New Ideas To Fight The Flu


 
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By Lucette Lagnado

How about a shot of ultraviolet light instead of a flu shot? With seasonal vaccines often proving ineffective, researchers work on germ-killing lamps and a ‘universal vaccine’ to keep the virus at bay

Researchers spooked by the recent brutal flu season and fearful of a pandemic are looking for something more effective than a seasonal shot to prevent the virus. Ideas include germ-killing lamps and a turbo-charged “universal vaccine” that would be effective for years and would fight all strains of flu, not just a few.

NYC Health + Hospitals, the nation’s largest public health system, recently convened experts to brainstorm how to handle a flu pandemic, in which millions would be stricken.

“It is not a matter of if it will happen, it is a matter of when it will happen,” Syra Madad, senior director of the system’s Special Pathogens Program, told the gathering of more than 100 hospital and government officials and researchers. “We have all the ingredients for a pandemic,” she said, recalling the 1918 flu that killed 50 million people across the world.

Since then, there have been major advances in science and infection control. But there are also more lethal bugs floating around in an incredibly mobile society, Dr. Madad said. In the 2017-2018 flu season, nearly 80,000 Americans died and more than 900,000 were hospitalized. Experts advise getting the seasonal shot; this week, they couldn’t predict this flu season’s severity or how effective the flu shot will be.

One weapon unavailable in 1918 is the flu shot, which Dr. Madad and other experts say is still a must, no matter its shortcomings.

A new drug to relieve flu symptoms was recently approved by the Food and Drug Administration, the first in nearly 20 years, the agency said. Xofluza is supposed to shorten the flu’s duration by a day or more and requires only one dose.

But preventing flu is the goal, and most experts agree that more effective vaccines are urgently needed. Typically, the seasonal shot has an effectiveness rate between 40% and 60%, according to the Centers for Disease Control and Prevention. In the most recent season, it reduced a person’s likelihood of getting sick with the flu by 40%. Getting the vaccine significantly reduces hospitalization among adults and children, says Dan Jernigan, director of CDC’s influenza division.

Every year, flu vaccines are planned months in advance. Predicting which strains the vaccine should cover “is a guessing game,” said Jeffrey Shaman, an associate professor at Columbia’s Mailman School of Public Health.

Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, is spearheading the federal effort for a universal vaccine. A leader during the AIDS epidemic, he sees that fight as a template for taking on the flu. He hopes to replicate the “passion” that went into AIDS research, with “young as well as experienced investigators from different fields” mobilized to seek a cure.

Dr. Fauci aims to assemble a dream team of scientists with different areas of expertise—such as virology, immunology and drug development—to work together on a universal vaccine. For seven years, his project, the Collaborative Influenza Vaccine Innovation Centers, will dole out $30 million a year in grants. The deadline for proposals is Nov. 29. Dr. Fauci said he welcomes researchers who aren’t flu experts to join the effort.

Among those researching a different tack is David Brenner, a professor of radiation biophysics at Columbia’s Vagelos College of Physicians & Surgeons. Dr. Brenner wants to fight the spread of flu with a form of ultraviolet light that can destroy germs but is safe for humans.

“Our approach is let us try and kill the virus before they get to you,” Dr. Brenner said. He sees his lamps as a supplement to a vaccine, not a substitute for one.

Hospitals already zap equipment with ultraviolet light to sanitize it, but the lamps are off-limits to people, because of health hazards. Dr. Brenner’s lamps emit “far UVC” light—a wavelength he said is safe for humans. These would be beamed “anywhere people congregate,” he said, such as doctors’ offices or airplanes.

Most experts said a long-term and more effective universal vaccine should be the priority.

“I am a firm believer that the best solution is an appropriate vaccine,” said Adolfo Garcia-Sastre, a professor of medicine and infectious diseases at the Icahn School of Medicine at Mount Sinai, noting that smallpox was eradicated by vaccine.

“The ultimate dream is the universal [vaccine], but even one that works better” than the seasonal flu shot would be welcome, Dr. Garcia-Sastre said.

He and his colleagues teamed up with other scientists, including some from the pharmaceuticals industry, and are seeking funding from Dr. Fauci’s effort to research a vaccine they say works differently from the seasonal shot. The flu virus is covered in proteins shaped like mushrooms, said Florian Krammer, one of the Sinai researchers and a professor of microbiology. The seasonal vaccine targets the mushroom’s “cap” to produce antibodies that fight back, Dr. Krammer said, but this cap changes, prompting the need to change the vaccine constantly.

The Sinai team’s vaccine focuses on the “stalk” of the virus, which doesn’t change, so a person would need, ideally, no more than two or three shots during his lifetime. A trial of the shot’s safety and immune response is under way on about 65 patients.

Dr. Fauci’s agency already is funding research into other universal vaccines, such as one by BiondVax Pharmaceuticals , an Israeli company. The vaccine, known as M-001, was designed to keep the “vast majority of flu strains” at bay, BiondVax said, and is being tested in the U.S.

A universal vaccine is probably years off, experts warned, and likely to be reached through incremental stages.

Robert Atmar at Baylor College of Medicine in Houston, the principal investigator of the M-001 trial, said more studies are needed. A universal vaccine, he said, “is a high bar to attain.”

PREVENTING A PANDEMIC

As flu season begins, researchers are working on ways to manage the virus, now and in the future.

FOR NOW

Seasonal flu shot: Still the best bet for avoiding the flu, it helps reduce dangers of hospitalization and death if you do get sick.

Xofluza: A new drug that recently received FDA approval. Like Tamiflu, it promises to shorten the misery of the flu by a day or more but requires only one dose.

FOR LATER

UVC lamps: A Columbia University researcher proposes using a special ultraviolet light to kill airborne flu germs.

Universal vaccine: The holy grail if achievable: a vaccine needed just once or twice in a lifetime that would protect against all strains of the flu.

 
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