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Thursday, April 17, 2008

Researchers chart how new flu strains travel


South Korean health officials walk to bury chickens at the infected chicken farm in Gimje, 162 miles south of Seoul on April 4, 2008. South Korea has started culling thousands of chickens after an outbreak of bird flu was confirmed to be the deadly H5N1 strain, officials said.
They emerge in Asia and eventually disappear in South America. The findings should help improve vaccines.

Solving a 60-year-old mystery, researchers have concluded that new flu strains emerge in eastern and southeastern Asia, move to Europe and North America six to nine months later, then travel to South America where they disappear forever.

The new findings should help researchers pick the correct flu strains for each year's vaccine, a process that must be carried out a year ahead of time and that is now analogous to making a long-term weather forecast supported by only limited data.

The group charged with making the decisions about vaccines has been right about 80% of the time, said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, and the new findings should lead to an even higher success rate.

"If we have competing candidates, this will help to pick which virus should go in a vaccine," added Dr. Arnold S. Monto, an epidemiologist and flu specialist at the University of Michigan.

Influenza strikes up to 15% of the world's population each year, killing, on average, about 250,000 to 500,000 people, according to the World Health Organization. About 300 million people annually are protected by an influenza vaccine, but producing the vaccine is something of a crapshoot because its ingredients are typically chosen nearly a year before the flu season to allow time for production.

The problem is that the flu virus mutates rapidly, particularly the gene for a surface protein called hemagglutinin that plays a key role in interacting with the human immune system. Those mutations reduce the efficacy of the immune response to the virus, limiting vaccine protection.

For more than a half a century, researchers have debated where these mutations occur. One idea, discredited only about a year ago, suggested that a background infection of the virus remained in each country outside the flu season, allowing mutations to occur.

Other hypotheses were that the virus migrated back and forth between the northern and southern hemispheres following the seasons, that the viruses circulated continuously in the tropics, or that new mutations occurred in China and spread to the rest of the world from there.

The new results, appearing today in the journal Nature and Friday in Science, suggest that there is a little bit of truth in each of those scenarios.

In the Science paper, an international team led by geneticists Colin A. Russell and Derek J. Smith of the University of Cambridge studied more than 13,000 samples of influenza A virus collected on six continents between 2002 and 2007.

They studied physical differences in the hemagglutinin molecules on the surfaces of the viruses by measuring how strongly each one bound to an antibody. They also determined the DNA sequence of the hemagglutinin gene for about 10% of the viruses.

The team found that once the viruses leave Asia, they don't change much and rarely return. The areas outside Asia are "evolutionary graveyards," Russell said.

In the Nature report, biologist Edward Holmes of Pennsylvania State University and his colleagues sequenced the entire genome of 1,302 influenza A viruses collected over a 12-year period.

Holmes' results were very similar to Russell's findings. Holmes' team was able to conclude that the viral mutations originated in only one area in the tropics but could not pinpoint the area.

Several factors contribute to Asia's role in the mutations. While flu season in the Western world typically occurs in winter, flu season in Asia generally is the rainy season. Because of the wide geographic variations in the region, there is generally a rainy season somewhere, allowing the viruses to propagate continuously.

Add to that the high population density, and the conditions are ripe for a high transmission rate and accompanying mutations.

The large rate of air travel from Asia to Europe and North America then carries the mutated viruses to a new environment where there is little resistance to them. Much less direct traffic occurs between Southeast Asia and South America, so the virus must travel via North America, delaying its passage.

Some of the virus is undoubtedly carried back to Asia via air travel, Smith said, but by that time widespread immunity to it has built up in the population and it cannot gain a foothold.

Although the new information will be useful in producing vaccines, Monto said, even more important is the proliferation of new influenza monitoring stations throughout Asia in response to fears of a bird flu pandemic.

Too often, he said, researchers have known which strain should be included in a vaccine but have not been able to obtain a good isolate of the virus. The new monitoring stations should be able to provide those strains, he said.

thomas.maugh@latimes.com

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Peanut Butter and Deadly Taunts

Late last spring, 14-year-old Sarah VanEssendelft of Mastic, N.Y., experienced bullying worthy of a teen movie.

Peanut allergies
The number of reported peanut allergies has doubled in recent years. Taunting kids with food now may turn into medical school yard problems.
(iStock/ABC News)

"There was a group of five girls ... and they decided they didn't want me sitting at their lunch table anymore," said VanEssendelft. To get her to leave, they all brought in peanut butter and jelly sandwiches.

For VanEssendelft, it might as well have been arsenic.

Two weeks later, a boy in the back of her class opened up a peanut butter cup. The smell was enough to trigger VanEssendelft's peanut allergy and send her to the emergency room with breathing problems.

"My throat felt tight and my lips were getting really swollen, really fast," said VanEssendelft. "I looked like Angelina Jolie."

On the one hand, mean tricks or sneaking candy looks like mild behavioral problems to school administrators. On the other hand, given VanEssendelft's serious peanut allergy, those sandwiches might very well have been weapons.

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More airports to use 'whole body imaging' machines

WASHINGTON (CNN) -- Some travelers at key airports in New York and Los Angeles may be put through machines that see through clothing and provide a detailed image of a person's body beginning later this week.

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The TSA says the screener who reviews the images is in a booth, unable to see the travelers.

It's the first expansion of the program since the machines were first put to the test in Phoenix, Arizona.

The "whole body imaging" machines have sparked complaints from privacy advocates.

But the Transportation Security Administration says that it has taken steps to protect individuals' privacy and that 90 percent of the travelers in Phoenix preferred the imaging machine to a pat-down.

The millimeter wave machines will be rolled out at John F. Kennedy International Airport in New York and Los Angeles International Airport in California later this week, TSA Administrator Kip Hawley told Congress on Tuesday.

The TSA will be purchasing at least 30 more machines for use at other U.S. airports this year, he added.

The TSA will use two different methods at JFK and LAX as they study the most effective way to use the machines.

At JFK, passengers sent to secondary screening will be given the option of a pat-down or a trip through the body imager. To protect the traveler's privacy, the screener who reviews the image is in a booth, unable to see the traveler, according to the TSA. The traveler's face is pixilated and the image is not stored, the TSA said.

At LAX, the millimeter wave machine will be located just beyond the checkpoint magnetometers.

Travelers will continuously and randomly be selected to go through the machine. While signs will inform them of the pat-down option, screeners will not announce that choice. But passengers electing not to go through the millimeter wave machine will be given the option of the pat-down.

A TSA spokesman said the agency is still exploring backscatter, another imaging technology in use at Phoenix's Sky Harbor International Airport.

Millimeter wave machines are already in use at airports in Britain, Spain, Japan, Australia, Mexico, Thailand and the Netherlands, as well as at some court and corrections facilities in Virginia, Colorado, Pennsylvania, California and Illinois.

Sky Harbor began using the machines last October.

Hawley also announced Tuesday the TSA is purchasing another 580 multi-view X-ray machines that are used to screen passengers' carry-on bags, bringing the total to 830 machines. The machines give screeners a clearer, more detailed view. Some 600 machines will be deployed by year's end, he said.

The technology is a "powerful platform" that can be adjusted to include software capable of detecting liquid explosives, he said.

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