Use of post-exposure #prophylaxis after occupational #exposure to #Zaire #ebolavirus (Clin Infect Dis., abstract)

[Source: Clinical Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Use of post-exposure prophylaxis after occupational exposure to Zaire ebolavirus

Karen K. Wong1, Richard T. Davey Jr.2, Angela L. Hewlett3, Colleen S. Kraft4, Aneesh K. Mehta4, Mark J. Mulligan4, Allison Beck4, William Dorman5, Christopher J. Kratochvil3, Lilin Lai4, Tara N. Palmore2, Susan Rogers4, Philip W. Smith3, Anthony F. Suffredini6, Mark Wolcott5, Ute Ströher1, and Timothy M. Uyeki1

Author Affiliations: 1U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States; 2National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States; 3University of Nebraska Medical Center, Omaha, Nebraska, United States; 4Emory University, Atlanta, Georgia, United States; 5US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, United States; 6Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States

Corresponding author: Karen K. Wong, 1600 Clifton Rd NE, MS C-09, Atlanta, GA 30329; kwong@cdc.gov

Alternate corresponding author: Timothy M. Uyeki, 1600 Clifton Rd NE, MS A-20, Atlanta, GA 30329; tuyeki@cdc.gov

 

Abstract

From September 2014–April 2015, six persons who had occupational exposures to Zaire ebolavirus in West Africa received investigational agents rVSV-ZEBOV or TKM-100802 for post-exposure prophylaxis and were monitored in the U.S. All patients experienced self-limited symptoms after PEP; none developed Ebola virus disease.

Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Keywords: Research; Abstracts; Ebola; Monoclonal Antibodies; Vaccines.

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Concordance of interim and final #estimates of #influenza #vaccine #effectiveness: a systematic review (@eurosurveillanc, abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Eurosurveillance, Volume 21, Issue 16, 21 April 2016 / Systematic Review

Concordance of interim and final estimates of influenza vaccine effectiveness: a systematic review

VK Leung 1 , BJ Cowling 2 , S Feng 2 , SG Sullivan 1 3

Author affiliations: 1. World Health Organization Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia; 2. World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; 3. Fielding School of Public Health, University of California, Los Angeles, United States

Correspondence: Sheena Sullivan (sheena.sullivan@influenzacentre.org)

Citation style for this article: Leung VK, Cowling BJ, Feng S, Sullivan SG. Concordance of interim and final estimates of influenza vaccine effectiveness: a systematic review. Euro Surveill. 2016;21(16):pii=30202. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.16.30202

Received:10 September 2015; Accepted:25 January 2016

 

Abstract

The World Health Organization’s Global Influenza Surveillance and Response System meets twice a year to generate a recommendation for the composition of the seasonal influenza vaccine. Interim vaccine effectiveness (VE) estimates provide a preliminary indication of influenza vaccine performance during the season and may be useful for decision making. We reviewed 17 pairs of studies reporting 33 pairs of interim and final estimates using the test-negative design to evaluate whether interim estimates can reliably predict final estimates. We examined features of the study design that may be correlated with interim estimates being substantially different from their final estimates and identified differences related to change in study period and concomitant changes in sample size, proportion vaccinated and proportion of cases. An absolute difference of no more than 10% between interim and final estimates was found for 18 of 33 reported pairs of estimates, including six of 12 pairs reporting VE against any influenza, six of 10 for influenza A(H1N1)pdm09, four of seven for influenza A(H3N2) and two of four for influenza B. While we identified inconsistencies in the methods, the similarities between interim and final estimates support the utility of generating and disseminating preliminary estimates of VE while virus circulation is ongoing.

Keywords: Research; Abstracts; Seasonal Influenza; Vaccines.

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#Pandemic #vaccination #strategies and #influenza severe outcomes during the influenza #H1N1pdm09 pandemic and the post-pandemic influenza season: the Nordic experience (@eurosurveillanc, abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Eurosurveillance, Volume 21, Issue 16, 21 April 2016 / Surveillance and outbreak report

Pandemic vaccination strategies and influenza severe outcomes during the influenza A(H1N1)pdm09 pandemic and the post-pandemic influenza season: the Nordic experience

JG Cuesta 1 7 , P Aavitsland 2 , H Englund 3 , Ó Gudlaugsson 4 , SH Hauge 5 , O Lyytikäinen 6 , G Sigmundsdóttir 4 , A Tegnell 3 , M Virtanen 6 , the Nordic influenza comparison group 8 , TG Krause 1

Author affiliations: 1. Statens Serum Institut, Copenhagen, Denmark; 2. Epidemi, Kristiansand, Norway; 3. Public Health Agency Sweden, Stockholm, Sweden; 4. Centre for Health Security and Communicable Disease Control, Reykjavik, Iceland; 5. Norwegian Institute of Public Health, Oslo, Norway; 6. National Institute for Health and Welfare, Helsinki, Finland; 7. European Programme for Intervention Epidemiology Training (EPIET), European; Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.; 8. The Nordic influenza comparison group members are listed at the end of the article

Correspondence: Julita Gil Cuesta (giljulita@gmail.com)

Citation style for this article: Cuesta JG, Aavitsland P, Englund H, Gudlaugsson Ó, Hauge SH, Lyytikäinen O, Sigmundsdóttir G, Tegnell A, Virtanen M, the Nordic influenza comparison group, Krause TG. Pandemic vaccination strategies and influenza severe outcomes during the influenza A(H1N1)pdm09 pandemic and the post-pandemic influenza season: the Nordic experience. Euro Surveill. 2016;21(16):pii=30208. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.16.30208

Received:14 April 2015; Accepted:03 December 2015

 

Abstract

During the 2009/10 influenza A(H1N1)pdm09 pandemic, the five Nordic countries adopted different approaches to pandemic vaccination. We compared pandemic vaccination strategies and severe influenza outcomes, in seasons 2009/10 and 2010/11 in these countries with similar influenza surveillance systems. We calculated the cumulative pandemic vaccination coverage in 2009/10 and cumulative incidence rates of laboratory confirmed A(H1N1)pdm09 infections, intensive care unit (ICU) admissions and deaths in 2009/10 and 2010/11. We estimated incidence risk ratios (IRR) in a Poisson regression model to compare those indicators between Denmark and the other countries. The vaccination coverage was lower in Denmark (6.1%) compared with Finland (48.2%), Iceland (44.1%), Norway (41.3%) and Sweden (60.0%). In 2009/10 Denmark had a similar cumulative incidence of A(H1N1)pdm09 ICU admissions and deaths compared with the other countries. In 2010/11 Denmark had a significantly higher cumulative incidence of A(H1N1)pdm09 ICU admissions (IRR: 2.4; 95% confidence interval (CI): 1.9–3.0) and deaths (IRR: 8.3; 95% CI: 5.1–13.5). Compared with Denmark, the other countries had higher pandemic vaccination coverage and experienced less A(H1N1)pdm09-related severe outcomes in 2010/11. Pandemic vaccination may have had an impact on severe influenza outcomes in the post-pandemic season. Surveillance of severe outcomes may be used to compare the impact of influenza between seasons and support different vaccination strategies.

Keywords: Research; Abstracts; Pandemic Influenza; Vaccines; H1N1pdm09.

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A #cluster of paralytic #poliomyelitis cases due to #transmission of slightly diverged #Sabin-2 #vaccine #virus (J Virol., abstract)

[Source: Journal of Virology, full page: (LINK). Abstract, edited.]

A cluster of paralytic poliomyelitis cases due to transmission of slightly diverged Sabin-2 vaccine virus

Ekaterina A. Korotkova a,b, Anatoly P. Gmyl b, Maria L. Yakovenko a,b, Olga E. Ivanova b, Tatyana P. Eremeeva b, Liubov I. Kozlovskaya b, Armen K. Shakaryan b, Galina Y. Lipskaya a, Irina L. Parshina c, Nataliya V. Loginovskikh d, Nadezhda S. Morozova e and Vadim I. Agol a,b#

Author Affiliations: aA. N. Belozersky Institute of Physical-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow 119899, Russia; bM. P. Chumakov Institute of Poliomyelitis and Viral Encephalitides, Moscow 142782, Russia; cCenter for Hygiene and Epidemiology in the Altai Region, Barnaul 656049, Russia; dCenter for Hygiene and Epidemiology in the Omsk Region, Omsk 644116, Russia; eFederal Center of Hygiene and Epidemiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow 117105, Russia

 

ABSTRACT

Four cases of acute flaccid paralysis caused by slightly evolved (Sabin-like) vaccine polioviruses of serotype 2 were registered in July-August, 2010 in an orphanage of Biysk (Altai Region, Russia). The Biysk cluster of vaccine-associated paralytic poliomyelitis (VAPP) had several uncommon, if not unique, features (1). Until this outbreak, Sabin-like viruses (in distinction with more markedly evolved vaccine-derived polioviruses, VDPV) were reported to cause only sporadic cases of VAPP. Consequently, VAPP were not considered to require outbreak-type responses. However, the Biysk outbreak completely blurred the borderline between Sabin-like viruses and VDPV in epidemiological terms (2). The outbreak demonstrated a very high disease/infection ratio, apparently exceeding even that reported for wild polioviruses. The viral genome structures did not provide any substantial hints as to the underlying reason(s) for such pathogenicity (3). The replacement of intestinal poliovirus lineages by other Sabin-like lineages during short intervals after the disease onsets was observed in two patients. Again, the sequences of the respective genomes provided no clues to explain these events (4). The polioviruses isolated from the patients and their contacts demonstrated a striking heterogeneity as well as rapid and uneven evolution of the whole genomes and their parts, apparently due to extensive interpersonal contacts in a relatively small closed community, multiple bottlenecking and recombination. Altogether, the results demonstrate several new aspects of pathogenicity, epidemiology, and evolution of vaccine-related polioviruses and underscore several serious gaps in understanding these problems.

 

IMPORTANCE.

The oral poliovirus vaccine largely contributed to the nearly complete disappearance of poliovirus-caused poliomyelitis. Being generally safe, it can, in some cases, result in a paralytic disease. Two types of such outcomes are distinguished: caused by slightly diverged (Sabin-like) viruses, on the one hand, and by significantly diverged VDPVs, on the other. This classification is based on the number of mutations in the viral genome region encoding a viral structural protein. Until now, only sporadic poliomyelitis cases due to Sabin-like polioviruses were described, and, in distinction with the VDPV-triggered outbreaks, they did not require broad-scale epidemiological responses. Here, an unusual outbreak of poliomyelitis caused by a Sabin-like virus is reported, which had an exceptionally high disease/infection ratio. This outbreak blurred the borderline between Sabin-like polioviruses and VDPV both in pathogenicity and kind of responses required as well as underscores important gaps in understanding pathogenicity, epidemiology, and evolution of vaccine-derived polioviruses.

 

FOOTNOTES

#To whom inquiries regarding the paper should be addressed: M. P. Chumakov Institute of Poliomyelitis and Viral Encephalitides, Moscow 142782, Russia; agol@belozersky.msu.ru.

Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Keywords: Research; Abstracts; Poliomyelitis; Vaccines.

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Modest #Waning of #Influenza #Vaccine #Efficacy and #Antibody #Titers During the 2007–2008 Influenza Season (J Infect Dis., abstract)

[Source: The Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

Modest Waning of Influenza Vaccine Efficacy and Antibody Titers During the 2007–2008 Influenza Season

Joshua G. Petrie1, Suzanne E. Ohmit1, Rachel Truscon1, Emileigh Johnson1, Thomas M. Braun2, Min Z. Levine3, Maryna C. Eichelberger4 and Arnold S. Monto1

Author Affiliations: 1Department of Epidemiology; 2Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor; 3Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia; 4Division of Viral Products, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland

Correspondence: J. G. Petrie, University of Michigan School of Public Health, 1415 Washington Hts, Ann Arbor, MI 48109 (jpetrie@umich.edu).

Presented in part: IDWeek 2015, San Diega, California, 7–11 October 2015. Poster 1915.

 

Abstract

Background. 

Antibody titers decrease with time following influenza vaccination, raising concerns that vaccine efficacy might wane. However, the relationship between time since vaccination and protection is unclear.

Methods. 

Time-varying vaccine efficacy (VE[t]) was examined in healthy adult participants (age range, 18–49 years) in a placebo-controlled trial of inactivated influenza vaccine (IIV) and live-attenuated influenza vaccine (LAIV) performed during the 2007–2008 influenza season. Symptomatic respiratory illnesses were laboratory-confirmed as influenza. VE(t) was estimated by fitting a smooth function based on residuals from Cox proportional hazards models. Subjects had blood samples collected immediately prior to vaccination, 30 days after vaccination, and at the end of the influenza season for testing by hemagglutination inhibition and neuraminidase inhibition assays.

Results. 

Overall efficacy was 70% (95% confidence interval [CI], 50%–82%) for IIV and 38% (95% CI, 5%–59%) for LAIV. Statistically significant waning was detected for IIV (P = .03) but not LAIV (P = .37); however, IIV remained significantly efficacious until data became sparse at the end of the season. Similarly, antibody titers against influenza virus hemagglutinin and neuraminidase significantly decreased over the season among IIV recipients.

Conclusions. 

Both vaccines were efficacious but LAIV less so. IIV efficacy decreased slowly over time, but the vaccine remained significantly efficacious for the majority of the season.

Key words: influenza – influenza vaccine – efficacy – waning – hemagglutinin – neuraminidase – antibody persistence – longevity of antibody – serologic assays – immune correlates

10.1093/infdis/jiw10410.1093/infdis/jiw106 Received December 22, 2015.

Accepted January 26, 2016.

© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Keywords: Research; Abstracts; Seasonal Influenza; Vaccines.

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#Vaccine #Effectiveness of #Polysaccharide Vaccines Against Clinical #Meningitis – Niamey, #Niger, June 2015 (PLoS Curr., abstract)

[Source: PLoS Currents Outbreaks, full page: (LINK). Abstract, edited.]

Vaccine Effectiveness of Polysaccharide Vaccines Against Clinical Meningitis – Niamey, Niger, June 2015

April 18, 2016 · Research Article

Authors: Marc Rondy, Djibo Issifou, Alkassoum S. Ibrahim, Zaneidou Maman, Goumbi Kadade, Hamidou Omou, Sidikou Fati, Esther Kissling, Sarah Meyer, Olivier Ronveaux

 

Abstract

Introduction:

In 2015, a large outbreak of serogroup C meningococcal meningitis hit Niamey, Niger, in response to which a vaccination campaign was conducted late April. Using a case-control study we measured the vaccine effectiveness (VE) of tri – (ACW) and quadrivalent (ACYW) polysaccharide meningococcal vaccines against clinical meningitis among 2-15 year olds in Niamey II district between April 28th and June 30th 2015.

Methods:

We selected all clinical cases registered in health centers and conducted a household- vaccination coverage cluster survey (control group). We ascertained vaccination from children/parent reports. Using odds of vaccination among controls and cases, we computed VE as 1-(Odds Ratio). To compute VE by day since vaccination, we simulated a density case control design randomly attributing recruitment dates to controls based on case dates of onset (3 controls per case). We calculated the number of days between vaccination and the date of onset/recruitment and computed VE by number of days since vaccination using a cubic-spline model. We repeated this simulated analysis 500 times and calculated the mean VE and the mean lower and upper bound of the 95% confidence interval (CI).

Results:

Among 523 cases and 1800 controls, 57% and 92% were vaccinated respectively. Overall, VE at more than 10 days following vaccination was 84% (95%CI: 75-89) and 97% (94-99) for the tri- and quadrivalent vaccines respectively. VE at days 5 and 10 after trivalent vaccination was 84% (95% CI: 74-91) and 89% (95% CI: 83-93) respectively. It was 88% (95% CI: 75-94) and 95.8% (95% CI: 92 -98) respectively for the quadrivalent vaccine.

Conclusion:

Results suggest a high VE of the polysaccharide vaccines against clinical meningitis, an outcome of low specificity, and a rapid protection after vaccination. We identified no potential biases leading to VE overestimation. Measuring VE and rapidity of protection against laboratory confirmed meningococcal meningitis is needed.

Funding Statement

The study was funded by the World Health Organization.

Keywords: Research; Abstracts; Meningococcal Meningitis; Vaccines; Niger.

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#Globular Head-Displayed Conserved #Influenza #H1 #Hemagglutinin #Stalk #Epitopes Confer Protection against Heterologous #H1N1 Virus (PLoS One, abstract)

[Source: PLoS One, full page: (LINK). Abstract, edited.]

Open Access / Peer-reviewed / Research Article

Globular Head-Displayed Conserved Influenza H1 Hemagglutinin Stalk Epitopes Confer Protection against Heterologous H1N1 Virus

Miriam Klausberger, Rupert Tscheliessnig, Silke Neff, Raffael Nachbagauer, Teddy John Wohlbold, Monika Wilde, Dieter Palmberger, Florian Krammer, Alois Jungbauer, Reingard Grabherr

PLOS / Published: April 18, 2016 / http://dx.doi.org/10.1371/journal.pone.0153579

 

Abstract

Significant genetic variability in the head region of the influenza A hemagglutinin, the main target of current vaccines, makes it challenging to develop a long-lived seasonal influenza prophylaxis. Vaccines based on the conserved hemagglutinin stalk domain might provide broader cross-reactive immunity. However, this region of the hemagglutinin is immunosubdominant to the head region. Peptide-based vaccines have gained much interest as they allow the immune system to focus on relevant but less immunogenic epitopes. We developed a novel influenza A hemagglutinin-based display platform for H1 hemagglutinin stalk peptides that we identified in an epitope mapping assay using human immune sera and synthetic HA peptides. Flow cytometry and competition assays suggest that the identified stalk sequences do not recapitulate the epitopes of already described broadly neutralizing stalk antibodies. Vaccine constructs displaying 25-mer stalk sequences provided up to 75% protection from lethal heterologous virus challenge in BALB/c mice and induced antibody responses against the H1 hemagglutinin. The developed platform based on a vaccine antigen has the potential to be either used as stand-alone or as prime-vaccine in combination with conventional seasonal or pandemic vaccines for the amplification of stalk-based cross-reactive immunity in humans or as platform to evaluate the relevance of viral peptides/epitopes for protection against influenza virus infection.

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Citation: Klausberger M, Tscheliessnig R, Neff S, Nachbagauer R, Wohlbold TJ, Wilde M, et al. (2016) Globular Head-Displayed Conserved Influenza H1 Hemagglutinin Stalk Epitopes Confer Protection against Heterologous H1N1 Virus. PLoS ONE 11(4): e0153579. doi:10.1371/journal.pone.0153579

Editor: Stephen J. Turner, Monash University, Australia, AUSTRALIA

Received: November 11, 2015; Accepted: March 31, 2016; Published: April 18, 2016

Copyright: © 2016 Klausberger et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: MK and MW received funding from the Austrian Science Foundation FWF Doctoral program BioToP-Molecular Technology of Proteins W1224 and DP also was funded by the FWF (P 25092-B13). RT was funded by the Austrian Centre of Industrial Biotechnology (ACIB). ACIB is a non-profit research centre supported by the Federal Ministry of Economy, Family and Youth (BMWJF), the Federal Ministry of Traffic, Innovation and Technology (BMVIT), the Syrian Business Promotion Agency SFG, the Standortagentur Tirol and ZIT – Technology Agency of the City of Vienna through the COMET-Funding Program managed by the Austrian Research Promotion Agency FFG. FK was supported by an Erwin Schrödinger fellowship (J 3232) from the Austrian Science Fund. This work was partially supported by NIH (National Institutes of Health) program project grant 1P01AI097092-01A1 and PATH (Program for Appropriate Technology in Health). The Austrian Centre of Industrial Biotechnology provided support in the form of salaries for authors [RT], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.

Competing interests: Rupert Tscheliessnig was funded by and is employed by the Austrian Centre of Industrial Biotechnology. The Icahn School of Medicine at Mount Sinai together with the University of Natural Resources and Life Sciences has filed a patent on the mentioned display system for influenza epitopes (influenza virus vaccines and uses thereof; application no. 62180405). There are no further patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Keywords: Research; Abstracts; H1N1; Seasonal Influenza; Pandemic Influenza; Vaccines.

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