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Draadje vogelgriep

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  1. [verwijderd] 30 augustus 2006 08:44
    RTRS-Akzo Nobel ontwikkelt vogelgriepvaccin met CDC
    ARNHEM (ANP) - Nobilon International, een dochterbedrijf van
    Akzo Nobel, gaat samenwerken met de Amerikaanse
    overheidsinstelling Centers for Disease Control en Prevention
    (CDC) voor de ontwikkeling van een vogelgriepvaccin. Het gaat om
    de ontwikkeling van een levend, verzwakt en temperatuurgevoelig
    celkweekvaccin tegen de H5N1-variant van het vogelgriepvirus.

    Dat liet Akzo Nobel woensdag weten. Het chemieconcern werkte
    al sinds 2004 samen met het Australische BioDiem aan het vaccin.
    Het gezamenlijke onderzoek duurt twee jaar en wordt uitgevoerd
    in Boxmeer en Atlanta. Celkweekproductie kan voorzien in een
    kortere productietijd van vaccins.

    ((ANP Redactie Economie, email economie(at)anp.nl, +31 20
    504 5999))
  2. [verwijderd] 30 augustus 2006 09:09
    Zie fig. 3.

    Akzo Nobel Works With US Scientists CDC To Fight Bird Flu
    Wednesday August 30th, 2006 / 8h28

    Edited Press Release
    AMSTERDAM -(Dow Jones)- Scientists at Akzo Nobel's Nobilon International human vaccines business working to fight the threat of a global bird flu pandemic have received a major boost following the signing of a cooperative research and development agreement with the Centers for Disease Control and Prevention (CDC) in the United States.
    The agreement-co-signed with Nobilon's international partner, Australian-based BioDiem Ltd-involves the development of a live attenuated cold-adapted cell culture vaccine against the H5N1 strain of the avian influenza virus.
    According to experts at the World Health Organization, a live vaccine would offer better and broader protection in the event of a pandemic outbreak.
    In 2004, the two companies agreed a licensing deal for BioDiem's cold-adapted intranasal flu vaccine and this technology will now be advanced through pre-clinical development at the CDC in its high-security laboratories in an effort to develop a vaccine which will protect against highly pathogenic avian influenza viruses that pose a pandemic threat.
    "This is an extremely important collaborative agreement which could prove crucial in our efforts to develop a vaccine for one of the world's leading health risks," said Toon Wilderbeek, Akzo Nobel's Board member responsible for Pharma.
    "A key challenge for developers of potential pandemic vaccines is sufficient supply. One of Nobilon's main areas of cutting-edge expertise is in cell culture production to provide benefits of scale-up, speed and efficiency. This is vital to any effective vaccination program."
    The cooperative research-to be carried out over two years at Boxmeer in the Netherlands and Atlanta in the United States-will generate, characterize and evaluate in pre-clinical models, live attenuated cold-adapted influenza vaccine (LAIV) candidates against influenza H5N1 viruses.
    A live attenuated influenza vaccine has been shown to have a number of advantages. It can trigger a broader immune response than inactivated influenza vaccines in children, as well as allowing for a single dose of a smaller amount of vaccine to provide meaningful protection, compared with currently available inactivated vaccines.
    The U.S. government has also recently acknowledged that cell culture production of influenza vaccines may provide a superior service compared with the traditional supply based on embryonated eggs. This is because the production timeline may be shortened and vaccine production may be increased with fewer delays.
    Pharmaceutical development company BioDiem's existing agreement with Nobilon gives the Akzo Nobel business access to BioDiem's technological expertise in influenza vaccines. Nobilon also has exclusive rights to manufacture, market and sell BioDiem's intranasal influenza vaccine in a number of key world markets.

    www.akzonobel.com/com/News/News.htm?i...
  3. [verwijderd] 30 augustus 2006 13:36
    Bird flu - the "new oil & gas" for investors...
    Looking for quick gains?
    The bird flu boom could give you 800% or more in just weeks...
    Bird flu stocks are skyrocketing.
    Top choice: HepaLife Technologies (HPLF).
    Less than 45 days ago this undiscovered company picked up patents for the key bird flu vaccine technology.
    Amazingly, its share price is still around $1.00. Buy today and you could potentially see gains of 800% or more as it takes off.
    Find the next Big Boom and you're almost assured gains like these ... I recognized the energy, semi- conductor, and other booms early on, and look how my subscribers profited:

    I'm forecasting HPLF to be my next big gainer!

    Ken Coleman
    The Investment-Tracker

    Kenneth Coleman's Investment-Tracker subscribers are up 52% over the past 5 years. He is a former member of the Senate Select Committee on Federal Reserve Policy, and his show is syndicated nationally on TNN. Mr. Coleman called gold's rise in 2002, as well as the dotcom buying mania from September 1999 to March 2000, and the subsequent meltdown. He also called the kick-off of the world's great bull market in 1982 in a book he wrote in 1981, the bond bull market of 1984, the dollar's plunge during 1984-87, and the rotational market of 1995-98.


    Are you looking for a new way to make big dollars in the post oil-boom market? Here's a strategy that savvy short term traders use for big gains.

    News drives up share prices. And big news equals big gains. Look at recent history: 9/11 drove up defense and security shares. Hurricane Katrina and other crisis events drove up oil and gas shares. But oil's played out. The avian flu index is up 43.69% so far this year, to oil's 14%.

    Bird flu is one of the biggest crisis stories in years. And this is just the beginning. Buy this vaccine developer today and you could potentially be holding the best, most profitable buy you've made in years.

    I believe the time is right for HPLF to skyrocket. Here's why...

    As news of the global bird flu scare picked up going into last winter's flu season, share prices of vaccine makers skyrocketed. One company shot up more than 800%. Another went from $3.82 to over $22 in about the same time.

    In January, after another news surge, a third flu-related company gained more than 120% in 13 days. Yet another zoomed from under $1 to more than $4 in less than 90 days during the same time.

    If you think that's impressive, wait till bird flu hits the U.S., as experts think it will sometime this winter. The story will dominate headlines, and HPLF's share prices could skyrocket to astronomical gains. I'm projecting 800% or more, based on what I've already seen in the industry, and the fact that the problem will become worse and the headlines will become louder.

  4. [verwijderd] 30 augustus 2006 13:52
    'Nieuwe vogelgriepdatabase nodig'
    UTRECHT - 24/08/06 - (Novum/AP) - Er moet een internationaal toegankelijke database komen met daarin de gegevens over vogelgriepuitbraken wereldwijd. Daartoe hebben zeventig van de meest prominente vogelgriepdeskundigen donderdag opgeroepen in een brief aan het tijdschrift Nature. Het gebrek aan bereidheid van sommige landen om data over uitbraken openbaar te maken belemmert volgens hen de strijd tegen het virus.

    Een van die landen, Indonesië, kondigde eerder deze maand aan voortaan wel informatie over vogelgriep te zullen delen met de internationale gemeenschap. Landen en laboratoria zijn soms onwillig om hun bevindingen snel vrij te geven, omdat ze deze eerst willen publiceren in toonaangevende wetenschappelijke tijdschriften.

    De Wereldgezondheidsorganisatie (WHO) betoonde zich sceptisch over de waarde van een internationale database. De prominentste vogelgriepdeskundigen hebben al toegang tot de gegevens van de WHO over de vogelgriep. De WHO ligt echter onder vuur omdat slechts een beperkt aantal wetenschappers toegang heeft tot de database. Omdat de WHO een VN-organisatie is, kan elke VN-lidstaat het vrijgeven van gegevens over de vogelgriep binnen zijn grenzen blokkeren.

    De Wereldbank drong er donderdag bij Indonesië op aan meer geld uit te geven aan de bestrijding van vogelgriep, uren nadat het land had aangekondigd te moeten bezuinigen op vogelgriepbestrijding vanwege de kosten die het heeft moeten maken als gevolg van recente natuurrampen. Indonesië wil in 2007 ruim 36 miljoen euro uitgeven, terwijl het dit jaar ruim 42 miljoen euro spendeert. Een Wereldbank-functionaris zei dat het bedrijfsleven vanwege de vogelgriep momenteel aarzelt om in Indonesië te investeren en dat de toerismebranche er mogelijk onder lijdt.

    © Tiscali/Novum
  5. [verwijderd] 31 augustus 2006 06:37
    106 Teletekst do 31 aug
    ***************************************
    Vogelbond tegen afschermplicht

    ***************************************
    ` De bond van vogelhouders vraagt om de
    intrekking van de afschermplicht voor
    pluimvee,die morgen ingaat.Minister
    Veerman wil voorkomen dat het vee in
    aanraking komt met wilde vogels die het
    vogelgriepvirus kunnen verspreiden.

    Het ministerie van Landbouw kondigde de
    afschermplicht vorige week af.Voor
    dieren die volledig zijn gevaccineerd,
    geldt de maatregel niet.

    De vogelhouders zien slechts ongemak
    voor de pluimveehouders en de vogels,
    terwijl het risico op besmetting te
    verwaarlozen zou zijn.De bond wijst er
    ook op dat in andere Europese landen
    geen afschermplicht geldt.
    ***************************************
  6. [verwijderd] 31 augustus 2006 10:33
    New Vaccine Against Bird Flu

    Article Date: 31 Aug 2006 - 0:00am (PDT)

    A new vaccine against bird flu being developed by an Australian company is a step closer today with the announcement that CDC Atlanta will conduct pre-clinical trials on a candidate vaccine developed by Melbourne biotechnology company BioDiem and Dutch company Akzo Nobel's Nobilon.

    The flu virus changes every season. So today's flu vaccines are grown in chicken eggs each year using a killed version of the current influenza virus doing the rounds. It's a slow process - too slow if a pandemic bird flu emerges.

    If it passes the trials, BioDiem's vaccine will have several advantages.

    It is a live vaccine and their seasonal flu vaccine based on the same technology has been shown to give broader protection against influenza virus variants in comparison with an inactivated flu vaccine. So while an inactivated pandemic flu vaccine would have to be remade to be effective each time the flu virus genetically changes, BioDiem's flu vaccine would be expected to still provide meaningful protection.

    The new vaccine can be grown in cell culture, so it can be mass produced faster. The current vaccine is made in eggs - a time consuming process taking at least three to four months - and the world capacity for vaccine production in eggs is limited, particularly if the chickens are infected.

    It will require just one dose and will give coverage within a day of administration. The inactive vaccines in development require two shots three weeks apart and then take two weeks to give protection.

    The new vaccine would also be administered as a nasal spray, allowing fast distribution and no needles.

    The US CDC at Atlanta is amongst the world's foremost authorities in emerging disease threats so it's exciting that they have agreed to run the pre-clinical trials.

    www.scienceinpublic.com
  7. [verwijderd] 31 augustus 2006 12:30
    Questions surround China bird flu vaccine

    HONG KONG (Reuters) - China is working on a bird flu vaccine for humans and initial test results suggest it is safe and effective, but a leading expert is treating the news with caution, saying more details and independent checks are needed.
    Government-backed Beijing Sinovac Biotech Co. said this week it had developed a H5N1 vaccine for humans, using a strain of the virus that had been found in recent years in Vietnam.
    In the first clinical trial that ended in June, 120 volunteers were injected with the experimental vaccine and none showed "serious adverse reactions". Their blood and urine showed the vaccine was safe for human use, Sinovac said in a statement.
    Four different dosages of the vaccine were used, but the one with 10 micrograms appeared to be most effective, stimulating 78.3 percent of protective antibodies. The company gave no other details on the vaccines.
    But an expert greeted the news with caution and asked if independent laboratories had carried out tests for antibodies.
    "Lots of tests are needed to evaluate the effectiveness of any experimental vaccine," said microbiologist Guan Yi at the University of Hong Kong, who has studied the virus since it made its first known jump to humans in Hong Kong in 1997.
    "Vaccines made elsewhere have to be tested and verified by dozens of independent laboratories at every stage. This is the acceptable standard," he said.
    The Chinese vaccine was jointly developed by the Chinese Centers for Disease Control and Prevention and supported by China's Ministry of Science and Technology.
    Pharmaceutical companies around the world are trying to develop a vaccine for the H5N1 virus, which experts fear could mutate into a form that can pass easily among humans, possibly killing millions. For the moment, the virus remains essentially a disease in birds.
    Flu viruses mutate constantly and experts fear that any pre-pandemic vaccine that is designed now might not confer enough protection against the eventual pandemic strain, if it emerges.
    RATIONALE
    Questions surround the positive test results from China.
    "How many of the participants developed antibodies?" Guan asked.
    He questioned the rationale for using the Vietnam strain as a basis for the vaccine because different strains are circulating in Indonesia, northern China, Europe, the Middle East and Africa.
    "This strain is different from the one in Indonesia and new ones that have emerged in other places," Guan said, calling for a more systematic and mature criteria on selecting the vaccine strain and the manufacturing process.
    "The vaccine could bring a small reaction for other H5N1 strains, it won't be completely ineffective. But when you create a vaccine, you try to make one that confers the most widespread protection, but the coverage of this one is narrow," he said.
    Sinovac, meanwhile, has plans to refurbish and expand its existing plant for seasonal flu vaccine to produce up to 20 million doses a year of pandemic flu vaccine from 2007.

    today.reuters.co.uk/news/articlenews....
  8. [verwijderd] 31 augustus 2006 15:01
    Weer alarm om ophokplicht
    UTRECHT - 31/08/06 - (Novum) - De afgekondigde ophokplicht voor hobbypluimvee moet worden ingetrokken. Dat stelt de Nederlandse Bond van Hoender-, Dwerghoender-, Sier- en Watervogelhouders (NHDB) namens honderdduizend hobbypluimveehouders in een brief aan de Tweede Kamer. Vrijdag start het vogeltrekseizoen en moet niet-gevaccineerd commercieel gehouden pluimvee en hobbypluimvee worden opgehokt om het risico op een vogelgriepuitbraak te beperken.

    Vorig jaar werd in Nederland ook een ophokplicht van kracht toen in diverse landen in Europa, waaronder Duitsland, vogelgriep werd vastgesteld. Toen was de NHDB ook tegen de ophokplicht voor hobbydieren, maar was deze minder streng voor watervogels. Die moesten toen ingeperkt worden met een lint. Nu moeten ze ook naar binnen.

    Volgens voorzitter Franc Beekmans van de NHDB wordt het welzijn van dieren onnodig geschaad als watervogels als zwanen dagenlang binnen moeten blijven. "Als je zwanen twee dagen in een garage legt zullen ze nooit meer zwemmen. Hun poten zijn niet gemaakt om hun gewicht zo lang te moeten dragen." Vaccinaties zijn voor de meeste hobbypluimveehouders te duur, zegt Beekmans.

    Volgens de NHDB is het vreemd dat hobbydieren ook opgehokt moeten worden. Een team van deskundigen van het ministerie van Landbouw stelde vorig jaar vast dat hobbypluimvee een veel kleiner risico loopt om het virus op te lopen en te verspreiden. De NHDB wijst erop dat in andere landen geen ophokplicht van kracht is.

    Viroloog Ab Osterhaus van de Erasmus Universiteit vindt de ophokplicht terecht. "In 2003 moesten dertig miljoen kippen geruimd worden door een vogelgriepuitbraak. Het lijkt me logisch dat het ministerie nu voorzorgsmaatregelen wil nemen. Je moet belangen afwegen." Dat het welzijn van de dieren daar mogelijk onder lijdt, wijst hij van de hand. "Als er straks weer miljoenen kippen over de kling gejaagd moeten worden, hebben we het nog wel eens over dierenwelzijn."

    © Tiscali/Novum
  9. [verwijderd] 1 september 2006 08:55
    Berna Biotech to build bigger flu vaccine plant in Spain

    31 August 2006

    Swiss company Berna Biotech has signed a collaboration agreement with the Spanish government to expand its Madrid vaccines plant to supply influenza and eventual bird flu vaccines to the country's health service. The new plant should be operating by 2009 or 2010, says Berna, and will also supply other countries.

    Acquired by Dutch biotech company Crucell in February, Berna Biotech had been negotiating since February last year to become Spain's main supplier of flu vaccines, fighting off competition from Catalonian pharmaceutical company Esteve and the Comunidad Valenciana. The new plant is likely to be a major expansion of Berna's current 4,000m2 site in San Sebastian de los Reyes, north of the capital.

    Spain has the largest annual flu vaccination programme in Europe, according to a World Health Organisation study. Last winter (2005-2006), it administered more than 9 million common flu vaccines through the SNS, its national health service, immunising more than 70% of the elderly population.

    Health officials say Spain will be the eighth European country to build a national vaccine plant, following the UK, France, Germany, Belgium, Italy, Switzerland and the Netherlands.

    Berna already markets eight vaccines in Spain, including the flu vaccine Inflexal, Epaxal against hepatitis A, Anotoxal against tetanus and Orochol aginst cholera.

    Recently the Spanish government admitted it was short on antiviral treatments to protect the population against a possible bird flu pandemic, saying only 140,000 doses had so far been received out of 10 million ordered from Roche and GSK. This followed the discovery of the lethal H5N1 virus in a dead bird in the northern Álava wetlands – Spain's first case of avian flu – in early July.

    www.manufacturing-chemist.info/story....

  10. gogogoo 1 september 2006 15:43
    Nobilon and BioDiem develop pandemic bird flu vaccine
    31 August 2006

    Scientists at Akzo Nobel's Nobilon International human vaccines business have received a boost following the signing of a cooperative research and development agreement with the Centers for Disease Control and Prevention (CDC) in the US.

    The agreement - co-signed with Nobilon's international partner, Australian-based BioDiem Ltd - involves the development of a live attenuated cold-adapted cell culture vaccine against the H5N1 strain of the avian influenza virus. According to experts at the World Health Organization, a live vaccine would offer better and broader protection in the event of a pandemic outbreak.

    In 2004, the two companies agreed a licensing deal for BioDiem's cold-adapted intranasal flu vaccine and this technology will now be advanced through pre-clinical development at the CDC in its high-security laboratories, in an effort to develop a vaccine that will protect against avian influenza viruses that pose a pandemic threat.

    'This is an extremely important collaborative agreement which could prove crucial in our efforts to develop a vaccine for one of the world's leading health risks,' said Toon Wilderbeek, Akzo Nobel's Board member responsible for pharmaceuticals.

    The cooperative research will be carried out over two years at Boxmeer in the Netherlands and Atlanta in the US, and will generate, characterise and evaluate in pre-clinical models, live attenuated cold-adapted influenza vaccine (LAIV) candidates against influenza H5N1 viruses.

    A live attenuated influenza vaccine has a number of advantages, Nobilon says. It can trigger a broader immune response than inactivated influenza vaccines in children, as well as allowing for a single dose of a smaller amount of vaccine to provide meaningful protection, compared with currently available inactivated vaccines.

    The U.S. government has also recently acknowledged that cell culture production of influenza vaccines may provide a superior service compared with the traditional supply based on embryonated eggs. This is because the production timeline may be shortened and vaccine production may be increased with fewer delays.

    www.manufacturing-chemist.info/story....
  11. gogogoo 1 september 2006 16:15
    quote:

    flosz schreef:

    [quote=gogogoo]
    Nobilon and BioDiem develop pandemic bird flu vaccine
    31 August 2006
    www.manufacturing-chemist.info/story....
    [/quote]
    Dat bedoel ik...nr.4, zie pag.97.
    gr.(gol)
    Maar wel met nieuwe datum.

    Kijk ik ben niet zo goed in het zoeken als jij Flosz.
    Maar ik check wel op de dag van publicatie of hetzelfde niet al gepost is. Helaas posten ze op die site blijkbaar 2 keer op verschillende data.
  12. [verwijderd] 1 september 2006 16:20
    Zie linkjes hierboven, post. 11:25.
    Over een week of twee komt exact hetzelfde bericht waarschijnlijk weer voorbij..., incl. "verse" datum.
    gr.
  13. [verwijderd] 4 september 2006 07:19
    RTRS-Intervet mag vaccins tegen vogelgriep verkopen
    N i e u w bericht, vervangt: Vaccin tegen vogelgriep van
    Intervet geregistreerd

    BOXMEER (ANP) - Het Nederlandse bedrijf Intervet mag zijn
    vaccin tegen vogelgriep in Europa op de markt brengen. Het
    vaccin dat vogels beschermt tegen het H5N1-virus is vrijdag
    officieel geregistreerd door de Europese Unie. De registratie
    komt vlak voor de herfst, waarin vogels in Europa een groot
    risico op vogelgriep lopen.

    Dat heeft Akzo Nobel vrijdag gemeld. Intervet is een dochter
    van de beursgenoteerde onderneming en is 's werelds grootste
    producent van vaccins voor dieren.

    Het concern zal moeten concurreren met bestaande vaccins
    tegen vogelgriep. Intervet heeft zelf ook al andere vaccins
    tegen vogelgriep op de markt gebracht, maar die zijn niet
    ontwikkeld tegen H5N1.

    Het nieuwe vaccin Nobilis Influenza is inmiddels al
    succesvol gebruikt in Italië, Vietnam en Hongkong. In Europese
    landen mag het middel uitsluitend onder strikte voorwaarden
    worden toegepast. De betrokken autoriteiten in een Europees land
    moeten het gebruik ervan goedkeuren.

    Het nieuwe middel van Intervet is bedoeld om vogels in te
    enten. Een H5N1-vaccin voor mensen is nog in ontwikkeling. Het
    Britse farmacieconcern GlaxoSmithKline verwacht dat volgend jaar
    gereed te hebben voor massaproductie.

    ((ANP Redactie Economie, email economie(at)anp.nl, +31 20
    504 5999))
  14. [verwijderd] 6 september 2006 22:04
    Alnylam Awarded Federal Grant to Develop RNAi Therapeutics for Pandemic Flu
    Wednesday September 6, 8:00 am ET

    CAMBRIDGE, Mass.--(BUSINESS WIRE)--Sept. 6, 2006--Alnylam Pharmaceuticals, Inc. (Nasdaq: ALNY - News), a leading RNAi therapeutics company, announced today that the National Institute of Allergy and Infectious Diseases (NIAID), a division of the National Institutes of Health (NIH), has awarded the company a Small Business Innovation Research (SBIR) grant to advance the development of RNAi therapeutics for pandemic influenza. The SBIR grant will provide Alnylam with approximately $590,000 in funding over a one-year period to support the company's research efforts on small interfering RNAs (siRNAs), the molecules that mediate RNAi, as anti-viral drugs with broad spectrum activity toward multiple influenza strains including the H5N1 virus.

    Niet zo veel geld, maar toch weer een beweging aan het front.

    Giraf
  15. gogogoo 6 september 2006 22:13
    quote:

    giraf+4 schreef:

    Alnylam Awarded Federal Grant to Develop RNAi Therapeutics for Pandemic Flu
    Wednesday September 6, 8:00 am ET

    CAMBRIDGE, Mass.--(BUSINESS WIRE)--Sept. 6, 2006--Alnylam Pharmaceuticals, Inc. (Nasdaq: ALNY - News), a leading RNAi therapeutics company, announced today that the National Institute of Allergy and Infectious Diseases (NIAID), a division of the National Institutes of Health (NIH), has awarded the company a Small Business Innovation Research (SBIR) grant to advance the development of RNAi therapeutics for pandemic influenza. The SBIR grant will provide Alnylam with approximately $590,000 in funding over a one-year period to support the company's research efforts on small interfering RNAs (siRNAs), the molecules that mediate RNAi, as anti-viral drugs with broad spectrum activity toward multiple influenza strains including the H5N1 virus.

    Niet zo veel geld, maar toch weer een beweging aan het front.

    Giraf
    Ik vroeg me al af of die Grants alleen periodiek toegekend werden. Of ook bij het behalen van bijvoorbeeld een milestone, meteen na het behalen ervan.
  16. [verwijderd] 11 september 2006 14:46
    Nature Medicine
    Published online: 8 September 2006; | doi:10.1038/nm1493
    Controlling immune response may cut bird flu death rate
    Study shows how H5N1 ravages the body.

    Avian influenza kills so many of its human victims because it replicates profusely and over-stimulates the immune system: those findings, from the most extensive analysis of those infected, suggest that drugs to calm the immune system might help when standard antiviral treatment is unavailable or given too late.
    Since 2003, more than 240 people have been diagnosed with H5N1 infections, and more than 140 of them have died. But there has been little information about how the virus ravages the body because many individuals are treated in rural or ill-equipped hospitals and too few samples have been collected. Autopsy tissue has also been hard to come by because of cultural taboos.
    Vietnamese researchers collected and analyzed samples from 18 individuals infected in 2004 and 2005, 13 of whom later died. The researchers, led by Menno de Jong of the Oxford University Clinical Research Unit in Ho Chi Minh City, took blood, nose and throat samples, typically about six days into an infection, and compared them with those from individuals infected with H3N2 or H1N1 human flu strains.
    The team found that H5N1 multiplies to levels up to hundreds of times higher than those of the human strains. The virus appears to prefer the lower respiratory tract, rather than the nose and throat favored by regular flu viruses. The team also detected viral RNA in the blood of patients who died, suggesting that it reached particularly high levels in these people, they report in Nature Medicine1.
    "It's really going to be a landmark paper in describing what happens when humans are infected with avian influenza," says Peter Openshaw, an Imperial College London expert in immune response to respiratory infections.
    The immune systems of those infected with H5N1 show hallmarks of intense activation. The researchers found high levels of several cytokines and chemokines in blood, particularly in patients who died, and a marked drop in infection-fighting white blood cells, or lymphocytes.
    This uncontrolled outpouring of molecules, dubbed a 'cytokine storm,' can be triggered by toxins and bacterial infection, and is thought to eventually lead to the failure of lungs or other organs.
    Researchers have previously suspected that avian flu can trigger a cytokine storm, which is also thought to have been important in severe acute respiratory syndrome and in the 1918 flu pandemic. But for H5N1, this is "the first time there is real data to support that concept," Openshaw says.
    It is possible that the virus triggers this reaction because it replicates so fast, or because it makes proteins that aggressively stimulate the human immune system.
    The study may explain why Tamiflu (oseltamivir), a drug that blocks viral replication, has so far saved few lives. The inflammatory response might have spun out of control by the time those infected began treatment, underscoring the need for early diagnosis and treatment.
    It also suggests that drugs that quell the immune response might cut the death rate. Some doctors have already tried using steroids, which broadly suppress the immune system, but those drugs have not shown a clear benefit. Medicines that instead act on specific molecules — such as the anti-tumor necrosis factor therapy used for rheumatoid arthritis — might be more effective.
    De Jong says researchers need to collect more samples to test, for example, whether genetic makeup makes some people particularly susceptible. "It's too bad we haven't learned more," De Jong says. "If samples had been collected from all those patients, we would be a lot further in understanding this disease."
    www.nature.com/news/2006/060904/full/...
    ******************
    Published online: 10 September 2006; | doi:10.1038/nm1477
    Fatal outcome of human influenza A (H5N1) is associated with high viral load and hypercytokinemia
    Menno D de Jong1, Cameron P Simmons1, Tran Tan Thanh1, Vo Minh Hien2, Gavin J D Smith3, Tran Nguyen Bich Chau1, Dang Minh Hoang1, Nguyen Van Vinh Chau2, Truong Huu Khanh4, Vo Cong Dong5, Phan Tu Qui4, Bach Van Cam4, Do Quang Ha1, Yi Guan3, J S Malik Peiris3, Nguyen Tran Chinh2, Tran Tinh Hien2 & Jeremy Farrar1
    1 Oxford University Clinical Research Unit, 190 Ben Ham Tu, Ho Chi Minh City, Vietnam.
    2 Hospital for Tropical Diseases, 190 Ben Ham Tu, Ho Chi Minh City, Vietnam.
    3 State Key Laboratory of Emerging Infectious Diseases, Department of Microbiology, The University of Hong Kong, 21 Sassoon Road, Hong Kong SAR, China.
    4 Pediatric Hospital Number One, 2 Su Van Hanh, Ho Chi Minh City, Vietnam.
    5 Pediatric Hospital Number Two, 14 Ly Tu Trang, Ho Chi Minh City, Vietnam.
    Correspondence should be addressed to Menno D de Jong dejongmd@gmail.com
    Avian influenza A (H5N1) viruses cause severe disease in humans1, 2, but the basis for their virulence remains unclear. In vitro and animal studies indicate that high and disseminated viral replication is important for disease pathogenesis3, 4, 5. Laboratory experiments suggest that virus-induced cytokine dysregulation may contribute to disease severity6, 7, 8, 9. To assess the relevance of these findings for human disease, we performed virological and immunological studies in 18 individuals with H5N1 and 8 individuals infected with human influenza virus subtypes. Influenza H5N1 infection in humans is characterized by high pharyngeal virus loads and frequent detection of viral RNA in rectum and blood. Viral RNA in blood was present only in fatal H5N1 cases and was associated with higher pharyngeal viral loads. We observed low peripheral blood T-lymphocyte counts and high chemokine and cytokine levels in H5N1-infected individuals, particularly in those who died, and these correlated with pharyngeal viral loads. Genetic characterization of H5N1 viruses revealed mutations in the viral polymerase complex associated with mammalian adaptation and virulence. Our observations indicate that high viral load, and the resulting intense inflammatory responses, are central to influenza H5N1 pathogenesis. The focus of clinical management should be on preventing this intense cytokine response, by early diagnosis and effective antiviral treatment.
    www.nature.com/nm/journal/vaop/ncurre...
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