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NIAID Establishes Centers of Excellence For Influenza Research and Surveillance


Anthony S. Fauci, M.D.
Director
National Institute of Allergy and Infectious Diseases

The threat of an influenza pandemic is a major source of concern for the public health community.

According to the World Health Organization (WHO), seasonal influenza epidemics account for an estimated 250,000-500,000 deaths each year. Pandemic influenza is less predictable. The three influenza pandemics of the last century, 1918, 1957, and 1968, caused approximately 50 million, 1-2 million, and 700,000 global deaths, respectively.

2007 marked the 10th anniversary of the first known human infections with highly pathogenic avian influenza (HPAI) H5N1. These 18 cases occurred in Hong Kong in 1997. In 2003, the virus resurfaced in poultry in several other Asian countries and caused a handful of human infections and deaths. Today, HPAI H5N1 infections in poultry and wild birds have spread to over 60 countries throughout Asia, the Middle East, Europe, and Africa. Human H5N1 infections have been reported in 14 countries.

Although sustained human-to-human H5N1 transmission has not and may never occur, the threat still looms of this virus or another influenza virus emerging to cause the first influenza pandemic of this century.

To address this threat, the United States government in 2004 initiated an aggressive effort toward pandemic influenza preparedness. This endeavor extends across federal departments and to all levels of government. Within the federal government, the Department of Health and Human Services (HHS) leads influenza surveillance and countermeasure development efforts through the complementary roles of its agencies. Part of the National Institutes of Health (NIH), the National Institute of Allergy and Infectious Diseases (NIAID) supports a robust research portfolio for the conduct of basic and clinical research leading to development of influenza countermeasures: vaccines, therapeutics, and diagnostics. In order to develop effective countermeasures against influenza, a fundamental understanding of the emerging virus is required.

To this end, in spring of 2007, NIAID awarded six research centers $23 million per year for seven years to establish the Centers of Excellence for Influenza Research and Surveillance (CEIRS). The CEIRS consists of six US-based Centers and international collaborators at surveillance sites around the globe (Figures 1, 2).

Collectively, the CEIRS will bolster current knowledge on two primary fronts. Animal influenza surveillance efforts will be expanded to more countries and will explore new animal reservoirs (not just birds) and influenza virus prevalence at the animal-human interface, will continue to provide virus characterization for vaccine development, and will track the natural spread of novel viruses and evaluate control strategies. Research on influenza virus pathogenesis and host response will improve the current understanding of immune correlates of protection for vaccine research, the host immune response during influenza infection, and determine the molecular mechanisms of transmission, adaptation to host, and pathogenicity.

The overarching goal of the CEIRS is to provide critical information to advise public health strategies for prevention and control of an influenza pandemic and to dampen the yearly impact of seasonal influenza. These efforts are an important complement to those of NIH’s sister agency within HHS, the Centers for Disease Control and Prevention (CDC), which leads the U.S. government in human influenza surveillance and detection.

Collectively, everything learned about the influenza virus for pandemic influenza preparedness will have a positive impact on informing control measures for seasonal influenza.

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Figure 2: