Academic journal article Bulletin of the World Health Organization

Hantavirus Vaccine Development

Academic journal article Bulletin of the World Health Organization

Hantavirus Vaccine Development

Article excerpt

Over the past 15 years considerable progress has been made in understanding haemorrhagic fever with renal syndrome (HFRS) and various related infections caused by hantaviruses, a distinct but antigenically and genetically similar group of viruses. HFRS caused by Hantaan virus has been known in China since at least 1931 and between 1950 and 1994 there were over 1 million cases and more than 42000 deaths (mortality rate, 3.85%). In the Republic of Korea, 1000 cases of HFRS were reported in 1994, while between 1978 and 1994 nearly 3000 cases were documented in 15 of the 29 Asian administrative districts of the former Soviet Union and the Russian Federation. In Europe, four distinct hantaviruses cause human disease, with the vast majority being Puumala virus, mainly in Norway, Sweden, Finland, Germany, Netherlands, France, and Belgium. In the Balkans severe cases of HFRS caused by Hantaan and Dobrava/Belgrade hantaviruses appear to be more prevalent than anywhere else in Europe. Finally, over 100 cases of the newly diagnosed hantavirus pulmonary syndrome (HPS) caused by Sin Nombre virus have been documented in North America.

In order to foster collaboration and improve understanding, WHO hosted in Helsinki on 31 May 1995 a meeting of 30 experts in hantavirus development. Below is a summary of the conclusions and recommendations made by the participants.

* Hantaviruses are significant human health pathogens in many parts of the world. The final objective of hantavirus vaccine development should therefore be a polyvalent vaccine that protects against all pathogenic hantaviruses.

* Inactivated vaccines against hantaviruses are the most developed, and the following observations can be made regarding them:

-- Two methods of inactivation ([beta]-propiolactone (BPL) and formalin) have been used. Both appear to yield equivalent final products, although BPL appears to retain some surface antigens that may be lost with formalin inactivation.

-- A primary vaccination series requires three doses, but more data are needed. All currently formulated vaccines appear to require a booster after one year. Additional information is required to determine long-term immunity and the level and type of antibody required to maintain lasting immunity.

* Three substrates have been developed for inactivated candidate vaccines (mouse brain, hamster kidney, and Mongolian gerbil). …

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