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  • Experts recommend switching to Asian-made flu vaccines

    Thursday, Feb 05, 2009,

    Anticipating a bigger wave of flu infections caused by a form of the virus that has become resistant to medication and vaccines, doctors and academics urged the government to switch to Asian versions of the flu vaccine.

    Health officials last week said that with employees returning to work en masse after the Lunar New Year holiday, flu infections from increased human interaction in crowded places could spread fast.

    Fear of the flu heightened when the Centers for Disease Control (CDC) said on Tuesday that two strains of the influenza type A had mutated slightly and developed resistance to the flu medication Tamiflu.

    Tamiflu was still 30 percent effective in fighting the virus in October, but the virus has recently developed 100 percent resistance against the drug, the CDC said.

    ?The H1N1 strain [of the flu virus] has mutated into a form that is 70 percent variant from the vaccine, and the H3N2 strain is 40 percent variant,? said CDC deputy director-general Chou Jih-haw (周志浩), referring to the government-funded vaccine inoculation offered free of charge last year to children, the elderly and other high-risk groups.

    CDC statistics showed that influenza type A comprised about 80 percent of all reported cases this winter. The type A H1N1 and H3N2 strains are currently circulating among flu victims.

    ?The H1 strain is weaker than the H3 strain. Although the H1 strain may infect more people [because of its mutation], it is less likely to make patients critically ill,? said Huang Li-min (黃立民), a pediatrician at National Taiwan University Hospital.

    However, Huang said that he was not sure whether the H1N1 strain would mutate into a form that could result in critical conditions. He recommended that doctors prescribe two types of flu medication simultaneously, such as Tamiflu combined with Amantadine, another type of flu treatment.

    This way, in case the virus strain has developed resistance to certain drugs, the medication may still be effective in controlling the disease, he said.

    The flu virus undergoes minor changes from time to time, and a major variant emerges about every five years, said Su Ih-jen (蘇益仁), director of the National Health Research Institute?s division of clinical research.

    Su urged the government to switch from European-made vaccines to Asian-made ones, saying the latter was more ?up to date? with new virus strains.

    ?In 2005, we published research showing that the virus strains in Taiwan were two years ahead of Europe,? he said. ?We should be using Asian versions of the vaccine to stay up to date with the disease.?

    In response, Chou said the CDC would assess the need to switch to the vaccines used in China, which he said would be more effective in combating the ever-changing virus.

    "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

  • #2
    Re: Experts recommend switching to Asian-made flu vaccines

    70% and 40% variant from vaccine????

    What is being measured?

    regarding switching from European vaccines to Asian made, is that because European (actually northern hemisphere) vaccines are based on best guess of what happened in the southern hemisphere 6 months earlier - which would be 1 year out-of-date if it was used to prevent the subsequent southern hemisphere seasonal influenza?

    .
    "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

    Comment


    • #3
      Re: Experts recommend switching to Asian-made flu vaccines

      For H3N2:



      <table style="width: auto;"><tbody><tr><td></td></tr><tr><td style="font-family: arial,sans-serif; font-size: 11px; text-align: right;">From TABLES</td></tr></tbody></table>

      Phylogenetic tree for relation between A/(H3N2) HA1 portions in Italian isolations during 2008/2009 epidemic season compared with previous season isolates.

      Current season H3N2 isolates evidently derived from A/Brisbane/10/2007 vaccine reference strain lineage, with the two amino acids changes (G50E e K140I) that differentiate from previous reference strain A/Wisconsin/67/2005. However, Italian isolates showed also to possess another important substitution (K173Q) at E antigenic site, reported also in the most recent reference strain A/Wisconsin/5/2008

      (...)

      From Seasonal Influenza thread: http://www.flutrackers.com/forum/sho...&postcount=361

      Comment


      • #4
        Re: Experts recommend switching to Asian-made flu vaccines

        SEASONAL INFLUENZA, VACCINE MISMATCH - TAIWAN
        *********************************************
        A ProMED-mail post
        <http://www.promedmail.org>
        ProMED-mail is a program of the
        International Society for Infectious Diseases
        <http://www.isid.org>

        ******
        [1]
        Date: Tue 3 Feb 2009
        Source: Taiwan Times [edited]
        <http://www.etaiwannews.com/etn/news_content.php?id=855358〈=eng_news>


        Flu vaccines not as effective this year as in the past
        ------------------------------------------------------
        Influenza vaccines that proved to be effective late last year have
        failed to live up to expectations early this year, the Department of
        Health (DOH) said Tuesday [3 Feb 2009]. Chou Jih-haw, Deputy
        Director-general of the DOH's Centers for Disease Control, said more
        than 3.2 million free flu shots were given to the public in autumn
        and winter last year. "Judging from the number of influenza cases in
        the fourth quarter of 2008, it was significantly lower than in the
        same period the previous year," Chou said. "But this year, tests of
        flu viruses on the patients showed that the results have not been as
        good as expected," he continued.

        Chou said influenza vaccines given in autumn 2008 and this winter
        should be effective against the H1N1 and H3N2 viruses, and tests
        taken from patients who were inoculated last year proved their
        effectiveness. But in January [2009], tests found the vaccines did
        not work [were not protective?] on 70 percent of those with H1N1
        viruses and 40 percent of those with the H3N2 virus. A vaccine is
        considered effective if it controls the virus in 80 percent to 90
        percent of those inoculated. Chou would not categorize the vaccines
        as ineffective, however, because influenza viruses are "prone to
        mutation," meaning that the virus formula for producing vaccines must
        be changed on a yearly basis.

        A former CDC Director suggested Tuesday that part of the problem may
        be that flu viruses tend to strike Taiwan between 6 months and 2
        years earlier than European countries and the United States. Su
        Ih-jen, Director of the Division of Clinical Research of the National
        Health Research Institutes, said that because of the time lag,
        influenza vaccines produced by European and American pharmaceutical
        makers based on data provided by the World Health Organization could
        not keep up with the outbreak of flu in Asia. Su noted that with
        close exchanges between Taiwan and China, Taiwan has become an
        outpost of influenza outbreaks.

        The World Health Organization began to address the issue of different
        prevalent viruses in Asia and Europe last April [2008]. Currently, 2
        out of 5 major vaccine manufacturers have made inroads into China,
        and the production of Asian influenza vaccines "has become a trend,"
        he said. Su suggested that the virus in every influenza outbreak is
        slightly different, and that "it can show major changes about every 5
        years, so the effectiveness of vaccines can diminish."

        [Byline: Lilian Wu]

        --
        Communicated by:
        ProMED-mail
        <promed@promedmail.org>

        ******
        [2]
        Date: Thu 5 Feb 2009
        Source: Taipei Times [edited]
        <http://www.taipeitimes.com/News/taiw.../05/2003435334>


        Experts recommend switching to Asian-made flu vaccines
        ------------------------------------------------------
        Anticipating a bigger wave of flu infections caused by a form of the
        virus that has become resistant to medication and vaccines, doctors
        and academics urged the government to switch to Asian versions of the
        flu vaccine. Health officials last week said that with employees
        returning to work en masse after the Lunar New Year holiday, flu
        infections from increased human interaction in crowded places could
        spread fast.

        Fear of the flu heightened when the Centers for Disease Control (CDC)
        said on Tuesday [3 Feb 2009] that 2 strains of the influenza type A
        had mutated slightly and developed resistance to the flu medication
        Tamiflu [oseltamivir]. Tamiflu was still 30 percent effective in
        fighting the virus in October [2008], but the virus has recently
        developed 100 percent resistance against the drug, the CDC said.

        "The H1N1 strain [of the flu virus] has mutated into a form that is
        70 percent variant from the vaccine, and the H3N2 strain is 40
        percent variant," said CDC Deputy Director-general Chou Jih-haw,
        referring to the government-funded vaccine inoculation offered free
        of charge last year to children, the elderly and other high-risk
        groups. CDC statistics showed that influenza type A comprised about
        80 percent of all reported cases this winter. The type A H1N1 and
        H3N2 strains are currently circulating among flu victims.

        "The H1 strain is weaker than the H3 strain. Although the H1 strain
        may infect more people [because of its mutation], it is less likely
        to make patients critically ill," said Huang Li-min, a pediatrician
        at National Taiwan University Hospital.

        However, Huang said that he was not sure whether the H1N1 strain
        would mutate into a form that could result in critical conditions. He
        recommended that doctors prescribe 2 types of flu medication
        simultaneously, such as Tamiflu [oseltamivir] combined with
        amantadine, another type of flu treatment. This way, in case the
        virus strain has developed resistance to certain drugs, the
        medication may still be effective in controlling the disease, he said.

        The flu virus undergoes minor changes from time to time, and a major
        variant emerges about every 5 years, said Su Ih-jen, Director of the
        National Health Research Institute's division of clinical research.
        Su urged the government to switch from European-made vaccines to
        Asian-made ones, saying the latter was more "up to date" with new
        virus strains. "In 2005, we published research showing that the virus
        strains in Taiwan were 2 years ahead of Europe," he said. "We should
        be using Asian versions of the vaccine to stay up to date with the
        disease." In response, Chou said the CDC would assess the need to
        switch to the vaccines used in China, which he said would be more
        effective in combating the ever-changing virus.

        [Byline: Shelley Huang]

        --
        Communicated by:
        ProMED-mail
        <promed@promedmail.org>

        [Vaccine mismatch is being invoked to explain the relatively poorer
        protective response obtained by vaccination in Taiwan in the current
        year compared to that obtained in the preceding year. This is
        attributed to progressive change in the epidemic virus as a
        consequence of accumulation of mutations in the viral genome.
        According to the above reports previous research in Taiwan has
        suggested that: "virus strains in Taiwan were 2 years ahead of
        Europe." On this basis it is proposed that vaccines more in harmony
        with requirements in south and southeast Asia should be developed locally.

        Increasing resistance of current epidemic strains to the antiviral
        drugs Tamiflu and amantadine in Taiwan is considered to be another
        consequence of the mutability of the virus rather than a consequence
        of the enhanced use of these drugs in clinical practice. In contrast
        a recent study in Europe (Kramarz et al., Eurosurveillance, Vol. 14,
        Issue 5, 2009
        (<http://www.eurosurveillance.org/View...rticleId=19112>)
        based on analysis of prescription data concluded that while the
        precise relationship between oseltamivir [Tamiflu] use and resistance
        of influenza A(H1N1) to oseltamivir remains uncertain, the available
        data do not suggest a link between the rapid rise in the proportion
        of the resistant A(H1N1) and the use of oseltamivir in Europe. - Mod.CP]

        [A map showing the location of Taiwan is available at:
        http://www.worldatlas.com/webimage/countrys/asia/tw.htm> -CopyEd. EJP]

        [see also:
        2008
        ----
        Influenza vaccine 2009 (02): S. hemisphere 20080923.3009
        Influenza vaccine 2009: S. hemisphere 20080922.2988
        Influenza vaccine 2008/2009 - N. hemisphere 20080805.2404
        Influenza virus, 2007/2008 vaccine mismatch 20080209.0529
        Influenza virus, vaccine response: RFI 20080209.0528
        2007
        ----
        Influenza: update & vaccine composition 20070810.2607
        Influenza vaccine 2007/2008 - N Hemisphere 20070215.0566]
        -

        ------
        ...................cp/ejp/mpp
        </pre>

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