Stepping Up to Protect Against Avian Flu

As new cases of H5N1, the so-called "avian flu," started appearing in China and Turkey this winter, researchers at the Bloomberg School stepped up to help the health community prepare itself for and protect the public from a potential influenza pandemic.

The School's Lynn Goldman, a pediatrician and environmental epidemiologist, has organized a Schoolwide flu task force, which reaches across the public health community to gather different perspectives on the disease—from biostatisticians to behavioral scientists and environmental health experts. The task force's goal, Goldman says, is to create a response not only to the imminent issue of avian flu but also to sometimes unwarranted scares.

Goldman, MD, MPH '81, MS, coordinated a flu symposium, which was held at the School on January 30 and drew more than 300 attendees from the School, and state and national health organizations, including Admiral John Agwunobi, MD, MPH '04, assistant secretary for health with the U.S. Department for Health and Human Services. The keynote speaker was Patrick Leahy, acting director of the U.S. Geological Survey, who showed how mapping could track migratory bird flyways and disease outbreaks around the globe.

The group discussed ways to track influenza transmission in hospital settings and how local communities, such as Baltimore, are trying to prepare for a possible pandemic of avian flu.

The School's Ruth Karron, MD, professor of International Health and a member of Goldman's flu task force, spoke about vaccine strategies at the symposium. She's studying a number of vaccines that use live attenuated virus (weakened virus) to create an immune response. Recently Karron tested a potentially successful live attenuated vaccine for the H9N2 virus, an avian influenza strain that occasionally causes disease in humans. This spring, she plans to study live attenuated vaccines for H5N1 virus.

Environmental epidemiologist Lynn Goldman has organized a Schoolwide flu task force to create a response not only to the avian flu but also to sometimes unwarranted scares.

Clinical trials with the live attenuated H5N1 vaccines will be conducted at the Center for Immunization Research's isolation unit at the Johns Hopkins Bayview Medical Center. Developed by scientists at the National Institute for Allergy and Infectious Diseases and MedImmune Inc., the vaccines are built with the same internal genes as FluMist, a live attenuated vaccine licensed for preventing seasonal flu. They also contain the avian H5 gene, modified to be less virulent, and the avian N1 gene. The volunteers will receive the vaccine by nose drop or nasal spray. 

One objective for Goldman's task force will be to work with rural communities and urban developments to prepare, obtain and disperse vaccines and other medications in the event of an outbreak.

The task force recently received a grant from the Horizon Foundation to work with Howard County in Maryland to create a community response model. "A couple of years ago, they had a case of suspected SARS, and that one case turned the county upside down in terms of resources and showed them that they were not as prepared as they thought they were," says Goldman.

Howard County is an ideal community to study, she says, because like many non-urban areas "it has one hospital, a sizable elderly population and people who are fairly isolated."