A Universal Flu Vaccine?

After receiving a $17.9 million from the National Institute of Allergy and Infectious Diseases, Versatope Therapeutics is set to develop a “universal” influenza vaccine that can cover more viral strains and last longer than current vaccines. The prophylactic treatment takes a novel approach at combating influenza by targeting the Matrix-2 protein that is conserved across different strains of influenza. The protein is displayed on the outer surface of bacteria and delivered in vesicles where it can be recognized by immune cells to subsequently bolster a defense against pathogens with the antigen. The concept has been proven in vivo, allowing Versatope to commence Phase I clinical trials around 2021 to test vaccine safety and dose limits. If this technology comes to fruition, we could make large strides in preventing influenza for the long-term, especially in populations that may not have the resources to get a new vaccine each year. Additionally, the new vaccine appears to stimulate an immune response up to two-times quicker than standard immunizations, thereby building up immunity at shorter time scales. Hear from the developers here: https://www.news-medical.net/news/20191024/Universal-influenza-vaccine-developed-at-Cornell-is-set-for-human-clinical-trials.aspx 

~Avi Kaye

Lab Worker Declines Vaccine, Gets Infected by Vaccinia from Occupational Needlestick

In December 2018, a 26 yo lab worker was injecting vaccinia virus (VACV, a member of the poxviridae family, 1) into the tails of mice (2). She accidentally stuck herself in the left index finger with the same needle. Her safety procedure post-stick was a 15 minute water rinse and a visit to the local emergency department. In September of the same year, before starting work with VACV, she had discussed the risks of working with VACV and was offered ACAM2000, the smallpox vaccine, but declined.

An important note about ACAM2000 is that while it has low risk of complication (for both the recipient and close contacts), it is a live-virus vaccine and the lesion at the administration site is infectious (3). In addition, while recommended unless medically contraindicated, ACAM2000 is optional and each lab working with VACV sets its own vaccine policy (2-3).

Her symptoms began on day 12 post-prick when she was treated for a 100.9°F fever, malaise, pain, lymph node swelling, and worsening edema of the prick site finger. She received Vaccinia Immunoglobulin Intravenous (VIGIV) on day 12 and tecovirimat on day 14, and her symptoms gradually began to lessen. There was necrotic tissue present all the way until day 94, though.

The CDC has highlighted three main takeaways from this incident (2). First, there was an inadequate understanding of the danger of VACV. Second, there needs to be better information about the danger of working with VACV and better awareness of the proper post-exposure procedures. Third, the drug tecovirimat can be used to treat VACV infections, but it needs further investigation.

-- Brian Smith

Sources:
1 - Viralzone: Poxviridae
2 - CDC Morbidity and Mortality Weekly Report: Novel Treatment of a Vaccinia Virus Infection from an Occupational Needlestick
3- CDC MMWR: Use of Vaccinia Virus Smallpox Vaccine

Terrifying New Virus Plagues Children!

https://www.sciencealert.com/there-s-now-strong-evidence-that-a-once-rare-virus-is-behind-a-polio-like-epidemic-in-the-us

This is a very relevant news article that documents how an enterovirus that has been associated with paralysis has been found in the spinal fluid of patients. This was found through the presence of antibodies in the fluid of the virus as well as through RNA detection of the virus.

This can have devastating effects for children who are susceptible to this virus. 

Viruses are part of a healthy microbiome

Traditionally, we seem to only think of “good bacteria” when considering the elements of a healthy microbiome. However, recent research provides evidence that viruses are also important for promoting gut health. Asymptomatic viruses that infect intraepithelial cells in the GI tract can initiate an immune response. The concept is similar to the live adenovirus vaccine that we discussed in class. Until recently, there has only been some evidence of viruses positive role in immune activation: For example, research on mice showed that a murine norovirus infection induced interferon release that stimulated immune cell development and even tissue regeneration. In a recently published paper, researchers treated wild-type mice with an antiviral for an extended period of time (6 weeks), and it specifically reduced the quantity of intraepithelial leukocytes (IELs). Next, by knocking out the RIG-I receptor - an important sensor of dsRNA - the authors were able to determine that commensal viruses contribute to immune defense through the RIG-I pathway. This research adds to our current conception of the microbiome and the positive synergistic relationship between our gut and our microscopic friends. 

~Avi Kaye

https://www.nature.com/articles/s41590-019-0530-y

Disease Expert Breaks Down Pandemic Scenes From Film & TV | WIRED

Wired does a series of videos in which they have experts in their fields come and review scenes from film and TV that feature their profession. There are some great ones, including a surgical resident, a crime scene forensics expert, a computer hacker, a lawyer, and even the former CIA chief of disguise to talk about spy scenes! They are all excellent.

Their latest video is exciting because it's Brian Amman, a disease expert from the CDC, and he talks a lot about viruses. He points out that the incubation period for viral infection is often exaggerated in how quickly it manifests in the movies, and points out when film and TV get viral safety and healthcare contamination right and wrong. It's 22 minutes that are entertaining - definitely worth a watch!

-- Brian Smith

Japan Just Imported Ebola to Prep for Possible Olympic Outbreak (October 17, 2019)

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According to news reports, Japan imported Ebola and 4 other pathogens in order to reduce the risk of potential outbreaks during the Olympics. One Nature report claims that the imported pathogens are the most dangerous viruses allowed to enter Japan. The viruses- Ebola, Lassa, Marburg and two causing American hemorrhagic fever and Crimean-Congo hemorrhagic fever are rated “biosafety-level-4” and are being held in the National Institute of Infectious Diseases. The live samples are being used to create diagnostics tests which will be able to detect antibodies from the viruses. One Rutgers microbiologist and biosecurity expert mentions views the importing of the viruses as unnecessary for protection and potentially a way for the government to deter bioterrorist attacks given that other governments may also be stockpiling infectious agents.

https://www.livescience.com/ebola-in-japan.html

-Micah

Evidence links poliolike disease in children to a common type of virus (Oct 21, 2019)

Since 2014, more than 500 children have had a condition called acute flaccid myelitis, a loss of muscle control of arms and legs, without good explanation. The leading explanation was that a normal viral infection turned into AFM, but little evidence pointed this way. Now, patient spinal fluid potentially links the group of viruses known as enteroviruses to AFM. One particular strain, EV-D68, had several outbreaks coinciding with cases of AFM, and several children with AFM also presented with some of the typical symptoms of EV-D68 presentation, a mild respiratory infection. Days before the triggering of AFM, reports of coughs and muscle aches were common. Though in the past, tests for enteroviruses in the spinal fluid have come back negative, in a recent study, about 69% of the cases had elevated antibodies against enteroviruses versus 7% of controls. Though this research does not help understand the predisposition for AFM or what might connect enteroviruses to AFM, it is evidence of potential association.

https://www.sciencemag.org/news/2019/10/evidence-links-poliolike-disease-children-common-type-virus

-Micah

Telugu speaking states with highest HIV infected jubilant with possibilities of cure. (Oct 14, 2019)

Many are hopeful after the first reported use of the human gene editing tool to genetically alter red blood cells to resist HIV. The New England Journal of Medicine published about a week ago an attempt of using CRISPR to treat disease in a human, and DNA changes were confined to the individual. This is not to say we have a cure…According to the New England Journal of Medicine, only 5-8% of cells are altered and these are outnumbered by the ones which are not (and thus still vulnerable). In the two states of Telangana and Andhra Pradesh which typically report higher rates of HIV than other, and, according to the director of the Telangana State AIDS Control Society, the prevalence remains at about .6 percent compared to the general country prevalence of .22 percent. Many other efforts, such as mandatory treatment to those affected, are currently in place, but people have renewed hope at the idea of a new cure.

https://www.tribuneindia.com/news/telugu-states-with-highest-hiv-infected-jubilant-over-possibilities-of-cure/847111.html

-Micah