Race against time - building on past research to contain H1N1
Allen Yeo
Thomson Reuters
June 2009
Scientists and national policy makers rely on scientific literature to develop a fundamental understanding of the H1N1 virus and to expedite the development of antiviral drugs and vaccines.
It has been just weeks since the start of the swine flu or H1N1 influenza virus outbreak, which was declared a pandemic on June 11 by the World Health Organization (WHO) (the first such declaration in 41 years). There is a general consensus amongst the global authorities that the virus should not be named Mexican flu since the genetic content is a hybrid of pig, bird and human influenza virus comprised of both European and Asian origin.
Memory is still fresh of the world's most recent influenza pandemic 41 years ago—the 1968 Hong Kong outbreak which took one million lives. The Spanish Flu of 1918-1920 killed more than 50 million people, or 2.5 percent of the world's population. The WHO is sparing no effort to preparing the global population to combat the virus. Any type of influenza outbreak has a high mortality trend associated with children and elderly. Apart from the running nose symptom commonly associated with flu, secondary bacterial infections leading to pneumonia or bronchitis are also prevalent.
Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases commented that scientists are "working on developing a vaccine with hopes of having a pilot version ready for testing in a few months".
Hence, the quest for scientific literature by scientists and national policy makers is a necessity for their fundamental understanding of the H1N1 virus, as they build on past research studies to expedite the development of antiviral drugs and vaccines in order to prevent a pandemic. The uncovering of critical past knowledge also explains the impact of H1N1 virus on humans, animals and the environment we live in.
1976 swine flu outbreak
It has been reported that there was an outbreak of swine influenza in Fort Dix, New Jersey, USA in 1976 (Gaydos JC; 2006). The virus caused severe respiratory illness in 13 soldiers resulting in one death, but the outbreak was quickly contained within a month. However, the mystery remained as to the source of the virus. Although credit was given to early medical intervention, the authorities were left pondering the question of "why did the transmission stop?". This was followed by a national sine flu vaccination campaign. Subsequently, it was reported that the vaccine had been strongly associated with the development of the neurologic disorder Guillain-Barre syndrome (GBS) (Nachamkin I; 2008).
The world is worried about human to human transmission, whilst pig farmers are concerned that infected humans do not pass the virus on to their pigs. The Center for Disease Control and Prevention (CDC, USA) recorded that inter-human transmission is low; there were only 12 confirmed cases between 2005 and 2009.
Vaccine development
G. Neumann in 1999 described a new reverse-genetics system that enables efficient generation of Influenza-A viruses entirely from cloned cDNAs (the core replicating block of genes). This system, which does not require helper virus infection, is very useful in mutagenesis studies and vaccine production, and received more than 300 citations in 25 Web of Science subject categories spanning respiratory and cancer studies to drug development and adversity. The comprehensive mapping of both past and current research is vital to understanding the various research applications to date. Researchers often use the Web of Science citation tree to visualize such revolutionary effect to monitor and clarify related research applications and seek collaborators. The citation tree helps researchers to clearly visualize and understand the connection between relevant past research (cited references) and articles of subsequent influence (known as forward citations).
Fig 1: Forward citations as shown by Java-enabled Citation Tree from Web of Science
Global H1N1 research
The global scientific community has been reporting on H1N1-related influenza studies for many decades. There are, up to date, 1,574 related unique journal articles (or records) and conference proceedings published worldwide in Web of Science (using topic search field: H1N1). Mathematically, Thompson WW in 2003 attempted, in his publication, "to develop a statistical model to predict USA annual flu-associated deaths by age group, virus, and influenza type and subtype"; and this has received a staggering 650 citations in total to date.
So which are the top organizations and countries studying the H1N1 virus?
Fig 2: Top five institutions and countries studying H1N1. Source: Web of Science
Preparing for the second wave
Although the WHO has made it clear that the H1N1 pandemic is indicative of the geographical spread and not the severity of the virus, they have cautioned the health authorities to be prepared for a second wave of infection, possibly a mutated and virulent strain of the virus. The effective search for relevant information in the pursuit of scientific knowledge is paramount in aiding our understanding of what was reported before and helping us uncover critical knowledge of past clinical studies and efficacy of drugs in development. This helps us to avoid the duplication of past research work and focus on promising or new areas of research.
Developing a vaccine or an antiviral drug is undoubtedly a race against the clock. Building on past scientific literature has yielded invaluable knowledge and tools to researchers and scientists worldwide that has proven effective and timely in helping them to understand our community better, and aid in their race against time to develop a cure and vaccine sooner, rather than later.
References:
Title: Mortality associated with influenza and respiratory syncytial virus in the United States
Author(s): Thompson WW, Shay DK, Weintraub E, et al.
Source: JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Volume: 289 Issue: 2
Pages: 179-186 Published: JAN 8 2003
Title: Swine influenza A outbreak, Fort Dix, New Jersey, 1976
Author(s): Gaydos JC, Top FH, Hodder RA, et al.
Source: EMERGING INFECTIOUS DISEASES Volume: 12 Issue: 1 Pages: 23-28 Published: JAN 2006
Title: Anti-ganglioside antibody induction by swine (A/NJ/1976/H1N1) and other influenza vaccines: Insights into vaccine-associated Guillain-Barre syndrome
Author(s): Nachamkin I, Shadomy SV, Moran AP, et al.
Source: JOURNAL OF INFECTIOUS DISEASES Volume: 198 Issue: 2 Pages: 226-233 Published: JUL 15 2008
Title: Generation of influenza A viruses entirely from cloned cDNAs
Author(s): Neumann, G; Watanabe, T; Ito, H, et al.
Source: PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA Volume: 96 Issue: 16 Pages: 9345-9350 Published: AUG 3 1999
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