published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

This paper examines the correlates of seasonal flu vaccination in Canada between 2000 and 2011. In terms of the socio-economic characteristics of the population that relate to higher take-up, my findings are consistent with the previous literature. Specifically, the most important predictors of vaccination are the risk factors: age and chronic conditions. My results also suggest that both novel respiratory disease outbreaks and provincial immunization program design are important determinants of the seasonal flu vaccine take-up. The absence of a separate vaccine intended to protect from a novel virus during its epidemic could increase the seasonal flu vaccine take-up. In cases when a separate vaccine is offered, the seasonal flu vaccine take-up depends on the timing of vaccines’ delivery and the extent of prior influenza immunization coverage for a specific population subgroup in a province.

In this study, the expression of HA, a key immunogenic protein of influenza viruses, in insect cells was compared using three baculovirus expression strategies: protein over-expression, surface (GP64) display, and capsid (VP39) display. Further, a recombinant virus expressing NA, another immunogenic influenza virus protein, was generated and fused to an HA epitope-tag. Western immunoblot using various antibodies, including those against HA, demonstrated the expression of HA and NA for all recombinant viruses. HA showed stronger expression when fused to the C-terminus of VP39 than the N-terminus, but unlike other expression methods, there was no observable cleavage of HA in VP39-displayed viruses. Cells infected with only over-expressed and surfaced-displayed HA were biologically active, and capable of hemadsorption and hemagglutination of chicken red blood cells. These results suggest that GP64 display or over-expression are the most efficacious modes of HA-expression for use as antigen to detect anti-HA antibodies in poultry. / NSERC, OGS, OMAFRA, CPRC

This study designed and computational docked a group of ligands intended to find potent inhibitors for Neuraminidase 4 which would have strong interactions with 8 conserved amino acids in the active site. Several trials of ligands were designed based on derivatives of neuraminic acid and evaluated as inhibitors of influenza neuraminidase. Optimized geometries of those ligands were determined using HF/B3LYP/6-311++G** techniques. Binding energies of the ligands bound to the N4 subtype of the neuraminidase protein were determined using AutoDock 4.0. Currently used inhibitors for influenza viruses will also be analyzed in the exactly same way. Comparing the binding information of those candidates and current ligands can provide a useful data about the potential of these species as antiviral drugs. / Department of Chemistry

Influenza is a major concern across healthcare environments. Annual vaccination of healthcare workers (HCWs) remains essential for maintaining the health and availability of HCWs, as well as influenza prevention in healthcare environments. Yet, annual vaccination coverage among HCWs continues to be below recommended standards during pandemic (pH1N1) and non-pandemic (sINFLU) influenza seasons. The primary aim of this research is to inform the design and implementation of effective HCW targeted influenza vaccination campaigns via a 1) systematic review of the existing literature on HCW pH1N1 vaccination, 2) qualitative content analysis of motivators and barriers to HCW pH1N1 and sINFLU vaccination, as well as 3) quantitative regression analysis of modifiable factors predicting pH1N1 and sINFLU vaccination. The qualitative and quantitative analysis processes were applied to data collected from a large-scale multi-professional sample of HCWs. Findings from all analysis sections were found to be consistent. Most attitudes, beliefs, motivators, and barriers influencing HCW influenza vaccination were similar for pH1N1 and sINFLU vaccinations. Yet, a number of notable differences were also identified. HCWs were likely to accept vaccination if they perceived, 1) vaccination to be safe, 2) vaccination to be protective against influenza for self, loved ones, patients or communities, and 3) influenza to be a serious and severe infection to self and others. Additionally, encouragement from supervisors and colleagues, physicians, and loves ones also enhanced vaccine uptake. Most HCWs avoided vaccination because of 1) limited knowledge or misinformation about vaccination, 2) concern for vaccine induced side-effects and 3) assuming vaccination was not a requirement for healthy adults. With respect to pH1N1 vaccination, mass media communications, perceptions of novel vaccinations, and rapid vaccine development processes especially deterred HCW pH1N1 vaccination. Future vaccination programs targeting HCWs should look towards influencing HCWs’ vaccination attitudes and promoting pro-vaccination cultures in healthcare workplaces.

Das Influenzavirus infiziert Säugetiere und Vögel. Der erste Schritt im Infektionszyklus ist die Anbindung des Viruses über sein Oberflächenprotein Hämagglutinin (HA) an Zuckerstrukturen auf Epithelzellen des respiratorischen Traktes im Wirtsorganismus. Aus den drei komplementaritätsbestimmenden Regionen (complementarity determining regions, CDRs) der schweren Kette eines monoklonalen Hämagglutinin-bindenden Antikörpers wurden drei lineare Peptide abgeleitet. Die Bindungseigenschaften der drei Peptide wurden experimentell mittels Oberflächenplasmonenresonanzspektroskopie untersucht. Es zeigte sich, dass in Übereinstimmung mit begleitenden Molekulardynamik-Simulationen zwei der drei Peptide (PeB und PeC) analog zur Bindefähigkeit des Antikörpers in der Lage sind, Influenzaviren vom Stamm X31 (H3N2 A/Aichi/2/1968) zu binden. Die Interaktion des Peptids PeB, welches potentiell mit der konservierten Rezeptorbindestelle im HA interagiert, wurde anschließend näher charakterisiert. Die Detektion der Influenzaviren war unter geeigneten Immobilisationsbedingungen im diagnostisch relevanten Bereich möglich. Die Spezifität der PeB-Virus-Bindung wurde mittels geeigneter Kontrollen auf der Seite des Analyten und des Liganden nachgewiesen. Des Weiteren war das Peptid PeB in der Lage die Bindung von X31-Viren an Mimetika seines natürlichen Rezeptors zu inhibieren, was die spezifische Interaktion mit der Rezeptorbindungsstelle im Hämagglutinin belegt. Anschließend wurde die Primärsequenz von PeB durch eine vollständige Substitutionsanalyse im Microarray-Format hinsichtlich der Struktur-Aktivitäts-Beziehungen charakterisiert. Dies führte außerdem zu verbesserten Peptidvarianten mit erhöhter Affinität und breiterer Spezifität gegen aktuelle Influenzastämme verschiedener Serotypen (z.B. H1N1/2009, H5N1/2004, H7N1/2013). Schließlich konnte durch Verwendung einer in der Primärsequenz angepassten höher affinen Peptidvariante die Influenzainfektion in vitro inhibiert werden. Damit stellen die vom ursprünglichen Peptid PeB abgeleiteten Varianten Rezeptormoleküle in biosensorischen Testsystemen sowie potentielle Wirkstoffe dar. / The influenza virus infects mammals and birds. The first step of the infection cycle comprises the attachment of the viral surface protein hemagglutinin (HA) on glycan structures on epithelial cells within the respiratory tract of the host organism. Starting from the complementarity determining regions (CDRs) of the heavy chain of a monoclonal hemagglutinin-binding antibody three linear peptides were derived. The binding properties of these peptides was characterized experimentally using surface plasmon resonance spectroscopy. In accordance with accompanying molecular dynamics simulation it was shown, that two of the three peptides (PeB and PeC) were able to bind the influenza virus of the strain X31 (H3N2 A/Aichi/2/1968) comparably to the antibody itself. The interaction of peptide PeB, which was supposed to bind to the conserved receptor binding site at the HA, was then characterized more in detail. The detection of influenza viruses was achieved within the diagnostically relevant concentration range using defined immobilization conditions. The specificity of the peptide-virus-binding was proven by appropriate control experiments. Additionally, peptide PeB was able to inhibit the binding of X31 viruses to mimics of its natural receptor. Furthermore the structure-activity-relationship within all the amino acids of peptide PeB was characterized using a full substitutional analysis in a microarray format. This led to improved peptidic variants, which were able to bind different influenza serotypes and inhibit the influenza infection in vitro. The found peptides and their variants can now be used as receptor molecules in biosensors and also represent potential drug candidates.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 47-01, page: . Adviser: John Herbold. Includes bibliographical references.

Thesis (M.P.A.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 86-88).

Thesis (M.P.A.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 86-88). Also available in print.

Vacinas inativadas de vírus inteiro (WIV) são amplamente utilizadas para o controle de influenza A em suínos (SIV) nos Estados Unidos e Europa e conferem proteção contra cepas homólogas à vacina reduzindo a doença clínica. Porém, a proteção da WIV pode ser limitada contra um desafio heterólogo. O aumento da doença respiratória associado à vacina (VAERD) foi descrito em suínos vacinados com uma WIV contendo uma cepa δ1-cluster-H1N2 e desafiado com uma cepa heteróloga contendo a mesma hemaglutinina, H1N1pdm09. Nesse contexto, os suínos apresentaram pneumonia severa com aumento das lesões pulmonares associado ao uso da WIV. No primeiro manuscrito foi avaliado se a formulação da WIV, o tempo entre o reforço vacinal e o desafio, e a idade de vacinação tinham impacto em VAERD. Suínos foram vacinados com duas vacinas bivalentes, WIV-δ1H1N2/H3N2 (MN08-TX98) ou WIV-δ1H1N2/H1N1pdm09 (MN08-CA09), administradas em duas doses com intervalo de três semanas, e desfiados com H1N1pdm09, três semanas após o reforço. Além disso, dois grupos foram vacinados com uma WIV-δ1H1N2 (MN08) e desafiados três ou seis semanas após o reforço. Em um estudo subsequente, dois grupos vacinados com uma WIV-δ1H1N2 com duas doses da vacina em diferentes idades: a primeira dose com 4 ou 9 semanas de idade e o reforço com 7 ou 12 semanas de idade. E um grupo vacinado com uma vacina viva atenuada de influenza (LAIV). Os animais foram desafiados com H1N1pdm09 às 15 semanas de idade. Com exceção dos grupos MN08-CA09, LAIV e controles, todos os grupos WIV apresentaram lesões pulmonares consistentes com VAERD. Nenhum grupo induziu anticorpos neutralizantes para o H1N1pdm09, exceto MN08-CA09. No entanto, grupos vacinados com a WIV-MN08 em diferentes idades induziram anticorpos IgG não-neutralizantes com reatividade cruzada com o H1N1pdm09 no soro e no pulmão, comparado com LAIV e controles. Esses dados sugerem que a idade da primeira dose da vacina, a formulação com a vacina bivalente MN08-TX98 e o desafio seis semanas após o reforço vacinal, não preveniram o desenvolvimento de VAERD. Em contraste, a vacinação com a LAIV demonstrou proteção até oito semanas após reforço. No segundo manuscrito foi avaliado o impacto dos adjuvantes na formulação da WIV no modelo de VAERD. Cinco grupos foram vacinados com WIV-δ1H1N2 formuladas com diferentes adjuvantes comerciais: óleo em água 1 (OW1), OW2, nano-emulsão (NE), gel polímero (GP) e partículas imuno-estimulantes aquosa (IMP). O protocolo vacinal/desafio foi utilizado com três semanas de intervalo entre as doses. Os grupos vacinados com WIV-OW apresentaram lesões macroscópicas nos pulmões consistentes com VAERD comparado com WIV-NE, WIV-GP e controles. Nenhum dos grupos induziu anticorpos neutralizantes contra o vírus do desafio (H1N1pdm09). Similarmente, os grupos WIV-OW, WIV-NE e WIV-GP induziram anticorpos não neutralizantes IgG de reatividade cruzada contra o H1N1pdm09 no soro e pulmão. Apesar dos anticorpos não neutralizantes com reatividade cruzada nos grupos WIV-NE e WIV-GP, não apresentaram lesões pulmonares tão severas como os grupos OW. Além disso, os adjuvantes tiveram um papel significativo na imunogenicidade da WIV e no desenvolvimento de VAERD. / Whole inactivated virus (WIV) vaccines reduce clinical disease against homologous influenza A virus (IAV) infection and are widely used in swine; however, WIV has been associated with vaccine-associated enhanced respiratory disease (VAERD) when challenged with heterologous IAV of the same hemagglutinin subtype. Here, we evaluated the impact of age at vaccination and timing between vaccination and challenge on development of VAERD using a model with a human-like 1δ cluster swine MN08 H1N2 as the vaccine component and pandemic H1N1 (H1N1pdm09) virus as the challenge strain. Pigs were vaccinated with bivalent WIV vaccine containing H1N2-MN08/H3N2-TX98 or H1N2-MN08/H1N1pdm09-CA09. All groups were challenged with H1N1pdm09 at 3 weeks post-boost (wpb). In addition, a monovalent WIV MN08 H1N2 group was challenged at 6 wpb to determine if time post-vaccination played a role on VAERD. In a follow up study, we compared the time of first WIV vaccination (4 or 9 weeks of age) and the boost three weeks later (7 or 12 weeks of age) to determine if age at first vaccination or if 8 weeks duration between vaccination and challenge impacted VAERD. A live-attenuated influenza virus (LAIV) vaccine administered at 4 and 7 weeks of age was also included. Pigs from study 2 were challenged with H1N1pdm09 at 15 weeks of age. All mismatched WIV groups had significantly higher macroscopic and microscopic lung lesions compared with LAIV, bivalent MN08-CA09 and non-vaccinated challenge controls. These data suggest that the age of first vaccination or length of time between booster dose and subsequent challenge do not alter the development VAERD in WIV vaccinated pigs. In the second paper, we evaluated the impact of adjuvant in WIV vaccine on VAERD-affected pigs. Pigs were vaccinated with WIV containing swine MN08/H1N2 that were formulated with five different commercially available adjuvants: OW1, OW2, nano-emulsion (NE), gel polymer (GP), and aqueous immunostimulating particulate (IMP). Pigs were vaccinated with 2 doses, 3 weeks apart, by the intramuscular (WIV-OW1, -OW2, -NE, and -GP) or intranasal (WIV-IMP) routes. Non-vaccinated and challenged pigs (NV/C) and non-vaccinated, non-challenged pigs (NV/NC) were included as controls. Following challenge with H1N1pdm09, WIV-OW1 and WIV-OW2 groups had significantly higher percentages of macroscopic lung lesions consistent with VAERD compared to the NV/C controls, and in contrast to WIV-NE, WIV-GP and WIV-IMP. Prior to challenge, WIV-OW, NE and GP groups had the hemagglutination inhibition antibody (HI) titers to the vaccine strain compared with controls. The WIV-IMP group had HI mean titers below the positive cut-off, with no response to any immune parameter measured, so it could not be implicated or excluded in the VAERD model. None of the groups had cross-reactive HI antibodies against the H1N1pdm09. WIV-OW groups had significantly higher levels of IgG antibody in serum against homologous and heterologous virus; however, the WIV-NE and WIV-GP groups also had serum IgG antibody against both viruses, so presence of total virus IgG alone did not explain the different VAERD outcomes. Adjuvant played a significant role in WIV immunogenicity and in VAERD; however the mechanism requires further investigation.