Influenza, Be Gone!

Along with an estimated 50% of Americans, I took my chances with the flu shot this year. Unfortunately, the gamble didn’t pay off. I also suspect that the hospital bill for visiting the Emergency Room with a 104.1° fever and then being admitted for 48 hours will far outweigh the $25 fee for the flu shot I skipped.

However, even as I am still swallowing my antiviral medications twice a day round the clock, I’m startled to notice reports of breaking scientific news that might herald an end to the yearly “to vaccinate or not to vaccinate” question. Published just yesterday in a collaboration by groups at the Burnham Institute for Medical Research in La Jolla, the CDC in Atlanta, and the Dana-Farber Cancer Institute in Boston, a team of scientists announced in the prestigious journal Nature Structural and Molecular Biology that they may have stumbled across a way to outwit the influenza virus.

The problem with the flu is that the virus mutates so rapidly that the single-dose-and-you’re-done model of most childhood vaccines doesn’t work. Instead, about this time every year, scientists around the world must analyze the many active strains of this year’s influenza outbreaks, compare the changes to last year’s outbreaks, and then, on the basis of evolving trends, try to guess which genes in the influenza genome shuffle will be present in next year’s disease. These guesses—and it’s all guesswork—will form the basis of next year’s vaccine cocktail. Since it takes a good six months to manufacture the vaccine, in order to be ready for the start of the fall vaccine season, production has to start now.

This guessing game is the reason why there is such wide variability in the efficacy of the vaccine. Those years in which very few people get sick are the ones in which we guessed correctly, and the vaccine is effective against the majority of strains of active influenza. But every few years the virus goes in a direction no one expects, and even vaccinated people still get sick. The influenza virus is a wily foe that has been making us sick for a long time.

This recent study is so promising precisely because it offers a potential way around the guessing game. After screening a library of 28 billion human antibodies—the parts of our immune system that recognize foreign invaders—this cross-institutional team discovered a handful that recognize not the constantly mutating surface of the influenza virus and the current targets of our vaccines, but rather a critical component of the viral machinery that does not change from year to year. This small cog in the mighty viral machine might be the molecular equivalent of Achilles’ heel. Studies in mice are promising: animals immunized with the protective antibodies were protected against a broad range of influenza viruses, including some of the more deadly strains known to cause pandemics.

Could this be the beginning of a single-shot, anti-pandemic influenza vaccine? It’s still too early to say. Results are nonetheless promising and a reminder that investing in biomedical research is a worthwhile enterprise. Influenza kills an estimated 250,000 people worldwide each year, and that’s not counting pandemic years. Anything we can do to minimize that toll is a good thing.

As for me, well, I’m still considered infectious, so I’m stuck at home with my computer and a pile of books I’ve been meaning to read but haven’t had time to get through lately. And I’m thinking I might start with an old favorite.

Love in the Time of Cholera.