CHAPEL HILL – Matthew Vogt, MD, PhD, Assistant Professor of Pediatrics in the Division of Infectious Diseases and of Microbiology & Immunology, and Michelle Hernandez, MD, Professor of Pediatrics in the Division of Allergy/Immunology, Director of the NC Child Health Research Network, Associate Medical Director of the NC Children’s Allergy & Asthma Center, Associate Director of Clinical Research, for the Children’s Research Institute (CRI), and Faculty Director of the CRI Clinical Research Unit, recently published, Enterovirus D68: a test case for the use of immunological surveillance to develop tools to mitigate the pandemic potential of emerging pathogens in Lancet Microbe.  The work discusses the need for “preparedness for emerging pathogens, such as enterovirus D68, by relying on both pathogen surveillance and immunological surveillance to guide rapid development of diagnostic, therapeutic, and preventative tools to combat the next pandemic. “

“The COVID-19 pandemic has demonstrated a critical need to establish a pre-emptive stockpile of tangible immunobiological countermeasures to accelerate the response to potential pandemic threats. To address this need we have established a pandemic response repository through microbial and immunological surveillance and epidemiology (PREMISE) initiative.”

“By using PREMISE to combat future outbreaks of enterovirus D68 acute flaccid myelitis, we aim to rapidly develop countermeasures for this devastating disease and from there expand the programme to better prepare for future emerging pathogens with pandemic potential.”

As an expert in the study of the human antibody response to enterovirus D68 infections, Dr. Vogt was consulted during early discussions of the PREMISE concept by the leaders of the initiative at the Vaccine Research Center of the National Institute of Allergy and Infectious Disease.  Enterovirus D68 is a virus on NIAID’s list of priority pathogens because it typically causes common cold symptoms but has also caused outbreaks of acute flaccid myelitis, or AFM.  AFM is a syndrome of polio-like paralysis, and outbreaks that are caused by enterovirus D68 almost exclusively affect otherwise healthy children.

As a pilot of the PREMISE initiative, which is intended to become a global programme that is pathogen agnostic, limited sites in the United States will prospectively collect paired blood samples from children pre- and post-enterovirus season (late summer into fall) with an option to collect a nasal swab during any respiratory illness that occurs during enterovirus season. With these samples, NIAID investigators will determine when children experience their first infection with enterovirus D68, what kind of antibodies they make in response to infection and use the samples to make banks of human monoclonal antibodies that could be used as countermeasures in future outbreaks.

In her role as Faculty Director of the Pediatrics Clinical Research Unit (PedsCRU) in the CRI, Dr. Hernandez will be running the PREMISE study at UNC – one of three sites for this pilot effort. Enrollment is slated to begin in February for children ages 10 and under. For those with children interested in contributing to this pandemic prevention effort, keep an eye out for future communications from PedsCRU about how to enroll.