Vaccine will take 3-5 years to complete safety testing

January 16, 2008. Times Online

Call for more bird flu vaccine as fourth swan dies at Abbotsbury reserve

A fourth swan from the Abbotsbury swannery in Dorset is believed to have been infected with the deadly H5N1 avian flu virus. The result is to be confirmed today by the Department for Environment, Food and Rural Affairs (Defra).

The mute swan was found dead on Friday and sent for testing to the Veterinary Laboratories Agency in Weybridge.

Government vets are not surprised by the further case and believe it is likely that other swans at the important reserve near Chesil Beach may be infected.

It is not known precisely how the virus arrived in the area, though the most plausible explanation is that a duck or similar species arrived from across the Channel during the cold snap before Christmas. The birds at the swannery are fairly static and do not migrate.

Among the brids that migrate to the UK when there are cold spells on the Continent are mallard, teal, widgeon and pochard as well as gulls.

John Houston, general manager at Abbotsbury Tourism, said that the latest case delayed a return to normal business. “It puts us back to square one in terms of waiting for a 21-day clearance before we are out of the woods,” he said.

“It's disappointing but not totally unexpected this early in the outbreak. It would be wonderful if it disappeared immediately but that's unrealistic. It's going to take a while for it to be contained and weeded out.”

The all-clear will be given only after 21 days have passed without any new bird infected with the virus at the swannery.

Abbotsbury is one of the most popular tourist attractions on the south coast and is due to reopen to the public on March 15 after the winter.

It has been owned by the Ilchester Estate since the 1540s though the swannery was established by Benedictine monks who built a monastery at the site in the 1040s.

There is some relief that there is no evidence of the virus being endemic in wild birds in the area. Similarly, the virus has not been found in any chick on a commerical poultry farm or backyard flock in the area.

The existing control and monitoring zones are to remain in place. There are some 32 premises within the zone, of which 19 are free-range operations, involving a total of 24,588 birds.

In the wider monitoring area there are 34 farms, of which 17 are free-range, with a total of 111,488 chickens.

Fred Landeg, the acting Chief Veterinary Officer, is appealing to anyone in the area who might own a small number of chickens to come forward so that their birds and premises can be checked.

All birds inside the control zone - which extends 15 miles southeast of Abbotsbury and includes Weymouth, Chesil Beach and Portland Bill - must be kept indoors. Owners are also advised to keep poultry away from wild birds in the larger monitoring area, which extends to some 20 miles and includes the town of Dorchester.

Under current government regulations only owners with more than 50 birds must enlist to the official poultry register, but others are encouraged to do so voluntarily.

France has raised the level of alert for a lethal avian flu outbreak as a result of the British outbreak and ordered all birds to be locked indoors in areas near lakes, ponds and the coast. Defra said there were no such plans in Britain.

The new outbreak has renewed calls for the routine vaccination of all free-range, organic and hobby birds against the deadly flu virus.

The Elm Farm Organic Research Centre has been campaigning for such a preventive strategy for more than two years. Defra has a stock of 10 million does of vaccine but so far they have been offered only for use to save rare birds and collections in zoos.

Richard Sanders, senior policy researcher at the centre, said the latest outbreak at Abbotsbury was now “a trigger point” and gave a definite indication the virus was circulating in wild birds.

He urged Defra to release its stocks of H5N1 vaccine to start an orderly programme of preventive treatment.The alternative to vaccination was to lock up all birds a move that was “unacceptable, impractical and with some species such as geese, impossible”, he said.

“When the national mood, as voiced so loudly by Jamie Oliver and Hugh Fearnley-Whittingstall, is for quality, high-welfare poultry production, then we must do everything in our power to protect and grow the sector.”

TIMESW ONLINE, JAN 4, 08, Nigel Hawkes, Health Editor

New vaccinations give scientists hope of conquering flu pandemic

vaccine that could help to control a flu pandemic has shown encouraging results in its first human trials.

The vaccine, made by Acambis, based in Cambridge, should protect against all strains of influenza A, the type responsible for pandemics. Unlike existing vaccines it does not have to be reformulated each year to match the prevalent strains of flu, so it could be stockpiled and used as soon as a pandemic strain emerges. Nor does it need to be grown on fertilised chicken eggs, as the existing vaccines do, but can be produced by cell culture.

The results, announced yesterday by Acambis, show that in human volunteers the Acam-Flu-A vaccine was safe and produced an immune response against its target, a small protein (peptide) called M2e that is found on the surface of all A-strains of the flu virus. The vaccine was also tested on ferrets, which are commonly used in flu research because they are susceptible to human and bird flu.

The ferrets were divided into two groups and either vaccinated with the new vaccine or left unvaccinated. They were then exposed to a large dose of the H5N1 bird flu that has killed millions of chickens and more than 200 people across Asia since 2003. All the unvaccinated ferrets died, but 70 per cent of the vaccinated ones survived.

A significant problem with conventional vaccines is that they attack parts of the flu virus that can change rapidly. Each season the World Health Organisation identifies the three strains that are circulating, normally two A-strains and one B, and the vaccine is made to order to provide protection against them. It is always a race against time, because millions of eggs have to be produced to grow the vaccine and if it is not used it is out of date by the following season.

Acambis’s approach was to identify some aspect of the virus that is unchanging. Pandemics are invariably caused by A-strains of flu; B-strains, which are found only in humans, may cause epidemics but have never caused pandemics.

The company identified a peptide, M2e, on the surface of all A-strains and developed a vaccine that targeted it. When an individual is vaccinated the vaccine teaches the immune system to recognise and be alert to the peptide so that as soon as flu arrives the body’s protective systems swing into action against it. To improve the vaccine’s effectiveness, it was combined in the trial with adjuvants, chemicals that ginger up the immune system and improve its ability to learn. The adjuvant called QS-21, made by Antigenics, proved to be the best. When this was added, 90 per cent of those vaccinated had antibodies against the M2e peptide.

Michael Watson, the executive vice-president for research and development at Acambis, said: “If there was an immediate threat of pandemic flu, it would be possible to complete the trials and market the vaccine within three years. Without such a threat, it will likely take longer, perhaps five years.

“The beauty of the vaccine is its simplicity. It could be used in several different ways. First, we could produce a pre-pandemic vaccine that we know would be effective against A-strains. If a bird flu strain such as H5N1 turned into a pandemic strain we could get the vaccine out of storage and use it. Alternatively we could use it as soon as we got the slightest inkling of a pandemic strain emerging. Or it could be used instead of the normal vaccine for protecting against seasonal flu, with a vaccine against B-strains added. That would depend on how effective it was, which we will only know after further trials.”

The fate of millions

— Flu viruses can drift and shift. Drift refers to the continual small changes that dictate the annual reformulation of the flu vaccine to ensure that it works. Shift happens rarely and unpredictably, and produces pandemics

— There were three shifts in the 20th century, causing pandemics in 1918, 1957 and 1968. Some virologists fear that another is overdue

— Pandemic strains strike human beings unprepared, and spread fast. The 1918 pandemic killed 20 million, some say 40 million

— Shifts occur when avian strains infect human beings, or avian and human strains share genes, as may be happening in Asia

— Since the H5N1 avian strain first appeared in 2003, a few hundred cases have been transmitted to humans. About half of those have died, but this is not yet a pandemic strain, and may never become one

India, Bangladesh Try to Halt Bird Flu

By MANIK BANERJEE – 7 hours ago, 1/17/08

CALCUTTA, India (AP) — India and Bangladesh searched for new cases of bird flu Thursday as authorities pressed ahead with plans to slaughter hundreds of thousands of birds in a bid to keep the outbreak from spreading, officials said.

No human cases have been reported since the latest outbreak of bird flu was first discovered earlier this week. But nearly 56,000 birds have died from the disease in eastern India, where authorities have begun slaughtering another 400,000 animals, most of them chickens. In Bangladesh, officials say about 20 birds have died and another 1,700 have been slaughtered.

Bangladeshi authorities say the outbreak in that country, which has so far been limited to a single poultry farm, is the H5N1 strain of the disease. In India, where the outbreak is more widespread, authorities say they are still conducting tests to determine what strain of bird flu killed the animals.

The outbreaks are in adjacent areas of the neighboring countries.

There was also uncertainty in India on Thursday about an undetermined number of new bird deaths in areas near the center of the outbreak in a rural region in the southwestern part of India's West Bengal state. Bangladeshi authorities were also searching for other cases of bird deaths.

While bird flu seemed to be the obvious culprit in the new deaths in West Bengal, the state's animal husbandry minister, Anisur Rahman, cautioned the symptoms indicated Newcastle disease, known locally as Ranikhet, a fatal respiratory virus that is not known to attack humans.

"But we are not taking chances and have sent samples to laboratories for testing for bird flu," he told The Associated Press.

Apart from slaughtering birds in areas where bird flu has been confirmed, health workers were also going door-to-door, looking for people with high fevers or breathing trouble, he said.

An outbreak of the H5N1 virus hit western India in 2006, but India declared the country bird flu-free after slaughtering hundreds of thousands of chickens. No human cases were reported. A smaller outbreak in northeastern India was contained last year.

Bird flu was first detected in Bangladesh in February 2007 at a poultry farm near the capital. Since then, authorities have slaughtered more than 300,000 chickens — including 19,000 killed during another outbreak earlier this month — at about 90 farms across the country. Nearly 360,000 eggs have been destroyed.

Bird flu has killed at least 217 people worldwide since it began ravaging Asian poultry stocks in late 2003. It remains hard for people to catch, but experts fear it will mutate into a form that spreads easily among humans, potentially sparking a pandemic. So far, most human cases have been linked to contact with infected birds.

What keeps us safe for now (unlike the birds) is that a strain of the H5N1 virus does not have the ability to spread from person to person.

Bird Flu Passed From Son to Father, W.H.O. Says

New York Times, June 23, 06 by Elisabeth Rosenfthal

An Indonesian man who died of H5N1 bird flu caught it from his 10-year-old son, the first laboratory-confirmed case of human-to-human transmission of the disease, according to a World Health Organization investigation of an unusual family cluster of bird-flu cases.

The investigators also found that the virus mutated slightly when the son had the disease, although not in any way that would allow it to pass more readily among people. Flu viruses like H5N1 mutate constantly, although most of the mutations are insignificant biologically; that appears to be have been the case in the Indonesian cluster.

"Yes, it is slightly altered, but in a way that viruses commonly mutate," said Dick Thompson, a spokesman for the World Health Organization n Geneva, describing the findings, which were not publicly released. "But that didn't make it more transmissible, or cause more severe disease."

The greater importance of the slightly modified virus is that it allowed researchers from the organization and the United States Centers for Disease Control to document for the first time that the virus almost certainly passed from the son directly to his father.

In previous cases where human-to-human transmission was suspected, scientists were not able to say for sure, either because test samples from the patients were not available or because the virus in the patients was the same as that found in poultry in the area.

Scientists say the H5N1 virus, which has killed hundreds of millions of birds worldwide, does not spread easily to humans or among them. But they have worried that it might, through normal biological processes, acquire the ability to do so, potentially setting off a devastating human pandemic.

More than 200 people have contracted bird flu around the world, almost all of them after very close contact with infected birds.

International health officials have been in Indonesia for much of the past month, investigating a family outbreak that affected seven relatives in a remote region of Sumatra. Six of the seven died.

Although Indonesia has been struggling all year to control a series of bird flu outbreaks in poultry, the family on Sumatra had no known direct contact with sick birds, although the first death in the family was a woman who sold vegetables in a market that also sold birds.

Scientists have suspected that H5N1, though an avian virus, could also spread from person to person in rare cases if there were prolonged close contact.

The family members in the cluster had a banquet in late April, when the vegetable merchant was already ill and coughing heavily. Some spent the night in the same small room with her. Some members also cared for their relatives when they were sick.

In hospitals, doctors and nurses generally wear masks when treating people who may have bird flu.

The first five family members to fall ill had identical strains of H5N1, one that is common in animals in Indonesia. But the virus mutated slightly in the sixth victim, the 10-year-old boy, and he apparently passed the mutated virus to his father. The presence of that mutation allowed the lab to confirm the route of transmission.

Still, Mr. Thompson said there was no evidence that the mutated virus is any better adapted to human infection than before. In fact, the World Health Organization has been following 54 neighbors and family members who lived near the family for a month, and none has contracted the virus.