H7N9 Spreads to Taiwan; Island

Biotechs Rush to Make VaccineBy Dave Silver Contributing WriterTAIPEI, Taiwan – With the number of confirmed H7N9 infections cases in China currently at 108 and 22 deaths, Taiwan confirmed its first case of H7N9 avian influenza infection – a 53-year-old Taiwanese returning to the island on April 9 after working in China's Jiangsu province. Meanwhile, viral material for use in both creating more accurate diagnostic kits and for vaccine production arrived in Taiwan, sent courtesy of Chinese health authorities.Taiwan's Department of Health has tasked Adimmune Corp. and Medigen Biotechnology Corp. with the job of producing a vaccine.The 53-year-old Taiwanese infected with H7N9 is in a coma and being held in a negative-pressure isolation ward in an unnamed hospital in Taipei. Taiwan's Center for Disease Control (CDC) has identified more than 130 people who had been in contact with the man since his return. Those people must now report for health checks and observations.Apparently, the patient had not been in contact with birds during his time in China, a worrying sign that H7N9 infection is easily transmitted. This is on top of an announcement from the World Health Organization (WHO) on April 24 that H7N9 is particularly lethal and transmits more easily to humans than H5N1 , for example. Both the Chinese health authorities and the WHO have said that human-to-human transmission while likely to have occurred in a few cases is not as yet a sustained method of infection.The U.S. Centers for Disease Control and Prevention (CDC) has activated its Emergency Operations Center and has been fully engaged in responding to the novel strain of influenza. CDC's partnership with China over the past decade has allowed authorities there to move quickly to sequence the genome of this particular strain of influenza A (H7N9) virus, and post it in an internet database for others to see.Adimmune, of Taipei, (TPE:4142) is the island's only private manufacturer of vaccines for human use, and the only one with experience in making vaccines in high volumes within a short period of time. Medigen, of Taipei, (TPE:3176) is a relative newcomer to vaccine production. Medigen has developed a cell-based vaccine production system, TideCell, where cell-supporting medium flows over the vaccine-producing cells in a tide-like fashion, reportedly allowing higher cell densities and higher yields than conventional production methods. The company has plans to build a plant to demonstrate its technology, but it's still at the drawing board stage. (See BioWorld Today, April 15, 2013.)The two companies are in an ongoing public spat over who is better qualified to handle to task. Likely both companies will be asked to do so, with Adimmune using the traditional chicken egg-based production method, and Medigen using its cell-based production method, one it claims will be particularly important if an island-wide poultry cull – with a subsequent egg shortage – is enacted if the infection situation significantly worsens.A vaccine would still take several months to produce even if work starts today, although it depends how urgently the vaccine is required. That is a decision for Taiwan's Department of Health. A vaccine with lower efficacy can be ready in a shorter time.The U.S. FDA issued an emergency use authorization for the CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panel-Influenza A/H7 (Eurasian Lineage) assay because there are no FDA-cleared tests that identify the existence of H7N9.