Man Flu: “I told you I was ill”
by Dr Rob Lambkin-Williams and Mr Alex Mann, hVIVO
We all believe that for men, flu is much worse than for women, but it is simply not true. The notion that immune function varies between men and women is supported by previous clinical data. However there is very little data describing differences in illness between men and women with flu.
At hVIVO (formerly known as Retroscreen Virology until April 2015), which is based adjacent to the University of London, we infect volunteers with respiratory viruses to see how the virus and the human body interact. We recently compared the difference between the sexes, do men really get sicker than women, do they just complain more, or are they being given a rough ride by their other halves? We compared frequency and severity of disease, how much virus the person produced and their immunity. There was no difference between men and women in either how sick they were or how much virus replicated. Simply, man flu is a myth!
However, what is not a myth, is how serious influenza can be in the elderly and certain at-risk groups such as asthmatics or those with other chronic underlying conditions. The yearly influenza vaccination campaign is of course vital and the UK can be proud of its success.
An article in the Lancet raised questions about the effectiveness of the current inactivated vaccines in those over 70 years of age. The paper from Michael L. Jackson and colleagues at the Group Health Center for Health Studies in Seattle, questioned the effectiveness of the vaccine . There can be little doubt that the vaccine is effective for most, but the key thing is that it can be improved. The current vaccine used for adults in the UK contains inactivated (dead) virus, but for the first time this year, healthy children will be offered a different type of flu vaccine, a weakened live virus that is sprayed intransally. The development of new types of vaccine is key to improving effectiveness.
There are two sides to the immune system, the antibody side, which is what most current flu vaccines are designed to stimulate; but there is also the cellular side. We recently, along with colleagues at Oxford University, tested a novel influenza vaccine designed to boost the cellular side of the immune system and we showed it worked . The key thing is that that this side of the immune system may give a broader protective immune response, which could last over several years and importantly may give immunity against any new flu viruses, including bird flu. Separately we conducted research along with Duke University in the USA, Oxford University and Southampton University that showed how important the cellular side of the immune system may be in protecting against flu 
In flu virology, this is the Holy Grail – a universal flu vaccine.
BUT, there is still a lot of work to do. At hVIVO we continue to infect volunteers with respiratory viruses such as Flu, Rhinovirus or Respiratory Syncytial Virus and quarantine them in a dedicated facility for up to two weeks. We do this to determine how the virus and the human body interact and to better understand all components of the immune system, hopefully we can help develop the most effective vaccine for the future.
- Jackson ML, Nelson JC, Weiss NS, Neuzil KM, Barlow W, et al. (2008) Influenza vaccination and risk of community-acquired pneumonia in immunocompetent elderly people: a population-based, nested case-control study. Lancet 372: 398-405.
- Lillie PJ, Berthoud TK, Powell TJ, Lambe T, Mullarkey C, et al. (2012) Preliminary assessment of the efficacy of a T-cell-based influenza vaccine, MVA-NP+M1, in humans. Clin Infect Dis 55: 19-25.
- Wilkinson TM, Li CK, Chui CS, Huang AK, Perkins M, et al. (2012) Preexisting influenza-specific CD4+ T cells correlate with disease protection against influenza challenge in humans. Nat Med 18: 274-280.