Rift valley fever: Next generation vaccines for an old foe

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Engineering Conferences International ECI Digital Archives Vaccine Technology IV Proceedings Spring 5-22-2012 Rift valley fever: Next generation vaccines for an old foe Brian Bird Viral Special Pathogens Branch Centers for Disease Control and Prevention Follow this and additional works at: http://dc.engconfintl.org/vaccine_iv Part of the Biomedical Engineering and Bioengineering Commons Recommended Citation Brian Bird, "Rift valley fever: Next generation vaccines for an old foe" in "Vaccine Technology IV", B. Buckland, University College London, UK; J. Aunins, Janis Biologics, LLC; P. Alves, ITQB/IBET; K. Jansen, Wyeth Vaccine Research Eds, ECI Symposium Series, (2013). http://dc.engconfintl.org/vaccine_iv/23 This Conference Proceeding is brought to you for free and open access by the Proceedings at ECI Digital Archives. It has been accepted for inclusion in Vaccine Technology IV by an authorized administrator of ECI Digital Archives. For more information, please contact franco@bepress.com.

CDC Rift Valley fever Vaccine Initiative Brian Bird DVM, MSPH, PhD Viral Special Pathogens Branch Centers for Disease Control and Prevention

Viral Special Pathogens Branch Focus on viral hemorrhagic fevers (>35 viruses, 5 Families) BSL-4, BSL-3+, BSL-2 labs Diagnostics Outbreak Response Serology, molecular, Next-Gen sequencing Epidemiology Laboratory Science molecular biology, pathogenesis, immunology, vaccines and anti-viral therapeutic drugs Ecology Uganda (Ebola, Marburg) South America (hantaviruses) Eastern and Southern Africa (RVF)

Rift Valley fever virus Mosquito-borne RNA virus (Bunyaviridae) (Aedes sp. mosquitoes most important) Endemic throughout Africa and parts of Arabian Peninsula Outbreaks linked to extensive rainfall mosquito abundance Outbreaks are extensive humans (10s to 100s thousands) livestock (millions) Threat of introduction into Middle East, Europe or US Many competent mosquito vectors in North America Potential bioterrorism threat

RVF disease Humans Majority: self limiting febrile illness ~1-2% of cases ACUTE: hepatitis > hemorrhagic syndrome (10-20% case fatality) DELAYED: encephalitis, retinitis, blindness Direct contact with infected livestock is the key risk factor for severe and lethal disease

RVF disease Livestock Sheep, cattle, goats Camelids Abortion storms near 100% sheep and cattle High newborn mortality 80-100% Adult mortality 5-20% Wildlife: Cape Buffalo transient viremia, many other species IgG positive Horses, swine, poultry unaffected

Current status of RVF vaccines No commercially available human or livestock vaccines for use in the U.S. and Europe Exciting time in RVFV vaccine research Recombinant MLAV, VLP, VRP, Paramyxovectored, Pox virus vectored etc. A couple of livestock vaccines in limited use in Africa (OBP, South Africa): inactivated vaccine live attenuated vaccines: Smithburn strain abortions, teratology, other fetal abnormalities No capacity to differentiate vaccinated from naturally infected animals Clone 13 LAV may be an improvement with fewer adverse effects

CDC RVF vaccine development strategy Virus amplification in livestock leads to explosive outbreaks and is needed to get spillover into humans Disease in livestock precedes disease in humans by ~ 1 month Significantly easier to get vaccines approved for livestock than humans One Health good livestock vaccines should indirectly reduce or prevent human disease Vaccine design should allow for further development in humans (FDA animal rule)

or why is CDC working on a livestock vaccine??? Don t you work on people diseases??? One Health good livestock vaccines should indirectly reduce or prevent human disease Bird and Nichol Curr Opinion in Virol,2012

Ideal RVF vaccine properties Precise identity and excellent purity Safety No post-vaxdisease; no abortions or fetal abnormalities (Historically this has been a BIG problem) Single dose, rapid and long lasting protection - best achieved with live attenuated vaccine Multiple attenuating lesions/ absence of reversion Inexpensive (produced at high titers = cheap/dose) Differentiate infected from vaccinated animals -DIVA

Towards rational vaccine design Reverse genetics approach Generation of precisely engineered infectious virus from plasmid DNA Identify and knock out critical virus virulence genes Use these modified viruses as vaccine candidates

Genome composition tripartite ss(-) RNA L segment ~6404nt Polymerase M segment ~3885nt NSm Gn Gc S segment ~1689 NP NSs

Major RVFV virulence factors L segment ~6404nt Polymerase -NSm virus attenuated in rats LD 50 ~3 logs Bird et. al., 2007 M segment ~3885nt NSm NSm Gn Gc S segment ~1689 NP NSs NSs Deletion of 70% NSs ORF attenuated in mice LD 50 ~4 logs Muller et. al. 1995

Generation of NSs- NSmvaccine RVFM RVFS BSR-T7 cell or VERO + pt7 wtrvfv RVFL L M S NSm NSm-M NSs-S L NSm-M NSs-S / Vax RVFL

Rodent results (~6yrs) Excellent safety with either candidate when given at doses up to 10,000x LD 50 of virulent virus (LD 50 = < 1.0 PFU) Complete protection from up to 10,000x LD 50 dose of virulent virus 28 days post-vax Robust IgG response >1:6400 PRNT 80 >1:1256 Rapid protection up to 100% within 48 hours post-vaccination in mice

Rodent results Excellent safety with either candidate when given at doses up to 10,000x LD 50 of virulent virus Complete protection from up to 10,000x LD 50 dose of virulent virus 28 days post-vax Robust IgG response >1:6400 PRNT 80 >1:1256 BUT WHAT ABOUT A RELEVANT HOST?????

/ Vaccine Sheep Trial Bird et al., Journal of Virology 2011 Deltamune Pty. Ltd. South Africa Safety and Efficacy Trial timed pregnant ewes 1.0x10 4 PFU SC N=29 vaccinates, N=3 sham controls Vacc. at day 42 gestation: (fetus most sensitive to teratogenesis, MP12/Smithburn)

/ Vaccine Trial Timeline Dr. Barbara Knust Pregnancy DxU/S N=32 selected 0 42 90 121 142/D+1 +5 Day of Pregnancy Timed Preg N=54

/ Vaccine Trial Timeline Safety 1 : Vaxearly gestation: N=29 + 3 shams U/S 0 42 90 121 142/D+1 +5 Day of Pregnancy Timed Preg Vaccination 10^4 PFU SC

/ Vaccine Trial Timeline Safety 1 : Vaxearly gestation: N=29 + 3 shams U/S U/S Preg Dx 0 42 90 121 142/D+1 +5 Day of Pregnancy Timed Preg Vaccination 10^4 PFU SC

/ Vaccine Trial Timeline Safety 1 : Vaxearly gestation: N=29 + 3 shams Safety 2: NO CHALLENGE, Monitor through full-term N=20 U/S U/S Preg Dx 0 42 90 121 142/D+1 Day of Pregnancy +5 Timed Preg Vaccination 10^4 PFU SC Lambs born

/ Vaccine Trial Timeline Safety 1 : Vaxearly gestation: N=30 + 3 shams Safety 2: NO CHALLENGE, Monitor through full-term N=20 U/S U/S Preg Dx VaxEfficacy/Challenge N=9 + 3 shams 0 42 90 121 142/D+1 Day of Pregnancy +5 Timed Preg Vaccination 10^4 PFU SC Challenge 10^6 PFU IV rrvfv Lambs born

/ Safety and Immunogenicity post-vaccination Shelley Campbell All vaccinated animals (N=29) seroconverted No fever detected post-vaccination No other adverse events detected No seroconversion in contact controls (N=3)

/ EFFICACY Challenge (n=9) at Day 121 pregnancy or 82 days post-vax No abortion or viremia in vaccinated animals Vacc. ewes: NO viremia or fever; day 1 to 14 Lambs born to vaccewes: virus neg. (blood, liver, brain) All shams (n=3) aborted by day 6 PC

/ EFFICACY Challenge (n=9) at Day 121 pregnancy or 82 days post-vax No abortion in vaccinated animals Vacc. ewes: NO viremia or fever; day 1 to 14 Lambs born to vaccewes: virus neg. (blood, liver, brain) All shams (n=3) aborted by day 6 PC

Differentiating Infected from Vaccinated Animals Polymerase Built into vaccine design 3-way ELISA assay recombinant proteins NSm NS m NP Gn NSs NSs Gc Vax animals: NP + only Infected animals: NP+ NSs+ NSm+

Ideal RVF vaccine properties Precise identity and excellent purity generated from plasmid DNA of 100% exact sequence Safety- / NOT a Select Agent, RSA and CDC IBC = BSL-2, awaiting more broad NIH RAC classification NO adverse events in rodents (n~350) NO adverse event in adult or pregnant sheep (n=42 total) Single dose rapid protection Mice 100% protection by 48-72 hrs Multiple attenuating lesions/ avoid reversion 2 complete virus gene deletions Differentiate infected from vaccinated animals DIVA based on vaccine lacking NSs and NSm genes Excellent Environmental containment Does not infect mosquito vectors (Crabtree et al, PLoS NTD 2012); no viremia in vaccinates Inexpensive / grows > 10 7 pfu/ml in routine VERO cell culture

César Albariño Hannes Swart Roelf Greyling Louis Maartens Stuart Nichol BaltusErasmus Kimberly Dodd

Lake Naivasha, Kenya Site of first reported RVF outbreak 1930