Arnold S. Monto | |
---|---|
Born | |
Citizenship | American |
Education | Weill Cornell Medicine (MD) Cornell University (BA) |
Occupations |
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Years active | 1958-Present |
Known for | Influenza seasonality [1] |
Medical career | |
Field | |
Institutions | University of Michigan School of Public Health |
Research | Influenza virus epidemiology |
Awards | Career Development Award, NIH Charles Merieux Award, National Foundation for Infectious Diseases Alexander Fleming Lifetime Achievement Award, Infectious Diseases Society of America [2] |
Arnold Monto (born March 22, 1933) is an American physician and epidemiologist. At the University of Michigan School of Public Health, Monto is the Thomas Francis, Jr. Collegiate Professor Emeritus of Public Health, professor emeritus of both epidemiology and global public health, and co-director of the Michigan Center for Respiratory Virus Research & Response. [3] His research focuses on the occurrence, prevention, and treatment of viral respiratory infections in industrialized and developing countries' populations.
Born in Brooklyn, New York City, Monto graduated from Erasmus Hall High School. He received a B.A. in zoology from Cornell University in 1954 and earned his M.D. from Cornell University Medical College, now Weill Cornell Medicine, in 1958. [4] From 1958 to 1960, he completed his internship and residency in medicine at the Vanderbilt University Medical Center. [5] From 1960 to 1962, he was a USPHS Post-Doctoral Fellow in Infectious Diseases at Stanford University Medical Center. [6]
Monto fulfilled his national service commitment in the Virus Diseases Section of the Middle America Research Unit: a part of the National Institute of Allergy and Infectious Diseases. While there, he began his career-long interest in respiratory illnesses; confirming that the same viruses causing illnesses in the temperate zones cause illnesses in the tropics. [3] He was among the first to observe that influenza viruses, in areas where temperatures were stable year-round, mainly occurred in the rainy season. [7] In 1965, Monto was recruited to the University of Michigan School of Public Health by Thomas Francis Jr., chair of and professor in the school's Department of Epidemiology. Monto rose through the academic ranks from research associate to professor. He served as chair of the school's Department of Population Planning and International Health from 1993 to 1996 and as director of the University of Michigan Center for Population Planning. [8] From 2002 to 2004, Monto was director of the University of Michigan Bioterrorism Preparedness Initiative. [9] In 2010, he was named the Thomas Francis Collegiate Professor of Public Health. [10] He is the founder and director of the University of Michigan-Israel Public Health Partnership for Collaborative Research and Education (2014–present) and is co-director of the Michigan Center for Respiratory Virus Research and Response, one of five centers across the country that collects data for the Centers for Disease Control and Prevention. [11] [12] Monto spent periods as a visiting scientist at Northwick Park Hospital Clinical Research Center in Harrow, England; at the World Health Organization in Geneva, working on implications of lower respiratory tract infections globally; and at the National Research Council, Washington, D.C. organizing studies of the causes of respiratory infections in low-resourced countries.
He is the author of over 350 research papers[ when? ] focusing mainly on the epidemiology and implications of respiratory infections, and co-editor of the Textbook of Influenza –Second Edition. [13]
In a career spanning six decades Monto has been involved in pandemic planning and emergency response [14] to influenza and other respiratory virus outbreaks, including the 1968 Hong Kong influenza pandemic, avian influenza, SARS, [15] MERS, [16] and the COVID-19 pandemic. [17]
In 2015, the U.S. Centers for Disease Control and Prevention established the annual "Arnold S. Monto Award" in honor of Monto for innovation in epidemiology and vaccinology. "Dr. Monto's work has helped us understand the value of measuring vaccine effectiveness in the communities where vaccines are used and taking that data to help enhance influenza prevention programs", said Joe Bresee, Chief of the Epidemiology and Prevention Branch of CDC's Influenza Division." [18]
In 2020, Monto was selected to chair the U.S. Food and Drug Administration Vaccines and Related Biological Products Advisory Committee (VRBPAC) on COVID-19 vaccines. [19]
Throughout his career, Monto has focused on the occurrence, prevention, and control of respiratory infections, with a particular interest in influenza. At the University of Michigan in 1965, he developed the Tecumseh Study of Respiratory Illness, which described the specific viruses involved in causing illnesses in American families over an 11-year period. [20] During the 1968 influenza pandemic, he found that vaccinating school-age children reduced infection in the entire community, an early demonstration of herd immunity. [21] Subsequently, he was involved in evaluating a variety of strategies to control influenza including vaccines, antivirals, and non-pharmaceutical interventions such as antiseptic tissues and face masks. [22] In particular, he designed and carried out critical studies evaluating the value of the neuraminidase inhibitors now in use for influenza. In the 2000s he was involved in developing pandemic control strategies including social distancing, leading to work at WHO and in the US during the 2009 swine flu pandemic. [23] He also led clinical trials establishing the superiority of inactivated vaccines compared to live attenuated vaccines in preventing influenza in adults. [24]
In 2010, Monto returned to the study of respiratory illnesses in families with the establishment of the Household Influenza Vaccine Evaluation (HIVE) Study. The design is a comprehensive one, allowing researchers to study many aspects of infection occurrence and prevention over time. The study has resulted in several notable findings related to natural infection with different viruses and the immune correlates of protection from different influenza vaccines. It was the first to demonstrate the potential problems with the serial use of such vaccines. [25] These issues are now being addressed as part of the Universal Influenza Vaccine Program. [26] [27] Monto was the plenary speaker for a 2017 NIH-led workshop of U.S. and international experts from academia, industry, and government to develop a strategic plan and research agenda aimed at the development of a universal influenza vaccine. [28] The design also allows study over time of other respiratory viruses including the coronaviruses. Monto is involved in other studies assessing influenza vaccine effectiveness in preventing medical encounters and hospitalization with a goal of improving protection. [29] A study in progress addresses the role of antivirals in seasonal and pandemic influenza control.
Influenza A virus (IAV) is the only species of the genus Alphainfluenzavirus of the virus family Orthomyxoviridae. It is a pathogen with strains that infect birds and some mammals, as well as causing seasonal flu in humans. Mammals in which different strains of IAV circulate with sustained transmission are bats, pigs, horses and dogs; other mammals can occasionally become infected.
Avian influenza, also known as avian flu or bird flu, is a disease caused by the influenza A virus, which primarily affects birds but can sometimes affect mammals including humans. Wild aquatic birds are the primary host of the influenza A virus, which is enzootic in many bird populations.
Orthomyxoviridae is a family of negative-sense RNA viruses. It includes seven genera: Alphainfluenzavirus, Betainfluenzavirus, Gammainfluenzavirus, Deltainfluenzavirus, Isavirus, Thogotovirus, and Quaranjavirus. The first four genera contain viruses that cause influenza in birds and mammals, including humans. Isaviruses infect salmon; the thogotoviruses are arboviruses, infecting vertebrates and invertebrates. The Quaranjaviruses are also arboviruses, infecting vertebrates (birds) and invertebrates (arthropods).
Oseltamivir, sold under the brand name Tamiflu among others, is an antiviral medication used to treat and prevent influenza A and influenza B, viruses that cause the flu. Many medical organizations recommend it in people who have complications or are at high risk of complications within 48 hours of first symptoms of infection. They recommend it to prevent infection in those at high risk, but not the general population. The Centers for Disease Control and Prevention (CDC) recommends that clinicians use their discretion to treat those at lower risk who present within 48 hours of first symptoms of infection. It is taken by mouth, either as a pill or liquid.
Influenza A virus subtype H5N1 (A/H5N1) is a subtype of the influenza A virus, which causes influenza (flu), predominantly in birds. It is enzootic in many bird populations, and also panzootic. A/H5N1 virus can also infect mammals that have been exposed to infected birds; in these cases, symptoms are frequently severe or fatal.
Swine influenza is an infection caused by any of several types of swine influenza viruses. Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) refers to any strain of the influenza family of viruses that is endemic in pigs. As of 2009, identified SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H2N1, H3N1, H3N2, and H2N3.
Human parainfluenza viruses (HPIVs) are the viruses that cause human parainfluenza. HPIVs are a paraphyletic group of four distinct single-stranded RNA viruses belonging to the Paramyxoviridae family. These viruses are closely associated with both human and veterinary disease. Virions are approximately 150–250 nm in size and contain negative sense RNA with a genome encompassing about 15,000 nucleotides.
Flu season is an annually recurring time period characterized by the prevalence of an outbreak of influenza (flu). The season occurs during the cold half of the year in each hemisphere. It takes approximately two days to show symptoms. Influenza activity can sometimes be predicted and even tracked geographically. While the beginning of major flu activity in each season varies by location, in any specific location these minor epidemics usually take about three weeks to reach its pinnacle, and another three weeks to significantly diminish.
Influenza A virus subtype H1N1 (A/H1N1) is a subtype of influenza A virus (IAV). Some human-adapted strains of H1N1 are endemic in humans and are one cause of seasonal influenza (flu). Other strains of H1N1 are endemic in pigs and in birds. Subtypes of IAV are defined by the combination of the antigenic H and N proteins in the viral envelope; for example, "H1N1" designates an IAV subtype that has a type-1 hemagglutinin (H) protein and a type-1 neuraminidase (N) protein.
An influenza pandemic is an epidemic of an influenza virus that spreads across a large region and infects a large proportion of the population. There have been five major influenza pandemics in the last 140 years, with the 1918 flu pandemic being the most severe; this is estimated to have been responsible for the deaths of 50–100 million people. The 2009 swine flu pandemic resulted in under 300,000 deaths and is considered relatively mild. These pandemics occur irregularly.
Influenza A virus subtype H3N2 (A/H3N2) is a subtype of influenza A virus (IAV). Some human-adapted strains of A/H3N2 are endemic in humans and are one cause of seasonal influenza (flu). Other strains of H1N1 are endemic in pigs and in birds. Subtypes of IAV are defined by the combination of the antigenic H and N proteins in the viral envelope; for example, "H1N1" designates an IAV subtype that has a type-1 hemagglutinin (H) protein and a type-1 neuraminidase (N) protein.
Vaccine efficacy or vaccine effectiveness is the percentage reduction of disease cases in a vaccinated group of people compared to an unvaccinated group. For example, a vaccine efficacy or effectiveness of 80% indicates an 80% decrease in the number of disease cases among a group of vaccinated people compared to a group in which nobody was vaccinated. When a study is carried out using the most favorable, ideal or perfectly controlled conditions, such as those in a clinical trial, the term vaccine efficacy is used. On the other hand, when a study is carried out to show how well a vaccine works when they are used in a bigger, typical population under less-than-perfectly controlled conditions, the term vaccine effectiveness is used.
Influenza, commonly known as the flu, is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These symptoms begin one to four days after exposure to the virus and last for about two to eight days. Diarrhea and vomiting can occur, particularly in children. Influenza may progress to pneumonia from the virus or a subsequent bacterial infection. Other complications include acute respiratory distress syndrome, meningitis, encephalitis, and worsening of pre-existing health problems such as asthma and cardiovascular disease.
The 2009 swine flu pandemic, caused by the H1N1/swine flu/influenza virus and declared by the World Health Organization (WHO) from June 2009 to August 2010, was the third recent flu pandemic involving the H1N1 virus. The first identified human case was in La Gloria, Mexico, a rural town in Veracruz. The virus appeared to be a new strain of H1N1 that resulted from a previous triple reassortment of bird, swine, and human flu viruses which further combined with a Eurasian pig flu virus, leading to the term "swine flu".
Airborne transmission or aerosol transmission is transmission of an infectious disease through small particles suspended in the air. Infectious diseases capable of airborne transmission include many of considerable importance both in human and veterinary medicine. The relevant infectious agent may be viruses, bacteria, or fungi, and they may be spread through breathing, talking, coughing, sneezing, raising of dust, spraying of liquids, flushing toilets, or any activities which generate aerosol particles or droplets.
Influenza prevention involves taking steps that one can use to decrease their chances of contracting flu viruses, such as the Pandemic H1N1/09 virus, responsible for the 2009 flu pandemic.
Ira M. Longini is an American biostatistician and infectious disease epidemiologist.
Allison Joan McGeer is a Canadian infectious disease specialist in the Sinai Health System, and a professor in the Department of Laboratory Medicine and Pathobiology at the University of Toronto. She also appointed at the Dalla Lana School of Public Health and a Senior Clinician Scientist at the Lunenfeld-Tanenbaum Research Institute, and is a partner of the National Collaborating Centre for Infectious Diseases. McGeer has led investigations into the severe acute respiratory syndrome outbreak in Toronto and worked alongside Donald Low. During the COVID-19 pandemic, McGeer has studied how SARS-CoV-2 survives in the air and has served on several provincial committees advising aspects of the Government of Ontario's pandemic response.
In epidemiology, a non-pharmaceutical intervention (NPI) is any method used to reduce the spread of an epidemic disease without requiring pharmaceutical drug treatments. Examples of non-pharmaceutical interventions that reduce the spread of infectious diseases include wearing a face mask and staying away from sick people.
The Global Influenza Surveillance and Response System (GISRS) is a global network of laboratories that has the purpose to monitor the spread of influenza with the aim to provide the World Health Organization with influenza control information. It was established in 1952 to conduct global influenza surveillance and to inform vaccine development. GISRS is coordinated by WHO and endorsed by national governments. Several millions of respiratory specimens are tested by GISRS annually to monitor the spread and evolution of influenza viruses through a network of laboratories in 127 countries representing 91% of the world's population. As well as human viruses, GISRS monitors avian and other potentially zoonotic influenza viruses. GISRS operates FluNet, an online tool used for virological surveillance of influenza.