Environmental distribution of certain modified live-virus vaccines with a high safety profile presents a low-risk, high-reward to control zoonotic diseases
Environmental distribution of certain modified live-virus vaccines with a high safety profile presents a low-risk, high-reward to control zoonotic diseases
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DOI：
10.1038/s41598-019-42714-9
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发表时间：
2019-05-01
影响因子：
4.6
通讯作者：
Wallace, Ryan
中科院分区：
文献类型：
--
作者：
Head, Jennifer R.;Vos, Ad;Wallace, Ryan
口服疫苗有助于难以接触的动物群体的免疫，但通常含有减毒活病毒，存在毒力返强或残留致病性的风险。在疫苗现场分发之前，人类风险评估至关重要，但目前没有标准化的方法。我们绘制了暴露途径，通过这些途径，口服疫苗的分布可能导致接种到人，并应用马尔可夫链来估计严重不良事件的数量。我们模拟了三次口服狂犬病疫苗（ORV）接种活动：（1）狐狸中的第一代ORV（SAD-B19），（2）犬中的SAD-B19，和（3）犬中的第三代ORV（SPBN GASGAS）。当分配给狐狸时，预计SAD-B19相关的人类死亡风险较低（0.18/1000万诱饵，95%CI：0.08，0.36），但与国际关注一致，当分配给犬时，风险高19倍（3.35/1000万诱饵，95%CI：2.83，3.98）。我们模拟了SPBN GAS-GAS没有死亡。在狗的运动中的人的死亡是特别敏感的狗咬伤率，在野生动物运动的动物消费率和人类接触率与未消费的诱饵。该模型强调了第三代狂犬病疫苗的安全性，并作为标准化方法的平台，为风险评估提供信息。
Oral vaccines aid immunization of hard to reach animal populations but often contain live-attenuated viruses that pose risks of reversion to virulence or residual pathogenicity. Human risk assessment is crucial prior to vaccine field distribution but there is currently no standardized approach. We mapped exposure pathways by which distribution of oral vaccines may result in inoculation into people and applied a Markov chain to estimate the number of severe adverse events. We simulated three oral rabies vaccination (ORV) campaigns: (1) first generation ORV (SAD-B19) in foxes, (2) SAD-B19 in dogs, and (3) third generation ORV (SPBN GASGAS) in dogs. The risk of SAD-B19-associated human deaths was predicted to be low (0.18 per 10 million baits, 95% CI: 0.08, 0.36) when distributed to foxes, but, consistent with international concern, 19 times greater (3.35 per 10 million baits, 95%CI: 2.83, 3.98) when distributed to dogs. We simulated no deaths from SPBN GAS-GAS. Human deaths during dog campaigns were particularly sensitive to dog bite rate, and during wildlife campaigns to animal consumption rate and human contact rate with unconsumed baits. This model highlights the safety of third generation rabies vaccines and serves as a platform for standardized approaches to inform risk assessments.