Category Archives: Flu

Articles about influenza (flu) or flu misinformation

New podcast! “The Man. The Myth. The Legend. Ron Fouchier on Science Communication”

Recorded June 23, 2014 at the American Society For Virology annual meeting in Fort Collins, Colorado.

 Please click here to access the podcast or subscribe on iTunes here.

Episode Description:
Talking about viruses, and in particular influenza virus (or flu), to the lay public remains an extremely difficult area of science reporting. Bad science communication regarding flu can be devastating–if we can’t get the right information to the public and get their support, then public health progress could be set back decades, risking the lives of many people. It’s really important to keep flu research going as so much about the disease and the underlying cause (= the virus) remains a mystery. Moreover, an effective vaccine or antiviral treatment remain elusive.

If you’ve followed science news in the last 3 years, you’ve most likely heard of Dr. Ron Fouchier and his research on understanding how bird flu spreads and if it’s possible for it to change into a form that can be passed between people. Voted one of Time Magazine’s “World’s 100 Most Influential People of 2012″, Fouchier shares with us his side of the avian H5N1 flu research controversy that catalyzed a frenzy of (bad) science reporting in 2011-2013. What made this research so controversial? Did the press misrepresent Fouchier? What has he learned about science communication during this process? For these answers and more insights into how the American press failed us, check out this podcast.

Show links:
Youtube video by Ron explaining the importance of his work and why it’s safe
Origin of H5N1 Storm by Vincent Racaniello
Dr. Ron Fouchier’s profile at Erasmus Medical Center
Second Flu Paper Published” by Ed Yong in Nature (great summary of the “conclusions” to this leg of the story as of 2012)
Scientists Brace For Media Storm Around Controversial Flu Studies” by Martin Enserink
WARNING: WORST KIND OF SCIENCE WRITING: “An engineered doomsday” editorial in the New York Times
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Thanks for your continued support! Nina

Viruses gone viral: communication issues in virology research

How can we talk to the public about viruses when it’s difficult to even define what they are? Guest virology experts Drs. Gary Ketner (Johns Hopkins School of Public Health) and Barry Margulies (Towson University) discuss the perils of communicating virus research to the media, the worst virus miscommunication they’ve ever seen, and how we can make virology more accessible to the public.

Show links:
Listen to the podcast HERE or subscribe to PHU on iTunes here.

Learn the basics about viruses (great for non-scientists too) at Virology 101.

Quick and easy read on Barry’s research: “Barry Margulies and co-workers are seeking innovative ways to attack cold sores”

This Week In Virology website

Articles about the Fouchier debate:
“Origin of H5N1 Storm” by Vincent Racaniello, Read this first if you’d like to know the facts!
“Seeing Terror Risk, US Asks Journals to Cut Flu Study Facts” by Denise Grady. Balanced article for general public.
EXAMPLES OF BAD SCIENCE WRITING:
An engineered doomsday” by (author not provided). Scare-mongering at its best. Check out the comments for a laugh!
Five easy mutations to make bid flu a lethal pandemic” by Debora MacKenzie. She’s got all the facts wrong and uses scare-mongering to draw readers in.

Scary monkey viruses? No, not really

An article published in US News & World Report last week on an exciting possible therapy for Ebola virus disease contains some of the worst scientific misinformation we’ve yet come across. Worse, the author, Jeff Nesbit, links to a similar article he wrote last year for US News & World Report, disseminating the same nonsense.

Last week’s article is ostensibly about a new antibody-based therapy for Ebola virus infection developed by U.S. military scientists. This therapeutic candidate, an antibody cocktail that cured several monkeys suffering from Ebola virus disease, truly is an exciting scientific discovery. Both articles, however, go on to discuss something even more frightening than Ebola, the threat of Simian hemorrhagic fever virus  (SHFV), jumping from non-human primates to people.

There are several problems with both the fearmongering premise and Nesbit’s background information. Nesbit starts his SHFV rant by discussing previous jumps of viruses from animals to humans like this:

 “Deadly, virulent viruses have jumped species from nonhuman primates such as chimpanzees to the human species three times in history: the SIV virus that almost certainly led to the worldwide AIDS pandemic, the SV-40 “cancer” virus that was accidentally included in polio vaccines in the 1950s, and the deadly Ebola virus.”

 This is bad, bad science writing, with some truth buried within wildly inaccurate history. It’s true that HIV is derived from simian immunodeficiency viruses, but that’s about as far as this paragraph gets without going off the rails. SV40 virus is indeed a simian virus that may have come to infect humans. We know, for example, that old polio vaccine stocks were contaminated with this virus, and that SV40 has been shown to cause cancer in small lab animals. Calling it the “cancer” virus, however, is inaccurate and inflammatory. Studies in the U.S. and Denmark, along with a larger analysis by the National Cancer Institute, have found no evidence that SV40 causes cancer in humans. Finally, we come to the easiest allegation to knock down, that Ebola virus jumped from non-human primates to people. In fact, the strongest evidence we have suggests that fruit bats are the reservoirs of Ebola and other similar viruses. It’s true that Ebola virus infects non-human primates in the wild and in captivity, but the source of any particular Ebola outbreak has never been identified, and it is decidedly not a virus harbored by primates.

It also needs to be point out that while the article rattles off two terrible examples of viruses that have crossed from animals into people, saying it’s happened three times in history is just silliness. It’s actually estimated that up to 75% of emerging diseases in humans came from animals. The list includes, aside from Nesbit’s three examples, Nipah virus, influenza viruses, rabies virus, and West Nile virus. We could go on, but won’t.

Next on the author’s agenda is convincing you that SHFV might be the next human plague:

“Because it is a close cousin to Ebola, biodefense researchers are also looking at SHFV. Both Chinese and U.S. researchers assume, for now, that it might be benign and a way to study the Ebola virus. And if it jumps to the human species — just as SIV, SV-40 and Ebola did — then the human species is nearly defenseless against it.”

From the top, SHFV actually is not a close cousin of Ebola at all. They cause a somewhat similar disease, but are virologically quite distinct. They share neither, a species, genus, family, or order. SHFV is an arterivirus, whereas Ebola is a filovirus. They have nothing in common in terms of shape or genome structure, and have drastically different replication cycles. SHFV is studied because the course of disease is similar, but it’s in fact a well-known virus, prized in the lab specifically because it does not infect humans, or human cells in the lab.  There’s really no reason to consider SHFV an impending threat,  and, accordingly, it’s studied in low biocontainment facilities. It’s true that we would be immunologically defenseless against SHFV were it to infect humans, but that’s true of most emerging pathogens, and not unique to this situation at all. We at PHU would never sit here and say SHFV could never infect a human, as viruses do make the species jump, as we’ve seen. But you can bet that for the virus to be studied in low containment that the risks have been evaluated, and the focus here should be on how SHFV can help us understand and treat disease in humans, not how it might make us sick itself. The article does close this way:

“And if it jumps to the human species — just as SIV, SV-40 and Ebola did — then the human species is nearly defenseless against it. But if it doesn’t — or can’t — jump from primates to us, then it just as equally could hold the key to a defense against the quite deadly Ebola virus.”

So he’s reined himself in at the end. We think it’s too late though; there didn’t need to be even a sentence suggesting you should fear SHFV. And the author certainly didn’t need to lump SV40 in with SIV and Ebola again, considering it’s never made someone sick. This is just the kind of article that makes us bang our heads on our desks, so we decided to make ourselves feel better by making sure you don’t believe more than a word or two of it. If you do want to learn more about the new Ebola therapy US News ostensibly reported on, here’s a much better article from NBC. It’s actually quite cool. The actual article in Science Translational Medicine can be found here.

-Steve

When the media goes out of its way to scare you

This week a new paper was published reporting the results of a study on H7N9 influenza virus transmission among ferrets.  Ferrets are frequently used as an animal model of influenza transmission among mammals, but claims that they are truly predictive of what will occur in humans are false.

NBC News, however, doesn’t necessarily want you to know that. They have published an article about this new study titled “H7N9 bird flu spreads much like ordinary flu”. Seasonal influenza viruses, and the 2009 H1N1 pandemic virus both spread readily through the air in both humans and ferrets. However, the H7N9 virus used in this new study spread readily only between ferret kept in the same cage. Of three ferrets in a nearby cage, all showed signs of illness, but only 2 produced antibodies and only 1 shed virus in nasal secretions, which is required for further transmission. This was despite directed airflow from the infected ferrets to the nearby cage, a situation obviously not replicated in the real world. In addition, transmission between pigs was inefficient, along with transmission between pigs and ferrets.

By way of comparison, when the 2009 influenza virus was used, all three ferrets in the nearby cage became infected, produced antibodies, and shed virus in nasal secretions. Therefore, the claim that avian H7N9 virus transmitted in the same way as a human influenza virus is demonstrably false. In essence, the study confirmed what we have already observed about H7N9 in humans. Mammals in extended, direct contact with each other (such as family members or ferrets housed together) can transmit the virus. People in casual contact likely don’t.

To be fair, the NBC article makes this clear within the body of the article, but their headline writers went way overboard, in a way that seems designed to frighten. For a more detailed explanation of why this new study shouldn’t alarm us, visit Vincent Racaniello’s virology blog. The H7N9 virus could certainly mutate to transmit more efficiently between people, but this latest study is a long way from showing that it already has that capability.

Stay tuned to PHU for more information on influenza in the near future, including virus biology, mutation, disease, treatment and pandemic potential.

-Steve

 

Avian Flu Update

Since our first post the scale of the H7N9 avian flu outbreak in China has continued to increase. Authorities are now reporting 63 cases and 14 deaths (Update-now 77 cases, 16 deaths), and Beijing has also reported its first case. Additionally, thanks to the rapid work of Chinese researchers, we have learned a lot about this novel virus. Some of the information we have learned about this virus is certainly worrisome, but it’s extremely important to understand that neither the WHO nor the Chinese government have found any evidence of sustained person-to-person transmission. This means that while the number of cases is increasing, all cases are believed due to transmission from an infected bird to person, or perhaps limited transmission between people with extensive close contact, such as family members.

Researchers at the Chinese Centers for Disease Control and Prevention have published their initial, but extensive analysis of the H7N9 virus in The New England Journal of Medicine. Interpreting these findings requires knowledge of some basic virology, which we’ll try to keep to the basics. Those desiring a more technical explanation of influenza virus structure, lifecycle, and disease should look at Influenza 101 on Dr. Vincent Racaniello’s virology blog.

H7N9 denotes the subtype of influenza virus as defined by the two main proteins on the surface of the virus, HA and NA. Human influenza viruses are typically H1 or H3, whereas avian viruses include H5 and H7, among others. Unlike most viruses, which have a genome consisting of either one or two strands of RNA or DNA, the influenza virus genome consists of eight separate RNA segments, each of which directs the production of viral proteins. This segmented nature of the genome underlies the ability of influenza to mutate dramatically and cause pandemics, which is described in detail in Influenza 101.

The HA protein is particularly important. It is responsible for attachment of the virus to a target cell, and is also the protein against which our immune response produces protective antibodies. The structure of the HA protein also determines whether a virus is better suited to infecting avian or human cells, and therefore distinguishes between human and avian influenza viruses. When avian flu viruses do infect human cells, they normally do so deep in the respiratory tract, rather than in the upper respiratory tract. This makes them much less transmissible, or “contagious”, because they are less likely to be sneezed, coughed, or breathed out.

The Chinese researchers identified several troubling mutations in the HA protein of H7N9. Some of these mutations may make the virus better adapted to infecting human cells, especially cells in the upper respiratory tract. Other mutations are associated with an increased ability to infect cells outside the respiratory tract, and with increased virulence. Some of these mutations, as well as a mutations in a protein called PB2, are among those identified in last year’s controversial H5N1 research on avian flu transmission in ferrets. This underscores the critical important of continuing avian flu transmission research, despite the sensationalistic reporting in major media outlets such as The New York Times last year.

In the same issue of NEJM U.S. CDC flu researchers published a companion article detailing the pandemic risk posted by H7N9. The mutations identified by Chinese researchers make the risk very real. However, there is still no evidence of sustained person-to-person transmission, and little or no evidence for transmission even between very close contacts. The Chinese government is monitoring thousands of people who have been in contact with H7N9 patients, so any such transmission is likely to be quickly identified. Of course, the Chinese researchers as well as scientists in the U.S. and around the world are feverishly working to have a vaccine ready in the event H7N9 proves capable of causing a pandemic. Additionally, H7N9 is susceptible to Tamiflu, as demonstrated by the successful treatment of a young girl in Beijing along with laboratory testing.

Excellent resources for following new developments continue to be the CDC page on H7N9, the WHO disease outbreak and FAQ pages and the CDC Flu Twitter page. Additionally, feel free to leave comments or pose questions on our website or Facebook page.

-Steve

A new bird flu? by Steve Goldstein

Yes, it does appear that a new type of bird flu has emerged in humans in southern China. What is meant by “bird flu” as opposed to our normal seasonal flu viruses or the pandemic H1N1 virus of 2009 fame? Avian flu viruses usually don’t infect people and when they do, transmission is almost always directly between birds and humans, as avian flu viruses typically don’t transmit well between people.

This H7N9 virus may be causing more severe disease than seasonal flu or similar avian flu viruses have caused in the past, and so has caught the attention of the World Health Organization, which is reporting 16 cases and 6 deaths so far. Fortunately for us, the virus does not seem to be transmitted from person-to-person. Therefore, measures already taken by the Chinese government, such as the culling of birds sold in local “wet markets”, have an excellent chance of stopping the outbreak.

The media has been kind enough to largely avoid the sensationalistic, inaccurate reporting that colored the debate about H5N1 research last year. Excellent articles about the current outbreak can be found here, here, and here.

The concern with avian flu viruses is that they might mutate and become more transmissible person-to-person. That’s certainly a possibility, which is why some of the world’s best scientists at the U.S. Centers for Disease Control and Prevention have already begun work on a vaccine to prevent H7N9 infection, just in case that happens.

The WHO FAQ page on H7N9 is an excellent resource, and you can also follow CDC Flu on Twitter. If you have questions for us feel free to post them in the comments, and if we can’t answer them ourselves we’ll get an answer for you from Dr. Andy Pekosz, who was featured in episode 1 of our podcast.

-Steve