In pursuit of influenza: Fort Monmouth to Valhalla (and back)

Super-spreaders: a historical review

The term super-spreader is used for multiple, and sometimes even conflicting, purposes. The reasons for this can be traced back to its complex history. Forerunners of the super-spreader concept-in discussions of so-called dangerous carriers and in analyses of explosive outbreaks during the early 20th century-revolved primarily around gastrointestinal diseases, not respiratory ones. In 1957-58, the H2N2 influenza pandemic and Wells and Riley's studies on tuberculosis drew attention to both the viability of airborne transmission and the existence of significant heterogeneity in infectivity. The term super-spreader was coined in 1972, in relation to computer simulations of influenza epidemics. Initially, super-spreaders were simply an additional feature within stochastic models of epidemics, with little effect on an epidemic's eventual course. The term was later appropriated to explain why outbreaks of airborne diseases continued in vaccinated populations, defying the predictions of contact-transmission-based models. The content and meaning of the term continued to fluctuate, from the mathematical characterisation of sexually active people with gonorrhoea, through HIV carriers with highly infectious semen, to central nodes within a network. This Historical Review reconstructs the historical growth of the concept of super-spreading, and offers insight into its current, highly diversified use.

Genetic analysis of mouse-adapted influenza A virus identifies roles for the NA, PB1, and PB2 genes in virulence

Adaptation of the prototype A/FM/1/47 H1N1 strain to mice resulted in selection of the A/FM/1/47-MA variant with increased virulence. Earlier analysis identified mutations in the HA and M1 genes that increase virulence in the mouse. Complete sequence analysis identified mutations in the PB1, PB2, HA, NA, and M1 genes. Reassortants were produced between the parental FM and FM-MA strains to obtain viruses that differ due to combinations of mutant genes. To assess the relationship between virulence and replication, the median lethal dose was determined for mice and growth properties were assessed in mouse lung, MDCK cells and chicken embryo. Not only were all five mutations shown to control virulence but also the replicative capacity in the mouse. The HA, NA and M1 mutations increased yield in all three hosts whereas in combination the PB1 and PB2 mutations were host restrictive changing the virus to a mouse specific strain. For the NA and M1 mutations the increase in growth in mouse lung was proportional to a 2-fold (log10) increase in virulence however the HA mutation increased virulence largely independent of increased growth indicating a change in pathological properties that damage the host. Thus mutations that affect virulence can be classified according to host-dependent and independent ability to increase growth as well as changes in pathological properties. Each of the PB1, PB2, NA, HA, and M1 genes acquired gain-of-function mutations for mouse infection that involve structural motifs that may serve as markers for virulence or targets for antiviral therapy.