Summer 2021 Publication

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INTERVIEW WITH AN EXPERT:DR YEN(Interview conducted by Eugenia Calvo Prieto)What drew you towards the study of epidemiology/epidemiological science?I am a virologist with training in veterinary medicine and epidemiology. As mostof the emerging infectious diseases are of animal origin, I was very interested tounderstand the drivers that facilitate their emergence and spread.Your research interests focus on the mechanisms of influenza transmission among andbetween different reservoirs, potential virus-host interactions and pathogenicity. Whattypes of influenza viruses do you study and what are some interesting findings?I study animal and human influenza viruses.For animal influenza viruses, such as avian influenza and swine influenza, we are interested tounderstand why some of these viruses can cross the species barrier and infect humans. For example,H5N1 or H7N9 avian influenza viruses can cause severe infections in humans with high case fatalityrates. Close contact with infected poultry at the human-animal interfaces, such as live poultry markets,is an important risk factor. Our study at the live poultry markets detected avian influenza viruses inairborne particles and from contaminated surfaces, suggesting the risk of exposure to these virusesvia aerosols and fomites.We studied the 2009 H1N1 human pandemic influenza virus that originatedfrom swine influenza viruses that lacked the sustained human-to-humantransmissibility; we identified viral factors that contributed to its efficienttransmissibility in humans. In addition, we use animal models to investigatethe size range of airborne particles that mediate human influenzatransmission. Since last year, our research has been extended to work withthe SARS-CoV-2 virus that causes COVID-19. We work closely with amultidisciplinary team to study the relative significance of different modes ofinfluenza transmission.You also examine the molecular determinants that can confer antiviral resistance, can youexplain what these determinants are?8| SUMMER 2021
Antivirals target specific viral proteins, usually, an enzyme that has a critical function during the virusreplication cycle. The mutation that confers resistance to the antiviral compounds may emerge in the targetedviral protein due to selection pressure. Since these targeted viral proteins are essential for viral replication,some of the resistant mutations may lead to a functional loss of the protein and reduce viralfitness. On the other hand, some mutations can confer resistance to antivirals withoutcausing too much fitness loss of the protein/viral fitness. These mutations have a higherpotential to spread in humans. Identify these mutations may help to improve the design ofcurrent antivirals.What are some ways we can prevent antimicrobial, specifically antiviral, resistance?One of the strategies to reduce antiviral resistance is combination therapy, a strategy that is very effective fortreatment against HIV infections. It is because the likelihood for a virus to acquire multiple mutations to conferresistance to different antivirals while maintaining its fitness is low.There has been a sharp drop in flu cases during the past year most likely due to maskwearingand social distancing. Could this be an effective way of preventing (and controlling)flu outbreaks? What else could we do to prevent there from being many flu cases like inpast years?The use of multiple non-pharmaceutical interventions has been effective in reducing thetransmission of SARS-CoV-2 and influenza. However, the socioeconomic cost of implementingthese interventions is significant. I can see this strategy being used again when we face a newinfluenza pandemic but not against epidemics. Influenza vaccines, especially novel vaccinesthat are currently under development with new vaccine technology, may be alternative tool.Additionally, since there have been such a small number of cases, how could the virus haveevolved or changed differently in the past year?Indeed, the global influenza activity has been very low in the past 16 months. In Hong Kong, we have almost nodetection (low numbers) of influenza patients through the surveillance system, but low influenza activity can stillbe detected in some regions. This low-level circulation may reduce the evolution rate of the virus. At the sametime, population immunity for the influenza virus is waning due to the lack of exposure to the viruses. It is likelythat we will see a surge of influenza activity when most of the countries lift COVID-19 related control measuresand when international travel is resumed.DR. YENABOUTDr. Hui-Ling Yen received her Ph.D. in Epidemiological Science from TheUniversity of Michigan, Ann Arbor followed by her postdoctoral training at St.Jude Children’s Research Hospital, Memphis, TN. Her research interests focus onunderstanding the mechanisms of influenza transmission among and betweendifferent reservoirs, investigating potential virus-host interactions that affect viralpathogenicity and transmission, and examining the molecular determinants thatconfer antiviral resistance.EUNOIA GLOBAL HEALTH |9
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