1. Global Advisory Committee on Vaccine Safety, WHO, Weekly Epidemiological Record, 29 January 2010

On twenty-first meeting in Geneva Global Advisory Committee on Vaccine Safety reviewed the safety of pandemic A (H1N1) influenza vaccines and the safety profile of a meningococcus A conjugate vaccine that that is going to be deployed in sub-Saharan Africa. The committee also discussed the use of bacille Calmette–Guérin (BCG) vaccine in areas with a high prevalence of infection with human immunodeficiency virus (HIV) and reviewed progress with global monitoring of adverse events following immunization (AEFI). In regards to pandemic vaccines the committee concluded that up to date, the safety data are reassuring, most of the adverse events that have been reported after immunization have not been serious, no unexpected safety concerns have been identified. However the reporting mechanisms on vaccine safety have been enhanced, most of the safety information to date is from passive surveillance and data from active surveillance will be assessed as they become available.

Selected Scientific Publications

1. Association between Severe Pandemic 2009 Influenza A (H1N1) Virus Infection and Immunoglobulin G2 Subclass Deficiency, C.L. Gordon, P. D. R. Johnson, M. Permezel et al., Clinical Infectious Diseases, electronically published 1 February 2010

The authors of this study assessed levels of serum IgG and IgG subclasses in 3 cohorts of patients; group with acute severe H1N1 infection (defined as infection requiring respiratory support in an intensive care unit), group with moderate H1N1 infection (defined as inpatients not hospitalized in an intensive care unit), and a random sample of healthy pregnant women. The statistical analysis has shown that hypoabuminemia, anemia, and low levels of total IgG, IgG1, and IgG2 were all statistically significantly associated with severe H1N1 infection, but only hypoalbuminemia and low mean IgG2 levels remained significant after multivariate analysis. Among 17 healthy pregnant control subjects, mildly low IgG1 and/or IgG2 levels were noted in 10, but pregnant patients with H1N1 infection had significantly lower levels of IgG2. Authors finding of a significant association between IgG2 deficiency and H1N1 infection severity needs further investigation in terms of pathogenesis severe influenza infections and it's implications for future clinical therapeutics.

The authors of this cross-sectional survey assessed attitudes of general practitioners (GPs) in four regions in France towards A/H1N1 pandemic vaccination. Of 1434 respondents, 885 (61.7%) were willing to accept A/H1N1 pandemic vaccination for themselves. The personal history of seasonal flu vaccination was the strongest independent predictive factor of willingness to accept A/H1N1 pandemic vaccination (p < .0001). GPs receiving seasonal vaccines every year were more likely to accept A/H1N1 pandemic vaccination than those who were never vaccinated in the prior 3 years (adjusted OR = 4.38; 95% CI, 2.44–4.67). Willingness to accept pandemic vaccination was also significantly associated with being on call for emergencies; positive attitudes towards other protective measures against A/H1N1 influenza virus in the practice; and a higher readiness to provide additional consultations in response to the pandemic. The authors concluded that however GPs showed a high acceptability of A/H1N1 pandemic vaccination their involvement in the mass vaccination campaign had initially  been neglected by French public health authorities which might have had negative impact on vaccine uptake in general population.

3. Rapid clinical diagnosis in fatal swine influenza (H1N1) pneumonia in an adult with negative rapid influenza diagnostic tests (RIDTs): Diagnostic swine influenza triad., Cunha BA, Syed U, Mickail N, Strollo S., Heart Lung. 2010 January – February

Based on experience in the pandemic that there was a lack of correlation between (rapid influenza diagnostic test) RIDT results and RT-PCR results ED staff of Winthrop-University Hospital Infectious Disease Division describe a method to diagnose probable H1N1 pneumonia in hospitalized adults with negative RIDTs. The authors of the study shows that this diagnostic swine flu triad was used effectively as the pandemic progressed, and was not only useful in correctly diagnosing probable H1N1 pneumonia in hospitalized adults with negative RIDTs, but was also in ruling out mimics of swine influenza, as well as bacterial community-acquired pneumonias (CAPs). Cunha BA and his group conclude that clinicians from other hospitals can gain from the Winthrop-University Hospital experience and use a similar diagnostic swine influenza triad to make a rapid clinical diagnosis of probable H1N1 pneumonia in hospitalized adult patients with negative RIDTs.

4. Effectiveness of Common Household Cleaning Agents in Reducing the Viability of Human Influenza A/H1N1, Jane S. Greatore, Rosanna F. Page, Martin D. Curran, Plos One, published online February 1, 2010

The purpose of this work was to test a representative range of common household cleaning agents in Europe for their effectiveness at killing or reducing the viability of influenza A virus. The results has shown that active ingredients in a number of the cleaning agents, wipes, and tissues tested were able to rapidly render influenza virus nonviable, as determined by plaque assay. Commercially available wipes with a claimed antiviral or antibacterial effect killed or reduced virus infectivity, while non-microbiocidal wipes and those containing only low concentrations (<5%) of surfactants showed lower anti-influenza activity. One of the interesting finding was that “home-made” low-technology agents such as 1% bleach, 10% malt vinegar, or 0.01% washing-up liquid rapidly and completely inactivated influenza virus. In the context of current and future influenza epidemics these results shows that especially in low-resource settings, the public does not need to source specialized cleaning products, but can rapidly disinfect potentially contaminated surfaces with agents readily available in most homes.