Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Monday, August 13, 2018

The Never-Ending Battle Against Deadly Bacteriums

"The fear is: Is it going to turn into the Hib story in the sense that it will grow more globally? And even if it doesn't, right now it's a problem in the North, where people -- and little ones, in particular -- are dying unnecessarily."
"This is an invasive bacterial disease. You can get meningitis, you can get septicemia, you can lose your leg. And once it gets a hold it really advances quite quickly, a little bit like the meningococcal diseases."
"The incidence is quite low but the mortality is quite high. ...In the first two years of life, you're most at risk for this disease. It does seem to be skewed toward the Indigenous populations being most at risk."
Andrew Cox, research officer, National Research Council, Canada
The vaccine developed at NRC kills all Hia Type A bacteria strains from different parts of Canada, leading Andrew Cox, senior research officer, to believe it will be 'a very good vaccine.' (Pierre-Paul Couture, CBC News)

The National Research Council was tasked to perform preliminary work on finding a pharmaceutical response to a deadly new disease afflicting Indigenous communities in Northern Canada. Researchers, under the direction of Dr. Cox worked diligently, undertaking major research work that began in 2012 leading to a workable approach on defeating the bacterium in question through to 2016. Undertaking a gradual and determined series of steps leading to a general concept to produce a solution that in mice could be proven to work.

Now what remained was to find a pharmaceutical company willing to take the concept through tests to determine whether the therapeutic process in question is both safe and effective for human use, and to proceed with the manufacture of a commercial product. "That's where the so-called Valley of Death is, where a lot of products don't get through because of the sheer cost and the stringency of the tests", admitted Dr. Cox, of a prevalent situation where brilliant ideas do not necessarily end up as drugs available to sufferers of a remote disease whose victims are few, making it unlikely that the costs associated would not be recovered through returns on investment due to the paucity of patients.

The vaccine in which much hope will now be vested is meant to grapple with a new type of bacterial infection breaking out across Canada's North called Hemophilus influenzae type A; or Hia. Name aside, this infection has little relation to and no bearing on common influenza, caused b a virus leading to the familiar symptoms we're all familiar with. This bacterial disease is extremely nasty and sometimes deadly. In decades past, a cousin of this disease, the Type B version, called Hib, caused consternation and illness on a wide scale. Drug companies developed a vaccine for Type B, the result of which is hat it has been largely eradicated in Canada as well as in many other countries.

That nature abhors a vacuum is proven by example after example, and in the case of Hia, it moved in where Hib had vacated its presence and expanded -- but for the time being, appears to be selectively targeting Indigenous communities in the North. According to the Public Health Agency of Canada, over 300 cases surface yearly with a ten percent death rate. It remains a mystery why this killer bug has its dangerous presence in Nunavut, in the Far North of Quebec and in the Northwest Territories, excluding, for some unknown reason, Yukon where its presence is far less noticeable.
Frank St. Michael demonstrates how scientists at the National Research Council of Canada and the Public Health Agency of Canada created a vaccine for Hia, a potentially deadly bacteria. It affects predominantly northern Indigenous communities. (Pierre-Paul Couture, CBC News)

"That's a key question [why it targets Indigenous communities]. Simplistically, you think maybe it's the living conditions", muses Dr. Cox, cautioning that the disease is certainly not exempt from surfacing in major cities in the south as well in due time. When Dr. Cox's research group in Ottawa and Montreal initiated their study of the disease, the basic approach was clear to them even before launching their research. To teach the immune system to 'recognize' a piece of the bacterium and for the immune system to respond by mounting a defence against its foreign presence.

The outside membrane of the bacterium was used; basically, a minuscule chunk of carbohydrate which the immune system 'learns' to recognize. Their research complete and ready for trials and eventually production, the NRC alerted pharmaceutical companies along with Indigenous communities and scientists from around the nation, inviting them to take part in discussions. What resulted was that InventVacc Biologicals of Vancouver has been granted a licence to take the technology pioneered by the NRC to the next step; testing and producing a commercial product.

Once -- and if -- approved, the resulting vaccine is meant to be given in the first months of life, responding to the reality that risk begins at a young age. InventVacc anticipates the drug trials starting around 2020, taking two to four years for completion before production can start. In acknowledging that more widespread health problems such as tuberculosis exist in the North, Dr. Cox addresses that reality by noting "...this is one thing that we believe we could prevent. It's a gratifying feeling when you think, 'Yeah, we found a way where we can combat this'. But I realize there's still a very long way to go."

  • Since the late 1990s, there has been an emergence of Hia infections, especially in Indigenous communities in the northern regions of Canada and Alaska associated with significant morbidity and approximately a 10% mortality rate.
  • A total of 102 Hia cases have been observed since 2007, an average of 12.5 cases per year, with territorial referrals representing one-third of the cases.
  • Most Hia cases were observed in Winnipeg, Edmonton and MontrĂ©al hospitals, which serve as referral centres for Canada's territories.
  • InventVacc Biologics Inc. and its parent company Inventprise specialize in developing and manufacturing vaccines for unmet needs. The president of the firm, Dr. Subhash Kapre, led the development of the MenAfrivac vaccine to prevent Meningococcal A epidemics in Africa.i

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