Tracy Staedter

Jan 9th 2019

Medical Advances Are Pushing the Future of Flu Detection


This time of year, mutants are on the hunt for their next victims. They’re influenza viruses, genetic shape-shifters that can transform into new strains in order to evade the human immune system. Highly contagious, these viruses are among the top 10 leading causes of death in the United States, right behind diabetes, according to Medical News Today. Last year, the flu hospitalized more than 900,000 Americans and killed 80,000, according to the Centers for Disease Control (CDC). Fortunately, researchers around the world are working on medical advances to develop new flu detection and prevention techniques. From molecules that glow when they attach to viruses, to a new FDA-approved drug that can eradicate the pathogen in a day, future flu medicines could save thousands of lives.

Hunting for Hidden Mutants

There’s a reason doctors call it “flu season,” noted the CDC. Although the influenza virus is present year-round, it generally peaks between December and February, with the most cases appearing in February. But finding it before it wreaks havoc isn’t easy. The virus is notoriously shifty, said the CDC. Tiny genetic changes occur constantly within these organisms as they multiply inside individuals and spread throughout a population. Over weeks and months, the changes accumulate to form new flu strains. This means that previously infected or vaccinated people who’ve built up warrior proteins, called antibodies, to combat last year’s flu strain don’t have them for this year’s strain. Occasionally, the genetic change is so big and abrupt that it can cause a pandemic, as it did back in 2009, when the H1N1 virus — otherwise called the swine flu — spread throughout the world.

These never-ending genetic mutations make flu detection a challenge. Although doctors have a range of tests available to confirm whether someone has the flu, none are perfect. The fast ones produce results in under 20 minutes, but are only about 50 to 70 percent accurate, said CBS News. The more accurate tests take several hours or even days to produce results. Some research groups have been working to develop faster, more accurate diagnostics. Last year, scientists at the University of Notre Dame released a study in which they developed a test and that detects the enzyme neuraminidase, which is found on the surfaces of influenza viruses. The test is made of engineered molecules designed to glow red under a laser when they attach to the neuraminidase enzyme, confirming the presence of the virus. The molecules glow blue if they bind with antiviral drugs such as Tamiflu or Relenza, that inhibit the enzyme and prevent the virus from gaining a foothold.

Flu tests are not common, though. Typically, they’re given to patients who may be at risk for developing life-threatening infections. They’re also used in situations where doctors need to determine the cause of a local, isolated outbreak. But if doctors had a quick, accurate test that not only detected the flu but also indicated whether the prescribed antiviral drug was taking effect, it could help drive more targeted treatments.

Engineering Mutant Warriors

Better flu treatments are in the works. At the end of October 2018, the Federal Drug Administration approved a new flu medicine developed in Japan that stops the influenza virus in just one dose. Called Xofluza, the drug targets an enzyme, called endonuclease, that the virus relies upon to make genetic copies of itself. That approach is similar to how the common anti-flu drug Tamiflu works, said PBS News Hour. It also blocks an enzyme (in this case, neuraminidase) that helps the flu virus replicate. The difference is that patients need only take one dose of Xofluza — compared to two daily doses of Tamiflu over five days — quickly reducing flu symptoms and the risk of infections.

As any doctor will tell you, the best defense against the flu is to get vaccinated. But because strains are always mutating, vaccines aren’t always effective. Scientists must make educated guesses early in the year, well before flu season, about how to formulate the vaccine. Sometimes they miss the mark. According to CNBC, flu vaccines have ranged in effectiveness.

Earlier this year, two research teams said they were close to developing a universal flu vaccine that would be effective against all strains, noted Scientific American. One team, led by scientists at the University of California, Los Angeles, has engineered molecules to hit flu viruses with a double whammy: They trigger the body’s immune system to create antibodies and also encourage it to produce disease-fighting white blood cells called T cells. Conventional vaccines elicit antibodies but not T cells. Having all hands on deck, so to speak, would mount a more robust attack against any flu virus attempting to infiltrate a new host.

Another team, this one led by scientists at the Icahn School of Medicine at Mount Sinai in New York City, has taken a different approach. After studying flu viruses, they made important discoveries about how viruses are able to mutate, which has to do with surface structures that look something like heads of broccoli covering the ball-shaped virus. It turns out the genetic mutations occur in the broccoli-like heads, but the stalk-like structure doesn’t mutate at all. Conventional vaccines target the head. But the Mount Sinai team figured out a way to design a vaccine that targets the stalk. They think a universal vaccine is just years away, reported CNBC.

Take Care of Yourself

Each fall and winter, the flu rears its ugly head. But as medical advances shed new light on how the flu virus works, better detection, treatments and vaccines will come into focus. For now, take care to get vaccinated and pay special attention to children, the elderly, pregnant women and people with certain chronic health conditions, who are at the highest risk.