Emory Report
June 8, 2009
Volume 61, Number 32


CEPAR Director Alex Isakov on Emory's response

An international public health response
National public health institutes (NPHIs) around the world, including the CDC, are on the first line of defense in diagnosing and containing outbreaks such as H1N1. Strengthening these public health systems is essential to global health.

For the past few years many of these institutes have been linked through the International Association of National Public Health Institutes (IANPHI), created in 2005 through support from the Gates Foundation and led by Emory and its partner, the national public health association of Finland.

“The ability to share expertise, experience and current assessments among scientific institutes around the world is critical to saving lives,” says Jeffrey Koplan, director of Emory’s Global Health Institute and president of IANPHI.

   

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 June 8, 2009
Flu outbreak mobilizes response

The recent A(H1N1) influenza outbreak rallied a wide variety of Emory departments, faculty, administrators and health care workers who rose to meet the many challenges presented by this rapidly emerging virus.

Coordinated by Emory’s Office of Critical Event Preparedness and Response (CEPAR), directed by emergency medicine physician Alex Isakov, the University’s response began with communications to faculty, staff, students and frontline health care professionals, who were kept informed through the CEPAR Web site as well as the Emory and Woodruff Health Sciences Center home pages and all-Emory e-mails. Leadership from across the University and Healthcare mobilized quickly to address the outbreak.

“Talented leaders and experts from across the enterprise worked together to minimize the impact of this novel influenza virus at Emory and the broader community. Our ability to coordinate an effective response will be important again as we anticipate what may be a very tough flu season this fall,” says Isakov.

Emory’s expertise in infectious diseases research and international public health leadership also were brought to the national and international forefront in the crisis.

Research on the frontline
Emory scientists quickly joined a national effort to develop better methods of rapid detection, prevention and treatment for H1N1.

As one of six National Institutes of Health (NIH) Centers of Excellence for Influenza Research and Surveillance, the Emory-University of Georgia Influenza Pathogenesis and Immunology Research Center (IPIRC), first established in 2007, was quickly asked to focus its research specifically on H1N1 as part of the NIH Pandemic Public Health Research Response Plan.

A flu center team led by microbiologist Richard Compans is using technology they developed with virus-like particles (VLPs) to develop a quicker, more efficient alternative to the current method of making flu vaccine by growing it in chicken eggs. VLPs are empty shells that look like viruses but don’t reproduce. In March, the researchers had reported the effectiveness of their VLP vaccine in mice in the journal PLOS One.

Another research team led by Rafi Ahmed, director of the Emory Vaccine Center, along with scientists at the University of Chicago, is using a new method of rapidly producing highly targeted monoclonal antibodies to develop a diagnostic test as well as a temporary therapy against H1N1. The antibodies, which can be isolated from a small amount of the blood of humans infected with the virus, could be targeted against H1N1 and rapidly reproduced to detect or attack the virus. Ahmed’s group first published the monoclonal antibody technology last April in the journal Nature.

Report to the vaccine community
The Emory-led Atlanta Vaccine Dinner Club brought the local scientific community together in the recently renovated WHSCAB Auditorium on May 20 to present on H1N1.

Four international experts, one reporting from “the eye of the storm” in Mexico and three from the CDC, drew a packed room including visitors from Atlanta and the Southeast.

Guillermo Ruiz-Palacios, director of infectious diseases at a major hospital in Mexico City, described how he became involved in handling the H1N1 outbreak by taking a worried call from a former student in Oaxaca. His student had isolated an unidentifiable virus at first thought to be related to SARS.

“That was when we got the sense that we had something really explosive on our hands,” said Ruiz-Palacios.
Soon his hospital was seeing 200 patients a day, while outside the hospital Mexico closed first schools and then other public facilities in an effort to dampen the outbreak.

Dan Jernigan, deputy director of the CDC’s National Center for Immunization and Respiratory Diseases, discussed why the emerging virus preferentially affects young people. The reason: until 1957, annual waves of flu included some of the same H1N1 elements that came from the devastating 1918 outbreak.

Scott Dowell, director of CDC’s global disease detection program, explained technology that helped a federal cross-border monitoring program detect the new virus variety in San Diego.

CDC’s H1N1 incident commander, Steve Redd, said public health officials planned intensively for pandemic flu but did not anticipate the speed at which the outbreak would arrive in the U.S. He said the CDC is now focused on vaccine development, aiding nations in the Southern Hemisphere, and refining policy recommendations on protective equipment for health care workers.

— Staff Reports