Questionable parenting practices? Yeah. But our dinner conversations are amazing and spark the level of curiosity and appreciation in public health that I wish more people had, especially right now.

About three weeks ago, my kids saw that I was a little worried about something. Instead of telling them outright, I turned to our old game and asked them to tell me what they thought was the scariest disease.

Most people would go for Ebola because of its Hollywood-level freak out potential. Cholera is very scary as well, and an awful way to die. But my kids know by now that there’s one blue ribbon winner in my book when it comes to very scary diseases: Influenza.

Not garden-variety seasonal influenza. No, I’m talking about pandemic level influenza, like the 1918 pandemic flu that killed an estimated 50 million people and sickened a fifth of the world’s population.

This strain of influenza is the stuff of nightmares. A disease that spreads so rapidly that 2-3 healthy people could get infected by one sick person. A disease so deadly that it turns our own immune system against us, tricking it into a massive overreaction called a cytokine storm that either kills us or lays waste to our natural defenses so that that infections like bacterial pneumonia just waltz right into our bodies.

It’s why in 1918 the healthiest people often died the fastest: as in showing up for work in the morning and dead by night kind of fast. In places like Baltimore, Philadelphia, Seattle and countless corners of the world, the Great Influenza killed so quickly and debilitated people so widely that basic services broke down. In scenes reminiscent of Medieval times during the Bubonic Plague, when families were asked to bring out their dead, there were instances of bodies being stacked in the streets of America’s major cities.

And just like Bubonic Plague, where victims near death displayed the tell-tale, malodourous rash of “Ring around the Rosie” children’s song fame, care providers in 1918-19 watched as patients who were near death turned blue from oxygen failing to get through disease-ravaged lungs.

Here’s another little-known twist: Most people refer to the 1918-19 pandemic as the Spanish Influenza, assuming that was where it originated. But that’s not the case. Because of World War I, most of northern Europe was in a news blackout and didn’t report that thousands of soldiers engaged in fighting there were falling sick. Spain was the first European country to report on the emergence of the new disease, earning the unfortunate label as the epicenter for the pandemic.

There is general consensus among global health experts and historians that the true origin of the Spanish Influenza was likely thousands of miles away from Spain. It’s one of the many inconvenient truths that was glossed over in the midst of all the finger pointing and xenophobia directed to China during Covid-19: The deadliest plague in modern human history started just over a century ago not in a lab or a crowded urban tenement, but on a pig farm in the middle of Kansas, USA.

Which is why I’m watching the pigs now.

On October 29, the U.S. Department of Agriculture detected the first known transmission of H5N1 avian influenza to pigs on a small backyard farm in Oregon where poultry had been infected and euthanized recently. While certainly not a reason to panic, this milestone was alarming enough that I couldn’t disguise my concern during family dinner three weeks ago.

There are several reasons why we should all be keeping an eye on where H5N1 goes next.

First, think of pigs like a Vitamix for whirling around zoononic (animal) and human strains of influenza and spilling out the perfect pandemic-level smoothie. Because we share so much in common with pigs, genetically speaking, and because pork is such an integral part of the global diet, the potential for this animal species to serve as an efficient transmitter of deadly influenza strains is particularly high. This is worrisome, because H5N1 is very deadly to humans, carrying with it a 50+ percent fatality rate (compared to a roughly 1 percent case fatality ratio for Covid-19 among U.S. patients).

Second, if Americans are angry now about the price of eggs – which strangely no presidential candidate connected to mass chicken culls from H5N1 – just wait for the economic and food supply impact of broader infections among pig herds.

But most importantly, America’s public health system has been slow to track H5N1, ignoring important lessons from Covid-19 and downplaying the potential threat that could be on the horizon. There are broad concerns that surveillance has lagged and impacted flocks and herds are being undercounted. U.S. media attention has focused on the safety of the nation’s milk supply, which is interesting since pasteurization kills all viruses and bacteria (something to note for all of you raw milk drinkers out there). And there seems to be inexplicable foot dragging with our efforts to conduct and broadly share regular genetic sequencing of different H5N1 samples to understand how the virus may be mutating into a more virulent pathogen.

Instead of focusing on the infrastructure we have in place to detect a potential spillover of H5N1 to humans, we are poised to cut funding and resources needed to effectively track and contain outbreaks before they spread.

While pandemic fatigue is real and we can’t dismiss its influence on U.S. politics, economics or popular culture right now, we also cannot afford to leave our front door open when a virus with pandemic intentions is creeping around our yard.

Now is the time to review and publicly discuss the lessons learned from Covid-19 on surveillance, health system strengthening, rapid reporting and effective intra—government and public communications. We have more advanced technologies and biosecurity measures that we can leverage, as well as incentives to ensure livestock operators are not collateral damage in our war against disease. Lastly, we can’t afford to weaken routine immunization policies when they may be our first line of defense against a novel pathogen that overwhelms our health systems again.

By combining proactive policies with strong communication strategies, including more effective ways to engage and educate the media, we can effectively prevent and manage the threat posed by H5N1 and other pandemic influenza viruses, safeguarding public health and minimizing economic disruptions.

The question is whether there is enough political will remaining after Covid to keep our guard up against pandemic threats, either homegrown in the U.S. or originating in a far-off hot zone. The answer is what keeps me up at night.

The post Watching the Pigs appeared first on Medika Life.

In March, as the Southern Hemisphere braced for winter flu season while fighting COVID-19, epidemiologist Cheryl Cohen and colleagues at South Africa’s National Institute for Communicable Diseases (NICD) set up a plan to learn from the double whammy. They hoped to study interactions between seasonal respiratory viruses and SARS-CoV-2, which causes COVID-19. Does infection with one change a person’s risk of catching the other? How do people fare when they have both?

But the flu season — and the answers — never came. NICD’s Centre for Respiratory Disease and Meningitis, which Cohen leads, has logged only a single flu case since the end of March. In previous years, the country’s surveillance platforms, which capture a sampling of flu cases from doctors offices, hospitals, and clinics, have documented, on average, about 700 cases during that period, Cohen says. “We’ve been doing flu surveillance since 1984, and it’s unprecedented.”

There are a number of factors that may have affected the 2020 influenza season. Masks, for one. More focus on hand hygiene and the disinfection of household surfaces, and then, social distancing. Add to that the closure of schools, children are the major engine for influenza transmission, and you can see possibly why the seasonal flu is having a hard time.

There is another reason though, and it has to do with viruses in general. They seem to prefer healthy hosts.

Viruses exhibit really strange behavior that we don’t as yet fully understand. When a new strain emerges, older viruses will often go into a phase of inactivity. It’s almost as though they are able to assess the landscape of potential hosts and realize they offer slim pickings. Scientists don’t fully understand this mechanism or what drives it.

Anecdotally, where I find myself currently ensconced in a remote village in the Philippines, Covid-19 is a rarity, almost no cases have presented. Here, the common flu virus is still alive and well, doing the rounds, and our rainy season brought with it all the usual flu encapsulated miseries.

So does this mean that traditional influenza will be back when the coronavirus runs its course? Possibly. We just don’t know enough about viruses to be sure. There is an alternative scenario though. One that becomes more likely with each passing day.

The possibility that this particular coronavirus, which is, don’t forget, a member of the family of influenza viruses, sticks around. Permanently. That our new term for flu becomes Covid. That we are already in the midst of a really terrible “flu” season that we’ve simply chosen to intentionally ‘mislabel’.

What supports this potential outcome?

The SARS-CoV-2 is an influenza virus with a twist. Its symptoms, when you first start feeling the effects of being infected, are initially indistinguishable from regular influenza. That’s why we need to rely on tests before we treat Covid-19 patients.

I take issue with articles like those issued by the WHO that seek to underline the differences between the regular influenza virus and SARS-CoV-2. This simply increases the public perception that we are dealing with something that’s not an influenza virus. Surely the time has come to admit that despite the severity and transmissibility of SARS-CoV-2, it is nothing more than a really aggressive influenza. A new breed of “flu”.

If your body fails to destroy the virus, that’s when things take a turn for the worse and when SARS-CoV-2 shows its true colors. It possesses an array of tools, a viral box of tricks, if you will, that regular “old school” influenza can only dream of.

Although it follows the conventional flu virus by using our nose and mouth to gain access to our bodies, that’s pretty much where the similarities end. Initial symptoms that appear flu-like are actually a precursor or warning for what can and does follow in some people. Unlike influenza, which pretty much limits itself to cardio and pulmonary attacks, the SARS-Cov-2 virus uses our bloodstream to transport itself to every organ and orifice of our bodies.

From your little toe to your brain, everything you own is fair game for this virus and there is emerging evidence that even those who don’t develop severe Covid-19, still sustain damage to their lungs and, perhaps, even other organs. We are only just starting to understand the long term impacts on survivors.

We use the term “influenza” to describe a whole range of viruses that cause respiratory like symptoms in their hosts. The coronavirus is part of this family, and while your organs, brain, and circulatory system are all at risk from it, it is still the lungs that are most likely to sustain serious damage from Covid-19, If it walks like a duck and quacks like a duck, even though it may have grown a few new feathers, it’s still a duck. Just a far more dangerous duck.

Viral Evolution

To have a context for the severity of influenza pandemics it might be helpful to know the death count of a typical flu season. Current estimates for the annual number of deaths from influenza are around 400,000 deaths per year. Paget et al (2019) suggest an average of 389,000 with an uncertainty range 294,000 from 518,000.

This means that in recent years (pre-Covid) the flu was responsible for the death of 0.0052% of the world population — one person out of 18,750. It is a number so negligible as to pay it no heed, which is exactly what flu became to us. A negligible concern. Unless you were old or suffered from a related condition that made contracting influenza potentially deadly, catching flu was simply an annoying part of life for most. Millions, possibly billions, were infected each year.

The interactive graph below shows our increase in life expectancy since the 1830s.

If the 1918 “Spanish Flu” pandemic estimates of 50 million deaths published by Johnson and Mueller are used, it implies that the Spanish flu killed 2.7% of the world population. If it was in fact higher, as the report suggests— 100 million— then the global death rate would have been 5.4% of the global population in 1918, estimated to have been around 1.8 billion.

In 2020, with over 140 million recorded births globally, you can see how even the 2 million deaths from Covid-19 cannot impact this curve. We have become too prolific and the old adage, “safety in numbers” may very well no longer count in our favor. Our proclivity for breeding and increased numbers merely offers viruses an untold wealth of opportunities.

Interestingly, as the graph shows, 1918 was the last time the world’s population experienced a contraction. In the last century, we’ve faced other influenza pandemics, but all have paled in comparison to the 1918 outbreak.

• The Russian Flu pandemic of 1977–78 was caused by the same H1N1 virus that caused the Spanish flu. According to Michaelis et al. (2009) around 700,000 died worldwide
• According to a WHO publication the “Hong Kong Flu” (1968–1969) killed between 1 and 4 million people
• Estimates for the death toll of the “Asian Flu” (1957–1958) vary between 1.5 and 4 million.
• Two decades before the Spanish flu the Russian flu pandemic (1889–1894) is believed to have killed 1 million people.

Viruses don’t just disappear. Take the H1N1 variant. Fifty years after the Spanish Flu pandemic, it was back. Reduced deaths can easily be attributed to our access to antibiotics, a relatively new medical tool to combat infections, and improved hygiene protocols. By the late seventies, we understood the nature of the enemy we were facing and how best to neutralize it.

So is the coronavirus flu, or isn’t it?

Yes, it is and no, it isn’t. In the strict sense of viral lineage, it is not an influenza virus. Both are enveloped, single-stranded RNA viruses, and both are encapsidated by nucleoprotein but there are fundamental differences between normal flu viruses and SARS-CoV2, notably the following;

• Polarity. The influenza virus is comprised of 8 single-stranded negative-sense, viral RNA segments. SARS-CoV-2 has single-stranded, non-segmented, positive-sense, viral RNA.
• Influenza viruses rely on the collaborative functions of 2 viral surface proteins, haemagglutinin (HA) and neuraminidase (NA) to enter and exit host cells. SARS-CoV-2 is covered in spike (S) proteins that facilitate invasion of host cells. S proteins bind to the host cell receptor, angiotensin-converting enzyme 2 (ACE2)
• Scientists also point to the different strains of Influenza viruses and the single strain of SARS-CoV-2. It is, however, early days and the mutations of the virus are now in evidence.

There is a very real possibility that SARS-CoV-2 will replace older influenza strains by establishing dominance in the host population (us). Failure to acknowledge this may be one of the reasons we’ve mishandled the pandemic so badly in terms of information and disseminating “need to know” details to the public. Trying to classify it as anything other than a new deadly strain of influenza may very well have hurt our efforts to contain it.

Rather than reclassifying it as its own deadly disease, we need to consider expanding our classification of influenza viruses to include it.

Yes, it is far more deadly than conventional strains of influenza, but as we’ve discussed, that doesn’t change its origins and nature and at some point, we may have to face the one glaring and unpleasant fact we’ve been avoiding.

The SARS-CoV-2 virus has supplanted influenza strains, replacing H1N1 and other common strains. and is now, officially, here to stay.

We need to deal with this unpleasant reality, adjust the public perception of the virus, and call a spade a spade. The virus will not magically disappear at some point in the near future. Everything we know about it suggests otherwise. It is mutating, frequently and rapidly and we are not going to simply wake up one morning to a world that is free of SARS-CoV-2. That is a pipedream and needs to be removed from the publics’ mindset.

SARS-CoV-2 is here to stay and we have to start working with that knowledge as the basis for our plans for the future. Medically, scientifically, economically, and as societies. We need to open up our world again and at the same time implement enforceable mandates for effective (not the current tea strainers we use) masks and social distancing.

Vaccines make up an integral part of our limited arsenal, but it is critical that they do not cause us to become complacent, that would be a false currency, given the nature of the virus and protection can be transient.

We need to start learning to co-exist with the new enemy, as we can no longer afford to try and “sit it out”. The virus doesn’t need to pay a mortgage our feed its children. We do and there are workable solutions we can implement to achieve this. We need to be addressing these now and with urgency.

SARS-CoV-2 has established itself as the top dog, and other common influenza strains will now take a back seat, waiting for it to show weakness. Perhaps in ten years, perhaps in fifty. When the opportunity presents, these “old familiars” will return, possibly exhibiting new tricks their years of isolation may have enabled. H1N1 is proof of their longevity, patience, and resilience.

We are directly responsible for many of these changes in viral behavior and viral evolution. Our drugs are not without impact on the viruses and we should never lose sight of the fact that for each countermeasure we deploy, viruses possess the ability to evolve and respond in kind. We need to be hyper-vigilant as our use of new technologies simply amplifies this risk.

Viruses have evolved and co-existed alongside us and our fates are, like it or not, inseparably intertwined.

We may also be dependant on viruses in ways we don’t yet fully understand. Our genetic code is in part comprised of bits of viral DNA amassed over generations, some of which are beneficial to our survival. This symbiotic relationship shouldn’t be ignored in our efforts to eradicate them. We need to examine ways of controlling and negating their impact on us as a species, rather than seeking to destroy them.

In our haste to counter, we may unleash a new strain that is far less tolerant of human life. To date, we’ve simply been lucky. We need to responsibly engineer our way to more good fortune and find ways to sustain this incredibly complex relationship in relative safety till we fully understand it. Only then can we seek to alter it.

So to re-examine our opening question again, you do know someone who contracted influenza this season, only it’s Covid-19, not the “normal flu” virus we would far rather have bumped into. It’s fair to say, considering this, that globally, the outlook for the 2021 “flu season” just became really bleak. It’s going to be a killer unless we act now to negate the impact of the SARS-CoV-2 virus. That means all of us, on the same page, acting cohesively and responsibly.

Spread the word. Killer flu on the loose! Get your flu (covid vaccine)shot, mask up and mind the gap.

The post Covid is Never Going to Be Over. We Need to Plan Accordingly appeared first on Medika Life.

It typically begins with the sudden onset of fever, chills, headache, and body aches. It then progresses to cause sore throat, cough, and nasal congestion. Redness of the eyes, abdominal pain, vomiting, and diarrhea can also be associated with influenza.

Influenza is spread from person to person by respiratory droplets created by coughing or sneezing. Contact with respiratory droplet-contaminated surfaces is another mode of transmission. Such surfaces include door knobs, elevator buttons, computer keyboards, and mobile devices like tablets and smartphones. Outbreaks of influenza typically begin in school aged children. This can then lead to transmission to adults, the elderly, and other children within the family.

Although the majority of children with influenza recover after about 7 days, some children even without prior medical problems can suffer serious adverse effects. Like all viral infections, influenza can weaken the immune system and make one susceptible to bacterial infections such as streptococcus and staphylococcus. These bacteria can cause co-infections such as pneumonia and sepsis — a serious sometimes life threatening bacterial infection of the blood.

Influenza can also invade the tissues of the heart and cause a dangerous condition myocarditis. Finally, neurologic complications from influenza can range from febrile seizures to viral infections of the brain called encephalopathy, which can lead to permanent cognitive impairment.

Some are at higher risk for serious complications

While these adverse effects can affect anyone, certain groups are at higher risk from serious complications of influenza than others.These include children under the age of 5 but especially younger than 2 years of age, pregnant women, adults over the age of 65, and those with chronic conditions like asthma, diabetes, heart problems, neurologic issues, or any major health condition.

Prevention is key

The best preventative measure to fight against influenza and its possible complications is vaccination with the annual flu vaccine. Flu season typically begins in October and November and peaks in January. It takes about 2 weeks for the body to generate a protective immune response after vaccination, so the time for vaccination is now. The flu vaccine is recommended for everyone 6 months of age or older but especially for those who fit the higher risk categories that were just mentioned above.

Children under 9 years of age who have never received a flu shot may need two doses usually given 4 weeks apart. There are specialized versions of the flu vaccine that are meant to be given to those who are 65 years of age or older. The flu vaccine is safe and has been shown to reduce influenza illness, doctor’s visits, trips to the emergency room, and missed work due to flu. The benefits affect all ages.

A recent study showed that flu vaccine reduced children’s risk of flu related pediatric ICU admissions by 74% during the flu seasons of 2010–2012. Another study showed that people 50 years of age and older who received the vaccine reduced their risk of flu-related hospitalization by 57%. Finally, other studies have shown that administering the flu vaccine to pregnant women (at any stage of pregnancy) can not only be beneficial to them, but it can also reduce the infant’s risk of getting the flu for several months after birth.

A common misconception about the flu vaccine is the thought that receiving the vaccine itself can cause the flu.

This is simply not true. The vaccine is compiled using an inactivated (dead) virus, so it is not possible to contract influenza from the vaccine. The live, intranasal version of the flu vaccine has not been recommended this year by the Center for Disease Control and Prevention due to its general lack of effectiveness noted during the last 3 flu seasons.

Some possible side effects from the flu vaccine include tenderness and pain from the injection site, headache, muscle aches, and chills. Fever can occur within 24 hours in 10% — 35% of children under the age of 2, but this rarely occurs in older children or adults. Generally speaking, side effects from the flu vaccine resolve within a few days.

Despite the safe and effective nature of the flu vaccine, there are a few contraindications to receiving it. As with all vaccines, if there has been a history of a severe allergic reaction — also known as an anaphylactic reaction — associated with flu vaccine, it should be avoided. Also if one has contracted the neurologic disease Guillain-Barre syndrome within 6 weeks of receiving a prior flu vaccine, one should not be vaccinated. Allergy to eggs used to be a contraindication to receiving flu vaccine, but that disqualifier has been removed recently. People with milder reactions like hives can receive the flu vaccine wherever it is available. Those with more severe reactions to eggs may need to receive the vaccine under the guidance of an allergist.

Tamiflu helps but can not cure

While the influenza vaccine is the most effective preventative measure to fight the flu, there are medications available that can shorten the course of the illness if one unfortunately becomes infected with the flu. Tamiflu (oseltamivir) remains an effective antiviral medication to treat people with influenza as young as 2 weeks of age. Another antiviral Relenza (zanamivir) is an inhaled medication that can be given to patients as young as 7 years of age. Administering these antivirals within 48 hours of symptoms can help to reduce the duration of fever and symptoms of influenza. They can also reduce the rate of severe complications especially in high risk patients.

Wash your hands

There are other preventative measures that can help one stay healthy during flu season.Frequent hand washing can help to limit exposure to germs. If soap and water are not nearby, alcohol based hand sanitizers (Purell) can be used. Avoiding close contact with those who are visibly sick can help reduce the risk of becoming sick. At the same time, staying home from work or school when you are sick can help prevent the spread of illness to other people. Covering your nose and mouth with a tissue while coughing or sneezing (or coughing/sneezing into your elbow) can also prevent those around you from becoming ill.

Also, while it can be difficult as it is second nature for a lot of us, avoid touching your eyes, nose, and mouth if possible. Germs are spread when someone touches a contaminated surface and then proceeds to touch his or her nose, eyes, or mouth. Disinfecting frequently touched surfaces at work or at schools such as keyboards, desks, and doorknobs can also be helpful. You may also want to think twice about touching another person’s tablet or smartphone who is visibly ill. As always, an ounce of prevention is worth a pound of cure. Staying active, getting sufficient rest, managing stress, drinking plenty of fluids, and making healthy diet choices can go a long way to ensuring a healthy and hearty holiday season.

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The similarities found between SARS-CoV-2 and SARS-CoV, MERS-CoV, or human immunodeficiency viruses (HIV) can enhance the development of potential therapeutic approaches and advance the understanding of the virus mechanism of action – Nature Magazine

For once, the global scientific community is focused as never before. Their shared goal is the production of a vaccine to prevent Covid-19. Other segments of this community have been exploring treatments. A direct benefit of this shared journey is our understanding of influenza viruses, and this knowledge has grown exponentially in the last few months. Could his knowledge lead to a potential “cure” for the flu?

Co-existing with Influenza

With flu season nearly on the US, panic is spreading about a deadly combination —  influenza and Covid-19— crippling America‘s already burdened hospital capacity. We don’t panic anymore about flu on its own. We’ve become accustomed to just dealing with the thousands of deaths that occur every year as a consequence of seasonal influenza. This year however, we’re already exhausted from dealing with a pandemic that is far from finished running its course. 

Hospitals are packed to the rafters, spare beds, oxygen and respirators are in short supply and the tools we use to assist those who take seriously ill with influenza have been appropriated by the Covid-19 pandemic. America simply doesn’t have the resources to save everyone if this year’s influenza strains prove virulent. Getting the flu shot, particularly if you are at risk from influenza, is CRITICAL! Now, more than ever, that flu shot could end up saving your life.

Any costs involved in immunizing those at risk should be met by local health authorities. The money spent now could ensure we avoid potential chaos in the coming months. 

Part of the problem is that influenza viruses have become a part of our day to day existence and no longer fill us with dread. 

Unless of course, as with Covid, you happen to fall into a high risk category. For modern day, run of the mill, seasonal influenza, at risk categories are described as the aged, the immune compromised and those with respiratory issues, diabetes, cardiac related conditions, immune compromised individuals, pregnant mothers and those classified as morbidly obese. This group of individuals rely on seasonal influenza vaccines to keep them safe.

Each year, in America, influenza claims tens of thousands of lives. It’s difficult to accurately determine how many because, as with Covid, it’s the complications of the infection that lead to death. Official figures — with influenza listed as the cause of death on a death certificate— are more than likely not reflective of the actual death tolls, 

People who died from the secondary, influenza related infections would not have died if not infected with influenza in the first place. This is an important fact that is difficult to factor into statistics because of the way in which deaths are recorded.

For instance, take the 2017–18 influenza season in the USA. Here are the figures as per the CDC website.

• Estimated Symptomatic Illness -45,000,000 people
• Estimated Medical Visits-21,000,000 people
• Estimated Hospitilizations-810,000 people
• Estimated Deaths 61,000 (possibly ranging from 46,000–95,000 people)

Clearly, influenza is a massive problem, particularly if considered for the financial burden it places on economies, lost working hours, the burden placed on health care and insurers and the obvious loss of life. Curing it, or rather preventing its ability to infect us, would radically change our lives. 

The Limitations of Vaccines

Vaccines are targeted. They produce very specific responses in our bodies designed to provide us with immunity against a very specific virus. An existing vaccine becomes useless if the virus is able to produce a new strain. It’s one of the reasons we need to keep getting inoculated each year. The influenza virus mutates and produces new strains on a yearly basis, rendering last years vaccine useless.

Whilst this mechanism ensures the ongoing profitability of vaccines for pharmaceutical companies, it is obviously not the ideal solution for the general public. Vaccinating large numbers of individuals is costly and these programs often miss many in the at-risk segments of the population. Poorer people cannot afford a seasonal flu shot. In addition to this, increasing distrust in vaccinations is leading to individuals intentionally declining these yearly attempts to protect them.

These vaccines are also not foolproof, as other strains of influenza can still attack the inoculated individual. Influenza vaccines don’t provide life-long or blanket immunity, they simply reduce risk to the latest strains. What we are desperately in need of is a treatment that can stop the virus in its tracks. 

It isn’t just the at-risk groups that are affected by influenza. Healthy individuals can also suffer long terms side effects, for instance damaging their heart muscle (myocarditis) or lungs as a result of a serious infection. We have been crying out for help for decades.

We are in need of a modern day medical miracle and we may well be on the verge of not just one, but many different breakthroughs in our fight against viruses, particularly those that cause influenza.

The drive to destroy viruses

Meet TaiGen Pharmaceuticals. They are a Taiwanese Pharma company that focuses on new cutting edge drugs. They’ve just filed an IND (Investigational New Drug) application with the US FDA for their influenza antiviral TG-1000. a drug designed to address different strains of Influenza.

Their candidate, TG-1000 is a novel pan-influenza antiviral, which interrupts viral replication and transmission via a cap-snatching mechanism and is able to do this effectively against influenza-A, influenza-B, avian flu H7N9, and Tamiflu-resistant viruses. Kuo-Lung Huang, the Chairman and CEO of TaiGen made the following statement about the application;

“We are excited about the IND filing in the US for the internally developed TG-1000 which has the potential to be a single dose treatment for influenza. TG-1000 IND filing demonstrates yet again TaiGen’s capacity and experience in research and development of NCEs.”

NCE is a New Chemical Entity (NCE), a drug that contains no active moiety that has been approved by FDA in any other application submitted under section 505(b) of the act. In other words, a completely new, unique drug that doesn’t comprise existing compounds.

Exploring Monoclonal Antibodies

An antibody is a protein that sticks to another specific protein called an antigen. Antibodies circulate throughout the body until they find and attach to the antigen. Once attached, they can force other parts of the immune system to destroy the cells containing the antigen. It’s a targeted attack that is focused in a way we’ve never had access to previously. We have cancer to thank for the development of these drugs.

Researchers can now design antibodies that specifically target a certain antigen, such as one found on cancer cells. They can then make many synthetic copies of that antibody in the lab. These are known as monoclonal antibodies (mAbs or Moabs). Even diseases such as arthritis can now be addressed with Moabs.

If these drugs work by targeting specific antigens, how then do they prove useful against an adaptive virus like the influenza virus? Wouldn’t you require a new version with each new outbreak? Not necessarily.

Some Moabs used to treat cancer are referred to as targeted therapy because they have a specific target on a cancer cell that they aim to find, attach to, and attack. Other Moabs are different. They act like immunotherapy because they make the immune system respond better to allow the body to find and attack cancer cells more effectively. It is these “naked” Moabs that are currently under scrutiny for treating Covid-19. The potential exists for these to be developed further to provide ongoing protection against influenza strains.

Clinical trial results for efficacy against Covid-19 involving a pair of antibodies developed by Regeneron Pharmaceuticals were released in September. In the last few days, President Trump received the Regeneron Moab for the early treatment of his Covid infection. A separate effort from Eli Lilly could yield data later in the fall and early promise has been shown. Data from both trials appear to indicate efficacy in early treatment of the Sars-nCoV-2 virus. 

mRNA based medicines

Using mRNA as a medicine is a fundamentally different approach than treating disease with other drug classes. It plays a fundamental role in human biology and mRNA is the set of instructions by which cells make all proteins and send them to various parts of the body.

These medicines take advantage of normal biological processes to express proteins and create a desired therapeutic effect. This enables the potential treatment of a broad spectrum of diseases, many of which cannot be addressed with current technologies. Their delivery mechanism and reduced or very limited side effects make mRNA medicines the perfect candidate for a safe and effective vaccine.

DNA is the gene and RNA gives instructions for certain proteins. So an mRNA vaccine contains the instruction for manufacturing a SARS-CoV2 protein. Once inside the cell, the protein is made and that triggers the bodies immune response. Similar to vector vaccines which use cold viruses to deliver the protein instructions, mRNA medicines deliver their instructions on their own. It’s another way of getting the virus protein safely made inside of you so your body can produce the required antibody.

Moderna and BioNTech/Fosun Pharma/Pfizer currently have mRNA Covid vaccine candidates in differing stages of trials. Pfizer initiated trials on its first cohort in Germany in May of 2020 and Moderna announced Phase 3 trials in late July in the US. Last month, their vaccine candidate mRNA-1273 was found to be safe and effective in Phase I participants aged 18–55 years.

mRNA medicines have the potential to safely address a host of diseases without the accompanying risks associated with traditional medicines, and our generic flu candidate may very well emerge from this group over the next two years. 

In terms of Covid-19 these vaccine candidates may not make it through the gate in first place, but they should not be dismissed. Their safety profiles make them candidates of first choice. In the meanwhile, our efforts to find a magic bullet against Covid continue unabated and an inevitable consequence of this will be discovery. That discovery could very well lead to the last flu jab you may ever need. Let’s keep our fingers crossed.

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