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European Biopharmaceutical Review

Going Viral

Influenza-like illnesses have been documented as causing pandemics since Charlemagne’s army was decimated by an outbreak in 876 AD. The viruses that cause influenza make ideal agents for human challenge studies, because the ailment they induce is transient yet well characterised. The use of H1N1 or H3N2 influenza A viruses manufactured to meet rigid industry standards such as Good Manufacturing Practice (GMP) in challenge trials can effectively emulate high incidence community disease – higher indeed than pandemic infection rates (80% versus 25%), but without the risk of serious adverse events.

Influenza Strains

It has been reported that the influenza virus originally developed in bats and spread sequentially to horses, poultry and pigs before entering the human population approximately 6,000 years ago. The virus contains 18 haemagglutinin (HA) and 13 neuraminidase (NI) genes, which can reassort to generate new serotypes of influenza. Strains present in poultry show particularly rapid mutation rates. H1, H2, H3, N1 and N2 variants have evolved sustained transmission into humans, and pandemic H1N1 and H3N2 are thought to have originated towards the end of the 19th century – with the former coinciding with outbreaks in animals. Both strains have been responsible for serial pandemics since 1900.

Interestingly, while there are high case fatalities whenever a new serotype emerges, the numbers fall as exposure to it persists. For the H1N1 pandemic in 1918, the initial fatality rate was very high at 2%; however, when H1N1 re-emerged in 2009, it had dropped to just 0.03%. This is due to the virus attenuating over time, but also because the population produces antibodies and becomes resistant or even immune.

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Adrian Wildfire is Project Director of the Infectious Diseases and Viral Challenge Unit at SGS Life Sciences and has nearly 30 years of experience in communicable diseases. He has trained and worked within the fields of bacteriology, virology, parasitology and mycology, obtaining his Fellowship in Medical Microbiology in 1990 and a Masters in Parasitology in 1998. 
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