ETIDIOH - NEW

  Abstract Neuraminidase inhibitors (NAIs) and cap-dependent endonuclease inhibitors (CENIs) represent two classes of antiviral drugs recommended for early treatment of patients with seasonal influenza A virus (IAV) infections. However, only limited human data , particularly on combination antiviral treatment , are available to inform optimal dosing regimens against novel IAVs, including highly pathogenic avian influenza A(H5N1) virus , associated with severe disease . Clade 2.3.4.4b A( H5N1 ) viruses have caused outbreaks in avian and mammalian species worldwide , highlighting the need to assess antiviral drug efficacy against these strains. We challenged ferrets with a D1.1 genotype A(H5N1) virus and treated infected animals with the NAI oseltamivir phosphate (OST) and the CENI baloxavir acid (BXA), alone or in combination , with treatment onset commencing pre- or post-symptom onset (24- or 48-hours post-inoculation (p.i.), respectively). When administered pre- or post-illness on...

  ABSTRACT The outbreak of highly pathogenic avian H5 influenza (HPAI) clade 2.3.4.4b in cattle has spread across the United States . Mice with pre-existing immunity to H1N1 virus or with a live-attenuated influenza vaccine showed protection against a lethal bovine-derived HPAI H5N1 viral challenge . Notably, ferrets with mixed immunity also demonstrated protection against a feline-derived H5N1 virus, independent of cross-reactive neutralization titers , but antibodies to whole virus were observed. To investigate protective factors, we conducted T cell epitope mapping using published H1N1 viral sequences and found high conservation of key T cell epitopes in the bovine HPAI H5N1 strain . Depletion of T cells in mice prior to and during primary H1N1 infection impacted cross-protective antibodies to H5N1 virus, with CD4 depletion increasing mortality and CD8 depletion mildly impacting morbidity upon H5N1 viral challenge. This underscores the need to investigate memory T cell responses...

  Abstract Seasonal and pandemic influenza viruses are continuous threats to human health, requiring rapid development of vaccines to multiple evolving viral strains. RNA vaccine technologies have the adaptability and manufacturability to facilitate pandemic preparedness but have limited flexibility in their route of administration , reducing the ability to establish local protective immune responses such as respiratory mucosal immunity . Here, we describe monovalent and bivalent replicon vaccines against A/Vietnam/1203/2004 H5N1 and A/Anhui/PA-1/2013 H7N9. These replicon vaccines express either H5 or H7 hemagglutinin and are formulated with a nanostructured lipid carrier (NLC) that permits both intramuscular (IM) and intranasal (IN) dosing. In mice , IM vaccination established systemic humoral and cellular responses but no detectable mucosal response , while IN administration induced robust systemic and mucosal immunity . The replicon-NLC vaccines protected against morbidity and m...

  Abstract The global spread of highly pathogenic avian influenza A(H5N1) clade 2.3.4.4b viruses has recently extended to include diverse mammalian species , raising new concerns about pandemic risk . In 2023, this clade was first detected in Russian marine mammals during a mass mortality event among northern fur seals in the Far East . Genetic analyses revealed the causative viruses to belong to genotype A3 of European origin , which is known to have circulated in wild birds across the Far East since 2022. Notably, these isolates harbor the mammalian-adaptive substitutions PB2-K482R and NP-N319K—mutations previously linked to enhanced virulence in non-H5 avian influenza viruses , but whose impact on A(H5N1) clade 2.3.4.4b viruses remained to be characterized. The heightened virulence of A3 genotype viruses is confirmed by data obtained via a mouse model . However, despite these adaptive changes, ferret transmission models showed no evidence of airborne transmission of the fur seal...

  Abstract The global spread of highly pathogenic avian influenza A(H5N1) viruses poses a serious pandemic threat . While sustained human-to-human transmission has not occurred, widespread circulation in birds , increased detection in mammals , and occasional human spillovers underscore the need for safe and effective vaccines . We evaluated an H5 mRNA vaccine candidate in ferrets using recent clade 2.3.4.4b A(H5N1) human isolates. Vaccination elicited strong neutralizing antibodies , conferred robust protection against lethal challenge , and significantly reduced viral titers . In a direct contact transmission model , mRNA vaccination decreased virus shedding in inoculated ferrets and reduced onward transmission ; it also protected vaccinated contact ferrets from infection following exposure to virus-shedding, unvaccinated ferrets. Additionally, sera from vaccinated animals cross-neutralized clade 2.3.2.1e human viruses to varying degrees, depending on the strain. These findings d...

  Abstract Influenza viruses cause hundreds of thousands of infections globally every year. In the past century, seasonal influenza viruses have included H1N1, H2N2 or H3N2 strains . H2N2 influenza viruses circulated in the human population between 1957-1968 . Previously, our group demonstrated a lack of H2N2 influenza virus immunity in individuals born after 1968 , as well as the effectiveness of hemagglutinin (HA) based vaccines for multiple influenza virus subtypes. In this study, H2 antigenic maps and radial graphs were generated using previously published data from H2 HA vaccinations of ferrets and seasonal influenza vaccinations of humans . The antigenic maps revealed a stark difference in clustering of HA antigens between the ferrets and humans, and the radial graphs showed specific antigen recognition varies greatly between different influenza preimmune ferrets . These maps also revealed the significant impact that different pre-existing immunities have on antigenic recogni...

  Abstract The spread of H5N1 clade 2.3.4.4b in dairy herds raises concerns about zoonotic transmission due to its high viral load in milk , a key contact point between livestock and humans . H5N1 clade 2.3.4.4b exhibits tropism for the mammary gland , with milk from infected animals containing high levels of infectious virus , posing potential risks to offspring via breastfeeding . Using a lactating ferret model , we demonstrate that mammary gland infection with bovine H5N1 transmits the virus to suckling kits , resulting in neonatal mortality . Viral RNA levels increased in milk and remained high in mammary tissue, with infected kits exhibiting elevated viral RNA in the oral and nasal cavities and feces . Additionally, we detected the H5N1 receptor, α2,3 sialic acid , in ferret and human mammary tissue . These data demonstrate that H5N1 clade 2.3.4.4b infection in lactating dams leads to mastitis-related disease and transmits to suckling pups, resulting in mortality among neonate...

  ABSTRACT Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of coronavirus disease 2019 (COVID-19), is characterized by its high contagiousness. The COVID-19 pandemic has exerted profound impacts on human society . The persistent circulation of SARS-CoV-2 in human populations continues to pose re-exposure risks for both vaccinated individuals and those with prior natural infection. Against this epidemiological background, there is an urgent need to characterize the transmission dynamics of SARS-CoV-2 in the context of pre-existing immunity . Using a ferret infection model , this study systematically addresses critical scientific questions , including viral transmission efficiency , temporal patterns of transmissibility , and the ability of pre-existing immunity to mitigate reinfection and viral shedding. The findings provide robust experimental evidence for elucidating the transmission mechanisms of SARS-CoV-2 and offer scientific insights to info...

  Abstract Background :  Monitoring antigenic drift in human influenza A viruses is essential for vaccine strain selection and ensuring protection against circulating strains. Antigenic drift is traditionally assessed using ferret antisera , which provide monospecific responses , and human vaccinee sera , which reflect exposure to multiple antigens. In this study we evaluated the pig as an alternative source of antisera to study antigenic drift compared to immune responses in ferrets and humans. We included seasonal influenza A(H1N1pdm09) human viruses that had shown different antigenic characteristics when using ferret or human antisera.  Methods :  Pairs of pigs were inoculated with six human A(H1N1)pdm09 viruses circulating between 2019 and 2023, a period of marked antigenic drift. Pig and ferret antisera were analysed by hemagglutination inhibition (HI) and virus neutralization (VN) assays.  Results :  Pigs were successfully infected with all strains, s...

  Abstract Highly pathogenic avian influenza A(H5) viruses globally impact wild and domestic birds, and have caused severe infections in mammals, including humans , underscoring their pandemic potential . The antigenic evolution of the A(H5) haemagglutinin (HA) poses challenges for pandemic preparedness and vaccine design . Here the global antigenic evolution of the A(H5) HA was captured in a high-resolution antigenic map . The map was used to design immunogenic and antigenically central vaccine HA antigens, eliciting antibody responses that broadly cover the A(H5) antigenic space. In ferrets , a central antigen protected as well as homologous vaccines against heterologous infection with two antigenically distinct viruses. This work showcases the rational design of subtype-wide influenza A(H5) pre-pandemic vaccines and demonstrates the value of antigenic maps for the evaluation of vaccine-induced immune responses through antibody profiles. Source: Nature,  https://www.nature.c...

  Highlights •  UniFluVec, an H1N1pdm vaccine candidate , includes NS1 and NEP modifications to boost attenuation and immunity. •  UniFluVec protects ferrets from H5N1 , enhancing clearance, limiting lung damage, and ensuring 100 % survival after one dose. •  Replication-deficient UniFluVec shows cross-protection , supporting its potential as a pre-pandemic intranasal vaccine. Abstract Background The emergence of new influenza strains with unpredictable antigenic properties poses a significant vaccination challenge. The increasing incidence of human H5 infections underscores the urgent need for effective pre-pandemic vaccines. Methods The UniFluVec and UniFluVec-wtNS1 viruses were designed as H1N1pdm vaccine candidates . Both viruses contained a heterologous A/Singapore/1/57-like (H2N2) NEP gene , which served as an attenuation factor . UniFluVec additionally carried a truncated to 124 amino acids NS1 gene , and an insertion of conserved influenza sequences. UniFluVe...

  ABSTRACT Influenza A viruses continuously circulate among avian and swine species, posing a persistent threat to public health . The development of influenza candidate vaccine viruses (CVVs) plays a pivotal role in the global strategy for influenza pandemic preparedness . Safety-testing of CVVs for attenuation in ferrets represents a critical step that takes place prior to making these viruses available to vaccine manufacturers . Development of pathogenicity standards is needed to establish acceptable thresholds of disease so that CVV safety can be assessed without the need for comparison to the parental virus. To assess the capacity of diverse CVVs to cause pathogenesis in mammalian hosts , clinical and virological parameters were compiled from CVV assessments in ferrets conducted using consistent methods over approximately 20 years to identify disease parameters most reflective of attenuation compared to wild-type strains. These analyses revealed an overall reduction in ferret ...

  Abstract Highly pathogenic avian influenza A(H5N1) clade 2.3.4.4b viruses have infected >1,000 herds of dairy cattle and hundreds of poultry flocks in the United States since the beginning of 2024. Seventy human cases have been reported during that period, mainly through occupational exposure . Although prior influenza A(H1N1)pdm09 virus infection has been shown to confer protection against influenza A(H5N1) clade 2.3.4.4b virus infection in the ferret model, it remains unclear if influenza vaccines , known to elicit a less potent and narrower cross-reactive immune response, can achieve a similar effect. In this article, we demonstrate that immunization with commercially available human seasonal influenza vaccines also confers partial protection against disease caused by H5N1 clade 2.3.4.4b virus in ferrets , which is partially associated with the presence of cross-reactive antibodies targeting H5N1 virus antigens. Source: US Centers for Disease Control and Prevention,  h...

  ABSTRACT The ferret model is widely used to study influenza A viruses (IAVs) isolated from multiple avian and mammalian species , as IAVs typically replicate in the respiratory tract of ferrets without the need for prior host adaptation . During standard IAV risk assessments , tissues are routinely collected from ferrets at a fixed time point post-inoculation to assess the capacity for systemic spread. Here, we describe a data set of virus titers in tissues collected from both respiratory tract and extrapulmonary sites 3 days post-inoculation from over 300 ferrets inoculated with more than 100 unique IAVs (inclusive of H1, H2, H3, H5, H7 , and H9 IAV subtypes, both mammalian and zoonotic origin ). All experiments were conducted by a single research group under a uniform experimental protocol , making it the largest well-controlled publicly available data set to date of discrete tissue titers reported on a per-ferret level. Analysis of these tissues revealed spatial variation in i...

  ABSTRACT Alterations in the PB2-627 domain of avian influenza virus (AIV) can potentially increase the risk of cross-host species infections in humans and mammals . Recently, there has been a rise in human cases of AIV infections without the presence of the known mammalian determinant PB2-E627K . Here, we identified a variant, PB2-627V , which has evolved in poultry and has contributed to the increase in human AIV infections . By screening global PB2 sequences , we discovered a new independent cluster of PB2-627V that emerged in the 2010s , prevalent in avian, mammalian, and human AIV isolates , including those of H9N2, H7N9, H3N8, 2.3.4.4b H5N1 , and other subtypes. We functionally assessed its host adaptation , fitness , and transmissibility across three subtypes of AIVs (H9N2, H7N9, and H3N8) in different host models . PB2-627V combines the viral properties of avian-like PB2-627E and human-like PB2-627K , facilitating AIVs to efficiently infect and replicate in chickens and mi...

  Abstract In an effort to avert future pandemics, surveillance studies aimed at identifying zoonotic viruses at high risk of spilling over into humans act to monitor the "viral chatter" at the animal-human interface. These studies are hampered, however, by the diversity of zoonotic viruses and the limited tools available to assess pandemic risk. Methods currently in use include the characterization of candidate viruses using in vitro laboratory assays and experimental transmission studies in animal models. However, transmission experiments yield relatively low-resolution outputs that are not immediately translatable to projections of viral dynamics at the level of a host population. To address this gap, we present an analytical framework to extend the use of measurements from experimental transmission studies to generate more quantitative risk assessments. Specifically, we use within-host viral titer data from index and contact animals to estimate parameters relevant to tran...

  ABSTRACT Airborne transmissibility of avian influenza viruses (AIVs) in humans is considered an essential component of their pandemic risk . Although several viral factors regulating airborne transmission (AT) have been delineated, it is not known what, if any, responses at the respiratory epithelia are determinants of AIV AT. Using responses in the ferret nasal epithelium to a panel of H1N1 AIVs, we describe host responses that segregate with AT phenotypes . AIV infection upregulated interferon alpha and gamma responses and IL-6 JAK-STAT signaling and downregulated oxidative phosphorylation . Single-cell transcriptomics revealed that cellular genotoxic stress and NF-kB, interferon, and cell fate pathways differentiated host responses to AIVs with different transmissibilities. These responses culminated in greater AIV antigen-containing exudate and debris in the respiratory spaces of the nasal epithelium of ferrets inoculated with AT AIVs. More abundant CMPK2, SP100, and CXCL10 t...

Editor’s summary The vast majority of the human population has immunity to influenza A virus (IAV) by prior infection, vaccination, or both . However, protection is generally subtype-specific , and it is not clear whether prior infection against one subtype could confer protection against clade 2.3.4.4b H5N1 IAVs , which are currently circulating in birds and dairy cows . Here, Restori et al. demonstrated that prior infection with the 2009 pandemic H1N1 IAV was protective against subsequent direct infection with H5N1 IAV in ferrets. Moreover, prior immunity reduced susceptibility to infection by transmission from an infected donor ferret. These data suggest that prior immunity to IAV, especially to the 2009 pandemic H1N1 virus, may offer a degree of protection against H5N1 infection. —Courtney Malo Abstract Zoonotic infections with emerging influenza viruses occur in the context of population-wide immunity to seasonal strains . Because of the worldwide spread of highly pathogenic clade...

Abstract Sudan virus (SUDV) causes highly lethal outbreaks of hemorrhagic disease throughout Africa , but there has yet to be an approved vaccine or therapeutic to combat this public health threat. The most common route of natural exposure to filoviruses is through mucosal contact which greatly impacts initial viral replication. Historically, SUDV animal models used an intramuscular infection route . Here, we sought to further characterize an animal model using mucosal challenge routes and compared the impact that intramuscular, intranasal, or aerosol exposure had on SUDV pathogenicity in a ferret model . We determined that the route of infection did not significantly impact overall SUDV pathogenicity; only subtle changes were detected in magnitude of viremia and oral viral shedding. Additionally, we sought to determine if preexisting Lloviu virus (LLOV) immunity could protect ferrets from lethal SUDV infection. We found that the previous immunity elicited by LLOV infection was not suf...

Abstract In March 2024, clade 2.3.4.4b highly pathogenic avian influenza A(H5N1) viruses were first detected in U.S. dairy cattle . Similar viruses have since caused 70 zoonotic human infections . To assess changes to zoonotic potential , we characterized A( H5N1 ) clade 2.3.4.4b viruses isolated from cows’ milk and birds . Bovine-derived viruses are lethal in mice and ferrets and transmit to direct but not airborne contact ferrets. All viruses replicate in human bronchial epithelial cells despite preferentially binding avian virus-like receptors. The bovine-derived viruses remain susceptible to FDA-approved antivirals , and they are inhibited by sera from ferrets vaccinated with WHO-recommended candidate vaccine viruses (CVV) or human sera from clade 2.3.4.4c vaccinees. While 2.3.4.4b viruses induce severe disease in mammalian models , they retain many avian virus-like characteristics. Combined, we conclude that the risk of contemporary bovine-derived viruses to humans not in contact ...