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Berry MT, Khan SR, Schlub TE, Notaras A, Kunasekaran M, Grulich AE, MacIntyre CR, Davenport MP, Khoury DS. Predicting vaccine effectiveness for mpox. Nat Commun 2024; 15:3856. [PMID: 38719852 PMCID: PMC11078999 DOI: 10.1038/s41467-024-48180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
The Modified Vaccinia Ankara vaccine developed by Bavarian Nordic (MVA-BN) was widely deployed to prevent mpox during the 2022 global outbreak. This vaccine was initially approved for mpox based on its reported immunogenicity (from phase I/II trials) and effectiveness in animal models, rather than evidence of clinical efficacy. However, no validated correlate of protection after vaccination has been identified. Here we performed a systematic search and meta-analysis of the available data to test whether vaccinia-binding ELISA endpoint titer is predictive of vaccine effectiveness against mpox. We observe a significant correlation between vaccine effectiveness and vaccinia-binding antibody titers, consistent with the existing assumption that antibody levels may be a correlate of protection. Combining this data with analysis of antibody kinetics after vaccination, we predict the durability of protection after vaccination and the impact of dose spacing. We find that delaying the second dose of MVA-BN vaccination will provide more durable protection and may be optimal in an outbreak with limited vaccine stock. Although further work is required to validate this correlate, this study provides a quantitative evidence-based approach for using antibody measurements to predict the effectiveness of mpox vaccination.
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Affiliation(s)
- Matthew T Berry
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Shanchita R Khan
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Timothy E Schlub
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Adriana Notaras
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Andrew E Grulich
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - C Raina MacIntyre
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- College of Public Service and Community Solutions, and College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Miles P Davenport
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
| | - David S Khoury
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
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Rodríguez-Pastor R, Hasik AZ, Knossow N, Bar-Shira E, Shahar N, Gutiérrez R, Zaman L, Harrus S, Lenski RE, Barrick JE, Hawlena H. Bartonella infections are prevalent in rodents despite efficient immune responses. Parasit Vectors 2023; 16:315. [PMID: 37667323 PMCID: PMC10478473 DOI: 10.1186/s13071-023-05918-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/06/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Pathogens face strong selection from host immune responses, yet many host populations support pervasive pathogen populations. We investigated this puzzle in a model system of Bartonella and rodents from Israel's northwestern Negev Desert. We chose to study this system because, in this region, 75-100% of rodents are infected with Bartonella at any given time, despite an efficient immunological response. In this region, Bartonella species circulate in three rodent species, and we tested the hypothesis that at least one of these hosts exhibits a waning immune response to Bartonella, which allows reinfections. METHODS We inoculated captive animals of all three rodent species with the same Bartonella strain, and we quantified the bacterial dynamics and Bartonella-specific immunoglobulin G antibody kinetics over a period of 139 days after the primary inoculation, and then for 60 days following reinoculation with the same strain. RESULTS Contrary to our hypothesis, we found a strong, long-lasting immunoglobulin G antibody response, with protective immunological memory in all three rodent species. That response prevented reinfection upon exposure of the rodents to the same Bartonella strain. CONCLUSIONS This study constitutes an initial step toward understanding how the interplay between traits of Bartonella and their hosts influences the epidemiological dynamics of these pathogens in nature.
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Affiliation(s)
- Ruth Rodríguez-Pastor
- Jacob Blaustein Center for Scientific Cooperation, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Midreshet Ben-Gurion, Israel
| | - Adam Z Hasik
- Jacob Blaustein Center for Scientific Cooperation, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Midreshet Ben-Gurion, Israel
- Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, UK
| | - Nadav Knossow
- The Mitrani Department of Desert Ecology, Swiss Institute for Dryland Environmental and Energy Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, 849900, Midreshet Ben-Gurion, Israel
| | - Enav Bar-Shira
- Section of Immunology, Department of Animal Sciences, Faculty of Agricultural, Nutritional and Environmental Sciences, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Naama Shahar
- The Mitrani Department of Desert Ecology, Swiss Institute for Dryland Environmental and Energy Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, 849900, Midreshet Ben-Gurion, Israel
| | - Ricardo Gutiérrez
- National Reference Center for Bacteriology, Costa Rican Institute for Research and Teaching in Nutrition and Health (INCIENSA), Cartago, Costa Rica
| | - Luis Zaman
- Department of Ecology and Evolutionary Biology, Center for the Study of Complex Systems (CSCS), University of Michigan, Ann Arbor, MI, USA
| | - Shimon Harrus
- Koret School of Veterinary Medicine, Faculty of Agricultural, Nutritional and Environmental Sciences, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Richard E Lenski
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, USA
| | - Jeffrey E Barrick
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA
| | - Hadas Hawlena
- The Mitrani Department of Desert Ecology, Swiss Institute for Dryland Environmental and Energy Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, 849900, Midreshet Ben-Gurion, Israel.
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Cowpox Viruses: A Zoo Full of Viral Diversity and Lurking Threats. Biomolecules 2023; 13:biom13020325. [PMID: 36830694 PMCID: PMC9953750 DOI: 10.3390/biom13020325] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Cowpox viruses (CPXVs) exhibit the broadest known host range among the Poxviridae family and have caused lethal outbreaks in various zoo animals and pets across 12 Eurasian countries, as well as an increasing number of human cases. Herein, we review the history of how the cowpox name has evolved since the 1700s up to modern times. Despite early documentation of the different properties of CPXV isolates, only modern genetic analyses and phylogenies have revealed the existence of multiple Orthopoxvirus species that are currently constrained under the CPXV designation. We further chronicle modern outbreaks in zoos, domesticated animals, and humans, and describe animal models of experimental CPXV infections and how these can help shaping CPXV species distinctions. We also describe the pathogenesis of modern CPXV infections in animals and humans, the geographic range of CPXVs, and discuss CPXV-host interactions at the molecular level and their effects on pathogenicity and host range. Finally, we discuss the potential threat of these viruses and the future of CPXV research to provide a comprehensive review of CPXVs.
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Abstract
Monkeypox is a zoonotic disease, presenting with fever, lymphadenopathy and vesicular-pustular skin lesions, that historically has rarely been reported outside the endemic regions of Central and West Africa. It was previously thought that human-to-human transmission was too low to sustain spread. During 2022, the number of cases of monkeypox, caused by clade II, rose rapidly globally, predominantly among men who have sex with men. In previous outbreaks with monkeypox clade 1 in endemic areas, children were disproportionately more affected with higher morbidity and mortality. It is unclear whether children are at similarly higher risk from monkeypox clade II. Nonetheless, children and pregnant women are considered high-risk groups and antiviral treatment should be considered for those affected. While smallpox vaccination offers good protection against monkeypox, the duration of protection is unknown, and infection occurs in vaccinated individuals. Should the current outbreak spread to children, authorities should be prepared to rapidly implement vaccination for children. In this review, we summarize epidemiological and clinical features, as well as the pathogenesis, treatment, and prevention options for monkeypox with a focus on considerations for children.
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Gushchin VA, Ogarkova DA, Dolzhikova IV, Zubkova OV, Grigoriev IV, Pochtovyi AA, Iliukhina AA, Ozharovskaia TA, Kuznetsova NA, Kustova DD, Shelkov AY, Zrelkin DI, Odintsova AS, Grousova DM, Kan VY, Davtyan SA, Siniavin AE, Belyaeva ED, Botikov AG, Bessonova AA, Vasilchenko LA, Vasina DV, Kleymenov DA, Slutskiy EA, Tkachuk AP, Burgasova OA, Loginova SY, Rozhdestvensky EV, Shcheblyakov DV, Tsibin AN, Komarov AG, Zlobin VI, Borisevich SV, Naroditsky BS, Logunov DY, Gintsburg AL. Estimation of anti-orthopoxvirus immunity in Moscow residents and potential risks of spreading Monkeypox virus. Front Immunol 2022; 13:1023164. [PMID: 36466896 PMCID: PMC9709467 DOI: 10.3389/fimmu.2022.1023164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/25/2022] [Indexed: 07/30/2023] Open
Abstract
WHO has declared the outbreak of monkeypox as a public health emergency of international concern. In less than three months, monkeypox was detected in more than 30 000 people and spread to more than 80 countries around the world. It is believed that the immunity formed to smallpox vaccine can protect from monkeypox infection with high efficiency. The widespread use of Vaccinia virus has not been carried out since the 1980s, which raises the question of the level of residual immunity among the population and the identification of groups requiring priority vaccination. We conducted a cross-sectional serological study of remaining immunity among Moscow residents. To do this, a collection of blood serum samples of age group over 30 years old was formed, an in-house ELISA test system was developed, and a virus neutralization protocol was set up. Serum samples were examined for the presence of IgG antibodies against Vaccinia virus (n=2908), as well as for the ability to neutralize plaque formation with a Vaccinia virus MNIIVP-10 strain (n=299). The results indicate the presence of neutralizing antibody titer of 1/20 or more in 33.3 to 53.2% of people older than 45 years. Among people 30-45 years old who probably have not been vaccinated, the proportion with virus neutralizing antibodies ranged from 3.2 to 6.7%. Despite the higher level of antibodies in age group older than 66 years, the proportion of positive samples in this group was slightly lower than in people aged 46-65 years. The results indicate the priority of vaccination in groups younger than 45, and possibly older than 66 years to ensure the protection of the population in case of spread of monkeypox among Moscow residents. The herd immunity level needed to stop the circulation of the virus should be at least 50.25 - 65.28%.
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Affiliation(s)
- Vladimir A. Gushchin
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department of Virology, Biological Faculty, Lomonosov Moscow State University, Moscow, Russia
| | - Darya A. Ogarkova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Inna V. Dolzhikova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Olga V. Zubkova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Igor V. Grigoriev
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrei A. Pochtovyi
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department of Virology, Biological Faculty, Lomonosov Moscow State University, Moscow, Russia
| | - Anna A. Iliukhina
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Tatiana A. Ozharovskaia
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Nadezhda A. Kuznetsova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Daria D. Kustova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Artem Y. Shelkov
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Denis I. Zrelkin
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alina S. Odintsova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Daria M. Grousova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Vladislav Y. Kan
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Sona A. Davtyan
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrei E. Siniavin
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Elizaveta D. Belyaeva
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrei G. Botikov
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Arina A. Bessonova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Lyudmila A. Vasilchenko
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Daria V. Vasina
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Denis A. Kleymenov
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | | | - Artem P. Tkachuk
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Olga A. Burgasova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
- Moscow Healthcare Department, Moscow, Russia
- Department of Infectious Diseases with the Courses of Epidemiology and Phthisiology, Peoples Friendship University of Russia (RUDN) University, Moscow, Russia
| | - Svetlana Y. Loginova
- Department of Especially Dangerous Viral Infections, 48-Central Research Institute of the Ministry of Defence of the Russian Federation, Moscow, Russia
| | - Evgeny V. Rozhdestvensky
- Department of Especially Dangerous Viral Infections, 48-Central Research Institute of the Ministry of Defence of the Russian Federation, Moscow, Russia
| | - Dmitry V. Shcheblyakov
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | | | | | - Vladimir I. Zlobin
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Sergei V. Borisevich
- Department of Especially Dangerous Viral Infections, 48-Central Research Institute of the Ministry of Defence of the Russian Federation, Moscow, Russia
| | - Boris S. Naroditsky
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Denis Y. Logunov
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alexander L. Gintsburg
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department of Infectiology and Virology, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov, First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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Capobianchi MR, Di Caro A, Piubelli C, Mori A, Bisoffi Z, Castilletti C. Monkeypox 2022 outbreak in non-endemic countries: Open questions relevant for public health, nonpharmacological intervention and literature review. Front Cell Infect Microbiol 2022; 12:1005955. [PMID: 36204640 PMCID: PMC9530127 DOI: 10.3389/fcimb.2022.1005955] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/24/2022] [Indexed: 01/18/2023] Open
Abstract
Starting from mid-May 2022, cases of human monkeypox started to rise in several non-endemic countries. By mid-July, more than 17000 confirmed/suspect cases have been reported by at least 82 countries worldwide, with a regular incremental trend. In order to contain the disease diffusion, risk evaluation is crucial to undertake informed decisions and effective communication campaigns. However, since orthopoxvirus infections so far have attracted low attention, due to the eradication of smallpox 40 years ago, and to the confinement of human monkeypox almost exclusively to endemic areas, several unresolved issues concerning natural history, ecology and pathogenesis remain. To this respect, we identified some open questions and reviewed the relevant literature on monkeypoxvirus and/or related orthopoxviruses. The results will be discussed in the perspective of their relevance to public health decisions, particularly those related to non-pharmacological interventions.
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Affiliation(s)
- Maria Rosaria Capobianchi
- Department of Infectious Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore-Don Calabria Hospital, Verona, Italy
- Saint Camillus International Medical University, Rome, Italy
| | - Antonino Di Caro
- Department of Infectious Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore-Don Calabria Hospital, Verona, Italy
- Saint Camillus International Medical University, Rome, Italy
| | - Chiara Piubelli
- Department of Infectious Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore-Don Calabria Hospital, Verona, Italy
| | - Antonio Mori
- Department of Infectious Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore-Don Calabria Hospital, Verona, Italy
| | - Zeno Bisoffi
- Department of Infectious Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore-Don Calabria Hospital, Verona, Italy
| | - Concetta Castilletti
- Department of Infectious Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Sacro Cuore-Don Calabria Hospital, Verona, Italy
- *Correspondence: Concetta Castilletti,
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Abdelaal A, Reda A, Lashin BI, Katamesh BE, Brakat AM, AL-Manaseer BM, Kaur S, Asija A, Patel NK, Basnyat S, Rabaan AA, Alhumaid S, Albayat H, Aljeldah M, Shammari BRA, Al-Najjar AH, Al-Jassem AK, AlShurbaji ST, Alshahrani FS, Alynbiawi A, Alfaraj ZH, Alfaraj DH, Aldawood AH, Sedhai YR, Mumbo V, Rodriguez-Morales AJ, Sah R. Preventing the Next Pandemic: Is Live Vaccine Efficacious against Monkeypox, or Is There a Need for Killed Virus and mRNA Vaccines? Vaccines (Basel) 2022; 10:vaccines10091419. [PMID: 36146497 PMCID: PMC9500691 DOI: 10.3390/vaccines10091419] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/18/2022] [Accepted: 08/26/2022] [Indexed: 11/27/2022] Open
Abstract
(1) Background: The monkeypox virus (MPV) is a double-stranded DNA virus belonging to the Poxviridae family, Chordopoxvirinae subfamily, and Orthopoxvirus genus. It was called monkeypox because it was first discovered in monkeys, in a Danish laboratory, in 1958. However, the actual reservoir for MPV is still unknown. (2) Methods and Results: We have reviewed the existing literature on the options for Monkeypox virus. There are three available vaccines for orthopoxviruses—ACAM2000, JYNNEOS, and LC16—with the first being a replicating vaccine and the latter being non- or minimally replicating. (3) Conclusions: Smallpox vaccinations previously provided coincidental immunity to MPV. ACAM2000 (a live-attenuated replicating vaccine) and JYNNEOS (a live-attenuated, nonreplicating vaccine) are two US FDA-approved vaccines that can prevent monkeypox. However, ACAM2000 may cause serious side effects, including cardiac problems, whereas JYNNEOS is associated with fewer complications. The recent outbreaks across the globe have once again highlighted the need for constant monitoring and the development of novel prophylactic and therapeutic modalities. Based on available data, there is still a need to develop an effective and safe new generation of vaccines specific for monkeypox that are killed or developed into a mRNA vaccine before monkeypox is declared a pandemic.
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Affiliation(s)
- Abdelaziz Abdelaal
- Postgraduate Medical Education, Harvard Medical School, Boston, MA 02115, USA
- School of Medicine, Boston University, Boston, MA 02118, USA
- Tanta Research Team, Tanta 31527, Egypt
- Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Abdullah Reda
- Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | | | - Basant E. Katamesh
- Tanta Research Team, Tanta 31527, Egypt
- Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Aml M. Brakat
- Faculty of Medicine, Zagazig University, Ash Sharqia Governorate, Zagazig 44519, Egypt
| | - Balqees Mahmoud AL-Manaseer
- Jordan University Hospital, Amman 11942, Jordan
- School of Medicine, University of Jordan, Amman 11733, Jordan
| | - Sayanika Kaur
- Department of Internal Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Ankush Asija
- Department of Internal Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Nimesh K. Patel
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Soney Basnyat
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - 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
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia
| | - Hawra Albayat
- Infectious Disease Department, King Saud Medical City, Riyadh 11564, Saudi Arabia
| | - Mohammed Aljeldah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin 39831, Saudi Arabia
| | - Basim R. Al Shammari
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin 39831, Saudi Arabia
| | - Amal H. Al-Najjar
- Drug & Poison Information Center, Pharmacy Department, Security Forces Hospital Program, Riyadh 11564, Saudi Arabia
| | - Ahmed K. Al-Jassem
- Drug & Poison Information Center, Pharmacy Department, Security Forces Hospital Program, Riyadh 11564, Saudi Arabia
| | - Sultan T. AlShurbaji
- Outpatient Pharmacy, Dr. Sulaiman Alhabib Medical Group, Diplomatic Quarter, Riyadh 91877, Saudi Arabia
| | - Fatimah S. Alshahrani
- Department of Internal Medicine, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ahlam Alynbiawi
- Infectious Diseases Section, Medical Specialties Department, King Fahad Medical City, Riyadh 12231, Saudi Arabia
| | - Zainab H. Alfaraj
- Department of Nursing, Maternity and Children Hospital, Dammam 31176, Saudi Arabia
| | - Duaa H. Alfaraj
- Department of Nursing, Maternity and Children Hospital, Dammam 31176, Saudi Arabia
| | - Ahmed H. Aldawood
- Molecular Diagnostic Laboratory, Dammam Regional Laboratory and Blood Bank, Dammam 31411, Saudi Arabia
| | - Yub Raj Sedhai
- Division of Pulmonary Diseases and Critical Care Medicine, University of Kentucky, Bowling Green, KY 40292, USA
| | - Victoria Mumbo
- Coast General Teaching and Referral Hospital, Mombasa P.O. Box 90231-80100, Kenya
| | - Alfonso J. Rodriguez-Morales
- Latin American Network on Monkeypox Virus Research (LAMOVI), Pereira 66001, Colombia
- Institución Universitaria Visión de las Américas, Pereira 12998, Colombia
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónomade las Américas, Pereira 66003, Colombia
- Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima 4861, Peru
| | - Ranjit Sah
- Postgraduate Medical Education, Harvard Medical School, Boston, MA 02115, USA
- Latin American Network on Monkeypox Virus Research (LAMOVI), Pereira 66001, Colombia
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu 44600, Nepal
- Correspondence: or ; Tel.: +977-9803098857
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MacIntyre CR, Heslop DJ, Nguyen P, Adam D, Trent M, Gerber BJ. Pacific Eclipse - A tabletop exercise on smallpox pandemic response. Vaccine 2021; 40:2478-2483. [PMID: 34865873 DOI: 10.1016/j.vaccine.2021.10.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/19/2021] [Accepted: 10/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In December 2019, we ran Pacific Eclipse, a pandemic tabletop exercise using smallpox originating in Fiji as a case study. Pacific Eclipse brought together international stakeholders from health, defence, law enforcement, emergency management and a range of other organisations. AIM To review potential gaps in preparedness and identify modifiable factors which could prevent a pandemic or mitigate the impact of a pandemic. METHODS Pacific Eclipse was held on December 9-10 in Washington DC, Phoenix and Honolulu simultaneously. The scenario began in Fiji and becomes a pandemic. Mathematical modelling of smallpox transmission was used to simulate the epidemic under different conditions and to test the effect of interventions. Live polling, using Poll Everywhere software that participants downloaded onto their smart phones, was used to gather participant decisions as the scenario unfolded. Stakeholders from state and federal government and non-government organisations from The United States, The United Kingdom, Australia, New Zealand, Canada, as well as industry and non-government organisations attended. RESULTS The scenario progressed in three phases and participants were able to make decisions during each phase using live polling. The polling showed very diverse and sometimes conflicting decision making. Factors influential to pandemic severity were identified and categorised as modifiable or unmodifiable. A series of recommendations were made on the modifiable determinants of pandemic severity and how these can be incorporated into pandemic planning. These included preventing an attack through intelligence, law enforcement and legislation, improved speed of diagnosis, speed and completeness of case finding and case isolation, speed and security of vaccination response (including stockpiling), speed and completeness of contact tracing, protecting critical infrastructure and business continuity, non-pharmaceutical interventions (social distancing, PPE, border control) and protecting first responders. DISCUSSION Pacific Eclipse illustrated the impact of a pandemic of smallpox under different response scenarios, which were validated to some extent by the COVID-19 pandemic. The framework developed from the scenario draws out modifiable determinants of pandemic severity which can inform pandemic planning for the ongoing COVID-19 pandemic and for future pandemics.
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Affiliation(s)
- C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, The University of New South Wales, Sydney, Australia
| | - David J Heslop
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Phi Nguyen
- Biosecurity Program, The Kirby Institute, The University of New South Wales, Sydney, Australia
| | | | - Mallory Trent
- Biosecurity Program, The Kirby Institute, The University of New South Wales, Sydney, Australia.
| | - Brian J Gerber
- Watts College of Public Service and Community Solutions, Arizona State University, United States
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Mohamed H, Esposito RA, Kutzler MA, Wigdahl B, Krebs FC, Miller V. Nonthermal plasma as part of a novel strategy for vaccination. PLASMA PROCESSES AND POLYMERS (PRINT) 2020; 17:2000051. [PMID: 32837491 PMCID: PMC7404442 DOI: 10.1002/ppap.202000051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/28/2020] [Accepted: 06/28/2020] [Indexed: 05/03/2023]
Abstract
Vaccination has been one of the most effective health intervention mechanisms to reduce morbidity and mortality associated with infectious diseases. Vaccines stimulate the body's protective immune responses through controlled exposure to modified versions of pathogens that establish immunological memory. However, only a few diseases have effective vaccines. The biological effects of nonthermal plasma on cells suggest that plasma could play an important role in improving efficacy of existing vaccines and overcoming some of the limitations and challenges with current vaccination strategies. This review summarizes the opportunities for nonthermal plasma for immunization and therapeutic purposes.
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Affiliation(s)
- Hager Mohamed
- Department of Microbiology and Immunology, Institute for Molecular Medicine and Infectious DiseaseDrexel University College of MedicinePhiladelphiaPennsylvania
| | - Rita A. Esposito
- Department of Microbiology and Immunology, Institute for Molecular Medicine and Infectious DiseaseDrexel University College of MedicinePhiladelphiaPennsylvania
| | - Michele A. Kutzler
- Department of Microbiology and Immunology, Institute for Molecular Medicine and Infectious DiseaseDrexel University College of MedicinePhiladelphiaPennsylvania
| | - Brian Wigdahl
- Department of Microbiology and Immunology, Institute for Molecular Medicine and Infectious DiseaseDrexel University College of MedicinePhiladelphiaPennsylvania
| | - Fred C. Krebs
- Department of Microbiology and Immunology, Institute for Molecular Medicine and Infectious DiseaseDrexel University College of MedicinePhiladelphiaPennsylvania
| | - Vandana Miller
- Department of Microbiology and Immunology, Institute for Molecular Medicine and Infectious DiseaseDrexel University College of MedicinePhiladelphiaPennsylvania
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Costantino V, Trent MJ, Sullivan JS, Kunasekaran MP, Gray R, MacIntyre R. Serological Immunity to Smallpox in New South Wales, Australia. Viruses 2020; 12:v12050554. [PMID: 32443405 PMCID: PMC7291091 DOI: 10.3390/v12050554] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 11/27/2022] Open
Abstract
The re-emergence of smallpox is an increasing and legitimate concern due to advances in synthetic biology. Vaccination programs against smallpox using the vaccinia virus vaccine ceased with the eradication of smallpox and, unlike many other countries, Australia did not use mass vaccinations. However, vaccinated migrants contribute to population immunity. Testing for vaccinia antibodies is not routinely performed in Australia, and few opportunities exist to estimate the level of residual population immunity against smallpox. Serological data on population immunity in Australia could inform management plans against a smallpox outbreak. Vaccinia antibodies were measured in 2003 in regular plasmapheresis donors at the Australian Red Cross Blood Service from New South Wales (NSW). The data were analysed to estimate the proportion of Australians in NSW with detectable serological immunity to vaccinia. The primary object of this study was to measure neutralising antibody titres against vaccinia virus. Titre levels in donor samples were determined by plaque reduction assay. To estimate current levels of immunity to smallpox infection, the decline in geometric mean titres (GMT) over time was projected using two values for the antibody levels estimated on the basis of different times since vaccination. The results of this study suggest that there is minimal residual immunity to the vaccinia virus in the Australian population. Although humoral immunity is protective against orthopoxvirus infections, cell-mediated immunity and immunological memory likely also play roles, which are not quantified by antibody levels. These data provide an immunological snapshot of the NSW population, which could inform emergency preparedness planning and outbreak control, especially concerning the stockpiling of vaccinia vaccine.
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Affiliation(s)
- Valentina Costantino
- Biosecurity Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; (M.J.T.); (M.P.K.); (R.M.)
- Correspondence:
| | - Mallory J. Trent
- Biosecurity Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; (M.J.T.); (M.P.K.); (R.M.)
| | - John S. Sullivan
- Central Clinical School, University of Sydney, Sydney, NSW 2052, Australia;
- School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Mohana P. Kunasekaran
- Biosecurity Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; (M.J.T.); (M.P.K.); (R.M.)
| | - Richard Gray
- Surveillance Evaluation and Research Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Raina MacIntyre
- Biosecurity Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; (M.J.T.); (M.P.K.); (R.M.)
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