medicalcondition:influenza

  • Russian biologist plans more CRISPR-edited babies
    https://www.nature.com/articles/d41586-019-01770-x

    Je n’ai pas réussi à extraire une simple partie de ce texte, tant l’ensemble me semble complètement hors-jeu. Je partage l’avis de l’auteur de l’article : la folie et l’hubris scientifiques se serrent la main dans le dos de l’humanité. Choisir de surcroit des femmes en difficulté (HIV positive) est bien dans la lignée machiste d’une science qui impose plus qu’elle ne propose.

    La guerre internationale à la réputation, la course à « être le premier » (ici le masculin s’impose), la science sans conscience ne peuvent que provoquer ce genre de dérives. Il faudra réfléchir à une « slow science » et à un réel partage des découvertes, qui permettrait de prendre le temps du recul, et qui pourrait associer la société civile (ici au sens de celle qui n’est pas engagée dans la guerre des sciences).

    The proposal follows a Chinese scientist who claimed to have created twins from edited embryos last year.
    David Cyranoski

    Denis Rebrikov

    Molecular biologist Denis Rebrikov is planning controversial gene-editing experiments in HIV-positive women.

    A Russian scientist says he is planning to produce gene-edited babies, an act that would make him only the second person known to have done this. It would also fly in the face of the scientific consensus that such experiments should be banned until an international ethical framework has agreed on the circumstances and safety measures that would justify them.

    Molecular biologist Denis Rebrikov has told Nature he is considering implanting gene-edited embryos into women, possibly before the end of the year if he can get approval by then. Chinese scientist He Jiankui prompted an international outcry when he announced last November that he had made the world’s first gene-edited babies — twin girls.

    The experiment will target the same gene, called CCR5, that He did, but Rebrikov claims his technique will offer greater benefits, pose fewer risks and be more ethically justifiable and acceptable to the public. Rebrikov plans to disable the gene, which encodes a protein that allows HIV to enter cells, in embryos that will be implanted into HIV-positive mothers, reducing the risk of them passing on the virus to the baby in utero. By contrast, He modified the gene in embryos created from fathers with HIV, which many geneticists said provided little clinical benefit because the risk of a father passing on HIV to his children is minimal.

    Rebrikov heads a genome-editing laboratory at Russia’s largest fertility clinic, the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology in Moscow and is a researcher at the Pirogov Russian National Research Medical University, also in Moscow.

    According to Rebrikov he already has an agreement with an HIV centre in the city to recruit women infected with HIV who want to take part in the experiment.

    But scientists and bioethicists contacted by Nature are troubled by Rebrikov’s plans.

    “The technology is not ready,” says Jennifer Doudna, a University of California Berkeley molecular biologist who pioneered the CRISPR-Cas9 genome-editing system that Rebrikov plans to use. “It is not surprising, but it is very disappointing and unsettling.”

    Alta Charo, a researcher in bioethics and law at the University of Wisconsin-Madison says Rebrikov’s plans are not an ethical use of the technology. “It is irresponsible to proceed with this protocol at this time,” adds Charo, who sits on a World Health Organization committee that is formulating ethical governance policies for human genome editing.
    Rules and regulations

    Implanting gene-edited embryos is banned in many countries. Russia has a law that prohibits genetic engineering in most circumstances, but it is unclear whether or how the rules would be enforced in relation to gene editing in an embryo. And Russia’s regulations on assisted reproduction do not explicitly refer to gene editing, according to a 2017 analysis of such regulations in a range of countries. (The law in China is also ambiguous: in 2003, the health ministry banned genetically modifying human embryos for reproduction but the ban carried no penalties and He’s legal status was and still is not clear).

    Rebrikov expects the health ministry to clarify the rules on the clinical use of gene-editing of embryos in the next nine months. Rebrikov says he feels a sense of urgency to help women with HIV, and is tempted to proceed with his experiments even before Russia hashes out regulations.

    To reduce the chance he would be punished for the experiments, Rebrikov plans to first seek approval from three government agencies, including the health ministry. That could take anywhere from one month to two years, he says.

    Konstantin Severinov, a molecular geneticist who recently helped the government design a funding program for gene-editing research, says such approvals might be difficult. Russia’s powerful Orthodox church opposes gene editing, says Severinov, who splits his time between Rutgers University in Piscataway, New Jersey, and the Skolkovo Institute of Science and Technology near Moscow.

    Before any scientist attempts to implant gene-edited embryos into women there needs to be a transparent, open debate about the scientific feasibility and ethical permissibility, says geneticist George Daley at Harvard Medical School in Boston, Massachusetts, who also heard about Rebrikov’s plans from Nature.

    One reason that gene-edited embryos have created a huge global debate is that, if allowed to grow into babies, the edits can be passed on to future generations — a far-reaching intervention known as altering the germ line. Researchers agree that the technology might, one day, help to eliminate genetic diseases such as sickle-cell anaemia and cystic fibrosis, but much more testing is needed before it is used in the alteration of human beings.

    In the wake of He’s announcement, many scientists renewed calls for an international moratorium on germline editing. Although that has yet to happen, the World Health Organization, the US National Academy of Sciences, the UK’s Royal Society and other prominent organizations have all discussed how to stop unethical and dangerous uses — often defined as ones that pose unnecessary or excessive risk — of genome editing in humans.
    HIV-positive mothers

    Although He was widely criticized for conducting his experiments using sperm from HIV-positive fathers, his argument was that he just wanted to protect people against ever getting the infection. But scientists and ethicists countered that there are other ways to decrease the risk of infection, such as contraceptives. There are also reasonable alternatives, such as drugs, for preventing maternal transmission of HIV, says Charo.

    Rebrikov agrees, and so plans to implant embryos only into a subset of HIV-positive mothers who do not respond to standard anti-HIV drugs. Their risk of transmitting the infection to the child is higher. If editing successfully disables the CCR5 gene, that risk would be greatly reduced, Rebrikov says. “This is a clinical situation which calls for this type of therapy,” he says.

    Most scientists say there is no justification for editing the CCR5 gene in embryos, even so, because the risks don’t outweigh the benefits. Even if the therapy goes as planned, and both copies of the CCR5 gene in cells are disabled, there is still a chance that such babies could become infected with HIV. The cell-surface protein encoded by CCR5 is thought to be the gateway for some 90% of HIV infections, but getting rid of it won’t affect other routes of HIV infection. There are still many unknowns about the safety of gene editing in embryos, says Gaetan Burgio at the Australian National University in Canberra. And what are the benefits of editing this gene, he asks. “I don’t see them.”
    Hitting the target

    There are also concerns about the safety of gene editing in embryos more generally. Rebrikov claims that his experiment — which, like He’s, will use the CRISPR-Cas9 genome-editing tool — will be safe.

    One big concern with He’s experiment — and with gene-editing in embryos more generally — is that CRISPR-Cas9 can cause unintended ‘off-target’ mutations away from the target gene, and that these could be dangerous if they, for instance, switched off a tumour-suppressor gene. But Rebrikov says that he is developing a technique that can ensure that there are no ‘off-target’ mutations; he plans to post preliminary findings online within a month, possibly on bioRxiv or in a peer-reviewed journal.

    Scientists contacted by Nature were sceptical that such assurances could be made about off-target mutations, or about another known challenge of using CRISPR-Cas 9 — so-called ‘on-target mutations’, in which the correct gene is edited, but not in the way intended.

    Rebrikov writes, in a paper published last year in the Bulletin of the RSMU, of which he is the editor in chief, that his technique disables both copies of the CCR5 gene (by deleting a section of 32 bases) more than 50% of the time. He says publishing in this journal was not a conflict of interest because reviewers and editors are blinded to a paper’s authors.

    But Doudna is sceptical of those results. “The data I have seen say it’s not that easy to control the way the DNA repair works.” Burgio, too, thinks that the edits probably led to other deletions or insertions that are difficult to detect, as is often the case with gene editing.

    Misplaced edits could mean that the gene isn’t properly disabled, and so the cell is still accessible to HIV, or that the mutated gene could function in a completely different and unpredictable way. “It can be a real mess,” says Burgio.

    What’s more, the unmutated CCR5 has many functions that are not yet well understood, but which offer some benefits, say scientists critical of Rebrikov’s plans. For instance, it seems to offer some protection against major complications following infection by the West Nile virus or influenza. “We know a lot about its [CCR5’s] role in HIV entry [to cells], but we don’t know much about its other effects,” says Burgio. A study published last week also suggested that people without a working copy of CCR5 might have a shortened lifespan.

    Rebrikov understands that if he proceeds with his experiment before Russia’s updated regulations are in place, he might be considered a second He Jiankui. But he says he would only do so if he’s sure of the safety of the procedure. “I think I’m crazy enough to do it,” he says.

    Nature 570, 145-146 (2019)
    doi: 10.1038/d41586-019-01770-x

  • Toux, fièvre, vomissements… une étrange épidémie dans un avion Emirates reliant Dubaï à New York
    https://www.ouest-france.fr/economie/transports/avion/toux-fievre-vomissements-une-etrange-epidemie-dans-un-avion-emirates-re


    Foto : Cortesía
    Alerta bacteriológica en Nueva York : Avión aterriza con 100 pasajeros enfermos

    À leur arrivée à New York, mercredi, plus 500 passagers d’un A380 de la compagnie Emirates ont été examinés. Une centaine d’entre eux présentaient de la fièvre, de la toux et certains étaient pris de nausées. Dix personnes ont été hospitalisées.

    Dix personnes hospitalisées, plus de 100 passagers se plaignant de toux et de fièvre. Le rappeur Vanilla Ice, parmi les 521 personnes bloquées sur le tarmac à New York : l’aéroport John F. Kennedy, s’est mobilisé mercredi face à une alerte santé d’une rare ampleur, probablement due à un épisode grippal.

    L’alerte a été donnée vers 09 h du matin (13 h GMT) à l’atterrissage du vol EK203 de la compagnie Emirates en provenance de Dubaï, assuré par un A380 avec 521 personnes à bord.

    Toux, fièvre et vomissements
    « On nous a informés qu’un grand nombre de passagers étaient malades : 106 présentaient des symptômes allant de la toux à de la fièvre et des vomissements », a expliqué Oxiris Barbot, responsable des services de santé de New York.

    L’appareil a alors été conduit « à distance » des terminaux, et des équipes médicales, dont des spécialistes de l’agence fédérale des Centres de contrôle et de prévention des maladies (CDC), sont montées à bord pour examiner les 521 passagers.

    Parmi eux, le rappeur Vanilla Ice, qui a informé ses fans qu’il était assis à l’étage supérieur de l’A380. « C’est dingue. Apparemment il y a plus de 100 personnes malades à l’étage inférieur, je suis content d’être en haut », a-t-il notamment tweeté.

    • Du coup, on en inspecte d’autres…
      #EK203 (au cas où…)

      These flights have been quarantined and evaluated over sick passengers | Deseret News (article du 9/09/2018)
      https://www.deseretnews.com/article/900030842/these-flights-have-been-quarantined-and-evaluated-over-sick-passengers.

      Several flights across the country have been quarantined and evaluated over the past few days after some passengers showed signs of sickness.

      On Wednesday, a flight from Dubai to John F. Kennedy Airport was quarantined after at least 19 passengers suffered from a confirmed case of the flu, according to ABC News.

      The CDC quarantined the Emirates aircraft, which held 520 passengers. The CDC evaluated 100 passengers, who said they suffered from coughs, headaches, sore throats and fevers, ABC News reported.

      At least 10 people were hospitalized as a “precaution.” The rest were cleared.

      Given the symptoms that we are seeing in the patients and given the history that they present, it looks like this is probably influenza,” acting New York City Health Commissioner Dr. Oxiris Barbot said. “But again, until we have our final results late tonight we won’t be able to give a final determination on what the underlying cause is of this illness.

      Similarly, Southwest Airlines passengers on four flights between Dallas, Houston and Harlingen, Texas, may have been exposed to #measles, the airline company told KTRK-TV.

      The airline said it contacted customers who traveled on the plane two weeks ago to see if anyone onboard had the highly contagious virus.

      The Houston Health Department is working with the Centers for Disease Control and Prevention to speak with the passengers.

      The department told KTRK that the passenger who had the virus did not visit the airport after their flight. They stayed in a waiting room for an hour after the flight.

      And, as The Verg_e reported, two more international flights were evaluated after passengers were caught coughing and showing signs of sickness.

      Both flights were from American Airlines, flying from Munich and Paris to Philadelphia International airport. About 12 people on each flight felt sick, according to a statement from the airport.

      The airport said “_all passengers on the two flights — totaling about 250 plus crew — were held for a medical review and the CDC was notified.

      Allen Parmet, an aerospace medicine expert, told The Verge, “It’s actually pretty common to have somebody coughing in a plane.

      If it turns out to be the flu, this could be an early forecast of the flu season ahead. And the CDC has some tips for keeping the virus from spreading: get vaccinated, and stay home when you’re sick, if you can,” according to The Verge.

      #grippe #flu #influenza
      #rougeole

      les consignes du CDC :
      #se_faire_vacciner
      #rester_chez_soi
      #ne_pas_tousser_dans_l'avion (bon, ça c’est de moi…)

    • C’est un coup des musulmans du pèlerinage #Hajj

      Health Scares At Two U.S. Airports Linked To Pilgrims Arriving From Muslim Hajj In Mecca
      https://www.inquisitr.com/5064809/health-scares-at-two-us-airports-linked-to-pilgrims-arriving-from-muslim-

      U.S. health officials revealed on Friday that major health scares at two U.S. airports involving inbound flights are tied to pilgrims returning from Hajj, the pilgrimage to Mecca that Muslims take at least once in their lifetime, and which ended in late August.

      Health officials on Wednesday sent an emergency response team to the John F. Kennedy International Airport in New York after more than 100 Emirates passengers from Dubai showed flu-like symptoms.

      In an interview with Reuters, Martin Cetron, director for the division of Global Migration and Quarantine at the U.S. Centers for Disease Control and Prevention, said that 11 of the nearly 549 passengers evaluated at the airport were sent to a local hospital for further testing.

      Ten were tested for respiratory pathogen in an attempt to rule out serious infections that may pose health threats to the public.

      Our most critical issue was to rule several respiratory illnesses of urgent public health significance,” Cetron said.

      Two tested positive for a virulent type of the influenza A virus. One of the two was found gravely ill with pneumonia and also infected with another respiratory virus. Another passenger was positive for the cold virus.

      Seven crew members of the flight who were not at the pilgrimage tested negative for respiratory infections that could be of public health concern.
       
      Another health scare happened at the Philadelphia International Airport the next day. Medical teams had to screen passengers who boarded two American Airlines flights from Europe when 12 passengers showed flu-like symptoms. One of the sick passengers visited Mecca for the Muslim pilgrimage.

      Of the 11 passengers taken to the hospital for evaluation, 10 had respiratory symptoms and one exhibited signs of food poisoning. The 10 patients were also tested for Middle East Respiratory Syndrome, but none was positive. MERS is a highly contagious viral respiratory illness first reported in Saudi Arabia in 2012.

      The incident prompted a medical review of 250 passengers from the two flights. Authorities said that this was done as a precautionary measure.

      While airport operations were not affected, out of an abundance of caution, officials performed medical evaluations and assessments,” the Philadelphia International Airport said on Twitter.

      CDC spokesman Benjamin Haynes said that CDC and public health officers worked with emergency medical service personnel and officials from the Customs and Border Protection to evaluate the sick passengers.

      Twelve were found to have coughs and sore throats, and one tested positive for flu. The CDC said that this is not unusual since flu is a year-round virus.

      #MERS-CoV (ça faisait longtemps, tiens !)

  • Inside the secret U.S. stockpile meant to save us all in a bioterror attack - The Washington Post
    https://www.washingtonpost.com/news/to-your-health/wp/2018/04/24/inside-the-secret-u-s-stockpile-meant-to-save-us-all-in-a-bioterror-

    This is quite a different kind of warehouse. It and several others across the country are part of the $7 billion Strategic National Stockpile, a government repository of drugs and supplies ready for deployment in a bioterrorism or nuclear attack, or against an infectious disease outbreak — of either a known pathogen or some unknown threat with pandemic potential, which global health officials dub “Disease X” — or other major public health emergency. There are antibiotics, including the powerful medication Ciprofloxacin, vaccines for smallpox and anthrax and antivirals for a deadly influenza pandemic.

    #Etats-Unis

  • Surprising Human Immune Responses Could Lead to Better Flu Vaccines
    http://www.wired.com/2014/11/antibody-landscape-flu-vaccine

    ... when influenza infects someone, it not only triggers an immune response for that particular strain, but for all the strains of that type of flu that have ever infected the person. This phenomenon, named ‘back-boosting,’ means that our old immunity gets boosted every time we’re faced with a new flu virus. Typically, the back boost response was stronger for past strains that were closely related to the infecting strain.

    (...)

    This means scientists can try to predict how the virus might mutate (an active area of research) and base a vaccine on that, without worrying about diminishing protection against current circulating strains

  • PLOS Computational Biology: Wikipedia Usage Estimates Prevalence of Influenza-Like Illness in the United States in Near Real-Time
    http://www.ploscompbiol.org/article/info%3Adoi%2F10.1371%2Fjournal.pcbi.1003581

    We introduce a novel method of estimating, in near-real time, the level of influenza-like illness (ILI) in the United States (US) by monitoring the rate of particular Wikipedia article views on a daily basis. We calculated the number of times certain influenza- or health-related Wikipedia articles were accessed each day between December 2007 and August 2013 and compared these data to official ILI activity levels provided by the Centers for Disease Control and Prevention (CDC). We developed a Poisson model that accurately estimates the level of ILI activity in the American population, up to two weeks ahead of the CDC, with an absolute average difference between the two estimates of just 0.27% over 294 weeks of data. Wikipedia-derived ILI models performed well through both abnormally high media coverage events (such as during the 2009 H1N1 pandemic) as well as unusually severe influenza seasons (such as the 2012–2013 influenza season). Wikipedia usage accurately estimated the week of peak ILI activity 17% more often than Google Flu Trends data and was often more accurate in its measure of ILI intensity.

    Extrait de l’abstract, la totalité de l’article est disponible. Dont ce graphique (_on est meilleur que #Google_Flu_trends…)


    Figure 1. Time series plot of CDC ILI data versus estimated ILI data.
    (A) Wikipedia Full Model (Mf) accurately estimated 3 out of 6 ILI activity peaks and had a mean absolute difference of 0.27% compared to CDC ILI data. (B) Wikipedia Lasso Model (Ml) accurately estimated 2 out of 6 ILI activity peaks and had a mean absolute difference of 0.29% compared to CDC ILI data,. (C) Google Flue Trends (GFT) model accurately estimated 2 of 6 ILI activity peaks and had a mean absolute difference of 0.42% compared to CDC ILI data.

  • Respiratory viruses: the viruses we detect in the human respiratory tract
    http://virologydownunder.blogspot.com.au/2014/03/respiratory-viruses-viruses-we-can.html

    A list of the viruses we can and do detect in the (mostly upper) respiratory tract.

    The standard testing panel/diagnostic menu/respiratory panel comprises the influenza A and B viruses, parainfluenza virus 1-3, respiratory syncytial virus, human metapneumovirus, adenoviruses

    #santé #visualisation #virus

  • Should we fear avian H5N1 influenza?
    http://www.virology.ws/2012/01/03/should-we-fear-avian-h5n1-influenza

    we cannot say with any certainty that the virus has infected only about 600 people. What we do know is that among the 600 seriously ill individuals infected with influenza H5N1 who are admitted to hospital, over half of them die.

    To know the fatality rate of avian H5N1 influenza virus in humans, we need to divide the number of fatalities by the number of infections. We do not know that last number – but there are hints that it could be quite large. (...)

    down a dangerous path of fearing that H5N1 influenza virus might be used as a weapon of #bioterrorism, and restricting the publication of scientific papers on the virus.

    #santé #grippe #peur #censure

    • C’est très intéressant de mesurer l’étendue de ce qu’on ne connaît pas : combien de gens sont infectés, combien en sont morts ? le ratio de 50% correspond aux personnes dépistées à l’hôpital… mais il est fréquent qu’on meure sans savoir de quoi…