Human rabies vaccines induce neutralising antibodies against the European bat rabies virus (Duvenhage)

Bat Rabies

The lyssaviruses are a diverse group of viruses capable of causing rabies, which is an invariably fatal encephalitic disease in both humans and animals. Currently, the lyssavirus genus consists of 12 species with 11 of these distinct species having been isolated from bats. The basis for the apparent geographical segregation of bat lyssavirus infection between the Old and New World is poorly understood. In the New World species of insectivorous, frugivorous, and hematophagous bats, all represent important reservoirs of rabies virus. In contrast, rabies virus has never been detected in Old World bat populations, despite being endemic in terrestrial mammals. Instead, both insectivorous and frugivorous bat species across the Old World appear to act as reservoirs for the non-rabies lyssaviruses. In this chapter, we describe the association of the different lyssaviruses with different bat species across the world, classifying bat species by their feeding behavior.

Antibodies induced by vaccination with purified chick embryo cell culture vaccine (PCECV) cross-neutralize non-classical bat lyssavirus strains

Tissue-culture vaccines like purified chick embryo cell vaccine (PCECV) have been shown to provide protection against classical rabies virus (RABV) via pre-exposure or post-exposure prophylaxis. A cross-neutralization study was conducted using a panel of 100 human sera, to determine, to what extent after vaccination with PCECV protection exists against non-classical bat lyssavirus strains like European bat lyssavirus (EBLV) type 1 and 2 and Australian bat lyssavirus (ABLV). Virus neutralizing antibody (VNA) concentrations against the rabies virus variants CVS-11, ABLV, EBLV-1 and EBLV-2 were determined by using a modified rapid fluorescent focus inhibition test. For ABLV and EBLV-2, the comparison to CVS-11 revealed almost identical results (100% adequate VNA concentrations >or=0.5 IU/mL; correlation coefficient r(2)=0.69 and 0.77, respectively), while for EBLV-1 more scattering was observed (97% adequate VNA concentrations; r(2)=0.50). In conclusion, vaccination with PCECV produces adequate VNA concentrations against classical RABV as well as non-classical lyssavirus strains ABLV, EBLV-1, and EBLV-2.

Rabies and other lyssavirus diseases

The full scale of the global burden of human rabies is unknown, owing to inadequate surveillance of this fatal disease. However, the terror of hydrophobia, a cardinal symptom of rabies encephalitis, is suffered by tens of thousands of people each year. The recent discovery of enzootic European bat lyssavirus infection in the UK is indicative of our expanding awareness of the Lyssavirus genus. The main mammalian vector species vary geographically, so the health problems created by the lyssaviruses and their management differ throughout the world. The methods by which these neurotropic viruses hijack neurophysiological mechanisms while evading immune surveillance is beginning to be unravelled by, for example, studies of molecular motor transport systems. Meanwhile, enormous challenges remain in the control of animal rabies and the provision of accessible, appropriate human prophylaxis worldwide.

New lyssavirus genotype from the Lesser Mouse-eared Bat (Myotis blythi), Kyrghyzstan

The Aravan virus was isolated from a Lesser Mouse-eared Bat (Myotis blythi) in the Osh region of Kyrghyzstan, central Asia, in 1991. We determined the complete sequence of the nucleoprotein (N) gene and compared it with those of 26 representative lyssaviruses obtained from databases. The Aravan virus was distinguished from seven distinct genotypes on the basis of nucleotide and amino acid identity. Phylogenetic analysis based on both nucleotide and amino acid sequences showed that the Aravan virus was more closely related to genotypes 4, 5, and--to a lesser extent--6, which circulates among insectivorus bats in Europe and Africa. The Aravan virus does not belong to any of the seven known genotypes of lyssaviruses, namely, rabies, Lagos bat, Mokola, and Duvenhage viruses and European bat lyssavirus 1, European bat lyssavirus 2, and Australian bat lyssavirus. Based on these data, we propose a new genotype for the Lyssavirus genus.

Potency of veterinary rabies vaccines in The Netherlands: a case for continued vigilance

Commercial rabies vaccines, used by veterinarians in the Netherlands, were collected for testing in the mouse potency test. Of the six vaccines tested, two were clearly below the minimal requirements for potency of 1.0 IU. Of these six vaccines the rabies virus glycoprotein (GP) and nucleoprotein (NP) contents were determined in an antigen competition ELISA. The GP content proved to correlate well with the potency found in the mouse potency test (r = 0.95, p < 0.01), whereas no such correlation was found for the NP content (r approximately 0, p > 0.05). After the manufacturers were told about the results, one of the two vaccines that did not comply with the requirements was withdrawn from the market. Measurement of the GP content of a second lot of the remaining vaccines indicated that sufficiently high levels of GP were present in all five. Additional in vivo testing in mice for efficacy against intracerebral challenge with the Dutch bat rabies virus EBL1-12 resulted in acceptable levels of protection with four of these five vaccines of the second lot. The data presented illustrate the need for continued potency evaluation of veterinary rabies vaccines in the Netherlands.

Protective activity of a murine monoclonal antibody against European bat lyssavirus 1 (EBL1) infection in mice

A mouse model was designed to test in vivo the efficacy of rabies immune globulins and specific neutralizing monoclonal antibodies to prevent European bat lyssavirus 1 infection. Human or equine rabies immune globulins previously found to contain variable amounts of neutralizing bat lyssavirus crossreactive antibodies were passively transferred to mice receiving intramuscularly a lethal dose of bat lyssavirus type 1. Immune globulins did not protect mice well against bat lyssavirus 1 whereas they reduced the mortality caused by rabies virus. In contrast, mice inoculated with bat lyssavirus 1 or rabies virus survived when passively immunized with bat lyssavirus 1 specific monoclonal antibody (mAb 8-2). This monoclonal antibody, an IgG2 alpha, recognized an epitope located in the antigenic site IIa of rabies glycoprotein. A mutation replacing the lysine 198 by glutamate in a rabies variant abrogated sensitivity to this neutralizing antibody. Because of its broad neutralizing spectrum against wild virus isolates, including European bat lyssaviruses, this monoclonal antibody should be a good candidate for rabies immune globulin replacement. It could improve efficacy of rabies vaccination, used either alone or in conjunction with human rabies immune globulins or monoclonal antibody cocktail to supplement their lack of crossreactivity to European bat lyssavirus 1.

T and B cell human responses to European bat lyssavirus after post-exposure rabies vaccination

T and B cell human responses to European bat lyssavirus (EBL1) induced by post-exposure rabies vaccination (PM virus vaccine) were evaluated by measuring plasmatic titres of EBL1-specific neutralizing antibodies; specific EBL1-binding antibodies; and proliferation indices of peripheral blood lymphocytes stimulated in vitro with EBL1. These parameters for vaccination efficacy were compared with those obtained with vaccine-related viruses (CVS and ERA) and with a non-vaccine-related virus. Mokola virus, the last implicated in vaccination failures. Twenty-two patients exposed to rabies risk who received a reduced rabies post-exposure vaccination were involved in the study. On day 21, vaccine induced CVS-specific neutralizing antibodies in all patients; but EBL1-specific neutralizing antibodies were induced in only 73% of patients. No vaccine had Mokola-specific neutralizing antibodies. Patients having EBL1-specific neutralizing antibodies were usually those in whom vaccination induced high titres of CVS-specific neutralizing antibodies. On day 21, peripheral blood lymphocytes of 86% of patients could be restimulated in vitro with vaccine, 43% with EBL1 and 45% with Mokola. Patients exhibiting a high vaccine-specific proliferation response more likely developed an EBL1- or a Mokola-specific proliferative response. No correlation was found between T and B cell responses. Rabies vaccination induced neither T nor B cell EBL1-specific responses in 22% of patients.

Recent data on the epidemiology and prophylaxis of human rabies in France

Rabies is an animal disease which is transmitted to man only by accident, most often through the bite (more rarely after scratches or licks of mucosa) of a rabid animal, domestic or wild. A good knowledge of the epizootiology of animal rabies is therefore necessary to establish, on solid grounds, the prophylaxis of human rabies. Inter-human transmission of rabies being an exceptional event which will be considered separately, the epidemiology of human rabies mainly studies the sources and circumstances of human exposure to rabid animals, which differ according to the epizootiology of animal rabies in a given country: either enzootic (or hyperenzootic) canine rabies, or enzootic selvatic rabies. It appears that the risk of human rabies is higher in the first situation for two reasons: (i) rabies viruses show an increased virulence due to numerous serial passages in dogs (viruses with short incubation period) and (ii) high frequency of dog-man contacts due to the high density of both populations.

Monoclonal antibodies to Mokola virus for identification of rabies and rabies-related viruses

Rabies and rabies-related virus strains were studied by using a panel of monoclonal antibodies directed against either nucleocapsid proteins or cell surface antigens of Mokola virus (Mok-3). Each strain was used in parallel to infect cultured cells and mice. Then, the patterns of reactivity of the different monoclonal antibodies were determined by the immunofluorescent-antibody staining procedure. On cells, the monoclonal antibodies differentiated fixed rabies virus strains (serotype 1) from rabies-related virus strains. The seven fixed strains (CVS, PV4, PM, Flury LEP and HEP, ERA, and SAD) reacted identically. The previous serotype groupings (serotype 2, Lagos-bat virus; serotype 3, Mokola virus; serotype 4, Duvenhage virus) established with anti-rabies monoclonal antibodies were confirmed, except for that of Lagos-bat Kindia, which appeared to be related to the African subtype of the Duvenhage serotype (Duv-2). Within the Mokola (Mok-1, -2, -3, and -5 and Umhlanga) and the Lagos-bat (Lag-1 and -2, Zimbabwe, Pinetown, and Dakar) serotypes, each strain appeared to be distinct. The African subtype of the Duvenhage serotype reacted differently from the European subtype. Within the Duvenhage serotype, subtypes Duv-4, -5, and -6 and Denmark reacted identically, while subtypes Duv-1, -2, and -3 and German Democratic Republic appeared to be distinct. The monoclonal antibodies specific for the cell surface antigens were also used in neutralization tests with all the strains. Two of them neutralized the infectivity of Mokola virus.

Recognition of rabies and rabies-related viruses by T cells derived from human vaccine recipients

Human peripheral blood mononuclear cells and T-cell lines and clones from individuals immunized with rabies PM vaccine were tested for the ability to recognize antigenic determinants in rabies and rabies-related viruses in an antigen-induced proliferation assay. Some, but not all, of the T cells from these individuals cross-reacted with various laboratory strains of rabies virus with rabies-related viruses such as Duvenhage and Mokola. In addition, these T cells were shown to react with epitopes of either the ribonucleoprotein or the viral glycoprotein. Rabies-specific cytotoxic T-cell responses by a CD4+ T-cell line were evident against antigenic determinants of the ribonucleoprotein and glycoprotein.

NIH test, a problematic method for testing potency of inactivated rabies vaccine

A critical review of the NIH test is given. The results of four studies are presented which show that in the case of purified chick embryo cell inactivated rabies vaccine there is a profound difference between the result after heterologous intracerebral challenge with the prescribed CVS strain and homologous challenge with the LEP-C 26 strain. CVS strains from various laboratories produced relatively uniform results following intracerebral administration. Two in vitro tests, the single radial immunodiffusion test and the modified antibody binding test were employed in the studies. The results are discussed and alternative procedures to the NIH test are recommended for future consideration.

Immunity against the European bat rabies (Duvenhage) virus induced by rabies vaccines: an experimental study in mice

Protection experiments were performed in mice with different inactivated vaccines prepared with the fixed rabies virus strains: PM (Pitman-Moore), PV4 (Pasteur virus) and LEP (Flury LEP) against an intracerebral challenge with a European bat virus (Duvenhage, strain Hamburg, DUV3). All vaccines protected mice against challenge with CVS (Challenge virus standard). Vaccines prepared with PV4 protected mice against a DUV3 challenge. On the contrary, PM or LEP vaccines did not protect mice against a DUV3 infection. The protection conferred by PV4 vaccines against Duvenhage could be due to the antigenic relationship which seems to exist between PV4 and European bat virus as revealed by serum-virus neutralization, absorption experiments and CTL crossreactivity. The four virus strains PAS, PV4, PM and CVS, originated from the Pasteur virus isolated in 1882 from the brain of a rabid cow, were classified in two groups on the basis of reactivity with neutralizing anti-glycoprotein monoclonal antibodies. One group contained the L. Pasteur (PAS) and the PV4 strains, the second contained PM and CVS strains. The divergence between the two virus groups possibly resulted from distinct passage histories.

Immunological relationships between rabies virus and rabies-related viruses studied with monoclonal antibodies to Mokola virus

Specific monoclonal antibodies (mAb) were prepared against a rabies-related lyssavirus, Mokola virus. A strain isolated in the Central African Republic, Mok-3, was used as immunogen. After 3 fusions more than 90 hybridoma cultures secreting mAb were identified. According to their different patterns of reactivity against rabies and rabies-related viruses, 61 ascites fluids were obtained. The antibody class was IgM for 2 of them and IgG for 59. They were specific for one of the 4 major viral proteins, as determined by immunofluorescence, neutralization and immunoblotting tests. Their patterns of reactivity were determined against 6 different strains of rabies-related viruses: Lagos-bat virus from Nigeria (Lag-1) and the Central African Republic (Lag-2), Duvenhage virus from the Republic of South Africa (Duv-1) and Federal Republic of Germany (Duv-3), Mokola virus from Nigeria (Mok-1) and Cameroon (Mok-2) and a fixed strain of rabies virus, the challenge virus strain (CVS). According to their reactivities with these strains and the pattern of fluorescence, the mAb were classified into 11 different groups with intracytoplasmic fluorescence and 7 groups with cell surface fluorescence. A differential diagnosis of these lyssaviruses is possible in tissue culture using some of these mAb.

Reactogenicity and immunogenicity of the newly developed purified chick embryo cell (PCEC)-rabies vaccine in man

Purified Chick Embryo Cell (PCEC) rabies vaccine was given to 88 healthy adults according to six different vaccination schedules. Local side effects were reported on reactivity forms after 16.4% of PCECV injections, general symptoms were recorded after 15.1% of the 292 doses administered. IgE antibodies specific for chicken proteins determined by the Radio Allergo Sorbens Test (RAST) could not be shown before and after the vaccinations. With no exception, all 88 vaccinees developed high titres of complement-fixing and neutralizing antibodies as determined by the Rapid Fluorescent Focus Inhibition Test and Serum Mouse Neutralization Test. For the first time, induction of serum interferon by PCEC rabies vaccine has been shown in man. In rabies vaccination, PCEC vaccine seems to be as effective as Human Diploid Cell Strain (HDCS) vaccine.