UK Bird Flu News - Bird Flu Vaccines

Australian probe puts US flu shots on hold

Health Canada approves FluMist for preventing seasonal influenza

Scientists discover three human antibodies that neutralize HIV

Biobank: Tracking the health of a generation

You might well ask whether there is anything left to test in my body. Having had all my genes sequenced, been given prototype vaccines, and had my brain scanned - twice - I have now taken part in the UK Biobank trial.

This involved three hours of tests and ended with me giving seven blood samples - fortunately this involved only one injection. There were also urine and saliva samples to donate. My genetic material was then shipped up to Stockport, to the Biobank freezer where it will be stored along with samples from all the 500,000 volunteers across the UK. I'll say more about that freezer later.

The UK Biobank scientists will track the health of this huge group of Britons for the next 30 years. With the help of NHS records, they will record every serious illness and death.

All volunteers undergo an array of physical checks. There are the obvious ones like height, weight, waist-to-hip ratio, eyesight, lung function, and hearing. And the less obvious: height while seated, heel density, eye pressure and grip strength.

Then, using a touch screen computer there were hundreds of questions to answer. Most were fairly straightforward and dealt with diet, exercise and lifestyle. I tried to work out, as I went along, what future health problems they were trying to anticipate. For example, there were memory tests to complete. If those who do badly at remembering pairs of cards go on to develop dementia in greater numbers, then it might point the way to early tests for dementia risk. There were lots of questions about diet and exercise which could cover an array of future illnesses.

Some subjects were highly personal: how many sexual partners have you had? Another was downright baffling: do you frequently break the speed limit on the motorway? This, apparently, is designed to show if you are a risk-taker. There was an option to skip any question that you didn't want to answer.

With all that genetic, physical and lifestyle data, scientists should be able to get a far better understanding of why some people fall ill and others don't. They will have a huge storehouse of genetic material to compare, which they will be able to cross-reference against the results of physical checks. The hope is that it will lead to better and earlier diagnosis of disease

And the volunteers will be invited to take part in further health checks and surveys in the future.

The UK Biobank will really come into its own in 30 years time, when many of the 500,000 volunteers have developed diseases or died. By 2040 the research will be in the hand of scientists who are probably now at primary school. It will be them and their children who will benefit the most from the project.

It is surely an admirable and unselfish gesture of half a million adults in Briton to agree to undergo all those tests, giving up their genetic secrets, in the knowledge that it is for the benefit of future generations, rather than themselves.

Finally, back to that freezer. It's got to be pretty big to hold all those samples. I'm told it's the biggest freezer of its kind in Europe - I reckon about the size of two medium family houses. I went inside because, being a TV correspondent, that's what you do. The freezer in your kitchen is set at minus 18C, which is fine for ice-cream and peas. The trays inside the Biobank freezer are down to minus 80C. After 10 minutes of filming and taking photographs, my ears were getting frost-bite, so we left before others bit of my genetic material were left behind.
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Intercell Reports Phase II Study Results Of Its Vaccine Enhancement Patch For Pandemic Influenza

Swine flu: How did we do?

This blog is no longer called Fergus on Flu, but I'm still happy to talk about pandemics.

Boiling down nearly 200 pages to two words, the Hine review's verdict on the UK response to H1N1 can be summed up as "highly satisfactory". Dame Deidre Hine repeatedly praises the planning and the response to the pandemic last year.

That said, there is a series of lessons to be learned, in particular about contract negotiations with vaccine manufacturers. She says the failure, in 2007, to negotiate get-out clauses in the vaccine contract "exposed the Exchequer to some risk". In other words, it cost the tax-payer money and we were left with lots of unused doses of vaccine. What Dame Deirdre does not tell us, because of commercial confidentiality, is how much that cost us.

Before condemning ministers and officials for poor planning, it's worth pointing out that no country in the world managed to negotiate a break clause with GlaxoSmithKline for its Pandemrix H1N1 vaccine.

Furthermore, had the pandemic been as bad as everyone originally feared, those extra doses of vaccine might have saved tens of thousands of lives.

Once last point. Given how mild the H1N1 pandemic was, how on earth are health officials and virologists ever going to interest the public in the potential dangers of the next pandemic? The next one may be a lot more serious.

LEAPS vaccine technology generates dendritic cells to stimulate immune system to fight viral illnesses

Welcome to Fergus's Medical Files

A blog is re-born. Thanks to all of you who followed Fergus on Flu; I hope you will continue with the blog in its new form.

So what will you find here? As well as original posts, I hope to give some greater detail and insights into the stories I am working on elsewhere. My role is pretty broad: to look at medical research, ethics, global disease threats and more.

The blog will also provide a discussion point for these issues and I hope you will get involved. As I made clear in the past, I am not a scientist or a doctor, but a journalist. My role is to interpret often complex scientific information and relay it to a largely lay audience. If you should find any glaring errors, I'll do my best to correct them as soon as possible.

NIH-Funded Scientists Find 2009 H1N1 Pandemic Influenza Vaccine Protects Mice from 1918 Influenza Virus

Letters: Scientific advice and common sense

You highlight a problem with scientific advice given by scientists with potential conflicts of interest (Report condemns swine flu experts' ties to big pharma, 4 June). Unfortunately, this is only the tip of an iceberg and reflects only one aspect of the problem with blind acceptance of scientific advice. Scientists are human beings and are driven by the same selfish desires as the rest of us. The altruistic scientist, driven only by "the search for truth", is a media fabrication. Fame and influence inflate egos. Hubris, arrogance and a woeful lack of self-awareness is common, in both scientific and medical communities.

In my experience many scientists cannot see beyond their limited horizons and only the most remarkable individuals are able to see the big picture. Wide-ranging controversies – such as the MMR scare, withholding of climate change data and the recent overreaction to the swine flu pandemic – show how powerful scientific evidence can be. This is neither intended to negate scientists nor scientific endeavour, but merely remind us that scientific advice must be tempered by a strong dose of common sense before public policy is altered.

Dr Tariq Ali

Oxford

• Marilynne Robinson (Mind over matter, Review, 5 June) offers a refreshing view that challenges the accepted dogma of neo-Darwinists and other scientific reductionists that the mysteries of nature have been sorted out through the application of unbiased science. They will have us believe that, given enough time, the chaotic laws of nature plus the simple mechanics of biological evolution explain everything.

An alternative possible scenario is that matter at its deepest level is characterised by: (a) a quality of "interconnectedness" or very primitive "mentality"; and (b) a natural law that drives matter towards complexity. Quantum theory provides evidence that supports premise (a). The evolution of matter, from the simple elements after the big bang to the complex elements of the periodic table, many of which are necessary as a basis for the biological evolution, which is also a manifestation of this general principle, provide evidence for premise (b). Both premises explain the gradual flowering of mentality from these simple elements that possess it in a most primitive and dilute form to that of the earliest micro-organisms capable of some overt communication and finally to us humans. There is no point of discontinuity at which suddenly the property of mentality emerged, just a sustained increase in material and mental complexity. Ergo, matter and mind are irrevocably entangled.

I am sorry to say that many scientists at present, contrary to the basic premise of science that all scientific explanations are temporary, proclaim views that they consider unshakable.

Professor Leon Freris

Radlett, Hertfordshire

Report condemns swine flu experts' ties to big pharma

Trio of scientists who urged stockpiling had previously been paid, says report

Scientists who drew up the key World Health Organisation guidelines advising governments to stockpile drugs in the event of a flu pandemic had previously been paid by drug companies which stood to profit, according to a report out today.

An investigation by the British Medical Journal and the Bureau of Investigative Journalism, the not-for-profit reporting unit, shows that WHO guidance issued in 2004 was authored by three scientists who had previously received payment for other work from Roche, which makes Tamiflu, and GlaxoSmithKline (GSK), manufacturer of Relenza.

City analysts say that pharmaceutical companies banked more than $7bn (£4.8bn) as governments stockpiled drugs. The issue of transparency has risen to the forefront of public health debate after dramatic predictions last year about a swine flu pandemic did not come true.

Some countries, notably Poland, declined to join the panic-buying of vaccines and antivirals triggered when the WHO declared the swine flu outbreak a pandemic a year ago this week. The UK, which warned that 65,000 could die as a result of the virus, spent an estimated £1bn stockpiling drugs and vaccines; officials are now attempting to unpick expensive drug contracts.

The cabinet office has launched an inquiry into the cost to the taxpayer of the panic-buying of drugs.

Today, the Council of Europe, produces a damning report into how a lack of openness around "decision making" has bedevilled planning for pandemics.

"The tentacles of drug company influence are in all levels in the decision-making process," said Paul Flynn, the Labour MP who sits on the council's health committee. "It must be right that the WHO is transparent because there has been distortion of priorities of public health services all over Europe, waste of huge sums of public money and provocation of unjustified fear."

Although the experts consulted made no secret of industry ties in other settings, declaring them in research papers and at universities, the WHO itself did not publicly disclose any of these in its seminal 2004 guidance. In its note, the WHO advised: "Countries that are considering the use of antivirals as part of their pandemic response will need to stockpile in advance."

Many nations would adopt this guidance, including Britain. In 2005, the government said it had begun bulk-buying the drug Tamiflu, initially ordering 14.6m doses after bird flu killed 40 in Asia.

The specific guidance on antivirals was written by Professor Fred Hayden. He has confirmed in an email that he was being paid by Roche for lectures and consultancy work at the time the guidance was produced and published. He received payments from GSK for consultancy and lecturing until 2002. He said "[declaration of interest] forms were filled out for the 2002 consultation".

The previous year Hayden was also one of the main authors of a Roche-sponsored study that asserted what was to become a main Tamiflu selling point – its claim of a 60% reduction in flu hospitalisations.

Dr Arnold Monto was the author of the WHO annex dealing with vaccine usage in pandemics. Between 2000 and 2004, and at the time of writing the annex, Monto had openly declared consultancy fees and research support from Roche and GSK. No conflict of interest statement was included in the annex published by the WHO.

When asked if he had signed a declaration of interest form for WHO, Dr Monto said "conflict of interest forms are requested before participation in any WHO meeting".

The third scientist, Professor Karl Nicholson, is credited with the WHO's influential work Pandemic Influenza. According to declarations he made in the BMJ and Lancet in 2003, he had received sponsorship from GSK and Roche.

Even though the previous year these declarations had been openly made, no conflict of interest statement was included in the annex. Nicholson said he last had "financial relations" with Roche in 2001.

When asked if he had signed a declaration of interest form for WHO, he replied: "The WHO does require attendees of meetings, such as those held in 2002 and 2004, to complete declarations of interest."

A WHO official told the BMJ it had to balance an individual's privacy with the robustness of guidelines, which were subject to a wide external review process.

MMWR: Preliminary Results: Surveillance for Guillain-Barré Syndrome After Receipt of Influenza A (H1N1) 2009 Monovalent Vaccine - United States, 2009-2010

Preliminary Results: Surveillance for Guillain-Barre Syndrome After Receipt of Influenza A (H1N1) 2009 Monovalent Vaccine --- United States, 2009--2010

Experts find compound to fight bird, seasonal flu (Reuters)

Reuters - Scientists have identified a chemical compound that can stop the H5N1 bird flu virus as well as seasonal human flu viruses from replicating.

Child flu jab trial results out

Children respond well to swine flu vaccines, trial shows

UPDATE: Questions and Answers about Updating Guidance on Infection Control Measures for Influenza in Healthcare Settings

Swine flu: One year on

This time last year, swine flu was on the brink of becoming a major global health story. With hindsight we can be thankful that the pandemic was mild for most while serious for a small minority.

In retrospect was it all a huge, global over-reaction? Not according to a team of experts assembled by the Science Media Centre. Professor Robert Dingwall from the University of Nottingham wondered what journalists would have said had the pandemic turned out to have been as serious as that in 1918.

Professor Peter Openshaw from Imperial College London said the public-health response had been proportionate and that politicians had listened to the experts. The general tone of those assembled was that it's always better to prepare for the worst rather than simply hope for the best. Mike Grannatt, formerly of the Cabinet Office and now an expert in risk communication, said the government must not be afraid of crying wolf in the future, because "one day the wolf will come" in the form of a more serious pandemic.

There are lessons to be learned. Professor Neil Ferguson, a leading disease modeller, felt that although his team was able to quickly determine that the H1N1 virus was mild for most, it took much longer to assess what the effect would be on the health service.

Professor Ferguson, an epidemiologist at Imperial College London, said ball-park projections for the transmissibility and severity of the virus were calculated within weeks of the first cases being highlighted in Mexico. This meant when the virus began circulation in the UK, people were aware that it was worth taking note of, but there was no reason to panic. But transforming ball-park projections into more accurate ones was more problematic.

Professor Dingwall pointed out the pandemic is not over. We are at the beginning of the flu season in the southern hemisphere. "We can't relax our vigilance, especially since the historic evidence is that a more virulent second wave is possible," he said.

I should stress that most experts, including Professor Dingwall think it unlikely that the H1N1 virus will mutate into something much more serious. Unlikely, but not impossible. Neil Ferguson said there had recently been a resurgence of flu in some southern American states, notably Alabama.

So the H1N1 virus is still out there. Dr Stephen Gardner, influenza policy director at GlaxoSmithKline, said the H1N1 pandemic strain is now being incorporated into seasonal flu vaccines. Seasonal flu jabs are trivalent; in other words, they are effective against three different strains of influenza. That should greatly simplify the vaccination process, for patients and GPs, when the flu season begins this autumn.

Flu vaccine lifts Novartis profit

MMWR UPDATE: Influenza Activity --- United States, August 30, 2009 - March 27, 2010, and Composition of the 2010 - 11 Influenza Vaccine