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Vannice KS, Hills SL, Schwartz LM, Barrett AD, Heffelfinger J, Hombach J, Letson GW, Solomon T, Marfin AA. The future of Japanese encephalitis vaccination: expert recommendations for achieving and maintaining optimal JE control. NPJ Vaccines 2021; 6:82. [PMID: 34131150 PMCID: PMC8206071 DOI: 10.1038/s41541-021-00338-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 04/15/2021] [Indexed: 02/05/2023] Open
Abstract
Vaccines against Japanese encephalitis (JE) have been available for decades. Currently, most JE-endemic countries have vaccination programs for their at-risk populations. Even so, JE remains the leading recognized cause of viral encephalitis in Asia. In 2018, the U.S. Centers for Disease Control and Prevention and PATH co-convened a group of independent experts to review JE prevention and control successes, identify remaining scientific and operational issues that need to be addressed, discuss opportunities to further strengthen JE vaccination programs, and identify strategies and solutions to ensure sustainability of JE control during the next decade. This paper summarizes the key discussion points and recommendations to sustain and expand JE control.
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Affiliation(s)
| | - Susan L Hills
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | | | - Alan D Barrett
- Sealy Institute for Vaccine Sciences, Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Joachim Hombach
- Department of Immunizations, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | | | - Tom Solomon
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, and Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
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Calderón-Peláez MA, Velandia-Romero ML, Bastidas-Legarda LY, Beltrán EO, Camacho-Ortega SJ, Castellanos JE. Dengue Virus Infection of Blood-Brain Barrier Cells: Consequences of Severe Disease. Front Microbiol 2019; 10:1435. [PMID: 31293558 PMCID: PMC6606788 DOI: 10.3389/fmicb.2019.01435] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 06/06/2019] [Indexed: 01/10/2023] Open
Abstract
More than 500 million people worldwide are infected each year by any of the four-dengue virus (DENV) serotypes. The clinical spectrum caused during these infections is wide and some patients may develop neurological alterations during or after the infection, which could be explained by the cryptic neurotropic and neurovirulent features of flaviviruses like DENV. Using in vivo and in vitro models, researchers have demonstrated that DENV can affect the cells from the blood-brain barrier (BBB) in several ways, which could result in brain tissue damage, neuronal loss, glial activation, tissue inflammation and hemorrhages. The latter suggests that BBB may be compromised during infection; however, it is not clear whether the damage is due to the infection per se or to the local and/or systemic inflammatory response established or activated by the BBB cells. Similarly, the kinetics and cascade of events that trigger tissue damage, and the cells that initiate it, are unknown. This review presents evidence of the BBB cell infection with DENV and the response established toward it by these cells; it also describes the consequences of this response on the nervous tissue, compares these evidence with the one reported with neurotropic viruses of the Flaviviridae family, and shows the complexity and unpredictability of dengue and the neurological alterations induced by it. Clinical evidence and in vitro and in vivo models suggest that this virus uses the bloodstream to enter nerve tissue where it infects the different cells of the neurovascular unit. Each of the cell populations respond individually and collectively and control infection and inflammation, in other cases this response exacerbates the damage leaving irreversible sequelae or causing death. This information will allow us to understand more about the complex disease known as dengue, and its impact on a specialized and delicate tissue like is the nervous tissue.
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Post Vaccinal Temporary Sensorineural Hearing Loss. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081780. [PMID: 30126227 PMCID: PMC6121486 DOI: 10.3390/ijerph15081780] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/02/2018] [Accepted: 08/17/2018] [Indexed: 11/17/2022]
Abstract
In our systematic research we identified four studies concerning the onset of neurological adverse events following vaccination and two excluding this association. A 33-year-old Italian man, belonging to the Italian Army was hospitalized because he suffered from vertigo, nausea and sudden right hearing loss not classified (NDD), that set in 24 h after the administration of tetanus-diphtheria and meningococcal vaccines. Some neurological events arising after vaccination are very difficult to treat. In our case, the functional recovery on low and medium frequencies was possible about 6 months after the morbid event.
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Khan SA, Kakati S, Dutta P, Chowdhury P, Borah J, Topno R, Jadhav SM, Mohapatra PK, Mahanta J, Gupte MD. Immunogenicity & safety of a single dose of live-attenuated Japanese encephalitis vaccine SA 14-14-2 in adults. Indian J Med Res 2018; 144:886-892. [PMID: 28474625 PMCID: PMC5433281 DOI: 10.4103/ijmr.ijmr_712_15] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background & objectives: Japanese encephalitis (JE) caused by mosquito-borne Flavivirus is one of the leading causes of viral encephalitis in Asia. Control strategies include vector control and human vaccination. Due to lack of immunization programmes in endemic regions, there are still high mortality and morbidity. A live-attenuated SA 14-14-2 JE vaccine (LAJEV) has been licensed and used in Asian countries, including India. We report the assessment of immunogenicity and safety of the vaccine in adults during the first mass adult vaccination campaign carried out in Assam, India. Methods: One thousand and seventy five adults (aged ≥15 yr) who received LAJEV were monitored for adverse events following immunization for one year. The safety assessment of vaccinated population was evaluated till 28 days and at 6 and 12 months. Blood samples collected from the enrolled participants were tested by plaque reduction neutralization test (PRNT50) to assess the neutralizing antibody titres (NATs) before vaccination and 28 days, six and 12 months post-vaccination (PV). Results: Among the 1075 vaccinated individuals, four reported minor adverse effects from 30 min to 28 days PV. Based on the pre-vaccination NAT, the study participants were categorized as seronegative, moderately seropositive and strongly seropositive. Nearly 85.5 per cent of JE seronegative participants seroconverted by 28 days PV. The geometric mean titre (GMT) in all the three groups increased by 28 days and decreased by six and 12 months PV. Nearly 60 per cent of the moderately positive individuals exhibited four-fold rise in GMT, 28 days PV. Almost 95.5 per cent of the participants in the study population remained seroprotected at the end of 12 months PV. Interpretation & conclusions: This study on immunogenicity and safety of LAJEV in adults showed that a single dose of the live-attenuated vaccine was safe and induced protective immunity to both JE seronegative and naturally seropositive adults. Further study is required to find out long term protective efficacy of this vaccine.
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Affiliation(s)
- Siraj Ahmed Khan
- ICMR-Regional Medical Research Centre (NE Region), Dibrugarh, Assam, India
| | - Sanjeeb Kakati
- Department of Medicine, Assam Medical College & Hospital, Dibrugarh, Assam, India
| | - Prafulla Dutta
- ICMR-Regional Medical Research Centre (NE Region), Dibrugarh, Assam, India
| | - Purvita Chowdhury
- ICMR-Regional Medical Research Centre (NE Region), Dibrugarh, Assam, India
| | - Jani Borah
- ICMR-Regional Medical Research Centre (NE Region), Dibrugarh, Assam, India
| | - Rashmee Topno
- ICMR-Regional Medical Research Centre (NE Region), Dibrugarh, Assam, India
| | | | | | - Jagadish Mahanta
- ICMR-Regional Medical Research Centre (NE Region), Dibrugarh, Assam, India
| | - Mohan D Gupte
- ICMR Chair in Epidemiology, Indian Council of Medical Research, New Delhi, India
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Hegde NR, Gore MM. Japanese encephalitis vaccines: Immunogenicity, protective efficacy, effectiveness, and impact on the burden of disease. Hum Vaccin Immunother 2017; 13:1-18. [PMID: 28301270 DOI: 10.1080/21645515.2017.1285472] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Japanese encephalitis (JE) is a serious public health concern in most of Asia. The disease is caused by JE virus (JEV), a flavivirus transmitted by Culex mosquitoes. Several vaccines have been developed to control JE in endemic areas as well as to protect travelers and military personnel who visit or are commissioned from non-endemic to endemic areas. The vaccines include inactivated vaccines produced in mouse brain or cell cultures, live attenuated vaccines, and a chimeric vaccine based on the live attenuated yellow fever virus 17D vaccine strain. All the marketed vaccines belong to the JEV genotype III, but have been shown to be efficacious against other genotypes and strains, with varying degrees of cross-neutralization, albeit at levels deemed to be protective. The protective responses have been shown to last three or more years, depending on the type of vaccine and the number of doses. This review presents a brief account of the different JE vaccines, their immunogenicity and protective ability, and the impact of JE vaccines in reducing the burden of disease in endemic countries.
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Affiliation(s)
- Nagendra R Hegde
- a Ella Foundation, Genome Valley , Turkapally, Shameerpet Mandal , Hyderabad , India
| | - Milind M Gore
- b National Institute of Virology, Indian Council of Medical Research , Pune , India
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Kwon HJ, Lee SY, Kim KH, Kim DS, Cha SH, Jo DS, Kang JH. The Immunogenicity and Safety of the Live-attenuated SA 14-14-2 Japanese Encephalitis Vaccine Given with a Two-dose Primary Schedule in Children. J Korean Med Sci 2015; 30:612-6. [PMID: 25931793 PMCID: PMC4414646 DOI: 10.3346/jkms.2015.30.5.612] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 12/10/2014] [Indexed: 11/25/2022] Open
Abstract
Effective and tolerable vaccination is an essential strategy to prevent Japanese encephalitis (JE) in endemic areas. Although the live attenuated SA 14-14-2 JE vaccine (LAJEV) has been widely used since its introduction, the systemic data of LAJEV was very rarely available in Korea. We conducted the open-label, prospective cohort study to assess the immunogenicity and safety of this vaccine. Ninety subjects were enrolled, and LAJEV in a 2-dose primary series was given with a 12-month interval. Neutralizing antibody titers were measured before and after each vaccination, and active monitoring for adverse events was performed. After the first dose, 91.1% of subjects had seroprotection with a geometric mean titer (GMT) of 40.9. Seroprotection rate after the second dose was 97%, and GMT showed an increase of 6.5-fold. Most adverse events following immunization were self-limited, and no serious adverse events were reported until 42 days after each dose. The 2-dose administration of LAJEV in the primary immunization schedule appeared to be highly immunogenic and safe.
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Affiliation(s)
- Hyo Jin Kwon
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Soo Young Lee
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ki Hwan Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Soo Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Ho Cha
- Department of Pediatrics, Kyunghee University College of Medicine, Seoul, Korea
| | - Dae Sun Jo
- Department of Pediatrics, Chonbuk National University College of Medicine, Jeonju, Korea
| | - Jin Han Kang
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
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Post-marketing surveillance of live-attenuated Japanese encephalitis vaccine safety in China. Vaccine 2014; 32:5875-9. [DOI: 10.1016/j.vaccine.2014.08.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 07/31/2014] [Accepted: 08/01/2014] [Indexed: 11/22/2022]
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Safety of Japanese encephalitis live attenuated vaccination in post-marketing surveillance in Guangdong, China, 2005-2012. Vaccine 2014; 32:1768-73. [PMID: 24503272 DOI: 10.1016/j.vaccine.2013.11.107] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 11/25/2013] [Accepted: 11/28/2013] [Indexed: 11/24/2022]
Abstract
We reviewed the adverse events following immunization of live attenuated Japanese encephalitis vaccine in Guangdong Province, China. During the period of 2005-2012, 23 million doses of live attenuated Japanese encephalitis vaccine were used and 1426 adverse events were reported (61.24 per million doses); of which, 570 (40%) were classified as allergic reactions (24.48 per million doses), 31 (2%) were neurologic events (1.33 per million doses), and 36 (2.5%) were diagnosed as serious adverse events (1.55 per million doses). This study suggests that the JEV-L has a reasonable safety profile, most adverse events are relatively mild, with relatively rare neurologic events being observed.
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Li X, Ma SJ, Liu X, Jiang LN, Zhou JH, Xiong YQ, Ding H, Chen Q. Immunogenicity and safety of currently available Japanese encephalitis vaccines: a systematic review. Hum Vaccin Immunother 2014; 10:3579-93. [PMID: 25668666 PMCID: PMC4514081 DOI: 10.4161/21645515.2014.980197] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/26/2014] [Accepted: 09/05/2014] [Indexed: 11/19/2022] Open
Abstract
A number of Japanese encephalitis (JE) vaccines have been used for preventing Japanese encephalitis around the world. We here reviewed the immunogenicity and safety of the currently available Japanese encephalitis vaccines. We searched Pubmed, Embase, Web of Science, the Cochrane Library and other online databases up to March 25, 2014 for studies focusing on currently used JE vaccines in any language. The primary outcomes were the seroconversion rate against JEV and adverse events. Meta-analysis was performed for the primary outcome when available. A total of 51 articles were included. Studies were grouped on the basic types of vaccines. This systematic review led to 2 aspects of the conclusions. On one hand, all the currently available JE vaccines are safe and effective. On the other hand, the overall of JE vaccine evaluation is disorganized, the large variation in study designs, vaccine types, schedules, doses, population and few hand-to-hand trails, make direct comparisons difficult. In order to make a more evidence-based decision on optimizing the JE vaccine, it is warranted to standardize the JE vaccine evaluation research.
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Key Words
- ACIP, The Advisory Committee on Immunization Practices
- AEs, Adverse events
- CENTRAL, Cochrane Central Register of Controlled Trials
- CIs, Confidence intervals
- DARE, Database of Abstracts of Reviews of Effects
- GMTs, Geometric mean titers
- HAART, Highly active antiretroviral therapy
- JE, Japanese encephalitis
- JE-CV, Chimeric live-attenuated JE vaccine
- JEV, Japanese encephalitis virus
- Japanese encephalitis vaccine
- LILACS, Latin American and Caribbean Health Sciences Literature
- MBJEV, Mouse brain–derived inactivated vaccines
- MMR, Measles mumps rubella vaccine
- NIP, National Immunization Program
- NOS, Newcastle–Ottawa scale
- ORs, Odd ratios
- PHK, Primary hamster kidney cells
- PRNT50, Plaque-reduction neutralization tests
- RCTs, Randomized controlled trials
- TBE, Tick-borne encephalitis vaccine
- TGPO, Thai Governmental Pharmaceutical Organization
- WHO, World Health Organization
- YF-VAX, Yellow fever vaccine
- YFV, Yellow fever virus
- YFV17D, Yellow fever virus 17D vaccine strain
- immunogenicity
- meta-analysis
- safety
- systematic review
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Affiliation(s)
- Xing Li
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Shu-Juan Ma
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Xie Liu
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Li-Na Jiang
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Jun-Hua Zhou
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Yi-Quan Xiong
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Hong Ding
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
| | - Qing Chen
- Department of Epidemiology; School of Public Health and Tropical Medicine; Southern Medical University; Guangzhou, China
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Schulze C. A 44-year-old patient with a new-onset seizure disorder after vaccination against Japanese encephalitis: a case report. J Med Case Rep 2013; 7:66. [PMID: 23497732 PMCID: PMC3602056 DOI: 10.1186/1752-1947-7-66] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 12/13/2012] [Indexed: 11/26/2022] Open
Abstract
Introduction Seizure disorders can have a wide variety of causes. In many cases, however, the underlying cause remains unknown. Vaccinations, for example, can trigger seizures, especially during childhood. In the literature, many cases have been reported in which febrile convulsions occurred after the administration of different types of vaccines, such as the measles, mumps and rubella vaccine or the tetanus and diphtheria vaccine. Only a few cases of epilepsy after vaccination have thus far been described in adults. Case presentation In the case reported here, a 44-year-old German Caucasian man working as a soldier had a seizure the day after he received a third dose of Japanese encephalitis vaccine. Before this vaccination, he had received multiple vaccines that he had tolerated well. He underwent several drug therapies at various institutions but has continued to experience different forms of seizures for more than 18 months. The intervals between seizures were approximately six weeks in length. The present work discusses our patient’s history, including all diagnostic procedures and results, as well as treatment approaches. None of the examinations revealed a possible cause for the seizures. Since no structural or genetic causes were detected, the seizures were deemed most likely to have been caused by the vaccinations, especially vaccination against Japanese encephalitis. To date, no medication has prevented our patient from having repeated attacks. Conclusions To the best of our knowledge there have been no previous cases reported in the literature where seizures occurred after multiple vaccinations in general or after vaccinations against Japanese encephalitis in particular. Although vaccines are tested before release, the appearance of new adverse reactions cannot be prevented in all cases. Seizure after vaccination is difficult to treat. In our patient’s case, different approaches have not led to a satisfying result to date.
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