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Kitro A, Imad HA, Pisutsan P, Matsee W, Sirikul W, Sapbamrer R, Rapheal E, Fernandez S, Cotrone TS, Farmer AR, Hunsawong T, Silachamroon U, Chatapat L, Olanwijitwong J, Salee P, Anderson KB, Piyaphanee W. Seroprevalence of dengue, Japanese encephalitis and Zika among long-term expatriates in Thailand. J Travel Med 2024; 31:taae022. [PMID: 38335250 DOI: 10.1093/jtm/taae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Travel to Southeast Asia increases the likelihood of acquiring mosquito-borne Flavivirus infections such as dengue (DENV), Japanese encephalitis (JEV) and Zika viruses (ZIKV). Expatriates are long-term travellers who have a higher risk of mosquito-borne illness at their destination country. The purpose of this study was to evaluate the seroprevalence of DENV, JEV and ZIKV infections and the determinants contributing to seropositivity among expatriates living in Thailand. METHODS A cross-sectional study was performed from December 2017 to February 2020. Expatriates from non-Flavivirus endemic countries were recruited. 5 mL of blood was collected for DENV 1-4, JEV and ZIKV antibody testing by plaque reduction neutralization test (PRNT50). Individuals with vaccination histories or diagnoses for dengue, Japanese encephalitis, yellow fever and tick-borne encephalitis were excluded. RESULTS Among 254 participants, most participants (83.1%) were male, the mean age was 65 years and the median duration of stay in Thailand was 6 years. Seroprevalence rate of any Flavivirus, non-specific DENV, DENV1-4, JEV and ZIKV were 34.3, 30.7, 20.5, 18.1, 18.9, 10.6, 4.7 and 2.8%, respectively. The presence of neutralizing antibodies against DENV1-4 positively correlates with the duration of stay in Thailand. DENV seropositivity was associated with living in urban areas (aOR 2.75, 95% CI 1.36-5.57). Expatriates were unlikely to have detectable anti-JEV antibodies regardless of time spent in a JEV-endemic area. No risk factors were identified that were significantly associated with JEV or ZIKV seropositivity. Only 48.4% received pre-travel counselling services, while only 18.9% visited a travel medicine specialist. CONCLUSIONS A high proportion (34.3%) of long-term expatriates living in Thailand were seropositive for flavivirus, mainly from dengue (30.7%). To minimize risk, travel medicine practitioners should provide adequate pre-travel health risk information on mosquito-borne flavivirus infection and offer advice on mosquito bite prevention strategies. Dengue vaccine might be considered in high-risk travellers such as long-term expatriate.
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Affiliation(s)
- Amornphat Kitro
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Environmental and Occupational Medicine Excellence Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Hisham Ahmed Imad
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Center for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Suita 565-0871, Japan
| | - Phimphan Pisutsan
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wasin Matsee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wachiranun Sirikul
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center of Data Analytics and Knowledge Synthesis for Health Care, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Environmental and Occupational Medicine Excellence Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Erica Rapheal
- School of Public Health, University of Minnesota, Minnesota, MN 55414, USA
| | - Stefan Fernandez
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Thomas S Cotrone
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Aaron R Farmer
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Taweewun Hunsawong
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Udomsak Silachamroon
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Lapakorn Chatapat
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Jutarmas Olanwijitwong
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Parichat Salee
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Kathryn B Anderson
- Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Watcharapong Piyaphanee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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2
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Dai YC, Sy AK, Jiz M, Tsai JJ, Bato J, Quinoñes MA, Reyes MAJ, Wang WK. Identification of prior dengue-naïve Dengvaxia recipients with an increased risk for symptomatic dengue during fever surveillance in the Philippines. Front Immunol 2023; 14:1202055. [PMID: 37554332 PMCID: PMC10405517 DOI: 10.3389/fimmu.2023.1202055] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/07/2023] [Indexed: 08/10/2023] Open
Abstract
Introduction Dengue virus (DENV) is the leading cause of mosquito-borne viral diseases in humans. Dengvaxia, the first licensed dengue vaccine, is recommended for DENV-seropositive individuals aged 9-45 years. In the Philippines, Dengvaxia was administered to more than 830,000 children without prior serological testing in 2016-2017. Subsequently, it was revealed that DENV-seronegative children who received Dengvaxia developed severe disease following breakthrough DENV infection. As a result, thousands of children participating in the mass vaccination campaign were at higher risk of severe dengue disease. It is vital that an assay that identifies baseline DENV-naïve Dengvaxia recipients be developed and validated. This would permit more frequent and extensive assessments and timely treatment of breakthrough DENV infections. Methods We evaluated the performance of a candidate assay, the DENV1-4 nonstructural protein 1 (NS1) IgG enzyme-linked immunosorbent assay (ELISA), developed by the University of Hawaii (UH), using well-documented serum/plasma samples including those >20 years post-DENV infection, and tested samples from 199 study participants including 100 Dengvaxia recipients from the fever surveillance programs in the Philippines. Results The sensitivity and specificity of the assay were 96.6% and 99.4%, respectively, which are higher than those reported for pre-vaccination screening. A significantly higher rate of symptomatic breakthrough DENV infection was found among children that were DENV-naïve (10/23) than among those that were DENV-immune (7/53) when vaccinated with Dengvaxia (p=0.004, Fisher's exact test), demonstrating the feasibility of the assay and algorithms in clinical practice. Conclusion The UH DENV1-4 NS1 IgG ELISA can determine baseline DENV serostatus among Dengvaxia recipients not only during non-acute dengue but also during breakthrough DENV infection, and has implications for assessing the long-term safety and effectiveness of Dengvaxia in the post-licensure period.
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Affiliation(s)
- Yu-Ching Dai
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Ava Kristy Sy
- National Reference Laboratory for Dengue and Other Arboviruses, Virology Department, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Mario Jiz
- Immunology Department, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Joan Bato
- National Reference Laboratory for Dengue and Other Arboviruses, Virology Department, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Mary Ann Quinoñes
- National Reference Laboratory for Dengue and Other Arboviruses, Virology Department, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Mary Anne Joy Reyes
- National Reference Laboratory for Dengue and Other Arboviruses, Virology Department, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Wei-Kung Wang
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
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Samrat SK, Bashir Q, Huang Y, Trieshmann CW, Tharappel AM, Zhang R, Chen K, Geoge Zheng Y, Li Z, Li H. Broad-Spectrum Small-Molecule Inhibitors Targeting the SAM-Binding Site of Flavivirus NS5 Methyltransferase. ACS Infect Dis 2023; 9:1319-1333. [PMID: 37348028 PMCID: PMC10436986 DOI: 10.1021/acsinfecdis.2c00571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Flavivirus infections, such as those caused by dengue virus (DENV), West Nile virus (WNV), yellow fever virus (YFV), and Zika virus (ZIKV), pose a rising threat to global health. There are no FDA-approved drugs for flaviviruses, although a small number of flaviviruses have vaccines. For flaviviruses or unknown viruses that may appear in the future, it is particularly desirable to identify broad-spectrum inhibitors. The NS5 protein is regarded as one of the most promising flavivirus drug targets because it is conserved across flaviviruses. In this study, we used FL-NAH, a fluorescent analog of the methyl donor S-adenosyl methionine (SAM), to develop a fluorescence polarization (FP)-based high throughput screening (HTS) assay to specifically target methyltransferase (MTase), a vital enzyme for flaviviruses that methylates the N7 and 2'-O positions of the viral 5'-RNA cap. Pilot screening identified two candidate MTase inhibitors, NSC 111552 and 288387. The two compounds inhibited the FL-NAH binding to the DENV3 MTase with low micromolar IC50. Functional assays verified the inhibitory potency of these molecules for the flavivirus MTase activity. Binding studies indicated that these molecules are bound directly to the DENV3 MTase with similar low micromolar affinity. Furthermore, we showed that these compounds greatly reduced ZIKV replication in cell-based experiments at dosages that did not cause cytotoxicity. Finally, docking studies revealed that these molecules bind to the SAM-binding region on the DENV3 MTase, and further mutagenesis studies verified residues important for the binding of these compounds. Overall, these compounds are innovative and attractive candidates for the development of broad-spectrum inhibitors for the treatment of flavivirus infections.
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Affiliation(s)
- Subodh Kumar Samrat
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Qamar Bashir
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Yiding Huang
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Carl William Trieshmann
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia, 30602, USA
| | - Anil Mathew Tharappel
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Ran Zhang
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Ke Chen
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Y. Geoge Zheng
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia, 30602, USA
| | - Zhong Li
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Hongmin Li
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
- Department of Chemistry and Biochemistry, College of Science & College of Medicine, The University of Arizona, Tucson AZ, 85721, USA
- The BIO5 Institute, The University of Arizona, Tucson, AZ 85721, USA
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4
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Thomas SJ. Is new dengue vaccine efficacy data a relief or cause for concern? NPJ Vaccines 2023; 8:55. [PMID: 37061527 PMCID: PMC10105158 DOI: 10.1038/s41541-023-00658-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/29/2023] [Indexed: 04/17/2023] Open
Abstract
Dengue is a major global public health problem requiring a safe and efficacious vaccine as the foundation of a comprehensive countermeasure strategy. Despite decades of attempts, the world has a single dengue vaccine licensed in numerous countries, but restrictions and conditions of its use have deterred uptake. Recently, clinical efficacy data has been revealed for two additional dengue vaccine candidates and the data appears encouraging. In this perspective I discuss dengue, the complexities of dengue vaccine development, early development setbacks, and how the latest data from the field may be cause for measured optimism. Finally, I provide some perspectives on evaluating dengue vaccine performance and how the pursuit of the perfect dengue vaccine may prevent advancement of vaccines which are good enough.
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Affiliation(s)
- Stephen J Thomas
- SUNY Upstate Medical University, Institute for Global Health and Translational Sciences, Syracuse, NY, USA.
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5
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Seesen M, Jearanaiwitayakul T, Limthongkul J, Midoeng P, Sunintaboon P, Ubol S. A bivalent form of nanoparticle-based dengue vaccine stimulated responses that potently eliminate both DENV-2 particles and DENV-2-infected cells. Vaccine 2023; 41:1638-1648. [PMID: 36740559 DOI: 10.1016/j.vaccine.2023.01.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/03/2022] [Accepted: 01/25/2023] [Indexed: 02/05/2023]
Abstract
Dengue is the most prevalent mosquito-borne viral disease and continues to be a global public health concern. Although a licensed dengue vaccine is available, its efficacy and safety profile are not satisfactory. Hence, there remains a need for a safe and effective dengue vaccine. We are currently developing a bivalent dengue vaccine candidate. This vaccine candidate is composed of a C-terminus truncated non-structural protein 1 (NS11-279) and envelope domain III (EDIII) of DENV-2 encapsidated in the nanocarriers, N, N, N-trimethyl chitosan nanoparticles (TMC NPs). The immunogenicity of this bivalent vaccine candidate was investigated in the present study using BALB/c mice. In this work, we demonstrate that NS1 + EDIII TMC NP-immunized mice strongly elicited antigen-specific antibody responses (anti-NS1 and anti-EDIII IgG) and T-cell responses (NS1- and EDIII-specific-CD4+ and CD8+ T cells). Importantly, the antibody response induced by NS1 + EDIII TMC NPs provided antiviral activities against DENV-2, including serotype-specific neutralization and antibody-mediated complement-dependent cytotoxicity. Moreover, the significant upregulation of Th1- and Th2-associated cytokines, as well as the increased levels of antigen-specific IgG2a and IgG1, indicated a balanced Th1/Th2 response. Collectively, our findings suggest that NS1 + EDIII TMC NPs induced protective responses that can not only neutralize infectious DENV-2 but also eliminate DENV-2-infected cells.
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Affiliation(s)
- Mathurin Seesen
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Tuksin Jearanaiwitayakul
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand; Department of Clinical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | - Jitra Limthongkul
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Panuwat Midoeng
- Division of Pathology, Army Institute of Pathology, Phramongkutklao Hospital, Bangkok, Thailand
| | - Panya Sunintaboon
- Department of Chemistry, Faculty of Science, Mahidol University, Salaya, Nakornpatom, Thailand
| | - Sukathida Ubol
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand.
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Sitarz R, Forma A, Karakuła K, Juchnowicz D, Baj J, Bogucki J, Rog J, Tee ML, Tee CA, Ly-Uson JT, Islam MS, Sikder MT, El-Monshed AH, Loutfy A, Qureshi MFH, Abbas M, Taseen S, Lakhani M, Wang C, Wan X, Tan Y, Pan R, Ho R, Jayakumar S, Ilango S, Kumar S, Ruiz-Chow ÁA, Iturbide A, González-Mille DD, Doan LP, Karakuła-Juchnowicz H. To Vaccinate or Not to Vaccinate-Reasons of Willingness and Reluctance of Students against SARS-CoV-2 Vaccination-An International Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114012. [PMID: 36360893 PMCID: PMC9657911 DOI: 10.3390/ijerph192114012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 06/02/2023]
Abstract
Despite the vaccine against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) being reported to be safe and effective, the unwillingness to vaccinate and doubts are still common. The aim of this international study was to assess the major reasons for the unwillingness to vaccinate in a group of students from Poland (n = 1202), Bangladesh (n = 1586), India (n = 484), Mexico (n = 234), Egypt (n = 566), Philippines (n = 2076), Pakistan (n = 506), Vietnam (n = 98) and China (n = 503). We conducted an online cross-sectional study that aimed to assess (1) the percentage of vaccinated and unvaccinated students and (2) the reasons associated with willingness/unwillingness to the vaccine. The study included 7255 respondents from 9 countries with a mean age of 21.85 ± 3.66 years. Only 22.11% (n = 1604) of students were vaccinated. However, the majority (69.25%, n = 5025) expressed a willingness to be vaccinated. More willing to vaccinate were students in informal relationships who worked mentally, used psychological/psychiatric services before the pandemic, and studied medicine. There are cultural differences regarding the reasons associated with the unwillingness to vaccinate, but some 'universal' might be distinguished that apply to the whole group.
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Affiliation(s)
- Ryszard Sitarz
- I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-059 Lublin, Poland
| | - Alicja Forma
- I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-059 Lublin, Poland
- Department of Forensic Medicine, Medical University of Lublin, 20-059 Lublin, Poland
| | - Kaja Karakuła
- I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-059 Lublin, Poland
- Department of Forensic Medicine, Medical University of Lublin, 20-059 Lublin, Poland
| | - Dariusz Juchnowicz
- Department of Psychiatry and Psychiatric Nursing, Medical University of Lublin, 20-059 Lublin, Poland
| | - Jacek Baj
- Department of Anatomy, Medical University of Lublin, 20-059 Lublin, Poland
| | - Jacek Bogucki
- Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Lublin, 20-059 Lublin, Poland
| | - Joanna Rog
- I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-059 Lublin, Poland
| | - Michael L. Tee
- College of Medicine, University of the Philippines Manila, Manila 1000, Philippines
| | - Cherica A. Tee
- College of Medicine, University of the Philippines Manila, Manila 1000, Philippines
| | - Josefina T. Ly-Uson
- College of Medicine, University of the Philippines Manila, Manila 1000, Philippines
| | - Md. Saiful Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
- Centre for Advanced Research Excellence in Public Health, Savar, Dhaka 1342, Bangladesh
| | - Md. Tajuddin Sikder
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Ahmed Hashem El-Monshed
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Mansoura University, Mansoura 35511, Egypt
- Nursing Department, College of Health and Sport Sciences, University of Bahrain, Manama 32038, Bahrain
| | - Ahmed Loutfy
- Department of Pediatric Nursing, Faculty of Nursing, Beni-Suef University, Beni-Suef 62521, Egypt
| | | | - Munib Abbas
- Department of Medicine, Karachi Medical and Dental College, North Nazimabad, Karachi 74700, Pakistan
| | - Shafaq Taseen
- Department of Medicine, Karachi Medical and Dental College, North Nazimabad, Karachi 74700, Pakistan
| | - Mahira Lakhani
- Medical College, Ziauddin Medical University, Saharah-e-Ghalib, Clifton, Karachi 75600, Pakistan
| | - Cuiyan Wang
- Faculty of Education, Huaibei Normal University, Huaibei 235000, China
| | - Xiaoyang Wan
- Faculty of Education, Huaibei Normal University, Huaibei 235000, China
| | - Yilin Tan
- Faculty of Education, Huaibei Normal University, Huaibei 235000, China
| | - Riyu Pan
- Anqing Normal University, Anqing 246133, China
| | - Roger Ho
- Department of Psychological Medicine, National University of Singapore, Singapore 117599, Singapore
| | - Saikarthik Jayakumar
- Department of Basic Medical Science and Department of Medical Education, College of Dentistry, Al Zulfi, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Saraswathi Ilango
- Madha Medical College and Research Institute, Kovoor, Chennai 600128, India
| | - Senthil Kumar
- Madha Medical College and Research Institute, Kovoor, Chennai 600128, India
| | | | | | | | | | - Hanna Karakuła-Juchnowicz
- I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-059 Lublin, Poland
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Seesen M, Jearanaiwitayakul T, Limthongkul J, Sunintaboon P, Ubol S. Mice immunized with trimethyl chitosan nanoparticles containing DENV-2 envelope domain III elicit neutralizing antibodies with undetectable antibody-dependent enhancement activity. J Gen Virol 2022; 103. [PMID: 35833704 DOI: 10.1099/jgv.0.001768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Dengue is a disease that poses a significant global public health concern. Although a tetravalent live-attenuated dengue vaccine has been licensed, its efficacy is still debated due to evidence of vaccine breakthrough infection. To avoid this issue, dengue vaccines should stimulate a high degree of serotype-specific response. Thus, envelope domain III (EDIII), which contains serotype-specific neutralizing epitopes, is an attractive target for dengue vaccine development. In this study, we investigated how EDIII encapsidated in N, N, N-trimethyl chitosan chloride nanoparticles (TMC NPs) stimulates a serotype-specific response and whether this response exerts a potential in vitro breakthrough infection. The immune response to DENV-2 elicited by EDIII TMC NP-immunized mice was monitored. We demonstrated that immunization with EDIII TMC NPs resulted in a high level of anti-EDIII antibody production. These antibodies included IgG, IgG1, and IgG2a subtypes. Importantly, antibodies from the immunized mice exerted efficient neutralizing activity with undetectable antibody dependent enhancement (ADE) activity. We also found that EDIII TMC NPs activated functional EDIII-specific CD4+ and CD8+ T cell responses. In conclusion, EDIII TMC NPs stimulated humoral immunity with a strong neutralizing antibody response, as well as a cellular immune response against DENV-2.
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Affiliation(s)
- Mathurin Seesen
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | | | - Jitra Limthongkul
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
| | - Panya Sunintaboon
- Department of Chemistry, Faculty of Science, Mahidol University, Salaya, Nakornpatom 73170, Thailand
| | - Sukathida Ubol
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
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Thomas S, Abraham A, Callaghan PJ, Rappuoli R. Challenges for Vaccinologists in the First Half of the Twenty-First Century. Methods Mol Biol 2022; 2410:3-25. [PMID: 34914040 DOI: 10.1007/978-1-0716-1884-4_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic of 2020-2021 has highlighted the importance of vaccines and vaccination in human health. The pandemic has resulted in social distancing, travel restrictions, decreased trade, high unemployment, commodity price decline, and financial stress that has impacted the global economy. Since December 2020, a massive vaccination campaign is undergoing in every country on the planet to protect against SARS-CoV-2. Vaccination is the cheapest health-care interventions that can save more lives than any other drugs or therapies. Some of the common diseases of the twentieth century including smallpox and polio are seldom reported due to intense vaccination programs that eradicated it. Smallpox is completely eradicated globally; whereas, polio is confined to only a couple of countries. Vaccination has not only improved the health of man but also improved food security by preventing diseases in farm animals and aquacultured fish. Awareness of the principles of immunology and novel vaccines has led to effective vaccination strategies. Climate change could lead to generation of new strains of infectious microorganisms that would require development of novel vaccines. Recent years have seen the increase in incidence of brain-eating amoeba and flesh-eating bacteria (necrotizing fasciitis). There are no vaccines for these diseases. Though vaccination programs have eradicated several diseases and increased the quality of life, there are several diseases that have no effective vaccines. Currently there are no vaccines for cancer, neurodegenerative diseases, autoimmune diseases, as well as infectious diseases like tuberculosis, AIDS, and parasitic diseases including malaria. Spontaneous evolution of pathogenic microorganisms may lead to pandemics that impact the health of not only humanity but also other animals. Hence, the challenge to vaccinologists is the development of novel vaccines and vaccination strategies within limited time period and using minimum resources. In addition, the vaccine developed should be administered globally within a short duration so as to prevent generation of pathogenic variants more lethal than the parent strain.
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Affiliation(s)
- Sunil Thomas
- Lankenau Institute for Medical Research, Wynnewood, USA.
| | - Ann Abraham
- Lankenau Institute for Medical Research, Wynnewood, USA
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Mendoza RU, Dayrit MM, Alfonso CR, Ong MMA. Public trust and the COVID-19 vaccination campaign: lessons from the Philippines as it emerges from the Dengvaxia controversy. Int J Health Plann Manage 2021; 36:2048-2055. [PMID: 34414601 PMCID: PMC8426681 DOI: 10.1002/hpm.3297] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 06/24/2021] [Accepted: 07/28/2021] [Indexed: 11/06/2022] Open
Abstract
While the entire world prepares and begins to roll out COVID-19 vaccines, the Philippines is still reeling from the consequences of the Dengvaxia controversy in 2016. Those highly political events led to the erosion of public trust in leaders and a significant damage to vaccine confidence in the country, now potentially impacting the uptake of COVID-19 vaccines. We discuss how public trust and confidence can be rehabilitated through accountability, transparency, and proper communication from the most trusted sources of the population. We also highlight key lessons for policymakers and leaders on allowing science to take the front seat, and politics behind, for the safety and well-being of the people during this public health crisis.
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Affiliation(s)
- Ronald U Mendoza
- School of Government, Ateneo de Manila University, Quezon City, Philippines
| | - Manuel M Dayrit
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
| | - Cenon R Alfonso
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
| | - Madeline Mae A Ong
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
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10
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Fongwen N, Delrieu I, Ham LH, Gubler DJ, Durbin A, Ooi EE, Peeling RW, Flasche S, Hartigan-Go K, Clifford S, Martinez CT, de Lamballerie X, Barnighausen T, Wilder-Smith A. Implementation strategies for the first licensed dengue vaccine: A meeting report. Vaccine 2021; 39:4759-4765. [PMID: 34253416 DOI: 10.1016/j.vaccine.2021.06.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 06/21/2021] [Accepted: 06/27/2021] [Indexed: 01/18/2023]
Abstract
Dengue vaccination would enhance the control of dengue, one of the most frequent vector-borne viral diseases globally. CYD-TDV is the first dengue vaccine to be licensed, but global uptake has been hampered due to its use being limited to seropositive persons aged 9 years and above, and the need for a 3-dose schedule. The Partnership for Dengue Control (PDC) organized a meeting with key opinion leaders and stakeholders to deliberate on implementation strategies for the use of CYD-TDV. New data have emerged that support the shortening of the primary schedule from a 3 to 2 dose schedule, extending the age range below 9 to 6 years of age, and expanding the indication from endemic populations to also include travelers to endemic areas. Cost-effectiveness may improve with the modified 2-dose regimen and with multiple testing. Strategies to implement a dengue vaccination program have been developed, in particular school-based strategies. A range of delivery scenarios can then be considered, using various settings for each step of the intervention. However, several challenges remain, including communication about limiting the use of this vaccine to seropositive individuals only. Affordability will vary from country to country, as will government commitment and community acceptance. Well-tailored communication strategies that target key stakeholders are expected to make up a significant part of any future dengue vaccination program.
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Affiliation(s)
- Noah Fongwen
- International Diagnostics Centre, London School of Hygiene and Tropical Medicine, United Kingdom
| | | | | | - Duane J Gubler
- Partnership for Dengue Control, Fondation Merieux, France
| | | | | | - Rosanna W Peeling
- International Diagnostics Centre, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Stefan Flasche
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | | | - Sam Clifford
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Carlos Torres Martinez
- Director of Cafettor Medical, Professor of Pediatric Infectious Diseases, Universidad del Bosque, in Bogotá, Colombia
| | - Xavier de Lamballerie
- UMR IRD 190, Inserm 1207 "Unité des Virus Émergents", Aix-Marseille Université - Institut de Recherche pour le Développement - Institut National de la Santé et de la Recherche Médicale - Institut de Recherche Biomédicale des Armées - Établissement Français du Sang, France
| | - Till Barnighausen
- Heidelberg Institute of Global Health, University of Heidelberg, Germany
| | - Annelies Wilder-Smith
- Heidelberg Institute of Global Health, University of Heidelberg, Germany; Institute for Social and Preventive Medicine, University of Bern, Switzerland.
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11
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Effectiveness of a single-dose mass dengue vaccination in Cebu, Philippines: A case-control study. Vaccine 2021; 39:5318-5325. [PMID: 34373121 DOI: 10.1016/j.vaccine.2021.07.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Dengue fever is an important public health problem in the Philippines. In April 2016, the Department of Health launched a three-dose school based dengue vaccination program of nine- to fourteen-year-old children in three regions with the highest number of dengue cases using CYD-TDV (Dengvaxia, Sanofi Pasteur). In July 2017, a community-based dengue vaccination program was implemented in Cebu province. The program was discontinued in December 2017 amidst public controversy, after the first dose had been administered. We assessed the effectiveness of a single dose of CYD-TDV against hospitalized virologically confirmed dengue (VCD). METHODS We conducted a case-control study in Cebu province following the dengue mass vaccination. Children who were nine to fourteen years of age during the mass vaccination and subsequently admitted to any of four participating public hospitals with suspected dengue were enrolled in the study as cases. Blood for RT-PCR and clinical and socio-demographic information were obtained. To estimate the level of vaccine protection, vaccination status was compared between children with hospitalized virologically confirmed dengue and controls of the same six-year age-group as the cases, matched on sex, neighborhood and time of occurrence of cases. FINDINGS We enrolled 490 cases and 980 controls. Receipt of one dose of CYD-TDV was associated with 26% (95 % CI, -2 to 47%; p = 0 0675) overall protection against hospitalized virologically confirmed dengue and 51% (95 % CI, 23 to 68; p = 0 0016) protection against dengue with warning signs. INTERPRETATION A single dose of CYD-TDV given to nine to fourteen-year-old children through a community-based mass vaccination program conferred protection against dengue with warning signs and severe dengue but we were unable to conclude on protection against milder illness.
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12
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Sikdar A, Gupta R, Boura E. Reviewing Antiviral Research Against Viruses Causing Human Diseases - A Structure Guided Approach. Curr Mol Pharmacol 2021; 15:306-337. [PMID: 34348638 DOI: 10.2174/1874467214666210804152836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 11/22/2022]
Abstract
The littlest of all the pathogens, viruses have continuously been the foremost strange microorganisms to consider. Viral Infections can cause extreme sicknesses as archived by the HIV/AIDS widespread or the later Ebola or Zika episodes. Apprehensive framework distortions are too regularly watched results of numerous viral contaminations. Besides, numerous infections are oncoviruses, which can trigger different sorts of cancer. Nearly every year a modern infection species rises debilitating the world populace with an annihilating episode. Subsequently, the need of creating antivirals to combat such rising infections. In any case, from the innovation of to begin with antiviral medicate Idoxuridine in 1962 to the revelation of Baloxavir marboxil (Xofluza) that was FDA-approved in 2018, the hone of creating antivirals has changed significantly. In this article, different auxiliary science strategies have been described that can be referral for therapeutics innovation.
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Affiliation(s)
- Arunima Sikdar
- Department of Hematology and Oncology, School of Medicine, The University of Tennessee Health Science Center, 920 Madison Ave, P.O.Box-38103, Memphis, Tennessee. United States
| | - Rupali Gupta
- Department of Neurology, Duke University Medical Center, Durham, North Carolina. United States
| | - Evzen Boura
- Department of Molecular Biology and Biochemistry, Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo namesti 542/2, P.O. Box:16000, Prague. Czech Republic
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13
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Jearanaiwitayakul T, Sunintaboon P, Chawengkittikul R, Limthongkul J, Midoeng P, Chaisuwirat P, Warit S, Ubol S. Whole inactivated dengue virus-loaded trimethyl chitosan nanoparticle-based vaccine: immunogenic properties in ex vivo and in vivo models. Hum Vaccin Immunother 2021; 17:2793-2807. [PMID: 33861177 DOI: 10.1080/21645515.2021.1884473] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Dengue virus (DENV) is a mosquito-borne virus that poses an incomparable public health problem, particularly in tropical and subtropical areas. Vaccination remains the most rational measure for controlling DENV infection. In this study, an ultraviolet irradiation (UV)-inactivated DENV-2 carried by N,N,N-trimethyl chitosan nanoparticles (UV-inactivated DENV2 TMC NPs) was investigated as a potential non-replicating dengue vaccine candidate. Using a human ex vivo model, the human monocyte-derived dendritic cells (MoDCs), we showed that TMC served as both a vaccine vehicle and a potent adjuvant. TMC NPs not only efficiently enhanced UV-inactivated DENV2 internalization into MoDCs but also greatly increased the breadth of UV-inactivated DENV2 immunogenicity to drive the maturation of MoDCs. Moreover, UV-inactivated DENV2 TMC NPs were highly immunogenic in mice, inducing greater levels of antibodies (total IgG, IgG1, IgG2a and neutralizing antibodies) and T cells (activated CD4⁺ and CD8⁺ T cells) against DENV-2 compared to soluble DENV-2 immunogens. Notably, the neutralizing activity of sera from mice immunized with UV-inactivated DENV2 TMC NPs was significantly augmented in the presence of complement activation, leading to the strong elimination of both DENV-2 particles and infected cells. We further showed that the immunogenicity of an inactivated dengue-based vaccine was significantly improved in a concentration-dependent manner. These positive results warrant further investigations of this platform of vaccine delivery for tetravalent vaccines or monovalent vaccines in sequential immunizations.
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Affiliation(s)
| | - Panya Sunintaboon
- Department of Chemistry, Faculty of Science, Mahidol University, Salaya, Thailand
| | | | - Jitra Limthongkul
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Panuwat Midoeng
- Army Institute of Pathology, Phramongkutklao Hospital, Bangkok, Thailand
| | | | - Saradee Warit
- Tuberculosis Research Laboratory, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathumthani, Thailand
| | - Sukathida Ubol
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
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14
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Plotkin SA. Dengue vaccines: the road to failure or to success? Hum Vaccin Immunother 2020; 16:2677-2679. [DOI: 10.1080/21645515.2020.1733367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Stanley A. Plotkin
- Department of Pediatrics, University of Pennsylvania, Vaxconsult, Doylestown, PA, USA
- Vaxconsult, Doylestown, PA, USA
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15
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Jearanaiwitayakul T, Sunintaboon P, Chawengkittikul R, Limthongkul J, Midoeng P, Warit S, Ubol S. Nanodelivery system enhances the immunogenicity of dengue-2 nonstructural protein 1, DENV-2 NS1. Vaccine 2020; 38:6814-6825. [PMID: 32829977 DOI: 10.1016/j.vaccine.2020.08.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/19/2020] [Accepted: 08/09/2020] [Indexed: 12/11/2022]
Abstract
Nonstructural protein 1 (NS1) of dengue virus (DENV) is currently recognized as a dengue vaccine candidate. Unfortunately, most of non-replicating immunogens typically stimulate unsatisfactory immune responses, thus, the additional adjuvant is required. In this study, C-terminal truncated DENV-2 NS1 loaded in N,N,N, trimethyl chitosan nanoparticles (NS11-279TMC NPs) was prepared through the ionic gelation method. The immunogenicity of NS11-279TMC NPs was investigated using human ex vivo as well as the murine model. Through a human ex vivo model, it was demonstrated in this study that not only can TMC particles effectively deliver NS11-279 protein into monocyte-derived dendritic cells (MoDCs), but also potently stimulate those cells, resulting in increased expression of maturation marker (CD83), costimulating molecules (CD80, CD86 and HLA-DR) and markedly secreted various types of innate immune cytokines/chemokines. Moreover, mice administered with NS11-279TMC NPs strongly elicited both antibody and T cell responses, produced higher levels of IgG, IgG1, IgG2a and potently activated CD8+ T cells, as compared to mice administered with soluble NS11-279. Importantly, we further demonstrated that anti-NS11-279 antibody induced by this platform of NS11-279 effectively eliminated DENV-2 infected cells through antibody dependent complement-mediated cytotoxicity. Significantly, anti-DENV2 NS11-279 antibody exerted cross-antiviral activity against DENV-1 and -4 but not against DENV-3 infected cells. These findings demonstrate that TMC exerts a desirable adjuvant for enhancing delivery and antigenicity of NS1 based dengue vaccine.
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Affiliation(s)
| | - Panya Sunintaboon
- Department of Chemistry, Faculty of Science, Mahidol University, Salaya, Nakornpatom 73170, Thailand.
| | | | - Jitra Limthongkul
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand.
| | - Panuwat Midoeng
- Division of Pathology, Army Institute of Pathology, Phramongkutklao Hospital, Bangkok, Thailand.
| | - Saradee Warit
- Tuberculosis Research Laboratory, Medical Molecular Biology Research Unit, BIOTEC, National Science and Technology Development Agency, Thailand Science Park, Pathum Thani, Thailand..
| | - Sukathida Ubol
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand.
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16
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Halstead SB, Katzelnick LC, Russell PK, Markoff L, Aguiar M, Dans LR, Dans AL. Ethics of a partially effective dengue vaccine: Lessons from the Philippines. Vaccine 2020; 38:5572-5576. [PMID: 32654899 PMCID: PMC7347470 DOI: 10.1016/j.vaccine.2020.06.079] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 12/31/2022]
Abstract
Dengvaxia, a chimeric yellow fever tetravalent dengue vaccine developed by SanofiPasteur is widely licensed in dengue-endemic countries. In a large cohort study Dengvaxia was found to partially protect children who had prior dengue virus (DENV) infections but sensitized seronegative children to breakthrough DENV disease of enhanced severity. In 2019, the European Medicines Agency and the US FDA issued licenses that reconciled safety issues by restricting vaccine to individuals with prior dengue infections. Using revised Dengvaxia efficacy and safety data we sought to estimate hospitalized and severe dengue cases among the more than 800,000 9 year-old children vaccinated in the Philippines. Despite an overall vaccine efficacy of 69% during 4 years post-vaccination we project there will be more than one thousand vaccinated seronegative and seropositive children hospitalized for severe dengue. Assisting these children through a program of enhanced surveillance leading to improved care deserves widespread support. Clinical responses observed during breakthrough dengue infections in vaccinated individuals counsel prudence in design of vaccine policies. Recommendations concerning continued use of this dengue vaccine are: (1) obtain a better definition of vaccine efficacy and safety through enhanced phase 4 surveillance, (2) obtain a valid, accessible, sensitive, specific and affordable serological test that identifies past wild-type dengue virus infection and (3) clarify safety and efficacy of Dengvaxia in flavivirus immunes. In the absence of an acceptable serological screening test these unresolved ethical issues suggest Dengvaxia be given only to those signing informed consent.
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Affiliation(s)
- Scott B Halstead
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20817, United States.
| | - Leah C Katzelnick
- Research Associate, Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA 94720, United States; Department of Biology, University of Florida, Gainesville, FL 32611, United States
| | - Philip K Russell
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
| | - Lewis Markoff
- Consultant, 6908 Nevis Road, Bethesda MD 20817, United States
| | - Maira Aguiar
- Dipartimento di Matematica, Università degli Studi di Trento, Via Sommarive 14, 38123 Povo Trento, Italy; Basque Center for Applied Mathematics (BCAM), Alameda Mazarredo, 14, 48009 Bilbao, Spain; Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Leonila R Dans
- Department of Pediatrics, College of Medicine, University of the Philippines, Manila, 547 Pedro Gil Street, Ermita, Manila 1000, Philippines
| | - Antonio L Dans
- Department of Medicine, College of Medicine, University of the Philippines, Manila 547 Pedro Gil Streeet, Ermita, Manila 1000, Philippines
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17
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Krishnamoorthy Y, Majella MG. Economic evaluation and budget impact analysis of dengue vaccination following pre-vaccination serological screening in India. Vaccine 2020; 38:5154-5162. [PMID: 32576458 DOI: 10.1016/j.vaccine.2020.06.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 06/06/2020] [Accepted: 06/09/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the budget impact and cost-effectiveness of dengue vaccination following pre-vaccination serological screening in India. METHODS We used a static cohort model (combination of decision tree and Markov model) to compare dengue disease and cost burden with and without dengue vaccination program with serological screening for a hypothetical cohort of 10-year-old adolescents. Budget impact was expressed in terms of total budget required for implementation of vaccination programme. Program impact was expressed in terms of disability-adjusted life-years (DALYs) averted. Cost effectiveness was expressed as costs per DALY averted. All costs are expressed in 2018 US dollars. Sensitivity analysis was performed for ICERs in different vaccination scenarios. RESULTS The total budget for implementation of dengue vaccination programme is approximately around US$ 530 million (INR 3620 crores). Our model results suggest dengue vaccination result in a net gain of almost 86,000 DALYS. We found the Dengue vaccine to be a cost-effective intervention with an ICER of $3364 (INR 2,30,098) which is less than three-times GDP per capita of India ($6047; INR 413,601). One-way sensitivity analysis shows that the ICER is most affected by the overall incidence of dengue infections followed by vaccine price. Probabilistic sensitivity analysis shows that ICER for dengue vaccination varied from $1182 (INR 80,837) to $6367 (INR 435,439). CONCLUSION Our study shows that dengue vaccine with pre-vaccination serological screening programme is a cost-effective intervention with the conservative estimates.
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18
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Yen PS, Failloux AB. A Review: Wolbachia-Based Population Replacement for Mosquito Control Shares Common Points with Genetically Modified Control Approaches. Pathogens 2020; 9:E404. [PMID: 32456036 PMCID: PMC7281599 DOI: 10.3390/pathogens9050404] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/15/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022] Open
Abstract
The growing expansion of mosquito vectors has made mosquito-borne arboviral diseases a global threat to public health, and the lack of licensed vaccines and treatments highlight the urgent need for efficient mosquito vector control. Compared to genetically modified control strategies, the intracellular bacterium Wolbachia, endowing a pathogen-blocking phenotype, is considered an environmentally friendly strategy to replace the target population for controlling arboviral diseases. However, the incomplete knowledge regarding the pathogen-blocking mechanism weakens the reliability of a Wolbachia-based population replacement strategy. Wolbachia infections are also vulnerable to environmental factors, temperature, and host diet, affecting their densities in mosquitoes and thus the virus-blocking phenotype. Here, we review the properties of the Wolbachia strategy as an approach to control mosquito populations in comparison with genetically modified control methods. Both strategies tend to limit arbovirus infections but increase the risk of selecting arbovirus escape mutants, rendering these strategies less reliable.
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Affiliation(s)
- Pei-Shi Yen
- Unit Arboviruses and Insect Vectors, Department of Virology, Institut Pasteur, F-75724 Paris, France
| | - Anna-Bella Failloux
- Unit Arboviruses and Insect Vectors, Department of Virology, Institut Pasteur, F-75724 Paris, France
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19
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Gore MM. Vaccines Against Dengue and West Nile Viruses in India: The Need of the Hour. Viral Immunol 2020; 33:423-433. [PMID: 32320353 DOI: 10.1089/vim.2019.0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The circulation of flaviviruses, dengue (DEN), Japanese encephalitis (JE) and West Nile (WN) viruses, and others, is generating a major concern in many countries. Both JE along with DEN have been endemic in large regions of India. WN virus infection, although circulating in southern regions for many years, in recent years, WN encephalitis patients have been demonstrated. While vaccines against JE have been developed and decrease outbreaks, in case of DEN and WN, vaccines are still in developing level, especially, it has been difficult to achieve the long-term protective immune response. The first licensed DEN vaccine, which is a live attenuated vaccine, was administered in countries where the virus is endemic, and has a potential to cause serious side effects, especially when administered to younger population as observed in the Philippines vaccination drive. In the case of WN, although the purified inactivated virion-based vaccine worked effectively as a veterinary vaccine for horses, no effective vaccine has yet been licensed for humans. The induction of CD4+ and CD8+ T cell responses is essential to complete protection by these viruses, as evidenced by responses to asymptomatic infections. Many studies have shown that neutralizing antibody (NAb) response is against surface structural proteins; CD4+ and CD8+ responses are mainly directed against nonstructural proteins rather than NAb response. New data suggest that encapsulating virus vaccines in nanoparticles (NPs) will direct antigen in cytoplasmic compartment by antigen-presenting cells, which will improve presentation to CD4+ and CD8+ T cells. Since tissue culture-derived, purified inactivated viruses are easier to manufacture and safer than developing live virus vaccines, inclusion of NP provides an attractive alternative for generating robust flaviviral vaccines that are affordable with long-lived protection.
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Affiliation(s)
- Milind M Gore
- Emeritus Scientist, ICMR-National Institute of Virology, Pune, India
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20
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Wilder-Smith A, Flasche S, Smith PG. Vaccine-attributable severe dengue in the Philippines. Lancet 2019; 394:2151-2152. [PMID: 31839188 DOI: 10.1016/s0140-6736(19)32525-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 10/08/2019] [Indexed: 11/18/2022]
Affiliation(s)
| | - Stefan Flasche
- London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Peter G Smith
- London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
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