Annual Scientific Meeting 2014 Abstracts & Speakers

We will continue to update these: 

Flu epidemiology update - Dr Ian Barr

Deputy Director at the WHO Collaborating Centre for Reference and Research on Influenza, Melbourne.

The 2013 influenza season in Australia was a low-normal season overall.  The season began in mid-June and peaked in late August however, cases were still being reported in November and into December.  There were some 28,282 NNDSS laboratory confirmed cases of influenza in 2013 compared to 44,577 cases in 2012 (a 37% reduction in 2013 vs 2012).  Larger numbers of “out of season” cases – Jan-May and Nov-Dec were seen in 2013, similar to what was seen in 2011.  The reason for this is unknown but maybe due to increased out of season testing, higher numbers of travellers returning from the northern hemisphere or other factors.  In terms of the severity of the season 2013 was lower than 2012 with fewer hospitalizations and ICU admissions and also fewer deaths from influenza reported (28 in 2013 vs 60 in 2012 –see Australian Influenza Report #9).  Circulating viruses consisted of a mixture of H1N1pdm09, H3N2 and B-Yamagata-lineage viruses with H1N1pmd and B viruses predominating in Australia and H3N2 and B-Yamagata viruses predominating in NZ.  The SH vaccine strains were generally well matched to the circulating strains in Australia and NZ. In the current 2013-4 Northern Hemisphere influenza season, North America have been experiencing a relatively severe H1N1pdm09 epidemic while Europe, China and Japan have had a milder season with a mixture of H1N1pdm and H3N2 viruses circulating.

Update on antivirals & other therapeutic approaches - Dr Aeron Hurt 

Senior Research Scientist & Head of Anti-viral Sensitivity Analysis, WHO Collaborating Centre for Reference & Research on Influenza, Melbourne

Antivirals play an important role in the treatment and prevention of influenza. This overview presentation will cover the current landscape of influenza antivirals that are either on the market or under late-phase clinical trials in various countries around the world. Recent data on the use, effectiveness and development of resistance will be presented for the currently approved antivirals adamantanes and neuraminidase inhibitors, as well as novel antivirals nitazoxanide, favipiravir (T-705) an fludase (DAS-181) that are undergoing clinical trial in 2014.

Hospital surveillance & reporting network - A/Prof Allen Cheng

Associate Professor in Infectious Diseases Epidemiology Department of Epidemiology and Preventive Medicine, Monash University, Infectious Diseases Physician, Alfred Hospital and Honorary Principal  Research Fellow Menzies School of Health Research.

Update on pandemic threats: H7N9 and MERS-CoV - A/Prof Ian Mackay

Qpid Laboratory, SASVRC, QCMRI, The University of Queensland

A healthcare worker who became ill 21-March 2012 was the first case to be confirmed as infected by the novel Middle East respiratory syndrome coronavirus (MERS-CoV). The first human case of avian influenza A(H7N9) virus infection became ill 19-February 2013. Neither virus can spread efficiently among humans, but a primary animal host or a source for zoonotic infection has yet to be confirmed. Data suggest that bats and camels are possible sources of MERS-CoV infections, while exposure to live bird markets is a major risk factor for acquiring an H7N9 infection.

Each virus remains geographically isolated; the Arabian peninsula for MERS-CoV and south-east China for H7N9. Around 200 cases of human infection have been ascribed to each virus to date; >40% of MERS-CoV cases have died as have >20% of H7N9 cases. No vaccines are available.

To date, testing of humans has been predominantly by PCR and on samples from severely ill hospitalized cases and their close symptomatic contacts. Prospective human studies are lacking so the distribution and thus transmission of these viruses within mild respiratory disease, or among the asymptomatic, remains unknown.

This presentation will provide an overview of virus discoveries, laboratory methods, case definitions and current epidemiology.

New/novel vaccines in late development stages and what is registered and about to be registered in Australia - Dr Gary Grohmann

Director, Immunobiology, Office of Laboratories and Scientific Services, Monitoring and Compliance Group, TGA. Canberra.

Over 7 million doses of trivalent influenza vaccine (TIV) were distributed throughout Australia in 2013. Vaccines currently available in Australia (supplied by 5 manufacturers) are; Agrippal (Novartis), Fluarix (GSK), Fluvax  (BioCSL), Influvac (Abbott), Intanza & Vaxigrip (Sanofi Pasteur). Other registered vaccines include FluAd (Novartis) and Fluarix Quadrivalent (QIV) and XFlu (GSK) but these are not currently supplied. In addition there are a number of registered pandemic vaccines. There are also a number of vaccines for which entry into the Australian market is under consideration including, a seasonal live attenuated influenza Vaccine (LAIV) (BioDiem), a QIV (Sanofi Pasteur), new TIVs and QIVs, and various pandemic vaccines.  By contrast there are 13 seasonal vaccines available in the USA and 17 in Europe/UK.

The technology landscape of influenza vaccines is changing with several new approaches being developed by manufacturers and researchers. Recent successes have included a number of LAIVs and Protein Sciences’ FluBlok, the first registered recombinant vaccine. Other likely successes in the future include recombinant subunit expression systems involving yeasts, tobacco plants and fungi, and vaccines using Virus-like particles (VLP) involving Lentivirus, baculovirus, fungi, and plant expression systems.

Influenza B - how serious is it? Dr Sue Huang

Director, WHO National Influenza Centre (NIC), New Zealand

Influenza vaccines in children – past, present and future - Dr Chris Blyth

Paediatric Infectious Diseases Physician and Clinical Microbiologist, School of Paediatrics and Child  Health (SPACH), University of WA

TIV in children: Untoward reactions - Ms Marlena Kaczmarek

Sidney Myer PhD Scholar, The Queensland Children's Medical Research Institute (QCMRI) & School of Population Health, The University of Queensland, Victorian Infectious Diseases Reference Laboratory (VIDRL)

Sidney Myer PhD Scholar, The Queensland Children's Medical Research Institute (QCMRI) & School of Population Health, The University of Queensland, Victorian Infectious Diseases Reference Laboratory (VIDRL)

In Australia, influenza vaccination is recommended for children aged over 6 months, although this recommendation is not funded under the National Immunisation Program. Following the 2010 influenza vaccination safety concerns, it was identified that there are limited summary data published on the risk of fever and febrile seizures in children following influenza vaccination.

We conducted a review of the risk of fever and febrile seizures following receipt of trivalent

inactivated influenza vaccine (TIV) in children aged ≥6 months to <36 months, searching PubMED and Google Scholar for English language articles from 2000 onwards, and initiated or ongoing unpublished studies since September 2007 using Clinicaltrials.gov.

We identified a total of 909 published papers, however after excluding 890 published papers or unpublished trials, 5 published papers and 14 unpublished trials were included in this review. Extracted data on number of events, children at risk and time of follow-up were converted to the risk of fever, which was averaged per week of follow-up (referred to as 'averaged weekly risk').

Following one dose of TIV, the median averaged weekly risk of any fever (≥37.5oC) was 26.0% (range 10.3-70.0%) in unpublished trials compared to 8.2% (range 5.3-28.3%) in published papers (p=0.04). The median averaged weekly risk of severe fever (≥39.0oC) was 3.2% (range 0-10.0%) and 2.0% (range 0.6-17.0%), respectively (p=0.91). No febrile convulsions were reported in the reviewed papers.

Although the relatively low rate of severe fever and absence of febrile reactions was reassuring, this study highlights the difficulty in obtaining, interpreting and comparing adverse event data following TIV. Variation in the reporting of fever by participant age groups, time since vaccination and the definition or measurement of fever resulted in a wide range of risk estimates.

It is strongly recommended that the reporting of adverse events following vaccination, including febrile reactions, should be standardised to allow comparison between manufacturers and influenza seasons.

Safety monitoring of seasonal influenza vaccines after the Horvath Review - Dr Bronwen Harvey (1) and Ms Julianne Quaine (2)

1. Head, Signal Investigation (Medicines), Unit Office of Product Review, Therapeutic Goods Administration 2. Assistant Secretary, Immunisation Branch, Australian Government Department of Health

Since the identification of an increased risk of fever and febrile convulsions in children under five years of age following administration of bioCSL Fluvax in 2010, there has been an increased focus on monitoring the safety of influenza vaccines, especially in young children and when vaccine strains change. 

A review of the management of the 2010 adverse events (the Horvath Review) resulted in a number of recommendations for improving vaccine safety monitoring and response which have now been substantially implemented. In addition, although bioCSL Fluvax is no longer registered for use in children under 5 years of age, there are still instances of immunisation providers using this product in this age group.

The presentation will provide an outline of changes to the vaccine safety monitoring and response system implemented since 2010 by the Department of Health as part of the Office of Health Protection’s oversight of the National Immunisation Program and regulatory activities undertaken by the Therapeutic Goods Administration, with a particular focus on ensuring the safety of seasonal influenza vaccines.   

Background overview of alternative vaccines: LAIV, adjuvants, ID vaccines - Dr Alan Hampson,

Chairman of the ISG, BSc, MSc, M.D.(Hon), FASM, OAM.

Parental attitudes to influenza and influenza vaccination - Ms Catherine King

PhD candidate, Sydney Medical School, University of Sydney; Information Manager, NCIRS

Accessibility barriers - Ms Susanne Sperber-Pflaumer and Dr Rod Pearce

Ms Susanne Sperber (1) and Dr Rod Pearce (2) 

1. ISG Communications Specialist

2. AM, Adelaide and country GP; Member of ATAGI; Medical Officer, Eastern Health Authority and Royal District Nursing Service; ISG Director

Relationship between pneumococcal pneumonia and influenza - Prof Robert Booy

Head of Research, National Centre for Immunisation Research and

Surveillance of Vaccine Preventable Diseases, ISG Director

- Background on interaction of flu and bacteria in pneumonia e.g. during pandemics

- Current epidemiology of severe pneumonia

- Influenza & Community-acquired Pneumonia Interactions The Impact of Order and Time of Infection

- Research implications

- Some reflections on use of vaccines for flu and pneumococcus, independently and together.

Conjugate pneumococcal vaccines for children and adults - Dr Margie Danchin

Paediatrician, Royal Children’s Hospital; Senior Researcher, Murdoch Children’s Research Institute

Communicating Influenza 2013 & 2014 - Kim Sampson (1) & Susanne Sperber (2)

1. CEO of the ISG 

2. ISG Communications Specialist