Tampa Bay Research Insights about Influenza

During a typical flu season in which we have developed and administered the correct vaccine, approximately 48 million people in the United States become infected, 114,000 require hospitalization, and 35,000 die as a result of complications from the infection. Globally, the flu results in the death of up to 500,000 people each season. The majority of deaths occur in the very young ( 65 yrs old), as members of both age groups have weakened immune systems that have difficulty fighting off the infection. This flu season (since January 2009) the seasonal flu has already resulted in the death of more than 13,000 of our citizens. Now, right in the middle of the current season a new variant of the flu virus, termed H1N1, has emerged and we have no vaccine to protect us. The emergence of such a virus variant has the potential to rapidly spread through the population and result in an epidemic or even a worldwide pandemic.

An epidemic occurs when there are more cases of a disease than normal. A pandemic is a worldwide epidemic of a disease. An influenza pandemic may occur when a new influenza virus appears against which the human population has no immunity (natural or vaccine-associated). With the increase in global transport (esp air travel), as well as urbanization and overcrowded conditions in some areas, epidemics due to a new influenza virus are likely to take hold around the world, and become a pandemic faster than before. Pandemics can be either mild or severe in the illness and death they cause, and the severity of a pandemic can change over the course of that pandemic.

As we were preparing this newsletter the WHO raised the influenza pandemic alert level to Phase 5. This is one level below a true pandemic and is characterized by human-to-human spread of the virus into at least two countries in one WHO region. As of May 7, 2009, 23 countries had officially reported 2099 cases of influenza A (H1N1) infection. Mexico had reported 1112 laboratory confirmed human cases of infection, including 42 deaths and the United States had reported 642 laboratory confirmed human cases, including two deaths. Phase 5 is a strong signal that a pandemic is imminent.

If an influenza pandemic does occur, we could expect the virus to spread rapidly due to the interconnected nature of the world and the high level of global travel. Based on current epidemiological models it is projected that between 2 and 7.4 million deaths could result worldwide. If such a pandemic evolved to become severe, we could also expect vaccines and antiviral agents to be in high demand, and potentially in short supply; medical facilities to be strained with demands to care for both influenza and non-influenza patients; and there could be significant shortages of personnel to provide essential community services. It is therefore imperative that we do all that is possible to mitigate the further spread of the virus.

At the moment, there are no vaccines for the H1N1 virus. However, there are actions that you can take to help prevent the spread of the flu.

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.

Avoid touching your eyes, nose or mouth. Germs spread this way.

Try to avoid close contact with sick people.

Stay home if you are sick for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further.

The CDC recommends the use of the antiviral drugs oseltamivir (Tamiflu) or zanamivir (Ralenza) for the treatment and/or prevention of infection with the new H1N1 flu virus. These antiviral drugs are prescription medicines that fight against the flu by keeping the viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. During the current outbreak, the priority use for influenza antiviral drugs during is to treat severe influenza illness.

At TBRI we have been investigating the potential of an orally active, commercially available, nutritional supplement (Immune Extra) to enhance the effectiveness of vaccines. Based on recent evidence generated by TBRI and collaborators we believe that this product has the potential to signficantly boost the effectiveness of vaccines, including those for influenza. These findings are being assembled in a manusript to be submitted for publication and are included as support information in grant applications soliciting funds to investigate the mechanisms by which Immune Extra exerts such an effect and to specifically test its ability to boost the immune response to influenza and HIV vaccines.