1<br />Selected Zoonotic Diseases <br />Conference Call<br />December 2, 2009<br />
Adam Macneil, PhD Special Pathogens Branch (SPB), CDC 404-639-4651 amacneil1@cdc.gov<br />Barbara Knust, DVM, MPH <br />SP...
Update: Epidemiology of Hantavirus Pulmonary Syndrome in the United States<br />Adam MacNeil, PhD, MPH<br />Barbara Knust,...
Hantavirus Pulmonary Syndrome (HPS)<br />Severe respiratory infection, high fatality<br />Febrile illness, acute thrombocy...
HPS in the United States<br />Discovered in 1993: Outbreak in Four Corners region of US<br />‘Retrospective’ diagnosis of ...
HPS registry data sources<br />1. Diagnostic samples submitted to CDC, case report form included<br />2. Case report forms...
HPS Registry<br />534 cases<br />36.5% case fatality<br />Infections occurred in 31 states<br />Majority of cases in south...
Deer mouse (Sin Nombre virus)<br />White-footed mouse (New York virus)<br />Hispid cotton rat (Black Creek Canal virus)<br...
Summary<br />Over 500 HPS cases documented<br />&gt;35% case fatality<br />HPS continues to occur<br />Majority of cases i...
Pediatric Hantavirus Pulmonary Syndrome, 2009<br />Case 1 (CO)<br />6 year old male<br />Presented to hospital: 5/16/09<br...
Clinical Findings<br />
Environmental Assessment– Rodent Exposures<br />Case 1: Rodent feces in child’s room and play areas<br />Case 2: Hand-grin...
Acknowledgements<br />Craig Levy, Arizona DHS<br />Dr. Elisabeth Lawaczek & Bill Ray, Colorado DPHE<br />Nicola Marsden-Ha...
Brian F. Allan, PhD Postdoctoral Fellow,<br />Tyson Research Center,<br />Washington University in Saint Louis<br />314-93...
William H. Wunner, PhDProfessor and Director of Outreach Education<br />and Technology Training<br />The WistarInstitute<b...
Heather Henderson, DVM, MPH <br />Georgia Department of Community Health<br />706-845-4035 ext. 235 hihenderson@dhr.state....
Oral immunization of raccoons and skunks with a canine adenovirus recombinant rabies vaccine<br />Heather Henderson, DVM, ...
Background<br />Oral vaccination of wildlife is an important part of rabies control<br />Attenuated (ERA/SAD/SAG) and reco...
Background<br />VNA produced against rabies virus glycoprotein (RVG)<br />RVG gene can be inserted into a viral vector to ...
Methods<br />14 raccoons<br />7 experimental group (CAV2-RVG)<br />7 control group (placebo), 1 animal died on day 21<br /...
Results<br />All animals seronegative at start of study<br />No adverse effects noted in animals receiving CAV2-RVG after ...
Results<br />Raccoons<br />Control group<br />6 / 6 seronegative 7 days after challenge<br />All succumbed to rabies<br />...
Results<br />Skunks<br />Negative control group<br />6 / 6 seronegative 7 days after challenge<br />4 / 6 succumbed to rab...
Discussion<br />CAV2 virus meets many criteria for an ideal recombinant rabies vaccine vector<br />Concerns include potent...
Co-authors<br />Felix Jackson (CDC)<br />Kayla Bean (CDC)<br />Brian Panasuk (CDC)<br />Michael Niezgoda (CDC)<br />Dennis...
31<br />Selected Zoonotic Diseases <br />Conference Call<br />December 2, 2009<br />
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December 2009 Selected Zoonotic Diseases Conference Call

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December 2009 Selected Zoonotic Diseases Conference Call

  1. 1. 1<br />Selected Zoonotic Diseases <br />Conference Call<br />December 2, 2009<br />
  2. 2. Adam Macneil, PhD Special Pathogens Branch (SPB), CDC 404-639-4651 amacneil1@cdc.gov<br />Barbara Knust, DVM, MPH <br />SPB, CDC<br />404-639-1104 bknust@cdc.gov <br />Hantavirus in the United States <br />Selected Zoonotic Diseases <br />Conference Call<br />December 2 ,2009<br />
  3. 3. Update: Epidemiology of Hantavirus Pulmonary Syndrome in the United States<br />Adam MacNeil, PhD, MPH<br />Barbara Knust, DVM, MPH<br />Special Pathogens Branch, CDC<br />The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.<br />
  4. 4. Hantavirus Pulmonary Syndrome (HPS)<br />Severe respiratory infection, high fatality<br />Febrile illness, acute thrombocytopenia<br />Rapid onset: Bilateral pulmonary edema / Acute respiratory distress syndrome<br />Caused by new world hantaviruses<br />Rodent reservoir<br />Multiple hantavirus species, reservoirs<br />US: mostly Sin Nombre virus, associated the deer mouse (Peromyscus maniculatus)<br />
  5. 5. HPS in the United States<br />Discovered in 1993: Outbreak in Four Corners region of US<br />‘Retrospective’ diagnosis of prior cases (serologic evidence back to 1959)<br />HPS Registry<br />Maintained by Special Pathogens Branch, CDC<br />Systematically collect data on all confirmed HPS cases in the US<br />Additional data fields (clinical, outcome, laboratory testing) to National Notifiable Diseases Surveillance System<br />
  6. 6. HPS registry data sources<br />1. Diagnostic samples submitted to CDC, case report form included<br />2. Case report forms submitted by states (diagnosis made at state or private lab)<br />3. National Notifiable Diseases Surveillance System<br />Recently attempted to acquire forms for all cases from 2006 onward<br />Contact state HD, acquire case report form<br />Thank you to state HD personnel who assisted<br />
  7. 7. HPS Registry<br />534 cases<br />36.5% case fatality<br />Infections occurred in 31 states<br />Majority of cases in southwestern US<br />63% cases male<br />78% white, 19% N. America / American Indian<br />Pediatric (16 years or less) cases rare: 7%<br />
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  13. 13. Deer mouse (Sin Nombre virus)<br />White-footed mouse (New York virus)<br />Hispid cotton rat (Black Creek Canal virus)<br />Rice rat (Bayou virus)<br />Distribution of hantavirus reservoirs<br />From: Mills et al, Vector-Borne and Zoonotic Diseases 2009: Epub ahead of print<br />
  14. 14. Summary<br />Over 500 HPS cases documented<br />&gt;35% case fatality<br />HPS continues to occur<br />Majority of cases in southwestern US<br />Cases and reservoirs do exist across entire US<br />Special Pathogens in the process of rolling out new website and maps<br />http://www.cdc.gov/ncidod/diseases/hanta/hps/noframes/epislides/episls.htm<br />Please contact with questions, data clarification, consultations<br />
  15. 15. Pediatric Hantavirus Pulmonary Syndrome, 2009<br />Case 1 (CO)<br />6 year old male<br />Presented to hospital: 5/16/09<br />Case 2 (WA)<br />14 year old male<br />Presented to hospital: 6/8/09<br />Case 3 (CO)<br />6 year old male<br />Presented to hospital: 7/12/09<br />Case 4 (AZ)<br />9 year old female<br />Presented to hospital: 7/12/09<br />
  16. 16. Clinical Findings<br />
  17. 17. Environmental Assessment– Rodent Exposures<br />Case 1: Rodent feces in child’s room and play areas<br />Case 2: Hand-grinding corn contaminated with rodent feces 8 days prior to illness<br />Case 3: Bitten by mouse 10 days prior to illness<br />Case 4: Rodent feces and nesting materials in home and play areas<br />
  18. 18. Acknowledgements<br />Craig Levy, Arizona DHS<br />Dr. Elisabeth Lawaczek & Bill Ray, Colorado DPHE<br />Nicola Marsden-Haug, Washington State DPH<br />State & Territorial Epidemiologists<br />NNDSS <br />SPB staff: Pierre Rollin, Jim Mills, Andy Comer, Craig Manning, Arie Manangan, Julie Pierzchala<br />
  19. 19. Brian F. Allan, PhD Postdoctoral Fellow,<br />Tyson Research Center,<br />Washington University in Saint Louis<br />314-935-8443 ballan@biology2.wustl.edu<br />Research on integrated pest management approaches to preventing lone star tick bites and ehrlichiosis<br />Selected Zoonotic Diseases <br />Conference Call<br />December 2, 2009<br />
  20. 20. William H. Wunner, PhDProfessor and Director of Outreach Education<br />and Technology Training<br />The WistarInstitute<br />215-898-3854 wunner@wistar.org<br />Deborah J. Briggs, PhD Adjunct Professor, College of Veterinary Medicine, <br />Kansas State University briggs@vet.k-state.edu<br />Overview of special collections on papers on rabies appearing in the journals Vaccine and PLoS NTD<br />Selected Zoonotic Diseases <br />Conference Call<br />December 2, 2009<br />
  21. 21. Heather Henderson, DVM, MPH <br />Georgia Department of Community Health<br />706-845-4035 ext. 235 hihenderson@dhr.state.ga.us<br />Oral immunization of raccoons and skunks with a canine adenovirus recombinant rabies vaccine <br />Selected Zoonotic Diseases <br />Conference Call<br />December 2, 2009<br />
  22. 22. Oral immunization of raccoons and skunks with a canine adenovirus recombinant rabies vaccine<br />Heather Henderson, DVM, MPH<br />Epidemiologist II, District 4 Public Health<br />Georgia Department of Community Health<br />
  23. 23. Background<br />Oral vaccination of wildlife is an important part of rabies control<br />Attenuated (ERA/SAD/SAG) and recombinant vaccinia (V-RG) vaccines have been used successfully in raccoons, foxes, coyotes<br />Concerns about residual pathogenicity and human contact with baits<br />No licensed oral vaccine effective in skunks<br />Need for oral vaccine with efficacy in majority of terrestrial reservoir species<br />
  24. 24. Background<br />VNA produced against rabies virus glycoprotein (RVG)<br />RVG gene can be inserted into a viral vector to produce recombinant vaccine<br />Vector must be able to replicate on mucosal surfaces, have minimal safety concerns<br />Canine adenovirus serotype 2 (CAV2) is associated with mild upper respiratory infections in dogs<br />Modified-live CAV2 vaccines used to prevent disease from CAV1 and CAV2 with excellent safety and efficacy<br />Human and canine-derived adenovirus vectors induce potent cellular, humoral, and mucosal immunity<br />CAV2-RVG previously constructed, effective against lethal challenge in mice when administered IM or IN<br />
  25. 25. Methods<br />14 raccoons<br />7 experimental group (CAV2-RVG)<br />7 control group (placebo), 1 animal died on day 21<br />Challenge with rabies virus day 28 post-vaccination<br />23 skunks<br />6 negative control (CAV2 parent virus)<br />5 experimental group 1 (CAV2-RVG, 1x108 TCID)<br />6 experimental group 2 (CAV2-RVG, 10-fold dilution)<br />6 positive control (recombinant virus SPBNGAS-GAS)<br />Challenge with rabies virus day 35 post-vaccination<br />All treatments administered PO<br />Animals euthanized at first clinical signs of rabies, brain tissue tested by DFA to confirm rabies<br />
  26. 26. Results<br />All animals seronegative at start of study<br />No adverse effects noted in animals receiving CAV2-RVG after &gt;500 animal-days observation<br />
  27. 27. Results<br />Raccoons<br />Control group<br />6 / 6 seronegative 7 days after challenge<br />All succumbed to rabies<br />Experimental group<br />6 / 7 seroconverted by day 21 after vaccination; 1 seroconverted within 7 days after challenge (day 35)<br />All survived challenge<br />
  28. 28. Results<br />Skunks<br />Negative control group<br />6 / 6 seronegative 7 days after challenge<br />4 / 6 succumbed to rabies<br />Experimental groups 1 and 2<br />10 / 11 seroconverted by day 21; 1 seroconverted by day 35<br />All survived challenge<br />Positive control group<br />5 / 6 seroconverted and survived challenge<br />1 remained seronegative and succumbed to rabies<br />
  29. 29. Discussion<br />CAV2 virus meets many criteria for an ideal recombinant rabies vaccine vector<br />Concerns include potential for inhibition by naturally occurring antibodies in target population and induced pathology in target or non-target species<br />More work needed to assess importance of excretion of live recombinant virus in feces; establish safety and efficacy in other species; determine optimal effective dose<br />Safe, effective, and affordable oral vaccine for free-roaming dogs in canine rabies-endemic countries will be essential for elimination of canine rabies—responsible for &gt;99% of human rabies<br />
  30. 30. Co-authors<br />Felix Jackson (CDC)<br />Kayla Bean (CDC)<br />Brian Panasuk (CDC)<br />Michael Niezgoda (CDC)<br />Dennis Slate (USDA/APHIS/WS)<br />Jianwei Li (Thomas Jefferson Univ.)<br />Bernard Dietzschold (Thomas Jefferson Univ.)<br />Jeff Mattis (CDC)<br />Charles E. Rupprecht (CDC)<br />
  31. 31. 31<br />Selected Zoonotic Diseases <br />Conference Call<br />December 2, 2009<br />

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