05 flu s lee
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Transcript of 05 flu s lee
4TH MERIAL FORUM
HAVE WE GOT PCVD &
SWINE INFLUENZA UNDER
CONTROL?
INFLUENZA IN HUMAN AND PIGS:
WHAT ARE THE DIFFERENCES?
Influenza in Humans epidemiology and control by vaccination
Sam Lee, PhD
Sr. Director, Pandemic Influenza Strategy
Franchise & Global Marketing Strategy
Sanofi Pasteur
Airborne Transmission of Respiratory Pathogens
Steinhoff, Johns Hopkins School of Public Health, EID_lect13_Steinhoff.pdf
Influenza Highly contagious respiratory illness caused by frequently changing virus
http://www.cdc.gov/flu/images.htm
http://en.wikipedia.org/wiki/Influenza
Antigenic Drift vs. Antigenic Shift
http://www.niaid.nih.gov/topics/flu/understandingflu/Pages/default.aspx
http://gamapserver.who.int/mapLibrary/Files/Maps/GISRS_20120426_1.png
Influenza Virus Antigenic & Genetic Drift
http://www.who.int/entity/influenza/vaccines/virus/recommendations/201202_recommendation.pdf
http://www.who.int/entity/influenza/vaccines/virus/201202_h5_h9_vaccinevirusupdate.pdf
http://www.antigenic-cartography.org/
Annual Impact of Seasonal Influenza in the United States
Deaths 36,0001
Hospitalizations 114,0002
Direct medical costs >$10 billion4
Infections and illnesses 50–60 million3
Physician visits 25 million3
1 Thompson WW et al. JAMA. 2003;289:179-186. 2 CDC. MMWR Recomm Rep. 2003;58(RR-8):1-34.
3 Chow A, et al. Emerg Infect Dis. 2006 Jan;12(1):114-21. 4 Molinari NA, et al. Vaccine. Jun 28 2007;25(27):5086-5096.
5 Szucs T. J Antimicrob Chemother. Nov 1999;44 Suppl B:11-15.
In-Direct medical costs >$50 billion5
10 10
Goals for Influenza Vaccination
Primary Goal: Prevent severe disease and complications,
and to prevent death
Secondary Goal: Prevent any mild form of the
disease or mild complications
Public Health Goal: Reduce disease
burden and medical costs for society
Vaccination provides effective protection against flu at all ages
In Healthy Adults
Influenza vaccination prevents influenza illness
in 70 – 90% of healthy adults aged < 65 years 4
Vaccination of healthy working adults was shown
to reduce work absenteeism by up to 78% 5
In Children
Vaccination reduces influenza
illness in children by 60 to 90% 2
Vaccination of children reduces
disease transmission
Demonstrated 61% indirect
protection (herd effect) of non-
vaccinated persons 3
*Influenza vaccination is most effective when circulating viruses are well-matched with vaccine viruses
In the Elderly Flu vaccination among the elderly has
been shown to reduce severe
illness and complications by up to
60%, and deaths by up to 80% 1
1 http://www.who.int/mediacentre/factsheets/fs211/en/Accessed July 2, 2010. 2 Nichol K. Vaccine ,2003;21(16):1769-75.
3 Loeb M, et al.. JAMA, 2010;303(10):943-50. 4 CDC. MMWR, 2009;58(RR8).
5 Samad AH, et al. J Occup Health, 2006;48(1):1-10.
Influenza Vaccine Strain Changes WHO Recommendations 1969-2012
Reichelderfer PS, et al. Influenza surveillance in the pacific basin. In: Current topics in medical virology 1988:412-38
J F M A M J J A S O N D
Southern hemisphere
Tropical
Northern hemisphere
Seasonal Occurrence of Influenza
Potential Benefit of Quadrivalent Vaccines B lineage circulation in Europe (2003-2011)
Victoria
Yamagata
Victoria Yamagata Yamagata Yamagata Yamagata Yamagata Victoria Vaccine
P P P X X X X Match with
dominant
circulating lineage
20%
44%
91% 92%
69%
94%
80%
56%
9% 8%
99%
31%
6%
1% 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2003-2004 2004-2005 2005-2006 2006-2007 2007-2008 2008-2009 2010-2011
Human-Animal Interface
http://www.nationalgeographic.de/thumbnails/lightbox/66/34/00/ea-khamjean-saugt-blut-aus-der-wunde-seines-kampfhahns-3466.jpg
http://www.swineflupandemicblog.info/
● Our Vision
● A world in which no one suffers or dies from a
vaccine preventable disease
● Our Mission
● To protect and improve human health
worldwide by providing superior, innovative
vaccines for the prevention and treatment of
disease and by playing an active role in the
immunization community to maximize
vaccination
SANOFI PASTEUR WORLDWIDE LEADER IN HUMAN VACCINES
Val de Reuil
Marcy-l’Etoile
Toronto
Shenzhen
Swiftwater (PA)
Canton (MA)
Rockville (MD)
Pilar
Chachoengsao Hyderabad
17
SANOFI PASTEUR GLOBAL PRODUCTION FOR GLOBAL HEALTH
● To produce vaccines in large quantities, meeting the highest quality
standards, to help fulfill public health needs
Sites under construction: Ocoyoacac (Mexico), Neuville (France), Shenzhen (China)
10 sites plus 3 under
construction
More than
50% of total staff
in industrial operations
More than 1 billion doses
of vaccine produced each
year
Nearly 2 billion invested in
production infrastructures
over the
past 5 years
(*) This vaccine is produced in response to the
threat of bioterrorism using strains of the
smallpox virus.
SANOFI PASTEUR THE BROADEST RANGE OF VACCINES WORLDWIDE
Smallpox (*)
Yellow fever
Mumps
Poliomyelitis
Measles
Influenza
Hepatitis A
Rabies
Japanese encephalitis
Hepatitis B
Rubella
Pertussis
Diphtheria
Haemophilus influenzae type b infections
Meningococcal meningitis
Pneumococcal infections
Tetanus
Tuberculosis
Typhoid fever
Cholera
Bacterial diseases
Viral diseases
Chickenpox
and against one eradicated disease
20 diseases
Creating Vaccines
Protecting Life
Back-up Slides
Influenza Vaccine Manufacturing Timeline Northern Hemisphere
Jan Dec Nov Feb Mar Apr May Jun Jul Aug Sep Oct
Surveillance &
Reassortants
Vaccination
Distribution
Produce &
Standardize Reagents
Production
(at risk)
Production
(may be at risk)
Production
Strain
Balancing
Filling &
Packaging
Formulation
Produce
Working
Seed
Production
Annual
License
Approval
Strain Selection
FDA
WHO
Wh
o / C
DC
/ E
CD
CV
ac
cin
e M
an
ufa
ctu
rin
g
an
d r
eg
istr
ati
on
Va
cc
ina
tio
n c
am
pa
ign
Ep
ide
mic
The A(H1N1) 2009 Pandemic: Key dates
14000
12000
10000
8000
6000
4000
2000
250
200
150
100
50
Apr 09 May 09 Sep 09Aug 09Jul 09Jun 09 Nov 09Oct 09 Dec 09 Jan 10
24
New influenza A virus
identified by CDC in
samples from Mexico
and US A
27
First case in Europe
02
First case in Asia
02
First case in Africa
26 WHO: Level of influenza
pandemic alert
from phase 3 to 4
27 WHO: Level of influenza
pandemic alert
from phase 4 to 5
26 WHO: recommended
strain for any vaccine A/California/7/2009 (H1N1)v
WHO: Level of influenza
pandemic alert
from phase 5 to 6
1 1 07 WHO, ACI P , ECDC
List of priority groups
for pandemic vaccination
WHO, CDC, ECDC
Stop reporting the
number of cases
15 US FD A licensed Sanofi Pasteur's
pandemic influenza vaccine
13 French Afssaps licensed Sanofi Pasteur's
pandemic influenza non-adjuvanted vaccine
1-8 Sanofi Pasteur announced preliminary results
from US and European clinical trials in adults
following one dose of influenza A (H1N1) 2009 vaccine
26 Sanofi Pasteur began large-scale production
of the novel H1N1 vaccine in the US and France
29 Sanofi Pasteur begins shipping
pandemic influenza vaccine in US
23 European Medicines Agency
recommends 3 A(H1N1)
2009 pandemic vaccines
for an EU-wide marketing
24 WHO: A/California/7/2009 (H1N1)-like virus
recommended for 2010 southern
hemisphere seasonal influenza vaccines
11
208 countries and territories
reported cases
China: first country to start
pandemic vaccine immunization, in students
21 20 V accination campaign
began in France and UK 05 V accination campaign
began in the US A
09 V accination campaign
began in Russia
V accinatiion campaign
began in Australia
30
Public Health Impact of Influenza Disease
Mean Annual Numbers of Deaths (US, 1976-99)
Virus Pneumonia &
Influenza
Respiratory &
Circulatory All Causes
A/H1N1 381 1960 2836
A/H3N2 6613 28940 40017
B 1103 5255 8349
Simonsen, et al., JID 2000;181:831
Thompson, et al., JAMA 2003;289:179
Virus Numbers of
Epidemics
Excess Pneumonia & Influenza
Hospitalizations (US, 1969-95)
A/H1N1 2 35,000-49,000
A/H3N2 12 85,000-220,000
B 4 56,000-114,000