Pandemics for exam 3 mc

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Pandemics for exam 3 mc

  1. 1. SIGNIFICANT CHALLENGES FOR AH1N1 VACCINE DEVELOPMENT: WILL VACCINES SOLVE THE PROBLEMS OF INFLUENZA AH1N1?Monday, February 6, 2012
  2. 2. THE PANDEMIC: April 27, 2009 The emergence of avian influenza A(H5N1) followed by the A(H1N1) influenza pandemic has focused the attention of the public and health authorities alike on the potential for prevention using the appropriate vaccinesMonday, February 6, 2012
  3. 3. Influenza Life CycleReference:Med. Micro. Murray et al Chapter 56Monday, February 6, 2012
  4. 4. Monday, February 6, 2012
  5. 5. Monday, February 6, 2012
  6. 6. CO-CIRCULATION WITH SEASONAL FLU IN 2010Monday, February 6, 2012
  7. 7. UPDATE: SOUTHEAST ASIA In southeast Asia, transmission of pandemic influenza virus A(H1N1) persists, but current activity levels are low Vietnam: influenza activity has declined substantially since peaking during October and November 2009 Thailand: focal outbreaks of influenza were reported from a few provinces in northern and central parts of the country, however, overall ILI activity remains low Latest available statistic for The Philippines from WHO: 3207 cases with 6 deaths as of 30 July 2009Monday, February 6, 2012
  8. 8. UPDATE: SOUTHEAST ASIA In southeast Asia, transmission of pandemic influenza virus A(H1N1) persists, but current activity levels are low Vietnam: influenza activity has declined substantially since peaking during October and November 2009 Thailand: focal outbreaks of influenza were reported from a few provinces in northern and central parts of the country, however, overall ILI activity remains low Latest available statistic for The Philippines from WHO: 3207 cases with 6 deaths as of 30 July 2009Monday, February 6, 2012
  9. 9. VACCINATION UPDATEMonday, February 6, 2012
  10. 10. VACCINATION UPDATE • “CDC recommends influenza vaccination as the first and most important step in protecting against fluMonday, February 6, 2012
  11. 11. VACCINATION UPDATE • “CDC recommends influenza vaccination as the first and most important step in protecting against flu • CDC is now encouraging everyone to get vaccinated against 2009 H1N1, including people 65 years and olderMonday, February 6, 2012
  12. 12. VACCINATION UPDATE • “CDC recommends influenza vaccination as the first and most important step in protecting against flu • CDC is now encouraging everyone to get vaccinated against 2009 H1N1, including people 65 years and older • While less common than with seasonal flu, severe illnesses and deaths from 2009 H1N1 have occurred in every age group, including people 65 and olderMonday, February 6, 2012
  13. 13. VACCINATION UPDATE • “CDC recommends influenza vaccination as the first and most important step in protecting against flu • CDC is now encouraging everyone to get vaccinated against 2009 H1N1, including people 65 years and older • While less common than with seasonal flu, severe illnesses and deaths from 2009 H1N1 have occurred in every age group, including people 65 and older • Vaccination of people with certain health conditions is especially important because they are more likely to get serious flu-related complicationsMonday, February 6, 2012
  14. 14. VACCINATION UPDATE • “CDC recommends influenza vaccination as the first and most important step in protecting against flu • CDC is now encouraging everyone to get vaccinated against 2009 H1N1, including people 65 years and older • While less common than with seasonal flu, severe illnesses and deaths from 2009 H1N1 have occurred in every age group, including people 65 and older • Vaccination of people with certain health conditions is especially important because they are more likely to get serious flu-related complications • Health complications that increase the risk of being hospitalized from 2009 H1N1 include: • Lung disease like asthma or chronic obstructive pulmonary disease (COPD); Diabetes; Heart disease; Neurological disease; PregnancyMonday, February 6, 2012
  15. 15. Monday, February 6, 2012
  16. 16. Monday, February 6, 2012
  17. 17. RECOMMENDATION: VACCINATIONMonday, February 6, 2012
  18. 18. ISSUE: MOCK-UP Mock-up vaccines contain an active ingredient for an VACCINES influenza virus that has not circulated recently in human populations and thus mimics the novelty of a pandemic virus Such advance studies can greatly expedite regulatory approvalMonday, February 6, 2012
  19. 19. ISSUE: MOCK-UP VACCINESMonday, February 6, 2012
  20. 20. ISSUE: MOCK-UP VACCINES • Mock-up pandemic influenza vaccine:Monday, February 6, 2012
  21. 21. ISSUE: MOCK-UP VACCINES • Mock-up pandemic influenza vaccine: • a vaccine that mimics the future pandemic influenza vaccine in terms of its composition and manufacturing methodMonday, February 6, 2012
  22. 22. ISSUE: MOCK-UP VACCINES • Mock-up pandemic influenza vaccine: • a vaccine that mimics the future pandemic influenza vaccine in terms of its composition and manufacturing method • NOTE: virus strain causing the pandemic is not knownMonday, February 6, 2012
  23. 23. ISSUE: MOCK-UP VACCINES • Mock-up pandemic influenza vaccine: • a vaccine that mimics the future pandemic influenza vaccine in terms of its composition and manufacturing method • NOTE: virus strain causing the pandemic is not known • mock-up vaccine contains another flu strain insteadMonday, February 6, 2012
  24. 24. ISSUE: MOCK-UP VACCINES • Mock-up pandemic influenza vaccine: • a vaccine that mimics the future pandemic influenza vaccine in terms of its composition and manufacturing method • NOTE: virus strain causing the pandemic is not known • mock-up vaccine contains another flu strain instead • a strain that is not circulating in humans, and to which humans have not been exposed in the pastMonday, February 6, 2012
  25. 25. ISSUE: MOCK-UP VACCINES • Mock-up pandemic influenza vaccine: • a vaccine that mimics the future pandemic influenza vaccine in terms of its composition and manufacturing method • NOTE: virus strain causing the pandemic is not known • mock-up vaccine contains another flu strain instead • a strain that is not circulating in humans, and to which humans have not been exposed in the past • test vaccines in preparation for any flu pandemic that may occur in the future : predict how people will react to the vaccine when the strain causing a pandemic is includedMonday, February 6, 2012
  26. 26. ISSUE: MOCK-UP VACCINESMonday, February 6, 2012
  27. 27. ISSUE: MOCK-UP • ISSUES: VACCINESMonday, February 6, 2012
  28. 28. ISSUE: MOCK-UP • ISSUES: VACCINES • 1) The viral strain chosen for this mock-up is one that is not currently circulating in humans. Thus, they are choosing a viral strain to which humans have no acquired immune defense.Monday, February 6, 2012
  29. 29. ISSUE: MOCK-UP • ISSUES: VACCINES • 1) The viral strain chosen for this mock-up is one that is not currently circulating in humans. Thus, they are choosing a viral strain to which humans have no acquired immune defense. • 2) These mock-up vaccines are tested on humans in order to "predict how people will react."Monday, February 6, 2012
  30. 30. ISSUE: MOCK-UP • ISSUES: VACCINES • 1) The viral strain chosen for this mock-up is one that is not currently circulating in humans. Thus, they are choosing a viral strain to which humans have no acquired immune defense. • 2) These mock-up vaccines are tested on humans in order to "predict how people will react." • CONSEQUENCES:Monday, February 6, 2012
  31. 31. ISSUE: MOCK-UP • ISSUES: VACCINES • 1) The viral strain chosen for this mock-up is one that is not currently circulating in humans. Thus, they are choosing a viral strain to which humans have no acquired immune defense. • 2) These mock-up vaccines are tested on humans in order to "predict how people will react." • CONSEQUENCES: • injecting people with viral fragments that have never been previously encountered by humansMonday, February 6, 2012
  32. 32. ISSUE: MOCK-UP • ISSUES: VACCINES • 1) The viral strain chosen for this mock-up is one that is not currently circulating in humans. Thus, they are choosing a viral strain to which humans have no acquired immune defense. • 2) These mock-up vaccines are tested on humans in order to "predict how people will react." • CONSEQUENCES: • injecting people with viral fragments that have never been previously encountered by humans • if mistakes are made in the processing of these vaccines, causing live viruses to be injected (instead of sufficiently weakened viruses), this could result in the spread of that new virus among the human populationMonday, February 6, 2012
  33. 33. ISSUE: MOCK-UP • ISSUES: VACCINES • 1) The viral strain chosen for this mock-up is one that is not currently circulating in humans. Thus, they are choosing a viral strain to which humans have no acquired immune defense. • 2) These mock-up vaccines are tested on humans in order to "predict how people will react." • CONSEQUENCES: • injecting people with viral fragments that have never been previously encountered by humans • if mistakes are made in the processing of these vaccines, causing live viruses to be injected (instead of sufficiently weakened viruses), this could result in the spread of that new virus among the human population • this process could be used as vector through which infectious disease is spread (depends on which virus is chosen for the mock-up vaccines)Monday, February 6, 2012
  34. 34. POSSIBLE MECHANISMS FOR THE EMERGENCE OF PANDEMIC VIRUSES • Human virus and bird virus reassort gene sequences in pig, resulting in banded virus in pig and normal human subject • alteration of receptor specificity during replication of an avian virus in pigs may occur both before and after reassortment with a human virusMonday, February 6, 2012
  35. 35. POSSIBLE MECHANISMS FOR THE EMERGENCE OF PANDEMIC VIRUSES • Bird virus adapts to virulent state in pigs, resulting in diseased human subject • an avian virus may become adapted in pigs to the extent that it would not require reassortment with a human virus for efficient replication in humansMonday, February 6, 2012
  36. 36. POSSIBLE MECHANISMS FOR THE EMERGENCE OF PANDEMIC VIRUSES • Bird virus and human virus reassort gene sequences in human, resulting in banded virus in normal human subject • direct transmission and reassortment in humans • eg. outbreak in Hong Kong in 1997Monday, February 6, 2012
  37. 37. POSSIBLE MECHANISMS FOR THE EMERGENCE OF PANDEMIC VIRUSES • Bird virus adapts to virulent state in diseased humans, resulting in diseased human subject • adaption in humans • outbreak in Hong Kong in 1997Monday, February 6, 2012
  38. 38. PREVENTION AND C0NTROL! 1. Vaccines! ! a. Inactivated! ! ! 1.whole! ! ! 2.subunit! ! b. Live attenuated- nasal spray available 2003! ! c. Recombinant - cDNA derived-in preparation! 2. Antiviral Drugs! ! a. Amantadine! ! b. Neuraminidase inhibitors -oseleotamivir! ! highly specific - based on crystal structure! ! block active site! ! c. Extremely important to use in conjunction!! ! with a rapid diagnostic kit.Monday, February 6, 2012

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