Altering virus coats may halt flu spread

Fri, 02 Feb 2007 01:29:20 GMT
By LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Making a small change in the outer coating of the lethal 1918 flu virus was enough to stop it from spreading, a discovery that may help scientists monitor today's bird flu and other influenza strains for signs of the next pandemic.
The 1918 pandemic was triggered by a bird virus that mutated into one that could attack humans, going on to kill a staggering 50 million people worldwide in a matter of months.

To learn what caused that catastrophic bird-to-human transformation, scientists with the Centers for Disease Control and Prevention turned back the clock: They worked with recreated batches of the actual H1N1 flu strain that spawned the 1918 pandemic, but they altered two spots in a key protein to make that virus a little more birdlike again.

Then the researchers dripped the altered virus into the noses of ferrets, who catch and spread influenza like humans do.

The infected ferrets still sickened and died as the flu ravaged their lungs. But remarkably, they didn't infect healthy ferrets caged right next to them, the CDC team reports in Friday's edition of the journal Science.

Why not? Most flu spreads when an infected person coughs or sneezes out droplets of virus. Ferrets infected with the altered 1918 virus didn't sneeze at all.

The research suggests that for a new flu strain to become a pandemic threat, a protein called hemagglutinin that coats the virus' surface must prefer attaching to cells found mostly in the human nose and windpipe, where it can be sneezed easily.

That's good news when it comes to the notorious Asian bird flu that scientists are watching anxiously today. That strain known as H5N1 bears hemagglutinin — the H in its name — that still prefers cells mostly found in the gastrointestinal tracts of birds. While it has killed at least 164 people worldwide and killed or prompted the slaughter of millions of birds across Asia since late 2003, the H5N1 virus can't yet spread easily from person to person.

"This is very, very elegant work," said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University who advises the federal government on flu issues.

"It may not be exactly the same mutations that would change an H5 virus," Schaffner cautioned. Still, he said, "We appear to be narrowing down our understanding of the kinds of mutations it might take to change a bird-specific virus to one that could be transmitted readily among humans."

The CDC's next step, in fact, is to study these same changes in hemagglutinin amino acids, the protein's building blocks, in H5N1.

But it will almost certainly take additional genetic changes to turn the H5N1 bird flu into a major human killer, changes that probably involve other proteins than just hemagglutinin, contends lead researcher Dr. Terrence Tumpey, a CDC microbiologist.

"I think that researchers may discover that the combination of genes needed is maybe unlikely to occur in nature," he said.

Flu advice would vary under U.S. plan

Fri, 02 Feb 2007 01:29:36 GMT
By MIKE STOBBE, AP Medical Writer
ATLANTA - In the worst case of a global flu epidemic, schools would close for three months and public events would be canceled.
In the most optimistic scenario, people merely would be told to wash their hands and stay home if they feel sick.

Those are the options the government plans to consider depending on the strength of a possible deadly flu epidemic. And the options would be graded like hurricanes: The worst case would be Category 5. The least-threatening outlook, Category 1.

Federal officials on Thursday released a grading system for flu pandemics. The steps were taken to give the public some help in deciding how anxious to get if a deadly new flu appears in the United States.

The government also is releasing a wave of radio and TV spots to remind people not to be complacent about a potential contagion.

"As avian influenza slips from the headlines, people may begin to believe that the threat is no longer real," said U.S. Secretary of Health and Human Services http://www.pandemicflu.gov

CDC practices for the Big One

Fri, 02 Feb 2007 01:31:00 GMT
By MIKE STOBBE, AP Medical Writer
ATLANTA - This was the Big One, a deadly flu epidemic. But fortunately it was a fake. So when U.S. health officials made some missteps in their largest-ever drill to prepare for a national outbreak of a deadly new flu, no one died.
Some information was wrong because people misstated facts as they passed them on — like a game of telephone gone slightly awry. Some information was classified, so some key public health experts didn't have all the facts.

And there was an ice storm — for real — that hit the Atlanta area and caused the U.S. Centers for Disease Control to stop the exercise early so employees wouldn't be caught in the weather.

Disaster planning has become a common concept in government, but it's relatively new at the CDC. "We haven't had a tradition in public health" of doing such drills, said Glen Nowak, a CDC spokesman.

The drill involved close to 300 CDC employees and was designed to run over a 24-hour period, from Wednesday to Thursday. Most of the action was at CDC's emergency operations center — the agency's equivalent to NASA's Mission Control in Houston.

An Associated Press reporter and three other journalists were allowed to observe — an unusual step for the CDC, but an effort to better work with the media and improve communication should a real pandemic occur.

The drill was designed and run by MPRI, an Atlanta consulting company led by retired military officers. The CDC is paying the company $7 million for its work on the drill, future exercises and some planning work.

It started with CDC Director Dr. Julie Gerberding and her top infectious disease staff meeting Wednesday morning to confront the hypothetical disaster — we repeat, this is a fake scenario:

• A 22-year-old Georgetown University student who visited his family in Indonesia returned to the United States. He became seriously ill the next day and went to a Washington, D.C. hospital. Lab tests confirmed he had the bird flu that's been killing people in Asia.

In reality, this kind of influenza — scientists call it H5N1 — has not been spread efficiently from person to person. But in the drill, CDC officials got information that it spread among the student's family back in Indonesia and might be a contagion threat here.

More bad news...

• The student lived in a dormitory, and some of his housemates were reporting flu-like illness.

• He was a member of the Georgetown swim team and may have infected several members before they went to New York for a swim meet.

• He was on three different flights on his way from Jakarta to Washington, exposing hundreds of other passengers who scattered to at least 16 U.S. cities. One was a 55-year-old man who had since died in Chicago from a respiratory illness that might be bird-flu related.

• The student died. Later that day, it became clear that eight people had cases of H5N1, including the Chicago man, and tests on others were pending.

At the time the exercise was cut short, the government was facing some big decisions. One was whether to start shipping from federal stockpiles more than 21 million doses of Tamiflu, and antiviral medication. Should it all go out at once, or just to states that had confirmed cases?

Another was whether to send all flights from Indonesian airports with sick patients only to certain U.S. airports — a measure that could jack up public concern and cause serious economic fallout.

Throughout the day, there were moments of miscommunication. In a late-morning briefing with a consulting company staffer playing the U.S. Secretary of Health and Human Services, Gerberding repeatedly said the student was in Baltimore . CDC officials at various times said they had passenger manifestos from two of the flights the student had been on, then they seemed to say they had the information on all, then they seemed to backtrack.
Slips were expected in a novel experience like this, but it's important to note that the facts of the case were straight at the crucial points. "We actually had all the correct information at the time decisions were made," said Dr. Stephen Redd, the CDC official who was the flu pandemic expert advising the exercise's incident commander.
A pretend press conference held by Gerberding in the afternoon, in which CDC staffer played reporters, caused the real reporters to mutter among themselves that the outcome probably would have lead to a confusing variety of reports about whether there was a pandemic or not.
"This is really hard. This is a really hard communication," Gerberding said.
More disturbing to CDC employees was how much information Gerberding and some other key officials held back, because not everyone in the room had the necessary security clearance. At one briefing, it became clear that some of the agency's top viral experts were in the dark about some potentially important details.
"What we learned from this is we have to practice," said Dr. Richard Besser, director of the CDC's Coordinating Office for Terrorism Preparedness and Emergency Response.

Bush urges parents to get kids outdoors

Fri, 02 Feb 2007 02:49:57 GMT
By DEB RIECHMANN, Associated Press Writer
WASHINGTON - President Bush said Thursday that childhood obesity is a costly problem for the country and puts stress on American families.
"One way for this nation to cope with the issue of obesity is to get people outside — whether it be through sports or hiking or conservation," Bush said while meeting with business leaders working to encourage exercise and healthy food choices through advertising.

He said first lady Laura Bush was on her way to New York to kick off Friday's "Wear Red Day" for the National Heart, Lung and Blood Institute's Red Dress Project to increase awareness that women are at risk for heart disease. Bush signed a proclamation making February American Heart Month.

"Mothers are the ones, a lot of times, who make choices for their children," the first lady said. "They make their choices on the foods they eat. They're the ones at home, many times, who encourage their children to exercise."

Earlier, the president and Mrs. Bush attended the 55th national prayer breakfast at a Washington hotel where he prayed for the safety of U.S. troops, saying: "During this time of war, we thank God that we are part of a nation that produces courageous men and women who volunteer to defend us."

In the Roosevelt Room, the president and Mrs. Bush met with executives from the food, beverage and entertainment industries to talk about improving healthy food offerings and encouraging physical fitness in their marketing and advertising campaigns.

More than 10 million school-age children in the United States — about 18 percent — are now considered overweight. The percentage of overweight children tripled among adolescents during the past 25 years, and nearly doubled for children ages 6 to 12. This increases their risk for adult heart disease and diabetes, lowers life expectancy and creates additional health care costs.

Following the meeting, Health and Human Services Secretary Mike Leavitt was to work with Roger Enrico, chairman of DreamWorks Animation SKG, and Peggy Conlon, president and chief executive officer of The Advertising Council, to launch a public awareness campaign to help prevent childhood obesity. The campaign will include ads featuring characters from the Shrek animated movies encouraging children to "Be a Player" and get up and play for an hour a day.

Representatives from General Mills Inc., Coca-Cola North America, Univision Communications Inc., Kraft Foods Inc., Kellogg Co., PepsiCo Inc., Subway Franchisee Advertising Fund Trust, McDonald's USA and Nickelodeon Television also were at the meeting.

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