Vaccine advances on the horizon

By Rafi Ahmed

With their children back in classrooms, and fall and winter rapidly approaching, parents are rightly concerned about the re-emergence of the H1N1, or swine flu virus.

Normally, flu viruses largely disappear during warm weather months, but the swine flu has been surprisingly resilient, as we’ve learned from outbreaks at summer youth camps and now on college campuses.

The World Health Organization recently said government health ministers should get prepared for an “explosion” of H1N1 cases once cold weather returns to the northern hemisphere, and the President’s Council of Advisors on Science and Technology predicts that H1N1 could infect up to half the U.S. population this fall and winter.

Fortunately, infectious disease experts, vaccine researchers and public health authorities have been working hard over the summer months to prepare for H1N1.

Vaccines are being tested among volunteers, including some here at the Emory Vaccine Center and the Emory-Children’s Center. Flu shots specifically aimed at H1N1 should be ready by October or November.

The first candidates to get vaccinated will likely be school-age children, health care workers, pregnant women and people with asthma or other chronic conditions that make the flu riskier.

The H1N1 pandemic demonstrates once again just how challenging it is for science to keep up with the spread of the pandemic. Developing a test for the various strains of influenza and manufacturing a vaccine to prevent them is a laborious process.

That’s why in our laboratories at Emory and elsewhere we are using a new method of rapidly producing highly targeted monoclonal antibodies to develop a quicker diagnostic test specifically for H1N1 as well as potential therapies to fight the virus.

A more distant goal is a new process that would greatly speed up the manufacturing of a vaccine.

At present, influenza vaccines must be grown in chicken eggs, extracted and then mass-produced — a process that takes months when large supplies are demanded.

A group of Emory scientists led by Professor Richard Compans is working with what is known as “virus-like particles,” empty shells that look a lot like viruses but lack the ability to reproduce.

In laboratory testing with mice they have had some success with a VLP vaccine that could cut the production process down significantly and speed the delivery of vaccine around the world.

Still, since the H1N1 flu outbreak was first identified in Mexico last spring — and quickly spread into the United States and to other countries — we have learned a lot about this form of influenza.

We know, for instance, that unlike seasonal flu, H1N1 seems to be more problematic for children than for the elderly. From examination of outbreaks at summer camps and other sites over the summer, we have a better sense of how it can be transmitted.

We know it is particularly risky for pregnant women. Utilizing some of the surveillance steps recommended when health authorities began preparing for a potential outbreak of avian flu — which, unlike H1N1, has not yet been significantly spread by human-to-human transmission — we have been quite successful at spotting potential H1N1 outbreaks and dealing with them quickly.

Because of our work here and in coordination with laboratories elsewhere in the U.S. and around the world, we should know even more in the next few months about H1N1 than we know now.

Influenza has a life of its own and a remarkable ability to mutate. To date, we have been fortunate with this strain because it has not shown itself to be especially virulent.

But that could change and on short notice we may be facing a much more threatening situation.

For these and other reasons our public health surveillance must remain at its peak.

The best research and scientific minds of our country will continue our work toward finding the fastest and most effective methods of testing, vaccinating and treating this and any other infectious-disease threat that comes along.

Rafi Ahmed is director of the Emory Vaccine Center and a Georgia Research Alliance eminent scholar.