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Influenza A – What’s Hot
TARRANT Symposium 2012
Kevin Fonseca
Clinical Virologist
ProvLab
Theme
Recent Controversies in Influenza Research
Animal Models Lively Discussion
Holy Grail of “Influenzaologists”
The Perfect Vaccine Able to predict Pandemics to the day/hour Able to clinically diagnose with 100%
certainty The Perfect Influenza test in 10 secs The Perfect Model
Controversy Balance the right to research with perceived
ethical obligations Create a potential bio-weapon Provide data to “terrorist organisations” Risks of pathogen escape (small-pox, anthrax,
influenza) Safety of the public What about “military research” When is research just to dangerous to conduct Does understanding the biology of infection in
animal models really help ?
Mortality = 58%
Belser et al Disease Models & Mechanisms 2011
Pandemic vs Seasonal H1N1 (Pre-pandemic)
Virus Ferrets Humans
Pandemic
Mild
Severe
Fatal
30% sneezed
No deaths
Found in GI (70%)
Generally mild
Not associated with GI symptoms
Lots of person-to-person transmission
Spectrum of illness with some fatalities
Some countries reported higher incidences or morbidity & mortality
50% sneezed
50% died
Found in GI (20%) [& contacts]
10% sneezed
No deaths
Found in GI (10%)
Seasonal 100% sneezed
No deaths
No GI infection
Generally mild
No GI symptoms
Fatalities occurred
Q – How accurate was the ferret model in predicting human disease ?
Reality ?
Ferret Model A(H3N2)v is easily
transmissible Causes mild illness
Human Cell Model A(H3N2)v > H3N2 Reaches a higher
titre
Observed Handful of cases (12) Mainly in young
children Mild illness Few hospitalizations Low level of
transmission thus far ? Pandemic
potential? Not covered by the
vaccine
