics, you can choose different viruses (which range from easy to difficult to manage) at the beginning of the game.

I think “The Great Flu” is a great way to educate the public about infectious diseases and epidemiology and have fun at the same time. If you are interested in more sinister online swine flu games check this out.  Who said learning science has to be tedious and dull?

Until next time...

Good Luck and Good Virus Hunting!!!!!

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On several occasions while driving in upstate New York, I noticed an exit sign on the NY State Thruway for Coxsackie, NY. And, not surprisingly, I began to wonder whether or not the Coxsackie virus was named after this obscure upstate NY town.

I first learned about coxsackie viruses as a graduate student while taking a medical virology course at the University of Wisconsin taught by the late noble laureate Howard Temin. However, despite a thirty year friendship with Vincent Racaniello, a BioCrowd co-founder and virologist extraordinaire, I never asked him about the origin of the coxsackie virus name. Much to my surprise, he had recently taken a trip to upstate NY and noticed the Coxsackie NY exit sign while driving on the thruway. This prompted him to blog about the coxsackie virus isolation, its pathogenic properties and of course, the origin of its name!

Coxsackie NY and the virus named after it 

by Vincent Racaniello,PhD

Recently while driving north on the New York State Thruway I passed the exit for the town of Coxsackie, NY (population 8,884). I grabbed my camera and photographed the exit sign, and reminded myself to write about the virus named after this small town.

In the summer of 1947 there were several small outbreaks of poliomyelitis in upstate New York. Gilbert Dalldorf, the director of the Wadsworth Laboratory in Albany, NY, and his associate Grace M. Sickles investigated this outbreak. In particular they sought polioviruses that could replicate in mice. This search was motivated by the fact that research on poliovirus required the use of monkeys which were extremely expensive. Dalldorf had attended the Fourth International Congress for Microbiology in 1947 where he heard that very young mice – suckling mice – could readily be infected with Theiler’s virus.

Dalldorf and Sickles made fecal suspensions from two children suspected of having poliomyelitis, and inoculated these into adult and suckling mice. Only the suckling mice (1 – 7 days old) developed paralysis; animals more than one week old were resistant to infection. The damage responsible for limb paralysis was widespread lesions in skeletal muscles, not in the central nervous system as occurs with poliovirus. Further study revealed that the viruses could be distinguished serologically from poliovirus.

Not only had Dalldorf and Sickles identified the first members of a very large group of human viruses, but they also introduced and popularized a new and inexpensive animal into the virology laboratory – the suckling mouse. In 1949 Dalldorf suggested that the new viruses be called Coxsackie viruses, because the first recognized human cases were residents of that New York village. This unique name is of native North American origin.

Over ten years later the importance of this work was recognized by Dr. Max Finland of Boston City Hospital:

The isolation by Dalldorf and Sickles of viruses which produced paralysis with destructive lesions of muscle in sucking mice and hamsters, from the stools of two children with signs of paralytic poliomyelitis was an achievement that may rank in importance with Landsteiner and Popper’s production of human poliomyelitis in monkeys.

In subsequent years many different Coxsackie viruses were isolated that cause a variety of clinical syndromes. Today at least 30 serotypes of Coxsackie viruses are classified in the enterovirus genus of the Picornaviridae. The viruses are classified into groups A or B depending upon the pathological effect in suckling mice.

Not every locale is pleased to have a virus named after it. In May 1993, an outbreak of an unexplained pulmonary illness occurred in the southwestern United States, in an area shared by Arizona, New Mexico, Colorado and Utah called “The Four Corners.” Muerto Canyon was proposed as the name for the etiologic agent of the disease, because the virus was first isolated from a rodent near the canyon. However after residents objected, the name Sin nombre virus was given to the agent of hantavirus pulmonary syndrome.

Dalldorf G, & Sickles GM (1948). An Unidentified, Filtrable Agent Isolated From the Feces of Children With Paralysis. Science (New York, N.Y.), 108 (2794), 61-62 PMID: 17777513

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Do you lie awake a night overwhelmed by the possibility of another infectious disease outbreak? Well, if you want to get a good night’s sleep, I highly recommend that you take a look at a brief history of American epidemics that was published in this past Sunday’s New York Times. According to the article, history shows that the number of American epidemics has been relatively small. In fact, the author suggests that there were only nine major epidemics in the US since 1892. 

While there were several major outbreaks in the early to mid 1900s (Spanish flu, 1918; smallpox, 1947 and polio, 1952), the US has been relatively unscathed in recent years—with the possible exception of the HIV/AIDS epidemic and possibly the herpes and HPV epidemics. This is because of America’s outstanding infectious diseases surveillance networks, its comprehensive vaccination programs and modern medical and hospital infrastructures.

However, no matter how vigilant we are, there is no way to prevent infectious disease outbreaks unless the pathogens that cause the diseases are eradicated from the planet as was the case for the smallpox virus. That said, the best way to manage infectious disease epidemics is to be prepared for all contingencies.  In my opinion, the recent swine flu outbreak—this was its second appearance, the first taking place in 1976—was a practice run. And I think the world did “pretty, pretty good” as Larry David, my former NYC softball teammate and co-creator of Seinfeld would say!

Until next time...

Good Luck and Good Job Hunting

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