{"id":2529,"date":"2018-11-13T12:49:47","date_gmt":"2018-11-13T12:49:47","guid":{"rendered":"https:\/\/www.mybiosource.com\/learn\/?p=2529"},"modified":"2023-03-13T12:42:02","modified_gmt":"2023-03-13T12:42:02","slug":"influenza-series-combating-influenza","status":"publish","type":"post","link":"https:\/\/www.mybiosource.com\/learn\/influenza-series-combating-influenza\/","title":{"rendered":"Influenza Series: Combating Influenza"},"content":{"rendered":"\n\n\n
\n

Table of Contents<\/u><\/strong><\/h3>\n

I. Introduction<\/strong><\/a>
\n\u2022 Overview of the impact of influenza epidemics throughout history
\n\u2022 Emergence of novel strains and global pandemics
\n\u2022 Notable pandemics: 1918 and H1N1 in the 21st century
\nII. WHO’s Efforts to Reduce Influenza-related Illness and Death<\/strong><\/a>
\nIII. 2009 Pandemic Swine Flu<\/strong><\/a>
\n\u2022 Believed to have emerged from Mexico in April 2009
\n\u2022 Rapid spread across multiple countries
\n\u2022 WHO declaration of global influenza pandemic
\nIV. Pandemic Influenza Preparedness and Response<\/strong><\/a>
\n\u2022 Global Influenza Surveillance and Response System (GISRS) and Pandemic Influenza Preparedness Framework
\n\u2022 Future: Universal Flu vaccine?
\n\u2022 Anti-Influenza Treatment
\n\u2022 Emerging trends in drug development
\n\u2022 Immunomodulatory Therapy<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Throughout history, influenza<\/span> epidemics<\/span> appear to have affected the population causing widespread illness and death. In the last century, four novel strains of the viruses have emerged each responsible for a global pandemic. One of the notably worst pandemics<\/span> recorded historically was in 1918 causing around 546,000 excess deaths in the United States alone and an estimated 50 million people worldwide. And, the first pandemic of the 21st<\/sup> century caused by the H1N1<\/span> influenza<\/span> virus has resulted in approximately 151,700 to 575,400 deaths globally during the time it circulated in the first year.<\/p>\n

For decades, World Health Organization has also continued the surveillance of the viruses involving several generations of renowned influenza<\/span> scientists\u2019, yet, it still is a great challenge among the scientific community and continues to remain a threat to humans. In an effort to reduce the number of influenza<\/span>-related illness and its associated deaths globally, WHO twice a year organizes consultations with various experts from WHO Collaborating Centers (CCs), Essential Regulatory Laboratories (ERLs) and other partners to make the recommendations on influenza<\/span> vaccine composition. In order to combat influenza<\/span>, various surveillance systems and centers were developed that both monitors and provides information about the influenza<\/span> viruses which can be used by the health researchers for the development of a vaccine with high efficacy and also by acting a source for the development of a novel anti-influenza<\/span> treatments in the future.<\/p>\n

 <\/p>\n

2009 Pandemic Swine Flu<\/span> It is believed to have emerged from Mexico in April 2009 and within weeks, the disease has spread over 30 countries and by July, it was reported in 122 countries. On 11 June 2009, WHO declared a global influenza<\/span> pandemic which officially was over in August 2010. According to CDC<\/span>, the virus is believed to be the result from reassortment which involves a process where two or more influenza<\/span> viruses can exchange genetic information by infecting an individual or an animal host. This form of abrupt major changes in influenza<\/span> viruses is known as \u2018antigenic shift<\/span>\u2019 meaning most of the people have little or no protection against the new virus. As this form of genetic mixing can result in the emergence of viruses that can potentially cause pandemic among humans, the need for better surveillance of the virus among pigs and other animals are needed.<\/p>\n

 <\/p>\n

Future Pandemic Preparedness Even with the current knowledge, predicting the future pandemic is not entirely possible including when and where it will occur or what the subtype will be. WHO has developed a guidance document on Pandemic Influenza<\/span> Preparedness and Response that provides information such as situation monitoring and assessment, planning and executing a preparedness exercise, reducing the spread of the disease, rapid containment training package and recommends actions before, during and after a pandemic. Also, the Global Influenza<\/span> Surveillance and Response System (GISRS) and the Pandemic Influenza<\/span> Preparedness Framework will assist various countries for the access of antiviral<\/span> drugs, vaccines and prepare for the management of pandemics<\/span>. In the Future: Universal Flu vaccine?<\/strong> Immunization<\/span> against influenza<\/span> is an important public health intervention in order to prevent, control and manage both the seasonal flu and pandemic influenza<\/span>.\u00a0 Because of the constantly evolving nature of influenza<\/span> viruses, global monitoring is essential for the reformulation of the vaccine components. The production of vaccine takes around 6 months and according to WHO\/Europe, the two types of influenza<\/span> vaccine available are the inactivated vaccines (IIV) and live attenuated<\/span> influenza<\/span> vaccines (LAIV).\u00a0 However, researchers across the globe and at the University of Rochester Medical Center are developing a \u2018universal\u2019 flu shot that can offer protection against all seasonal and pandemic strains of the virus. The report suggests that the most promising strategies are creating a vaccine that targets the \u2018stalk\u2019 of a protein enveloping the virus. The \u2018stalk\u2019 of the virus appears to be relatively constant and by directing a vaccine and the immune response of the body towards the stalk could provide a broad protection against the infection. Anti-Influenza<\/span> Treatment<\/strong> During the late 20th<\/sup> Century, antivirals were developed to treat influenza<\/span>. In 1964, amantadine<\/span> as an inhibitor of influenza<\/span> was reported which provided the basis for the recent development of neuraminidase<\/span> inhibitors. The current anti-influenza<\/span> drugs are the neuraminidase<\/span> (NA) inhibitors (Oseltamivir<\/span> and Zanamivir<\/span>) and M2 ion-channel inhibitors amantadine<\/span> and rimantadine<\/span>. However, the efficacies of these drugs are declining as the drug-resistant variants of virus continue to emerge and clearly, the development of a novel antiviral<\/span> drug remains essential.<\/p>\n

Emerging trends in drug development<\/strong> FDA approved new drug for the treatment of influenza<\/span><\/strong>: After nearly 20 years, U.S Food and Drug Administration<\/span> approved Xofluza (baloxavir marboxil) for the treatment of acute uncomplicated influenza<\/span>. It can be used for individuals 12 years or older and when treatment is initiated within 48 hours, it can reduce the symptoms and the duration of the illness. The safety and efficacy of the drug were demonstrated in two randomized controlled clinical trials<\/span> of 1,832 individuals who either received a Xofluza, a placebo or another antiviral<\/span> drug within 48 hours of the onset of symptoms. In both the trials, those who took Xo`fluza had a shorter time to alleviation of symptoms.<\/p>\n

Favipiravir \u2013 It is a new antivira<\/span>l drug and when taken orally, it interferes with the replication of influenz<\/span>a viral RN<\/span>A by inhibiting the RN<\/span>A polymeras<\/span>e activity. siRNA as antivira<\/span>l<\/strong> \u2013 although there are reports that siRNA could trigger innate immune reactions such as the Toll-Like Recepto<\/span>r (TLR), the novel second generation transfection reagents and nanoparticle technology that are developed can bypass the TLP pathway showing promising results as an anti-influenz<\/span>a treatment option. Fludase<\/strong> \u2013 This antivira<\/span>l drug has completed preclinical development and has entered the clinical development to prove its safety and efficacy when used among humans. The Emergency Investigational New Drug Application granted by US FDA allowed the treatment of a severely immunocompromised individual with Fludase after undergoing an allogeneic stem cel<\/span>l transplantation and the result showed improvement in the patient\u2019s respiratory status. Immunomodulatory<\/strong> <strong>;Therapy \u2013 Its role remains unclear with a limited number of published data based on randomized controlled trials (RCTs). In some studies, the passive immunotherapy such as convalescent plasm<\/span>a and hyperimmune globuli<\/span>n has demonstrated benefit when given as an adjunctive therapy for severe influenz<\/span>a. One study has supported the use of a triple combination of oseltamivi<\/span>r, clarithromyci<\/span>n and naproxen for severe influenz<\/span>a although confirmatory studies could be very valuable. References<\/strong><\/span><\/span><\/p>\n

    \n
  1. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5198166\/<\/a><\/li>\n
  2. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29727518<\/a><\/li>\n
  3. https:\/\/www.cdc.gov\/flu\/spotlights\/pandemic-global-estimates.htm<\/a><\/li>\n
  4. https:\/\/www.urmc.rochester.edu\/news\/story\/5177\/in-pursuit-of-a-universal-flu-shot.aspx<\/a><\/li>\n
  5. https:\/\/www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm624226.htm<\/a><\/li>\n
  6. https:\/\/www.pharmaceutical-journal.com\/opinion\/comment\/research-and-developments-of-vaccines-and-drug-treatments-for-influenza\/11050937.article?firstPass=false<\/a><\/li>\n
  7. https:\/\/www.drugdevelopment-technology.com\/projects\/fludase\/<\/a><\/li>\n
  8. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29325970<\/a><\/li>\n
  9. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3185718\/<\/a><\/li>\n
  10. http:\/\/www.who.int\/wer\/2009\/wer8421.pdf?ua=1<\/a><\/li>\n
  11. https:\/\/www.cdc.gov\/h1n1flu\/information_h1n1_virus_qa.htm<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Table of Contents I. Introduction \u2022 Overview of the impact of influenza epidemics throughout history \u2022 Emergence of novel strains and global pandemics \u2022 Notable pandemics: 1918 and H1N1 in the 21st century II. WHO’s Efforts to Reduce Influenza-related Illness and Death III. 2009 Pandemic Swine Flu \u2022 Believed to have emerged from Mexico in […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[31],"tags":[56],"class_list":["post-2529","post","type-post","status-publish","format-standard","hentry","category-news","tag-combating-influenza"],"_links":{"self":[{"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/posts\/2529","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/comments?post=2529"}],"version-history":[{"count":0,"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/posts\/2529\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/media?parent=2529"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/categories?post=2529"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mybiosource.com\/learn\/wp-json\/wp\/v2\/tags?post=2529"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}