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Researchers in the University of Cambridge's Department of Zoology have developed a new methodology to analyse pathogen evolution. This `antigenic cartography' has led to the group becoming integrally involved in the World Health Organisation (WHO) influenza vaccine strain selection process, and has directly contributed to more accurate and appropriate flu vaccine design, with associated international impacts on disease prevention and public health (the flu vaccine is given to ~350 million people annually). The research has directly affected how public health professionals conduct disease surveillance and sampling.
The work of Professor Ferguson and colleagues at Imperial College on modelling the effect of different intervention measures on the spread and health impact of a new influenza pandemic has substantially shaped UK and international public policy-making over the last 7 years. Prior to 2009, this work shaped UK policy on antiviral and pre-pandemic vaccine stockpiling and use, and on the potential use of school closure and border restrictions during a pandemic. During the 2009 H1N1 pandemic, real-time research provided the first estimates of key epidemiological parameters of the new pandemic virus, demonstrating the low-to-moderate severity and lower than typical transmissibility. In the UK, US and other countries, these data informed public policy decisions to pull back from use of economically costly interventions (such as reactive school closure or antiviral prophylaxis) and focus on targeted use of vaccination as the principal pandemic mitigation measure.
Professor Rima's research on measles and mumps viruses over 4 decades at Queen's University allowed him to play an important role in re-establishing public confidence in the safety of the measles-mumps-rubella (MMR) vaccine. Claims that MMR vaccine could cause autism in 1998 undermined the vaccine uptake but Rima's expert testimony and that of others established in court that these claims were unfounded. This re-assurance and subsequent promotion of MMR vaccination reduced measles cases in the UK. In the USA, it also reduced the real risk that the Vaccine Court Fund, which compensates vaccinees for genuine vaccine related adverse events, would be bankrupted by over 50,000 claims amounting to between $30-50 Billion.
Clinical Trials undertaken by the Oxford Vaccine Group led to the recommended immunisation of three million UK children during the 2009 H1N1 influenza pandemic. This research was also used to inform World Health Organization (WHO) global policy. The 2009 H1N1 influenza pandemic, or "Swine Flu", was first identified in April 2009 and declared a pandemic by the WHO in June 2009. After acquiring two novel flu vaccines for the 2009 H1N1 influenza virus, the UK government approached the Oxford Vaccine Group to provide paediatric data on the safety of each vaccine. Rapidly recruiting 943 children to the study, the Group delivered essential data to the Department of Health prior to the onset of the winter influenza season. In August 2010, the WHO declared the H1N1 pandemic over.
Research undertaken at UCL's Centre for Infectious Disease Epidemiology has provided evidence about vaccination of different groups against influenza which have influenced policy and practice. In particular, our work underpins the government's ongoing policy on vaccination of healthcare workers, and is cited every year in the Chief Medical Officer's letter to healthcare workers as well as international recommendations on influenza vaccination of healthcare workers, including widespread mandatory vaccination programmes in North America. Research on influenza and acute cardiovascular events has informed US recommendations for prevention of stroke through vaccination. Recent work also informed the decision in the UK to extend regular influenza vaccination to children.
Recent outbreaks across Europe of Bluetongue, a viral disease particularly affecting sheep, have driven research at LSHTM by Professor Polly Roy and her team, resulting in the Bluetongue virus (BTV) becoming one of the best understood viruses at the structural and molecular levels. The research has ultimately enabled the creation of several promising new vaccines. In addition the Roy group has contributed towards exploiting virus-like particles (VLPs) as a method to produce safe vaccines against human and animal viral pathogen. The most advanced example is a BTV vaccine for livestock, which is manufactured by Boehringer Ingelheim (BI).
Research at the University of Oxford into molecular evolution led to the development of BEAST, a powerful suite of computer programs for evolutionary analysis. Viral genome sequences from infected populations can be analysed to infer both viral population history and epidemiological parameters. This approach has been used to track and predict the transmission and evolution of pathogens, particularly viral infections of humans such as influenza and HIV. BEAST was used alongside traditional epidemiological methods by the World Health Organization to rapidly assess and identify the origins of the 2009 H1N1 `Swine Flu' pandemic; immediate recommendations for necessary international action followed. This approach is now widely adopted by health protection agencies and health ministries around the world and is being applied to understand viral diseases of both humans and animals.
Research carried out by the Health Protection and Influenza Research Group (HPIRG), Division of Epidemiology and Public Health, impacted directly on the UK Government's response to the 2009 influenza pandemic, feeding directly into policy-making decisions. The group was appointed as an official WHO Collaborating Centre for pandemic influenza in 2010 and through its related research has "reduced the economic impact on Member States for pandemic preparedness" (quote from reference 7, section 5). In 2011, it secured £7M funding from the US Centers for Disease Control and Prevention (CDC) to lead `once only' work to determine the modes of influenza transmission using a human challenge model.
Viral infections pose a significant risk of long-term disease and death to cats. In Europe alone, over 30 million domestic cats are vaccinated each year against three core pathogenic viruses. Research performed at the University of Glasgow has systematically supported the development of key technologies against major feline viral diseases. This work has delivered incremental but wide-reaching benefits to veterinary healthcare and animal welfare by providing: (i) reagents used in the diagnostic industry; (ii) viral screening services for big cat conservation programmes; (iii) developmental input into the creation of one of the most efficacious and widely used vaccines against feline leukaemia virus; (iv) testing of feline vaccines for efficacy and safety; and (v) development of best practice guidelines and training for veterinary practitioners on feline viruses.
Research conducted by LSHTM into how governments and international organisations are preparing for an influenza pandemic has made an important contribution towards efforts to avoid the risks of up to 150m deaths anticipated by WHO in the event of such a pandemic. Governments, including the UK, and global institutions, have made policy changes and resource allocation decisions directly as a result of this research and technical advice.