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Takkinsatian P, Wannaphahoon K, Upapan P, Senawong S, Prommalikit O. Measles seroprevalence in Thailand: are adolescents and young adults at risk of measles? Singapore Med J 2024; 65:340-347. [PMID: 35651287 PMCID: PMC11232711 DOI: 10.11622/smedj.2022058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/06/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION During the last decade, measles has become an important re-emerging disease in Thailand. The objective of this study was to measure measles seroprevalence and its influencing factors so as to plan an improved vaccination programme. METHODS A total of 600 participants aged between 9 months and 50 years were divided into seven groups representing birth cohorts that experienced different measles vaccination policies. Participants' blood samples were obtained to measure measles immunoglobulin G (IgG) levels. RESULTS None of the participants in the age group of 9 months had measles IgG levels beyond a protective level. Participants in the age groups 2.5, 5-15, 16-29, 30-33, 34-40 and 41-50 years had 82% (95% confidence interval [CI] 73.3-90.7), 50% (95% CI 36.1-63.9), 52% (95% CI 42.3-62.7), 70% (95% CI 61.1-78.9), 88.8% (95% CI 84.1-93.5) and 98.8% (95% CI 96.4-100.0) measles seropositivity, respectively. The study did not find any significant factors affecting measles seropositivity. CONCLUSION Individuals aged 15-34 years are vulnerable to measles infections. Supplementary vaccination should be encouraged in special situations, including postexposure prophylaxis for young adults during an outbreak and for high-risk occupations such as healthcare personnel.
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Affiliation(s)
- Panit Takkinsatian
- Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Kamolmart Wannaphahoon
- Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Prasit Upapan
- Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Sansnee Senawong
- Department of Immunology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Olarn Prommalikit
- Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
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Nampota-Nkomba N, Keita AM, Juma J, Sidibe D, Kourouma N, Sissoko S, Haidara FC, Traore CT, Traore CB, Traore A, Gaume B, Sow SO, Kotloff KL, Tapia MD. An Upsurge of Measles Cases in Mali-a Consequence of Pandemic-associated Disruption in Routine Immunization. Open Forum Infect Dis 2024; 11:ofae154. [PMID: 38617075 PMCID: PMC11010308 DOI: 10.1093/ofid/ofae154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/18/2024] [Indexed: 04/16/2024] Open
Abstract
Measles deaths highlight immunization program gaps. In the Child Health and Mortality Prevention Surveillance study in Mali, we observed a rise in under-5 measles-related deaths in 2022 that corresponded with increased measles cases at the same time and a decline in measles vaccine coverage in Mali in 2020.
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Affiliation(s)
- Nginache Nampota-Nkomba
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - Jane Juma
- Centre pour le Développement des Vaccins-Mali, Bamako, Mali
| | | | - Nana Kourouma
- Centre pour le Développement des Vaccins-Mali, Bamako, Mali
| | - Seydou Sissoko
- Centre pour le Développement des Vaccins-Mali, Bamako, Mali
| | | | - Cheick Tidiane Traore
- Direction Générale de la Santé et de l’Hygiène Publique, Ministry of Health and Social Development, Bamako, Mali
| | | | - Awa Traore
- Centre pour le Développement des Vaccins-Mali, Bamako, Mali
| | - Brigitte Gaume
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - Karen L Kotloff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Milagritos D Tapia
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
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3
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Ortiz-Cam L, Jones-Engel L, Mendoza P, Castillo-Neyra R. Association between seroprevalence of measles virus in monkeys and degree of human-monkey contact in Bangladesh. One Health 2023; 17:100571. [PMID: 37332882 PMCID: PMC10272506 DOI: 10.1016/j.onehlt.2023.100571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 06/20/2023] Open
Abstract
Measles infections can cause significant morbidity and mortality in human and monkey populations. The endemicity of measles in human populations and viral circulation within populations of free-living monkeys may have important repercussions for potential zoonotic transmission events and for the long-term health of monkey populations. Yet, there has not yet been a rigorous investigation of the dynamics of measles transmission where human and monkey populations coexist. In this study, to determine the difference in seroprevalence of the measles virus across different contexts of human-monkey contact, we analyzed serum samples collected from 56 apparently healthy Macaca mulatta monkeys who occupied diverse contexts, with different degrees of human-monkey contact, in Bangladesh. This is the first report of measles virus seroprevalence in monkeys in Bangladesh. We found a clear association between measles virus seropositivity in monkeys and the context in which they interact with humans. Seroprevalence was the lowest in wild areas (0.0%) and increased in shrines (4.8%), urban areas (5.9%), and was highest among monkeys who are used as performance animals (50.0%). This work suggests that a One Health approach informed by local interspecies transmission dynamics is necessary to develop strategies that both improve measles vaccination coverage, achieve long-term surveillance in monkey populations, and prevent measles spillback to monkeys. This approach aims to inform conservation efforts and protect the long-term health of human and monkey populations.
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Affiliation(s)
- Lizzie Ortiz-Cam
- National Forest and Wildlife Service (SERFOR), Lima, Peru
- School of Veterinary Medicine and Zoothecnic, Cayetano Heredia Peruvian University, Lima, Peru
- School of Public Health and Administration, Cayetano Heredia Peruvian University, Lima, Peru
| | - Lisa Jones-Engel
- People for the Ethical Treatment of Animals (PETA), Norfolk, VA, USA
| | - Patricia Mendoza
- Neotropical Primate Conservation, Lima, Peru
- Department of Biology, Missouri University, St Louis, USA
| | - Ricardo Castillo-Neyra
- School of Public Health and Administration, Cayetano Heredia Peruvian University, Lima, Peru
- Department of Biostatistics, Epidemiology and Informatics at University of Pennsylvania, Philadelphia, USA
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Fappani C, Gori M, Bianchi S, Terraneo M, Bilardi E, Colzani D, Tanzi E, Canuti M, Amendola A. Differential diagnosis of fever and rash cases negative for measles and rubella to complement surveillance activities. J Med Virol 2023; 95:e29141. [PMID: 37796084 DOI: 10.1002/jmv.29141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/09/2023] [Accepted: 09/21/2023] [Indexed: 10/06/2023]
Abstract
In the quest to eliminate measles virus (MV) and rubella virus (Ruv), every suspected case must be properly identified and diagnosed. Since 2017, in Milan (Italy), a total of 978 measles and rubella suspected cases (fever and rash) were investigated and 310 were not laboratory confirmed (discarded cases). To improve surveillance activities, we investigated the presence in discarded cases of 8 other viral pathogens commonly associated with rash: human herpesvirus 6 (HHV-6) and 7 (HHV-7), parvovirus B19 (B19V), enterovirus (EV), Epstein-Barr virus (EBV), human adenovirus (HAdV), cytomegalovirus (HCMV), and SARS-CoV-2. Differential diagnosis was carried out on 289 discarded cases by multiplex real-time PCR assays. At least one pathogen was detected in 188 cases (65.1%) with HHV-7 being the most frequently detected virus. No difference in the number of detected infections overtime was observed and infections were identified in all age groups. As expected, most HHV-6, EV, HAdV, and HCMV-positive cases were found in children aged 0-4 years and HHV-7 was most frequent in the 15-39 age group. In light of the World Health Organization measles elimination goal, the introduction of laboratory methods for differential diagnosis is required for the final classification of clinically compatible cases. The used screening panel allowed us to increase the percentage of virus-positive cases to 87.5%, allowing us to clarify viral involvement and epidemiology, improve diagnosis, and strengthen surveillance activities. As all investigated pathogens were detected, this diagnostic panel was a suitable tool to complement MV and RuV surveillance activities.
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Affiliation(s)
- Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
| | - Maria Gori
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
| | - Silvia Bianchi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
| | - Mara Terraneo
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Erica Bilardi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Elisabetta Tanzi
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, Milan, Italy
| | - Marta Canuti
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Antonella Amendola
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Coordinate Research Centre EpiSoMI (Epidemiology and Molecular Surveillance of Infections), Università degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, Milan, Italy
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Zareh-Khoshchehreh R, Salimi V, Nasab GSF, Naseri M, Fard FAN, Azad TM. Genetic Characterization of the H Gene of MeV Strains (H1, B3, and D4) Recently Circulated in Iran for Improving the Molecular Measles Surveillance in the National Measles Lab. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:1730-1738. [PMID: 37744531 PMCID: PMC10512145 DOI: 10.18502/ijph.v52i8.13412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/19/2023] [Indexed: 09/26/2023]
Abstract
Background Despite decreasing the global burden of measles disease after the introduction of vaccination, measles remains one of the most devastating childhood diseases. Since genotype B3 is reported as a predominant Measles Virus (MeV) genotype recently, the current study aimed to better understand MeV genetic variation by analyzing the complete sequence of Hemagglutinin (H) gene associated with outbreaks of circulated genotypes in Iran. Methods Nine positive measles specimens were selected from three circulated different genotypes H1, B3, and D4. Two different regions of MeV RNA were detected by RT-PCR assay. Sequence data and phylogenetic trees were analyzed and constructed by MEGA X software program. Moreover, missense and silent mutations in critical positions of the MeV-H protein were investigated. Results The result of phylogenetic analysis from the C-terminus of the Nucleoprotein gene (NP-450) and the complete H gene revealed that the mean sequence diversity was 0.06%-0.08% and 0.04%, respectively. Genotype H1 had the highest mutation in this study; however, the substitutions in genotype B3 fundamentally occurred in critical epitopes. Moreover, genotype D4 was more stable than genotypes B3 and H1. Conclusion Mutations were investigated in the whole sequence of H protein. Moreover, the mutations that occur in the critical sites of the protein have an important effect on the pathogenicity of the virus. In this way, we were able to illustrate why genotype B3 is more transmissible than other measles genotypes and is the most important circulating genotype around the world.
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Affiliation(s)
- Raziyeh Zareh-Khoshchehreh
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Virology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Vahid Salimi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazal Sadat Fatemi Nasab
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Naseri
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Adjami Nezhad Fard
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Talat Mokhtari Azad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Cheng WY, Chen BS, Wang HC, Liu MT. Genetic Characteristics of Measles Viruses Isolated in Taiwan between 2015 and 2020. Viruses 2023; 15:211. [PMID: 36680251 PMCID: PMC9863581 DOI: 10.3390/v15010211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
A genetic analysis of circulating measles virus (MeV) provides strong evidence of an interruption in endemic measles and supports the elimination status of this disease. This study investigated 219 MeVs isolated between 2015 and 2020. Based on the 450 nucleotide sequences of the nucleoprotein gene (N-450), three genotypes of the H1, D8 and B3 with 8, 18 and 6 different N-450 sequences, respectively, were identified. The H1 genotype virus has not circulated in Taiwan since 2017, and the D8 and B3 genotype MeVs became dominant between 2018 and 2019. Different D8 genotype variants were imported from neighboring countries, and the majority of MeV variants were detected only for a short period. However, MVs/Gir Somnath.IND/42.16[D8], a named strain designated by the World Health Organization (WHO), was detected over 2 years. To explore whether the endemic transmission of measles has been underestimated, another sequence window of the hypervariable, noncoding regions between the matrix (M) and fusion (F) genes (MF-NCR) was introduced to clarify the transmission chain. From the chronological sequence analysis of MeVs with N-450 and MF-NCR sequence windows, no endemic MeV variants lasted over 4 weeks, providing strong evidence to support the contention that Taiwan has reached the status for measles elimination.
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Affiliation(s)
- Wen-Yueh Cheng
- Center for Research, Diagnostic and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei 11561, Taiwan
| | | | | | - Ming-Tsan Liu
- Center for Research, Diagnostic and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei 11561, Taiwan
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Yılmaz TD, Üçeş Harmanoğulları L. Infectious Diseases and Migration: Measles Cases in a Province, Turkey Before and After the Pandemic. GÜNCEL PEDIATRI 2022. [DOI: 10.4274/jcp.2022.82246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Winter AK, Lambert B, Klein D, Klepac P, Papadopoulos T, Truelove S, Burgess C, Santos H, Knapp JK, Reef SE, Kayembe LK, Shendale S, Kretsinger K, Lessler J, Vynnycky E, McCarthy K, Ferrari M, Jit M. Feasibility of measles and rubella vaccination programmes for disease elimination: a modelling study. THE LANCET GLOBAL HEALTH 2022; 10:e1412-e1422. [PMID: 36113527 PMCID: PMC9557212 DOI: 10.1016/s2214-109x(22)00335-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 06/21/2022] [Accepted: 07/18/2022] [Indexed: 12/15/2022] Open
Abstract
Background Marked reductions in the incidence of measles and rubella have been observed since the widespread use of the measles and rubella vaccines. Although no global goal for measles eradication has been established, all six WHO regions have set measles elimination targets. However, a gap remains between current control levels and elimination targets, as shown by large measles outbreaks between 2017 and 2019. We aimed to model the potential for measles and rubella elimination globally to inform a WHO report to the 73rd World Health Assembly on the feasibility of measles and rubella eradication. Methods In this study, we modelled the probability of measles and rubella elimination between 2020 and 2100 under different vaccination scenarios in 93 countries of interest. We evaluated measles and rubella burden and elimination across two national transmission models each (Dynamic Measles Immunisation Calculation Engine [DynaMICE], Pennsylvania State University [PSU], Johns Hopkins University, and Public Health England models), and one subnational measles transmission model (Institute for Disease Modeling model). The vaccination scenarios included a so-called business as usual approach, which continues present vaccination coverage, and an intensified investment approach, which increases coverage into the future. The annual numbers of infections projected by each model, country, and vaccination scenario were used to explore if, when, and for how long the infections would be below a threshold for elimination. Findings The intensified investment scenario led to large reductions in measles and rubella incidence and burden. Rubella elimination is likely to be achievable in all countries and measles elimination is likely in some countries, but not all. The PSU and DynaMICE national measles models estimated that by 2050, the probability of elimination would exceed 75% in 14 (16%) and 36 (39%) of 93 modelled countries, respectively. The subnational model of measles transmission highlighted inequity in routine coverage as a likely driver of the continuance of endemic measles transmission in a subset of countries. Interpretation To reach regional elimination goals, it will be necessary to innovate vaccination strategies and technologies that increase spatial equity of routine vaccination, in addition to investing in existing surveillance and outbreak response programmes. Funding WHO, Gavi, the Vaccine Alliance, US Centers for Disease Control and Prevention, and the Bill & Melinda Gates Foundation.
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Measles Experience, Practice, and Knowledge by Pediatricians in the Context of Resurgent US Outbreaks. J Pediatr 2022; 246:213-219.e1. [PMID: 35427690 DOI: 10.1016/j.jpeds.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/31/2022] [Accepted: 04/07/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To assess measles experience, practice, and knowledge by pediatricians in the context of resurgent US outbreaks in 2018-2019. STUDY DESIGN A nationally representative network of pediatricians were surveyed by email and mail from January to April 2020. RESULTS The response rate was 67% (297 of 444). In the 3 years preceding the survey, 52% of the respondents reported awareness of measles cases in/near their community. Most thought that media reports about recent measles outbreaks had decreased delay/refusal of measles, mumps, and rubella (MMR) vaccine (6% "greatly decreased"; 66% "moderately decreased"). More than 60% of the pediatricians responded correctly for 6 of 9 true/false measles knowledge items. Less than 50% responded correctly for 3 true/false items, including statements about pretravel MMR recommendations for a preschooler and measles isolation precautions. The most common resources that the pediatricians would "sometimes" or "often/always" consult for measles information were those from the American Academy of Pediatrics (72%), a state or local public health department (70%), and the Centers for Disease Control and Prevention (63%). More than 90% of the pediatricians reported correct clinical practice for MMR vaccination of a 9-month-old before international travel. More than one-third of the respondents did not have a plan for measles exposures in their clinic. Pediatricians aware of measles cases in/near their community in the previous 3 years and those working in a hospital/clinic or Health Maintenance Organization setting were more likely to have a plan for measles exposures. CONCLUSIONS During this time of heightened risk for measles outbreaks, there are opportunities to strengthen the knowledge and implementation of measles pretravel vaccination and infection prevention and control recommendations among pediatricians.
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Abstract
DNA viruses often persist in the body of their host, becoming latent and recurring many months or years later. By contrast, most RNA viruses cause acute infections that are cleared from the host as they lack the mechanisms to persist. However, it is becoming clear that viral RNA can persist after clinical recovery and elimination of detectable infectious virus. This persistence can either be asymptomatic or associated with late progressive disease or nonspecific lingering symptoms, such as may be the case following infection with Ebola or Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Why does viral RNA sometimes persist after recovery from an acute infection? Where does the RNA come from? And what are the consequences?
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Rabaan AA, Mutair AA, Alhumaid S, Garout M, Alsubki RA, Alshahrani FS, Alfouzan WA, Alestad JH, Alsaleh AE, Al-Mozaini MA, Koritala T, Alotaibi S, Temsah MH, Akbar A, Ahmad R, Khalid Z, Muhammad J, Ahmed N. Updates on Measles Incidence and Eradication: Emphasis on the Immunological Aspects of Measles Infection. Medicina (B Aires) 2022; 58:medicina58050680. [PMID: 35630096 PMCID: PMC9147347 DOI: 10.3390/medicina58050680] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 12/31/2022] Open
Abstract
Measles is an RNA virus infectious disease mainly seen in children. Despite the availability of an effective vaccine against measles, it remains a health issue in children. Although it is a self-limiting disease, it becomes severe in undernourished and immune-compromised individuals. Measles infection is associated with secondary infections by opportunistic bacteria due to the immunosuppressive effects of the measles virus. Recent reports highlight that measles infection erases the already existing immune memory of various pathogens. This review covers the incidence, pathogenesis, measles variants, clinical presentations, secondary infections, elimination of measles virus on a global scale, and especially the immune responses related to measles infection.
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Affiliation(s)
- Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
- Correspondence: (A.A.R.); (N.A.)
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia;
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia;
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia;
| | - Roua A. Alsubki
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia;
| | - Fatimah S. Alshahrani
- Department of Internal Medicine, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia;
- Department of Internal Medicine, Division of Infectious Diseases, College of Medicine, King Saud University Medical City, Riyadh 11451, Saudi Arabia
| | - Wadha A. Alfouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait;
- Microbiology Unit, Department of Laboratories, Farwania Hospital, Farwania 85000, Kuwait
| | - Jeehan H. Alestad
- Immunology and Infectious Microbiology Department, University of Glasgow, Glasgow G1 1XQ, UK;
- Microbiology Department, College of Medicine, Jabriya 46300, Kuwait
| | - Abdullah E. Alsaleh
- Core Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia;
| | - Maha A. Al-Mozaini
- Immunocompromised Host Research Section, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh 11564, Saudi Arabia;
| | - Thoyaja Koritala
- Division of Hospital Internal Medicine, Mayo Clinic Health System, Mankato, MN 56001, USA;
| | - Sultan Alotaibi
- Molecular Microbiology Department, King Fahad Medical City, Riyadh 11525, Saudi Arabia;
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Ali Akbar
- Department of Microbiology, University of Balochistan, Quetta 87300, Pakistan;
| | - Rafiq Ahmad
- Department of Microbiology, The University of Haripur, Haripur 22610, Pakistan; (R.A.); (Z.K.); (J.M.)
| | - Zainab Khalid
- Department of Microbiology, The University of Haripur, Haripur 22610, Pakistan; (R.A.); (Z.K.); (J.M.)
| | - Javed Muhammad
- Department of Microbiology, The University of Haripur, Haripur 22610, Pakistan; (R.A.); (Z.K.); (J.M.)
| | - Naveed Ahmed
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, University Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
- Correspondence: (A.A.R.); (N.A.)
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Arslan F, Ankaralı H. Sars-Cov-2 virus and vaccination; biological and statistical framework. Expert Rev Vaccines 2021; 20:1059-1063. [PMID: 34365880 PMCID: PMC8425431 DOI: 10.1080/14760584.2021.1965884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction The Development of the SARS-CoV-2 virus vaccine and its update on an ongoing pandemic is the first subject of the world health agenda. Areas covered First, we will scrutinize the biological features of the measles virus (MV), variola virus (smallpox virus), influenza virus, and their vaccines to compare them with the SARS-CoV-2 virus and vaccine. Next, we will discuss the statistical details of measuring the effectiveness of an improved vaccine. Expert opinion Amidst the pandemic, we ought to acknowledge our prior experiences with respiratory viruses and vaccines. In the planning stage of observational Phase-III vaccine effectiveness studies, the sample size, sampling method, statistical model, and selection of variables are crucial in obtaining high-quality and valid results.
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Affiliation(s)
- Ferhat Arslan
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Handan Ankaralı
- Department of Biostatistics, Istanbul Medeniyet University, Istanbul, Turkey
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Moss WJ, Shendale S, Lindstrand A, O'Brien KL, Turner N, Goodman T, Kretsinger K. Feasibility assessment of measles and rubella eradication. Vaccine 2021; 39:3544-3559. [PMID: 34045102 DOI: 10.1016/j.vaccine.2021.04.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 04/14/2021] [Indexed: 12/28/2022]
Abstract
This report addresses the epidemiological aspects and feasibility of measles and rubella eradication and the potential resource requirements in response to the request of the Director-General at the Seventieth World Health Assembly held on May 31, 2017. A guiding principle is that the path toward measles and rubella eradication should serve to strengthen primary health care, promote universal health coverage, and be a pathfinder for new vision and strategy for immunization over the next decade as laid out in the Immunization Agenda 2030. Specifically, this report: 1) highlights the importance of measles and rubella as global health priorities; 2) reviews the current global measles and rubella situation; 3) summarizes prior assessments of the feasibility of measles and rubella eradication; 4) assesses the progress and challenges in achieving regional measles and rubella elimination; 5) assesses additional considerations for measles and rubella eradication, including the results of modelling and economic analyses; 6) assesses the implications of establishing a measles and rubella eradication goal and the process for setting an eradication target date; 7) proposes a framework for determining preconditions for setting a target date for measles and rubella eradication and how these preconditions should be understood and used; and 8) concludes with recommendations endorsed by SAGE.
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Affiliation(s)
- William J Moss
- International Vaccine Access Center, Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Stephanie Shendale
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Ann Lindstrand
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Katherine L O'Brien
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Nikki Turner
- Division of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Tracey Goodman
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Katrina Kretsinger
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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14
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Bağcı Z, Daki YY. Positive Effect of Single-Dose Measles Vaccination in Reducing the Incidence of Pneumonia in Children with Measles. J Trop Pediatr 2021; 67:5980412. [PMID: 33185246 DOI: 10.1093/tropej/fmaa085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM Measles is a worldwide common, highly infectious and vaccine-preventable contagious disease with high morbidity and mortality rates. We investigated the effects of administering single-dose measles vaccination in children with measles on the incidence of pneumonia and hospitalization. MATERIALS AND METHODS We retrospectively analysed the hospital records of children aged 0-18 years who were diagnosed with measles within a year before the study in a training and research hospital in Mogadishu, Somalia. We compared the measles vaccine ratios, hospitalization rates, hospitalization duration and pneumonia development rates. RESULTS We found that 34 (15.6%) patients had received measles vaccination, while 184 (84.4%) did not receive the vaccination. All the vaccinated patients received only a single dose of the vaccine. The proportion of those who had received pneumonia vaccine (14/34, 41.2%) was significantly lower than that of those who had never received a dose of measles containing vaccine (179/184, 97.3%) (p = 0.001). Moreover, patients who were immunized [n = 3 (3.1%)] had a significantly lower hospitalization rate than those who were not immunized [n = 94 (96.9%)] (p = 0.001). CONCLUSION The risk of pneumonia in children with measles vaccination, rate of hospitalization and length of hospital stay was significantly lower in children who had received even a single dose of the vaccine when compared with that in those who had not vaccinated. The results of this study reiterate the need for more effective global measles vaccination.
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Affiliation(s)
- Zafer Bağcı
- Department of Pediatrics, Konya Education and Research Hospital, University of Health Sciences, Konya, Turkey
| | - Yunis Yusuf Daki
- Department of Pediatrics, Konya Education and Research Hospital, University of Health Sciences, Konya, Turkey.,Department of Pediatrics, Somalia Mogadishu Recep Tayyip Erdoğan Education and Research Hospital, University of Health Sciences Turkey, Mogadishu, Somalia
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15
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Diaz-San Segundo F, Medina GN, Spinard E, Kloc A, Ramirez-Medina E, Azzinaro P, Mueller S, Rieder E, de Los Santos T. Use of Synonymous Deoptimization to Derive Modified Live Attenuated Strains of Foot and Mouth Disease Virus. Front Microbiol 2021; 11:610286. [PMID: 33552021 PMCID: PMC7861043 DOI: 10.3389/fmicb.2020.610286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/23/2020] [Indexed: 12/12/2022] Open
Abstract
Foot-and-mouth disease (FMD) is one of the most economically important viral diseases that can affect livestock. In the last 70 years, use of an inactivated whole antigen vaccine has contributed to the eradication of disease from many developed nations. However, recent outbreaks in Europe and Eastern Asia demonstrated that infection can spread as wildfire causing economic and social devastation. Therefore, it is essential to develop new control strategies that could confer early protection and rapidly stop disease spread. Live attenuated vaccines (LAV) are one of the best choices to obtain a strong early and long-lasting protection against viral diseases. In proof of concept studies, we previously demonstrated that “synonymous codon deoptimization” could be applied to the P1 capsid coding region of the viral genome to derive attenuated FMDV serotype A12 strains. Here, we demonstrate that a similar approach can be extended to the highly conserved non-structural P2 and P3 coding regions, providing a backbone for multiple serotype FMDV LAV development. Engineered codon deoptimized P2, P3 or P2, and P3 combined regions were included into the A24Cruzeiro infectious clone optimized for vaccine production, resulting in viable progeny that exhibited different degrees of attenuation in cell culture, in mice, and in the natural host (swine). Derived strains were thoroughly characterized in vitro and in vivo. Our work demonstrates that overall, the entire FMDV genome tolerates codon deoptimization, highlighting the potential of using this technology to derive novel improved LAV candidates.
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Affiliation(s)
- Fayna Diaz-San Segundo
- Plum Island Animal Disease Center (PIADC), Agricultural Research Service, United States Department of Agriculture, Greenport, NY, United States
| | - Gisselle N Medina
- Plum Island Animal Disease Center (PIADC), Agricultural Research Service, United States Department of Agriculture, Greenport, NY, United States.,Kansas State University College of Veterinary Medicine, Manhattan, KS, United States
| | - Edward Spinard
- Plum Island Animal Disease Center (PIADC), Agricultural Research Service, United States Department of Agriculture, Greenport, NY, United States.,PIADC Research Participation Program, Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - Anna Kloc
- Plum Island Animal Disease Center (PIADC), Agricultural Research Service, United States Department of Agriculture, Greenport, NY, United States.,PIADC Research Participation Program, Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - Elizabeth Ramirez-Medina
- Plum Island Animal Disease Center (PIADC), Agricultural Research Service, United States Department of Agriculture, Greenport, NY, United States.,Department of Pathobiology and Veterinary Science, University of Connecticut, Storrs, CT, United States
| | - Paul Azzinaro
- Plum Island Animal Disease Center (PIADC), Agricultural Research Service, United States Department of Agriculture, Greenport, NY, United States
| | | | - Elizabeth Rieder
- Plum Island Animal Disease Center (PIADC), Agricultural Research Service, United States Department of Agriculture, Greenport, NY, United States
| | - Teresa de Los Santos
- Plum Island Animal Disease Center (PIADC), Agricultural Research Service, United States Department of Agriculture, Greenport, NY, United States
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16
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Kobayashi T, Nishiura H. Transmission Network of Measles During the Yamagata Outbreak in Japan, 2017. J Epidemiol 2020; 32:96-104. [PMID: 33281152 PMCID: PMC8761560 DOI: 10.2188/jea.je20200455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background A measles outbreak involving 60 cases occurred in Yamagata, Japan in 2017. Using two different mathematical models for different datasets, we aimed to estimate measles transmissibility over time and explore any heterogeneous transmission patterns. Methods The first model relied on the temporal distribution for date of illness onset for cases, and a generation-dependent model was applied to the data. Another model focused on the transmission network. Using the illness-onset date along with the serial interval and geographical location of exposure, we reconstructed a transmission network with 19 unknown links. We then compared the number of secondary transmissions with and without clinical symptoms or laboratory findings. Results Using a generation-dependent model (assuming three generations other than the index case), the reproduction number (R) over generations 0, 1, and 2 were 25.3, 1.3, and <0.1, respectively, explicitly yielding the transmissibility over each generation. The network data enabled us to demonstrate that both the mean and the variance for the number of secondary transmissions per primary case declined over time. Comparing primary cases with and without secondary transmission, high viral shedding was the only significant determinant (P < 0.01). Conclusions The R declined abruptly over subsequent generations. Use of network data revealed the distribution of the number of secondary transmissions per primary case and also allowed us to identify possible secondary transmission risk factors. High viral shedding from the throat mucosa was identified as a potential predictor of secondary transmission.
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Affiliation(s)
- Tetsuro Kobayashi
- Kyoto University School of Public Health.,CREST, Japan Science and Technology Agency.,Graduate School of Medicine, Hokkaido University
| | - Hiroshi Nishiura
- Kyoto University School of Public Health.,CREST, Japan Science and Technology Agency.,Graduate School of Medicine, Hokkaido University
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17
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Furuse Y, Oshitani H. Viruses That Can and Cannot Coexist With Humans and the Future of SARS-CoV-2. Front Microbiol 2020; 11:583252. [PMID: 33042101 PMCID: PMC7530166 DOI: 10.3389/fmicb.2020.583252] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 08/19/2020] [Indexed: 12/14/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a worldwide pandemic. Many projections concerning the outbreak, such as the estimated number of cases and deaths in upcoming months, have been made available. However, what happens to the virus after the pandemic subsides has not been fully explored. In this article, we discuss the ways that past and present human viruses have emerged via zoonotic transmission, the mechanisms that they have acquired the ability for effective transmission among humans, the process to sustain a chain of transmission to coexist with humans, and the factors important for complete containment leading to eradication of viruses. These aspects of viral disease may provide clues for the future path that SARS-CoV-2 might take in relation to human infection.
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Affiliation(s)
- Yuki Furuse
- Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
- Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
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18
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Sereenen E, Saw YM, Erkhembayar R, Volodya B, Dashpagma O, Orsoo O, Kariya T, Ochir C, Yamamoto E, Hamajima N. Estimation of the unvaccinated among those aged less than 25 years according to aimag and its association with incidence of measles outbreak 2015-2016 in Mongolia. NAGOYA JOURNAL OF MEDICAL SCIENCE 2020; 82:437-447. [PMID: 33132428 PMCID: PMC7548245 DOI: 10.18999/nagjms.82.3.437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 01/14/2020] [Indexed: 12/03/2022]
Abstract
Mongolia had an epidemic of measles in 2015-2016, even though more than 90% of the population have been vaccinated since 1997. This study aimed to examine the associations between unvaccinated proportion and measles incidence according to aimag. Mongolia has 21 provinces (aimag) with Ulaanbaatar as the capital city. Vaccination coverage between 1991 and 2014 and measles incidence according to aimag were obtained from the National Center for Communicable Diseases of Mongolia database. Accumulated unvaccinated proportion (AUP) among those aged 1 to 24 years in 2015 was estimated from the unvaccinated at the 1st dose of 1991 to 2014. From 1991 to 2014, unvaccinated proportion among those aged 1 to 24 years in the whole country has been reducing from 28.0% in 1991 to 1.8% in 2014. The AUP in 2015 varied from 2.7% (Selenge) to 21.8% (Govisumber). The incidence was remarkably higher in only two aimags with a large density of the unvaccinated aged 1 to 24 years (Ulaanbaatar and Darkhan-Uul) than in the other aimags. The incidence had no significant correlation with the AUP, although the correlation between the incidence and the density of unvaccinated aged 1 to 24 years was significant when the two aimags were included. In conclusion, the AUP between 2.7% and 21.8% had no correlation with the incidence according to aimags in Mongolia measles epidemic 2015-2016.
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Affiliation(s)
- Enkhbold Sereenen
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- E-Health Project, Ministry of Health, Ulaanbaatar, Mongolia
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Ryenchindorj Erkhembayar
- Department of International Cyber Education, Graduate School, Mongolian National University of Medical Science, Ulaanbaatar, Mongolia
| | - Baigal Volodya
- Immunization Department, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
| | - Otgonbayar Dashpagma
- Immunization Department, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
| | - Oyunchimeg Orsoo
- Department of Public Administration, Ministry of Health, Ulaanbaatar, Mongolia
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Chimedsuren Ochir
- Department of International Cyber Education, Graduate School, Mongolian National University of Medical Science, Ulaanbaatar, Mongolia
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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19
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A Temperature-Dependent Translation Defect Caused by Internal Ribosome Entry Site Mutation Attenuates Foot-and-Mouth Disease Virus: Implications for Rational Vaccine Design. J Virol 2020; 94:JVI.00990-20. [PMID: 32493820 DOI: 10.1128/jvi.00990-20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 12/21/2022] Open
Abstract
Foot-and-mouth disease (FMD), which is caused by FMD virus (FMDV), remains a major plague among cloven-hoofed animals worldwide, and its outbreak often has disastrous socioeconomic consequences. A live-attenuated FMDV vaccine will greatly facilitate the global control and eradication of FMD, but a safe and effective attenuated FMDV vaccine has not yet been successfully developed. Here, we found that the internal ribosome entry site (IRES) element in the viral genome is a critical virulence determinant of FMDV, and a nucleotide substitution of cytosine (C) for guanine (G) at position 351 of the IRES endows FMDV with temperature-sensitive and attenuation (ts&att) phenotypes. Furthermore, we demonstrated that the C351G mutation of IRES causes a temperature-dependent translation defect by impairing its binding to cellular pyrimidine tract-binding protein (PTB), resulting in the ts&att phenotypes of FMDV. Natural hosts inoculated with viruses carrying the IRES C351G mutation showed no clinical signs, viremia, virus excretion, or viral transmission but still produced a potent neutralizing antibody response that provided complete protection. Importantly, the IRES C351G mutation is a universal determinant of the ts&att phenotypes of different FMDV strains, and the C351G mutant was incapable of reversion to virulence during in vitro and in vivo passages. Collectively, our findings suggested that manipulation of the IRES, especially its C351G mutation, may serve as a feasible strategy to develop live-attenuated FMDV vaccines.IMPORTANCE The World Organization for Animal Health has called for global control and eradication of foot-and-mouth disease (FMD), the most economically and socially devastating disease affecting animal husbandry worldwide. Live-attenuated vaccines are considered the most effective strategy for prevention, control, and eradication of infectious diseases due to their capacity to induce potent and long-lasting protective immunity. However, efforts to develop FMD virus (FMDV) live-attenuated vaccines have achieved only limited success. Here, by structure-function study of the FMDV internal ribosome entry site (IRES), we find that the C351 mutation of the IRES confers FMDV with an ideal temperature-sensitive attenuation phenotype by decreasing its interaction with cellular pyrimidine tract-binding protein (PTB) to cause IRES-mediated temperature-dependent translation defects. The temperature-sensitive attenuated strains generated by manipulation of the IRES address the challenges of FMDV attenuation differences among various livestock species and immunogenicity maintenance encountered previously, and this strategy can be applied to other viruses with an IRES to rationally design and develop live-attenuated vaccines.
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20
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Plans-Rubió P. Are the Objectives Proposed by the WHO for Routine Measles Vaccination Coverage and Population Measles Immunity Sufficient to Achieve Measles Elimination from Europe? Vaccines (Basel) 2020; 8:vaccines8020218. [PMID: 32414021 PMCID: PMC7349949 DOI: 10.3390/vaccines8020218] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 12/20/2022] Open
Abstract
Background: The World Health Organization (WHO) proposed two-dose measles vaccination coverage of at least 95% of the population and percentages of measles immunity in the population of 85%−95% in order to achieve measles elimination in Europe. The objectives of this study were: (1) to determine the measles vaccination coverage required to establish herd immunity against measles viruses with basic reproduction numbers (Ro) ranging from 6 to 60, and (2) to assess whether the objectives proposed by the WHO are sufficient to establish herd immunity against measles viruses. Methods: The herd immunity effects of the recommended objectives were assessed by considering the prevalence of protected individuals required to establish herd immunity against measles viruses with Ro values ranging from 6 to 60. Results: The study found that percentages of two-dose measles vaccination coverage from 88% to 100% could establish herd immunity against measles viruses with Ro from 6 to 19, assuming 95% measles vaccination effectiveness. The study found that the objective of 95% for two-dose measles vaccination coverage proposed by the WHO would not be sufficient to establish herd immunity against measles viruses with Ro ≥ 10, assuming 95% measles vaccination effectiveness. By contrast, a 97% measles vaccination coverage objective was sufficient to establish herd immunity against measles viruses, with Ro values from 6 to 13. Measles immunity levels recommended in individuals aged 1−4 years (≥85%) and 5−9 years (≥90%) might not be sufficient to establish herd immunity against most measles viruses, while those recommended in individuals aged 10 or more years (≥95%) could be sufficient to establish herd immunity against measles viruses with Ro values from 6 to 20. Conclusion: To meet the goal of measles elimination in Europe, it is necessary to achieve percentages of two-dose measles vaccination coverage of at least 97%, and measles immunity levels in children aged 1−9 years of at least 95%.
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Affiliation(s)
- Pedro Plans-Rubió
- Public Health Agency of Catalonia, Department of Health of Catalonia, Barcelona 08005, Spain;
- Ciber of Epidemiology and Public Health (CIBERESP), Madrid 28028, Spain
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21
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Measles and rubella IgG seroprevalence in persons 6 month-35 years of age, Mongolia, 2016. Vaccine 2020; 38:4200-4208. [PMID: 32381479 DOI: 10.1016/j.vaccine.2020.04.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/17/2020] [Accepted: 04/09/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND In 2015-2016, Mongolia experienced an unexpected large measles outbreak affecting mostly young children and adults. After two nationwide vaccination campaigns, measles transmission declined. To determine if there were any remaining immunity gaps to measles or rubella in the population, a nationally representative serosurvey for measles and rubella antibodies was conducted after the outbreak was over. METHODS A nationwide, cross-sectional, stratified, three-stage cluster serosurvey was conducted in November-December 2016. A priori, four regional strata (Ulaanbaatar, Western, Central, and Gobi-Eastern) and five age strata (6 months-23 months, 2-7 years, 8-17 years, 18-30 years, and 31-35 years) were created. Households were visited, members interviewed, and blood specimens were collected from age-appropriate members. Blood specimens were tested for measles immunoglobulin G (IgG) and rubella IgG (Enzygnost® Anti-measles Virus/IgG and Anti-rubella Virus/IgG, Siemens, Healthcare Diagnostics Products, GmbH Marburg, Germany). Factors associated with seropositivity were evaluated. RESULTS Among 4598 persons aged 6 months to 35 years participating in the serosurvey, 94% were measles IgG positive and 95% were rubella IgG positive. Measles IgG seropositivity was associated with increasing age and higher education. Rubella IgG seropositivity was associated with increasing age, higher education, smaller household size, receipt of MMR in routine immunization, residence outside the Western Region, non-Muslim religious affiliation, and non-Kazakh ethnicity. Muslim Kazakhs living in Western Region had the lowest rubella seroprevalence of all survey participants. CONCLUSIONS Nationally, high immunity to both measles and rubella has been achieved among persons 1-35 years of age, which should be sufficient to eliminate both measles and rubella if future birth cohorts have ≥ 95% two dose vaccination coverage. Catch-up vaccination is needed to close immunity gaps found among some subpopulations, particularly Muslim Kazakhs living in Western Region.
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22
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Takeda M, Seki F, Yamamoto Y, Nao N, Tokiwa H. Animal morbilliviruses and their cross-species transmission potential. Curr Opin Virol 2020; 41:38-45. [PMID: 32344228 DOI: 10.1016/j.coviro.2020.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 02/01/2023]
Abstract
Like measles virus (MV), whose primary hosts are humans, non-human animal morbilliviruses use SLAM (signaling lymphocytic activation molecule) and PVRL4 (nectin-4) expressed on immune and epithelial cells, respectively, as receptors. PVRL4's amino acid sequence is highly conserved across species, while that of SLAM varies significantly. However, non-host animal SLAMs often function as receptors for different morbilliviruses. Uniquely, human SLAM is somewhat specific for MV, but canine distemper virus, which shows the widest host range among morbilliviruses, readily gains the ability to use human SLAM. The host range for morbilliviruses is also modulated by their ability to counteract the host's innate immunity, but the risk of cross-species transmission of non-human animal morbilliviruses to humans could occur if MV is successfully eradicated.
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Affiliation(s)
- Makoto Takeda
- Department of Virology 3, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashimurayama, Tokyo 208-0011, Japan.
| | - Fumio Seki
- Department of Virology 3, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashimurayama, Tokyo 208-0011, Japan
| | - Yuta Yamamoto
- Department of Chemistry, Rikkyo University, Nishi-Ikebukuro 3-34-1, Toshima-ku, Tokyo 171-8501, Japan
| | - Naganori Nao
- Department of Virology 3, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashimurayama, Tokyo 208-0011, Japan
| | - Hiroaki Tokiwa
- Department of Chemistry, Rikkyo University, Nishi-Ikebukuro 3-34-1, Toshima-ku, Tokyo 171-8501, Japan
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23
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Park MS, Kim JI, Bae JY, Park MS. Animal models for the risk assessment of viral pandemic potential. Lab Anim Res 2020; 36:11. [PMID: 32337177 PMCID: PMC7175453 DOI: 10.1186/s42826-020-00040-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/10/2020] [Indexed: 02/07/2023] Open
Abstract
Pandemics affect human lives severely and globally. Experience predicts that there will be a pandemic for sure although the time is unknown. When a viral epidemic breaks out, assessing its pandemic risk is an important part of the process that characterizes genomic property, viral pathogenicity, transmission in animal model, and so forth. In this review, we intend to figure out how a pandemic may occur by looking into the past influenza pandemic events. We discuss interpretations of the experimental evidences resulted from animal model studies and extend implications of viral pandemic potentials and ingredients to emerging viral epidemics. Focusing on the pandemic potential of viral infectious diseases, we suggest what should be assessed to prevent global catastrophes from influenza virus, Middle East respiratory syndrome coronavirus, dengue and Zika viruses.
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Affiliation(s)
- Mee Sook Park
- Department of Microbiology, Institute for Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea 02841
| | - Jin Il Kim
- Department of Microbiology, Institute for Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea 02841
| | - Joon-Yong Bae
- Department of Microbiology, Institute for Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea 02841
| | - Man-Seong Park
- Department of Microbiology, Institute for Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea 02841
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24
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Misin A, Antonello RM, Di Bella S, Campisciano G, Zanotta N, Giacobbe DR, Comar M, Luzzati R. Measles: An Overview of a Re-Emerging Disease in Children and Immunocompromised Patients. Microorganisms 2020; 8:E276. [PMID: 32085446 PMCID: PMC7074809 DOI: 10.3390/microorganisms8020276] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/15/2020] [Accepted: 02/16/2020] [Indexed: 12/15/2022] Open
Abstract
Despite the availability of a safe and effective vaccine, in 2018, around 350,000 measles cases were reported worldwide, which resulted in an estimate of 142,300 deaths from measles. Additionally, in 2017, global measles cases spiked, causing the death of 110,000 people, mostly children under the age of 5 years and immunocompromised adults. The increase in measles incidence is caused by the ongoing reduction of vaccination coverage. This event has triggered public and scientific interest. For this reason, we reviewed the pathophysiology of measles infection, focusing on mechanisms by which the virus spreads systemically through the host organism. By reaching the lymphocytes from the airways through a "trojan horse" strategy, measles induces an immunosuppression status. H and F glycoproteins, both expressed in the envelope, ensure attachment of the virus to host cells and spreading from one cell to another by binding to several receptors, as described in detail. The severity of the disease depends both on the age and underlying conditions of patients as well as the social and health context in which epidemics spread, and is often burdened by sequelae and complications that may occur several years after infection. Particular attention was paid to special groups that are more susceptible to severe or atypical measles. An overview of microbiology, symptoms, diagnosis, prevention, and treatment completes and enriches the review.
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Affiliation(s)
- Andrea Misin
- Department of Infectious Diseases, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Via G.L. Gatteri 25/1, 34125 Trieste, Italy; (S.D.B.); (R.L.)
| | - Roberta Maria Antonello
- Faculty of Medicine and Surgery, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Stefano Di Bella
- Department of Infectious Diseases, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Via G.L. Gatteri 25/1, 34125 Trieste, Italy; (S.D.B.); (R.L.)
| | - Giuseppina Campisciano
- SSD of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy; (G.C.); (N.Z.); (M.C.)
| | - Nunzia Zanotta
- SSD of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy; (G.C.); (N.Z.); (M.C.)
| | - Daniele Roberto Giacobbe
- Infectious Diseases Unit, Ospedale Policlinico San Martino—IRCCS, L.go R. Benzi 10, 16132 Genoa, Italy;
- Department of Health Sciences (DISSAL), University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy
| | - Manola Comar
- SSD of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy; (G.C.); (N.Z.); (M.C.)
- Department of Medical Sciences, University of Trieste, Piazzale Europa 1, 34127 Trieste, Italy
| | - Roberto Luzzati
- Department of Infectious Diseases, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Via G.L. Gatteri 25/1, 34125 Trieste, Italy; (S.D.B.); (R.L.)
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25
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Hidalgo J, Woc-Colburn L. Influenza, Measles, SARS, MERS, and Smallpox. HIGHLY INFECTIOUS DISEASES IN CRITICAL CARE 2020. [PMCID: PMC7120728 DOI: 10.1007/978-3-030-33803-9_5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Influenza, measles, SARS, MERS, and smallpox illnesses are caused by highly infectious viral pathogens that induce critical illness. These biologically diverse viruses enter and replicate within host cells triggering viral- and host-mediated damage that results in pneumonia and multiorgan failure in severe cases. Early case identification and strict infection control limit healthcare transmission. Vaccination allowed smallpox eradication and limits global measles and seasonal influenza mortality. While SARS-coronavirus (CoV) is no longer circulating, MERS-CoV and zoonotic influenza viruses, with pandemic potential, remain persistent threats. Supportive critical care is the mainstay of treatment for severe disease due to these viral infections.
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Affiliation(s)
- Jorge Hidalgo
- Division of Critical Care, Karl Heusner Memorial Hospital, Belize City, Belize
| | - Laila Woc-Colburn
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX USA
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26
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Measles outbreak from Hong Kong International Airport to the hospital due to secondary vaccine failure in healthcare workers. Infect Control Hosp Epidemiol 2019; 40:1407-1415. [PMID: 31587686 DOI: 10.1017/ice.2019.278] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To report an outbreak of measles with epidemiological link between Hong Kong International Airport (HKIA) and a hospital. METHODS Epidemiological investigations, patients' measles serology, and phylogenetic analysis of the hemagglutinin (H) and nucleoprotein (N) genes of measles virus isolates were conducted. RESULTS In total, 29 HKIA staff of diverse ranks and working locations were infected with measles within 1 month. Significantly fewer affected staff had history of travel than non-HKIA-related measles patients [10 of 29 (34.5%) vs 28 of 35 (80%); P < .01]. Of 9 airport staff who could recall detailed exposure history, 6 (66.7%) had visited self-service food premises at HKIA during the incubation period, where food trays, as observed during the epidemiological field investigation, were not washed after use. Furthermore, 1 airport baggage handler who was admitted to hospital A before rash onset infected 2 healthcare workers (HCWs) known to have 2 doses of MMR vaccination with positive measles IgG and lower viral loads in respiratory specimens. Infections in these 2 HCWs warranted contact tracing of another 168 persons (97 patients and 71 HCWs). Phylogenetic comparison of H and N gene sequences confirmed the clonality of outbreak strains. CONCLUSION Despite good herd immunity with overall seroprevalence of >95% against measles, major outbreaks of measles occurred among HKIA staff having daily contact with many international pssengers. Lessons from severe acute respiratory syndrome (SARS) and measles outbreaks suggested that an airport can be a strategic epidemic center. Pre-exanthem transmission of measles from airport staff to HCWs with secondary vaccine failure poses a grave challenge to hospital infection control.
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A Survey of Vaccine-Induced Measles IgG Antibody Titer to Verify Temporal Changes in Response to Measles Vaccination in Young Adults. Vaccines (Basel) 2019; 7:vaccines7030118. [PMID: 31546797 PMCID: PMC6789707 DOI: 10.3390/vaccines7030118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/14/2019] [Accepted: 09/17/2019] [Indexed: 01/29/2023] Open
Abstract
In Japan, sporadic measles cases increased rapidly in 2019 compared to the past six years. To clarify the persistence of immunity against measles in young adults, this study explored the persistence of immunoglobulin G (IgG) antibody titers against the measles virus in 17- to 24-year-old young participants who reside in the Chiba prefecture of Japan. Measles-specific IgG antibody titers, determined by enzyme immunoassay in serum samples collected from 506 participants, were assessed through statistical analyses. Multivariable regression analysis revealed that the distribution of measles IgG antibody titers was significantly correlated with a medical history of measles (P < 0.05), while there was no significant correlation between the number of vaccinations related to measles IgG titers. Furthermore, measles IgG titers tended to decrease, as revealed by the temporal change in IgG titers, during the elapsed period after the last vaccination (P = 0.08). These results indicate that periodic vaccination against measles is required to prevent sporadic measles infection in young and older adults.
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Low percentages of measles vaccination coverage with two doses of vaccine and low herd immunity levels explain measles incidence and persistence of measles in the European Union in 2017–2018. Eur J Clin Microbiol Infect Dis 2019; 38:1719-1729. [DOI: 10.1007/s10096-019-03604-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 05/24/2019] [Indexed: 10/26/2022]
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29
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Hong DT, Hien ND, Thao PTP, Anh DD, Mai HH, Huyen DTT, Huong NL, Phuong BH, Iijima M, Ito T, Nakayama T. Immunogenicity of the AIK-C measles vaccine in infants aged <9 months in Vietnam. Vaccine 2019; 37:4576-4580. [PMID: 31174936 DOI: 10.1016/j.vaccine.2019.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 10/26/2022]
Abstract
Measles-associated deaths have been reported in infants <9 months during outbreaks. A cohort study was conducted on 210 infants aged 6-8 months to evaluate the immunogenicity and safety of the AIK-C measles vaccine containing 104.21 plaque-forming units (PFU)/0.5 mL produced in Vietnam. Paired serum samples were obtained from 196 subjects. Seropositivity was defined as ≥120 mIU/mL. The seroresponse rate was 173/196 (88.27%, 95% confidence interval (CI): 83.77-92.77%) with geometric mean titer (GMT) of 511 mIU/mL (95% CI: 688-880 mIU/mL), and no significant differences were observed by different age groups. Among 196 paired sera, they were categorized into four groups: 122 subjects <14 IU/mL, 28 subjects 14-<60 mIU/mL, 30 subjects 60-<120 mIU/mL, and 16 subjects ≥ 120 mIU/mL. The seroresponse rate was 112/122 (91.8%, 95% CI: 86.94-96.67%) with GMT (597 mIU/mL, 95% CI: 749-1002 mIU/mL) in the <14 mIU/L group. In the 14-<60 mIU/mL group, the seroresponse rate was 18/28 (64.29%) with 184 mIU/L of GMT and was significantly lower (p < 0.01) than that in the <14 mIU/mL group. In the 16 seropositive group, all subjects showed seroconversion (4-fold higher than before) with a higher GMT of 1078 mIU/mL. Local pain and itching at the injection site were observed in 8 subjects (3.8%) within 7 days of the vaccination. Regarding systemic adverse reactions, febrile illness ≥37.5 °C was observed in 14 subjects (6.7%). These results indicate that the AIK-C measles vaccine is effective and safe for infants aged 6-8 months and will contribute to reducing the number of measles-associated deaths in future outbreaks.
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Affiliation(s)
- Duong Thi Hong
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Nguyen Dang Hien
- Center for Research and Production of Vaccine and Biological, Hanoi, Viet Nam
| | | | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Hoang Hong Mai
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | | | - Bui Huy Phuong
- Hai Duong Center for Diseases Control, Hai Duong, Viet Nam
| | | | - Takashi Ito
- Laboratory of Viral Infection II, Kitasato Institute for Life Sciences, Tokyo, Japan
| | - Tetsuo Nakayama
- Laboratory of Viral Infection II, Kitasato Institute for Life Sciences, Tokyo, Japan.
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Sir-Ondo-Enguier PN, Ngoungou EB, Nghomo YN, Boundenga L, Moupiga-Ndong P, Ibinga E, Deparis X, Lékana-Douki JB. Syndromic surveillance of potentially epidemic infectious diseases: Detection of a measles epidemic in two health centers in Gabon, Central Africa. Infect Dis Rep 2019; 11:7701. [PMID: 31205640 PMCID: PMC6547028 DOI: 10.4081/idr.2019.7701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 04/10/2019] [Indexed: 12/11/2022] Open
Abstract
Measles is a respiratory disease caused by the measles virus (MV) belonging to the Paramyxovirus family and the Morbillivirus genus. Due to a failure in maintaining immunization coverage in some countries, measles is a re-emerging disease in the human population, especially in Africa. The aim of this study was to describe a measles epidemic in Gabon. At first, a syndromic surveillance was set up. Blood samples from febrile patients with maculopapular rash were taken and sent to the measles reference center in Cameroon for laboratory confirmation. Between March and May 2016, 79 clinically suspected cases were reported including 82.3% (n=65) and 17.7% (n=14) in Oyem and Libreville, respectively. In total, 39.2% (n=31) of children were 11 months-old, 34.2% (n=27) were children aged 1 to 4 years, 11.4% (n=9) were older children from 5 to 9 years, 6.3% (n=5) of children were aged 10 to 15 years and 8.9% (n=7) were 15 years and older. 53.3% (16/30) were laboratory confirmed. This measles outbreak reiterates the importance of maintaining a high level of vaccine coverage in Gabon for vaccine-preventable diseases, as well as the usefulness of a near-real-time surveillance system for the detection of infectious diseases.
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Affiliation(s)
- Pater Noster Sir-Ondo-Enguier
- UMR 912 Sciences Economiques et Sociales de la Santé et Traitement de I'Information Médicale, Université d'Aix-Marseille, Marseille, France.,Unité, Evolution, Épidémiologie et Résistances Parasitaires, Centre International de Recherches Médicales de Franceville - CIRMF, Franceville, Gabon
| | - Edgard Brice Ngoungou
- Département d'Epidémiologie Biostatistiques et Informatique Médicale (DEBIM), Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon
| | | | - Larson Boundenga
- Unité, Evolution, Épidémiologie et Résistances Parasitaires, Centre International de Recherches Médicales de Franceville - CIRMF, Franceville, Gabon
| | | | - Euloge Ibinga
- Département d'Epidémiologie Biostatistiques et Informatique Médicale (DEBIM), Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon
| | - Xavier Deparis
- UMR 912 Sciences Economiques et Sociales de la Santé et Traitement de I'Information Médicale, Université d'Aix-Marseille, Marseille, France
| | - Jean-Bernard Lékana-Douki
- Unité, Evolution, Épidémiologie et Résistances Parasitaires, Centre International de Recherches Médicales de Franceville - CIRMF, Franceville, Gabon.,Département de Parasitologie-Mycologie et de Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon
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Orsoo O, Saw YM, Sereenen E, Yadamsuren B, Byambaa A, Kariya T, Yamamoto E, Hamajima N. Epidemiological characteristics and trends of a Nationwide measles outbreak in Mongolia, 2015-2016. BMC Public Health 2019; 19:201. [PMID: 30770746 PMCID: PMC6377723 DOI: 10.1186/s12889-019-6511-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 02/04/2019] [Indexed: 11/24/2022] Open
Abstract
Background Mongolia was one of the four countries that received a measles-elimination certificate from the World Health Organization Regional Office for the Western Pacific in 2014. Following the outbreaks in many countries including China, a large measles outbreak occurred in Mongolia in 2015. This study reports 2015–2016 measles outbreak incidence, mortality, and complications, according to time, geographical distribution, and host characteristics. Methods The epidemiological characteristics and trends of measles outbreak were analyzed using the Mongolian national surveillance data reported to the Center for Health Development, Ministry of Health, from January 2015 to December 2016. Results In total, 23,464 cases of measles including eight deaths were reported in 2015, and 30,273 cases of measles including 132 deaths were reported in 2016, which peaked in June 2015 and March 2016, respectively. Majority of the cases were reported from Ulaanbaatar (35,397, 65.9%). The highest attack rates were 241 per 10,000 population in Darkhan-Uul aimag, and 263 per 10,000 population in Ulaanbaatar. Measles-related death, nosocomial infection, and complications were most frequent among children aged < 1 year. Conclusions Following no reports of measles since 2011, a large nationwide outbreak occurred in Mongolia, despite the high vaccination coverage in the past. The highest incidence rate was reported in Ulaanbaatar city, and Umnugovi aimag in 2015 and Darkhan-Uul aimag in 2016. The most affected age group were aged < 1 year and those aged 15–24 years. Mortality cases were prominent among children aged < 1 year who were not eligible for vaccination. A systematic vaccination strategy is required to prevent another measles outbreak. Electronic supplementary material The online version of this article (10.1186/s12889-019-6511-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Oyunchimeg Orsoo
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Department of Medical Service, Ministry of Health, Ulaanbaatar, Mongolia
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. .,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Enkhbold Sereenen
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Department of Public Administration and Management, Ministry of Health, Ulaanbaatar, Mongolia
| | | | - Ariunsanaa Byambaa
- Department of Microbiology and Immunology, School of Pharmacy and Bio-Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Mura M, Ruffié C, Billon-Denis E, Combredet C, Tournier J, Tangy F. hCD46 receptor is not required for measles vaccine Schwarz strain replication in vivo: Type-I IFN is the species barrier in mice. Virology 2018; 524:151-159. [DOI: 10.1016/j.virol.2018.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 08/13/2018] [Accepted: 08/17/2018] [Indexed: 12/26/2022]
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Kisangau N, Sergon K, Ibrahim Y, Yonga F, Langat D, Nzunza R, Borus P, Galgalo T, Lowther SA. Progress towards elimination of measles in Kenya, 2003-2016. Pan Afr Med J 2018; 31:65. [PMID: 31007812 PMCID: PMC6457729 DOI: 10.11604/pamj.2018.31.65.16309] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 06/29/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction Measles is targeted for elimination in the World Health Organization African Region by the year 2020. In 2011, Kenya was off track in attaining the 2012 pre-elimination goal. We describe the epidemiology of measles in Kenya and assess progress made towards elimination. Methods We reviewed national case-based measles surveillance and immunization data from January 2003 to December 2016. A case was confirmed if serum was positive for anti-measles IgM antibody, was epidemiologically linked to a laboratory-confirmed case or clinically compatible. Data on case-patient demographics, vaccination status, and clinical outcome and measles containing vaccine (MCV) coverage were analyzed. We calculated measles surveillance indicators and incidence, using population estimates for the respective years. Results The coverage of first dose MCV (MCV1) increased from 65% to 86% from 2003-2012, then declined to 75% in 2016. Coverage of second dose MCV (MCV2) remained < 50% since introduction in 2013. During 2003-2016, there were 26,188 suspected measles cases were reported, with 9043(35%) confirmed cases, and 165 deaths (case fatality rate, 1.8%). The non-measles febrile rash illness rate was consistently > 2/100,000 population, and “80% of the sub-national level investigated a case in 11 of the 14 years. National incidence ranged from 4 to 62/million in 2003-2006 and decreased to 3/million in 2016. The age specific incidence ranged from 1 to 364/million population and was highest among children aged < 1 year. Conclusion Kenya has made progress towards measles elimination. However, this progress remains at risk and the recent declines in MCV1 coverage and the low uptake in MCV2 could reverse these gains.
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Affiliation(s)
- Ngina Kisangau
- Field Epidemiology and Laboratory Training Program, Kenya
| | - Kibet Sergon
- World Health Organization, Immunization and Vaccines, Kenya
| | - Yusuf Ibrahim
- Ministry of Health, Division of Disease Surveillance and Epidemic Response, Kenya
| | - Florence Yonga
- Ministry of Health, Division of Disease Surveillance and Epidemic Response, Kenya
| | - Daniel Langat
- Ministry of Health, Division of Disease Surveillance and Epidemic Response, Kenya
| | - Rosemary Nzunza
- Kenya Medical Research Institute, Centre for Virus Research, Kenya
| | - Peter Borus
- World Health Organization, Measles and Polio Laboratory, Kenya
| | - Tura Galgalo
- United States Centers for Disease Control and Prevention, Kenya
| | - Sara A Lowther
- United States Centers for Disease Control and Prevention, Kenya.,Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
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RASOOL MUHAMMADHIDAYAT, RAFIQ AHSAN, NAWAZ MUHAMMADZEESHAN, SHAFIQUE MUHAMMAD, SAQALEIN MUHAMMAD. Sero-epidemiology and Risk Factor Analysis of Measles Among Children in Pakistan. Pol J Microbiol 2018; 67:227-231. [PMID: 30015462 PMCID: PMC7256824 DOI: 10.21307/pjm-2018-025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 07/12/2017] [Accepted: 07/12/2017] [Indexed: 11/11/2022] Open
Abstract
Comparative cross sectional study was conducted on blood samples (n = 231) collected from children of 1 to 10 years of age in Punjab Pakistan through convenient sampling method. Indirect haemagglutination assay (IHA) was standardized and used for serodiagnosis and evaluation of humoral immunity against measles. Associated risk factors including age, gender, locale, and vaccination status were analyzed. Geometric mean titre (GMT) of vaccinated individuals was significantly higher (p < 0.001) than that of non-vaccinated individuals showing that IHA titre of vaccinated individuals was a measure of humoral immune response; whereas, in case of non-vaccinated individuals an indicative of exposure to the measles infection.
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Affiliation(s)
| | - AHSAN RAFIQ
- Department of Microbiology, Government College University, Faisalabad, Pakistan
| | | | - MUHAMMAD SHAFIQUE
- Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - MUHAMMAD SAQALEIN
- Department of Microbiology, Government College University, Faisalabad, Pakistan
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Abstract
Measles is a highly contagious disease that results from infection with measles virus and is still responsible for more than 100 000 deaths every year, down from more than 2 million deaths annually before the introduction and widespread use of measles vaccine. Measles virus is transmitted by the respiratory route and illness begins with fever, cough, coryza, and conjunctivitis followed by a characteristic rash. Complications of measles affect most organ systems, with pneumonia accounting for most measles-associated morbidity and mortality. The management of patients with measles includes provision of vitamin A. Measles is best prevented through vaccination, and the major reductions in measles incidence and mortality have renewed interest in regional elimination and global eradication. However, urgent efforts are needed to increase stagnating global coverage with two doses of measles vaccine through advocacy, education, and the strengthening of routine immunisation systems. Use of combined measles-rubella vaccines provides an opportunity to eliminate rubella and congenital rubella syndrome. Ongoing research efforts, including the development of point-of-care diagnostics and microneedle patches, will facilitate progress towards measles elimination and eradication.
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Affiliation(s)
- William J Moss
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; W Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
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Julik E, Reyes-Del Valle J. A Recombinant Measles Vaccine with Enhanced Resistance to Passive Immunity. Viruses 2017; 9:v9100265. [PMID: 28934110 PMCID: PMC5691617 DOI: 10.3390/v9100265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/19/2017] [Accepted: 09/19/2017] [Indexed: 12/12/2022] Open
Abstract
Current measles vaccines suffer from poor effectiveness in young infants due primarily to the inhibitory effect of residual maternal immunity on vaccine responses. The development of a measles vaccine that resists such passive immunity would strongly contribute to the stalled effort toward measles eradication. In this concise communication, we show that a measles virus (MV) with enhanced hemagglutinin (H) expression and incorporation, termed MVvac2-H2, retained its enhanced immunogenicity, previously established in older mice, when administered to very young, genetically modified, MV-susceptible mice in the presence of passive anti-measles immunity. This immunity level mimics the sub-neutralizing immunity prevalent in infants too young to be vaccinated. Additionally, toward a more physiological small animal model of maternal anti-measles immunity interference, we document vertical transfer of passive anti-MV immunity in genetically-modified, MV susceptible mice and show in this physiological model a better MVvac2-H2 immunogenic profile than that of the parental vaccine strain. In sum, these data support the notion that enhancing MV hemagglutinin incorporation can circumvent in vivo neutralization. This strategy merits additional exploration as an alternative pediatric measles vaccine.
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Affiliation(s)
- Emily Julik
- School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA.
- Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Jorge Reyes-Del Valle
- School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA.
- Process Development Department, Virus and Gene Therapy, Merck KGaA, 64293 Darmstadt, Germany.
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Bester JC. Measles Vaccination is Best for Children: The Argument for Relying on Herd Immunity Fails. JOURNAL OF BIOETHICAL INQUIRY 2017; 14:375-384. [PMID: 28815434 DOI: 10.1007/s11673-017-9799-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 11/29/2016] [Indexed: 06/07/2023]
Abstract
This article examines an argument which may negatively influence measles vaccination uptake. According to the argument, an individual child in a highly vaccinated society may be better off by being non-vaccinated; the child does not risk vaccine adverse effects and is protected against measles through herd immunity. Firstly, the conclusion of the argument is challenged by showing that herd immunity's protection is unreliable and inferior to vaccination. Secondly, the logic of the argument is challenged by showing that the argument is inherently self-defeating and therefore logically inconsistent. In practice the argument cannot be used to protect children against measles. Measles vaccination is undoubtedly best for children, even in highly vaccinated societies. Only if a medical contraindication to vaccination exists should vaccination be waived in favour of reliance on herd immunity. This places obligations on those who stand in care relationships with the child: parents, healthcare providers, and the state.
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Affiliation(s)
- Johan Christiaan Bester
- University of Nevada, Las Vegas (UNLV) School of Medicine, 2040 W Charleston Blvd, Las Vegas, Nevada, 89102 and Center for Applied Ethics, University of Stellenbosch, Stellenbosch, South Africa.
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A measles outbreak in Sindh, Pakistan caused by a genotype B3 virus. Arch Virol 2017; 162:3603-3610. [PMID: 28803415 DOI: 10.1007/s00705-017-3524-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/14/2017] [Indexed: 10/19/2022]
Abstract
Measles continues to be a major public health issue causing substantial outbreaks worldwide, mostly affecting young children. Molecular analysis of measles viruses provides important information on outbreak linkages and transmission pathways that can be helpful towards implementation of appropriate control programs. In Pakistan, the control of measles is still tenuous, and progress towards elimination has been irregular and challenging. In the 2013 measles outbreak we received 4,682 sera collected from suspected patients in 23 districts across Sindh. A total of 3,283 samples were confirmed measles positive using IgM ELISA with the highest infection rate in children aged 1-12 months. Males were more affected than females and a visible peak was observed from January to April. Among the 3,283 cases, 59.1% were unvaccinated, 29.6% had received 1 dose and 10.3% had received 2 doses of measles vaccine while 0.85% had an unknown vaccination status. For genotype detection and phylogenetic analysis, 60 throat swab samples were collected from suspected patients below 15 years of age in eight districts of Sindh province. Forty four (73%; 44/60) throat swab samples were successfully genotyped using RT-PCR. Phylogenetic analyses based on partial sequences of the nucleocapsid protein gene revealed that all Pakistani measles virus strains belonged to genotype B3 and were closely related to those isolated from neighboring countries such as Iran, Afghanistan (99.1-100%) and India with 98.6 - 99.6% nucleotide homology. This is the first report on the phylogenetic analysis of measles B3 genotype strains from Pakistan and highlights the need for strengthening the surveillance systems and improving immunization coverage across the country.
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Zahoor MA. Global eradication of measles virus: current status. Future Virol 2017. [DOI: 10.2217/fvl-2017-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Davis R, Mbabazi WB. Challenges to global measles eradication: is it all in the timing? Pan Afr Med J 2017; 27:11. [PMID: 29296146 PMCID: PMC5745928 DOI: 10.11604/pamj.supp.2017.27.3.12553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 04/22/2017] [Indexed: 11/30/2022] Open
Abstract
The case for global eradication of measles was first made in 1982. Since then, technical aspects of measles eradication have concluded that measles satisfied all criteria required for eradication. To date, only smallpox, among human diseases, has been eradicated, with polio, the next eradication candidate. In all previous eradication programmes, the pattern of slow implementation and missed deadlines is similar. Lessons from these past eradication programs should inform development of a time-limited measles eradication program. Notably, no measles eradication resolution is likely until member states are satisfied that polio eradication is accomplished. However, there is an impetus for measles eradication from the western hemisphere, where governments continue to pay the high costs of keeping their region measles free until global measles eradication is achieved. While previous vaccine preventable diseases eradications have depended on supplemental immunizations (SIAs), measles eradication will have to build both on SIAs and routine immunization systems strengthening. This article reviews non-technical considerations that could facilitate the delivery of a time-limited measles eradication initiative. The issues discussed are categorized as a) specificities of measles disease; b) specifics of measles vaccine/vaccination; c) special considerations for endemic countries and d) organization of international partnerships. The disease and vaccine specific issues are not insurmountable. The introduction of routine measles second dose, in the context of EPI systems strengthening, is paramount to endemic developing countries. In the international partnerships, it should be noted that i) Measles eradication will be easier and cheaper; ii) the return on investment is compelling; iii) leverage is feasible on the experiences of the Measles/Rubella initiative; iv) two disease eradication targets in one initiative are feasible and v) for the first time, an eradication investment case will inform the decisions. However, if previous eradication efforts have been marathons, measles eradication will need to be a sprint.
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Affiliation(s)
- Robert Davis
- American Red Cross, PO Box 41275-00100, Nairobi, Kenya
| | - William Baguma Mbabazi
- African Field Epidemiology Network, Lugogo House, Plot 42, Lugogo By-pass, P.O. Box 12874 Kampala, Uganda
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Plans-Rubió P. Why does measles persist in Europe? Eur J Clin Microbiol Infect Dis 2017; 36:1899-1906. [PMID: 28550369 DOI: 10.1007/s10096-017-3011-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/08/2017] [Indexed: 11/26/2022]
Abstract
Several reasons may explain why measles was not eliminated by 2015 and continues to persist in Europe, including low measles vaccination coverage, low anti-measles herd immunity levels, and the mobility of individuals with measles across Europe. The study assessed the mean measles vaccination coverage in the European Union and the WHO European region with one and two doses of measles vaccine from 1980 to 2015, and the prevalence of vaccine-induced protected individuals and anti-measles herd immunity levels in the WHO European region during 2000-2015. The study found that measles vaccination coverage with two doses of vaccine was <90% in the European Union and the WHO European region from 1995 to 2015. In the WHO European region, the two-dose measles vaccination coverage during the 2000-2015 period was <95% in 41 countries (79%), and the prevalence of vaccine-induced protected individuals in the target vaccination population was lower than the herd immunity threshold of 94.4% in 33 countries (63%). The additional vaccination coverage required to establish herd immunity in these countries ranged from 0.2% to 18%. Two of the factors explaining measles persistence in Europe in 2015 were the two-dose measles vaccination coverage <95% and the prevalence of individuals with vaccine-induced protection of <94.4% in most countries of the WHO European region during the 2000-2015 period. Screening and vaccination programs should be developed to detect and immunize susceptible individuals in areas and population groups without anti-measles herd immunity in all European countries.
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Affiliation(s)
- P Plans-Rubió
- Public Health Agency of Catalonia, Department of Health of Catalonia, Roc Boronat 83-95, Barcelona, 08005, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
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Takahashi S, Metcalf CJE, Ferrari MJ, Tatem AJ, Lessler J. The geography of measles vaccination in the African Great Lakes region. Nat Commun 2017; 8:15585. [PMID: 28541287 PMCID: PMC5458501 DOI: 10.1038/ncomms15585] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 04/07/2017] [Indexed: 11/09/2022] Open
Abstract
Expanded access to measles vaccination was among the most successful public health interventions of recent decades. All WHO regions currently target measles elimination by 2020, yet continued measles circulation makes that goal seem elusive. Using Demographic and Health Surveys with generalized additive models, we quantify spatial patterns of measles vaccination in ten contiguous countries in the African Great Lakes region between 2009-2014. Seven countries have 'coldspots' where vaccine coverage is below the WHO target of 80%. Over 14 million children under 5 years of age live in coldspots across the region, and a total of 8-12 million children are unvaccinated. Spatial patterns of vaccination do not map directly onto sub-national administrative units and transnational coldspots exist. Clustering of low vaccination areas may allow for pockets of susceptibility that sustain circulation despite high overall coverage. Targeting at-risk areas and transnational coordination are likely required to eliminate measles in the region.
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Affiliation(s)
- Saki Takahashi
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey 08544, USA
| | - C. Jessica E. Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey 08544, USA
- Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, New Jersey 08544, USA
| | - Matthew J. Ferrari
- Center for Infectious Disease Dynamics, The Pennsylvania State University, State College, Pennsylvania 16802, USA
| | - Andrew J. Tatem
- WorldPop, Department of Geography and Environment, University of Southampton, Southampton SO17 1BJ, UK
- Flowminder Foundation, Stockholm SE-11355, Sweden
| | - Justin Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
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Martínez-Girón R, Pantanowitz L. Lower respiratory tract viral infections: Diagnostic role of exfoliative cytology. Diagn Cytopathol 2017; 45:614-620. [PMID: 28247571 PMCID: PMC7163526 DOI: 10.1002/dc.23697] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/09/2017] [Accepted: 02/15/2017] [Indexed: 12/17/2022]
Abstract
Viral lower respiratory tract infections (VLRTI) remain one of the most common causes of morbidity and mortality worldwide. For many years, the diagnosis of VLRTI was based on laboratory techniques such as viral isolation in cell culture, antigen detection by direct fluorescent antibody staining, and rapid enzyme immunoassay. Radiological imaging and morphology also play an important role in diagnosing these infections. Exfoliative cytology provides a simple, rapid, inexpensive, and valuable means to diagnose and manage VLRTI. Here we review viral‐associated cytomorphological changes seen in exfoliated cells of the lower respiratory tract. Diagn. Cytopathol. 2017;45:614–620. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Rafael Martínez-Girón
- INCLÍNICA Foundation for Clinical, Pneumological and Carcinogenic Research, Oviedo, 16. 33007, Spain
| | - Liron Pantanowitz
- Department of Pathology, UPMC Shadyside, UPMC Cancer Pavilion Suite 201, Pittsburgh, Pennsylvania
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Prada JM, Metcalf CJE, Takahashi S, Lessler J, Tatem AJ, Ferrari M. Demographics, epidemiology and the impact of vaccination campaigns in a measles-free world - Can elimination be maintained? Vaccine 2017; 35:1488-1493. [PMID: 28216186 PMCID: PMC5341736 DOI: 10.1016/j.vaccine.2017.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 01/26/2017] [Accepted: 02/03/2017] [Indexed: 12/09/2022]
Abstract
Introduction All six WHO regions currently have goals for measles elimination by 2020. Measles vaccination is delivered via routine immunization programmes, which in most sub-Saharan African countries reach children around 9 months of age, and supplementary immunization activities (SIAs), which target a wider age range at multi-annual intervals. In the absence of endemic measles circulation, the proportion of individuals susceptible to measles will gradually increase through accumulation of new unvaccinated individuals in each birth cohort, increasing the risk of an epidemic. The impact of SIAs and the financial investment they require, depend on coverage and target age range. Materials and methods We evaluated the impact of target population age range for periodic SIAs, evaluating outcomes for two different levels of coverage, using a demographic and epidemiological model adapted to reflect populations in 4 sub-Saharan African countries. Results We found that a single SIA can maintain elimination over short time-scales, even with low routine coverage. However, maintaining elimination for more than a few years is difficult, even with large (high coverage/wide age range) recurrent SIAs, due to the build-up of susceptible individuals. Across the demographic and vaccination contexts investigated, expanding SIAs to target individuals over 10 years did not significantly reduce outbreak risk. Conclusions Elimination was not maintained in the contexts we evaluated without a second opportunity for vaccination. In the absence of an expanded routine program, SIAs provide a powerful option for providing this second dose. We show that a single high coverage SIA can deliver most key benefits in terms of maintaining elimination, with follow-up campaigns potentially requiring smaller investments. This makes post-campaign evaluation of coverage increasingly relevant to correctly assess future outbreak risk.
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Affiliation(s)
- J M Prada
- Department of Ecology and Evolutionary Biology, Princeton University, USA.
| | - C J E Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, USA; Office of Population Research, WWS, Princeton University, USA; Fogarty International Center, National Institutes of Health, USA
| | - S Takahashi
- Department of Ecology and Evolutionary Biology, Princeton University, USA
| | - J Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - A J Tatem
- WorldPop, Department of Geography and Environment, University of Southampton, UK; Flowminder Foundation, Stockholm, Sweden
| | - M Ferrari
- Center for Infectious Disease Dynamics, Pennsylvania State University, USA
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Voigt EA, Ovsyannikova IG, Haralambieva IH, Kennedy RB, Larrabee BR, Schaid DJ, Poland GA. Genetically defined race, but not sex, is associated with higher humoral and cellular immune responses to measles vaccination. Vaccine 2016; 34:4913-4919. [PMID: 27591105 DOI: 10.1016/j.vaccine.2016.08.060] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/17/2016] [Accepted: 08/18/2016] [Indexed: 12/20/2022]
Abstract
In addition to host genetic and environmental factors, variations in immune responses to vaccination are influenced by demographic variables, such as race and sex. The influence of genetic race and sex on measles vaccine responses is not well understood, yet important for the development of much-needed improved measles vaccines with lower failure rates. We assessed associations between genetically defined race and sex with measles humoral and cellular immunity after measles vaccination in three independent and geographically distinct cohorts totaling 2872 healthy racially diverse children, older adolescents, and young adults. We found no associations between biological sex and either humoral or cellular immunity to measles vaccine, and no correlation between humoral and cellular immunity in these study subjects. Genetically defined race was, however, significantly associated with both measles vaccine-induced humoral and cellular immune responses, with subjects genetically classified as having African-American ancestry demonstrating significantly higher antibody and cell-mediated immune responses relative to subjects of Caucasian ancestry. This information may be useful in designing novel measles vaccines that are optimally effective across human genetic backgrounds.
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Affiliation(s)
- Emily A Voigt
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
| | | | | | - Richard B Kennedy
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
| | - Beth R Larrabee
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Daniel J Schaid
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Gregory A Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA.
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Abstract
Measles is an infectious disease in humans caused by the measles virus (MeV). Before the introduction of an effective measles vaccine, virtually everyone experienced measles during childhood. Symptoms of measles include fever and maculopapular skin rash accompanied by cough, coryza and/or conjunctivitis. MeV causes immunosuppression, and severe sequelae of measles include pneumonia, gastroenteritis, blindness, measles inclusion body encephalitis and subacute sclerosing panencephalitis. Case confirmation depends on clinical presentation and results of laboratory tests, including the detection of anti-MeV IgM antibodies and/or viral RNA. All current measles vaccines contain a live attenuated strain of MeV, and great progress has been made to increase global vaccination coverage to drive down the incidence of measles. However, endemic transmission continues in many parts of the world. Measles remains a considerable cause of childhood mortality worldwide, with estimates that >100,000 fatal cases occur each year. Case fatality ratio estimates vary from <0.01% in industrialized countries to >5% in developing countries. All six WHO regions have set goals to eliminate endemic transmission of MeV by achieving and maintaining high levels of vaccination coverage accompanied by a sensitive surveillance system. Because of the availability of a highly effective and relatively inexpensive vaccine, the monotypic nature of the virus and the lack of an animal reservoir, measles is considered a candidate for eradication.
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Seruyange E, Gahutu JB, Mambo Muvunyi C, Uwimana ZG, Gatera M, Twagirumugabe T, Katare S, Karenzi B, Bergström T. Measles seroprevalence, outbreaks, and vaccine coverage in Rwanda. Infect Dis (Lond) 2016; 48:800-7. [PMID: 27386895 DOI: 10.1080/23744235.2016.1201720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Measles outbreaks are reported after insufficient vaccine coverage, especially in countries recovering from natural disaster or conflict. We compared seroprevalence to measles in blood donors in Rwanda and Sweden and explored distribution of active cases of measles and vaccine coverage in Rwanda. METHODS 516 Rwandan and 215 Swedish blood donors were assayed for measles-specific immunoglobulin G (IgG) by enzyme-linked immunosorbent assay (ELISA). Data on vaccine coverage and acute cases in Rwanda from 1980 to 2014 were collected, and IgM on serum samples and polymerase chain reaction (PCR) on nasopharyngeal (NPH) swabs from suspected measles cases during 2010-2011 were analysed. RESULTS The seroprevalence of measles IgG was significantly higher in Swedish blood donors (92.6%; 95% CI: 89.1-96.1%) compared to Rwandan subjects (71.5%; 95% CI: 67.6-75.4%) and more pronounced <35 years of age. The OD values were significantly lower in the Rwandan blood donors as compared to Swedish subjects (p < 0.00001). However, effective measles vaccine coverage was concomitant with decrease in measles cases in Rwanda, with the exception of an outbreak in 1995 following the 1994 genocide. 76/544 serum samples were IgM positive and 21/31 NPH swabs were PCR positive for measles, determined by sequencing to be of genotype B3. CONCLUSIONS Measles seroprevalence was lower in Rwandan blood donors compared to Swedish subjects. Despite this, the number of reported measles cases in Rwanda rapidly decreased during the study period, concomitant with increased vaccine coverage. Taken together, the circulation of measles was limited in Rwanda and vaccine coverage was favourable, but seroprevalence and IgG levels were low especially in younger age groups.
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Affiliation(s)
- Eric Seruyange
- a College of Medicine and Health Sciences , University of Rwanda , Rwanda ;,b Rwanda Military Hospital , Kigali , Rwanda ;,c Department of Infectious Diseases , Institute of Biomedicine, University of Gothenburg , Sweden
| | - Jean-Bosco Gahutu
- a College of Medicine and Health Sciences , University of Rwanda , Rwanda
| | | | - Zena G Uwimana
- d National Reference Laboratory , Rwanda Biomedical Centre , Kigali , Rwanda
| | - Maurice Gatera
- e Expanded Program on Immunization , Rwanda Biomedical Centre , Kigali , Rwanda
| | - Theogene Twagirumugabe
- a College of Medicine and Health Sciences , University of Rwanda , Rwanda ;,c Department of Infectious Diseases , Institute of Biomedicine, University of Gothenburg , Sweden
| | - Swaibu Katare
- f National Centre for Blood Transfusion , Rwanda Biomedical Centre , Kigali , Rwanda
| | - Ben Karenzi
- b Rwanda Military Hospital , Kigali , Rwanda
| | - Tomas Bergström
- c Department of Infectious Diseases , Institute of Biomedicine, University of Gothenburg , Sweden
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Kanduc D. Measles virus hemagglutinin epitopes are potential hotspots for crossreactions with immunodeficiency-related proteins. Future Microbiol 2016; 10:503-15. [PMID: 25865190 DOI: 10.2217/fmb.14.137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AIMS Measles virus (MV) infection induces a protective immunity that is accompanied by a transient pathologic suppression of the immune system. This immunologic paradox remains unexplained in spite of the numerous hypotheses that have been advanced (i.e., cytokine production, soluble immunosuppressive factor, cell cycle block, signaling lymphocyte activation molecule receptor and MV infection of dendritic cells, among others). METHODS Searching for molecular link(s) between MV infection and host immunodeficiency, this study used the Immune Epitope DataBase to analyze the peptide sharing between the antigenic MV hemagglutinin (H) protein and human proteins associated with immunodeficiency. RESULTS It was found that the majority of MVH derived epitopes share several exact pentapeptide sequences with numerous human proteins involved in immune functions and immunodeficiency, such as B- and T-cell antigens, and complement components. CONCLUSION The data suggest that crossreactivity might contribute to our understanding of the link between MV immunogenicity and MV-induced immunosuppression, and highlight peptides unique to MV as a basis for developing effective and safe anti-MV vaccines.
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Beineke A, Baumgärtner W, Wohlsein P. Cross-species transmission of canine distemper virus-an update. One Health 2015; 1:49-59. [PMID: 28616465 PMCID: PMC5462633 DOI: 10.1016/j.onehlt.2015.09.002] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 01/13/2023] Open
Abstract
Canine distemper virus (CDV) is a pantropic morbillivirus with a worldwide distribution, which causes fatal disease in dogs. Affected animals develop dyspnea, diarrhea, neurological signs and profound immunosuppression. Systemic CDV infection, resembling distemper in domestic dogs, can be found also in wild canids (e.g. wolves, foxes), procyonids (e.g. raccoons, kinkajous), ailurids (e.g. red pandas), ursids (e.g. black bears, giant pandas), mustelids (e.g. ferrets, minks), viverrids (e.g. civets, genets), hyaenids (e.g. spotted hyenas), and large felids (e.g. lions, tigers). Furthermore, besides infection with the closely related phocine distemper virus, seals can become infected by CDV. In some CDV outbreaks including the mass mortalities among Baikal and Caspian seals and large felids in the Serengeti Park, terrestrial carnivores including dogs and wolves have been suspected as vectors for the infectious agent. In addition, lethal infections have been described in non-carnivore species such as peccaries and non-human primates demonstrating the remarkable ability of the pathogen to cross species barriers. Mutations affecting the CDV H protein required for virus attachment to host-cell receptors are associated with virulence and disease emergence in novel host species. The broad and expanding host range of CDV and its maintenance within wildlife reservoir hosts considerably hampers disease eradication.
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Affiliation(s)
- Andreas Beineke
- Department of Pathology, University of Veterinary Medicine Hannover, Bünteweg 17, D-30559 Hanover, Germany
- Center for Systems Neuroscience, Hanover, Germany
| | - Wolfgang Baumgärtner
- Department of Pathology, University of Veterinary Medicine Hannover, Bünteweg 17, D-30559 Hanover, Germany
- Center for Systems Neuroscience, Hanover, Germany
| | - Peter Wohlsein
- Department of Pathology, University of Veterinary Medicine Hannover, Bünteweg 17, D-30559 Hanover, Germany
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Synonymous Deoptimization of Foot-and-Mouth Disease Virus Causes Attenuation In Vivo while Inducing a Strong Neutralizing Antibody Response. J Virol 2015; 90:1298-310. [PMID: 26581977 DOI: 10.1128/jvi.02167-15] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 11/04/2015] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Codon bias deoptimization has been previously used to successfully attenuate human pathogens, including poliovirus, respiratory syncytial virus, and influenza virus. We have applied a similar technology to deoptimize the capsid-coding region (P1) of foot-and-mouth disease virus (FMDV). Despite the introduction of 489 nucleotide changes (19%), synonymous deoptimization of the P1 region rendered a viable FMDV progeny. The resulting strain was stable and reached cell culture titers similar to those obtained for wild-type (WT) virus, but at reduced specific infectivity. Studies in mice showed that 100% of animals inoculated with the FMDV A12 P1 deoptimized mutant (A12-P1 deopt) survived, even when the animals were infected at doses 100 times higher than the dose required to cause death by WT virus. All mice inoculated with the A12-P1 deopt mutant developed a strong antibody response and were protected against subsequent lethal challenge with WT virus at 21 days postinoculation. Remarkably, the vaccine safety margin was at least 1,000-fold higher for A12-P1 deopt than for WT virus. Similar patterns of attenuation were observed in swine, in which animals inoculated with A12-P1 deopt virus did not develop clinical disease until doses reached 1,000 to 10,000 times the dose required to cause severe disease in 2 days with WT A12. Consistently, high levels of antibody titers were induced, even at the lowest dose tested. These results highlight the potential use of synonymous codon pair deoptimization as a strategy to safely attenuate FMDV and further develop live attenuated vaccine candidates to control such a feared livestock disease. IMPORTANCE Foot-and-mouth disease (FMD) is one of the most feared viral diseases that can affect livestock. Although this disease appeared to be contained in developed nations by the end of the last century, recent outbreaks in Europe, Japan, Taiwan, South Korea, etc., have demonstrated that infection can spread rapidly, causing devastating economic and social consequences. The Global Foot-and-Mouth Disease Research Alliance (GFRA), an international organization launched in 2003, has set as part of their five main goals the development of next-generation control measures and strategies, including improved vaccines and biotherapeutics. Our work demonstrates that newly developed codon pair bias deoptimization technologies can be applied to FMD virus to obtain attenuated strains with potential for further development as novel live attenuated vaccine candidates that may rapidly control disease without reverting to virulence.
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