A new production method could cut the time it takes to get more H1N1 flu vaccine on the market, a University of South Dakota assistant professor told medical students Thursday.
The new cell-based vaccine could reach the public faster than the current egg-based method, said Victor Huber of the Sanford School of Medicine.
"After we identified the (H1N1) virus, it took six months to create the vaccine," he said. "With new technology, we could reduce the time down to three months."
The cell-based method could help fight the next wave of H1N1 and other pandemics, Huber told the Sigma Xi scientific research society.
"We can grow (vaccine) in cells that are maintained in a lab setting. We don't have to wait," he said. "If something occurs and we are at the end of the flu season, the cells are ready to go."
The change to a cell-based vaccine would not only speed up production but also solve many problems with egg-based vaccines, Huber said.
"With the current vaccine, you have problems with allergies and shortages with eggs," he said. "You also have problems with bacterial contamination and the inability to grow (some vaccines) in eggs. And we can have the mismatch from circulating strains."
The current H1N1 flu has produced challenges never before faced in medicine, Huber said.
"We are at a truly interesting time," he said. "This influenza is something we haven't seen before in the human population, which causes the pandemic."
Not only did researchers face a virus they hadn't seen, but extensive testing was required to ensure the vaccine was safe for the general public, he said.
In addition, this has become the first pandemic in which the nasal vaccination has become available, he said. Efforts are under way to expand the use of nasal vaccines beyond the current ages 2-49, but complications could arise in the elderly, he said.
Officials were also successful in creating public awareness about H1N1 and the importance of vaccinations, he said. Attention has been focused on early vaccinations for seasonal flu as well as H1N1, he said.
"Our surveillance is good in regards to H1N1. We are very good at getting the word out," he said. "As we saw with shutting down schools, our pre-pandemic preparedness shows our plans do work."
The H1N1 pandemic arose last April and struck hard over the summer, which is unusual for influenza, Huber said. While the number of H1N1 cases has apparently subsided, Huber anticipates another wave of flu in the coming weeks.
H1N1 has a high infection ability shortly before symptoms appear and after the fever is past, Huber said. H1N1 has hit youngsters hard because a child's infection period covers 10 days, beginning six days before symptoms appear — compared to one day for adults — and continues until one day after a fever disappears.
South Dakota has recorded H1N1 deaths in different age groups. However, the death of a Sioux Falls child from H1N1 has accelerated many parents' demand for the vaccine.
The flu itself doesn't create all of the problems, Huber said. "The secondary complications are significant," he said.
Much is at stake in finding a faster process for producing vaccinations, Huber said.
Influenza in the United States takes an annual toll of 36,000 deaths; 200,000 hospitalizations; 25 million doctor visits; 95 million infections and illnesses; and $3-15 billion in economic costs, including lost time at work.
Huber emphasized that H1N1 — named "swine flu" at first — does not come from hogs and is not acquired by eating pork. H1N1 contains bits of swine influenza, which contributed to the name, he said.
Researchers can learn from past pandemics, which occur every 10 to 40 years, Huber said.
In 1918, the United States saw 25 million infected and 500,000 deaths. Worldwide, the figures were 500 million cases with estimates of as many as 100 million deaths.
The 1918 pandemic also included a spike in mortality among people in their 20s and 30s, which is unusual for influenza, Huber said.
"In 1900, the U.S. life expectancy was 45 years," he said. "But in 1918-19, the life expectancy dropped 10 years strictly because of the flu pandemic."
Thanks in large part to vaccines, life expectancy didn't see those drops during pandemics in the 1980s and 1990s, he said.
No vaccine was available for the 1918 flu pandemic. In 1933, Influenza A virus was isolated and a vaccine was licensed in 1945. However, evidence arose only two years later that the virus had changed and the vaccine was not protecting against H1N1.
In 1952, the World Health Organization (WHO) received global surveillance. More viral shifts occurred in following years, with the re-emergence of seasonal H1N1 in 1977. The avian (bird) flu showed up in humans in 1997 and came back in 2003, and the possibility remains of an avian pandemic.
H1N1 flu has also returned, Huber said. Work continues on vaccines, he added.
"This is not the end for influenza season," he said. "It will be interesting to see how it plays out, especially since we had vaccinations early."
Huber defended the measures taken for H1N1, including quarantines and the closing of schools.
"It was very important early on, especially because we don't know what the virus was going to do," he said. "In hindsight, it looks like we overdid it, but it was better to err on the side of caution."
Huber warned against complacency during future outbreaks. "We hope we don't just assume it was like the last time and not take measures," he said.
Now in his second year at USD, Huber is building up a new virology research group. Even if the current vaccine proves highly successful, researchers need to continue their work, he said.
"There is still the potential for other strains to create a pandemic. It's not the only H1N1 we have," he said. "If we can fine tune the vaccine, we will be better prepared for the future."