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BIOINFORMATICS IN PANDEMIC
1
INTRODUCTION
Although high-throughput techniques are an integral part of today’s drug and vaccine
discovery process, accelerating the process manifold, the introduction of a new drug
or vaccine in the market still takes 10–15 years and therefore requires a huge
investment [Plotkin, 2005]. Technological advancements, along with improved and
innovative strategies, could reduce the cost and the time required to develop a new
drug. Most infectious diseases are caused by viral and bacterial pathogens. An
increase of 58% in the mortality rate due to such infectious diseases has been reported
from 1980 to 1992 in the United States [Pinner et al., 1996]. According to the 2004
World Health Organization Report
[www.who.int/whr/2004/annex/topic/en/annex_2_en.pdf], 16.4 million people died
worldwide in that year from infectious diseases. Although several antibiotics are
currently available for each bacterial pathogen, the emerging drug-resistant strains of
such pathogens make them difficult to control, perhaps due to decades-old uses of
such drugs in human patients [Arias and Murray, 2009].
Drug target identification is the first step in the drug discovery process [Chan et
al., 2010]. Because of the availability of both pathogen and host–genome sequences,
it has become easier to identify drug targets at the genomic level for any given
pathogen [Allsop, 1998; Stumm et al., 2002; Meinke et al., 2004; Owa, 2007]. In recent
years, the strategies are shifting progressively from a generic approach to genomic
and metabolomic approaches to identify novel drug targets that are required to design
new defenses against antibiotic resistant pathogens. Tremendous advancements
have been made in target identification and drug discovery since the human genome
sequence became available [Lander et al., 2001; Venter et al., 2001].
BIOINFORMATICS IN PANDEMIC
2
Use of computational approaches, with integrated genomics, proteomics,
transcriptomics, interactomics, signalomics, and metabolomics, are current trends in
target discovery for most human diseases, especially for cancer, cardiovascular,
neuroendocrine, and infectious diseases; they make the discovery process faster and
more cost effective. Currently, genomics and more specifically in silico comparative,
subtractive, and functional genomics are being widely used to identify novel drug and
vaccine targets in order to develop effective antibacterial agents and vaccines against
bacterial pathogens that are either resistant to existing antibacterial regimens or for
which a suitable vaccine is not available [Pucci, 2006].
WHAT IS PANDEMIC?
A pandemic is defined as “an epidemic occurring worldwide, or over a very wide
area, crossing international boundaries and usually affecting a large number of
people”. The classical definition includes nothing about population immunity, virology
or disease severity. By this definition, pandemics can be said to occur annually in each
of the temperate southern and northern hemispheres, given that seasonal epidemics
cross international boundaries and affect a large number of people. However,
seasonal epidemics are not considered pandemics.
A true influenza pandemic occurs when almost simultaneous transmission
takes place worldwide. In the case of pandemic influenza A(H1N1), widespread
transmission was documented in both hemispheres between April and September
2009. Transmission occurred early in the influenza season in the temperate southern
hemisphere but out of season in the northern hemisphere. This out-of-season
transmission is what characterizes an influenza pandemic, as distinct from a pandemic
due to another type of virus.
BIOINFORMATICS IN PANDEMIC
3
Figure 1: Diagram representing the spread of a pandemic
Simultaneous worldwide transmission of influenza is sufficient to define an
influenza pandemic and is consistent with the classical definition of “an epidemic
occurring worldwide”. There is then ample opportunity to further describe the potential
range of influenza pandemics in terms of transmissibility and disease severity. The
emerging evidence for A(H1N1) is that transmissibility, as estimated by the effective
reproduction number (R, or average number of people infected by a single infectious
person) ranged from 1.2 to 1.3 for the general population but was around 1.5 in
children (Kathryn Glass, Australian National University, personal communication).
Some early estimates of R for pandemic influenza H1N1 2009 may have been
overestimated.
Severity, as estimated by the case fatality ratio, probably ranged from 0.01 to
0.03%. These values are very similar to those normally seen in the case of seasonal
influenza. However, the number of deaths was higher in younger people, a recognized
feature of previous influenza pandemics.
BIOINFORMATICS IN PANDEMIC
4
It is tempting to surmise that the complicated pandemic definitions used by the
World Health Organization (WHO) and the Centers for Disease Control and Prevention
of the United States of America involved severity in a deliberate attempt to garner
political attention and financial support for pandemic preparedness. As noted by Doshi,
the perceived need for this support can be understood given concerns about influenza
A(H5N1) and the severe acute respiratory syndrome (SARS). However, conflating
spread and severity allowed the suggestion that 2009 A(H1N1) was not a pandemic.
It was, in fact, a classical pandemic, only much less severe than many had anticipated
or were prepared to acknowledge, even as the evidence accumulated.
In 2009 WHO declared a pandemic several weeks after the criteria for the
definition of a classical pandemic had been met. Part of the delay was no doubt related
to the nexus between the formal declaration of a pandemic and the manufacture of a
pandemic-specific vaccine. If a classical pandemic definition had been used, linking
the declaration to vaccine production would have been unnecessary. This could have
been done with a severity index and, depending on the availability and quality of the
emerging evidence on severity, a pandemic specific vaccine may have been deemed
unnecessary. Alternatively authorities may have decided to order vaccine in much
smaller quantities.
The response to A(H1N1) has been justified as being precautionary, but a
precautionary response should be rational and proportionate and should have
reasonable chances of success. We have argued that the population-based public
health responses in Australia and, by implication, elsewhere, were not likely to
succeed. Similarly, the authors of the draft report on the response to the International
Health Regulations during the 2009 pandemic note that what happened during the
pandemic reflected the activity of the virus and, by implication, not the interventions.
BIOINFORMATICS IN PANDEMIC
5
Risk is assessed by anticipation of severity and precaution should be calibrated
to risk. As Doshi has argued, we need to redefine pandemic influenza. We can
then describe the potential severity range of future pandemics. Finally, we need to use
evidence to assess severity early to anticipate risk. [WHO bulletin].
The approach of reductive genomics
Subtractive genomics is the process in which the subtraction of sequences
between host and the pathogen proteome which helps in providing information for a
set of proteins which are essential to pathogen but are not present in the host.
Subtractive genomics plays an important role in identification of potential drug targets.
These targets are those proteins which are considered essential for the survival of the
organism [Dutta et al., 2006].
Subtractive genomics studies applied in 3 types of cases
i. Multi-Drug resistant pathogenic organism:
Salmonella enterica serovar typhi is a human-specific gram-negative pathogen
causing enteric typhoid fever, a severe infection of the Reticuloendothelial system.
Infection of S. typhi leads to the development of typhoid, or enteric fever. This
disease is characterized by the sudden onset of a sustained and systemic fever,
severe headache, nausea, and loss of appetite. [Everest et al. 2001]. Worldwide,
typhoid fever affects roughly millions of people annually, causing deaths. The early
administration of antibiotic treatment has proven to be highly effective in eliminating
infections, but indiscriminate use of antibiotics has led to the emergence of
multidrug-resistant strains of S. enterica serovar Typhi.
Listeriosis, the infectious disease caused by Listeria monocytogenes causes serious
localized and generalized infections in humans especially among pregnant women,
the elderly or individuals with a weakened immune system. In serious cases,
it can lead to brain infection and even death. Several symptoms are ranged from
BIOINFORMATICS IN PANDEMIC
6
flu-like illness to severe complications including meningitis, septicemia,
spontaneous abortion or listeriosis of the newborn (FAO/WHO, 2002). The
prolonged and uncontrolled use of antibiotics in treatment against many pathogens
has caused the multiple drug resistance. [WHO,2002].
ii. Pathogenic organisms with No effective drugs available:
The Leishmania donovani is an intracellular parasite causing kala azar disease, which
is almost always fatal if left untreated. As there is no effective medicine available so
far, leishmaniasis infection is a worldwide public health challenge.
Botulism (Latin, botulus, "sausage") also known as botulinus intoxication is a rare but
serious paralytic illness caused by botulinum toxin, which is produced by the bacterium
Clostridium botulinum. Severe botulism leads to reduced movement of the muscles of
respiration, and this may be experienced as dyspnea (difficulty breathing), but when
severe can lead to respiratory failure which may lead to coma and eventually
death if untreated. Clostridium botulinum would normally be harmless to humans, but
it can infect by a virus, the viral DNA gets integrated into the bacterial genome, causes
the host to produce toxins. Neurotoxin production is the unifying feature of the species
C. botulinum. Seven types of toxins have been identified and allocated a letter
(A-G). Organisms genetically identified as other Clostridium species have caused
human botulism, Clostridium butyricum producing type E toxin and Clostridium baratii
producing type F toxin. The ability of C. botulinum to naturally transfer neurotoxin
genes to other clostridia is concerning, especially in the food industry where
preservation systems are designed to destroy or inhibit only Clostridium botulinum but
no other Clostridium species. [Tomb et al., 1997].
iii. Pathogenic organism with no virulence factor identified:
Streptococcus Suis are a Gram-positive, facultative anaerobe coccus, possessing
cell wall antigenic determinants. S. suis is responsible for a wide variety of porcine
disease syndromes, such as meningitis, septicae.mia, arthritis and endocarditis.It has
more than 35 serotype which are responsible in the cause of serious infections in
BIOINFORMATICS IN PANDEMIC
7
humans [Higgins et al., 1998]. Since no critical virulence factor is well known in
the pathogen they applied in silico subtractive proteomics approach to identify
potent drug targets in S. suis so that new drugs can be tailored to resist this zoonotic
emerging disease.
Figure 2: Diagram representing the application of bioinformatics in vaccine and drug discovery path.
Application of Bioinformatics
BIOINFORMATICS IN PANDEMIC
8
Conclusion:
The result analysis shows that subtractive genomics approach can be successfully
applied to identify drug targets in a pathogenic organisms which is specific for that
organisms and hence drugs against it cannot show cross reactions with human
proteins. Wet lab analysis of the derived essential organism specific targets
obtained from the above said studies can enhance the drug development process.
Bioinformatics can aid in identification of drug or vaccine targets at the earliest with
least resources and economy
BIOINFORMATICS IN PANDEMIC
9
Bibliography
Allsop AE. 1998. Bacterial genome sequencing and drug discovery Curr Opin Biotechnol 9:637–642
Arias CA, Murray BE. 2009. Antibiotic-resistant bugs in the 21st century—a clinical super-challenge. N
Engl J Med 360:439–443 Dong QJ, Wang Q, Xin YN, Li N, Xuan SY. 2009.
Bandaranayake D, Huang QS, Bissielo A, Wood T, Mackereth G, Baker MG, et al., 2009 H1N1
Serosurvey Investigation Team, et al. Risk factors and immunity in a nationally representative
population following the 2009 influenza A(H1N1) pandemic. PLoS ONE 2010; 5: e13211-
doi: 10.1371/journal.pone.0013211 pmid: 20976224.
Donaldson LJ, Rutter PD, Ellis BM, Greaves FE, Mytton OT, Pebody RG, et al., et al. Mortality from
pandemic A/H1N1 2009 influenza in England: public health surveillance study. BMJ 2009; 339: b5213-
doi: 10.1136/bmj.b5213 pmid: 20007665.
Dutta, A., Singh, S. K., Ghosh, P., Mukherjee, R., Mitter, S. and Bandyopadhyay, D., In silico
identification of potential therapeutic targets in the human pathogen Helicobacter pylori, In Silico Biol.,
6: 0005, (2006).
Everest et al., Trends Microbial. 9: 316 (2001) [PMID: 11435104]
FAO/WHO Microbiological Risk Assessment Series. 2002. Risk Assessment of Listeria
monocytogenes in ready–to–eat foods: Interpretative Summary
http://www.who.int/foodsafety/micro/jemra/assessment/listeria/
Kelly HA, Priest PC, Mercer GN, Dowse GK. We should not be complacent about our population-based
public health response to the first influenza pandemic of the 21st century. BMC Public Health 2011; 11:
78- doi: 10.1186/1471-2458-11-78 pmid: 21291568.
Last JM, editor. A dictionary of epidemiology, 4th edition. New York: Oxford University Press; 2001.
McVernon J, Laurie K, Nolan T, Owen R, Irving D, Capper H, et al., et al. Seroprevalence of 2009
pandemic influenza A(H1N1) virus in Australian blood donors, October - December 2009. Euro
Surveill 2010; 15: pii=19678- pmid: 20946757.
Meinke A, Henics T, Nagy E. 2004. Bacterial genomes pave the way to novel vaccines. Curr Opin
Microbiol 7:314–320.
Mercer G, Glass K, Beckers N. Effective reproduction numbers are commonly overestimated early in a
disease outbreak. Stat Med 2011; 30: 984-94.
Miller MA, Viboud C, Balinska M, Simonsen L. The signature features of influenza pandemics–
implications for policy. N Engl J Med 2009; 360: 2595-8 doi: 10.1056/NEJMp0903906 pmid: 19423872.
Owa T. 2007. Drug target validation and identification of secondary drug target effects using DNA
microarrays. Tanpakushitsu Kakusan Koso 52:1808–1809
Owa T. 2007. Drug target validation and identification of secondary drug target effects using DNA
microarrays. Tanpakushitsu Kakusan Koso 52:1808–1809.
Plotkin SA. 2005. Why certain vaccines have been delayed or not developed at all. Health Aff
(Millwood) 24:631–634.
Pucci MJ. 2006. Use of genomics to select antibacterial targets. Biochem Pharmacol 71:1066–1072.
Report of the review committee on the functioning of the International Health Regulations (2005) and
on pandemic influenza A (H1N1). International Health Regulations Review Committee; 2009. Available
from: http://www.who.int/ihr/preview_report_review_committee_mar2011_en.pdf [accessed 13 April
2011].
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Stumm G, Russ A, Nehls M. 2002. Deductive genomics: a functional approach to identify innovative
drug targets in the post-genome era. Am J Pharmacogenom 2:263–271
Tomb, O. White, A.R. Kerlavage, R.A. Clayton, G.G. Sutton and R.D.Fleischmann “Comparative
Genomics and Understanding of Microbial Biology” Nature (1997) 388,539-47.
Viboud C, Tam T, Fleming D, Handel A, Miller MA, Simonsen L. Transmissibility and mortality impact
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epidemic. Vaccine 2006; 24: 6701-7 doi: 10.1016/j.vaccine.2006.05.067 pmid: 16806596.
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Bioinformatics in pandemic Script

  • 1. BIOINFORMATICS IN PANDEMIC 1 INTRODUCTION Although high-throughput techniques are an integral part of today’s drug and vaccine discovery process, accelerating the process manifold, the introduction of a new drug or vaccine in the market still takes 10–15 years and therefore requires a huge investment [Plotkin, 2005]. Technological advancements, along with improved and innovative strategies, could reduce the cost and the time required to develop a new drug. Most infectious diseases are caused by viral and bacterial pathogens. An increase of 58% in the mortality rate due to such infectious diseases has been reported from 1980 to 1992 in the United States [Pinner et al., 1996]. According to the 2004 World Health Organization Report [www.who.int/whr/2004/annex/topic/en/annex_2_en.pdf], 16.4 million people died worldwide in that year from infectious diseases. Although several antibiotics are currently available for each bacterial pathogen, the emerging drug-resistant strains of such pathogens make them difficult to control, perhaps due to decades-old uses of such drugs in human patients [Arias and Murray, 2009]. Drug target identification is the first step in the drug discovery process [Chan et al., 2010]. Because of the availability of both pathogen and host–genome sequences, it has become easier to identify drug targets at the genomic level for any given pathogen [Allsop, 1998; Stumm et al., 2002; Meinke et al., 2004; Owa, 2007]. In recent years, the strategies are shifting progressively from a generic approach to genomic and metabolomic approaches to identify novel drug targets that are required to design new defenses against antibiotic resistant pathogens. Tremendous advancements have been made in target identification and drug discovery since the human genome sequence became available [Lander et al., 2001; Venter et al., 2001].
  • 2. BIOINFORMATICS IN PANDEMIC 2 Use of computational approaches, with integrated genomics, proteomics, transcriptomics, interactomics, signalomics, and metabolomics, are current trends in target discovery for most human diseases, especially for cancer, cardiovascular, neuroendocrine, and infectious diseases; they make the discovery process faster and more cost effective. Currently, genomics and more specifically in silico comparative, subtractive, and functional genomics are being widely used to identify novel drug and vaccine targets in order to develop effective antibacterial agents and vaccines against bacterial pathogens that are either resistant to existing antibacterial regimens or for which a suitable vaccine is not available [Pucci, 2006]. WHAT IS PANDEMIC? A pandemic is defined as “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people”. The classical definition includes nothing about population immunity, virology or disease severity. By this definition, pandemics can be said to occur annually in each of the temperate southern and northern hemispheres, given that seasonal epidemics cross international boundaries and affect a large number of people. However, seasonal epidemics are not considered pandemics. A true influenza pandemic occurs when almost simultaneous transmission takes place worldwide. In the case of pandemic influenza A(H1N1), widespread transmission was documented in both hemispheres between April and September 2009. Transmission occurred early in the influenza season in the temperate southern hemisphere but out of season in the northern hemisphere. This out-of-season transmission is what characterizes an influenza pandemic, as distinct from a pandemic due to another type of virus.
  • 3. BIOINFORMATICS IN PANDEMIC 3 Figure 1: Diagram representing the spread of a pandemic Simultaneous worldwide transmission of influenza is sufficient to define an influenza pandemic and is consistent with the classical definition of “an epidemic occurring worldwide”. There is then ample opportunity to further describe the potential range of influenza pandemics in terms of transmissibility and disease severity. The emerging evidence for A(H1N1) is that transmissibility, as estimated by the effective reproduction number (R, or average number of people infected by a single infectious person) ranged from 1.2 to 1.3 for the general population but was around 1.5 in children (Kathryn Glass, Australian National University, personal communication). Some early estimates of R for pandemic influenza H1N1 2009 may have been overestimated. Severity, as estimated by the case fatality ratio, probably ranged from 0.01 to 0.03%. These values are very similar to those normally seen in the case of seasonal influenza. However, the number of deaths was higher in younger people, a recognized feature of previous influenza pandemics.
  • 4. BIOINFORMATICS IN PANDEMIC 4 It is tempting to surmise that the complicated pandemic definitions used by the World Health Organization (WHO) and the Centers for Disease Control and Prevention of the United States of America involved severity in a deliberate attempt to garner political attention and financial support for pandemic preparedness. As noted by Doshi, the perceived need for this support can be understood given concerns about influenza A(H5N1) and the severe acute respiratory syndrome (SARS). However, conflating spread and severity allowed the suggestion that 2009 A(H1N1) was not a pandemic. It was, in fact, a classical pandemic, only much less severe than many had anticipated or were prepared to acknowledge, even as the evidence accumulated. In 2009 WHO declared a pandemic several weeks after the criteria for the definition of a classical pandemic had been met. Part of the delay was no doubt related to the nexus between the formal declaration of a pandemic and the manufacture of a pandemic-specific vaccine. If a classical pandemic definition had been used, linking the declaration to vaccine production would have been unnecessary. This could have been done with a severity index and, depending on the availability and quality of the emerging evidence on severity, a pandemic specific vaccine may have been deemed unnecessary. Alternatively authorities may have decided to order vaccine in much smaller quantities. The response to A(H1N1) has been justified as being precautionary, but a precautionary response should be rational and proportionate and should have reasonable chances of success. We have argued that the population-based public health responses in Australia and, by implication, elsewhere, were not likely to succeed. Similarly, the authors of the draft report on the response to the International Health Regulations during the 2009 pandemic note that what happened during the pandemic reflected the activity of the virus and, by implication, not the interventions.
  • 5. BIOINFORMATICS IN PANDEMIC 5 Risk is assessed by anticipation of severity and precaution should be calibrated to risk. As Doshi has argued, we need to redefine pandemic influenza. We can then describe the potential severity range of future pandemics. Finally, we need to use evidence to assess severity early to anticipate risk. [WHO bulletin]. The approach of reductive genomics Subtractive genomics is the process in which the subtraction of sequences between host and the pathogen proteome which helps in providing information for a set of proteins which are essential to pathogen but are not present in the host. Subtractive genomics plays an important role in identification of potential drug targets. These targets are those proteins which are considered essential for the survival of the organism [Dutta et al., 2006]. Subtractive genomics studies applied in 3 types of cases i. Multi-Drug resistant pathogenic organism: Salmonella enterica serovar typhi is a human-specific gram-negative pathogen causing enteric typhoid fever, a severe infection of the Reticuloendothelial system. Infection of S. typhi leads to the development of typhoid, or enteric fever. This disease is characterized by the sudden onset of a sustained and systemic fever, severe headache, nausea, and loss of appetite. [Everest et al. 2001]. Worldwide, typhoid fever affects roughly millions of people annually, causing deaths. The early administration of antibiotic treatment has proven to be highly effective in eliminating infections, but indiscriminate use of antibiotics has led to the emergence of multidrug-resistant strains of S. enterica serovar Typhi. Listeriosis, the infectious disease caused by Listeria monocytogenes causes serious localized and generalized infections in humans especially among pregnant women, the elderly or individuals with a weakened immune system. In serious cases, it can lead to brain infection and even death. Several symptoms are ranged from
  • 6. BIOINFORMATICS IN PANDEMIC 6 flu-like illness to severe complications including meningitis, septicemia, spontaneous abortion or listeriosis of the newborn (FAO/WHO, 2002). The prolonged and uncontrolled use of antibiotics in treatment against many pathogens has caused the multiple drug resistance. [WHO,2002]. ii. Pathogenic organisms with No effective drugs available: The Leishmania donovani is an intracellular parasite causing kala azar disease, which is almost always fatal if left untreated. As there is no effective medicine available so far, leishmaniasis infection is a worldwide public health challenge. Botulism (Latin, botulus, "sausage") also known as botulinus intoxication is a rare but serious paralytic illness caused by botulinum toxin, which is produced by the bacterium Clostridium botulinum. Severe botulism leads to reduced movement of the muscles of respiration, and this may be experienced as dyspnea (difficulty breathing), but when severe can lead to respiratory failure which may lead to coma and eventually death if untreated. Clostridium botulinum would normally be harmless to humans, but it can infect by a virus, the viral DNA gets integrated into the bacterial genome, causes the host to produce toxins. Neurotoxin production is the unifying feature of the species C. botulinum. Seven types of toxins have been identified and allocated a letter (A-G). Organisms genetically identified as other Clostridium species have caused human botulism, Clostridium butyricum producing type E toxin and Clostridium baratii producing type F toxin. The ability of C. botulinum to naturally transfer neurotoxin genes to other clostridia is concerning, especially in the food industry where preservation systems are designed to destroy or inhibit only Clostridium botulinum but no other Clostridium species. [Tomb et al., 1997]. iii. Pathogenic organism with no virulence factor identified: Streptococcus Suis are a Gram-positive, facultative anaerobe coccus, possessing cell wall antigenic determinants. S. suis is responsible for a wide variety of porcine disease syndromes, such as meningitis, septicae.mia, arthritis and endocarditis.It has more than 35 serotype which are responsible in the cause of serious infections in
  • 7. BIOINFORMATICS IN PANDEMIC 7 humans [Higgins et al., 1998]. Since no critical virulence factor is well known in the pathogen they applied in silico subtractive proteomics approach to identify potent drug targets in S. suis so that new drugs can be tailored to resist this zoonotic emerging disease. Figure 2: Diagram representing the application of bioinformatics in vaccine and drug discovery path. Application of Bioinformatics
  • 8. BIOINFORMATICS IN PANDEMIC 8 Conclusion: The result analysis shows that subtractive genomics approach can be successfully applied to identify drug targets in a pathogenic organisms which is specific for that organisms and hence drugs against it cannot show cross reactions with human proteins. Wet lab analysis of the derived essential organism specific targets obtained from the above said studies can enhance the drug development process. Bioinformatics can aid in identification of drug or vaccine targets at the earliest with least resources and economy
  • 9. BIOINFORMATICS IN PANDEMIC 9 Bibliography Allsop AE. 1998. Bacterial genome sequencing and drug discovery Curr Opin Biotechnol 9:637–642 Arias CA, Murray BE. 2009. Antibiotic-resistant bugs in the 21st century—a clinical super-challenge. N Engl J Med 360:439–443 Dong QJ, Wang Q, Xin YN, Li N, Xuan SY. 2009. Bandaranayake D, Huang QS, Bissielo A, Wood T, Mackereth G, Baker MG, et al., 2009 H1N1 Serosurvey Investigation Team, et al. Risk factors and immunity in a nationally representative population following the 2009 influenza A(H1N1) pandemic. PLoS ONE 2010; 5: e13211- doi: 10.1371/journal.pone.0013211 pmid: 20976224. Donaldson LJ, Rutter PD, Ellis BM, Greaves FE, Mytton OT, Pebody RG, et al., et al. Mortality from pandemic A/H1N1 2009 influenza in England: public health surveillance study. BMJ 2009; 339: b5213- doi: 10.1136/bmj.b5213 pmid: 20007665. Dutta, A., Singh, S. K., Ghosh, P., Mukherjee, R., Mitter, S. and Bandyopadhyay, D., In silico identification of potential therapeutic targets in the human pathogen Helicobacter pylori, In Silico Biol., 6: 0005, (2006). Everest et al., Trends Microbial. 9: 316 (2001) [PMID: 11435104] FAO/WHO Microbiological Risk Assessment Series. 2002. Risk Assessment of Listeria monocytogenes in ready–to–eat foods: Interpretative Summary http://www.who.int/foodsafety/micro/jemra/assessment/listeria/ Kelly HA, Priest PC, Mercer GN, Dowse GK. We should not be complacent about our population-based public health response to the first influenza pandemic of the 21st century. BMC Public Health 2011; 11: 78- doi: 10.1186/1471-2458-11-78 pmid: 21291568. Last JM, editor. A dictionary of epidemiology, 4th edition. New York: Oxford University Press; 2001. McVernon J, Laurie K, Nolan T, Owen R, Irving D, Capper H, et al., et al. Seroprevalence of 2009 pandemic influenza A(H1N1) virus in Australian blood donors, October - December 2009. Euro Surveill 2010; 15: pii=19678- pmid: 20946757. Meinke A, Henics T, Nagy E. 2004. Bacterial genomes pave the way to novel vaccines. Curr Opin Microbiol 7:314–320. Mercer G, Glass K, Beckers N. Effective reproduction numbers are commonly overestimated early in a disease outbreak. Stat Med 2011; 30: 984-94. Miller MA, Viboud C, Balinska M, Simonsen L. The signature features of influenza pandemics– implications for policy. N Engl J Med 2009; 360: 2595-8 doi: 10.1056/NEJMp0903906 pmid: 19423872. Owa T. 2007. Drug target validation and identification of secondary drug target effects using DNA microarrays. Tanpakushitsu Kakusan Koso 52:1808–1809 Owa T. 2007. Drug target validation and identification of secondary drug target effects using DNA microarrays. Tanpakushitsu Kakusan Koso 52:1808–1809. Plotkin SA. 2005. Why certain vaccines have been delayed or not developed at all. Health Aff (Millwood) 24:631–634. Pucci MJ. 2006. Use of genomics to select antibacterial targets. Biochem Pharmacol 71:1066–1072. Report of the review committee on the functioning of the International Health Regulations (2005) and on pandemic influenza A (H1N1). International Health Regulations Review Committee; 2009. Available from: http://www.who.int/ihr/preview_report_review_committee_mar2011_en.pdf [accessed 13 April 2011].
  • 10. BIOINFORMATICS IN PANDEMIC 10 Stumm G, Russ A, Nehls M. 2002. Deductive genomics: a functional approach to identify innovative drug targets in the post-genome era. Am J Pharmacogenom 2:263–271 Tomb, O. White, A.R. Kerlavage, R.A. Clayton, G.G. Sutton and R.D.Fleischmann “Comparative Genomics and Understanding of Microbial Biology” Nature (1997) 388,539-47. Viboud C, Tam T, Fleming D, Handel A, Miller MA, Simonsen L. Transmissibility and mortality impact of epidemic and pandemic influenza, with emphasis on the unusually deadly 1951 epidemic. Vaccine 2006; 24: 6701-7 doi: 10.1016/j.vaccine.2006.05.067 pmid: 16806596. Wilson N, Baker MG. The emerging influenza pandemic: estimating the case fatality ratio. Euro Surveill 2009; 14: pii=19255- pmid: 19573509.