Course Notes & other materials

Week 1: 30 Aug
Week 2: 6 Sept
Week 3: 13 Sept
Week 4: 20 Sept
Week 5: 27 Sept
Week 6: 4 Oct
Week 7: 11 Oct
Week 8: 18 Oct
Week 9: 25 Oct
Week 10: 1 Nov
Week 11: 8 Nov
Week 12: 15 Nov
Week 13: 22 Nov
Week 14: 29 Nov

News & information

These items were posted on the front page, and are now archived here since most remain of general or historical interest.

News Archive

2 August 2015: A trial of the Ebola vaccine rVSV-ZEBOV developed in Canada was halted early because it had exceeded its efficacy predictions, with (apparant) 100% protection of immunized contacts of diagnosed Ebola patients. The de-facto control groups were contacts who refused or had to delay immunization.

11 August 2014: The two Americans with Ebola infections were treated with a cocktail of three monoclonal antibodies against the virus, specific for the Zaire strain. Some angry (and thoughtless) people in the Twitterverse have asked why the "rich Americans" got the special treatment, not the poor of Africa. The answer's simple: these agents have never been used in people, and might have proved harmful or lethal; that would have been catastrophic in Africa. The medically-trained American patients understood the risk they were taking.

3 July 2014: California's whooping cough (pertussis) “epidemic has escalated...with 4,558 cases reported this year as of Tuesday — 1,100 of those in the last two weeks.” Of the cases in 2014 so far, “3,614, or 84%, have occurred in patients 18 or younger,” and of the “142 illnesses that required hospitalization, 89, or 63%, were in infants four months or younger.” Authorities urge all pregnant women in the 3rd trimester to get immunized.

16 June 2014: The FDA has approved a $1 bilion Novartis plant in North Carolina to manufacture FluCelVax, their new flu vaccine, the first approved (2012) to be made in cell culture rather than eggs. The new process takes weeks instead of months. Ironically, Novartis is looking to get out of the vaccine business.

16 June 2014: MERS continues to spread, with cases in 21 countries. Latest count is 808 cases, 311 fatalities, meaning it's spreading faster than AIDS did in its first year.

16 June 2014: California has upgraded an outbreak to an epidemic, with 800 cases of pertussis (whooping cough) reported in the past two weeks. There have been 3,400 cases in the state this year. Nationwide there is a 24% increase in cases reported to the CDC in the past year. The state Department of Public Health recommends boosters for all pregnant women; two infants there have died of pertussis this year

6 April 2014: According to WHO, Iraq has reported its first case of polio in 14 years. It is thought the infection traveled from Syria. There are 27 confirmed cases in Syria, though it's widely believed there are more. On the happy side, southeast Asia has been declared "polio-free" with the last case being in India in January 2011.

2 August 2013: WHO reports a total of 81 cases of MERS-CoV infection, with 45 deaths. Most cases are from Saudi Arabia, in which a cluster of hospital-acquired cases has been described. The Middle East Respiratory Syndrome coronavirus has similarity to the one that caused the SARS outbreak.

03 June 2013: Thousands of cases of measles are reported from Pakistan, with 239 deaths in the first 6 months of 2013. Immunization rate is under 60%; in the poorest populations, parents do not bring kids to care centers, so a house-to-house campaign is needed but not currently available.

09 May 2013: Seattle-based nonprofit IDRI and Medicago Inc. have collaborated on a phase-I demonstration of efficacy of a H5N1 bird flu vaccine. Three aspects are unusual: The vaccine's protein is made in transgenic Nicotiana benthamiana (a close relative of tobacco) plants, not in eggs; either alum or IDRI's own Glucopyranosyl Lipid A (GLA) adjuvants were added; and the vaccine was injected either intramuscularly or intradermally. All configurations exceeded international standards for immunogenicity, without significant adverse effects. They have not yet reported testing reduced-dosage intradermal dosing, which could be a way to more efficiently present the vaccine to dendritic cells, saving precious immunogen in a pandemic.

13 April 2013: A measles outbreak in Swansea, Wales (UK) has infected 700 children, with a 20% complication rate. Long lines to get immunized with the MMR vaccine are reminiscent of the old days when measles was known and feared by all parents.

As of 29 May 2013, China confirmed 132 human H7N9 influenza infections since February; 37 of the infected people have died. The current cases were reported in three provinces in east China, as well as the municipality of Shanghai. H7N9 is an avian strain whose potential for human-to-human transmission is "higher than any other known avian influenza virus" (WHO). This outbreak is being monitored closely by WHO and Chinese authorities, as there is no vaccine and antigenic shift is always possible. It's difficuly to monitor because this fully-avian strain does not make birds noticably sick. In May the first oseltamivir (Tamiflu)-resistant strain was isolated.

Protection against the potentially-serious A strain by the 2012-3 flu vaccine in persons over 65 was not significantly different from zero. As we discuss in class, it's important to immunize children to protect the elderly who can catch flu from them.

Nature reports: After years of struggle, the production of seasonal flu vaccine in the United States has entered the modern era. On 20 November [2102], the Food and Drug Administration (FDA) approved its first seasonal flu vaccine made in cell culture, rather than in fertilized chicken eggs. The vaccine, Flucelvax, is made by the Swiss pharmaceutical company Novartis and was approved by the European Union in 2007 under the name Optaflu. More...

14 December 2012: The U.S. Food and Drug Administration today approved raxibacumab injection to treat inhalational anthrax. Raxibacumab also is approved to prevent inhalational anthrax when alternative therapies are not available or not appropriate. Raxibacumab is a monoclonal antibody that neutralizes toxins produced by B. anthracis that can cause massive and irreversible tissue injury and death. The FDA granted raxibacumab fast track designation, priority review, and orphan product designation.

Pfizer announced (August 2012) that it was ending its Phase 3 trial of bapineuzumab, a monoclonal antibody against amyloid-beta, in Alzheimer disease. It just didn't work. They suggest the affinity for the antigen may have been too low, but one also wonders how much IV antibody crosses the blood-brain barrier.

On 12 January 2012 India reported it has gone an entire year without a new case of polio reported. Nevertheless they plan to continue their intense immunization campaign, with 174 million kids on the list for the next 3 months. Worldwide, only 600 cases, but some in countries that had previously been polio-free. These cases are probably imported.

In its May 2011 meeting the World Health Assembly again gave the remaining stocks of smallpox virus a reprieve, to the disappointment of many "destructionists." But the decision will be reviewed in 2014, earlier than the United States, the primary "retentionist," wanted. More on the story from ScienceInsider.

The FDA has now approved Zostavax, the shingles vaccine, for people 50-59 (as well as older people). ACIP decided not to endorse the recommendation since supplies are limited or uncertain, but it's OK to get the vaccine if you can. Remember: live vaccine precautions for Zostavax.

Remember the man with AIDS and leukemia who got a CCR5 delta-32 stem cell transplant? He now lives in San Francisco, and there is a CBS article and video about him. It's very interesting, though the video reporter does not understand the story very well.

Nobel Prizes for Innate Immunology! Announced on 3 October, 2011, were Nobel Prized in Physiology or Medicine for three pioneers. Ralph Steinman of Rockefeller won his prize for identifying, naming, and showing key roles for the dendritic cell. Sadly, he died a few days before the announcement, unknown to the Nobel organization; nevertheless, they have decided that he will indeed receive the award, posthumously. Jules Hoffmann of Strasbourg won for the identification of Toll as a key molecule in the fruit fly's innate defenses. And Bruce Beutler of Scripps was recognized for identifying the Toll-like receptors and their roles in mammalian innate immunity.

The first small trial of a monoclonal antibody against IL-17, the effector cytokine of Th17 cells, has been reported. It worked well in some patients with psoriasis, rheumatoid arthritis, or uveitis, consistent with Th17 cells being at least part of the pathogenesis of those conditions.

A new report by the World Health Organization slams the use of tests for antibody to tuberculosis, which are widely used in the Third World. These kinds of test can be great, but depend critically on the purity and consistency of the antigen preparation used; and WHO found results all over the place. Furthermore, though the report doesn't stress it, since antibody is not protective against TB, measuring antibody seems a bit, well, misdirected. There are better tests but unfortunately they're more expensive.

The New York Times has an interesting article about whether boys should be immunized against human papilloma virus (HPV). As evidence accumulates (especially about the role of HPV in head-and-neck cancer) the answer seems to be: Yes! About 2/3 of girls, and 40% of boys, are reported to be immunized in the USA.

Rinderpest, one of the most devastating diseases of cattle and wildlife, was declared eliminated from the world last week by the Food and Agricultural Organization. It's only the second infectious disease we've been able to eradicate so far. Does someone want to blog about that achievement? There is a lot on the Web.