Throughout my career, I’ve always gravitated toward opportunities in which I could help the most people. I’m a pulmonologist and critical care physician by training, so early on I treated many people with acute infectious diseases. They would be hospitalized with a clinical problem like pneumonia or sepsis, and I did my best to treat them effectively.
During my fellowship in pulmonary critical care at the University of California at San Francisco (UCSF), I also completed a master’s degree in public health at the University of California at Berkeley. That experience upped my fluency in epidemiology and biostatistics. I was able to ask clinical questions in a more rigorous way that elicited rich responses. The idea of applying this skill set to developing new medicines that could benefit thousands of people around the world was what drew me to Genentech.
My career here was initially focused on asthma and respiratory disease. Later on, I was asked to help create late-stage development strategies in infectious disease to support our research and development organizations, one of which focused on medicines to treat the flu. I thought it could be incredibly meaningful to work in an area like flu, a major public health threat that impacts millions of people each year. Although we anticipate the flu every year, there continues to be a great unmet need because it’s an infection that not only spreads rapidly within our bodies but also to those around us.
One of the most devastating examples of the widespread effect influenza can have is the Spanish flu pandemic of 1918. It swept the globe, killing three to five percent of the world’s population — between 50 and 100 million people — making it one of the deadliest natural disasters in human history. It was so severe, in fact, that the life expectancy in the United States dropped by about 12 years.
Luckily, we have not seen a repeat of the 1918 Spanish flu, but the threat of future flu pandemics remains a real concern.1 Despite significant medical advancements over the past 100 years, including the rise of antiviral treatments, there are still between three to five million cases of the flu annually, resulting in millions of hospitalizations and up to 650,000 deaths worldwide. To understand the potential lethality of the flu, it’s important to understand how the disease works.
The influenza virus enters
the respiratory system through
the mouth or nose
and begins to
The virus enters host
cells and begins
Within a day or two, viruses spread throughout the respiratory system, causing lung and nasal inflammation which result in cough and congestion.2, 4
Infection in the respiratory tract causes an immune response throughout the body, triggering symptoms like fever or chills, headache, muscle aches and fatigue.3
The influenza virus enters the respiratory system through the mouth or nose and begins to spread within the body.1
The virus enters host cells and begins to replicate, making new influenza viruses.2
Within a day or two, viruses spread throughout the respiratory system, causing lung and nasal inflammation which result in cough and congestion.1, 3
Infection in the respiratory tract causes an immune response throughout the body, triggering symptoms like fever or chills, headache, muscle aches and fatigue.2
The flu is highly contagious, especially because you can transmit the virus even before you’re clinically sick. Thousands of droplets spread every time someone with the flu coughs, sneezes or breathes, and those droplets can very easily be inhaled by those they are exposed to daily. Plus, the droplets can land on a table or other surfaces and live on them for up to 48 hours. When people touch the impacted areas and then touch their nose or mouth, they can also infect themselves with the virus.
Vaccinations are still our best line of defense in preventing the flu, and the Centers for Disease Control and Prevention (CDC) recommends that everyone six months and older get vaccinated annually. But not everyone gets vaccinated, and even people who are vaccinated can still get the flu. During the 2017-2018 flu season, for example, vaccine effectiveness was estimated to be 40%.
At Genentech, we believe that the mismatch between the annual flu vaccine and the actual circulating strains of influenza underscores the importance of flu treatment. Even if people do everything they’re supposed to — yearly vaccinations at the start of flu season, routine cleaning of surfaces, steering clear of people who are sick and frequently washing their hands — people can still get the flu. Overall, we know that three to eleven percent of the U.S. population will still contract the flu each year. If you do get the flu, it’s important to talk to your doctor quickly because antiviral medicines taken within the first 48 hours may help you feel better faster and avoid spreading the virus to others.
It’s been incredible to see the advancements in the medical field since I left clinical practice about 10 years ago. In particular, I’m excited to see progress in developing new medicines to treat influenza, which comprises a key part of the strategy to protect public health.5,6 We clearly need new antiviral agents to address this major global public health problem, and I’m confident that scientists around the world, including those at Genentech, will continue to advocate for flu prevention and invest in developing medicines to treat it.
1 Centers for Disease Control and Prevention. Viruses of Special Concern. Retrieved September 28, 2018, from: https://www.cdc.gov/flu/pandemic-resources/monitoring/viruses-concern.html.
2 Taubenberger JK, Morens DM. The pathology of influenza virus infections. Annu Rev Pathol. 2008;3:499-522.
3 Canini L, Carrat F. Population modeling of influenza A/H1N1 virus kinetics and symptom dynamics. J Virol. 2011;85:2764-70.
4 Carrat F, Vergu E, Ferguson NM, et al. Time lines of infection and disease in human influenza: a review of volunteer challenge studies. Am J Epidemiol. 2008;167:775-85.
5 NIH: National Institute of Allergy and Infectious Diseases, Influenza Treatment. Retrieved September 28, 2018, from: https://www.niaid.nih.gov/diseases-conditions/influenza-treatment.
6 FDA. Guidance for Industry Influenza: Developing Drugs for Treatment and/or Prophylaxis. Retrieved September 28, 2018, from:https://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm091219.pdf.