H2N2 virus

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However, the researchers have conducted a small test of 90 people, which showed that people under the age of 50 have little or no immunity to the strain. Resistance to the virus strain in people above the age of 50 appeared to dramatically increase.

The article warns that this strain of H2N2 is currently circulating in birds and pigs and have drawn parallels between this and the H1N1 Swine flu strain, which jumped to humans in 2009 and continues to cause significant health problems and even death. The researchers advise that similar patterns of immunity levels to H1N1 are also found.

The emergence of a new strain of the H1N1 virus in 2009 lead to worldwide panic. However, the virus was not a "brand new" virus that had not circulated in humans before, which was what most public health experts had expected from any future pandemic flu virus. Instead, the Swine flu H1N1 virus was incredibly similar to that which caused H1N1 Spanish flu, which had killed around 50 million people worldwide about 90 years previously. A version of this virus had continued to circulate in pigs for nearly a century (hence the label of Swine flu) and was eventually able to transfer back to humans and cause a new pandemic at a time when immunity levels had dropped significantly.

The researchers comment that the unexpected origin of the current H1N1 pandemic provides a cautionary tale and warn that is possible that the H2N2 strain could ultimately behave in a similar way, creating a new flu pandemic to which the general (and especially the younger) population presently have little or no immunity.

What steps then do the researchers propose should be taken?
Those involved in the research concluded that the potential risk of a global and potentially lethal pandemic meant that serious consideration of a pre-emptive vaccination programme was warranted. 
The researchers rightly point out that there are concerns over whether it makes sense to expose individuals to vaccines for a virus that is not currently circulating in humans. There is also the possibility that if the virus does cross over to humans, it will have mutated to the extent where the previously licensed vaccine will be ineffective. Further studies of the existing H2N2 vaccine would certainly be required to confirm its safety and efficacy.

Having considered the potential obstacles to global pre-emptive vaccination including cost, logistical realities and public concerns about vaccines generally, a number of possible courses of action by worldwide government authorities have been suggested. These include:
1. Manufacture of the vaccine licensed in 1957 for use against the original H2N2 virus and immunisation of enough of the worlds population to provide immunity. The intention of this is to vaccinate a large enough proportion of people so that the virus cannot easily spread to non-vaccinated individuals.
2. Stockpiling of the vaccine licensed in 1957 so that in the event of an outbreak, supplies are readily available. Those contributing to the article however express the view that this would be more expensive and less effective than routine vaccination.
3. The manufacture of  lots of H2N2 vaccine, which can be used to rapidly increase production as soon as signs of an outbreak occur. Whilst it is noted that this may be a cheaper option, it is also argued that this would be a less effective pre-emptive measure of protecting the world population from a possible pandemic than either of the other two options.

Personal Comment
As a consequence of this research article, there is an argument that government agencies should develop a pre-emptive vaccine programme against H2N2. However, it must be borne in mind that despite the theoretical parallels, it can be extremely difficult to identify if, never mind when, such a strain of flu will cross the species barrier to affect humans again. In addition it is very difficult to predict how widely the disease will spread or how severely it will affect people.

As a clinical negligence solicitor, I have had the sad opportunity to witness the devastating effects that the Swine flu outbreak has had upon a very unfortunate minority of sufferers, and the tragic consequences that can follow from either a failure to diagnose and appreciate the possible severity of the illness, or conversely, a misdiagnosis of Swine flu being made, when in fact the individual was suffering from a more serious illness requiring urgent treatment.  It should be remembered though that although the current outbreak of Swine flu has proved to be extremely dangerous for some individuals, it does not cause the majority of people to become seriously ill. Whilst heed should be paid to the researchers' findings and comments, it is important to ensure that it is not utilised as a scaremongering tactic without looking at the limitations of what this research can reliably predict for the future.

Kym Provan
Senior Solicitor

The Hidden Dangers of Swine Flu



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