Sometimes medical researchers must raid the past for cures of the future.
For Winnipeg intensive-care specialist Anand Kumar, a single article about the 1918 influenza epidemic sparked the idea for an ingeniously simple H1N1 treatment that could be saving lives within six weeks.
"This form of therapy helped back then and I think it can do the same for us now," said Dr. Kumar, who treated dozens of Manitoba's most severe H1N1 cases last spring.
During the 1918 flu epidemic that killed upwards of 50 million people, doctors devised a method of extracting plasma from flu survivors and transfusing it into people stricken with the virus. The process of borrowing antibodies reduced death rates significantly and has been adapted to treat hepatitis A, herpes infections and other viruses.
But until now, it hasn't been used to treat another flu outbreak.
"That's because you don't see people horribly ill from seasonal flu very often," Dr. Kumar said. "This year, though, the risk is so high and we anticipate so many people will be ill, that it makes sense to develop this as an emergency therapy."
Many intensive-care doctors have felt helpless in treating severe H1N1 cases. Once they exhaust the therapies at their disposal - the antiviral Tamiflu and supportive care such as fluids and oxygen - they can do little but watch. So far, 78 Canadians have died of the virus.
"Things like Tamiflu definitely help, but some people will get severely ill despite that," said Dr. Kumar, who monitored 40 ventilated patients at the height of the spring onslaught. "This gives us another bullet in the gun for this battle."
Dr. Kumar is working with Winnipeg-based biopharmaceutical company Cangene to produce the treatment, called hyperimmune globulin. Yesterday, Cangene started posting ads asking for H1N1 survivors to donate plasma.
"We did this with SARS, collecting plasma from recovered health-care workers, so we're experienced," said company president John Langstaff.
The production process faces a number of regulatory and funding hurdles before the globulin can be distributed to hospitals, but Dr. Kumar doesn't anticipate any great delays. "The hope is, if everything goes well, it will be available by Christmas," he said. "I'd like to see it available on a compassionate basis within six weeks. Whether we'll get there or not, I don't know."
Health Canada will begin rolling out an H1N1 vaccine by late October or early November. The globulin differs from a vaccine in that it will be used to treat severe cases of the virus, rather than prevent contraction. "Basically, you take antibodies from someone who's recovered from H1N1, you concentrate it, and then you give it to someone who's deathly ill fighting for their lives," Dr. Kumar said. "The theory is this will help because it loans patients the immune system of someone who's already fought the virus off."
Researchers in Europe and the United States are also exploring globulin treatments, but the Winnipeg team appears to have a jump on the world.
"We could be extremely lucky and not need this," Dr. Kumar said, "and I'd love to be lucky, but I'd rather be prepared."