Scientists will pay tribute to the astonishing success of AIDS drugs and highlight steps being taken towards a cure -- a goal once deemed all but out of reach.

Entitled "Imagine the Future," the three-day conference builds on the 30th anniversary on Monday of the isolation of the human immunodeficiency virus (HIV).

The Nobel-winning achievement, by a team led by Luc Montagnier of France's Pasteur Institute, unmasked a killer.

Then began the drive to treat the disease and halt its spread.

"The discovery of HIV in 1983 and the proof that it was the cause of AIDS in 1984 were the first major scientific breakthroughs that provided a specific target for blood-screening tests and opened the doorway to the development of antiretroviral medications," said Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases (NIAID).

Introduced in 1996, after many years of frantic drug research, antiretrovirals are saving the lives of millions of people infected with HIV and helping to contain the virus' spread, Fauci said in an email.

By suppressing viral levels, antiretrovirals can prevent HIV being transmitted by pregnant women to their unborn children, and by infected people to their sexual partners.

But there have also been setbacks, particularly in the quest for a vaccine.

Only last month, US authorities halted the latest clinical trial -- launched in 2009 -- after the prototype formula failed to prevent infection.

Finding antibodies that are able to identify the slippery, mutating virus has proven to be almost as hard as the proverbial search for a needle in a haystack.

"Vaccine research continues to suffer from setbacks -- but pursue a vaccine we must if we are to truly see the end of AIDS," said Adeeba Kamarulzaman, a professor of infectious diseases at the University of Malaya, who will co-chair a global conference on AIDS science in Kuala Lumpur in June.

Counter-intuitively, the main hope nowadays seems to rest on a cure.

Three years ago, Francoise Barre-Sinoussi -- a 2008 Nobel co-recipient with Montagnier -- mapped a strategy for attacking HIV's "reservoir."

This is the cellular bolthole where the virus lurks after being pounded with antiretrovirals. Once the drugs are stopped, the virus re-emerges and spreads once more through the bloodstream.

"The great challenge will be to fully understand where the virus hides, how it manages to stay hidden so effectively and how to lure it out of its hiding place. We've learnt a lot about this in the past few years," said Sharon Lewin, a professor at Monash University in Melbourne, Australia.

-- 'Functional cure' --

Lewin is part of a team cautiously experimenting with an anti-cancer drug to flush out the virus that destroys the immune system and exposes infected people to pneumonia, TB, and other opportunistic diseases.

In trials on 20 patients, the cancer drug awoke the dormant virus in 90 percent of volunteers. The ultimate goal is to kill the newly-exposed virus, leaving the cell it hid in to die eventually of old age.

"We do have drugs that seem to wake up the virus but these are only the first steps in ultimately clearing it out completely," said Lewin.

Two other small studies using antiretrovirals at a very early stage of infection, before viral levels build up, have excited hopes of a "functional cure."

One involved a baby in Mississippi, apparently cleared of the virus after being given aggressive antiretroviral treatment within 30 hours of birth.

"It is certainly a very exciting finding, but this is only a single case and additional studies are needed to determine whether the circumstances of this particular case can be replicated among other HIV-exposed children," said Fauci.

The other is a small French study of 14 HIV patients, known as the VISCONTI cohort, given drugs very soon -- within 10 weeks -- after infection. Treatment normally starts only once the immune system becomes compromised, sometimes years after infection.

The VISCONTI group stopped taking the daily drugs after about three years, and have remained healthy.

And crucially, none of the individuals are among that rare group of people -- fewer than one percent of the population -- who seem able to naturally stave off HIV and are known as "natural" or "elite controllers."

AIDS has killed 30 million people.

An estimated 34 million people are infected with HIV worldwide, and about 1.8 million die every year.

A year after the Montagnier team's historic publication in Science on May 20, 1983, a team led by Robert Gallo of the United States published similar findings -- triggering an acrimonious debate with research funding and prestige at stake.

It turned out that Gallo had worked on a viral sample originally sent to him by Montagnier.

Credit for isolating HIV thus went to the French team, but Gallo was recognised for determining that the virus caused AIDS, something the Montagnier study was not clear on.

]]> Mon, 20 MAY 2013 12:44:21 AEST Washington (AFP) May 18, 2013 - The hunt for an HIV vaccine has gobbled up $8 billion in the past decade, and the failure of the most recent efficacy trial has delivered yet another setback to 26 years of efforts.

With the next attempts expected to be years away, top researchers now say there is a "void" or a "gap" in current clinical trial efforts to test whether a vaccine may be safe and effective in people.

A kind of ongoing autopsy of the last four major bids to make an HIV vaccine has informed the field as to what does not work, with the latest casualty being a trial called HVTN 505 that was halted early because it did not prevent HIV.

"It leaves us with a gap in several years before we have another HIV vaccine efficacy trial under way, and that is unfortunate," said James Kublin, executive director of the HIV Vaccine Trials Network.

Another concern for researchers is that two vaccine trials -- HVTN 505 and a previous trial known as STEP that ended unsuccessfully in 2007 -- both revealed apparent increases in the number of vaccinated patients who got HIV.

HVTN 505 showed 41 cases of HIV were acquired in the vaccine group, compared to 31 in the placebo group. Among some 2,500 participants, the difference was not statistically significant, and so researchers found that no harm was caused by the trial.

"But the number is in the wrong direction," said trial leader Scott Hammer, who described the trial's outcome as a "disappointment."

Researchers are still investigating why this may have happened, but some theorize the cold virus known as Ad5 that served as a vector to deliver the vaccine may have somehow caused more infections by making it easier for HIV to penetrate the body.

"You scratch your head," said Hammer, a professor of medicine at Columbia University, adding that Ad5 may now be considered too risky and other options are being investigated.

"No one is going to want to a do a major trial with this sort of vector in the future," he told AFP.

The key puzzle in the vaccine search has been the nature of the human immunodeficiency virus itself, which has managed to fool modern medicine by changing its genetic makeup so often that a single weapon cannot silence it.

"The virus is a very elusive foe," said Wayne Koff, chief scientific officer at the International AIDS Vaccine Initiative (IAVI).

"It is more variable than almost any other virus that a vaccine has been attempted for. So if one wants to make antibodies against a virus that is variable, one has to have a broadly reactive antibody," he told AFP.

A small number of HIV-positive people have been found to produce antibodies that can neutralize a broad range of HIV variants, but scientists have not yet figured out how to make a vaccine from that information.

"Lots of people are working on that very hard. I would have thought we would have that immunogen to test in phase I trials by now, but hopefully soon," said Hammer, a leading HIV researcher.

About 34 million people are infected with HIV worldwide, and AIDS has killed 30 million people since the epidemic began 30 years ago.

The vaccine field has fallen short of expectations since 1984, when Margaret Heckler, who was then US secretary of Health and Human Services, declared a vaccine would be ready for testing in about two years' time.

The first phase I trial of a vaccine began in 1987 at the National Institutes of Health in Bethesda, Maryland, and included 138 healthy volunteers. The first large-scale trials did not begin until the late 1990s.

The sole success story to date has been a trial in Thailand known as RV144, which in 2009 saw a modest, 31 percent rate of protection, still far below the 50 percent threshold needed in order to license a vaccine.

Researchers are continuing to study the results for clues as to why it worked in some cases but not others, and why it appears the protective effects may have waned over time.

A similar vaccine modeled for South Africans is expected to enter human trials in the next couple of years. Other approaches for increasing T-cell immunity are also on the horizon.

"I am an optimist. I think we are at least halfway there, hopefully further," said Hammer. "The world needs an HIV vaccine."

]]> Mon, 20 MAY 2013 12:44:21 AEST Davis CA (SPX) May 17, 2013 - Scientists at the University of California, Davis, detected the H1N1 (2009) virus in free-ranging northern elephant seals off the central California coast a year after the human pandemic began, according to a study published May 15, in the journal PLOS ONE. It is the first report of that flu strain in any marine mammal.

"We thought we might find influenza viruses, which have been found before in marine mammals, but we did not expect to find pandemic H1N1," said lead author Tracey Goldstein, an associate professor with the UC Davis One Health Institute and Wildlife Health Center. "This shows influenza viruses can move among species."

UC Davis researchers have been studying flu viruses in wild birds and mammals since 2007 as part of the Centers of Excellence in Influenza Research and Surveillance program funded by National Institutes of Health. The goal of this research is to understand how viruses emerge and move among animals and people.

Between 2009 and 2011, the team of scientists tested nasal swabs from more than 900 marine mammals from 10 different species off the Pacific Coast from Alaska to California. They detected H1N1 infection in two northern elephant seals and antibodies to the virus in an additional 28 elephant seals, indicating more widespread exposure.

Neither infected seal appeared to be ill, indicating marine mammals may be infected without showing clinical signs of illness.

The findings are particularly pertinent to people who handle marine mammals, such as veterinarians and animal rescue and rehabilitation workers, Goldstein said. They are also a reminder of the importance of wearing personal protective gear when working around marine mammals, both to prevent workers' exposure to diseases, as well as to prevent the transmission of human diseases to animals.

H1N1 originated in pigs. It emerged in humans in 2009, spreading worldwide as a pandemic. The World Health Organization now considers the H1N1 strain from 2009 to be under control, taking on the behavior of a seasonal virus.

"H1N1 was circulating in humans in 2009," said Goldstein. "The seals on land in early 2010 tested negative before they went to sea, but when they returned from sea in spring 2010, they tested positive. So the question is where did it come from?"

When elephant seals are at sea, they spend most of their time foraging in the northeast Pacific Ocean off the continental shelf, which makes direct contact with humans unlikely, the report said.

The seals had been satellite tagged and tracked, so the researchers knew exactly where they had been and when they arrived on the coast. The first seal traveled from California on Feb. 11 to southeast Alaska to forage off the continental shelf, returning to Point Piedras Blancas near San Simeon, Calif., on April 24.

The second seal left Ano Nuevo State Reserve in San Mateo County, Calif., on Feb. 8, traveling to the northeast Pacific and returning on May 5. Infections in both seals were detected within days of their return to land. The report said exposure likely occurred in the seals before they reached land, either while at sea or upon entering the near-shore environment.

The research, led by scientists Goldstein and Walter Boyce at the UC Davis School of Veterinary Medicine's One Health Institute, was conducted with collaborators Nacho Mena and Adolfo Garcia-Sastre at the Icahn School of Medicine at Mount Sinai in New York, who sequenced the virus isolates and characterized their phenotypic properties.

"The study of influenza virus infections in unusual hosts, such as elephant seals, is likely to provide us with clues to understand the ability of influenza virus to jump from one host to another and initiate pandemics," said Garcia-Sastre, professor of microbiology and director of the Global Health and Emerging Pathogens Institute at the Icahn School of Medicine.

]]> Mon, 20 MAY 2013 12:44:21 AEST Moscow (AFP) May 16, 2013 - There is no government strategy to fight the spread of AIDS in Russia, where the number of deaths caused by the disease continues to grow, a senior healthcare official said on Thursday.

"We have no national strategy to fight against AIDS," the director of the Russian Federal Agency against AIDS, Vadim Pokrovsky, told a news conference.

The rate of new HIV infections grew 12 percent in 2012 -- 69,849 new cases against 62,384 new cases in 2011, according to the government figures.

The number of deaths caused by AIDS in Russia also continued to grow, with 20,511 deaths registered in 2012 against 18,414 deaths in 2011 -- an 11.4 percent increase.

"The state spends 19 billion rubles ($606 million, 470 million euros) a year for diagnosis and treatment of people who have contracted AIDS and only 200 million rubles for prevention programs," Pokrovsky said.

"We are fighting not against the epidemic itself, but against its consequences... In the absence of prevention (measures) we should expect an increase in the number of new cases," he added.

The high rates of AIDS-related mortality in Russia are caused by a widespread practice of a delayed anti-retroviral treatment as doctors often use expensive drugs sparingly, Pokrovsky said.

In total, some 720,000 people have contracted HIV in Russia since the first cases were recorded in the country in 1987, according to the latest official statistics. Nearly 130,000 patients have died so far.

But a 2011 report by the United Nations AIDS agency, UNAIDS, puts the real figure of HIV-infected people at about 1.2 million people -- roughly one percent of the adult population.

In Western and Central Europe, the rate is five times lower -- at about 0.2 percent.

Experts speak of "a generalisation of the AIDS epidemic" that affects not just high-risk groups -- such as drug addicts or prostitutes -- but all of society, said Pokrovsky.

]]> Mon, 20 MAY 2013 12:44:21 AEST Geneva (AFP) May 15, 2013 - Two Saudi health workers have contracted the deadly coronavirus from patients, marking the first evidence of transmission in a hospital setting, the World Health Organization said Wednesday.

"This is the first time health care workers have been diagnosed with nCoV (novel coronavirus) infection after exposure to patients," the WHO said in a statement.

The two health care workers were among six new cases announced by the Saudi health ministry on Tuesday.

The UN's health body said that while other health care workers had contracted the deadly disease in Jordan, there had until now not been clear evidence that they had been infected by patients carrying the virus.

"This is the first time we have pretty hard and fast evidence of it," WHO spokesman Gregory Haertl explained to AFP.

"Health care facilities that provide care for patients with suspected nCoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients and health care workers," the agency said.

WHO said one of the new patients with laboratory-confirmed nCoV was a 45-year-old man who became ill on May 2, and who was currently in a critical condition.

The second patient was a 43-year-old woman with a coexisting health condition, who became ill on May 8 and was in a stable condition.

"Health care providers are advised to be vigilant among recent travellers returning from areas affected by the virus who develop SARI," or severe acute respiratory infections, WHO said.

The organisation however continued to say travel restrictions and special screening was not yet called for to limit the spread of the virus.

Since last September, WHO says it has been informed of a global total of 40 laboratory confirmed cases of the virus, including 20 deaths.

While the virus has been deadliest in Saudi Arabia, which now counts 30 infections, half of them fatal, cases have also been reported in Jordan, Qatar, Germany, Britain and France, where two patients are now in hospital in the northern city of Lille.

]]> Mon, 20 MAY 2013 12:44:21 AEST Riyadh (AFP) May 14, 2013 - Panic has gripped Saudis in the country's east, where most cases of the deadly coronavirus have been detected, witnesses said, as the death toll from the SARS-like virus in the kingdom hits 15.

Scores of people have reported to the emergency services at hospitals in the city of Al-Ahsa in Eastern Province after showing even the slightest signs of a fever.

"I felt the symptoms of a cold, accompanied by a fever," a young man told AFP by telephone on Monday from one hospital where he was admitted and placed in quarantine.

"I came to hospital. The symptoms disappeared by the end of the day, but I am still kept in a quarantine with other patients, which scares me," he said, asking to remain anonymous.

Anyone showing possible symptoms of the virus after being admitted to hospitals in Al-Ahsa region had been placed in isolation, Saudi authorities said.

Fifteen of the 24 people who have contracted the coronavirus in Saudi Arabia since August have died, Health Minister Abdullah al-Rabia said on Sunday.

A total of 13 cases have been detected in the King Fahd hospital, in Al-Ahsa. Among those was a nine-year-old girl who died a few hours after arriving at hospital with a strong fever.

Another fatality was Haidar Ghanem, a disabled 21-year-old man who had a "strong fever" for a week, according to his father Mokhtar. He died last Thursday, four days after being admitted to hospital after falling unconscious.

The minister said on Sunday that three new suspected cases had been identified.

In all, 34 cases have been reported worldwide since the virus was first detected in September 2012, with 18 of the victims dying, according to the World Heath Organization.

While the virus has been deadliest in Saudi Arabia, cases have also been reported in Jordan, Germany, Britain and France where two patients are now in hospital in the northern city of Lille.

The virus is a cousin of Severe Acute Respiratory Syndrome (SARS), which triggered a scare 10 years ago when it erupted in east Asia, leaping to humans from animal hosts and eventually killing some 800 people.

In France, two people have contracted the virus, including one who on Sunday was moved to intensive care after his condition deteriorated.

He is believed to have been infected after sharing a hospital ward with a 65-year-old man, who was later diagnosed with the virus thought to have been contracted while he was on holiday in Dubai last month.

The WHO urged people in France to stay calm and not overburden hospitals to allow for proper treatment of those actually infected with the virus.

"There have only been less than a handful of cases in France so far... The chances are very small that anyone in France has this disease," WHO spokesman Gregory Hartl told AFP.

However Keiji Fakuda, WHO's assistant director general for health security and environment, told a Riyadh news conference on Sunday the new virus posed an "important and major challenge" for countries affected and for the world generally.

He said experts were still grappling to understand all aspects of the virus and how humans become infected, stressing, however, that "this new virus is not the SARS virus."

"This is a new infection and there are also many gaps in our knowledge that will inevitably take time to fill in," a WHO statement cited Fukuda as saying.

]]> Mon, 20 MAY 2013 12:44:21 AEST Blacksburg VA (SPX) May 15, 2013 - The newest public health threat in developing countries may not be a cinematic-quality emerging disease but actually a disease from animals that was identified more than 100 years ago.

Virginia Tech researchers have identified leptospirosis as a significant health threat in Botswana. The world's most common disease transmitted to humans by animals, according to the World Health Organization, leptospirosis is a two-phase disease that begins with flu-like symptoms but can cause meningitis, liver damage, pulmonary hemorrhage, renal failure, and even death if untreated.

"The problem in Botswana and much of Africa is that leptospirosis may remain unidentified in animal populations but contribute importantly to human disease, possibly misdiagnosed as other more iconic endemic diseases such as malaria," said disease ecologist Kathleen Alexander , an associate professor of wildlife in the College of Natural Resources and the Environment.

Under a grant from the National Science Foundation, researchers in Alexander's wildlife health and disease laboratory have identified banded mongoose in Botswana as being infected with Leptospira interrogans, the pathogen that causes leptospirosis.

The animals, although wild, live near humans, sharing scarce water resources and scavenging in human waste. The pathogen can pass to humans through soil or water contaminated with infected urine. Mongoose and other species are consumed as bushmeat, which may also contribute to leptospirosis exposure and infection in humans.

This first published confirmation of leptospirosis in wildlife in Botswana appeared today (May 14, 2013) in the journal Zoonoses and Public Health. The study, "Leptospira interrogans at the Human-Wildlife Interface in Northern Botswana: A Newly Identified Public Health Threat," was written by postdoctoral associates Sarah Jobbins and Claire Sanderson, and Alexander, who is affiliated with Virginia Tech's Fralin Life Science Institute. Jobbins is lead author and Alexander is corresponding author.

"Given the global importance of this disease, I was convinced that we were going to find Leptospira interrogans in some species in the ecosystem," said Alexander. "The pathogen had not been reported previously in the country with the exception of one cow in Southern Botswana over a quarter of a century ago.

"We looked at public health records dating back to 1974 and there were no records of any human cases," she continued. "The doctors who I talked with at the hospital said they were not expecting to see the disease in patients as they were not aware that the pathogen occurred in the country."

"This pathogen has a wide host range and can infect many animals, both wild and domestic, including dogs," said Jobbins. "Banded mongoose are not likely the only species infected in the ecosystem, but they serve as an important sentinel allowing us to identify health risks to humans."

Alexander, a veterinarian and researcher with the Center for African Resources: Animals, Communities and Land Use (CARACAL), has been conducting a long-term study of human, wildlife, and environmental health in the Chobe District of Northern Botswana, an area that includes the Chobe National Park, forest reserves, and surrounding villages.

"Our research program is directed at understanding how people, animals, and the environment are connected, including the potential for diseases to move between humans and wildlife," said Alexander. "Diseases such as leptospirosis that have been around for a very long time are often overlooked and underfunded amid the hunt for the next newly emerging disease."

"Leptospirosis was first described in 1886, but we still know little about the occurrence of this disease in Africa, despite the knowledge that it can impact human health substantially and that Africa is expected to have the highest burden of disease," said Jobbins.

With the identification of leptospirosis in the ecosystem, Alexander worries about the public health threat this disease may pose to the highly immune-compromised population of Botswana, where 25 percent of 15- to 49-year-olds are HIV positive, according to the Botswana Government's Ministry of Health.

"In much of Africa, people die without a cause being determined," she continued. "Leptospirosis is likely impacting populations in the region, but without knowledge that the organism is present in the environment, overburdened public health officials are unlikely to identify clinical cases in humans, particularly if the supporting diagnostics are not easily accessible."

The researchers looked for Leptospira interrogans in archived kidneys collected from banded mongoose that had been found dead from a variety of causes. Of the sampled mongoose, 43 percent tested positive for the pathogen.

"Given this high prevalence in mongoose, we believe that Botswana possesses an as-yet-unidentified burden of human leptospirosis," said Jobbins. "There is an urgent need to look for this disease in humans who have clinical signs consistent with infection."

Because banded mongoose have an extended range across sub-Saharan Africa, the study results have important implications to public health beyond Botswana. Across Africa, human and animal populations overlap, and many species are becoming tolerant of humans.

"Investigating exposure in other wildlife, and assessing what species act as carriers, is essential for improving our understanding of human, wildlife, and domestic animal risk of leptospirosis in this ecosystem," the researchers wrote.

The study also cited climate change predictions that the region will become more arid, concentrating humans and animals even more around limited surface water, increasing the potential for disease transmission of water-associated organisms.

"Infectious diseases, particularly those that can be transmitted from animals, often occur where people are more vulnerable to environmental change and have less access to public health services," said Alexander.

"This is particularly true in Africa. While we are concerned about emerging diseases that might threaten public health - the next new pandemic - we need to be careful that we don't drop the ball and stop pursuing important diseases like leptospirosis that have already been identified as having a significant impact on human health.

"As humans move into traditional wildlife areas and transform landscapes, interactions between humans and wildlife will change in important ways," she continued. "Many wildlife species are becoming progressively more urbanized, setting the stage for increased contact with humans and the potential for transmission of diseases such as leptospirosis. The more important threat to human health likely arises from known pathogens occurring in changing landscapes."

Alexander is working together with the Botswana government to identify immediate research and management action - in particular, the need to alert frontline medical practitioners and public health officials to the potential for leptospirosis infections to occur in humans and to include this pathogen in diagnostic assessments and disease surveillance.

]]> Mon, 20 MAY 2013 12:44:21 AEST Heidelberg, Germany (SPX) May 15, 2013 - On 31 March 2013, the Chinese National Health and Family Planning Commission announced human cases of novel H7N9 influenza virus infections. A group of scientists, led by Professor Chen Hualan of the Harbin Veterinary Research Institute at the Chinese Academy of Agricultural Sciences, has investigated the origins of this novel H7N9 influenza virus and published their results in Springer's open access journal Chinese Science Bulletin (SpringerOpen).

Following analysis of H7N9 influenza viruses collected from live poultry markets, it was found that these viruses circulating among birds were responsible for human infections.

These results provide a basis for the government to take actions for controlling this public health threat. The novel H7N9 influenza virus was identified in China as the agent, that causes a flu-like disease in humans, resulting in some deaths.

A total of 970 samples were collected from live poultry markets and poultry farms located in Shanghai and Anhui Province. Samples analyzed included drinking water, feces, contaminated soil, and cloacal and tracheal swabs.

Of these samples, 20 were positive for the presence of H7N9 influenza viruses. All of the positive samples originated from live poultry markets in Shanghai. Of these 20 positive samples, 10 were isolated from chickens, 3 from pigeons, and 7 were from environmental samples.

The complete genome of three H7N9 isolates, from a chicken, pigeon, and environmental sample, was sequenced and deposited into the GISAID database. Genetic analysis of these isolates revealed high homology across all eight gene segments.

The analysis of these novel H7N9 influenza virus isolates showed that that the six internal genes were derived from avian H9N2 viruses, but the ancestor of their hemagglutinin (HA) and neuraminidase (NA) genes is unknown.

HA receptor-binding specificity is a major molecular determinant for the host range of influenza viruses. Within the HA protein of novel H7N9 viruses, there was a leucine residue at position 226, which is characteristic of the HA gene in human influenza viruses. This finding implies that H7N9 viruses have partially acquired human receptor-binding specificity.

The authors conclude: "We suggest that strong measures, such as continued surveillance of avian and human hosts, control of animal movement, shutdown of live poultry markets, and culling of poultry in affected areas, should be taken during this initial stage of virus prevalence to prevent a possible pandemic.

"Additionally, it is also imperative to evaluate the pathogenicity and transmissibility of these H7N9 viruses, and to develop effective vaccines and antiviral drugs so as to reduce their adverse effects upon human health."

Shi J Z, Deng G H, Liu P H, et al (2013). Isolation and characterization of H7N9 viruses from live poultry markets-Implication of the source of current H7N9 infection in humans. Chinese Science Bulletin. DOI: 10.1007/s11434-013-5873-4. The article is freely available on SpringerLink

]]> Mon, 20 MAY 2013 12:44:21 AEST Shanghai (AFP) May 16, 2013 - The virus has already killed her mother, and Kelly Gu's father lies critically ill with H7N9 bird flu in a Shanghai hospital bed -- the only couple both infected in China's outbreak of the disease.

As her mother lay dying Gu was urgently summoned back to Shanghai from her doctoral studies in chemistry in France, but she was too late, missing the chance to say goodbye by a day.

In her first interview with Western media, she told AFP she knew her mother was dead when her father, already showing symptoms of fatigue and fever, told her by phone: "It's just like winning a lottery, it's a lottery of very bad luck."

The Gu family's experience portrays a government-run health system battling a new disease, while sometimes showing a lack of empathy for victims and their kin.

The H7N9 strain of bird flu has sickened 130 people in mainland China and killed 35 of them, according to the latest available national figures.

The government and World Health Organization (WHO) have repeatedly said there is no evidence of sustained human-to-human transmission, but Gu's parents could be a rare "family cluster".

Experts of the US government's Centers for Disease Control public health agency say such clusters could represent limited spread between people caused by prolonged, unprotected exposure.

If the virus were to mutate into a form easily transmissible among humans it could trigger a pandemic.

Gu, 26, said her father, who works in a property management office, was sad about his only child living overseas -- a fact that may have saved her life.

Her mother, a 52-year old housewife she described as an optimist with a knack for technology, was probably infected on her daily trip to market near their home in western Shanghai.

She had already been ill for five days by the time the central government revealed the H7N9 outbreak, going twice to a district-level hospital. The next day, having trouble breathing and suffering from fever, she went to one of Shanghai's finest hospitals, Huashan.

But the emergency room doctor sent her home, ordering three days rest. She was dead in two.

Beijing has been praised by the WHO for openness over H7N9, in contrast to its cover-up a decade ago of Severe Acute Respiratory Syndrome (SARS), which originated in China and killed 800 people globally.

But critics question why it took the government three weeks to make an announcement after the first deaths, despite Internet postings describing a mysterious illness at a Shanghai hospital.

And the case of Gu's parents -- she declined to give their full names -- reflects how the government-run health system struggled in the early stages.

"(The doctor) hadn't seen the scanning result of my mother's lung and he hadn't asked her to take another one. He just judged it was a normal fever and sent her back home," Gu said.

Her mother died on April 3 of acute respiratory distress, and was confirmed to have the H7N9 virus a day later, one of Shanghai's earliest cases. Her father had started showing symptoms on April 1.

There are only two other such "family clusters", a father and two sons in Shanghai and another father and son in Shandong province.

Gu's father has defied doctors' expectations by clinging to life, but is under sedation on a respirator and does not respond when she tries to talk with him on a video link.

She makes a daily trek to see him at an isolation hospital in southwest Shanghai, where green lawns give it the atmosphere of a country club, and consult with doctors who say there is little they can do.

In desperation, she sneaked into a news conference with a visiting WHO team last month to ask about possible treatment for her father, but Shanghai officials cut her off before she could complete her question.

"Even though the doctor said the possibility was zero, I never gave up," she said. "If he can recover, I'll stay with him. I'll take the place of my mother and take care of him."

But her father had seen the rapid deterioration in his wife's health, and the symptoms described by a public health poster in Huashan hospital. As he fell ill he recognised the symptoms in himself.

"When my mother passed away, my father just held her hand and said, 'Wait for me. I'll be there to accompany you,'" Gu said.

]]> Mon, 20 MAY 2013 12:44:21 AEST Boston MA (SPX) May 14, 2013 - In the summer of 1968, a new strain of influenza appeared in Hong Kong. This strain, known as H3N2, spread around the globe and eventually killed an estimated 1 million people.

A new study from MIT reveals that there are many strains of H3N2 circulating in birds and pigs that are genetically similar to the 1968 strain and have the potential to generate a pandemic if they leap to humans.

The researchers, led by Ram Sasisekharan, the Alfred H. Caspary Professor of Biological Engineering at MIT, also found that current flu vaccines might not offer protection against these strains.

"There are indeed examples of H3N2 that we need to be concerned about," says Sasisekharan, who is also a member of MIT's Koch Institute for Integrative Cancer Research.

"From a pandemic-preparedness point of view, we should potentially start including some of these H3 strains as part of influenza vaccines." Influenza evolution

In the past 100 years, influenza viruses that emerged from pigs or birds have caused several notable flu pandemics. When one of these avian or swine viruses gains the ability to infect humans, it can often evade the immune system, which is primed to recognize only strains that commonly infect humans.

Strains of H3N2 have been circulating in humans since the 1968 pandemic, but they have evolved to a less dangerous form that produces a nasty seasonal flu. However, H3N2 strains are also circulating in pigs and birds.

Sasisekharan and his colleagues wanted to determine the risk of H3N2 strains re-emerging in humans, whose immune systems would no longer recognize the more dangerous forms of H3N2. This type of event has a recent precedent: In 2009, a strain of H1N1 emerged that was very similar to the virus that caused a 1918 pandemic that killed 50 million to 100 million people.

"We asked if that could happen with H3," Sasisekharan says. "You would think it's more readily possible with H3 because we observe that there seems to be a lot more mixing of H3 between humans and swine."

Genetic similarities
In the new study, the researchers compared the 1968 H3N2 strain and about 1,100 H3 strains now circulating in pigs and birds, focusing on the gene that codes for the viral hemagglutinin (HA) protein.

After comparing HA genetic sequences in five key locations that control the viruses' interactions with infected hosts, the researchers calculated an "antigenic index" for each strain. This value indicates the percentage of these genetic regions identical to those of the 1968 pandemic strain and helps determine how well an influenza virus can evade a host's immune response.

The researchers also took into account the patterns of attachment of the HA protein to sugar molecules called glycans. The virus' ability to attach to glycan receptors found on human respiratory-tract cells is key to infecting humans.

Seeking viruses with an antigenic index of at least 49 percent and glycan-attachment patterns identical to those of the 1968 virus, the research team identified 581 H3 viruses isolated since 2000 that could potentially cause a pandemic. Of these, 549 came from birds and 32 from pigs.

The researchers then exposed some of these strains to antibodies provoked by the current H3 seasonal-flu vaccines. As they predicted, these antibodies were unable to recognize or attack these H3 strains. Of the 581 HA sequences, six swine strains already contain the standard HA mutations necessary for human adaptation, and are thus capable of entering the human population either directly or via genetic reassortment, Sasisekharan says.

"One of the amazing things about the influenza virus is its ability to grab genes from different pools," he says. "There could be viral genes that mix among pigs, or between birds and pigs."

Sasisekharan and colleagues are now doing a similar genetic study of H5 influenza strains. The H3 study was funded by the National Institutes of Health and the National Science Foundation.

The study, which appears in the May 10 issue of the journal Scientific Reports, also offers the World Health Organization and public-health agencies' insight into viral strains that should raise red flags if detected.

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