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Wirchnianski AS, Nyakatura EK, Herbert AS, Kuehne AI, Abbasi SA, Florez C, Storm N, McKay LGA, Dailey L, Kuang E, Abelson DM, Wec AZ, Chakraborti S, Holtsberg FW, Shulenin S, Bornholdt ZA, Aman MJ, Honko AN, Griffiths A, Dye JM, Chandran K, Lai JR. Design and characterization of protective pan-ebolavirus and pan-filovirus bispecific antibodies. PLoS Pathog 2024; 20:e1012134. [PMID: 38603762 PMCID: PMC11037526 DOI: 10.1371/journal.ppat.1012134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 04/23/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
Monoclonal antibodies (mAbs) are an important class of antiviral therapeutics. MAbs are highly selective, well tolerated, and have long in vivo half-life as well as the capacity to induce immune-mediated virus clearance. Their activities can be further enhanced by integration of their variable fragments (Fvs) into bispecific antibodies (bsAbs), affording simultaneous targeting of multiple epitopes to improve potency and breadth and/or to mitigate against viral escape by a single mutation. Here, we explore a bsAb strategy for generation of pan-ebolavirus and pan-filovirus immunotherapeutics. Filoviruses, including Ebola virus (EBOV), Sudan virus (SUDV), and Marburg virus (MARV), cause severe hemorrhagic fever. Although there are two FDA-approved mAb therapies for EBOV infection, these do not extend to other filoviruses. Here, we combine Fvs from broad ebolavirus mAbs to generate novel pan-ebolavirus bsAbs that are potently neutralizing, confer protection in mice, and are resistant to viral escape. Moreover, we combine Fvs from pan-ebolavirus mAbs with those of protective MARV mAbs to generate pan-filovirus protective bsAbs. These results provide guidelines for broad antiviral bsAb design and generate new immunotherapeutic candidates.
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MESH Headings
- Animals
- Mice
- Antibodies, Bispecific/immunology
- Antibodies, Bispecific/pharmacology
- Antibodies, Bispecific/therapeutic use
- Ebolavirus/immunology
- Hemorrhagic Fever, Ebola/immunology
- Hemorrhagic Fever, Ebola/prevention & control
- Hemorrhagic Fever, Ebola/virology
- Antibodies, Viral/immunology
- Humans
- Filoviridae/immunology
- Antibodies, Neutralizing/immunology
- Antibodies, Neutralizing/therapeutic use
- Antibodies, Monoclonal/immunology
- Female
- Mice, Inbred BALB C
- Filoviridae Infections/immunology
- Filoviridae Infections/therapy
- Filoviridae Infections/prevention & control
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Affiliation(s)
- Ariel S. Wirchnianski
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, New York, United States of America
| | - Elisabeth K. Nyakatura
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Andrew S. Herbert
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, United States of America
- The Geneva Foundation, Tacoma, Washington, United States of America
| | - Ana I. Kuehne
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, United States of America
| | - Shawn A. Abbasi
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, United States of America
- The Geneva Foundation, Tacoma, Washington, United States of America
| | - Catalina Florez
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, United States of America
- The Geneva Foundation, Tacoma, Washington, United States of America
| | - Nadia Storm
- Department of Virology, Immunology, and Microbiology; and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Lindsay G. A. McKay
- Department of Virology, Immunology, and Microbiology; and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Leandrew Dailey
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Erin Kuang
- Mapp Biopharmaceutical Inc., San Diego, California, United States of America
| | - Dafna M. Abelson
- Mapp Biopharmaceutical Inc., San Diego, California, United States of America
| | - Anna Z. Wec
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, New York, United States of America
| | - Srinjoy Chakraborti
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | | | - Sergey Shulenin
- Integrated BioTherapeutics, Inc., Rockville, Maryland, United States of America
| | | | - M. Javad Aman
- Integrated BioTherapeutics, Inc., Rockville, Maryland, United States of America
| | - Anna N. Honko
- Department of Virology, Immunology, and Microbiology; and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Anthony Griffiths
- Department of Virology, Immunology, and Microbiology; and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - John M. Dye
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, United States of America
| | - Kartik Chandran
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, New York, United States of America
| | - Jonathan R. Lai
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York, United States of America
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Wachekwa I, Camanor SW, Kpoeh-Thomas T, Glaydor F, Barclay-Korboi YM, Moses JS, Bartekwa-Gwaikolo JW. A review of the John F. Kennedy Medical Center's response to the COVID-19 pandemic in Liberia. Front Public Health 2024; 11:1258938. [PMID: 38264239 PMCID: PMC10803570 DOI: 10.3389/fpubh.2023.1258938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/18/2023] [Indexed: 01/25/2024] Open
Abstract
Objective Over the past decades, the world has experienced a series of emerging and re-emerging infectious disease pandemics with dire consequences for economies and healthcare delivery. Hospitals are expected to have the ability to detect and respond appropriately to epidemics with minimal disruptions to routine services. We sought to review the John F. Kennedy Medical Center's readiness to respond to the COVID-19 pandemic. Methods We used the pretest-posttest design in June 2021 and May 2023 to assess the hospital's improvements in its COVID-19 readiness capacity by collecting data on the hospital's characteristics and using the WHO COVID-19 Rapid hospital readiness checklist. We scored each readiness indicator according to the WHO criteria and the hospital's overall readiness score, performed the chi-square test for the change in readiness (change, 95% CI, p-value) between 2021 and 2023, and classified the center's readiness (poor: < 50%, fair: 50-79%, or satisfactory: ≥80%). The overall hospital readiness for COVID-19 response was poor in 2021 (mean score = 49%, 95% CI: 39-57%) and fair in 2023 (mean score = 69%, 95% CI: 56-81%). The mean change in hospital readiness was 20% (95% CI: 5.7-35%, p-value = 0.009). Between 2021 and 2023, the hospital made satisfactory improvements in leadership and incident management system [from 57% in 2021 to 86% in 2023 (change = 29%, 95% CI: 17-41%, p < 0.001)]; risk communication and community engagement [38-88% (change = 50%, 95% CI: 39-61%, p < 0.001)]; patient management [63-88% (change = 25%, 95% CI: 14-36%, p < 0.001)]; and rapid identification and diagnosis [67-83% (change = 16%, 95% CI: 4.2-28%, p = 0.009)]. The hospital made fair but significant improvements in terms of coordination and communication [42-75% (change = 33%, 95% CI: 20-46%, p < 0.001)], human resources capacity [33-75% (change = 42%, 95% CI: 29-55%, p < 0.001)], continuation of critical support services [50-75% (PD = 25%, 95% CI: 12-38%, p < 0.001)], and IPC [38-63% (change = 25%, 12-38%, p < 0.001)]. However, there was no or unsatisfactory improvement in terms of surveillance and information management; administration, finance, and business continuity; surge capacity; and occupational and mental health psychosocial support. Conclusion Substantial gaps still remain in the hospital's readiness to respond to the COVID-19 outbreak. The study highlights the urgent need for investment in resilient strategies to boost readiness to respond to future outbreaks at the hospital.
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Affiliation(s)
- Ian Wachekwa
- Department of Internal Medicine, John F. Kennedy Medical Center, Monrovia, Liberia
- Office of the Chief Medical Officer, John F. Kennedy Medical Center, Monrovia, Liberia
- Infection Prevention and Control Unit, John F. Kennedy Medical Center, Monrovia, Liberia
| | - Sia Wata Camanor
- Office of the Chief Medical Officer, John F. Kennedy Medical Center, Monrovia, Liberia
| | | | - Facia Glaydor
- Epi-Surveillance, John F. Kennedy Medical Center, Monrovia, Liberia
| | | | - J. Soka Moses
- Partnership for Research on Vaccines and Infectious Diseases in Liberia, Monrovia, Liberia
| | - Joyce Weade Bartekwa-Gwaikolo
- Department of Internal Medicine, John F. Kennedy Medical Center, Monrovia, Liberia
- Infection Prevention and Control Unit, John F. Kennedy Medical Center, Monrovia, Liberia
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Espinoza B, Adiga A, Venkatramanan S, Warren AS, Chen J, Lewis BL, Vullikanti A, Swarup S, Moon S, Barrett CL, Athreya S, Sundaresan R, Chandru V, Laxminarayan R, Schaffer B, Poor HV, Levin SA, Marathe MV. Coupled models of genomic surveillance and evolving pandemics with applications for timely public health interventions. Proc Natl Acad Sci U S A 2023; 120:e2305227120. [PMID: 37983514 PMCID: PMC10691339 DOI: 10.1073/pnas.2305227120] [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] [Received: 04/04/2023] [Accepted: 10/13/2023] [Indexed: 11/22/2023] Open
Abstract
Disease surveillance systems provide early warnings of disease outbreaks before they become public health emergencies. However, pandemics containment would be challenging due to the complex immunity landscape created by multiple variants. Genomic surveillance is critical for detecting novel variants with diverse characteristics and importation/emergence times. Yet, a systematic study incorporating genomic monitoring, situation assessment, and intervention strategies is lacking in the literature. We formulate an integrated computational modeling framework to study a realistic course of action based on sequencing, analysis, and response. We study the effects of the second variant's importation time, its infectiousness advantage and, its cross-infection on the novel variant's detection time, and the resulting intervention scenarios to contain epidemics driven by two-variants dynamics. Our results illustrate the limitation in the intervention's effectiveness due to the variants' competing dynamics and provide the following insights: i) There is a set of importation times that yields the worst detection time for the second variant, which depends on the first variant's basic reproductive number; ii) When the second variant is imported relatively early with respect to the first variant, the cross-infection level does not impact the detection time of the second variant. We found that depending on the target metric, the best outcomes are attained under different interventions' regimes. Our results emphasize the importance of sustained enforcement of Non-Pharmaceutical Interventions on preventing epidemic resurgence due to importation/emergence of novel variants. We also discuss how our methods can be used to study when a novel variant emerges within a population.
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Affiliation(s)
- Baltazar Espinoza
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Aniruddha Adiga
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Srinivasan Venkatramanan
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Andrew Scott Warren
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Jiangzhuo Chen
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Bryan Leroy Lewis
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Anil Vullikanti
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
- Department of Computer Science, University of Virginia, Charlottesville, VA22904
| | - Samarth Swarup
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Sifat Moon
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
| | - Christopher Louis Barrett
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
- Department of Computer Science, University of Virginia, Charlottesville, VA22904
| | - Siva Athreya
- Indian Statistical Institute, Bengaluru, Karnataka560059, India
- International Centre for Theoretical Sciences, Bengaluru, Karnataka560089, India
| | - Rajesh Sundaresan
- Department of Electrical and Communication Engineering, Indian Institute of Science, Bengaluru, Karnataka560012, India
- Robert Bosch Centre for Cyber-Physical Systems, Indian Institute of Science, Bengaluru, Karnataka560012, India
- Centre for Networked Intelligence, Indian Institute of Science, Bengaluru, Karnataka560012, India
| | - Vijay Chandru
- Strand Life Sciences, Bengaluru, Karnataka560024, India
- BioSystems Science and Engineering, Indian Institute of Science, Bengaluru, Karnataka560012, India
| | | | - Benjamin Schaffer
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ08544
- Department of Electrical and Computer Engineering, Princeton University, Princeton, NJ08544
| | - H. Vincent Poor
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ08544
| | - Simon A. Levin
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ08544
| | - Madhav V. Marathe
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA22904
- Department of Computer Science, University of Virginia, Charlottesville, VA22904
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Nanomedicine for drug resistant pathogens and COVID-19 using mushroom nanocomposite inspired with bacteriocin – A Review. INORG CHEM COMMUN 2023; 152:110682. [PMID: 37041990 PMCID: PMC10067464 DOI: 10.1016/j.inoche.2023.110682] [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: 12/30/2022] [Revised: 03/25/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023]
Abstract
Multidrug resistant (MDR) pathogens have become a major global health challenge and have severely threatened the health of society. Current conditions have gotten worse as a result of the COVID-19 pandemic, and infection rates in the future will rise. It is necessary to design, respond effectively, and take action to address these challenges by investigating new avenues. In this regard, the fabrication of metal NPs utilized by various methods, including green synthesis using mushroom, is highly versatile, cost-effective, eco-compatible, and superior. In contrast, biofabrication of metal NPs can be employed as a powerful weapon against MDR pathogens and have immense biomedical applications. In addition, the advancement in nanotechnology has made possible to modify the nanomaterials and enhance their activities. Metal NPs with biomolecules composite to prevents their microbial adhesion and kills the microbial pathogens through biofilm formation. Bacteriocin is an excellent antimicrobial peptide that works well as an augmentation substance to boost the antimicrobial effects. As a result, we concentrate on the creation of new, eco-compatible mycosynthesized metal NPs with bacteriocin nanocomposite via electrostatic, covalent, or non-covalent bindings. The synergistic benefits of metal NPs with bacteriocin to combat MDR pathogens and COVID-19, as well as other biomedical applications, are discussed in this review. Moreover, the importance of the adverse outcome pathway (AOP) in risk analysis of manufactured metal nanocomposite nanomaterial and their future possibilities also discussed.
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Escudero-Pérez B, Lalande A, Mathieu C, Lawrence P. Host–Pathogen Interactions Influencing Zoonotic Spillover Potential and Transmission in Humans. Viruses 2023; 15:v15030599. [PMID: 36992308 PMCID: PMC10060007 DOI: 10.3390/v15030599] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
Emerging infectious diseases of zoonotic origin are an ever-increasing public health risk and economic burden. The factors that determine if and when an animal virus is able to spill over into the human population with sufficient success to achieve ongoing transmission in humans are complex and dynamic. We are currently unable to fully predict which pathogens may appear in humans, where and with what impact. In this review, we highlight current knowledge of the key host–pathogen interactions known to influence zoonotic spillover potential and transmission in humans, with a particular focus on two important human viruses of zoonotic origin, the Nipah virus and the Ebola virus. Namely, key factors determining spillover potential include cellular and tissue tropism, as well as the virulence and pathogenic characteristics of the pathogen and the capacity of the pathogen to adapt and evolve within a novel host environment. We also detail our emerging understanding of the importance of steric hindrance of host cell factors by viral proteins using a “flytrap”-type mechanism of protein amyloidogenesis that could be crucial in developing future antiviral therapies against emerging pathogens. Finally, we discuss strategies to prepare for and to reduce the frequency of zoonotic spillover occurrences in order to minimize the risk of new outbreaks.
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Affiliation(s)
- Beatriz Escudero-Pérez
- WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel-Reims, 38124 Braunschweig, Germany
| | - Alexandre Lalande
- CIRI (Centre International de Recherche en Infectiologie), Team Neuro-Invasion, TROpism and VIRal Encephalitis, INSERM U1111, CNRS UMR5308, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, 69007 Lyon, France
| | - Cyrille Mathieu
- CIRI (Centre International de Recherche en Infectiologie), Team Neuro-Invasion, TROpism and VIRal Encephalitis, INSERM U1111, CNRS UMR5308, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, 69007 Lyon, France
| | - Philip Lawrence
- CONFLUENCE: Sciences et Humanités (EA 1598), Université Catholique de Lyon (UCLy), 69002 Lyon, France
- Correspondence:
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6
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Zhang Z, Zhao Z, Wang Y, Wu S, Wang B, Zhang J, Song X, Chen Y, Lv P, Hou L. Comparative immunogenicity analysis of intradermal versus intramuscular immunization with a recombinant human adenovirus type 5 vaccine against Ebola virus. Front Immunol 2022; 13:963049. [PMID: 36119119 PMCID: PMC9472118 DOI: 10.3389/fimmu.2022.963049] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/01/2022] [Indexed: 11/17/2022] Open
Abstract
The proper route for vaccine delivery plays an important role in activating a robust immune response. Several viral vector-based vaccines against Ebola disease administered intramuscularly have been found to have excellent immunogenicity and protectiveness. In this study, we evaluated different vaccine routes for Ad5-EBOV delivery by comparing humoral and cellular responses, germinal center reactions, dendritic cell activation and antigen expression. Mice injected intramuscularly with the vaccine exhibited an advantage in antigen expression, leading to more robust germinal center and humoral responses, while intradermal injection recruited more migrating DCs and induced a more polyfunctional cellular response. Our study provides more data for future use of viral vector-based vaccines.
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Analysis of individual-level data from 2018-2020 Ebola outbreak in Democratic Republic of the Congo. Sci Rep 2022; 12:5534. [PMID: 35365724 PMCID: PMC8972744 DOI: 10.1038/s41598-022-09564-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/17/2022] [Indexed: 11/08/2022] Open
Abstract
The 2018–2020 Ebola virus disease epidemic in Democratic Republic of the Congo (DRC) resulted in 3481 cases (probable and confirmed) and 2299 deaths. In this paper, we use a novel statistical method to analyze the individual-level incidence and hospitalization data on DRC Ebola victims. Our analysis suggests that an increase in the rate of quarantine and isolation that has shortened the infectiousness period by approximately one day during the epidemic’s third and final wave was likely responsible for the eventual containment of the outbreak. The analysis further reveals that the total effective population size or the average number of individuals at risk for the disease exposure in three epidemic waves over the period of 24 months was around 16,000–a much smaller number than previously estimated and likely an evidence of at least partial protection of the population at risk through ring vaccination and contact tracing as well as adherence to strict quarantine and isolation policies.
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Ali Al Shehri S, Al-Sulaiman AM, Azmi S, Alshehri SS. Bio-safety and bio-security: A major global concern for ongoing COVID-19 pandemic. Saudi J Biol Sci 2022; 29:132-139. [PMID: 34483699 PMCID: PMC8404373 DOI: 10.1016/j.sjbs.2021.08.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/15/2022] Open
Abstract
Besides its impacts on governance, economics, human culture, geostrategic partnership and environment, globalization greatly exerted control over science and security policies. Biosecurity is the critical job of efforts, policy and preparation to protect health of human, animal and environmental against any biological threats. With the transition into a global village, the possibility of biosecurity breaches has significantly increased. The COVID-19 pandemic is an example of an infringement on biosecurity that has posed a serious threat to the world. Since the first report on the recognition of COVID-19, a number of governments have taken preventive measures, like; lockdown, screening and early detection of suspected and implementing the required response to protect the loss of life and economy. Unfortunately, some of these measures have only recently been taken in some countries, which have contributed significantly to an increased morbidity and loss of life on a daily basis. In this article, the biological risks affecting human, animal and environmental conditions, biosafety violations and preventive measures have been discussed in order to reduce the outbreak and impacts of a pandemic like COVID-19.
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Affiliation(s)
| | - AM Al-Sulaiman
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sarfuddin Azmi
- Scientific Research Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Sultan S. Alshehri
- Prince Sultan Military Medical City, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
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9
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van Zyl GU. New Technological Developments in Identification and Monitoring of New and Emerging Infections. ENCYCLOPEDIA OF INFECTION AND IMMUNITY 2022. [PMCID: PMC8291697 DOI: 10.1016/b978-0-12-818731-9.00094-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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Bitanihirwe B, Ssewanyana D, Ddumba-Nyanzi I. Pacing Forward in the Face of Fragility: Lessons From African Institutions and Governments' Response to Public Health Emergencies. Front Public Health 2021; 9:714812. [PMID: 34900886 PMCID: PMC8655676 DOI: 10.3389/fpubh.2021.714812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022] Open
Abstract
Africa is home to 54 United Nation member states, each possessing a wealth of ethno-cultural, physiographic, and economic diversity. While Africa is credited as having the youngest population in the world, it also exhibits a unique set of “unfortunate realties” ranging from famine and poverty to volatile politics, conflicts, and diseases. These unfortunate realities all converge around social inequalities in health, that are compounded by fragile healthcare systems and a lack of political will by the continent's leaders to improve smart investment and infrastructure planning for the benefit of its people. Noteworthy are the disparities in responsive approaches to crises and emergencies that exist across African governments and institutions. In this context, the present article draws attention to 3 distinct public health emergencies (PHEs) that have occurred in Africa since 2010. We focus on the 2013–2016 Ebola outbreak in Western Africa, the ongoing COVID-19 pandemic which continues to spread throughout the continent, and the destructive locust swarms that ravaged crops across East Africa in 2020. Our aim is to provide an integrated perspective on how governments and institutions handled these PHEs and how scientific and technological innovation, along with educational response played a role in the decision-making process. We conclude by touching on public health policies and strategies to address the development of sustainable health care systems with the potential to improve the health and well-being of the African people.
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Affiliation(s)
- Byron Bitanihirwe
- Humanitarian and Conflict Response Institute, University of Manchester, Manchester, United Kingdom
| | - Derrick Ssewanyana
- Alliance for Health Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
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11
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Bhardwaj SK, Singh H, Deep A, Khatri M, Bhaumik J, Kim KH, Bhardwaj N. UVC-based photoinactivation as an efficient tool to control the transmission of coronaviruses. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 792:148548. [PMID: 34465056 PMCID: PMC8238411 DOI: 10.1016/j.scitotenv.2021.148548] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/28/2021] [Accepted: 06/15/2021] [Indexed: 05/04/2023]
Abstract
The ongoing COVID-19 pandemic made us re-realize the importance of environmental disinfection and sanitation in indoor areas, hospitals, and clinical rooms. UVC irradiation of high energy and short wavelengths, especially in the 200-290-nm range possesses the great potential for germicidal disinfection. These properties of UVC allow to damage or destruct the nucleic acids (DNA/RNA) in diverse microbes (e.g., bacteria, fungi, and viruses). UVC light can hence be used as a promising tool for prevention and control of their infection or transmission. The present review offers insights into the historical perspective, mode of action, and recent advancements in the application of UVC-based antiviral therapy against coronaviruses (including SARS CoV-2). Moreover, the application of UVC lights in the sanitization of healthcare units, public places, medical instruments, respirators, and personal protective equipment (PPE) is also discussed. This article, therefore, is expected to deliver a new path for the developments of UVC-based viricidal approach.
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Affiliation(s)
- Sanjeev K Bhardwaj
- Department of Nanomaterials and Application Technology, Center of Innovative and Applied Bioprocessing, Sector 81 (Knowledge City), S.A.S. Nagar 140306, Punjab, India
| | - Harpreet Singh
- Department of Biotechnology, University Institute of Engineering Technology (UIET), Panjab University, Chandigarh, India
| | - Akash Deep
- Central Scientific Instruments Organisation, Sector 30-C, Chandigarh 160030, India
| | - Madhu Khatri
- Department of Biotechnology, University Institute of Engineering Technology (UIET), Panjab University, Chandigarh, India
| | - Jayeeta Bhaumik
- Department of Nanomaterials and Application Technology, Center of Innovative and Applied Bioprocessing, Sector 81 (Knowledge City), S.A.S. Nagar 140306, Punjab, India
| | - Ki-Hyun Kim
- Department of Civil and Environmental Engineering, Hanyang University, 222 Wangsimni-Ro, Seoul 04763, Republic of Korea.
| | - Neha Bhardwaj
- Department of Biotechnology, University Institute of Engineering Technology (UIET), Panjab University, Chandigarh, India.
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12
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Abstract
PURPOSE OF REVIEW The purpose of the review is to summarize recent advances in understanding the origins, drivers and clinical context of zoonotic disease epidemics and pandemics. In addition, we aimed to highlight the role of clinicians in identifying sentinel cases of zoonotic disease outbreaks. RECENT FINDINGS The majority of emerging infectious disease events over recent decades, including the COVID-19 pandemic, have been caused by zoonotic viruses and bacteria. In particular, coronaviruses, haemorrhagic fever viruses, arboviruses and influenza A viruses have caused significant epidemics globally. There have been recent advances in understanding the origins and drivers of zoonotic epidemics, yet there are gaps in diagnostic capacity and clinical training about zoonoses. SUMMARY Identifying the origins of zoonotic pathogens, understanding factors influencing disease transmission and improving the diagnostic capacity of clinicians will be crucial to early detection and prevention of further epidemics of zoonoses.
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Affiliation(s)
| | - Peter M Rabinowitz
- Department of Medicine
- Department of Environmental and Occupational Health Sciences, Department of Global Health, University of Washington, Seattle, Washington, USA
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Hilderink M, de Winter I. No need to beat around the bushmeat-The role of wildlife trade and conservation initiatives in the emergence of zoonotic diseases. Heliyon 2021; 7:e07692. [PMID: 34386637 PMCID: PMC8342965 DOI: 10.1016/j.heliyon.2021.e07692] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/17/2021] [Accepted: 07/28/2021] [Indexed: 12/24/2022] Open
Abstract
Wildlife species constitute a vast and uncharted reservoir of zoonotic pathogens that can pose a severe threat to global human health. Zoonoses have become increasingly impactful over the past decades, and the expanding trade in wildlife is unarguably among the most significant risk factors for their emergence. Despite several warnings from the academic community about the spillover risks associated with wildlife trade, the ongoing COVID-19 pandemic underlines that current policies on the wildlife industry are deficient. Conservation initiatives, rather than practices that attempt to eradicate zoonotic pathogens or the wild species that harbour them, could play a vital role in preventing the emergence of life-threatening zoonoses. This review explores how wildlife conservation initiatives could effectively reduce the risk of new zoonotic diseases emerging from the wildlife trade by integrating existing literature on zoonotic diseases and risk factors associated with wildlife trade. Conservation should mainly aim at reducing human-wildlife interactions in the wildlife trade by protecting wildlife habitats and providing local communities with alternative protein sources. In addition, conservation should focus on regulating the legal wildlife trade and education about disease transfer and safer hunting and butchering methods. By uniting efforts for wildlife protection and universal concern for preventing zoonotic epidemics, conservation initiatives have the potential to safeguard both biodiversity, animal welfare, and global human health security.
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McCormick BJJ, Waiswa P, Nalwadda C, Sewankambo NK, Knobler SL. SMART Vaccines 2.0 decision-support platform: a tool to facilitate and promote priority setting for sustainable vaccination in resource-limited settings. BMJ Glob Health 2021; 5:bmjgh-2020-003587. [PMID: 33239338 PMCID: PMC7689585 DOI: 10.1136/bmjgh-2020-003587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 11/06/2022] Open
Abstract
In resource-constrained environments, priority setting is critical to making sustainable decisions for introducing new and underused vaccines and choosing among vaccine products. Donor organisations and national governments in low-income and middle-income countries (LMICs) recognise the need to support prioritisation of vaccine decisions driven by local health system capacity, epidemiology and financial sustainability. Successful efforts have supported the establishment of National Immunisation Technical Advisory Groups (NITAGs) to undertake evidence-informed decision making (EIDM) in LMICs. Now, attention is increasingly focused on supporting their function to leverage local expertise and priorities. EIDM and priority-setting functions are complex and dynamic processes. Here, we report a pilot of a web-based decision-support tool. Applying tenets of multicriteria decision analysis, SMART Vaccines 2.0 supported transparent, reproducible and evidence-informed priority setting with an easy-to-use interface and shareable outputs. The pilot was run by the Uganda NITAG who were requested by the Ministry of Health (MOH) in 2016 to produce recommendations on the prioritised introduction of five new vaccines. The tool was acceptable to the NITAG and supported their recommendations to the MOH. The tool highlighted sensitivity in the prioritisation process to the inherent biases of different stakeholders. This feature also enabled examination of the implications of data uncertainty. Feedback from users identified areas where the tool could more explicitly support evidence-to-recommendation frameworks, ultimately informing the next generation of the platform, PriorityVax. Country ownership and priority setting in vaccine decisions are central to sustainability. PriorityVax promotes auditable and rigorous deliberations; enables and captures the decision matrix of users; and generates shareable documentation of the process.
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Affiliation(s)
- Benjamin J J McCormick
- Division of International Epidemiology and Population Studies, Fogarty International Center, Bethesda, Maryland, USA
| | - Peter Waiswa
- School of Public Health, Makerere University, Kampala, Uganda.,International Health, Dept of Public Health Sciences (IHCAR), Karolinska Institutet, Stockholm, Sweden
| | | | - Nelson K Sewankambo
- Uganda National Academy of Sciences, Kampala, Uganda.,School of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Stacey L Knobler
- Division of International Epidemiology and Population Studies, Fogarty International Center, Bethesda, Maryland, USA .,Sabin Vaccine Institute, Washington, District of Columbia, USA
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Kawuki J, Musa TH, Yu X. Impact of recurrent outbreaks of Ebola virus disease in Africa: a meta-analysis of case fatality rates. Public Health 2021; 195:89-97. [PMID: 34077889 DOI: 10.1016/j.puhe.2021.03.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/19/2021] [Accepted: 03/30/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Between 2010 and 2020, Africa witnessed several outbreaks of Ebola virus disease (EVD), each presenting with varying case fatality rate (CFR) and other socio-economic impacts. This study aims to summarize the CFR and identify potential factors that influenced the severity of EVD outbreaks in Africa. STUDY DESIGN This was a systematic review and meta-analysis of EVD outbreaks published between January 2010 and March 2020, using Web of Science, Scopus, and PubMed databases. METHODS Only English-language articles and reports, including the number of cases and deaths during the outbreak in Africa, were considered. The quality of the included articles was assessed using Murad's quality assessment tool. The analysis was conducted using Stata (version 12), pooled effect sizes were calculated using the random-effects model, and heterogeneity was tested for using the I2 statistic. RESULTS Thirteen studies with 32,300 cases and 13,727 deaths were identified, whose pooled CFR was 60% (95% confidence interval [CI]: 47-73%). The most EVD-affected countries were the Democratic Republic of Congo with five outbreaks and a pooled CFR of 65% (95% CI: 59-71%), followed by Uganda with three outbreaks and CFR of 83% (95% CI: 60-99%). Zaire ebolavirus caused the most outbreaks (10), with a CFR of 58% (95% CI: 45-71%). Besides, outbreaks with fewer than 1000 cases reported a higher CFR rate (65%, 95% CI: 54-75%) compared with those with more cases (51%, 95% CI: 33-69%). CONCLUSION The study has revealed a considerably high CFR caused by the recurrent EVD outbreaks in Africa. It also notes an implementation gap in the prevention and control strategies and thus identifies a need to strengthen the surveillance systems and response mechanisms to enable early detection and prompt control of future outbreaks.
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Affiliation(s)
- J Kawuki
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Global Health, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu Province, China; Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - T H Musa
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu Province, China; Biomedical Research Institute, Darfur College, Nyala, Sudan
| | - X Yu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Global Health, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu Province, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu Province, China.
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Vanderslott S, Van Ryneveld M, Marchant M, Lees S, Nolna SK, Marsh V. How can community engagement in health research be strengthened for infectious disease outbreaks in Sub-Saharan Africa? A scoping review of the literature. BMC Public Health 2021; 21:633. [PMID: 33794820 PMCID: PMC8012744 DOI: 10.1186/s12889-021-10348-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Community engagement (CE) is a well-established practical and scholarly field, recognised as core to the science and ethics of health research, for which researchers and practitioners have increasingly asked questions about desired standards and evaluation. In infectious disease outbreak contexts, questions may be more complex. However, it is unclear what body of knowledge has been developed for CE specifically as it applies to emerging infectious diseases. This scoping review seeks to describe (1) How CE has been conceptualised and understood; and (2) What conclusions have research teams reached on the effectiveness of CE in these settings, including challenges and facilitators. METHODS We used a scoping review framework by Arksey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005) to structure our review. We conducted a brainstorming session and initial trial search to inform the protocol, search terms, and strategy. Three researchers discussed, developed and applied agreed screening tools and selection criteria to the final search results. Five researchers used the screening tools to screen abstracts and full text for inclusion by consensus. Additional publications were sought from references of retrieved publications and an expert call for literature. We analysed and reported emerging themes qualitatively. RESULTS We included 59 papers from a total of 722 articles derived from our trial and final literature searches, as well as a process of "citation chasing" and an expert call for grey literature. The core material related exclusively to health research trials during the 2014-2016 West Africa Ebola outbreak. We synthesized reports on components of effectiveness of CE to identify and propose three themes as essential elements of effective CE. CONCLUSIONS While there is a large volume of literature documenting CE activities in infectious disease research settings generally, there are few accounts of effectiveness dimensions of CE. Our review proposes three themes to facilitate the effectiveness of CE initiatives as essential elements of CE activities in infectious diseases studies: (1) Communication towards building collaborative relationships; (2) Producing contextual knowledge; and (3) Learning lessons over time. As there were relatively few in-depth accounts of CE from our literature review, documentation and accounts of CE used in health research should be prioritised.
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Affiliation(s)
- Samantha Vanderslott
- Oxford Vaccine Group & Oxford Martin School, University of Oxford, 34 Broad St, Oxford, OX1 2BD, UK.
| | - Manya Van Ryneveld
- School of Public Health, University of the Western Cape, Robert Sobukwe Road, Bellville, 7535, Republic of South Africa
| | - Mark Marchant
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Shelley Lees
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Sylvie Kwedi Nolna
- Department of Public Health, University of Yaounde I, Rue Melen, Yaounde, Cameroon
| | - Vicki Marsh
- KEMRI Wellcome Trust Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, NDM, Oxford University, Oxford, UK
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Kilifi, Kenya
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Randhawa N, Mailhot H, Lang DT, Martínez-López B, Gilardi K, Mazet JAK. Fine scale infectious disease modeling using satellite-derived data. Sci Rep 2021; 11:6946. [PMID: 33767257 PMCID: PMC7994421 DOI: 10.1038/s41598-021-86124-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/10/2021] [Indexed: 11/09/2022] Open
Abstract
Innovative tools for modeling infectious agents are essential for better understanding disease spread given the inherent complexity of changing and interacting ecological, environmental, and demographic factors. We leveraged fine-scale satellite data on urban areas to build a road-connected geospatial network upon which to model disease spread. This model was tested by simulating the spread of the 2009 pandemic influenza in Rwanda and also used to determine the effects of vaccination regimens on outbreak spread and impact. Our results were comparable to data collected during the actual pandemic in Rwanda, determining the initial places affected after outbreak introduction in Kigali. They also highlighted the effectiveness of preventing outbreaks by targeting mitigation efforts at points of outbreak origin. This modeling approach can be valuable for planning and control purposes in real-time disease situations, providing helpful baseline scenarios during initial phases of outbreaks, and can be applied to other infectious diseases where high population mobility promotes rapid disease propagation.
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Affiliation(s)
- Nistara Randhawa
- One Health Institute, School of Veterinary Medicine, University of California, Davis, USA.
| | | | | | - Beatriz Martínez-López
- Center for Animal Disease Modeling and Surveillance, Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, USA
| | - Kirsten Gilardi
- One Health Institute, School of Veterinary Medicine, University of California, Davis, USA
| | - Jonna A K Mazet
- One Health Institute, School of Veterinary Medicine, University of California, Davis, USA.
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Ouattara S, Århem N. Fighting Ebola in the Shadow of Conspiracy Theories and Sorcery Suspicions. CAHIERS D ETUDES AFRICAINES 2021. [DOI: 10.4000/etudesafricaines.33151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Domachowske J. Ebola. Vaccines (Basel) 2021. [DOI: 10.1007/978-3-030-58414-6_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Oren E, Martinez L, Hensley RE, Jain P, Ahmed T, Purnajo I, Nara A, Tsou MH. Twitter Communication During an Outbreak of Hepatitis A in San Diego, 2016-2018. Am J Public Health 2020; 110:S348-S355. [PMID: 33001731 PMCID: PMC7532315 DOI: 10.2105/ajph.2020.305900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objectives. To examine how and what information is communicated via social media during an infectious disease outbreak.Methods. In the context of the 2016 through 2018 hepatitis A outbreak in San Diego County, California, we used a grounded theory-based thematic analysis that employed qualitative and quantitative approaches to uncover themes in a sample of public tweets (n = 744) from Twitter, a primary platform used by key stakeholders to communicate to the public during the outbreak.Results. Tweets contained both general and hepatitis A-specific information related to the outbreak, restatements of policy and comments critical of government responses to the outbreak, information with the potential to shape risk perceptions, and expressions of concern regarding individuals experiencing homelessness and their role in spreading hepatitis A. We also identified misinformation and common channels of content driving themes that emerged in our sample.Conclusions. Public health professionals may identify real-time public risk perceptions and concerns via social media during an outbreak and target responses that fulfill the informational needs of those who seek direction and reassurance during times of uncertainty.
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Affiliation(s)
- Eyal Oren
- Eyal Oren, Purva Jain, Taufa Ahmed, and Intan Purnajo are with the Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA. Lourdes Martinez and R. Eliza Hensley are with the School of Communication, San Diego State University. Atsushi Nara and Ming-Hsiang Tsou are with the Department of Geography, San Diego State University
| | - Lourdes Martinez
- Eyal Oren, Purva Jain, Taufa Ahmed, and Intan Purnajo are with the Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA. Lourdes Martinez and R. Eliza Hensley are with the School of Communication, San Diego State University. Atsushi Nara and Ming-Hsiang Tsou are with the Department of Geography, San Diego State University
| | - R. Eliza Hensley
- Eyal Oren, Purva Jain, Taufa Ahmed, and Intan Purnajo are with the Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA. Lourdes Martinez and R. Eliza Hensley are with the School of Communication, San Diego State University. Atsushi Nara and Ming-Hsiang Tsou are with the Department of Geography, San Diego State University
| | - Purva Jain
- Eyal Oren, Purva Jain, Taufa Ahmed, and Intan Purnajo are with the Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA. Lourdes Martinez and R. Eliza Hensley are with the School of Communication, San Diego State University. Atsushi Nara and Ming-Hsiang Tsou are with the Department of Geography, San Diego State University
| | - Taufa Ahmed
- Eyal Oren, Purva Jain, Taufa Ahmed, and Intan Purnajo are with the Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA. Lourdes Martinez and R. Eliza Hensley are with the School of Communication, San Diego State University. Atsushi Nara and Ming-Hsiang Tsou are with the Department of Geography, San Diego State University
| | - Intan Purnajo
- Eyal Oren, Purva Jain, Taufa Ahmed, and Intan Purnajo are with the Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA. Lourdes Martinez and R. Eliza Hensley are with the School of Communication, San Diego State University. Atsushi Nara and Ming-Hsiang Tsou are with the Department of Geography, San Diego State University
| | - Atsushi Nara
- Eyal Oren, Purva Jain, Taufa Ahmed, and Intan Purnajo are with the Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA. Lourdes Martinez and R. Eliza Hensley are with the School of Communication, San Diego State University. Atsushi Nara and Ming-Hsiang Tsou are with the Department of Geography, San Diego State University
| | - Ming-Hsiang Tsou
- Eyal Oren, Purva Jain, Taufa Ahmed, and Intan Purnajo are with the Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA. Lourdes Martinez and R. Eliza Hensley are with the School of Communication, San Diego State University. Atsushi Nara and Ming-Hsiang Tsou are with the Department of Geography, San Diego State University
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Park J, Chaffee AW, Harrigan RJ, Schoenberg FP. A non-parametric Hawkes model of the spread of Ebola in west Africa. J Appl Stat 2020; 49:621-637. [DOI: 10.1080/02664763.2020.1825646] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Junhyung Park
- Department of Statistics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Adam W. Chaffee
- Department of Statistics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ryan J. Harrigan
- Institute of the Environment and Sustainability, University of California, Los Angeles, Los Angeles, CA, USA
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Gurunathan S, Qasim M, Choi Y, Do JT, Park C, Hong K, Kim JH, Song H. Antiviral Potential of Nanoparticles-Can Nanoparticles Fight Against Coronaviruses? NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E1645. [PMID: 32825737 PMCID: PMC7557932 DOI: 10.3390/nano10091645] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/08/2020] [Accepted: 08/18/2020] [Indexed: 12/12/2022]
Abstract
Infectious diseases account for more than 20% of global mortality and viruses are responsible for about one-third of these deaths. Highly infectious viral diseases such as severe acute respiratory (SARS), Middle East respiratory syndrome (MERS) and coronavirus disease (COVID-19) are emerging more frequently and their worldwide spread poses a serious threat to human health and the global economy. The current COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of 27 July 2020, SARS-CoV-2 has infected over 16 million people and led to the death of more than 652,434 individuals as on 27 July 2020 while also causing significant economic losses. To date, there are no vaccines or specific antiviral drugs to prevent or treat COVID-19. Hence, it is necessary to accelerate the development of antiviral drugs and vaccines to help mitigate this pandemic. Non-Conventional antiviral agents must also be considered and exploited. In this regard, nanoparticles can be used as antiviral agents for the treatment of various viral infections. The use of nanoparticles provides an interesting opportunity for the development of novel antiviral therapies with a low probability of developing drug resistance compared to conventional chemical-based antiviral therapies. In this review, we first discuss viral mechanisms of entry into host cells and then we detail the major and important types of nanomaterials that could be used as antiviral agents. These nanomaterials include silver, gold, quantum dots, organic nanoparticles, liposomes, dendrimers and polymers. Further, we consider antiviral mechanisms, the effects of nanoparticles on coronaviruses and therapeutic approaches of nanoparticles. Finally, we provide our perspective on the future of nanoparticles in the fight against viral infections.
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Affiliation(s)
- Sangiliyandi Gurunathan
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Seoul 05029, Korea; (S.G.); (Y.C.); (J.T.D.); (C.P.); (K.H.); (J.-H.K.)
| | - Muhammad Qasim
- Center of Bioengineering and Nanomedicine, Department of Food Science, University of Otago, Dunedin 9054, New Zealand;
| | - Youngsok Choi
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Seoul 05029, Korea; (S.G.); (Y.C.); (J.T.D.); (C.P.); (K.H.); (J.-H.K.)
| | - Jeong Tae Do
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Seoul 05029, Korea; (S.G.); (Y.C.); (J.T.D.); (C.P.); (K.H.); (J.-H.K.)
| | - Chankyu Park
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Seoul 05029, Korea; (S.G.); (Y.C.); (J.T.D.); (C.P.); (K.H.); (J.-H.K.)
| | - Kwonho Hong
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Seoul 05029, Korea; (S.G.); (Y.C.); (J.T.D.); (C.P.); (K.H.); (J.-H.K.)
| | - Jin-Hoi Kim
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Seoul 05029, Korea; (S.G.); (Y.C.); (J.T.D.); (C.P.); (K.H.); (J.-H.K.)
| | - Hyuk Song
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Seoul 05029, Korea; (S.G.); (Y.C.); (J.T.D.); (C.P.); (K.H.); (J.-H.K.)
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The Importance of Developing Rigorous Social Science Methods for Community Engagement and Behavior Change During Outbreak Response. Disaster Med Public Health Prep 2020; 15:685-690. [PMID: 32641188 DOI: 10.1017/dmp.2020.163] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Despite growing international attention, the anthropological and socio-behavioral elements of epidemics continue to be understudied and under resourced and lag behind the traditional outbreak response infrastructure. As seen in the current 2019 coronavirus disease (COVID-19) pandemic, the importance of socio-behavioral elements in understanding transmission and facilitating control of many outbreak-prone pathogens, this is problematic. Beyond the recent strengthening of global outbreak response capacities and global health security measures, a greater focus on the socio-behavioral components of outbreak response is required. We add to the current discussion by briefly highlighting the importance of socio-behavior in the Ebola virus disease (EVD) response, and describe vital areas of future development, including methods for community engagement and validated frameworks for behavioral modeling and change in outbreak settings.
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Kannamkottapilly Chandrasekharan P, Rahul A, Gopakumar RNS, Thekkumkara Surendran Nair A. Stakeholder Perspective of Handling the Deceased during the Nipah Virus Outbreak in Kerala, South India, 2018. Am J Trop Med Hyg 2020; 103:1241-1246. [PMID: 32588798 DOI: 10.4269/ajtmh.20-0155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
In any outbreak situation, a poor stakeholder response can impede the outbreak control and can have high economic and social cost. We conducted a qualitative study to understand stakeholder response in handling of the Nipah deceased persons during the outbreak of Nipah in Kerala, 2018. To understand the responses and to generate knowledge from the data, we used grounded theory approach for the study and conducted in-depth interviews and focus group discussion. Mixed public response and swift state response emerged as the main themes in our study. Under the "mixed public response," three categories emerged, including anxiety and fear, conflicting religious beliefs, and humanitarian concern. Under the "swift state response," the categories emerged were critical resources and robust guidance. A collective effort involving the administration, local and religious groups, and a culturally acceptable scientific protocol proved to be good examples of gaining social acceptance. Kerala puts forth a model of efficient community engagement and communication to gain public support and acceptance in a fatal disease outbreak.
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Affiliation(s)
| | - Arya Rahul
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, India
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A Resource for Planning for Disasters and Outbreaks: Lessons From the West African Ebola Epidemic. Disaster Med Public Health Prep 2020; 15:143. [PMID: 32452332 DOI: 10.1017/dmp.2020.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Eccleston-Turner M, Brassington I. Restricting Access to Pathogen Samples and Epidemiological Data: A Not-So-Brief History of “Viral Sovereignty” and the Mark It Left on the World. INFECTIOUS DISEASES IN THE NEW MILLENNIUM 2020; 82. [PMCID: PMC7226898 DOI: 10.1007/978-3-030-39819-4_8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
In 2007 the Indonesian government claimed sovereignty over the H5N1 influenza virus samples isolated within Indonesia’s territories, refusing to share those samples with the World Health Organisation. Indonesia’s sovereignty claims conflicted with the decades-long practice of sharing influenza samples with the WHO, and was seen as an affront to scientific norms of cooperation and openness. The conflict was ostensibly resolved in 2011 with the introduction of the WHO’s Pandemic Influenza Preparedness Framework (PIP Framework), which was intended to secure access to influenza viruses from around the world and effect a fairer distribution of vaccines and other benefits associated with the use of pandemic influenza samples. The problem is, the PIP Framework did not resolve the issues created with the concept of viral sovereignty. In fact, by recognising the sovereign rights of states over this subset of pathogens, the PIP Framework legitimised viral sovereignty as a broader legal norm. Instead of resisting this concept, the WHO quietly acceded to it and reinforced a set of perverse incentives for countries to restrict access to pathogens precisely when those pathogens embody the greatest value: during a public health emergency. This chapter demonstrates that the concept of viral sovereignty did not begin with Indonesia in 2007, and more importantly, it did not end with the PIP Framework in 2011. Despite the term “viral sovereignty” fading into relative obscurity, the concept itself is now an established legal norm that could delay efforts to save lives during epidemics and pandemics.
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Ezezika O, Keita AK. Outsmarting Ebola through stronger national health systems. SCIENTIFIC AFRICAN 2020. [DOI: 10.1016/j.sciaf.2020.e00309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Markotter W, Coertse J, De Vries L, Geldenhuys M, Mortlock M. Bat-borne viruses in Africa: a critical review. J Zool (1987) 2020; 311:77-98. [PMID: 32427175 PMCID: PMC7228346 DOI: 10.1111/jzo.12769] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/27/2019] [Accepted: 01/15/2020] [Indexed: 12/17/2022]
Abstract
In Africa, bat‐borne zoonoses emerged in the past few decades resulting in large outbreaks or just sporadic spillovers. In addition, hundreds of more viruses are described without any information on zoonotic potential. We discuss important characteristics of bats including bat biology, evolution, distribution and ecology that not only make them unique among most mammals but also contribute to their potential as viral reservoirs. The detection of a virus in bats does not imply that spillover will occur and several biological, ecological and anthropogenic factors play a role in such an event. We summarize and critically analyse the current knowledge on African bats as reservoirs for corona‐, filo‐, paramyxo‐ and lyssaviruses. We highlight that important information on epidemiology, bat biology and ecology is often not available to make informed decisions on zoonotic spillover potential. Even if knowledge gaps exist, it is still important to recognize the role of bats in zoonotic disease outbreaks and implement mitigation strategies to prevent exposure to infectious agents including working safely with bats. Equally important is the crucial role of bats in various ecosystem services. This necessitates a multidisciplinary One Health approach to close knowledge gaps and ensure the development of responsible mitigation strategies to not only minimize risk of infection but also ensure conservation of the species.
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Affiliation(s)
- W Markotter
- Department of Medical Virology Centre for Viral Zoonoses Faculty of Health Sciences University of Pretoria Pretoria South Africa
| | - J Coertse
- Department of Medical Virology Centre for Viral Zoonoses Faculty of Health Sciences University of Pretoria Pretoria South Africa
| | - L De Vries
- Department of Medical Virology Centre for Viral Zoonoses Faculty of Health Sciences University of Pretoria Pretoria South Africa
| | - M Geldenhuys
- Department of Medical Virology Centre for Viral Zoonoses Faculty of Health Sciences University of Pretoria Pretoria South Africa
| | - M Mortlock
- Department of Medical Virology Centre for Viral Zoonoses Faculty of Health Sciences University of Pretoria Pretoria South Africa
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Matson MJ, Chertow DS, Munster VJ. Delayed recognition of Ebola virus disease is associated with longer and larger outbreaks. Emerg Microbes Infect 2020; 9:291-301. [PMID: 32013784 PMCID: PMC7034085 DOI: 10.1080/22221751.2020.1722036] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The average time required to detect an Ebola virus disease (EVD) outbreak following spillover of Ebola virus (EBOV) to a primary human case has remained essentially unchanged for over 40 years, with some of the longest delays in detection occurring in recent decades. In this review, our aim was to examine the relationship between delays in detection of EVD and the duration and size of outbreaks, and we report that longer delays are associated with longer and larger EVD outbreaks. Historically, EVD outbreaks have typically been comprised of less than 100 cases (median = 60) and have lasted less than 4 months (median = 118 days). The ongoing outbreak in Democratic Republic of the Congo, together with the 2013–2016 west Africa outbreak, are stark outliers amidst these trends and had two of the longest delays in detection on record. While significant progress has been made in the development of EVD countermeasures, implementation during EVD outbreaks is problematic. Thus, EVD surveillance must be improved by the broad deployment of modern diagnostic tools, as prompt recognition of EVD has the potential to stem early transmission and ultimately limit the duration and size of outbreaks.
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Affiliation(s)
- M Jeremiah Matson
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA.,Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Daniel S Chertow
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA.,Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Vincent J Munster
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
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Talisuna AO, Okiro EA, Yahaya AA, Stephen M, Bonkoungou B, Musa EO, Minkoulou EM, Okeibunor J, Impouma B, Djingarey HM, Yao NKM, Oka S, Yoti Z, Fall IS. Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016-2018. Global Health 2020; 16:9. [PMID: 31941554 DOI: 10.1186/s12992-019-050-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/30/2019] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Emerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll. To provide evidence for the investment case for public health emergency preparedness, we analysed the spatial and temporal distribution of epidemics, disasters and other potential public health emergencies in the WHO African region between 2016 and 2018. METHODS We abstracted data from several sources, including: the WHO African Region's weekly bulletins on epidemics and emergencies, the WHO-Disease Outbreak News (DON) and the Emergency Events Database (EM-DAT) of the Centre for Research on the Epidemiology of Disasters (CRED). Other sources were: the Program for Monitoring Emerging Diseases (ProMED) and the Global Infectious Disease and Epidemiology Network (GIDEON). We included information on the time and location of the event, the number of cases and deaths and counter-checked the different data sources. DATA ANALYSIS We used bubble plots for temporal analysis and generated graphs and maps showing the frequency and distribution of each event. Based on the frequency of events, we categorised countries into three: Tier 1, 10 or more events, Tier 2, 5-9 events, and Tier 3, less than 5 or no event. Finally, we compared the event frequencies to a summary International Health Regulations (IHR) index generated from the IHR technical area scores of the 2018 annual reports. RESULTS Over 260 events were identified between 2016 and 2018. Forty-one countries (87%) had at least one epidemic between 2016 and 2018, and 21 of them (45%) had at least one epidemic annually. Twenty-two countries (47%) had disasters/humanitarian crises. Seven countries (the epicentres) experienced over 10 events and all of them had limited or developing IHR capacities. The top five causes of epidemics were: Cholera, Measles, Viral Haemorrhagic Diseases, Malaria and Meningitis. CONCLUSIONS The frequent and widespread occurrence of epidemics and disasters in Africa is a clarion call for investing in preparedness. While strengthening preparedness should be guided by global frameworks, it is the responsibility of each government to finance country specific needs. We call upon all African countries to establish governance and predictable financing mechanisms for IHR implementation and to build resilient health systems everywhere.
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Affiliation(s)
- Ambrose Otau Talisuna
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo.
| | - Emelda Aluoch Okiro
- Population Health Unit, Kenya Medical Research Institute - Wellcome Trust Research Programme, P.O. Box 43640-00100, Nairobi, Kenya
| | - Ali Ahmed Yahaya
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Mary Stephen
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Boukare Bonkoungou
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Emmanuel Onuche Musa
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | | | - Joseph Okeibunor
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Benido Impouma
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Haruna Mamoudou Djingarey
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - N'da Konan Michel Yao
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Sakuya Oka
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Zabulon Yoti
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Ibrahima Socé Fall
- World Health Organization, Emergency Response Department, Health Emergencies programme, Geneva, Switzerland
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Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016-2018. Global Health 2020; 16:9. [PMID: 31941554 PMCID: PMC6964091 DOI: 10.1186/s12992-019-0540-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/30/2019] [Indexed: 11/17/2022] Open
Abstract
Background Emerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll. To provide evidence for the investment case for public health emergency preparedness, we analysed the spatial and temporal distribution of epidemics, disasters and other potential public health emergencies in the WHO African region between 2016 and 2018. Methods We abstracted data from several sources, including: the WHO African Region’s weekly bulletins on epidemics and emergencies, the WHO-Disease Outbreak News (DON) and the Emergency Events Database (EM-DAT) of the Centre for Research on the Epidemiology of Disasters (CRED). Other sources were: the Program for Monitoring Emerging Diseases (ProMED) and the Global Infectious Disease and Epidemiology Network (GIDEON). We included information on the time and location of the event, the number of cases and deaths and counter-checked the different data sources. Data analysis We used bubble plots for temporal analysis and generated graphs and maps showing the frequency and distribution of each event. Based on the frequency of events, we categorised countries into three: Tier 1, 10 or more events, Tier 2, 5–9 events, and Tier 3, less than 5 or no event. Finally, we compared the event frequencies to a summary International Health Regulations (IHR) index generated from the IHR technical area scores of the 2018 annual reports. Results Over 260 events were identified between 2016 and 2018. Forty-one countries (87%) had at least one epidemic between 2016 and 2018, and 21 of them (45%) had at least one epidemic annually. Twenty-two countries (47%) had disasters/humanitarian crises. Seven countries (the epicentres) experienced over 10 events and all of them had limited or developing IHR capacities. The top five causes of epidemics were: Cholera, Measles, Viral Haemorrhagic Diseases, Malaria and Meningitis. Conclusions The frequent and widespread occurrence of epidemics and disasters in Africa is a clarion call for investing in preparedness. While strengthening preparedness should be guided by global frameworks, it is the responsibility of each government to finance country specific needs. We call upon all African countries to establish governance and predictable financing mechanisms for IHR implementation and to build resilient health systems everywhere.
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32
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Shapiro JT, Sovie AR, Faller CR, Monadjem A, Fletcher RJ, McCleery RA. Ebola spillover correlates with bat diversity. EUR J WILDLIFE RES 2020. [DOI: 10.1007/s10344-019-1346-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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33
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Kunkel A, Keita M, Diallo B, le Polain de Waroux O, Subissi L, Wague B, Molala R, Lonfandjo P, Bokete SB, Perea W, Djingarey MH. Assessment of a health facility based active case finding system for Ebola virus disease in Mbandaka, Democratic Republic of the Congo, June-July 2018. BMC Infect Dis 2019; 19:981. [PMID: 31752717 PMCID: PMC6873572 DOI: 10.1186/s12879-019-4600-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 10/28/2019] [Indexed: 11/30/2022] Open
Abstract
Background The ninth outbreak of Ebola Virus Disease (EVD) in the Democratic Republic of the Congo occurred in Équateur Province from 8 May-24 July 2018. A system of health facility (HF)-based active case finding (ACF) was implemented in Mbandaka, a regional capital with four confirmed EVD cases, following completion of contact tracing. The goal of this HF-based ACF system was to look for undetected EVD cases among patients that visited HFs beginning one week prior to the system’s implementation. Methods From 23 June – 24 July 2018, ACF teams visited HFs in Mbandaka and reviewed all medical records as far back as 17 June for any consultations meeting the suspected EVD case definition. The teams then assessed whether to validate these as suspected EVD cases based on factors such as recovery, epidemiological links, and their clinical judgement. ACF teams also assessed HFs’ awareness of EVD symptoms and the process for alerting suspected cases. We calculated descriptive statistics regarding the characteristics of reviewed consultations, alert cases, and visited HFs. We also used univariate and multivariate random effects logistic regression models to evaluate the impact of repeated ACF visits to the same HF on the staff’s awareness of EVD. Results ACF teams reviewed 37,746 consultations, of which 690 met the definition of a suspected case of EVD. Two were validated as suspected EVD cases and transferred to the Ebola Treatment Unit for testing; both tested negative. Repeated ACF visits to the same HF were significantly associated with improved EVD awareness (p < 0.001) in univariate and multivariate analyses. Conclusion HF-based ACF during EVD outbreaks may improve EVD awareness and reveal many individuals meeting the suspected case definition. However, many who meet this definition may not have EVD, depending on the population size covered by ACF and amount of ongoing EVD transmission. Given the burdensome procedure of testing suspected EVD cases, future HF-based ACF systems would benefit from improved clarity on which patients require further testing.
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Affiliation(s)
- Amber Kunkel
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France. .,Global Outbreak Alert and Response Network (GOARN), Geneva, Switzerland.
| | - Mory Keita
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Boubacar Diallo
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Olivier le Polain de Waroux
- Global Outbreak Alert and Response Network (GOARN), Geneva, Switzerland.,Public Health England, London, UK.,UK-Public Health Rapid Support Team, London, UK.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Bocar Wague
- Global Outbreak Alert and Response Network (GOARN), Geneva, Switzerland.,Ministry of Health of Mauritania, Nouakchott, Mauritania
| | - Roger Molala
- Provincial Health Division of the Équateur Region, Mbandaka, Democratic Republic of the Congo
| | - Pierre Lonfandjo
- Provincial Health Division of the Équateur Region, Mbandaka, Democratic Republic of the Congo
| | - Sébastien Bokoo Bokete
- Provincial Health Division of the Équateur Region, Mbandaka, Democratic Republic of the Congo
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Tian X, Chen D, Wang H, Xu S, Zhu L, Wu X, Wu Z. The induction and characterization of monoclonal antibodies specific to GP of Ebola virus. J Med Virol 2019; 92:996-1006. [PMID: 31663613 DOI: 10.1002/jmv.25615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 10/24/2019] [Indexed: 01/18/2023]
Abstract
The Ebola virus is highly infectious and characterized by hemorrhagic fever, headache, and so on with a high mortality rate. Currently, there are neither therapeutic drugs or vaccines against the Ebola virus nor fast diagnostic methods for the detection of Ebola virus infection. This study reported the induction and isolation of two monoclonal antibodies that specifically recognized the glycoprotein (GP) and secreted glycoprotein (sGP) of the Ebola virus. Plasmids encoding either GP or sGP were constructed and immunized BALB/c mice, accordingly purified sGP was boosted. The antisera were analyzed for binding activity against sGP protein in enzyme-linked immunosorbent assay (ELISA) and neutralization activity in a pseudotyped virus neutralization assay. A number of reactive clones were isolated and two monoclonal antibodies T231 and T242 were identified to react with both GP and sGP. Western blot and ELISA assays showed that the monoclonal antibodies could react with GP and sGP, respectively. Moreover, they could recognize Ebola pseudovirus by cellular immunochemistry assay. We labeled the monoclonal antibody T231 with biotin and analyzed the competitiveness of the two antibodies by the ELISA test. The results showed that the binding epitopes of the two monoclonal antibodies to sGP were partially overlapped. In summary, two GP-specific mAbs were identified, which will be used to detect the Ebola virus or investigate GP.
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Affiliation(s)
- Xiaoyan Tian
- Department of General Surgery, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China.,Center for Public Health Research, Nanjing University, Nanjing, China
| | - Deyan Chen
- Center for Public Health Research, Nanjing University, Nanjing, China
| | - Huanru Wang
- Center for Public Health Research, Nanjing University, Nanjing, China
| | - Shijie Xu
- Center for Public Health Research, Nanjing University, Nanjing, China
| | - Linjing Zhu
- Y-Clone Medical Science Co Ltd, Nanjing, China
| | - Xilin Wu
- Center for Public Health Research, Nanjing University, Nanjing, China.,Y-Clone Medical Science Co Ltd, Nanjing, China
| | - Zhiwei Wu
- Center for Public Health Research, Nanjing University, Nanjing, China.,State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing, China
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35
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Becker DJ, Washburne AD, Faust CL, Pulliam JRC, Mordecai EA, Lloyd-Smith JO, Plowright RK. Dynamic and integrative approaches to understanding pathogen spillover. Philos Trans R Soc Lond B Biol Sci 2019; 374:20190014. [PMID: 31401959 PMCID: PMC6711302 DOI: 10.1098/rstb.2019.0014] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2019] [Indexed: 12/23/2022] Open
Affiliation(s)
- Daniel J. Becker
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
- Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
- Department of Biology, Indiana University, Bloomington, IN, USA
| | - Alex D. Washburne
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - Christina L. Faust
- Institute of Biodiversity Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Juliet R. C. Pulliam
- South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | | | - James O. Lloyd-Smith
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, CA, USA
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Raina K. Plowright
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
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36
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Becker DJ, Washburne AD, Faust CL, Mordecai EA, Plowright RK. The problem of scale in the prediction and management of pathogen spillover. Philos Trans R Soc Lond B Biol Sci 2019; 374:20190224. [PMID: 31401958 PMCID: PMC6711304 DOI: 10.1098/rstb.2019.0224] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2019] [Indexed: 01/28/2023] Open
Abstract
Disease emergence events, epidemics and pandemics all underscore the need to predict zoonotic pathogen spillover. Because cross-species transmission is inherently hierarchical, involving processes that occur at varying levels of biological organization, such predictive efforts can be complicated by the many scales and vastness of data potentially required for forecasting. A wide range of approaches are currently used to forecast spillover risk (e.g. macroecology, pathogen discovery, surveillance of human populations, among others), each of which is bound within particular phylogenetic, spatial and temporal scales of prediction. Here, we contextualize these diverse approaches within their forecasting goals and resulting scales of prediction to illustrate critical areas of conceptual and pragmatic overlap. Specifically, we focus on an ecological perspective to envision a research pipeline that connects these different scales of data and predictions from the aims of discovery to intervention. Pathogen discovery and predictions focused at the phylogenetic scale can first provide coarse and pattern-based guidance for which reservoirs, vectors and pathogens are likely to be involved in spillover, thereby narrowing surveillance targets and where such efforts should be conducted. Next, these predictions can be followed with ecologically driven spatio-temporal studies of reservoirs and vectors to quantify spatio-temporal fluctuations in infection and to mechanistically understand how pathogens circulate and are transmitted to humans. This approach can also help identify general regions and periods for which spillover is most likely. We illustrate this point by highlighting several case studies where long-term, ecologically focused studies (e.g. Lyme disease in the northeast USA, Hendra virus in eastern Australia, Plasmodium knowlesi in Southeast Asia) have facilitated predicting spillover in space and time and facilitated the design of possible intervention strategies. Such studies can in turn help narrow human surveillance efforts and help refine and improve future large-scale, phylogenetic predictions. We conclude by discussing how greater integration and exchange between data and predictions generated across these varying scales could ultimately help generate more actionable forecasts and interventions. This article is part of the theme issue 'Dynamic and integrative approaches to understanding pathogen spillover'.
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Affiliation(s)
- Daniel J. Becker
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
- Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
- Department of Biology, Indiana University, Bloomington, IN, USA
| | - Alex D. Washburne
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - Christina L. Faust
- Institute of Biodiversity Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | | | - Raina K. Plowright
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
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Khalil H, Ecke F, Evander M, Bucht G, Hörnfeldt B. Population Dynamics of Bank Voles Predicts Human Puumala Hantavirus Risk. ECOHEALTH 2019; 16:545-557. [PMID: 31309365 PMCID: PMC6858908 DOI: 10.1007/s10393-019-01424-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 05/15/2019] [Accepted: 05/15/2019] [Indexed: 06/01/2023]
Abstract
Predicting risk of zoonotic diseases, i.e., diseases shared by humans and animals, is often complicated by the population ecology of wildlife host(s). We here demonstrate how ecological knowledge of a disease system can be used for early prediction of human risk using Puumala hantavirus (PUUV) in bank voles (Myodes glareolus), which causes Nephropathia epidemica (NE) in humans, as a model system. Bank vole populations at northern latitudes exhibit multiannual fluctuations in density and spatial distribution, a phenomenon that has been studied extensively. Nevertheless, existing studies predict NE incidence only a few months before an outbreak. We used a time series on cyclic bank vole population density (1972-2013), their PUUV infection rates (1979-1986; 2003-2013), and NE incidence in Sweden (1990-2013). Depending on the relationship between vole density and infection prevalence (proportion of infected animals), either overall density of bank voles or the density of infected bank voles may be used to predict seasonal NE incidence. The density and spatial distribution of voles at density minima of a population cycle contribute to the early warning of NE risk later at its cyclic peak. When bank voles remain relatively widespread in the landscape during cyclic minima, PUUV can spread from a high baseline during a cycle, culminating in high prevalence in bank voles and potentially high NE risk during peak densities.
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Affiliation(s)
- Hussein Khalil
- Department of Wildlife, Fish, and Environmental Studies, Swedish University of Agricultural Sciences, 901 83, Umeå, Sweden.
| | - Frauke Ecke
- Department of Wildlife, Fish, and Environmental Studies, Swedish University of Agricultural Sciences, 901 83, Umeå, Sweden
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences, P.O. Box 7050, 750 07, Uppsala, Sweden
| | - Magnus Evander
- Department of Clinical Microbiology, Virology, Umeå University, 901 85, Umeå, Sweden
| | - Göran Bucht
- Swedish Defense Research Agency, CBRN Defence and Security, Umeå, Sweden
| | - Birger Hörnfeldt
- Department of Wildlife, Fish, and Environmental Studies, Swedish University of Agricultural Sciences, 901 83, Umeå, Sweden
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Kuisma E, Olson SH, Cameron KN, Reed PE, Karesh WB, Ondzie AI, Akongo MJ, Kaba SD, Fischer RJ, Seifert SN, Muñoz-Fontela C, Becker-Ziaja B, Escudero-Pérez B, Goma-Nkoua C, Munster VJ, Mombouli JV. Long-term wildlife mortality surveillance in northern Congo: a model for the detection of Ebola virus disease epizootics. Philos Trans R Soc Lond B Biol Sci 2019; 374:20180339. [PMID: 31401969 DOI: 10.1098/rstb.2018.0339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Ebolavirus (EBOV) has caused disease outbreaks taking thousands of lives, costing billions of dollars in control efforts and threatening great ape populations. EBOV ecology is not fully understood but infected wildlife and consumption of animal carcasses have been linked to human outbreaks, especially in the Congo Basin. Partnering with the Congolese Ministry of Health, we conducted wildlife mortality surveillance and educational outreach in the northern Republic of Congo (RoC). Designed for EBOV detection and to alert public health authorities, we established a low-cost wildlife mortality reporting network covering 50 000 km2. Simultaneously, we delivered educational outreach promoting behavioural change to over 6600 people in rural northern RoC. We achieved specimen collection by training project staff on a safe sampling protocol and equipping geographically distributed bases with sampling kits. We established in-country diagnostics for EBOV testing, reducing diagnostic turnaround time to 3 days and demonstrated the absence of EBOV in 58 carcasses. Central Africa remains a high-risk EBOV region, but RoC, home to the largest remaining populations of great apes, has not had an epidemic since 2005. This effort continues to function as an untested early warning system in RoC, where people and great apes have died from past Ebola virus disease outbreaks. This article is part of the theme issue 'Dynamic and integrative approaches to understanding pathogen spillover'.
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Affiliation(s)
- Eeva Kuisma
- Wildlife Conservation Society, Wildlife Health Program, 151 Avenue du General de Gaulle, BP14537 Brazzaville, Republic of Congo
| | - Sarah H Olson
- Wildlife Conservation Society, Wildlife Health Program, 2300 Southern Boulevard, Bronx, New York, NY 10460, USA
| | - Kenneth N Cameron
- Wildlife Conservation Society, Wildlife Health Program, 2300 Southern Boulevard, Bronx, New York, NY 10460, USA
| | - Patricia E Reed
- Wildlife Conservation Society, Wildlife Health Program, 2300 Southern Boulevard, Bronx, New York, NY 10460, USA
| | - William B Karesh
- Health and Policy, EcoHealth Alliance, 460 West 34th Street, New York, NY 10001, USA
| | - Alain I Ondzie
- Wildlife Conservation Society, Wildlife Health Program, 151 Avenue du General de Gaulle, BP14537 Brazzaville, Republic of Congo
| | - Marc-Joël Akongo
- Wildlife Conservation Society, Wildlife Health Program, 151 Avenue du General de Gaulle, BP14537 Brazzaville, Republic of Congo
| | - Serge D Kaba
- Wildlife Conservation Society, Wildlife Health Program, 151 Avenue du General de Gaulle, BP14537 Brazzaville, Republic of Congo
| | - Robert J Fischer
- Laboratory of Virology, Virus Ecology Unit, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, 903s 4th street, Hamilton, MT, USA
| | - Stephanie N Seifert
- Laboratory of Virology, Virus Ecology Unit, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, 903s 4th street, Hamilton, MT, USA
| | - César Muñoz-Fontela
- Bernhard Nocht Institute for Tropical Medicine and German Center for Infection Research DZIF, Bernhard Nocht Strasse 74, 20359 Hamburg, Germany
| | | | - Beatriz Escudero-Pérez
- Bernhard Nocht Institute for Tropical Medicine and German Center for Infection Research DZIF, Bernhard Nocht Strasse 74, 20359 Hamburg, Germany
| | - Cynthia Goma-Nkoua
- Service d'Epidémiologie Moléculaire, Laboratoire National de Santé Publique, Avenue du General de Gaulle, BP120 Brazzaville, Republic of Congo
| | - Vincent J Munster
- Laboratory of Virology, Virus Ecology Unit, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, 903s 4th street, Hamilton, MT, USA
| | - Jean-Vivien Mombouli
- Service d'Epidémiologie Moléculaire, Laboratoire National de Santé Publique, Avenue du General de Gaulle, BP120 Brazzaville, Republic of Congo
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van Lieshout LP, Soule G, Sorensen D, Frost KL, He S, Tierney K, Safronetz D, Booth SA, Kobinger GP, Qiu X, Wootton SK. Intramuscular Adeno-Associated Virus-Mediated Expression of Monoclonal Antibodies Provides 100% Protection Against Ebola Virus Infection in Mice. J Infect Dis 2019; 217:916-925. [PMID: 29365142 DOI: 10.1093/infdis/jix644] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 12/30/2017] [Indexed: 01/14/2023] Open
Abstract
The 2013-2016 West Africa outbreak demonstrated the epidemic potential of Ebola virus and highlighted the need for counter strategies. Monoclonal antibody (mAb)-based therapies hold promise as treatment options for Ebola virus infections. However, production of clinical-grade mAbs is labor intensive, and immunity is short lived. Conversely, adeno-associated virus (AAV)-mediated mAb gene transfer provides the host with a genetic blueprint to manufacture mAbs in vivo, leading to steady release of antibody over many months. Here we demonstrate that AAV-mediated expression of nonneutralizing mAb 5D2 or 7C9 confers 100% protection against mouse-adapted Ebola virus infection, while neutralizing mAb 2G4 was 83% protective. A 2-component cocktail, AAV-2G4/AAV-5D2, provided complete protection when administered 7 days prior to challenge and was partially protective with a 3-day lead time. Finally, AAV-mAb therapies provided sustained protection from challenge 5 months following AAV administration. AAV-mAb may be a viable alternative strategy for vaccination against emerging infectious diseases.
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Affiliation(s)
| | - Geoff Soule
- Zoonotic Diseases and Special Pathogens Program, Canada
| | - Debra Sorensen
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Kathy L Frost
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Shihua He
- Zoonotic Diseases and Special Pathogens Program, Canada
| | - Kevin Tierney
- Zoonotic Diseases and Special Pathogens Program, Canada
| | - David Safronetz
- Zoonotic Diseases and Special Pathogens Program, Canada.,Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Stephanie A Booth
- Molecular Pathobiology, National Microbiology Laboratory, Public Health Agency of Canada, Canada
| | - Gary P Kobinger
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.,Department of Microbiology and Immunology, Faculty of Medicine, Laval University, Québec City, Canada
| | - Xiangguo Qiu
- Zoonotic Diseases and Special Pathogens Program, Canada.,Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
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40
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Nagbe T, Yealue K, Yeabah T, Rude JM, Fallah M, Skrip L, Agbo C, Mouhamoud N, Okeibunor JC, Tuopileyi R, Talisuna A, Yahaya AA, Rajatonirina S, Frimpong JA, Stephen M, Hamblion E, Nyenswah T, Dahn B, Gasasira A, Fall IS. Integrated disease surveillance and response implementation in Liberia, findings from a data quality audit, 2017. Pan Afr Med J 2019; 33:10. [PMID: 31402968 PMCID: PMC6675580 DOI: 10.11604/pamj.supp.2019.33.2.17608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/14/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction in spite of the efforts and resources committed by the division of infectious disease and epidemiology (DIDE) of the national public health institute of Liberia (NPHIL)/Ministry of health to strengthening integrated disease surveillance and response (IDSR) across the country, quality data management system remains a challenge to the Liberia NPHIL/MoH (Ministry of health), with incomplete and inconsistent data constantly being reported at different levels of the surveillance system. As part of the monitoring and evaluation strategy for IDSR continuous improvement, data quality assessment (DQA) of the IDSR system to identify successes and gaps in the disease surveillance information system (DSIS) with the aim of ensuring data accuracy, reliability and credibility of generated data at all levels of the health system; and to inform an operational plan to address data quality needs for IDSR activities is required. Methods multi-stage cluster sampling that included stage 1: simple random sample (SRS) of five counties, stage 2: simple random sample of two districts and stage 3: simple random sample of three health facilities was employed during the study pilot assessment done in Montserrado County with Liberia institute of bio medical research (LIBR) inclusive. A total of thirty (30) facilities was targeted, twenty nine (29) of the facilities were successfully audited: one hospital, two health centers, twenty clinics and respondents included: health facility surveillance focal persons (HFSFP), zonal surveillance officers (ZSOs), district surveillance officers (DSOs) and County surveillance officers (CSOs). Results the assessment revealed that data use is limited to risk communication and sensitization, no examples of use of data for prioritization or decision making at the subnational level. The findings indicated the following: 23% (7/29) of health facilities having dedicated phone for reporting, 20% (6/29) reported no cell phone network, 17% (5/29) reported daily access to internet, 56.6% (17/29) reported a consistent supply of electricity, and no facility reported access to functional laptop. It was also established that 40% of health facilities have experienced a stock out of laboratory specimens packaging supplies in the past year. About half of the surveyed health facilities delivered specimens through riders and were assisted by the DSOs. There was a large variety in the reported packaging process, with many staff unable to give clear processes. The findings during the exercise also indicated that 91% of health facility staff were mentored on data quality check and data management including the importance of the timeliness and completeness of reporting through supportive supervision and mentorship; 65% of the health facility assessed received supervision on IDSR core performance indicator; and 58% of the health facility officer in charge gave feedback to the community level. Conclusion public health is a data-intensive field which needs high-quality data and authoritative information to support public health assessment, decision-making and to assure the health of communities. Data quality assessment is important for public health. In this review completeness, accuracy, and timeliness were the three most-assessed attributes. Quantitative data quality assessment primarily used descriptive surveys and data audits, while qualitative data quality assessment methods include primarily interviews, questionnaires administration, documentation reviews and field observations. We found that data-use and data-process have not been given adequate attention, although they were equally important factors which determine the quality of data. Other limitations of the previous studies were inconsistency in the definition of the attributes of data quality, failure to address data users' concerns and a lack of triangulation of mixed methods for data quality assessment. The reliability and validity of the data quality assessment were rarely reported. These gaps suggest that in the future, data quality assessment for public health needs to consider equally the three dimensions of data quality, data use and data process. Measuring the perceptions of end users or consumers towards data quality will enrich our understanding of data quality issues. Data use is limited to risk communication and sensitization, no examples of use of data for prioritization or decision making at the sub national level.
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Affiliation(s)
- Thomas Nagbe
- National Public Health Institute, Monrovia, Liberia
| | | | | | | | | | - Laura Skrip
- National Public Health Institute, Monrovia, Liberia
| | | | | | | | | | - Ambrose Talisuna
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Ali Ahmed Yahaya
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | | | - Mary Stephen
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Esther Hamblion
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | - Bernice Dahn
- National Public Health Institute, Monrovia, Liberia
| | | | - Ibrahima Socé Fall
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
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41
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Policy and Science for Global Health Security: Shaping the Course of International Health. Trop Med Infect Dis 2019; 4:tropicalmed4020060. [PMID: 30974815 PMCID: PMC6631183 DOI: 10.3390/tropicalmed4020060] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/05/2019] [Accepted: 04/08/2019] [Indexed: 01/05/2023] Open
Abstract
The global burden of infectious diseases and the increased attention to natural, accidental, and deliberate biological threats has resulted in significant investment in infectious disease research. Translating the results of these studies to inform prevention, detection, and response efforts often can be challenging, especially if prior relationships and communications have not been established with decision-makers. Whatever scientific information is shared with decision-makers before, during, and after public health emergencies is highly dependent on the individuals or organizations who are communicating with policy-makers. This article briefly describes the landscape of stakeholders involved in information-sharing before and during emergencies. We identify critical gaps in translation of scientific expertise and results, and biosafety and biosecurity measures to public health policy and practice with a focus on One Health and zoonotic diseases. Finally, we conclude by exploring ways of improving communication and funding, both of which help to address the identified gaps. By leveraging existing scientific information (from both the natural and social sciences) in the public health decision-making process, large-scale outbreaks may be averted even in low-income countries.
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42
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Edwards MR, Basler CF. Current status of small molecule drug development for Ebola virus and other filoviruses. Curr Opin Virol 2019; 35:42-56. [PMID: 31003196 PMCID: PMC6556423 DOI: 10.1016/j.coviro.2019.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/12/2019] [Indexed: 12/16/2022]
Abstract
The filovirus family includes some of the deadliest viruses known, including Ebola virus and Marburg virus. These viruses cause periodic outbreaks of severe disease that can be spread from person to person, making the filoviruses important public health threats. There remains a need for approved drugs that target all or most members of this virus family. Small molecule inhibitors that target conserved functions hold promise as pan-filovirus therapeutics. To date, compounds that effectively target virus entry, genome replication, gene expression, and virus egress have been described. The most advanced inhibitors are nucleoside analogs that target viral RNA synthesis reactions.
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Affiliation(s)
- Megan R Edwards
- Center for Microbial Pathogenesis, Institute for Biomedical Sciences, Georgia State University, United States
| | - Christopher F Basler
- Center for Microbial Pathogenesis, Institute for Biomedical Sciences, Georgia State University, United States.
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43
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Dube A. Nanomedicines for Infectious Diseases. Pharm Res 2019; 36:63. [PMID: 30859326 DOI: 10.1007/s11095-019-2603-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/04/2019] [Indexed: 01/27/2023]
Affiliation(s)
- Admire Dube
- Discipline of Pharmaceutics, School of Pharmacy, University of the Western Cape, Cape Town, South Africa.
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44
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Enhancing Epidemiology Capacity During the 2014-15 West Africa Ebola Outbreak: An Assessment of the Role of Applied Public Health Epidemiologists. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 26:595-601. [PMID: 30747796 DOI: 10.1097/phh.0000000000000982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT In late 2014, the Centers for Disease Control and Prevention requested the support of the Council of State and Territorial Epidemiologists to enhance epidemiologic capacity in the West African countries impacted or threatened by an outbreak of Ebola virus disease. In response, the Council of State and Territorial Epidemiologists recruited 36 senior epidemiologists who, collectively, made 45 deployments to West Africa, averaging 42 days each. OBJECTIVE To assess the self-reported experiences and contributions of the deployed epidemiologists, as well as the role of nonprofit public health organizations in large-scale emergency response. DESIGN Electronic assessment of the deployed epidemiologists. PARTICIPANTS Experienced applied public health epidemiologists who volunteered to participate in the response to the West Africa Ebola virus disease emergency. MAIN OUTCOME MEASURES Descriptive data. RESULTS The chief, reported functional contributions made during deployments include improving surveillance processes (reported by 73.3% of respondents), building meaningful relationships to facilitate response activities (66.7%), improving data quality (53.3%), and improving understanding of the disease/outbreak (40.0%). Among the professional benefits of deployment to West Africa to assist with Ebola virus disease outbreak response are stimulating enthusiasm for public health work (93.3%, n = 30), broadened perspective of global health (86.7%), and sharpened epidemiological skills (56.7%). CONCLUSIONS Owing to their ability to access experienced, senior professionals, the Council of State and Territorial Epidemiologists and other nonprofit public health associations can play a meaningful role boosting surge capacity in a sustained, large-scale emergency response.
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45
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Ward MD, Brueggemann EE, Kenny T, Reitstetter RE, Mahone CR, Trevino S, Wetzel K, Donnelly GC, Retterer C, Norgren RB, Panchal RG, Warren TK, Bavari S, Cazares LH. Characterization of the plasma proteome of nonhuman primates during Ebola virus disease or melioidosis: a host response comparison. Clin Proteomics 2019; 16:7. [PMID: 30774579 PMCID: PMC6366079 DOI: 10.1186/s12014-019-9227-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/30/2019] [Indexed: 12/19/2022] Open
Abstract
Background In-depth examination of the plasma proteomic response to infection with a wide variety of pathogens can assist in the development of new diagnostic paradigms, while providing insight into the interdependent pathogenic processes which encompass a host’s immunological and physiological responses. Ebola virus (EBOV) causes a highly lethal infection termed Ebola virus disease (EVD) in primates and humans. The Gram negative non-spore forming bacillus Burkholderia pseudomallei (Bp) causes melioidosis in primates and humans, characterized by severe pneumonia with high mortality. We sought to examine the host response to infection with these two bio-threat pathogens using established animal models to provide information on the feasibility of pre-symptomatic diagnosis, since the induction of host molecular signaling networks can occur before clinical presentation and pathogen detection. Methods Herein we report the quantitative proteomic analysis of plasma collected at various times of disease progression from 10 EBOV-infected and 5 Bp-infected nonhuman primates (NHP). Our strategy employed high resolution LC–MS/MS and a peptide-tagging approach for relative protein quantitation. In each infection type, for all proteins with > 1.3 fold abundance change at any post-infection time point, a direct comparison was made with levels obtained from plasma collected daily from 5 naïve rhesus macaques, to determine the fold changes that were significant, and establish the natural variability of abundance for endogenous plasma proteins. Results A total of 41 plasma proteins displayed significant alterations in abundance during EBOV infection, and 28 proteins had altered levels during Bp infection, when compared to naïve NHPs. Many major acute phase proteins quantitated displayed similar fold-changes between the two infection types but exhibited different temporal dynamics. Proteins related to the clotting cascade, immune signaling and complement system exhibited significant differential abundance during infection with EBOV or Bp, indicating a specificity of the response. Conclusions These results advance our understanding of the global plasma proteomic response to EBOV and Bp infection in relevant primate models for human disease and provide insight into potential innate immune response differences between viral and bacterial infections. Electronic supplementary material The online version of this article (10.1186/s12014-019-9227-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michael D Ward
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Ernst E Brueggemann
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Tara Kenny
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Raven E Reitstetter
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Christopher R Mahone
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Sylvia Trevino
- 2Bacteriology Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Kelly Wetzel
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Ginger C Donnelly
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Cary Retterer
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Robert B Norgren
- 3Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE 68198 USA
| | - Rekha G Panchal
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Travis K Warren
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Sina Bavari
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
| | - Lisa H Cazares
- 1Molecular and Translational Sciences Division, U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702 USA
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46
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Oppenheim B, Gallivan M, Madhav NK, Brown N, Serhiyenko V, Wolfe ND, Ayscue P. Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index. BMJ Glob Health 2019; 4:e001157. [PMID: 30775006 PMCID: PMC6352812 DOI: 10.1136/bmjgh-2018-001157] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/24/2018] [Accepted: 12/03/2018] [Indexed: 01/15/2023] Open
Abstract
Introduction Robust metrics for national-level preparedness are critical for assessing global resilience to epidemic and pandemic outbreaks. However, existing preparedness assessments focus primarily on public health systems or specific legislative frameworks, and do not measure other essential capacities that enable and support public health preparedness and response. Methods We developed an Epidemic Preparedness Index (EPI) to assess national-level preparedness. The EPI is global, covering 188 countries. It consists of five subindices measuring each country’s economic resources, public health communications, infrastructure, public health systems and institutional capacity. To evaluate the construct validity of the EPI, we tested its correlation with proxy measures for preparedness and response capacity, including the timeliness of outbreak detection and reporting, as well as vaccination rates during the 2009 H1N1 influenza pandemic. Results The most prepared countries were concentrated in Europe and North America, while the least prepared countries clustered in Central and West Africa and Southeast Asia. Better prepared countries were found to report infectious disease outbreaks more quickly and to have vaccinated a larger proportion of their population during the 2009 pandemic. Conclusion The EPI measures a country’s capacity to detect and respond to infectious disease events. Existing tools, such as the Joint External Evaluation (JEE), have been designed to measure preparedness within a country over time. The EPI complements the JEE by providing a holistic view of preparedness and is constructed to support comparative risk assessment between countries. The index can be updated rapidly to generate global estimates of pandemic preparedness that can inform strategy and resource allocation.
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Affiliation(s)
| | | | | | - Naor Brown
- Metabiota, San Francisco, California, USA
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47
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Spengler JR, Bergeron É, Spiropoulou CF. Crimean-Congo hemorrhagic fever and expansion from endemic regions. Curr Opin Virol 2019; 34:70-78. [PMID: 30660091 DOI: 10.1016/j.coviro.2018.12.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 12/11/2018] [Indexed: 10/27/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a virus-mediated hemorrhagic disease that occurs over a wide geographic region. In recent years, a variety of active and passive surveillance networks have improved our knowledge of areas with existing circulation of Crimean-Congo hemorrhagic fever virus (CCHFV), the etiologic agent of CCHF. These investigations aid in better defining the distribution of the virus. Expansion of a virus into new areas can occur through a variety of means, including introduction of infected humans, vectors, or animals. Here, these potential contributors to expansion of CCHFV into neighboring countries and geographically distant locations are reviewed, and the likelihood and possible implications of these events, based on known characteristics of the virus and its natural maintenance and transmission cycles are explored. Furthermore, this report discusses limitations in the currently described distribution of CCHFV, and the challenges in assessing viral circulation identified in a new region as geographic expansion of the virus.
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Affiliation(s)
- Jessica R Spengler
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Éric Bergeron
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Christina F Spiropoulou
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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48
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Nzietchueng S, Kambarage D, Rwego IB, Mfinanga SG, Mbonye A, Mutonga D, Kaboyo W, Makumbi I, Muriuki S, Casimir N, Mduma S, Makasi C, Kitua AY. Post-Ebola Awakening: Urgent Call for Investing in Maintaining Effective Preparedness Capacities at the National and Regional Levels in Sub-Saharan Africa. East Afr Health Res J 2019; 3:79-84. [PMID: 34308199 PMCID: PMC8279345 DOI: 10.24248/eahrj-d-19-00019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/01/2019] [Indexed: 11/20/2022] Open
Abstract
Background: The 2014 Ebola outbreak reminded us of the importance of preparedness for addressing health security threats. Learning from this experience, we aim to (1) enhance the understanding of preparedness by policy and decision makers, (2) discuss opportunities for Africa to invest in the prevention of health security threats, (3) highlight the value of investing in preventing health security threats, and (4) propose innovations to enhance investments for the prevention or containment of health security threats at the source. Methods: We used observations of governments' attitudes towards investing in preparedness for health security prevention or containment at the source. We conducted a literature review through PubMed, the World Wide Web, and Mendeley using the keywords: “health emergency financing”, “investing in health threats prevention”, and “stopping outbreaks at the source”. Results: Countries in sub-Saharan Africa invest inadequately towards building and maintaining critical capacities for preventing, detecting, and containing outbreaks at the source. Global health security emergency funding schemes target responses to outbreaks but neglect their prevention. Governments are not absorbing and maintaining adequately capacity built through GHS, World Bank, and development aid projects – a lost opportunity for building and retaining outbreak prevention capacity. Recommendations: Governments should (1) allocate adequate national budgets for health honouring the Abuja and related commitments; (2) own and maintain capacities developed through International Development Aids, OH networks, research consortia and projects; (3) establish a regional health security threats prevention fund. The global community and scientists should (1) consider broadening existing health emergency funds to finance the prevention and containment outbreaks at the source and (2) Strengthen economic analyses and case studies as incentives for governments' budget allocations to prevent health security threats.
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Affiliation(s)
- Serge Nzietchueng
- One Health Division, Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA.,USAID/EPT-2 Preparedness and Response Project
| | | | - Innocent B Rwego
- One Health Division, Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA.,Department of Biosecurity, Ecosystems and Veterinary Public Health, Makerere University, Kampala, Uganda
| | - Sayoki G Mfinanga
- National Institute for Medical Research, Dar es Salaam, Tanzania.,Department of Public Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Afrique One-ASPIRE
| | - Anthony Mbonye
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | | | - Issa Makumbi
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Ndongo Casimir
- Veterinary Service, Ministry of Livestock, Fisheries and Animal Industries.,National Public Health Institute, Abidjan, Côte d'Ivoire
| | - Stephen Mduma
- National Institute for Medical Research, Dar es Salaam, Tanzania.,Public Health and Environmental Advancement Interventions "NGALAKERI" NGO, Morogoro, Tanzania
| | - Charles Makasi
- National Institute for Medical Research, Dar es Salaam, Tanzania.,Public Health and Environmental Advancement Interventions "NGALAKERI" NGO, Morogoro, Tanzania
| | - Andrew Y Kitua
- USAID/EPT-2 Preparedness and Response Project.,Department of Biosecurity, Ecosystems and Veterinary Public Health, Makerere University, Kampala, Uganda.,Public Health and Environmental Advancement Interventions "NGALAKERI" NGO, Morogoro, Tanzania
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49
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Basler CF, Krogan NJ, Leung DW, Amarasinghe GK. Virus and host interactions critical for filoviral RNA synthesis as therapeutic targets. Antiviral Res 2018; 162:90-100. [PMID: 30550800 DOI: 10.1016/j.antiviral.2018.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/05/2018] [Accepted: 12/08/2018] [Indexed: 01/24/2023]
Abstract
Filoviruses, which include Ebola virus (EBOV) and Marburg virus, are negative-sense RNA viruses associated with sporadic outbreaks of severe viral hemorrhagic fever characterized by uncontrolled virus replication. The extreme virulence and emerging nature of these zoonotic pathogens make them a significant threat to human health. Replication of the filovirus genome and production of viral RNAs require the function of a complex of four viral proteins, the nucleoprotein (NP), viral protein 35 (VP35), viral protein 30 (VP30) and large protein (L). The latter performs the enzymatic activities required for production of viral RNAs and capping of viral mRNAs. Although it has been recognized that interactions between the virus-encoded components of the EBOV RNA polymerase complex are required for viral RNA synthesis reactions, specific molecular details have, until recently, been lacking. New efforts have combined structural biology and molecular virology to reveal in great detail the molecular basis for critical protein-protein interactions (PPIs) necessary for viral RNA synthesis. These efforts include recent studies that have identified a range of interacting host factors and in some instances demonstrated unique mechanisms by which they act. For a select number of these interactions, combined use of mutagenesis, over-expressing of peptides corresponding to PPI interfaces and identification of small molecules that disrupt PPIs have demonstrated the functional significance of virus-virus and virus-host PPIs and suggest several as potential targets for therapeutic intervention.
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Affiliation(s)
- Christopher F Basler
- Center for Microbial Pathogenesis, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA.
| | - Nevan J Krogan
- Quantitative Biosciences Institute (QBI), UCSF, San Francisco, CA, USA; Gladstone Institute of Data Science and Biotechnology, J. David Gladstone Institutes, San Francisco, CA, USA; Department of Cellular and Molecular Pharmacology, UCSF, San Francisco, CA, USA
| | - Daisy W Leung
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Gaya K Amarasinghe
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
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50
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Vaughan K, Xu X, Peters B, Sette A. Investigation of Outbreak-Specific Nonsynonymous Mutations on Ebolavirus GP in the Context of Known Immune Reactivity. J Immunol Res 2018; 2018:1846207. [PMID: 30581874 PMCID: PMC6276448 DOI: 10.1155/2018/1846207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/01/2018] [Accepted: 10/22/2018] [Indexed: 11/17/2022] Open
Abstract
The global response to the most recent EBOV outbreak has led to increased generation and availability of data, which can be globally analyzed to increase our understanding of immune responses to EBOV. We analyzed the published antibody epitope data to identify regions immunogenic for humans on the main GP antigenic target and determine sequence variance/nonsynonymous mutations between historical isolates and variants from the 2013-2016 outbreak. Approximately half of the GP sequence has been reported as targeted by antibody responses. Our results show an enrichment of nonsynonymous mutations (NSMs) within epitopic regions on GP (70%, p = 0.0133). Mapping NSMs to human epitope reactivity may be useful for future therapeutic and prophylaxis development as well as for our general understanding of immunity against EBOV.
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Affiliation(s)
- Kerrie Vaughan
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA
| | - Xiaojun Xu
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA
| | - Bjoern Peters
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA
- University of California San Diego, Department of Medicine, La Jolla, CA 92093, USA
| | - Alessandro Sette
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA
- University of California San Diego, Department of Medicine, La Jolla, CA 92093, USA
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