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Henao-Restrepo AM, Camacho A, Longini IM, Watson CH, Edmunds WJ, Egger M, Carroll MW, Dean NE, Diatta I, Doumbia M, Draguez B, Duraffour S, Enwere G, Grais R, Gunther S, Gsell PS, Hossmann S, Watle SV, Kondé MK, Kéïta S, Kone S, Kuisma E, Levine MM, Mandal S, Mauget T, Norheim G, Riveros X, Soumah A, Trelle S, Vicari AS, Røttingen JA, Kieny MP. Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: final results from the Guinea ring vaccination, open-label, cluster-randomised trial (Ebola Ça Suffit!). Lancet 2017; 389:505-518. [PMID: 28017403 PMCID: PMC5364328 DOI: 10.1016/s0140-6736(16)32621-6] [Citation(s) in RCA: 690] [Impact Index Per Article: 98.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 11/25/2016] [Accepted: 12/06/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND rVSV-ZEBOV is a recombinant, replication competent vesicular stomatitis virus-based candidate vaccine expressing a surface glycoprotein of Zaire Ebolavirus. We tested the effect of rVSV-ZEBOV in preventing Ebola virus disease in contacts and contacts of contacts of recently confirmed cases in Guinea, west Africa. METHODS We did an open-label, cluster-randomised ring vaccination trial (Ebola ça Suffit!) in the communities of Conakry and eight surrounding prefectures in the Basse-Guinée region of Guinea, and in Tomkolili and Bombali in Sierra Leone. We assessed the efficacy of a single intramuscular dose of rVSV-ZEBOV (2×107 plaque-forming units administered in the deltoid muscle) in the prevention of laboratory confirmed Ebola virus disease. After confirmation of a case of Ebola virus disease, we definitively enumerated on a list a ring (cluster) of all their contacts and contacts of contacts including named contacts and contacts of contacts who were absent at the time of the trial team visit. The list was archived, then we randomly assigned clusters (1:1) to either immediate vaccination or delayed vaccination (21 days later) of all eligible individuals (eg, those aged ≥18 years and not pregnant, breastfeeding, or severely ill). An independent statistician generated the assignment sequence using block randomisation with randomly varying blocks, stratified by location (urban vs rural) and size of rings (≤20 individuals vs >20 individuals). Ebola response teams and laboratory workers were unaware of assignments. After a recommendation by an independent data and safety monitoring board, randomisation was stopped and immediate vaccination was also offered to children aged 6-17 years and all identified rings. The prespecified primary outcome was a laboratory confirmed case of Ebola virus disease with onset 10 days or more from randomisation. The primary analysis compared the incidence of Ebola virus disease in eligible and vaccinated individuals assigned to immediate vaccination versus eligible contacts and contacts of contacts assigned to delayed vaccination. This trial is registered with the Pan African Clinical Trials Registry, number PACTR201503001057193. FINDINGS In the randomised part of the trial we identified 4539 contacts and contacts of contacts in 51 clusters randomly assigned to immediate vaccination (of whom 3232 were eligible, 2151 consented, and 2119 were immediately vaccinated) and 4557 contacts and contacts of contacts in 47 clusters randomly assigned to delayed vaccination (of whom 3096 were eligible, 2539 consented, and 2041 were vaccinated 21 days after randomisation). No cases of Ebola virus disease occurred 10 days or more after randomisation among randomly assigned contacts and contacts of contacts vaccinated in immediate clusters versus 16 cases (7 clusters affected) among all eligible individuals in delayed clusters. Vaccine efficacy was 100% (95% CI 68·9-100·0, p=0·0045), and the calculated intraclass correlation coefficient was 0·035. Additionally, we defined 19 non-randomised clusters in which we enumerated 2745 contacts and contacts of contacts, 2006 of whom were eligible and 1677 were immediately vaccinated, including 194 children. The evidence from all 117 clusters showed that no cases of Ebola virus disease occurred 10 days or more after randomisation among all immediately vaccinated contacts and contacts of contacts versus 23 cases (11 clusters affected) among all eligible contacts and contacts of contacts in delayed plus all eligible contacts and contacts of contacts never vaccinated in immediate clusters. The estimated vaccine efficacy here was 100% (95% CI 79·3-100·0, p=0·0033). 52% of contacts and contacts of contacts assigned to immediate vaccination and in non-randomised clusters received the vaccine immediately; vaccination protected both vaccinated and unvaccinated people in those clusters. 5837 individuals in total received the vaccine (5643 adults and 194 children), and all vaccinees were followed up for 84 days. 3149 (53·9%) of 5837 individuals reported at least one adverse event in the 14 days after vaccination; these were typically mild (87·5% of all 7211 adverse events). Headache (1832 [25·4%]), fatigue (1361 [18·9%]), and muscle pain (942 [13·1%]) were the most commonly reported adverse events in this period across all age groups. 80 serious adverse events were identified, of which two were judged to be related to vaccination (one febrile reaction and one anaphylaxis) and one possibly related (influenza-like illness); all three recovered without sequelae. INTERPRETATION The results add weight to the interim assessment that rVSV-ZEBOV offers substantial protection against Ebola virus disease, with no cases among vaccinated individuals from day 10 after vaccination in both randomised and non-randomised clusters. FUNDING WHO, UK Wellcome Trust, the UK Government through the Department of International Development, Médecins Sans Frontières, Norwegian Ministry of Foreign Affairs (through the Research Council of Norway's GLOBVAC programme), and the Canadian Government (through the Public Health Agency of Canada, Canadian Institutes of Health Research, International Development Research Centre and Department of Foreign Affairs, Trade and Development).
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Affiliation(s)
| | - Anton Camacho
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ira M Longini
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Conall H Watson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - W John Edmunds
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa
| | | | - Natalie E Dean
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Ibrahima Diatta
- Clinical Trials Unit Bern, University of Bern, Bern, Switzerland
| | - Moussa Doumbia
- WHO, Geneva, Switzerland; Centre National d'Appui à la Lutte contre la Maladie, Bamako, Mali
| | | | - Sophie Duraffour
- Bernard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | | | | | - Stephan Gunther
- Bernard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | | | | | - Sara Viksmoen Watle
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Mandy Kader Kondé
- Center Of Excellence For Training, Research On Malaria & Priority Diseases In Guinea, Conakry, Guinea
| | - Sakoba Kéïta
- Ebola Response, Ministry of Health, Conakry, Guinea
| | | | - Eewa Kuisma
- Bernard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | - Myron M Levine
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | - Gunnstein Norheim
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | - Sven Trelle
- Clinical Trials Unit Bern, University of Bern, Bern, Switzerland
| | | | - John-Arne Røttingen
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway; Department of Health and Society, University of Oslo, Norway; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA; Coalition for Epidemic Preparedness Innovations, care of Norwegian Institute of Public Health, Oslo, Norway
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202
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Wirtz VJ, Hogerzeil HV, Gray AL, Bigdeli M, de Joncheere CP, Ewen MA, Gyansa-Lutterodt M, Jing S, Luiza VL, Mbindyo RM, Möller H, Moucheraud C, Pécoul B, Rägo L, Rashidian A, Ross-Degnan D, Stephens PN, Teerawattananon Y, 't Hoen EFM, Wagner AK, Yadav P, Reich MR. Essential medicines for universal health coverage. Lancet 2017; 389:403-476. [PMID: 27832874 PMCID: PMC7159295 DOI: 10.1016/s0140-6736(16)31599-9] [Citation(s) in RCA: 297] [Impact Index Per Article: 42.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 09/05/2016] [Accepted: 09/05/2016] [Indexed: 01/03/2023]
Affiliation(s)
- Veronika J Wirtz
- Department of Global Health/Center for Global Health and Development, Boston University School of Public Health, Boston, MA, USA.
| | - Hans V Hogerzeil
- Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Andrew L Gray
- Division of Pharmacology, Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | | | | | | | | | - Sun Jing
- Peking Union Medical College School of Public Health, Beijing, China
| | - Vera L Luiza
- National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Helene Möller
- United Nations Children's Fund, Supply Division, Copenhagen, Denmark
| | - Corrina Moucheraud
- UCLA Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Bernard Pécoul
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Lembit Rägo
- Regulation of Medicines and other Health Technologies, Geneva, Switzerland
| | - Arash Rashidian
- Department of Information, Evidence and Research, Eastern Mediterranean Region, World Health Organization, Cairo, Egypt; School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Dennis Ross-Degnan
- Research, Eastern Mediterranean Region, World Health Organization, Cairo, Egypt; Harvard Medical School, Boston, MA, USA; Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program (HITAP), Thai Ministry of Public Health Nonthaburi, Thailand
| | - Ellen F M 't Hoen
- Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Anita K Wagner
- Research, Eastern Mediterranean Region, World Health Organization, Cairo, Egypt; Harvard Medical School, Boston, MA, USA
| | - Prashant Yadav
- William Davidson Institute at the University of Michigan, Ann Arbor, MI, USA
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203
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Regules JA, Beigel JH, Paolino KM, Voell J, Castellano AR, Hu Z, Muñoz P, Moon JE, Ruck RC, Bennett JW, Twomey PS, Gutiérrez RL, Remich SA, Hack HR, Wisniewski ML, Josleyn MD, Kwilas SA, Van Deusen N, Mbaya OT, Zhou Y, Stanley DA, Jing W, Smith KS, Shi M, Ledgerwood JE, Graham BS, Sullivan NJ, Jagodzinski LL, Peel SA, Alimonti JB, Hooper JW, Silvera PM, Martin BK, Monath TP, Ramsey WJ, Link CJ, Lane HC, Michael NL, Davey RT, Thomas SJ. A Recombinant Vesicular Stomatitis Virus Ebola Vaccine. N Engl J Med 2017; 376:330-341. [PMID: 25830322 PMCID: PMC5408576 DOI: 10.1056/nejmoa1414216] [Citation(s) in RCA: 273] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The worst Ebola virus disease (EVD) outbreak in history has resulted in more than 28,000 cases and 11,000 deaths. We present the final results of two phase 1 trials of an attenuated, replication-competent, recombinant vesicular stomatitis virus (rVSV)-based vaccine candidate designed to prevent EVD. METHODS We conducted two phase 1, placebo-controlled, double-blind, dose-escalation trials of an rVSV-based vaccine candidate expressing the glycoprotein of a Zaire strain of Ebola virus (ZEBOV). A total of 39 adults at each site (78 participants in all) were consecutively enrolled into groups of 13. At each site, volunteers received one of three doses of the rVSV-ZEBOV vaccine (3 million plaque-forming units [PFU], 20 million PFU, or 100 million PFU) or placebo. Volunteers at one of the sites received a second dose at day 28. Safety and immunogenicity were assessed. RESULTS The most common adverse events were injection-site pain, fatigue, myalgia, and headache. Transient rVSV viremia was noted in all the vaccine recipients after dose 1. The rates of adverse events and viremia were lower after the second dose than after the first dose. By day 28, all the vaccine recipients had seroconversion as assessed by an enzyme-linked immunosorbent assay (ELISA) against the glycoprotein of the ZEBOV-Kikwit strain. At day 28, geometric mean titers of antibodies against ZEBOV glycoprotein were higher in the groups that received 20 million PFU or 100 million PFU than in the group that received 3 million PFU, as assessed by ELISA and by pseudovirion neutralization assay. A second dose at 28 days after dose 1 significantly increased antibody titers at day 56, but the effect was diminished at 6 months. CONCLUSIONS This Ebola vaccine candidate elicited anti-Ebola antibody responses. After vaccination, rVSV viremia occurred frequently but was transient. These results support further evaluation of the vaccine dose of 20 million PFU for preexposure prophylaxis and suggest that a second dose may boost antibody responses. (Funded by the National Institutes of Health and others; rVSV∆G-ZEBOV-GP ClinicalTrials.gov numbers, NCT02269423 and NCT02280408 .).
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Affiliation(s)
- Jason A Regules
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - John H Beigel
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Kristopher M Paolino
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Jocelyn Voell
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Amy R Castellano
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Zonghui Hu
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Paula Muñoz
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - James E Moon
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Richard C Ruck
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Jason W Bennett
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Patrick S Twomey
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Ramiro L Gutiérrez
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Shon A Remich
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Holly R Hack
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Meagan L Wisniewski
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Matthew D Josleyn
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Steven A Kwilas
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Nicole Van Deusen
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Olivier Tshiani Mbaya
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Yan Zhou
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Daphne A Stanley
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Wang Jing
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Kirsten S Smith
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Meng Shi
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Julie E Ledgerwood
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Barney S Graham
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Nancy J Sullivan
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Linda L Jagodzinski
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Sheila A Peel
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Judie B Alimonti
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Jay W Hooper
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Peter M Silvera
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Brian K Martin
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Thomas P Monath
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - W Jay Ramsey
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Charles J Link
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - H Clifford Lane
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Nelson L Michael
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Richard T Davey
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
| | - Stephen J Thomas
- From the Walter Reed Army Institute of Research (J.A.R., K.M.P., A.R.C., J.E.M., R.C.R., J.W.B., P.S.T., S.A.R., H.R.H., M.S., L.L.J., S.A.P., N.L.M., S.J.T.) and Naval Medical Research Center (R.L.G.), Silver Spring, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research (J.H.B., W.J.), and the U.S. Army Medical Research Institute of Infectious Diseases (M.L.W., M.D.J., S.A.K., N.V.D., K.S.S., J.W.H., P.M.S.), Frederick, and the National Institute of Allergy and Infectious Diseases (NIAID) (J.V., Z.H., P.M., H.C.L., R.T.D.) and NIAID Vaccine Research Center (O.T.M., Y.Z., D.A.S., J.E.L., B.S.G., N.J.S.), Bethesda - all in Maryland; the Public Health Agency of Canada, Ottawa (J.B.A.); and BioProtection Systems-NewLink Genetics, Ames, IA (B.K.M., T.P.M., W.J.R., C.J.L.)
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204
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Abstract
Two of the most important contemporary emerging viruses that affect human health in Africa are Ebola virus (EBOV) and Lassa virus (LASV). The 2013-2016 West African outbreak of EBOV was responsible for more than 11,000 deaths, primarily in Guinea, Sierra Leone and Liberia. LASV is constantly emerging in these and surrounding West African countries, with an estimate of more than 500,000 cases of Lassa fever, and approximately 5,000 deaths, annually. Both EBOV and LASV are zoonotic, and human infection often results in a severe haemorrhagic fever in both cases. However, the contribution of specific immune responses to disease differs between EBOV and LASV. This Review examines innate and adaptive immune responses to these viruses with the goal of delineating responses that are associated with protective versus pathogenic outcomes.
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205
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Abstract
Since the discovery of Marburg virus 50 years ago, filoviruses have reemerged in the human population more than 40 times. Already the first episode was as dramatic as most of the subsequent ones, but none of them was as devastating as the West-African Ebola virus outbreak in 2013-2015. Although progress toward a better understanding of the viruses is impressive, there is clearly a need to improve and strengthen the measures to detect and control these deadly infections.
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Affiliation(s)
- Hans Dieter Klenk
- Institut für Virologie, Philipps-Universität Marburg, Marburg, Germany.
| | - Werner Slenczka
- Institut für Virologie, Philipps-Universität Marburg, Marburg, Germany
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206
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Lauer KB, Borrow R, Blanchard TJ. Multivalent and Multipathogen Viral Vector Vaccines. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2017; 24:e00298-16. [PMID: 27535837 PMCID: PMC5216423 DOI: 10.1128/cvi.00298-16] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The presentation and delivery of antigens are crucial for inducing immunity and, desirably, lifelong protection. Recombinant viral vectors-proven safe and successful in veterinary vaccine applications-are ideal shuttles to deliver foreign proteins to induce an immune response with protective antibody levels by mimicking natural infection. Some examples of viral vectors are adenoviruses, measles virus, or poxviruses. The required attributes to qualify as a vaccine vector are as follows: stable insertion of coding sequences into the genome, induction of a protective immune response, a proven safety record, and the potential for large-scale production. The need to develop new vaccines for infectious diseases, increase vaccine accessibility, reduce health costs, and simplify overloaded immunization schedules has driven the idea to combine antigens from the same or various pathogens. To protect effectively, some vaccines require multiple antigens of one pathogen or different pathogen serotypes/serogroups in combination (multivalent or polyvalent vaccines). Future multivalent vaccine candidates are likely to be required for complex diseases like malaria and HIV. Other novel strategies propose an antigen combination of different pathogens to protect against several diseases at once (multidisease or multipathogen vaccines).
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Affiliation(s)
- Katharina B Lauer
- University of Manchester, Institute of Inflammation and Repair, Manchester, United Kingdom
- University of Cambridge, Department of Pathology, Cambridge, United Kingdom
| | - Ray Borrow
- University of Manchester, Institute of Inflammation and Repair, Manchester, United Kingdom
- Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Thomas J Blanchard
- University of Manchester, Institute of Inflammation and Repair, Manchester, United Kingdom
- Consultant in Infectious Diseases and Tropical Medicine, Royal Liverpool Hospital, Liverpool, United Kingdom
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207
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Higgs ES, Dubey SA, Coller BAG, Simon JK, Bollinger L, Sorenson RA, Wilson B, Nason MC, Hensley LE. Accelerating Vaccine Development During the 2013-2016 West African Ebola Virus Disease Outbreak. Curr Top Microbiol Immunol 2017; 411:229-261. [PMID: 28918539 DOI: 10.1007/82_2017_53] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The Ebola virus disease outbreak that began in Western Africa in December 2013 was unprecedented in both scope and spread, and the global response was slower and less coherent than was optimal given the scale and pace of the epidemic. Past experience with limited localized outbreaks, lack of licensed medical countermeasures, reluctance by first responders to direct scarce resources to clinical research, community resistance to outside interventions, and lack of local infrastructure were among the factors delaying clinical research during the outbreak. Despite these hurdles, the global health community succeeded in accelerating Ebola virus vaccine development, in a 5-month interval initiating phase I trials in humans in September 2014 and initiating phase II/III trails in February 2015. Each of the three Ebola virus disease-affected countries, Sierra Leone, Guinea, and Liberia, conducted a phase II/III Ebola virus vaccine trial. Only one of these trials evaluating recombinant vesicular stomatitis virus expressing Ebola virus glycoprotein demonstrated vaccine efficacy using an innovative mobile ring vaccination trial design based on a ring vaccination strategy responsible for eradicating smallpox that reached areas of new outbreaks. Thoughtful and intensive community engagement in each country enabled the critical community partnership and acceptance of the phase II/III in each country. Due to the delayed clinical trial initiation, relative to the epidemiologic peak of the outbreak in the three countries, vaccine interventions may or may not have played a major role in bringing the epidemic under control. Having demonstrated that clinical trials can be performed during a large outbreak, the global research community can now build on the experience to implement trials more rapidly and efficiently in future outbreaks. Incorporating clinical research needs into planning for future health emergencies and understanding what kind of trial designs is needed for reliable results in an epidemic of limited duration should improve global response to future infectious disease outbreaks.
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Affiliation(s)
- Elizabeth S Higgs
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
| | | | | | | | - Laura Bollinger
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD, USA
| | - Robert A Sorenson
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | - Martha C Nason
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Lisa E Hensley
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD, USA
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208
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Zai J, Yi Y, Xia H, Zhang B, Yuan Z. A new strategy for full-length Ebola virus glycoprotein expression in E.coli. Virol Sin 2016; 31:500-508. [PMID: 28000060 DOI: 10.1007/s12250-016-3845-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 11/22/2016] [Indexed: 11/26/2022] Open
Abstract
Ebola virus (EBOV) causes severe hemorrhagic fever in humans and non-human primates with high rates of fatality. Glycoprotein (GP) is the only envelope protein of EBOV, which may play a critical role in virus attachment and entry as well as stimulating host protective immune responses. However, the lack of expression of full-length GP in Escherichia coli hinders the further study of its function in viral pathogenesis. In this study, the vp40 gene was fused to the full-length gp gene and cloned into a prokaryotic expression vector. We showed that the VP40-GP and GP-VP40 fusion proteins could be expressed in E.coli at 16 °C. In addition, it was shown that the position of vp40 in the fusion proteins affected the yields of the fusion proteins, with a higher level of production of the fusion protein when vp40 was upstream of gp compared to when it was downstream. The results provide a strategy for the expression of a large quantity of EBOV full-length GP, which is of importance for further analyzing the relationship between the structure and function of GP and developing an antibody for the treatment of EBOV infection.
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Affiliation(s)
- Junjie Zai
- Key Laboratory of Agricultural and Environmental Microbiology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yinhua Yi
- Key Laboratory of Agricultural and Environmental Microbiology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Han Xia
- Key Laboratory of Agricultural and Environmental Microbiology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Bo Zhang
- Key Laboratory of Special Pathogens and Biosafety, Center for Emerging Infectious Diseases, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Zhiming Yuan
- Key Laboratory of Agricultural and Environmental Microbiology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
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209
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Clarke DK, Hendry RM, Singh V, Rose JK, Seligman SJ, Klug B, Kochhar S, Mac LM, Carbery B, Chen RT. Live virus vaccines based on a vesicular stomatitis virus (VSV) backbone: Standardized template with key considerations for a risk/benefit assessment. Vaccine 2016; 34:6597-6609. [PMID: 27395563 PMCID: PMC5220644 DOI: 10.1016/j.vaccine.2016.06.071] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 12/30/2022]
Abstract
The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) was formed to evaluate the safety of live, recombinant viral vaccines incorporating genes from heterologous viral and other microbial pathogens in their genome (so-called "chimeric virus vaccines"). Many such viral vector vaccines are now at various stages of clinical evaluation. Here, we introduce an attenuated form of recombinant vesicular stomatitis virus (rVSV) as a potential chimeric virus vaccine for HIV-1, with implications for use as a vaccine vector for other pathogens. The rVSV/HIV-1 vaccine vector was attenuated by combining two major genome modifications. These modifications acted synergistically to greatly enhance vector attenuation and the resulting rVSV vector demonstrated safety in sensitive mouse and non-human primate neurovirulence models. This vector expressing HIV-1 gag protein has completed evaluation in two Phase I clinical trials. In one trial the rVSV/HIV-1 vector was administered in a homologous two-dose regimen, and in a second trial with pDNA in a heterologous prime boost regimen. No serious adverse events were reported nor was vector detected in blood, urine or saliva post vaccination in either trial. Gag specific immune responses were induced in both trials with highest frequency T cell responses detected in the prime boost regimen. The rVSV/HIV-1 vector also demonstrated safety in an ongoing Phase I trial in HIV-1 positive participants. Additionally, clinical trial material has been produced with the rVSV vector expressing HIV-1 env, and Phase I clinical evaluation will initiate in the beginning of 2016. In this paper, we use a standardized template describing key characteristics of the novel rVSV vaccine vectors, in comparison to wild type VSV. The template facilitates scientific discourse among key stakeholders by increasing transparency and comparability of information. The Brighton Collaboration V3SWG template may also be useful as a guide to the evaluation of other recombinant viral vector vaccines.
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MESH Headings
- AIDS Vaccines/adverse effects
- AIDS Vaccines/genetics
- AIDS Vaccines/immunology
- Animals
- Clinical Trials, Phase I as Topic
- Drug Carriers
- Drug Evaluation, Preclinical
- Drug-Related Side Effects and Adverse Reactions/epidemiology
- Drug-Related Side Effects and Adverse Reactions/pathology
- Genetic Vectors
- Humans
- Primates
- Risk Assessment
- T-Lymphocytes/immunology
- Vaccines, Attenuated/adverse effects
- Vaccines, Attenuated/genetics
- Vaccines, Synthetic/adverse effects
- Vaccines, Synthetic/genetics
- Vaccines, Synthetic/immunology
- Vesiculovirus/genetics
- env Gene Products, Human Immunodeficiency Virus/genetics
- env Gene Products, Human Immunodeficiency Virus/immunology
- gag Gene Products, Human Immunodeficiency Virus/genetics
- gag Gene Products, Human Immunodeficiency Virus/immunology
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Affiliation(s)
| | - R Michael Hendry
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
| | - Vidisha Singh
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA.
| | - John K Rose
- Department of Pathology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Stephen J Seligman
- Department of Microbiology and Immunology, New York Medical College, Valhalla, NY 10595, USA; St. Giles Laboratory of Human Genetics of Infectious Diseases, The Rockefeller University, New York, NY 10065, USA
| | | | | | - Lisa Marie Mac
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
| | - Baevin Carbery
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
| | - Robert T Chen
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
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210
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Romley J, Goutam P, Sood N. National Survey Indicates that Individual Vaccination Decisions Respond Positively to Community Vaccination Rates. PLoS One 2016; 11:e0166858. [PMID: 27870907 PMCID: PMC5117726 DOI: 10.1371/journal.pone.0166858] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 11/05/2016] [Indexed: 11/25/2022] Open
Abstract
Some models of vaccination behavior imply that an individual's willingness to vaccinate could be negatively correlated with the vaccination rate in her community. The rationale is that a higher community vaccination rate reduces the risk of contracting the vaccine-preventable disease and thus reduces the individual's incentive to vaccinate. At the same time, as for many health-related behaviors, individuals may want to conform to the vaccination behavior of peers, counteracting a reduced incentive to vaccinate due to herd immunity. Currently there is limited empirical evidence on how individual vaccination decisions respond to the vaccination decisions of peers. In the fall of 2014, we used a rapid survey technology to ask a large sample of U.S. adults about their willingness to use a vaccine for Ebola. Respondents expressed a greater inclination to use the vaccine in a hypothetical scenario with a high community vaccination rate. In particular, an increase in the community vaccination rate from 10% to 90% had the same impact on reported utilization as a nearly 50% reduction in out-of-pocket cost. These findings are consistent with a tendency to conform with vaccination among peers, and suggest that policies promoting vaccination could be more effective than has been recognized.
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Affiliation(s)
- John Romley
- Price School of Public Policy, University of Southern California, Los Angeles, California, United States of America
- School of Pharmacy, University of Southern California, Los Angeles, California, United States of America
- Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, United States of America
| | - Prodyumna Goutam
- Pardee RAND Graduate School, RAND Corporation, Santa Monica, California, United States of America
| | - Neeraj Sood
- Price School of Public Policy, University of Southern California, Los Angeles, California, United States of America
- Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, United States of America
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211
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Rivera A, Messaoudi I. Molecular mechanisms of Ebola pathogenesis. J Leukoc Biol 2016; 100:889-904. [PMID: 27587404 PMCID: PMC6608070 DOI: 10.1189/jlb.4ri0316-099rr] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 08/02/2016] [Accepted: 08/03/2016] [Indexed: 12/13/2022] Open
Abstract
Ebola viruses (EBOVs) and Marburg viruses (MARVs) are among the deadliest human viruses, as highlighted by the recent and widespread Ebola virus outbreak in West Africa, which was the largest and longest epidemic of Ebola virus disease (EVD) in history, resulting in significant loss of life and disruptions across multiple continents. Although the number of cases has nearly reached its nadir, a recent cluster of 5 cases in Guinea on March 17, 2016, has extended the enhanced surveillance period to June 15, 2016. New, enhanced 90-d surveillance windows replaced the 42-d surveillance window to ensure the rapid detection of new cases that may arise from a missed transmission chain, reintroduction from an animal reservoir, or more important, reemergence of the virus that has persisted in an EVD survivor. In this review, we summarize our current understanding of EBOV pathogenesis, describe vaccine and therapeutic candidates in clinical trials, and discuss mechanisms of viral persistence and long-term health sequelae for EVD survivors.
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Affiliation(s)
- Andrea Rivera
- Division of Biomedical Sciences, University of California, Riverside, Riverside, California, USA
| | - Ilhem Messaoudi
- Division of Biomedical Sciences, University of California, Riverside, Riverside, California, USA
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212
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Abstract
For 40 years ebolaviruses have been responsible for sporadic outbreaks of severe and often fatal hemorrhagic fever in humans and nonhuman primates. In December 2013 an unprecedented Zaire ebolavirus epidemic began in West Africa. Although "patient zero" has finally been reached after 2 years, the virus is again causing disease in the region. Currently there are no licensed vaccines or therapeutic countermeasures against ebolaviruses; however, the epidemic in West Africa has focused attention on the potential vaccine platforms developed over the past 15 years. There has been remarkable progress using a variety of platforms including DNA, subunit, and several viral vector approaches, replicating and non-replicating, which have shown varying degrees of protective efficacy in the "gold-standard" nonhuman primate models for Ebolavirus infections. A number of these vaccine platforms have moved into clinical trials over the past year with the hope of finding an efficacious vaccine to prevent future outbreaks/epidemics of Ebola hemorrhagic fever on the scale of the West African epidemic.
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Affiliation(s)
- Chad E Mire
- a Galveston National Laboratory, and Department of Microbiology and Immunology , University of Texas Medical Branch , Galveston , TX , USA
| | - Thomas W Geisbert
- a Galveston National Laboratory, and Department of Microbiology and Immunology , University of Texas Medical Branch , Galveston , TX , USA
| | - Heinz Feldmann
- b Laboratory of Virology, Division of Intramural Research , National Institute of Allergy and Infectious Diseases, National Institutes of Health , Hamilton , MT , USA
| | - Andrea Marzi
- b Laboratory of Virology, Division of Intramural Research , National Institute of Allergy and Infectious Diseases, National Institutes of Health , Hamilton , MT , USA
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213
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Khurana S, Fuentes S, Coyle EM, Ravichandran S, Davey RT, Beigel JH. Human antibody repertoire after VSV-Ebola vaccination identifies novel targets and virus-neutralizing IgM antibodies. Nat Med 2016; 22:1439-1447. [PMID: 27798615 DOI: 10.1038/nm.4201] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 09/12/2016] [Indexed: 12/15/2022]
Abstract
Development of an effective vaccine against Ebola virus is of high priority. However, knowledge about potential correlates of protection and the durability of immune response after vaccination is limited. Here, we elucidate the human antibody repertoire after administration of vesicular stomatitis virus (VSV)-Ebola vaccine at 3 million, 20 million and 100 million plaque-forming units (PFU) and homologous VSV-Ebola vaccine boost in healthy adult volunteers. Whole genome-fragment phage display libraries, expressing linear and conformational epitopes of Ebola glycoprotein (GP), showed higher diversity of antibody epitopes in individuals vaccinated with 20 million PFU than in those vaccinated with 3 million or 100 million PFU. Surface plasmon resonance kinetics showed higher levels of GP-binding antibodies after a single vaccination with 20 million or 100 million PFU than with 3 million PFU, and these correlated strongly with neutralization titers. A second vaccination did not boost antibody or virus neutralization titers, which declined rapidly, and induced only minimal antibody affinity maturation. Isotype analysis revealed a predominant IgM response even after the second vaccination, which contributed substantially to virus neutralization in vitro. These findings may help identify new vaccine targets and aid development and evaluation of effective countermeasures against Ebola.
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Affiliation(s)
- Surender Khurana
- Division of Viral Products, Center for Biologics Evaluation and Research (CBER), US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Sandra Fuentes
- Division of Viral Products, Center for Biologics Evaluation and Research (CBER), US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Elizabeth M Coyle
- Division of Viral Products, Center for Biologics Evaluation and Research (CBER), US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Supriya Ravichandran
- Division of Viral Products, Center for Biologics Evaluation and Research (CBER), US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Richard T Davey
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - John H Beigel
- Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
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214
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Abstract
The recent outbreak of Ebola virus disease in West Africa has led to more than 11,000 deaths, with a peak in mortality from August through December of 2014. A meeting convened by the World Health Organization (WHO) in September 2014, concluded that an urgent unmet need exists for efficacy and safety testing of the Ebola virus vaccine candidates and that clinical trials should be expedited. These vaccines could be used both in an outbreak setting and to provide long-term protection in populations at risk of sporadic outbreaks. A number of vaccines have been evaluated in phase 1 trials, but the two most advanced first-generation Ebola vaccine candidates are the live replicating vesicular stomatitis virus (rVSV) and the replication-defective chimpanzee adenovirus 3 (ChAd3). This review focuses on these two vaccines in clinical development and discusses the future opportunities and challenges faced in the licensure and deployment of Ebola virus vaccines.
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Affiliation(s)
- Vincent Pavot
- The Jenner Institute, University of Oxford, Oxford, UK
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215
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Wang Y, Li J, Hu Y, Liang Q, Wei M, Zhu F. Ebola vaccines in clinical trial: The promising candidates. Hum Vaccin Immunother 2016; 13:153-168. [PMID: 27764560 DOI: 10.1080/21645515.2016.1225637] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Ebola virus disease (EVD) has become a great threat to humans across the world in recent years. The 2014 Ebola epidemic in West Africa caused numerous deaths and attracted worldwide attentions. Since no specific drugs and treatments against EVD was available, vaccination was considered as the most promising and effective method of controlling this epidemic. So far, 7 vaccine candidates had been developed and evaluated through clinical trials. Among them, the recombinant vesicular stomatitis virus-based vaccine (rVSV-EBOV) is the most promising candidate, which demonstrated a significant protection against EVD in phase III clinical trial. However, several concerns were still associated with the Ebola vaccine candidates, including the safety profile in some particular populations, the immunization schedule for emergency vaccination, and the persistence of the protection. We retrospectively reviewed the current development of Ebola vaccines and discussed issues and challenges remaining to be investigated in the future.
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Affiliation(s)
- Yuxiao Wang
- a School of Public Health; Southeast University , Nanjing , PR China
| | - Jingxin Li
- b Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , PR China
| | - Yuemei Hu
- b Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , PR China
| | - Qi Liang
- b Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , PR China
| | - Mingwei Wei
- c School of Public Health, Nanjing Medical University , Nanjing , PR China
| | - Fengcai Zhu
- b Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , PR China
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216
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Wu S, Kroeker A, Wong G, He S, Hou L, Audet J, Wei H, Zhang Z, Fernando L, Soule G, Tran K, Bi S, Zhu T, Yu X, Chen W, Qiu X. An Adenovirus Vaccine Expressing Ebola Virus Variant Makona Glycoprotein Is Efficacious in Guinea Pigs and Nonhuman Primates. J Infect Dis 2016; 214:S326-S332. [PMID: 27493239 PMCID: PMC5050474 DOI: 10.1093/infdis/jiw250] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
A licensed vaccine against Ebola virus (EBOV) remains unavailable, despite >11 000 deaths from the 2014-2016 outbreak of EBOV disease in West Africa. Past studies have shown that recombinant vaccine viruses expressing EBOV glycoprotein (GP) are able to protect nonhuman primates (NHPs) from a lethal EBOV challenge. However, these vaccines express the viral GP-based EBOV variants found in Central Africa, which has 97.3% amino acid homology to the Makona variant found in West Africa. Our previous study showed that a recombinant adenovirus serotype 5 (Ad5)-vectored vaccine expressing the Makona EBOV GP (MakGP) was safe and immunogenic during clinical trials in China, but it is unknown whether the vaccine protects against EBOV infection. Here, we demonstrate that guinea pigs immunized with Ad5-MakGP developed robust humoral responses and were protected against exposure to guinea pig-adapted EBOV. Ad5-MakGP also elicited specific B- and T-cell immunity in NHPs and conferred 100% protection when animals were challenged 4 weeks after immunization. These results support further clinical development of this candidate and highlight the utility of Ad5-MakGP as a prophylactic measure in future outbreaks of EBOV disease.
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Affiliation(s)
- Shipo Wu
- Beijing Institute of Biotechnology
| | - Andrea Kroeker
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Gary Wong
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Shihua He
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | | | - Jonathan Audet
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Haiyan Wei
- Institute of Infectious Disease, Henan Centre for Disease Control, Zhengzhou
| | | | - Lisa Fernando
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Geoff Soule
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Kaylie Tran
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Shengli Bi
- Institute of Viral Disease, China Center for Disease Control and Prevention, Beijing
| | - Tao Zhu
- Tianjin CanSino Biotechnology, China
| | | | - Wei Chen
- Beijing Institute of Biotechnology
| | - Xiangguo Qiu
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
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217
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Watle SV, Norheim G, Røttingen JA. Ebola vaccines - Where are we? Hum Vaccin Immunother 2016; 12:2700-2703. [PMID: 27548643 PMCID: PMC5084983 DOI: 10.1080/21645515.2016.1217372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 07/22/2016] [Indexed: 01/07/2023] Open
Abstract
The 2014-16 Ebola outbreak in West Africa has by far been the largest and most devastating Ebola outbreak so far. At the start of the epidemic only 2 Ebola DNA vaccine candidates had been tested in clinical trials and the correlate of protection in humans was unknown. International stakeholders coordinated by the World Health Organization agreed to fast-track the development of 2 Ebola vaccine candidates, based on adenovirus and vesicular stomatitis virus (VSV) vectors. Phase I and II clinical trials were initiated in the autumn of 2014 and found both vaccines to be acceptable for proceeding to phase III trials. Despite the epidemic waning in the spring of 2015, by July 2015 preliminary results from a phase III trial in Guinea proved the Ebola VSV vaccine to be effective.
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Affiliation(s)
- Sara Viksmoen Watle
- Domain for Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Gunnstein Norheim
- Domain for Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - John-Arne Røttingen
- Domain for Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
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218
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Abstract
Long-term control of viral outbreaks requires the use of vaccines to impart acquired resistance and ensuing protection. In the wake of an epidemic, established immunity against a particular disease can limit spread and significantly decrease mortality. Creation of a safe and efficacious vaccine against Ebola virus (EBOV) has proven elusive so far, but various inventive strategies are now being employed to counteract the threat of outbreaks caused by EBOV and related filoviruses. Here, we present a current overview of progress in the field of Ebola virus vaccine development.
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Affiliation(s)
- Rohan Keshwara
- Department of Microbiology and Immunology, Sidney Kimmel Medical College,Thomas Jefferson University, Philadelphia, Pennsylvania 19107;
| | - Reed F Johnson
- Emerging Viral Pathogens Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892
| | - Matthias J Schnell
- Department of Microbiology and Immunology, Sidney Kimmel Medical College,Thomas Jefferson University, Philadelphia, Pennsylvania 19107;
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219
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Medaglini D, Harandi AM, Ottenhoff THM, Siegrist CA. Ebola vaccine R&D: Filling the knowledge gaps. Sci Transl Med 2016; 7:317ps24. [PMID: 26659569 DOI: 10.1126/scitranslmed.aad3106] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
With an emphasis on systems analyses, the VSV-EBOVAC project harnesses state-of-the-art technologies that illuminate mechanisms behind the observed immunogenicity and reactogenicity of the rVSV-ZEBOV vaccine and ensures that such information is shared among stakeholders.
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Affiliation(s)
- Donata Medaglini
- Laboratorio di Microbiologia Molecolare e Biotecnologia (LA.M.M.B.), Dipartimento di Biotecnologie Mediche, Università di Siena, 53100 Siena, Italy. Sclavo Vaccines Association, 53100 Siena, Italy.
| | - Ali M Harandi
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 7A, Gothenburg, Sweden
| | - Tom H M Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Claire-Anne Siegrist
- Center for Vaccinology, Geneva University Hospitals and University of Geneva, 1211 Geneva, Switzerland
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220
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Konduru K, Shurtleff AC, Bradfute SB, Nakamura S, Bavari S, Kaplan G. Ebolavirus Glycoprotein Fc Fusion Protein Protects Guinea Pigs against Lethal Challenge. PLoS One 2016; 11:e0162446. [PMID: 27622456 PMCID: PMC5021345 DOI: 10.1371/journal.pone.0162446] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 08/23/2016] [Indexed: 11/26/2022] Open
Abstract
Ebola virus (EBOV), a member of the Filoviridae that can cause severe hemorrhagic fever in humans and nonhuman primates, poses a significant threat to the public health. Currently, there are no licensed vaccines or therapeutics to prevent and treat EBOV infection. Several vaccines based on the EBOV glycoprotein (GP) are under development, including vectored, virus-like particles, and protein-based subunit vaccines. We previously demonstrated that a subunit vaccine containing the extracellular domain of the Ebola ebolavirus (EBOV) GP fused to the Fc fragment of human IgG1 (EBOVgp-Fc) protected mice against EBOV lethal challenge. Here, we show that the EBOVgp-Fc vaccine formulated with QS-21, alum, or polyinosinic-polycytidylic acid-poly-L-lysine carboxymethylcellulose (poly-ICLC) adjuvants induced strong humoral immune responses in guinea pigs. The vaccinated animals developed anti-GP total antibody titers of approximately 105−106 and neutralizing antibody titers of approximately 103 as assessed by a BSL-2 neutralization assay based on vesicular stomatitis virus (VSV) pseudotypes. The poly-ICLC formulated EBOVgp-Fc vaccine protected all the guinea pigs against EBOV lethal challenge performed under BSL-4 conditions whereas the same vaccine formulated with QS-21 or alum only induced partial protection. Vaccination with a mucin-deleted EBOVgp-Fc construct formulated with QS-21 adjuvant did not have a significant effect in anti-GP antibody levels and protection against EBOV lethal challenge compared to the full-length GP construct. The bulk of the humoral response induced by the EBOVgp-Fc vaccine was directed against epitopes outside the EBOV mucin region. Our findings indicate that different adjuvants can eliciting varying levels of protection against lethal EBOV challenge in guinea pigs vaccinated with EBOVgp-Fc, and suggest that levels of total anti-GP antibodies elicit by protein-based GP subunit vaccines do not correlate with protection. Our data further support the development of Fc fusions of GP as a candidate vaccine for human use.
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Affiliation(s)
- Krishnamurthy Konduru
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD 20993, United States of America
- * E-mail:
| | - Amy C. Shurtleff
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD 21702, United States of America
| | - Steven B. Bradfute
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD 21702, United States of America
| | - Siham Nakamura
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD 20993, United States of America
| | - Sina Bavari
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD 21702, United States of America
| | - Gerardo Kaplan
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD 20993, United States of America
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221
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Martins KA, Jahrling PB, Bavari S, Kuhn JH. Ebola virus disease candidate vaccines under evaluation in clinical trials. Expert Rev Vaccines 2016; 15:1101-12. [PMID: 27160784 PMCID: PMC5026048 DOI: 10.1080/14760584.2016.1187566] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Filoviruses are the etiological agents of two human illnesses: Ebola virus disease and Marburg virus disease. Until 2013, medical countermeasure development against these afflictions was limited to only a few research institutes worldwide as both infections were considered exotic due to very low case numbers. Together with the high case-fatality rate of both diseases, evaluation of any candidate countermeasure in properly controlled clinical trials seemed impossible. However, in 2013, Ebola virus was identified as the etiological agent of a large disease outbreak in Western Africa including almost 30,000 infections and more than 11,000 deaths, including case exportations to Europe and North America. These large case numbers resulted in medical countermeasure development against Ebola virus disease becoming a global public-health priority. This review summarizes the status quo of candidate vaccines against Ebola virus disease, with a focus on those that are currently under evaluation in clinical trials.
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Affiliation(s)
- Karen A. Martins
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland, USA
| | - Peter B. Jahrling
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
| | - Sina Bavari
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland, USA
| | - Jens H. Kuhn
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland, USA
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222
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Marzi A, Hanley PW, Haddock E, Martellaro C, Kobinger G, Feldmann H. Efficacy of Vesicular Stomatitis Virus-Ebola Virus Postexposure Treatment in Rhesus Macaques Infected With Ebola Virus Makona. J Infect Dis 2016; 214:S360-S366. [PMID: 27496978 DOI: 10.1093/infdis/jiw218] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The Ebola virus (EBOV) epidemic in West Africa increased the focus on vaccine development against this hemorrhagic fever-causing pathogen, and as a consequence human clinical trials for a few selected platforms were accelerated. One of these vaccines is vesicular stomatitis virus (VSV)-EBOV, also known as rVSV-ZEBOV, a fast-acting vaccine against EBOV and so far the only vaccine with reported efficacy against EBOV infections in humans in phase III clinical trials. In this study, we analyzed the potential of VSV-EBOV for postexposure treatment of rhesus macaques infected with EBOV-Makona. We treated groups of animals with 1 dose of VSV-EBOV either in a single injection at 1 or 24 hours after EBOV exposure or with 2 injections, half the dose at each time point; 1 control group received the same dose of the VSV-based Marburg virus vaccine at both time points; another group remained untreated. Although all untreated animals succumbed to EBOV infection, 33%-67% of the animals in each treatment group survived the infection, including the group treated with the VSV-based Marburg virus vaccine. This result suggests that protection from postexposure vaccination may be antigen unspecific and due rather to an early activation of the innate immune system. In conclusion, VSV-EBOV remains a potent and fast-acting prophylactic vaccine but demonstrates only limited efficacy in postexposure treatment.
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Affiliation(s)
| | - Patrick W Hanley
- Rocky Mountain Veterinary Branch, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | | | | | - Gary Kobinger
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba
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223
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Widdowson MA, Schrag SJ, Carter RJ, Carr W, Legardy-Williams J, Gibson L, Lisk DR, Jalloh MI, Bash-Taqi DA, Kargbo SAS, Idriss A, Deen GF, Russell JBW, McDonald W, Albert AP, Basket M, Callis A, Carter VM, Ogunsanya KRC, Gee J, Pinner R, Mahon BE, Goldstein ST, Seward JF, Samai M, Schuchat A. Implementing an Ebola Vaccine Study - Sierra Leone. MMWR Suppl 2016; 65:98-106. [PMID: 27387395 DOI: 10.15585/mmwr.su6503a14] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
In October 2014, the College of Medicine and Allied Health Sciences of the University of Sierra Leone, the Sierra Leone Ministry of Health and Sanitation, and CDC joined the global effort to accelerate assessment and availability of candidate Ebola vaccines and began planning for the Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE). STRIVE was an individually randomized controlled phase II/III trial to evaluate efficacy, immunogenicity, and safety of the recombinant vesicular stomatitis virus Ebola vaccine (rVSV-ZEBOV). The study population was health care and frontline workers in select chiefdoms of the five most affected districts in Sierra Leone. Participants were randomized to receive a single intramuscular dose of rVSV-ZEBOV at enrollment or to receive a single intramuscular dose 18-24 weeks after enrollment. All participants were followed up monthly until 6 months after vaccination. Two substudies separately assessed detailed reactogenicity over 1 month and immunogenicity over 12 months. During the 5 months before the trial, STRIVE and partners built a research platform in Sierra Leone comprising participant follow-up sites, cold chain, reliable power supply, and vaccination clinics and hired and trained at least 350 national staff. Wide-ranging community outreach, informational sessions, and messaging were conducted before and during the trial to ensure full communication to the population of the study area regarding procedures and current knowledge about the trial vaccine. During April 9-August 15, 2015, STRIVE enrolled 8,673 participants, of whom 453 and 539 were also enrolled in the safety and immunogenicity substudies, respectively. As of April 28, 2016, no Ebola cases and no vaccine-related serious adverse events, which by regulatory definition include death, life-threatening illness, hospitalization or prolongation of hospitalization, or permanent disability, were reported in the study population. Although STRIVE will not produce an estimate of vaccine efficacy because of low case frequency as the epidemic was controlled, data on safety and immunogenicity will support decisions on licensure of rVSV-ZEBOV.The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).
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224
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Ebola Virus Disease: Therapeutic and Potential Preventative Opportunities. Microbiol Spectr 2016; 4. [PMID: 27337455 DOI: 10.1128/microbiolspec.ei10-0014-2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The 2014 Ebola virus disease (EVD) epidemic in West Africa was unprecedented in its geographical distribution, scale, and toll on public health infrastructure. Standard public health measures were rapidly overwhelmed, and many projections on outbreak progression through the region were dire. At the beginning of the outbreak there were no treatments or vaccines that had been shown to be safe and effective for treating or preventing EVD, limiting health care providers to offer supportive care under extremely challenging circumstances and at great risk to themselves. Over time, however, drugs and vaccines in the development pipeline were prioritized based on all available research data and were moved forward for evaluation in clinical trials to demonstrate safety and efficacy. The armamentarium against EVD eventually included biologics such as monoclonal antibodies, convalescent plasma, and vaccines as well as small molecule therapeutics such as small interfering RNAs and nucleoside analogs. This article provides a high-level overview of the interventions and prophylactics considered for use in the outbreak and discusses the challenges faced when attempting to deploy investigational countermeasures in the midst of an evolving epidemic.
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225
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Circulating follicular T helper cells and cytokine profile in humans following vaccination with the rVSV-ZEBOV Ebola vaccine. Sci Rep 2016; 6:27944. [PMID: 27323685 PMCID: PMC4914957 DOI: 10.1038/srep27944] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 05/27/2016] [Indexed: 02/07/2023] Open
Abstract
The most recent Zaire Ebolavirus (ZEBOV) outbreak was the largest and most widespread in recorded history, emphasizing the need for an effective vaccine. Here, we analyzed human cellular immune responses induced by a single dose of the rVSV-ZEBOV vaccine candidate, which showed significant protective efficacy in endemic populations in Guinea. This is the first in-depth characterization of ZEBOV-GP specific, circulating follicular T cells (cTfh). Since antibody titers correlated with protection in preclinical models of ZEBOV infection, Tfh were predicted to correlate with protection. Indeed, the ZEBOV-specific cTfh data correlated with antibody titers in human vaccines and unexpectedly with the Tfh17 subset. The combination of two cutting edge technologies allowed the immuno-profiling of rare cell populations and may help elucidate correlates of protection for a variety of vaccines.
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226
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Wongthida P, Jengarn J, Narkpuk J, Koonyosying P, Srisutthisamphan K, Wanitchang A, Leaungwutiwong P, Teeravechyan S, Jongkaewwattana A. In Vitro and In Vivo Attenuation of Vesicular Stomatitis Virus (VSV) by Phosphoprotein Deletion. PLoS One 2016; 11:e0157287. [PMID: 27315286 PMCID: PMC4912100 DOI: 10.1371/journal.pone.0157287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 05/26/2016] [Indexed: 02/02/2023] Open
Abstract
Vesicular stomatitis virus (VSV) is highly immunogenic and able to stimulate both innate and adaptive immune responses. However, its ability to induce adverse effects has held back the use of VSV as a potential vaccine vector. In this study we developed VSV-ΔP, a safe yet potent replication-defective recombinant VSV in which the phosphoprotein (P) gene was deleted. VSV-ΔP replicated only in supporting cells expressing P (BHK-P cells) and at levels more than 2 logs lower than VSV. In vivo studies indicated that the moderate replication of VSV-ΔP in vitro was associated with the attenuation of this virus in the mouse model, whereas mice intracranially injected with VSV succumbed to neurotoxicity. Furthermore, we constructed VSV and VSV-ΔP expressing a variety of antigens including hemagglutinin-neuraminidase (HN) from Newcastle disease virus (NDV), hemagglutinin (HA) from either a 2009 H1N1 pandemic influenza virus (pdm/09) or the avian H7N9. VSV and VSV-ΔP incorporated the foreign antigens on their surface resulting in induction of robust neutralizing antibody, serum IgG, and hemagglutination inhibition (HAI) titers against their corresponding viruses. These results indicated that VSV with P gene deletion was attenuated in vitro and in vivo, and possibly expressed the foreign antigen on its surface. Therefore, the P gene-deletion strategy may offer a potentially useful and safer approach for attenuating negative-sense RNA viruses which use phosphoprotein as a cofactor for viral replication.
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Affiliation(s)
- Phonphimon Wongthida
- Virology and Cell Technology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Thailand Science Park, Phahonyothin Rd., Klong Nueng, Klong Luang, Pathum Thani, 12120, Thailand
- * E-mail:
| | - Juggragarn Jengarn
- Virology and Cell Technology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Thailand Science Park, Phahonyothin Rd., Klong Nueng, Klong Luang, Pathum Thani, 12120, Thailand
| | - Jaraspim Narkpuk
- Virology and Cell Technology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Thailand Science Park, Phahonyothin Rd., Klong Nueng, Klong Luang, Pathum Thani, 12120, Thailand
| | - Pongpisid Koonyosying
- Protein-Ligand Engineering and Molecular Biology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Thailand Science Park, Phahonyothin Rd., Klong Nueng, Klong Luang, Pathum Thani, 12120, Thailand
| | - Kanjana Srisutthisamphan
- Department of Biochemistry, Faculty of Science, Kasetsart University, Ngam Wong Wan Rd., Ladyaow, Chatuchak, Bangkok, 10900, Thailand
| | - Asawin Wanitchang
- Virology and Cell Technology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Thailand Science Park, Phahonyothin Rd., Klong Nueng, Klong Luang, Pathum Thani, 12120, Thailand
| | - Pornsawan Leaungwutiwong
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Ratchawithi Rd., Ratchadewee, Bangkok, 10400, Thailand
| | - Samaporn Teeravechyan
- Virology and Cell Technology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Thailand Science Park, Phahonyothin Rd., Klong Nueng, Klong Luang, Pathum Thani, 12120, Thailand
| | - Anan Jongkaewwattana
- Virology and Cell Technology Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), 113 Thailand Science Park, Phahonyothin Rd., Klong Nueng, Klong Luang, Pathum Thani, 12120, Thailand
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Abstract
In today's highly globalised world, protecting human security is a core challenge for political leaders who are simultaneously dealing with terrorism, refugee and migration crises, disease epidemics, and climate change. Promoting universal health coverage (UHC) will help prevent another disease outbreak similar to the recent Ebola outbreak in west Africa, and create robust health systems, capable of withstanding future shocks. Robust health systems, in turn, are the prerequisites for achieving UHC. We propose three areas for global health action by the G7 countries at their meeting in Japan in May, 2016, to protect human security around the world: restructuring of the global health architecture so that it enables preparedness and responses to health emergencies; development of platforms to share best practices and harness shared learning about the resilience and sustainability of health systems; and strengthening of coordination and financing for research and development and system innovations for global health security. Rather than creating new funding or organisations, global leaders should reorganise current financing structures and institutions so that they work more effectively and efficiently. By making smart investments, countries will improve their capacity to monitor, track, review, and assess health system performance and accountability, and thereby be better prepared for future global health shocks.
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229
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Vetter P, Dayer JA, Schibler M, Allegranzi B, Brown D, Calmy A, Christie D, Eremin S, Hagon O, Henderson D, Iten A, Kelley E, Marais F, Ndoye B, Pugin J, Robert-Nicoud H, Sterk E, Tapper M, Siegrist CA, Kaiser L, Pittet D. The 2014–2015 Ebola outbreak in West Africa: Hands On. Antimicrob Resist Infect Control 2016. [PMCID: PMC4858848 DOI: 10.1186/s13756-016-0112-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The International Consortium for Prevention and Infection Control (ICPIC) organises a biannual conference (ICPIC) on various subjects related to infection prevention, treatment and control. During ICPIC 2015, held in Geneva in June 2015, a full one-day session focused on the 2014–2015 Ebola virus disease (EVD) outbreak in West Africa. This article is a non-exhaustive compilation of these discussions. It concentrates on lessons learned and imagining a way forward for the communities most affected by the epidemic. The reader can access video recordings of all lectures delivered during this one-day session, as referenced. Topics include the timeline of the international response, linkages between the dynamics of the epidemic and infection prevention and control, the importance of community engagement, and updates on virology, diagnosis, treatment and vaccination issues. The paper also includes discussions from public health, infectious diseases, critical care and infection control experts who cared for patients with EVD in Africa, in Europe, and in the United Sates and were involved in Ebola preparedness in both high- and low-resource settings and countries. This review concludes that too little is known about the pathogenesis and treatment of EVD, therefore basic and applied research in this area are urgently required. Furthermore, it is clear that epidemic preparedness needs to improve globally, in particular through the strengthening of health systems at local and national levels. There is a strong need for culturally sensitive approaches to public health which could be designed and delivered by social scientists and medical professionals working together. As of December 2015, this epidemic killed more than 11,000 people and infected more than 28,000; it has also generated more than 17,000 survivors and orphans, many of whom face somatic and psychological complications. The continued treatment and rehabilitation of these people is a public health priority, which also requires an integration of specific medical and social science approaches, not always available in West Africa.
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Ewer K, Rampling T, Venkatraman N, Bowyer G, Wright D, Lambe T, Imoukhuede EB, Payne R, Fehling SK, Strecker T, Biedenkopf N, Krähling V, Tully CM, Edwards NJ, Bentley EM, Samuel D, Labbé G, Jin J, Gibani M, Minhinnick A, Wilkie M, Poulton I, Lella N, Roberts R, Hartnell F, Bliss C, Sierra-Davidson K, Powlson J, Berrie E, Tedder R, Roman F, De Ryck I, Nicosia A, Sullivan NJ, Stanley DA, Mbaya OT, Ledgerwood JE, Schwartz RM, Siani L, Colloca S, Folgori A, Di Marco S, Cortese R, Wright E, Becker S, Graham BS, Koup RA, Levine MM, Volkmann A, Chaplin P, Pollard AJ, Draper SJ, Ballou WR, Lawrie A, Gilbert SC, Hill AVS. A Monovalent Chimpanzee Adenovirus Ebola Vaccine Boosted with MVA. N Engl J Med 2016; 374:1635-46. [PMID: 25629663 PMCID: PMC5798586 DOI: 10.1056/nejmoa1411627] [Citation(s) in RCA: 250] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The West African outbreak of Ebola virus disease that peaked in 2014 has caused more than 11,000 deaths. The development of an effective Ebola vaccine is a priority for control of a future outbreak. METHODS In this phase 1 study, we administered a single dose of the chimpanzee adenovirus 3 (ChAd3) vaccine encoding the surface glycoprotein of Zaire ebolavirus (ZEBOV) to 60 healthy adult volunteers in Oxford, United Kingdom. The vaccine was administered in three dose levels--1×10(10) viral particles, 2.5×10(10) viral particles, and 5×10(10) viral particles--with 20 participants in each group. We then assessed the effect of adding a booster dose of a modified vaccinia Ankara (MVA) strain, encoding the same Ebola virus glycoprotein, in 30 of the 60 participants and evaluated a reduced prime-boost interval in another 16 participants. We also compared antibody responses to inactivated whole Ebola virus virions and neutralizing antibody activity with those observed in phase 1 studies of a recombinant vesicular stomatitis virus-based vaccine expressing a ZEBOV glycoprotein (rVSV-ZEBOV) to determine relative potency and assess durability. RESULTS No safety concerns were identified at any of the dose levels studied. Four weeks after immunization with the ChAd3 vaccine, ZEBOV-specific antibody responses were similar to those induced by rVSV-ZEBOV vaccination, with a geometric mean titer of 752 and 921, respectively. ZEBOV neutralization activity was also similar with the two vaccines (geometric mean titer, 14.9 and 22.2, respectively). Boosting with the MVA vector increased virus-specific antibodies by a factor of 12 (geometric mean titer, 9007) and increased glycoprotein-specific CD8+ T cells by a factor of 5. Significant increases in neutralizing antibodies were seen after boosting in all 30 participants (geometric mean titer, 139; P<0.001). Virus-specific antibody responses in participants primed with ChAd3 remained positive 6 months after vaccination (geometric mean titer, 758) but were significantly higher in those who had received the MVA booster (geometric mean titer, 1750; P<0.001). CONCLUSIONS The ChAd3 vaccine boosted with MVA elicited B-cell and T-cell immune responses to ZEBOV that were superior to those induced by the ChAd3 vaccine alone. (Funded by the Wellcome Trust and others; ClinicalTrials.gov number, NCT02240875.).
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Affiliation(s)
- Katie Ewer
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Tommy Rampling
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Navin Venkatraman
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Georgina Bowyer
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Danny Wright
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Teresa Lambe
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Egeruan B Imoukhuede
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Ruth Payne
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Sarah Katharina Fehling
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Thomas Strecker
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Nadine Biedenkopf
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Verena Krähling
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Claire M Tully
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Nick J Edwards
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Emma M Bentley
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Dhanraj Samuel
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Geneviève Labbé
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Jing Jin
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Malick Gibani
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Alice Minhinnick
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Morven Wilkie
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Ian Poulton
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Natalie Lella
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Rachel Roberts
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Felicity Hartnell
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Carly Bliss
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Kailan Sierra-Davidson
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Jonathan Powlson
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Eleanor Berrie
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Richard Tedder
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Francois Roman
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Iris De Ryck
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Alfredo Nicosia
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Nancy J Sullivan
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Daphne A Stanley
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Olivier T Mbaya
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Julie E Ledgerwood
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Richard M Schwartz
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Loredana Siani
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Stefano Colloca
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Antonella Folgori
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Stefania Di Marco
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Riccardo Cortese
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Edward Wright
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Stephan Becker
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Barney S Graham
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Richard A Koup
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Myron M Levine
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Ariane Volkmann
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Paul Chaplin
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Andrew J Pollard
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Simon J Draper
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - W Ripley Ballou
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Alison Lawrie
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Sarah C Gilbert
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
| | - Adrian V S Hill
- From the Jenner Institute and Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford (K.E., T.R., N.V., G.B., D.W., T.L., E.B.I., R.P., C.M.T., N.J.E., G.L., J.J., M.G., A.M., M.W., I.P., N.L., R.R., F.H., C.B., K.S.-D., J.P., E.B., A.J.P., S.J.D., A.L., S.C.G., A.V.S.H.), and Viral Pseudotype Unit, Faculty of Science and Technology, University of Westminster (E.M.B., E.W.), and Virus Reference Department, Public Health Agency (D.S., R.T.), London - all in the United Kingdom; the Institute of Virology, Philipps University Marburg (S.K.F., T.S., N.B., V.K., S.B.), and German Center for Infection Research, Partner Site Giessen-Marburg-Langen (S.B.), Marburg, and Bavarian Nordic, Martinsried (A.V., P.C.) - all in Germany; GlaxoSmithKline Biologicals, Rixensart, Belgium (F.R., I.D.R., W.R.B.); ReiThera, Rome (A.N., L.S., S.C., A.F., S.D.M.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (N.J.S., D.A.S., O.T.M., J.E.L., R.M.S., B.S.G., R.A.K.), and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (M.M.L.) - both in Maryland; and Keires, Basel, Switzerland (R.C.)
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Agnandji ST, Huttner A, Zinser ME, Njuguna P, Dahlke C, Fernandes JF, Yerly S, Dayer JA, Kraehling V, Kasonta R, Adegnika AA, Altfeld M, Auderset F, Bache EB, Biedenkopf N, Borregaard S, Brosnahan JS, Burrow R, Combescure C, Desmeules J, Eickmann M, Fehling SK, Finckh A, Goncalves AR, Grobusch MP, Hooper J, Jambrecina A, Kabwende AL, Kaya G, Kimani D, Lell B, Lemaître B, Lohse AW, Massinga-Loembe M, Matthey A, Mordmüller B, Nolting A, Ogwang C, Ramharter M, Schmidt-Chanasit J, Schmiedel S, Silvera P, Stahl FR, Staines HM, Strecker T, Stubbe HC, Tsofa B, Zaki S, Fast P, Moorthy V, Kaiser L, Krishna S, Becker S, Kieny MP, Bejon P, Kremsner PG, Addo MM, Siegrist CA. Phase 1 Trials of rVSV Ebola Vaccine in Africa and Europe. N Engl J Med 2016; 374:1647-60. [PMID: 25830326 PMCID: PMC5490784 DOI: 10.1056/nejmoa1502924] [Citation(s) in RCA: 311] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The replication-competent recombinant vesicular stomatitis virus (rVSV)-based vaccine expressing a Zaire ebolavirus (ZEBOV) glycoprotein was selected for rapid safety and immunogenicity testing before its use in West Africa. METHODS We performed three open-label, dose-escalation phase 1 trials and one randomized, double-blind, controlled phase 1 trial to assess the safety, side-effect profile, and immunogenicity of rVSV-ZEBOV at various doses in 158 healthy adults in Europe and Africa. All participants were injected with doses of vaccine ranging from 300,000 to 50 million plaque-forming units (PFU) or placebo. RESULTS No serious vaccine-related adverse events were reported. Mild-to-moderate early-onset reactogenicity was frequent but transient (median, 1 day). Fever was observed in up to 30% of vaccinees. Vaccine viremia was detected within 3 days in 123 of the 130 participants (95%) receiving 3 million PFU or more; rVSV was not detected in saliva or urine. In the second week after injection, arthritis affecting one to four joints developed in 11 of 51 participants (22%) in Geneva, with pain lasting a median of 8 days (interquartile range, 4 to 87); 2 self-limited cases occurred in 60 participants (3%) in Hamburg, Germany, and Kilifi, Kenya. The virus was identified in one synovial-fluid aspirate and in skin vesicles of 2 other vaccinees, showing peripheral viral replication in the second week after immunization. ZEBOV-glycoprotein-specific antibody responses were detected in all the participants, with similar glycoprotein-binding antibody titers but significantly higher neutralizing antibody titers at higher doses. Glycoprotein-binding antibody titers were sustained through 180 days in all participants. CONCLUSIONS In these studies, rVSV-ZEBOV was reactogenic but immunogenic after a single dose and warrants further evaluation for safety and efficacy. (Funded by the Wellcome Trust and others; ClinicalTrials.gov numbers, NCT02283099, NCT02287480, and NCT02296983; Pan African Clinical Trials Registry number, PACTR201411000919191.).
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Affiliation(s)
- Selidji T Agnandji
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Angela Huttner
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Madeleine E Zinser
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Patricia Njuguna
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Christine Dahlke
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - José F Fernandes
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Sabine Yerly
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Julie-Anne Dayer
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Verena Kraehling
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Rahel Kasonta
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Akim A Adegnika
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Marcus Altfeld
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Floriane Auderset
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Emmanuel B Bache
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Nadine Biedenkopf
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Saskia Borregaard
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Jessica S Brosnahan
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Rebekah Burrow
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Christophe Combescure
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Jules Desmeules
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Markus Eickmann
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Sarah K Fehling
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Axel Finckh
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Ana Rita Goncalves
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Martin P Grobusch
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Jay Hooper
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Alen Jambrecina
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Anita L Kabwende
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Gürkan Kaya
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Domtila Kimani
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Bertrand Lell
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Barbara Lemaître
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Ansgar W Lohse
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Marguerite Massinga-Loembe
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Alain Matthey
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Benjamin Mordmüller
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Anne Nolting
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Caroline Ogwang
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Michael Ramharter
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Jonas Schmidt-Chanasit
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Stefan Schmiedel
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Peter Silvera
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Felix R Stahl
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Henry M Staines
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Thomas Strecker
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Hans C Stubbe
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Benjamin Tsofa
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Sherif Zaki
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Patricia Fast
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Vasee Moorthy
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Laurent Kaiser
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Sanjeev Krishna
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Stephan Becker
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Marie-Paule Kieny
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Philip Bejon
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Peter G Kremsner
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Marylyn M Addo
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
| | - Claire-Anne Siegrist
- From the Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.); Institut für Tropenmedizin, Universitätsklinikum Tübingen, and German Center for Infection Research, Tübingen (S.T.A., J.F.F., A.A.A., E.B.B., J.S.B., M.P.G., A.L.K., B. Lell, M.M.-L., B.M., M.R., S.K., P.G.K.), University Medical Center Hamburg-Eppendorf, 1st Department of Medicine (M.E.Z., C.D., R.K., A.W.L., A.N., S.S., H.C.S., M.M.A.), and Institute for Clinical Chemistry and Laboratory Medicine (F.R.S.), German Center for Infection Research, partner site Standort Hamburg-Lübeck-Borstel (C.D., A.N., J.S.-C., H.C.S., M.M.A.), Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology (M.A.), Clinical Trial Center North (S. Borregaard, A.J.), and Bernhard Nocht Institute for Tropical Medicine, World Health Organization (WHO) Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, National Reference Center for Tropical Infectious Diseases (J.S.-C.), Hamburg, Philipps University Marburg, Institute for Virology, and the German Center for Infection Research (DZIF), partner site Giessen-Marburg-Langen, Marburg (V.K., N.B., M.E., S.K.F., T.S., S. Becker), and the Division of Veterinary Medicine, Paul Ehrlich Institute, Langen (R.K.) - all in Germany; the Infection Control Program (A.H.), Divisions of Infectious Diseases (A.H., J.-A.D., L.K.), Clinical Epidemiology (C.C.), Rheumatology (A.F.), and Dermatology (G.K.), and Centers for Clinical Research (J.D., A.M.) and Vaccinology (C.-A.S.), Geneva University Hospitals and Faculty of Medicine, the Virology Laboratory, Geneva University Hospitals (S.Y., A.R.G., L.K.), WHO Collaborative Center for Vaccinology, Faculty of Medicine (F.A., B. Lemaître, C.-A.S.), and the WHO (P.F., V.M., M.-P.K.) - all in Geneva; the Kenya Medical Research Institute-Wellcome Trust Research Program, Center for Geographic Medicine
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Abstract
The Ebolavirus genus includes five member species, all of which pose a threat to global public health. These viruses cause fatal hemorrhagic fever in humans and nonhuman primates, and are considered category A pathogens due to the risk of their use as a bioweapon. The potential for an outbreak, either as a result of a natural emergence, deliberate release, or imported case underscores the need for protective vaccines. Recent progress in advancing vaccines for use against the strain of Zaire ebolavirus (EBOV) responsible for the West African Ebola outbreak offers reasons for optimism against EBOV, and demonstrates that protection against other Ebolavirus species is achievable.
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Affiliation(s)
- Robert A Kozak
- a Special Pathogens Program, National Microbiology Laboratory , Public Health Agency of Canada , Winnipeg , Canada.,b Department of Medical Microbiology , University of Manitoba , Winnipeg , Canada
| | - Gary P Kobinger
- a Special Pathogens Program, National Microbiology Laboratory , Public Health Agency of Canada , Winnipeg , Canada.,b Department of Medical Microbiology , University of Manitoba , Winnipeg , Canada.,c Department of Pathology and Laboratory Medicine , University of Pennsylvania School of Medicine , Philadelphia , PA , USA
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Dye JM, Warfield KL, Wells JB, Unfer RC, Shulenin S, Vu H, Nichols DK, Aman MJ, Bavari S. Virus-Like Particle Vaccination Protects Nonhuman Primates from Lethal Aerosol Exposure with Marburgvirus (VLP Vaccination Protects Macaques against Aerosol Challenges). Viruses 2016; 8:94. [PMID: 27070636 PMCID: PMC4848589 DOI: 10.3390/v8040094] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 03/23/2016] [Accepted: 03/24/2016] [Indexed: 01/21/2023] Open
Abstract
Marburg virus (MARV) was the first filovirus to be identified following an outbreak of viral hemorrhagic fever disease in Marburg, Germany in 1967. Due to several factors inherent to filoviruses, they are considered a potential bioweapon that could be disseminated via an aerosol route. Previous studies demonstrated that MARV virus-like particles (VLPs) containing the glycoprotein (GP), matrix protein VP40 and nucleoprotein (NP) generated using a baculovirus/insect cell expression system could protect macaques from subcutaneous (SQ) challenge with multiple species of marburgviruses. In the current study, the protective efficacy of the MARV VLPs in conjunction with two different adjuvants: QS-21, a saponin derivative, and poly I:C against homologous aerosol challenge was assessed in cynomolgus macaques. Antibody responses against the GP antigen were equivalent in all groups receiving MARV VLPs irrespective of the adjuvant; adjuvant only-vaccinated macaques did not demonstrate appreciable antibody responses. All macaques were subsequently challenged with lethal doses of MARV via aerosol or SQ as a positive control. All MARV VLP-vaccinated macaques survived either aerosol or SQ challenge while animals administered adjuvant only exhibited clinical signs and lesions consistent with MARV disease and were euthanized after meeting the predetermined criteria. Therefore, MARV VLPs induce IgG antibodies recognizing MARV GP and VP40 and protect cynomolgus macaques from an otherwise lethal aerosol exposure with MARV.
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Affiliation(s)
- John M Dye
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD 21702, USA.
| | | | - Jay B Wells
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD 21702, USA.
| | - Robert C Unfer
- Integrated Biotherapeutics, Inc., Gaithersburg, MD 20878, USA.
| | - Sergey Shulenin
- Integrated Biotherapeutics, Inc., Gaithersburg, MD 20878, USA.
| | - Hong Vu
- Integrated Biotherapeutics, Inc., Gaithersburg, MD 20878, USA.
| | - Donald K Nichols
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD 21702, USA.
| | - M Javad Aman
- Integrated Biotherapeutics, Inc., Gaithersburg, MD 20878, USA.
| | - Sina Bavari
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD 21702, USA.
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234
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Fan Y, Moon JJ. Particulate delivery systems for vaccination against bioterrorism agents and emerging infectious pathogens. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2016; 9. [PMID: 27038091 DOI: 10.1002/wnan.1403] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 02/10/2016] [Accepted: 02/15/2016] [Indexed: 01/15/2023]
Abstract
Bioterrorism agents that can be easily transmitted with high mortality rates and cause debilitating diseases pose major threats to national security and public health. The recent Ebola virus outbreak in West Africa and ongoing Zika virus outbreak in Brazil, now spreading throughout Latin America, are case examples of emerging infectious pathogens that have incited widespread fear and economic and social disruption on a global scale. Prophylactic vaccines would provide effective countermeasures against infectious pathogens and biological warfare agents. However, traditional approaches relying on attenuated or inactivated vaccines have been hampered by their unacceptable levels of reactogenicity and safety issues, whereas subunit antigen-based vaccines suffer from suboptimal immunogenicity and efficacy. In contrast, particulate vaccine delivery systems offer key advantages, including efficient and stable delivery of subunit antigens, co-delivery of adjuvant molecules to bolster immune responses, low reactogenicity due to the use of biocompatible biomaterials, and robust efficiency to elicit humoral and cellular immunity in systemic and mucosal tissues. Thus, vaccine nanoparticles and microparticles are promising platforms for clinical development of biodefense vaccines. In this review, we summarize the current status of research efforts to develop particulate vaccine delivery systems against bioterrorism agents and emerging infectious pathogens. WIREs Nanomed Nanobiotechnol 2017, 9:e1403. doi: 10.1002/wnan.1403 For further resources related to this article, please visit the WIREs website.
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Affiliation(s)
- Yuchen Fan
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI, USA.,Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - James J Moon
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, MI, USA.,Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
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235
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Ayub G, Waheed Y, Najmi MH. Prediction and conservancy analysis of promiscuous T-cell binding epitopes of Ebola virus L protein: An in silico approach. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2016. [DOI: 10.1016/s2222-1808(15)61007-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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236
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Lever RA, Whitty CJM. Ebola virus disease: emergence, outbreak and future directions. Br Med Bull 2016; 117:95-106. [PMID: 26872858 DOI: 10.1093/bmb/ldw005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND The West African Ebola crisis of 2013-15 is the largest outbreak since Ebola was first identified; Ebola has high case fatality. SOURCES OF DATA Pubmed with terms 'Ebola' and 'EVD' from January 1976 to June 2015. Public domain material. AREAS OF AGREEMENT The emergence of Ebola virus, virology, clinical features and the major elements of the 2014 outbreak and the public health response. Ebola is only transmitted by direct contact with infected individuals (including dead bodies) and their body fluids. Methods of control in hospitals and burials, and protection of healthcare workers are well established if difficult to achieve. AREAS OF CONTENTION There remains uncertainty surrounding specific public health interventions and novel therapies (including vaccines). How best to reduce transmission in the community during major outbreaks remains unclear. FUTURE DIRECTIONS The potential of vaccine and therapeutic candidates in the event of another outbreak on this scale. . SEARCH STRATEGY We searched all entries on the MedLine database/PubMed from 1976-2015 with the MeSH terms 'ebola', 'EVD', 'haemorrhagic fever'. We also reviewed publically available information via institutional websites from Governmental, NGOs and news organizations pertaining to the above search terms.
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Affiliation(s)
- Robert A Lever
- Hospital for Tropical Diseases, 2B Maple House, 149 Tottenham Court Road, London W1T 7DN, UK
| | - Christopher J M Whitty
- Hospital for Tropical Diseases, 2B Maple House, 149 Tottenham Court Road, London W1T 7DN, UK
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237
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Cytomegalovirus-based vaccine expressing Ebola virus glycoprotein protects nonhuman primates from Ebola virus infection. Sci Rep 2016; 6:21674. [PMID: 26876974 PMCID: PMC4753684 DOI: 10.1038/srep21674] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 01/28/2016] [Indexed: 11/08/2022] Open
Abstract
Ebolaviruses pose significant public health problems due to their high lethality, unpredictable emergence, and localization to the poorest areas of the world. In addition to implementation of standard public health control procedures, a number of experimental human vaccines are being explored as a further means for outbreak control. Recombinant cytomegalovirus (CMV)-based vectors are a novel vaccine platform that have been shown to induce substantial levels of durable, but primarily T-cell-biased responses against the encoded heterologous target antigen. Herein, we demonstrate the ability of rhesus CMV (RhCMV) expressing Ebola virus (EBOV) glycoprotein (GP) to provide protective immunity to rhesus macaques against lethal EBOV challenge. Surprisingly, vaccination was associated with high levels of GP-specific antibodies, but with no detectable GP-directed cellular immunity.
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238
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Krause PR, Bryant PR, Clark T, Dempsey W, Henchal E, Michael NL, Regules JA, Gruber MF. Immunology of protection from Ebola virus infection. Sci Transl Med 2016; 7:286ps11. [PMID: 25947159 DOI: 10.1126/scitranslmed.aaa8202] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
A December 2014 meeting reviewed Ebola virus immunology relevant to vaccine development, including Ebola prevention, immunity, assay standardization, and regulatory considerations. Vaccinated humans appear to achieve immune responses comparable in magnitude with those associated with protection in nonhuman primates, suggesting that immunological data could be used to demonstrate vaccine efficacy.
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Affiliation(s)
- Philip R Krause
- Office of Vaccines Research and Review, U.S. Food and Drug Administration/Center for Biologics Evaluation and Research, Silver Spring, MD, USA.
| | - Paula R Bryant
- Division of Microbial and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Thomas Clark
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Walla Dempsey
- Division of Microbial and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Erik Henchal
- Office of Vaccines Research and Review, U.S. Food and Drug Administration/Center for Biologics Evaluation and Research, Silver Spring, MD, USA
| | | | - Jason A Regules
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Marion F Gruber
- Office of Vaccines Research and Review, U.S. Food and Drug Administration/Center for Biologics Evaluation and Research, Silver Spring, MD, USA
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239
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Tsang MK, Ye W, Wang G, Li J, Yang M, Hao J. Ultrasensitive Detection of Ebola Virus Oligonucleotide Based on Upconversion Nanoprobe/Nanoporous Membrane System. ACS NANO 2016; 10:598-605. [PMID: 26720408 DOI: 10.1021/acsnano.5b05622] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Ebola outbreaks are currently of great concern, and therefore, development of effective diagnosis methods is urgently needed. The key for lethal virus detection is high sensitivity, since early-stage detection of virus may increase the probability of survival. Here, we propose a luminescence scheme of assay consisting of BaGdF5:Yb/Er upconversion nanoparticles (UCNPs) conjugated with oligonucleotide probe and gold nanoparticles (AuNPs) linked with target Ebola virus oligonucleotide. As a proof of concept, a homogeneous assay was fabricated and tested, yielding a detection limit at picomolar level. The luminescence resonance energy transfer is ascribed to the spectral overlapping of upconversion luminescence and the absorption characteristics of AuNPs. Moreover, we anchored the UCNPs and AuNPs on a nanoporous alumina (NAAO) membrane to form a heterogeneous assay. Importantly, the detection limit was greatly improved, exhibiting a remarkable value at the femtomolar level. The enhancement is attributed to the increased light-matter interaction throughout the nanopore walls of the NAAO membrane. The specificity test suggested that the nanoprobes were specific to Ebola virus oligonucleotides. The strategy combining UCNPs, AuNPs, and NAAO membrane provides new insight into low-cost, rapid, and ultrasensitive detection of different diseases. Furthermore, we explored the feasibility of clinical application by using inactivated Ebola virus samples. The detection results showed great potential of our heterogeneous design for practical application.
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Affiliation(s)
- Ming-Kiu Tsang
- Department of Applied Physics, The Hong Kong Polytechnic University , Hung Hom, Kowloon, Hong Kong, P. R. China
| | - WeiWei Ye
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University , Hung Hom, Kowloon, Hong Kong, P. R. China
- Institute of Ocean Research, Zhejiang University of Technology , Hangzhou, Zhejiang 310014, P. R. China
| | - Guojing Wang
- National Center for Clinical Laboratory, Beijing Hospital of the Ministry of Health , No. 1 Dahua Road, Dongdan, Beijing 100730, P. R. China
| | - Jingming Li
- National Center for Clinical Laboratory, Beijing Hospital of the Ministry of Health , No. 1 Dahua Road, Dongdan, Beijing 100730, P. R. China
| | - Mo Yang
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University , Hung Hom, Kowloon, Hong Kong, P. R. China
| | - Jianhua Hao
- Department of Applied Physics, The Hong Kong Polytechnic University , Hung Hom, Kowloon, Hong Kong, P. R. China
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240
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Wong G, Qiu X. Designing Efficacious Vesicular Stomatitis Virus-Vectored Vaccines Against Ebola Virus. Methods Mol Biol 2016; 1403:245-257. [PMID: 27076134 DOI: 10.1007/978-1-4939-3387-7_12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Infection with the Ebola virus (EBOV) causes an aggressive hemorrhagic disease in humans and nonhuman primates. Traditional approaches, such as vaccination with inactivated virion preparations, have had limited efficacy, whereas immunization with live-attenuated EBOV is not feasible due to the highly lethal nature of the pathogen. This has necessitated the development of other approaches towards an effective EBOV vaccine. Over the past decade, recombinant viruses expressing the EBOV glycoprotein (GP) have constituted the most promising platforms, as evidenced by their ability to protect naïve nonhuman primates from a lethal EBOV challenge. The vesicular stomatitis virus (VSV) is one such vector and is currently progressing through the clinical pipeline. This chapter presents methodologies for the design, cloning, rescue, and preparation of live, recombinant VSV vaccines expressing GP for research purposes.
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Affiliation(s)
- Gary Wong
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, Canada
- Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - Xiangguo Qiu
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, Canada.
- Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada.
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241
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Single-Vector, Single-Injection Recombinant Vesicular Stomatitis Virus Vaccines Against High-Containment Viruses. Methods Mol Biol 2016; 1403:295-311. [PMID: 27076138 DOI: 10.1007/978-1-4939-3387-7_16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There are many avenues for making an effective vaccine against viruses. Depending on the virus these can include one of the following: inactivation of whole virions; attenuation of viruses; recombinant viral proteins; non-replication-competent virus particles; or surrogate virus vector systems such as vesicular stomatitis virus (VSV). VSV is a prototypic enveloped animal virus that has been used for over four decades to study virus replication, entry, and assembly due to its ability to replicate to high titers in a wide variety of mammalian and insect cells. The use of reverse genetics to recover infectious and single-cycle replicating VSV from plasmid DNA transfected in cell culture began a revolution in the study of recombinant VSV (rVSV). This platform can be manipulated to study the viral genetic sequences and proteins important in the virus life cycle. Additionally, foreign genes can be inserted between naturally occurring or generated start/stop signals and polyadenylation sites within the VSV genome. VSV has a tolerance for foreign gene expression which has led to numerous rVSVs reported in the literature. Of particular interest are the very effective single-dose rVSV vaccine vectors against high-containment viruses such as filoviruses, henipaviruses, and arenaviruses. Herein we describe the methods for selecting foreign antigenic genes, selecting the location within the VSV genome for insertion, generation of rVSV using reverse genetics, and proper vaccine study designs.
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242
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Ebola vaccine, therapeutics, and diagnostics. Uirusu 2016; 66:63-72. [PMID: 28484180 DOI: 10.2222/jsv.66.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Ebolaviruses, members of the family Filoviridae, cause severe hemorrhagic fever in humans and nonhuman primates, with human case fatality rates of up to 90%. No effective prophylaxis or treatment for Ebola virus disease (EVD) is yet commercially available. During the latest outbreak of EVD in West Africa, several unapproved drugs were used for the treatment of patients. This outbreak has indeed accelerated efforts to develop antiviral strategies and some of the vaccine and drug candidates have undergone clinical trials. This article reviews previous researches and recent advances on the development of vaccine, therapeutics, and diagnostics for EVD.
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243
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Trefry JC, Wollen SE, Nasar F, Shamblin JD, Kern SJ, Bearss JJ, Jefferson MA, Chance TB, Kugelman JR, Ladner JT, Honko AN, Kobs DJ, Wending MQS, Sabourin CL, Pratt WD, Palacios GF, Pitt MLM. Ebola Virus Infections in Nonhuman Primates Are Temporally Influenced by Glycoprotein Poly-U Editing Site Populations in the Exposure Material. Viruses 2015; 7:6739-54. [PMID: 26703716 PMCID: PMC4690892 DOI: 10.3390/v7122969] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 12/03/2015] [Accepted: 12/07/2015] [Indexed: 01/04/2023] Open
Abstract
Recent experimentation with the variants of the Ebola virus that differ in the glycoprotein's poly-uridine site, which dictates the form of glycoprotein produced through a transcriptional stutter, has resulted in questions regarding the pathogenicity and lethality of the stocks used to develop products currently undergoing human clinical trials to combat the disease. In order to address these concerns and prevent the delay of these critical research programs, we designed an experiment that permitted us to intramuscularly challenge statistically significant numbers of naïve and vaccinated cynomolgus macaques with either a 7U or 8U variant of the Ebola virus, Kikwit isolate. In naïve animals, no difference in survivorship was observed; however, there was a significant delay in the disease course between the two groups. Significant differences were also observed in time-of-fever, serum chemistry, and hematology. In vaccinated animals, there was no statistical difference in survivorship between either challenge groups, with two succumbing in the 7U group compared to 1 in the 8U challenge group. In summary, survivorship was not affected, but the Ebola virus disease course in nonhuman primates is temporally influenced by glycoprotein poly-U editing site populations.
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Affiliation(s)
- John C Trefry
- Virology Division, US Army Medical Research Institute for Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Suzanne E Wollen
- Virology Division, US Army Medical Research Institute for Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Farooq Nasar
- Virology Division, US Army Medical Research Institute for Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Joshua D Shamblin
- Virology Division, US Army Medical Research Institute for Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Steven J Kern
- Virology Division, US Army Medical Research Institute for Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Jeremy J Bearss
- Pathology Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Michelle A Jefferson
- Pathology Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Taylor B Chance
- Pathology Division, U.S. Army Medical Research Institute of Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Jeffery R Kugelman
- Molecular and Translational Sciences, U.S. Army Medical Research Institute of Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Jason T Ladner
- Molecular and Translational Sciences, U.S. Army Medical Research Institute of Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Anna N Honko
- Virology Division, US Army Medical Research Institute for Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Dean J Kobs
- Battelle Memorial Institute, 505 King Ave., Columbus, OH 43201, USA.
| | | | - Carol L Sabourin
- Battelle Memorial Institute, 505 King Ave., Columbus, OH 43201, USA.
| | - William D Pratt
- Virology Division, US Army Medical Research Institute for Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - Gustavo F Palacios
- Molecular and Translational Sciences, U.S. Army Medical Research Institute of Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
| | - M Louise M Pitt
- Virology Division, US Army Medical Research Institute for Infectious Diseases, 1425 Porter St., Fort Detrick, MD 21702, USA.
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244
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de Wit E, Marzi A, Bushmaker T, Brining D, Scott D, Richt JA, Geisbert TW, Feldmann H. Safety of recombinant VSV-Ebola virus vaccine vector in pigs. Emerg Infect Dis 2015; 21:702-4. [PMID: 25811738 PMCID: PMC4378486 DOI: 10.3201/eid2104.142012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The ongoing Ebola outbreak in West Africa has resulted in fast-track development of vaccine candidates. We tested a vesicular stomatitis virus vector expressing Ebola virus glycoprotein for safety in pigs. Inoculation did not cause disease and vaccine virus shedding was minimal, which indicated that the vaccine virus does not pose a risk of dissemination in pigs.
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245
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Pinsky BA, Sahoo MK, Sandlund J, Kleman M, Kulkarni M, Grufman P, Nygren M, Kwiatkowski R, Baron EJ, Tenover F, Denison B, Higuchi R, Van Atta R, Beer NR, Carrillo AC, Naraghi-Arani P, Mire CE, Ranadheera C, Grolla A, Lagerqvist N, Persing DH. Analytical Performance Characteristics of the Cepheid GeneXpert Ebola Assay for the Detection of Ebola Virus. PLoS One 2015; 10:e0142216. [PMID: 26562786 PMCID: PMC4643052 DOI: 10.1371/journal.pone.0142216] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 10/19/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The recently developed Xpert® Ebola Assay is a novel nucleic acid amplification test for simplified detection of Ebola virus (EBOV) in whole blood and buccal swab samples. The assay targets sequences in two EBOV genes, lowering the risk for new variants to escape detection in the test. The objective of this report is to present analytical characteristics of the Xpert® Ebola Assay on whole blood samples. METHODS AND FINDINGS This study evaluated the assay's analytical sensitivity, analytical specificity, inclusivity and exclusivity performance in whole blood specimens. EBOV RNA, inactivated EBOV, and infectious EBOV were used as targets. The dynamic range of the assay, the inactivation of virus, and specimen stability were also evaluated. The lower limit of detection (LoD) for the assay using inactivated virus was estimated to be 73 copies/mL (95% CI: 51-97 copies/mL). The LoD for infectious virus was estimated to be 1 plaque-forming unit/mL, and for RNA to be 232 copies/mL (95% CI 163-302 copies/mL). The assay correctly identified five different Ebola viruses, Yambuku-Mayinga, Makona-C07, Yambuku-Ecran, Gabon-Ilembe, and Kikwit-956210, and correctly excluded all non-EBOV isolates tested. The conditions used by Xpert® Ebola for inactivation of infectious virus reduced EBOV titer by ≥6 logs. CONCLUSION In summary, we found the Xpert® Ebola Assay to have high analytical sensitivity and specificity for the detection of EBOV in whole blood. It offers ease of use, fast turnaround time, and remote monitoring. The test has an efficient viral inactivation protocol, fulfills inclusivity and exclusivity criteria, and has specimen stability characteristics consistent with the need for decentralized testing. The simplicity of the assay should enable testing in a wide variety of laboratory settings, including remote laboratories that are not capable of performing highly complex nucleic acid amplification tests, and during outbreaks where time to detection is critical.
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Affiliation(s)
- Benjamin A. Pinsky
- Department of Pathology, Stanford University School of Medicine, Stanford, California, United States of America
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, United States of America
- * E-mail:
| | - Malaya K. Sahoo
- Department of Pathology, Stanford University School of Medicine, Stanford, California, United States of America
| | - Johanna Sandlund
- Department of Pathology, Stanford University School of Medicine, Stanford, California, United States of America
- Clinical Microbiology Laboratory, Stanford Health Care and Stanford Children’s Health, Palo Alto, California, United States of America
| | | | - Medha Kulkarni
- Cepheid, Sunnyvale, California, United States of America
| | | | | | | | - Ellen Jo Baron
- Cepheid, Sunnyvale, California, United States of America
| | - Fred Tenover
- Cepheid, Sunnyvale, California, United States of America
| | - Blake Denison
- Cepheid, Sunnyvale, California, United States of America
| | | | - Reuel Van Atta
- Cepheid, Sunnyvale, California, United States of America
| | - Neil Reginald Beer
- Lawrence Livermore National Laboratory, Livermore, California, United States of America
| | - Alda Celena Carrillo
- Lawrence Livermore National Laboratory, Livermore, California, United States of America
| | - Pejman Naraghi-Arani
- Lawrence Livermore National Laboratory, Livermore, California, United States of America
| | - Chad E. Mire
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Charlene Ranadheera
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Allen Grolla
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
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Development and Characterization of a Guinea Pig-Adapted Sudan Virus. J Virol 2015; 90:392-9. [PMID: 26491156 DOI: 10.1128/jvi.02331-15] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 10/10/2015] [Indexed: 12/17/2022] Open
Abstract
UNLABELLED Infections with Sudan virus (SUDV), a member of the genus Ebolavirus, result in a severe hemorrhagic fever with a fatal outcome in over 50% of human cases. The paucity of prophylactics and therapeutics against SUDV is attributed to the lack of a small-animal model to screen promising compounds. By repeatedly passaging SUDV within the livers and spleens of guinea pigs in vivo, a guinea pig-adapted SUDV variant (SUDV-GA) uniformly lethal to these animals, with a 50% lethal dose (LD50) of 5.3 × 10(-2) 50% tissue culture infective doses (TCID50), was developed. Animals infected with SUDV-GA developed high viremia and died between 9 and 14 days postinfection. Several hallmarks of SUDV infection, including lymphadenopathy, increased liver enzyme activities, and coagulation abnormalities, were observed. Virological analyses and gross pathology, histopathology, and immunohistochemistry findings indicate that SUDV-GA replicates in the livers and spleens of infected animals similarly to SUDV infections in nonhuman primates. These developments will accelerate the development of specific medical countermeasures in preparation for a future disease outbreak due to SUDV. IMPORTANCE A disease outbreak due to Ebola virus (EBOV), suspected to have emerged during December 2013 in Guinea, with over 11,000 dead and 28,000 infected, is finally winding down. Experimental EBOV vaccines and treatments were administered to patients under compassionate circumstances with promising results, and availability of an approved countermeasure appears to be close. However, the same range of experimental candidates against a potential disease outbreak caused by other members of the genus Ebolavirus, such as Sudan virus (SUDV), is not readily available. One bottleneck contributing to this situation is the lack of a small-animal model to screen promising drugs in an efficient and economical manner. To address this, we have generated a SUDV variant (SUDV-GA) that is uniformly lethal to guinea pigs. Animals infected with SUDV-GA develop disease similar to that of SUDV-infected humans and monkeys. We believe that this model will significantly accelerate the development of life-saving measures against SUDV infections.
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Coltart CEM, Johnson AM, Whitty CJM. Role of healthcare workers in early epidemic spread of Ebola: policy implications of prophylactic compared to reactive vaccination policy in outbreak prevention and control. BMC Med 2015; 13:271. [PMID: 26482396 PMCID: PMC4612417 DOI: 10.1186/s12916-015-0477-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/03/2015] [Indexed: 12/02/2022] Open
Abstract
Ebola causes severe illness in humans and has epidemic potential. How to deploy vaccines most effectively is a central policy question since different strategies have implications for ideal vaccine profile. More than one vaccine may be needed. A vaccine optimised for prophylactic vaccination in high-risk areas but when the virus is not actively circulating should be safe, well tolerated, and provide long-lasting protection; a two- or three-dose strategy would be realistic. Conversely, a reactive vaccine deployed in an outbreak context for ring-vaccination strategies should have rapid onset of protection with one dose, but longevity of protection is less important. In initial cases, before an outbreak is recognised, healthcare workers (HCWs) are at particular risk of acquiring and transmitting infection, thus potentially augmenting early epidemics. We hypothesise that many early outbreak cases could be averted, or epidemics aborted, by prophylactic vaccination of HCWs. This paper explores the potential impact of prophylactic versus reactive vaccination strategies of HCWs in preventing early epidemic transmissions. To do this, we use the limited data available from Ebola epidemics (current and historic) to reconstruct transmission trees and illustrate the theoretical impact of these vaccination strategies. Our data suggest a substantial potential benefit of prophylactic versus reactive vaccination of HCWs in preventing early transmissions. We estimate that prophylactic vaccination with a coverage >99% and theoretical 100% efficacy could avert nearly two-thirds of cases studied; 75% coverage would still confer clear benefit (40% cases averted), but reactive vaccination would be of less value in the early epidemic. A prophylactic vaccination campaign for front-line HCWs is not a trivial undertaking; whether to prioritise long-lasting vaccines and provide prophylaxis to HCWs is a live policy question. Prophylactic vaccination is likely to have a greater impact on the mitigation of future epidemics than reactive strategies and, in some cases, might prevent them. However, in a confirmed outbreak, reactive vaccination would be an essential humanitarian priority. The value of HCW Ebola vaccination is often only seen in terms of personal protection of the HCW workforce. A prophylactic vaccination strategy is likely to bring substantial additional benefit by preventing early transmission and might abort some epidemics. This has implications both for policy and for the optimum product profile for vaccines currently in development.
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Affiliation(s)
- Cordelia E M Coltart
- Research Department of Infection and Population Health, Institute of Epidemiology, UCL, London, UK.
| | - Anne M Johnson
- Research Department of Infection and Population Health, Institute of Epidemiology, UCL, London, UK
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Marzi A, Feldmann F, Geisbert TW, Feldmann H, Safronetz D. Vesicular stomatitis virus-based vaccines against Lassa and Ebola viruses. Emerg Infect Dis 2015; 21:305-7. [PMID: 25625358 PMCID: PMC4313664 DOI: 10.3201/eid2102.141649] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
We demonstrated that previous vaccination with a vesicular stomatitis virus (VSV)–based Lassa virus vaccine does not alter protective efficacy of subsequent vaccination with a VSV-based Ebola virus vaccine. These findings demonstrate the utility of VSV-based vaccines against divergent viral pathogens, even when preexisting immunity to the vaccine vector is present.
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249
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Khan MA, Hossain MU, Rakib-Uz-Zaman SM, Morshed MN. Epitope-based peptide vaccine design and target site depiction against Ebola viruses: an immunoinformatics study. Scand J Immunol 2015; 82:25-34. [PMID: 25857850 PMCID: PMC7169600 DOI: 10.1111/sji.12302] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 03/21/2015] [Indexed: 12/28/2022]
Abstract
Ebola viruses (EBOVs) have been identified as an emerging threat in recent year as it causes severe haemorrhagic fever in human. Epitope‐based vaccine design for EBOVs remains a top priority because a mere progress has been made in this regard. Another reason is the lack of antiviral drug and licensed vaccine although there is a severe outbreak in Central Africa. In this study, we aimed to design an epitope‐based vaccine that can trigger a significant immune response as well as to prognosticate inhibitor that can bind with potential drug target sites using various immunoinformatics and docking simulation tools. The capacity to induce both humoral and cell‐mediated immunity by T cell and B cell was checked for the selected protein. The peptide region spanning 9 amino acids from 42 to 50 and the sequence TLASIGTAF were found as the most potential B and T cell epitopes, respectively. This peptide could interact with 12 HLAs and showed high population coverage up to 80.99%. Using molecular docking, the epitope was further appraised for binding against HLA molecules to verify the binding cleft interaction. In addition with this, the allergenicity of the epitopes was also evaluated. In the post‐therapeutic strategy, docking study of predicted 3D structure identified suitable therapeutic inhibitor against targeted protein. However, this computational epitope‐based peptide vaccine designing and target site prediction against EBOVs open up a new horizon which may be the prospective way in Ebola viruses research; the results require validation by in vitro and in vivo experiments.
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Affiliation(s)
- M A Khan
- Department of Science and Humanities, Military Institute of Science and Technology (MIST), Mirpur Cantonment, Bangladesh
| | - M U Hossain
- Department of Biotechnology and Genetic Engineering, Life Science Faculty, Mawlana Bhashani Science and Technology University, Santosh, Bangladesh
| | - S M Rakib-Uz-Zaman
- Department of Genetic Engineering and Biotechnology, Life Science Faculty, Shahjalal University of Science and Technology, Kumargaon, Bangladesh
| | - M N Morshed
- Department of Science and Humanities, Military Institute of Science and Technology (MIST), Mirpur Cantonment, Bangladesh
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250
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A Highly Immunogenic and Protective Middle East Respiratory Syndrome Coronavirus Vaccine Based on a Recombinant Measles Virus Vaccine Platform. J Virol 2015; 89:11654-67. [PMID: 26355094 DOI: 10.1128/jvi.01815-15] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/03/2015] [Indexed: 12/19/2022] Open
Abstract
UNLABELLED In 2012, the first cases of infection with the Middle East respiratory syndrome coronavirus (MERS-CoV) were identified. Since then, more than 1,000 cases of MERS-CoV infection have been confirmed; infection is typically associated with considerable morbidity and, in approximately 30% of cases, mortality. Currently, there is no protective vaccine available. Replication-competent recombinant measles virus (MV) expressing foreign antigens constitutes a promising tool to induce protective immunity against corresponding pathogens. Therefore, we generated MVs expressing the spike glycoprotein of MERS-CoV in its full-length (MERS-S) or a truncated, soluble variant of MERS-S (MERS-solS). The genes encoding MERS-S and MERS-solS were cloned into the vaccine strain MVvac2 genome, and the respective viruses were rescued (MVvac2-CoV-S and MVvac2-CoV-solS). These recombinant MVs were amplified and characterized at passages 3 and 10. The replication of MVvac2-CoV-S in Vero cells turned out to be comparable to that of the control virus MVvac2-GFP (encoding green fluorescent protein), while titers of MVvac2-CoV-solS were impaired approximately 3-fold. The genomic stability and expression of the inserted antigens were confirmed via sequencing of viral cDNA and immunoblot analysis. In vivo, immunization of type I interferon receptor-deficient (IFNAR(-/-))-CD46Ge mice with 2 × 10(5) 50% tissue culture infective doses of MVvac2-CoV-S(H) or MVvac2-CoV-solS(H) in a prime-boost regimen induced robust levels of both MV- and MERS-CoV-neutralizing antibodies. Additionally, induction of specific T cells was demonstrated by T cell proliferation, antigen-specific T cell cytotoxicity, and gamma interferon secretion after stimulation of splenocytes with MERS-CoV-S presented by murine dendritic cells. MERS-CoV challenge experiments indicated the protective capacity of these immune responses in vaccinated mice. IMPORTANCE Although MERS-CoV has not yet acquired extensive distribution, being mainly confined to the Arabic and Korean peninsulas, it could adapt to spread more readily among humans and thereby become pandemic. Therefore, the development of a vaccine is mandatory. The integration of antigen-coding genes into recombinant MV resulting in coexpression of MV and foreign antigens can efficiently be achieved. Thus, in combination with the excellent safety profile of the MV vaccine, recombinant MV seems to constitute an ideal vaccine platform. The present study shows that a recombinant MV expressing MERS-S is genetically stable and induces strong humoral and cellular immunity against MERS-CoV in vaccinated mice. Subsequent challenge experiments indicated protection of vaccinated animals, illustrating the potential of MV as a vaccine platform with the potential to target emerging infections, such as MERS-CoV.
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