TUESDAY 16 SEPTEMBER 2014

SPI 1 WHY SHOULD BE A PUBLIC HEALTH PRIORITY? THE INFLUENZA TIMES We need to work on collaboration CONFERENCE NEWSPAPER

Yesterday morning’s SPI-track program But when it comes to inspiring changes in be- politicians, because in the end, they will decide kicked off with this simple key question. havior, scientists need to empathize with their on strategy and policy direction. “We need to SS2 MUGAS: REVIEW AND STATISTICAL ANALYSIS OF DATA Indeed, in order to limit the burden, stakeholders. For example, the data proving vac- understand why politicians behave the way they cines are safe mainly originate from high-income do. Politicians expect certainty. They are afraid influenza should become a public countries. But in order to raise confidence in low of being criticized on their integrity. But our PROF. health priority, and stakeholders should income countries, we will need data local risk statements are full of if’s, or’s and when’s. And (ERASMUS MC, THE groups can identify with, based on studies in so politicians are completely confused on what Efficacy and effectiveness ) PRESENTED understand the severity and impact these countries, said Abdulla Brooks, from the they should do. As a result, we are selling them THE OBJECTIVES OF THE of flu, and be involved. The SPI-track Infectious Diseases Unit at Kamalapur Field Site a hazard, a threat, and not something they can MUGAS FOUNDATION AND in Bangladesh. buy”, Capua said. ■ of oseltamivir unveiled generated a wide variety of ideas OUTLINED THE PROCEDURE TO INITIATE A PROJECT. Raina MacIntyre from the University of New to tackle the hurdle. Here are some MUGAS IS DEDICATED TO South Wales in Australia, demonstrated the role in the 1980s and 1990s. snapshots. of influenza vaccination in preventing heart The ongoing debate on the PROMOTING PUBLIC HEALTH diseases. “There are many ways in which infec- effectiveness of the newest BY ADDRESSING UNSOLVED Better surveillance fuels earlier detection and tious diseases overlap with coronary diseases. class of antivirals, the neu- SCIENTIFIC ISSUES THAT more effective information. “Flu is a moving target Therefore, we have to engage cardiologists in our raminidase inhibitors, has HAMPER EFFECTIVE EVIDENCE- and viruses are smart and simply unpredictable”, activities, and make them part of what we do. become a hurdle for public BASED DECISION-MAKING. said Ab Osterhaus, Erasmus MC , The Not only talk to them, but partner with them.” health response to seasonal Netherlands: “If we want to conquer the beast, we Vaccination is perhaps not perceived as an art of and pandemic influenza. need to use all available technologies and work on heroic medicine, but in the end, it is preventing a collaboration.” Surveillance systems are already large amount of heart diseases in people. An overview of the MUGAS- in lower respiratory tract complications were very effective and make annual vaccine reformula- initiated statistical review observed, with no difference between age groups. tion possible; on the basis of antibody presence Ilaria Capua, both virologist and Member of of all available data was Adverse events presented principally as gastro- Check our photo album in the population at large, it is possible to predict the Italian Parliament, stressed not only the presented by Prof. Arnold intestinal conditions, including vomiting and which viruses should be put in a vaccine. importance of communication with the public on Facebook Monto (University of nausea. Three clinical trials in pediatric patients at large and with fellow scientists, but also with www.facebook.com/ Michigan, USA). The aim were included, with age and clinical heterogenei- EuropeanScientistsFightingInfluenza of the study was to offer a ties calling for trial-specific analyses and second- thorough, independent and ary meta-analysis. Although no differences were The Multiparty Group for Advice on transparent meta-analysis of published and un- found or results were inconclusive for two trials published data from clinical trials, carried during in asthmatic children, statistically significant Science (MUGAS) offered yesterday or follow us on Twitter the procedure of licensure of the neuraminidase reduction in the time to alleviation was detected @ESWIRigaConfere a timely satellite symposium on the inhibitors. Despite different routes of administra- in healthy children. Dr. Dobson concluded that review and statistical analysis of tion, oseltamivir and have a similar although the use of neuraminidase inhibitors mechanism of action and data on both antivirals should be weighed against the risk, the meta- The Heinrich Pette Institute (HPI), located in Hamburg/Germany, is dedicated to oseltamivir data. Nancy Cox (Centers for were evaluated. Prof. Monto outlined the overall analysis provided strong evidence of their useful- basic research of the biology of most-relevant human pathogenic viruses and the EDITORIAL BOARD Disease and Prevention, USA) opened approach used, with all data collected from ran- ness against seasonal and pandemic influenza. pathogenesis underlying the respective virus-induced diseases. The institute’s domized placebo-controlled clinical trials in adult long-established mission is to provide new technologies and solutions to improve editor-in-chief graphic design the session by welcoming the support and pediatric patients (therapeutic use only), and The Post-pandemic Review of anti-Influenza therapeutic procedures for established and emerging viral diseases. These include — Damion Ekiert — Tom Adriaensen provided by MUGAS for the urgently all analyses performed on an individual patient Drug Effectiveness (PRIDE) study completed the AIDS, Influenza and Hepatitis as well as certain types of cancer linked to basis. MUGAS report and was presented by Puja Myles reporters photos with Herpes-, Polyoma- and other DNA-Viruses. needed assessment of the efficacy and (University of Nottingham, UK). The observational — Leslie Reperant — Koen Broos Preliminary results of the meta-analysis, soon to study was performed to assess the usefulness The institute has created several advanced technology platforms that facilitate — Stephanie Bertram effectiveness of oseltamivir, one of the comprehensive investigation of the processes, including a High-Throughput be published, were presented by Joanna Dobson of oseltamivir treatment during the pandemic — Rory de Vries major neuraminidase inhibitors used to Sequencing Facility, BSL2/BSL3 Small Animal Models and advanced Microscopy and (London School of Hygiene and Tropical Medicine, of 2009, by conducting a systematic review and — Hans Housen Image Analysis. Research projects at the HPI comprise multi-disciplinary approaches fight influenza. UK). Nine clinical trials on oseltamivir in adults meta-analysis of published data. The review of 44 and are closely linked with research groups in the Hamburg metropolitan region as were included, with similar inclusion criteria, and 52 studies with mortality and severe disease well as other national and international collaboration partners. intervention protocol and main outcome, defined as the outcome, respectively, demonstrated Although vaccines are cornerstones of public as the time to alleviation of all symptoms. Two significant clinical effects of early treatment Visit us: www.hpi-hamburg.de health’s arsenal for the prevention and control of clinical trials were carried out in the elderly popu- with oseltamivir. The standardization and meta- influenza, antiviral drugs play an essential role in lation and one trial in individuals with chronic analysis of raw data obtained form 80 research the fight. Their effectiveness has been the subject cardiac or respiratory illness. Close to 70% of the groups in 38 countries of 6 WHO regions further of debates for many years, as were early antivirals patients proved to be infected with influenza A supported the effectiveness of early oseltamivir developed against influenza, such as the M2 virus, mainly of subtype H3N2. Statistically sig- treatment against mortality, as well as that of channel blockers and , nificant reductions in the time to alleviation and late treatment in critically ill patients. ■ THE INFLUENZA TIMES

SPA3 SPB1 VIRUS STRUCTURE AND REPLICATION Cross-protection against influenza: Influenza virions – Trojan exosomes?! no longer a utopia? During the session “Viral Structure The high variation of influenza viruses relies on the segmented RNA genome which allows and Replication” novel insights into genetic . Little is known about the Immunological basis for novel was divided in two camps: those adhering to the the influenza virus particle were given. packaging signals in vRNA complexes. Results influenza vaccines importance of cross-reactive T cells and those FOCUS POINTS OF presented by Catherine Isel from the University Besides the identification of a new After hearing Marc Sprenger during the ESWI who firmly believe in the importance of cross- UNIVERSAL VACCINE: of Strasbourg clearly indicate that incompat- opening on Sunday and Ab Osterhaus at the reactive antibodies. functional site in the PB2 subunit ibility between the vRNA packaging signals has ■ INDUCE B CELLS GENERATING plenary session on Monday, there was a clear POTENT STALK-SPECIFIC and the crucial role of influenza RNA negative effects on the genetic reassortment. take-home message: the efficiency of currently Stalk-specific antibodies: less potent Futhermore, she could show a crucial role for ANTIBODIES (PREFERABLY IGA used influenza vaccines is subject to improve- but more broad packaging signals during genetic the M segment in packaging and reassortment. ISOTYPE) ment, especially in rare occasions that the vaccine Presentations discussing the importance of cross- reassortment, role of HA and M2 protein antigens poorly match the dominant circulating reactive antibodies boiled down to the same ■ INDUCE T CELLS DIRECTED Influenza viruses are known to build complex virus strains. Since this obviously indicates that conclusion: due to antigenic drift usually only HA AGAINST CONSERVED modification in assembly of influenza and pleomorphic virions which are difficult novel generation influenza vaccines should be stalk-specific antibodies can be broadly reactive, REGIONS OF INFLUENZA virus particles and fascinating new to analyze in detail. Here, Edward Hutchinson developed, the Monday immunology session was in contrast to conventional HA globular head- PROTEINS from the University of Oxford presented a new of a particular interest, since according to the specific antibodies that are highly strain specific. data about the virion architecture were technique to allow a closer look to the content ■ USE LIVE / REPLICATING presented. of these structures. By using quantitative mass mammalian hosts. He suggests that OR VECTOR TO spectrometry, he was able to demonstrate that viruses have co-opted parts of the exosome INDUCE BOTH CD4 AND CD8 The RNA-dependent RNA polymerase of influ- the complement of viral proteins is conserved assembly pathway for their virion production, T CELL RESPONSES enza viruses is essential for viral transcription across different combinations of virus and host. which leads to the host specific architecture of and replication. The PB2 polymerase subunit Hutchinson’s data show that the examined non- influenza viruses. This data raises the question is responsible for the cap-‘snatching’-activity, structural protein NS1 is clearly associated with of whether influenza virions are essentially in the future to further characterize the breadth whereby cap structures of the host cell’s pre- the virions. Additionally, Hutchinson revealed Trojan exosomes. of the response and the level of cross-protection mRNAs are transferred onto viral mRNAs. Nev- that a large number of host cell proteins are in- in humans remains to be determined. ertheless, the key functional sites of PB2 remain corporated into virions. Even after an extensive, Taken together, this session clearly underscores unknown. Dai Hatakeyama from Tokushima optimized purification protocol for the virions, that the impact of the virus producing host is Cross-reactive T cells can protect from Bunri University showed nicely that the Val/ a large number of associated host-cell proteins much greater then we suspected before. And in severe disease. Arg/Gly (VRG) site in PB2 is crucial for interac- remain. Futhermore, Hutchinson showed that the future, we need to consider these differences Focusing on the other arm of the adaptive im- tion with acetyl-CoA as well as RNA polymerase the incorporation of these proteins is also when designing more effective vaccines. ■ mune system, natural infection with influenza vi- activity and viral replication in vitro. host specific, e.g. CD9 is only incorporated by rus leads to the production of influenza-specific T cells. Importantly, vaccination with an inactivated vaccine generally does not lead to the induction of an adequate CD8+ T cell response. In animal models it has been extensively shown that CD8+ T cells can confer heterosubtypic immunity, THE ROLE OF HOST but evidence in humans is still largely lacking. ORGANISM INCREASES IN Caroline van de Sandt showed that in blood from healthy donors, influenza B specific T-cells could INFLUENZA RESEARCH be expanded and were capable of recognizing DATA PRESENTED SUGGEST an from a completely different THAT THE CHOICE lineage. That cross-reactive T cells also have a OF HOST ORGANISM abstracts all speakers would be touching upon Apparently, these stalk-specific antibodies have protective effect was shown by Saranya Sridhar, FOR INFLUENZA important implications for the design of novel a major disadvantage: they appear to be less taking advantage of the 2009 H1N1 pandemic. In influenza vaccines. potent in neutralizing virus than globular head- an experiment of nature he used blood samples VIRUS RESEARCH specific antibodies. Matthew Miller elegantly from 300 donors during the first wave of the PLAYS A PREVIOUSLY Designing a universal vaccine: Are demonstrated that when tested in a polyclonal pandemic, of which 180 were still negative for HI UNDERAPPRECIATED ROLE B- or T-cells important? background, the neutralizing potency of HA-stalk and VN antibodies against pH1N1, meaning that IN INFLUENZA VIRUS Even though the speakers did not focus on the de- binding antibodies was markedly increased they had not yet been infected with the pandemic BIOLOGY,INCLUDING sign of novel influenza vaccines, it soon became relative to that of antibodies that bind to the virus. He looked for cross-reactive T cells recogni- GENETIC REASSORTMENT apparent that all were interested in the defining HA-head domain. Taking it one step further and zing pH1N1 virus within these donors, and AS WELL AS VACCINE the immunological correlates of cross-protective looking at antibody isotypes, Miller showed that showed that the presence of these T cells corre- PRODUCTION. immunity. The factors that can actually confer IgA was capable of neutralizing virus with supe- lated with less severe disease when these donors cross-protective immunity were elaborately rior potency relative to IgG. Since Florian Kram- were naturally infected with pH1N1 virus. This discussed, and the obvious next step would be mer showed that stalk-specific cross-reactive shows that both B cells and T cells can contribute taking this knowledge to the drawing board to antibodies are induced by natural influenza virus to cross-protection against severe disease caused design a universal influenza vaccine. The session infection in animal models, it will be interesting by antigenically different strains.. ■ THE INFLUENZA TIMES

SPA3 IMMUNOLOGY SPB1 VIRUS STRUCTURE AND REPLICATION Cross-protection against influenza: Influenza virions – Trojan exosomes?! no longer a utopia? During the session “Viral Structure The high variation of influenza viruses relies on the segmented RNA genome which allows and Replication” novel insights into genetic reassortment. Little is known about the Immunological basis for novel was divided in two camps: those adhering to the the influenza virus particle were given. packaging signals in vRNA complexes. Results influenza vaccines importance of cross-reactive T cells and those FOCUS POINTS OF presented by Catherine Isel from the University Besides the identification of a new After hearing Marc Sprenger during the ESWI who firmly believe in the importance of cross- UNIVERSAL VACCINE: of Strasbourg clearly indicate that incompat- opening on Sunday and Ab Osterhaus at the reactive antibodies. functional site in the PB2 subunit ibility between the vRNA packaging signals has ■ INDUCE B CELLS GENERATING plenary session on Monday, there was a clear POTENT STALK-SPECIFIC and the crucial role of influenza RNA negative effects on the genetic reassortment. take-home message: the efficiency of currently Stalk-specific antibodies: less potent Futhermore, she could show a crucial role for ANTIBODIES (PREFERABLY IGA used influenza vaccines is subject to improve- but more broad packaging signals during genetic the M segment in packaging and reassortment. ISOTYPE) ment, especially in rare occasions that the vaccine Presentations discussing the importance of cross- reassortment, role of HA and M2 protein antigens poorly match the dominant circulating reactive antibodies boiled down to the same ■ INDUCE T CELLS DIRECTED Influenza viruses are known to build complex virus strains. Since this obviously indicates that conclusion: due to antigenic drift usually only HA AGAINST CONSERVED modification in assembly of influenza and pleomorphic virions which are difficult novel generation influenza vaccines should be stalk-specific antibodies can be broadly reactive, REGIONS OF INFLUENZA virus particles and fascinating new to analyze in detail. Here, Edward Hutchinson developed, the Monday immunology session was in contrast to conventional HA globular head- PROTEINS from the University of Oxford presented a new of a particular interest, since according to the specific antibodies that are highly strain specific. data about the virion architecture were technique to allow a closer look to the content ■ USE LIVE / REPLICATING presented. of these structures. By using quantitative mass mammalian hosts. He suggests that influenza VACCINE OR VECTOR TO spectrometry, he was able to demonstrate that viruses have co-opted parts of the exosome INDUCE BOTH CD4 AND CD8 The RNA-dependent RNA polymerase of influ- the complement of viral proteins is conserved assembly pathway for their virion production, T CELL RESPONSES enza viruses is essential for viral transcription across different combinations of virus and host. which leads to the host specific architecture of and replication. The PB2 polymerase subunit Hutchinson’s data show that the examined non- influenza viruses. This data raises the question is responsible for the cap-‘snatching’-activity, structural protein NS1 is clearly associated with of whether influenza virions are essentially in the future to further characterize the breadth whereby cap structures of the host cell’s pre- the virions. Additionally, Hutchinson revealed Trojan exosomes. of the response and the level of cross-protection mRNAs are transferred onto viral mRNAs. Nev- that a large number of host cell proteins are in- in humans remains to be determined. ertheless, the key functional sites of PB2 remain corporated into virions. Even after an extensive, Taken together, this session clearly underscores unknown. Dai Hatakeyama from Tokushima optimized purification protocol for the virions, that the impact of the virus producing host is Cross-reactive T cells can protect from Bunri University showed nicely that the Val/ a large number of associated host-cell proteins much greater then we suspected before. And in severe disease. Arg/Gly (VRG) site in PB2 is crucial for interac- remain. Futhermore, Hutchinson showed that the future, we need to consider these differences Focusing on the other arm of the adaptive im- tion with acetyl-CoA as well as RNA polymerase the incorporation of these proteins is also when designing more effective vaccines. ■ mune system, natural infection with influenza vi- activity and viral replication in vitro. host specific, e.g. CD9 is only incorporated by rus leads to the production of influenza-specific T cells. Importantly, vaccination with an inactivated vaccine generally does not lead to the induction of an adequate CD8+ T cell response. In animal models it has been extensively shown that CD8+ T cells can confer heterosubtypic immunity, THE ROLE OF HOST but evidence in humans is still largely lacking. ORGANISM INCREASES IN Caroline van de Sandt showed that in blood from healthy donors, influenza B specific T-cells could INFLUENZA RESEARCH be expanded and were capable of recognizing DATA PRESENTED SUGGEST an influenza B virus from a completely different THAT THE CHOICE lineage. That cross-reactive T cells also have a OF HOST ORGANISM abstracts all speakers would be touching upon Apparently, these stalk-specific antibodies have protective effect was shown by Saranya Sridhar, FOR INFLUENZA important implications for the design of novel a major disadvantage: they appear to be less taking advantage of the 2009 H1N1 pandemic. In influenza vaccines. potent in neutralizing virus than globular head- an experiment of nature he used blood samples VIRUS RESEARCH specific antibodies. Matthew Miller elegantly from 300 donors during the first wave of the PLAYS A PREVIOUSLY Designing a universal vaccine: Are demonstrated that when tested in a polyclonal pandemic, of which 180 were still negative for HI UNDERAPPRECIATED ROLE B- or T-cells important? background, the neutralizing potency of HA-stalk and VN antibodies against pH1N1, meaning that IN INFLUENZA VIRUS Even though the speakers did not focus on the de- binding antibodies was markedly increased they had not yet been infected with the pandemic BIOLOGY,INCLUDING sign of novel influenza vaccines, it soon became relative to that of antibodies that bind to the virus. He looked for cross-reactive T cells recogni- GENETIC REASSORTMENT apparent that all were interested in the defining HA-head domain. Taking it one step further and zing pH1N1 virus within these donors, and AS WELL AS VACCINE the immunological correlates of cross-protective looking at antibody isotypes, Miller showed that showed that the presence of these T cells corre- PRODUCTION. immunity. The factors that can actually confer IgA was capable of neutralizing virus with supe- lated with less severe disease when these donors cross-protective immunity were elaborately rior potency relative to IgG. Since Florian Kram- were naturally infected with pH1N1 virus. This discussed, and the obvious next step would be mer showed that stalk-specific cross-reactive shows that both B cells and T cells can contribute taking this knowledge to the drawing board to antibodies are induced by natural influenza virus to cross-protection against severe disease caused design a universal influenza vaccine. The session infection in animal models, it will be interesting by antigenically different strains.. ■ TUESDAY 16 SEPTEMBER 2014

SPI 1 WHY SHOULD INFLUENZA BE A PUBLIC HEALTH PRIORITY? THE INFLUENZA TIMES We need to work on collaboration CONFERENCE NEWSPAPER

Yesterday morning’s SPI-track program But when it comes to inspiring changes in be- politicians, because in the end, they will decide kicked off with this simple key question. havior, scientists need to empathize with their on strategy and policy direction. “We need to SS2 MUGAS: REVIEW AND STATISTICAL ANALYSIS OF OSELTAMIVIR DATA Indeed, in order to limit the burden, stakeholders. For example, the data proving vac- understand why politicians behave the way they cines are safe mainly originate from high-income do. Politicians expect certainty. They are afraid influenza should become a public countries. But in order to raise confidence in low of being criticized on their integrity. But our PROF. AB OSTERHAUS health priority, and stakeholders should income countries, we will need data local risk statements are full of if’s, or’s and when’s. And (ERASMUS MC, THE groups can identify with, based on studies in so politicians are completely confused on what Efficacy and effectiveness NETHERLANDS) PRESENTED understand the severity and impact these countries, said Abdulla Brooks, from the they should do. As a result, we are selling them THE OBJECTIVES OF THE of flu, and be involved. The SPI-track Infectious Diseases Unit at Kamalapur Field Site a hazard, a threat, and not something they can MUGAS FOUNDATION AND in Bangladesh. buy”, Capua said. ■ of oseltamivir unveiled generated a wide variety of ideas OUTLINED THE PROCEDURE TO INITIATE A PROJECT. Raina MacIntyre from the University of New to tackle the hurdle. Here are some MUGAS IS DEDICATED TO South Wales in Australia, demonstrated the role in the 1980s and 1990s. snapshots. of influenza vaccination in preventing heart The ongoing debate on the PROMOTING PUBLIC HEALTH diseases. “There are many ways in which infec- effectiveness of the newest BY ADDRESSING UNSOLVED Better surveillance fuels earlier detection and tious diseases overlap with coronary diseases. class of antivirals, the neu- SCIENTIFIC ISSUES THAT more effective information. “Flu is a moving target Therefore, we have to engage cardiologists in our raminidase inhibitors, has HAMPER EFFECTIVE EVIDENCE- and viruses are smart and simply unpredictable”, activities, and make them part of what we do. become a hurdle for public BASED DECISION-MAKING. said Ab Osterhaus, Erasmus MC Rotterdam, The Not only talk to them, but partner with them.” health response to seasonal Netherlands: “If we want to conquer the beast, we Vaccination is perhaps not perceived as an art of and pandemic influenza. need to use all available technologies and work on heroic medicine, but in the end, it is preventing a collaboration.” Surveillance systems are already large amount of heart diseases in people. An overview of the MUGAS- in lower respiratory tract complications were very effective and make annual vaccine reformula- initiated statistical review observed, with no difference between age groups. tion possible; on the basis of antibody presence Ilaria Capua, both virologist and Member of of all available data was Adverse events presented principally as gastro- Check our photo album in the population at large, it is possible to predict the Italian Parliament, stressed not only the presented by Prof. Arnold intestinal conditions, including vomiting and which viruses should be put in a vaccine. importance of communication with the public on Facebook Monto (University of nausea. Three clinical trials in pediatric patients at large and with fellow scientists, but also with www.facebook.com/ Michigan, USA). The aim were included, with age and clinical heterogenei- EuropeanScientistsFightingInfluenza of the study was to offer a ties calling for trial-specific analyses and second- thorough, independent and ary meta-analysis. Although no differences were The Multiparty Group for Advice on transparent meta-analysis of published and un- found or results were inconclusive for two trials published data from clinical trials, carried during in asthmatic children, statistically significant Science (MUGAS) offered yesterday or follow us on Twitter the procedure of licensure of the neuraminidase reduction in the time to alleviation was detected @ESWIRigaConfere a timely satellite symposium on the inhibitors. Despite different routes of administra- in healthy children. Dr. Dobson concluded that review and statistical analysis of tion, oseltamivir and zanamivir have a similar although the use of neuraminidase inhibitors mechanism of action and data on both antivirals should be weighed against the risk, the meta- The Heinrich Pette Institute (HPI), located in Hamburg/Germany, is dedicated to oseltamivir data. Nancy Cox (Centers for were evaluated. Prof. Monto outlined the overall analysis provided strong evidence of their useful- basic research of the biology of most-relevant human pathogenic viruses and the EDITORIAL BOARD Disease and Prevention, USA) opened approach used, with all data collected from ran- ness against seasonal and pandemic influenza. pathogenesis underlying the respective virus-induced diseases. The institute’s domized placebo-controlled clinical trials in adult long-established mission is to provide new technologies and solutions to improve editor-in-chief graphic design the session by welcoming the support and pediatric patients (therapeutic use only), and The Post-pandemic Review of anti-Influenza therapeutic procedures for established and emerging viral diseases. These include — Damion Ekiert — Tom Adriaensen provided by MUGAS for the urgently all analyses performed on an individual patient Drug Effectiveness (PRIDE) study completed the AIDS, Influenza and Hepatitis as well as certain types of cancer linked to infections basis. MUGAS report and was presented by Puja Myles reporters photos with Herpes-, Polyoma- and other DNA-Viruses. needed assessment of the efficacy and (University of Nottingham, UK). The observational — Leslie Reperant — Koen Broos Preliminary results of the meta-analysis, soon to study was performed to assess the usefulness The institute has created several advanced technology platforms that facilitate — Stephanie Bertram effectiveness of oseltamivir, one of the comprehensive investigation of the infection processes, including a High-Throughput be published, were presented by Joanna Dobson of oseltamivir treatment during the pandemic — Rory de Vries major neuraminidase inhibitors used to Sequencing Facility, BSL2/BSL3 Small Animal Models and advanced Microscopy and (London School of Hygiene and Tropical Medicine, of 2009, by conducting a systematic review and — Hans Housen Image Analysis. Research projects at the HPI comprise multi-disciplinary approaches fight influenza. UK). Nine clinical trials on oseltamivir in adults meta-analysis of published data. The review of 44 and are closely linked with research groups in the Hamburg metropolitan region as were included, with similar inclusion criteria, and 52 studies with mortality and severe disease well as other national and international collaboration partners. intervention protocol and main outcome, defined as the outcome, respectively, demonstrated Although vaccines are cornerstones of public as the time to alleviation of all symptoms. Two significant clinical effects of early treatment Visit us: www.hpi-hamburg.de health’s arsenal for the prevention and control of clinical trials were carried out in the elderly popu- with oseltamivir. The standardization and meta- influenza, antiviral drugs play an essential role in lation and one trial in individuals with chronic analysis of raw data obtained form 80 research the fight. Their effectiveness has been the subject cardiac or respiratory illness. Close to 70% of the groups in 38 countries of 6 WHO regions further of debates for many years, as were early antivirals patients proved to be infected with influenza A supported the effectiveness of early oseltamivir developed against influenza, such as the M2 virus, mainly of subtype H3N2. Statistically sig- treatment against mortality, as well as that of channel blockers amantadine and rimantadine, nificant reductions in the time to alleviation and late treatment in critically ill patients. ■