Global Virus Network Responds to Ebola Outbreak in the Democratic Republic of the Congo

Global Virus Network Responds to Ebola Outbreak in the Democratic Republic of the Congo

Baltimore, Maryland, USA, May 31, 2018: The Global Virus Network (GVN) is mobilizing a coordinated effort to the Ebola outbreak in the Democratic Republic of the Congo (DRC) through its Centers of Excellence.  The GVN represents 41 Centers of Excellence and 7 affiliates in 26 countries and comprises foremost experts in every class of virus causing disease in humans.

“The GVN Centers of Excellence are directly contributing to the fight against Ebola, working in different research areas that are of crucial importance to confronting such epidemics,” said Prof. Christian Bréchot, MD, PhD, President of the GVN.  “Several of GVN’s Centers are also sending scientists to the DRC.  Moreover, the GVN is currently serving as a hub to aggregate and disseminate information on each Center’s individual responses to the outbreak to better coalesce and inform a collective approach. In tandem with organizations such as the WHO’s Global Outbreak Alert and Response Network (GOARN), and other international institutions, the GVN will coordinate research and response efforts and serve as a catalyst for shared information to focus efforts on the areas in greatest need.”

According to the World Health Organization (WHO), as of May 29, 2018, there are 36 confirmed cases, 13 probable cases, and, 4 suspect cases, totaling 53 cases including 25 deaths. Ebola virus was discovered in 1976 by the Ebola River in the DRC (formerly known as Zaire).  It is not definitively known where Ebola originates, however, it is believed that bats are the main reservoir for the virus.

Four species of ebolaviruses cause disease in humans and the one causing the outbreak in the DRC is Ebola virus (Zaire ebolavirus).  Ebola Virus Disease (EVD) spreads to people through direct contact with bodily fluids of a person who is infected with the virus and presenting disease, objects contaminated with the virus, as well as dead bodies from EVD. The virus can also spread to people through direct contact with the blood, body fluids and tissues of infected fruit bats or primates.

“When my colleagues and I co-founded the GVN in 2011, we made a commitment to share data so that science could be fast-tracked in situations such as the latest Ebola outbreak in the DRC,” said Dr. Gallo, who is Co-Founder and International Scientific Advisor of the GVN and The Homer & Martha Gudeslky Distinguished Professor in Medicine, Co-Founder and Director of the Institute of Human Virology at the University of Maryland School of Medicine, a GVN Center of Excellence.  “Without an organized network of the world’s leading virologists supporting implementation organizations such as GOARN, the science of the epidemic will progress slowly.  We have an experimental vaccine that we believe may be effective, but more research is needed.”

GVN Center of Excellence, The Scripps Research Institute (TSRI), is heavily involved in Ebola virus research and the deployment of equipment and supplies to the DRC.  Said Michael Oldstone, MD, Professor, Department of Immunology and Microbiology at TSRI and Co-Director of the GVN Center of Excellence, “Our group has been studying Ebola in Sierra Leone for more than four years. We are focused on detailing the innate and adoptive immune response in those dying and those that survive, studying host genetics and viral genetics, and analyzing biomarkers for, and molecular mechanism of, the enhanced vascular permeability, or the so-called hemorrhagic component.”

Erica Ollmann Saphire, PhD, Professor, Department of Immunology and Microbiology at TSRI and Co-Director of the GVN Center of Excellence, who is researching the proteins of the Ebola virus, said her team has mobilized loads of donated personal protective equipment and supplies to the DRC. The tools were already delivered to Kinshasa to support epidemiology, mapping, and immune studies. Dr. Saphire will also be studying the immune responses in survivors and vaccines. She founded and directs a global effort to understand and develop antibody therapeutics against these viruses, and has recently engineered improved antibodies that are being evaluated for treatment of disease.

Kristian G. Andersen, PhD, Assistant Professor, Director of Infectious Disease Genomics, STSI, Department of Immunology and Microbiology also at TSRI, and whose lab in the past used virus sequencing to understand and track past outbreaks such as Ebola, Lassa, and Zika, said, “The current outbreak is confusing.  The most critical questions at this point relate to understanding (1) the scale of the outbreak, (2) when it started, and, (3) how it is spreading.  Is it human-to-human infection or repeated animal to human infection?  We can address all those questions by sequencing the virus from a subset of the cases, and we are on standby to assist.”

At Emory University, Raymond Schinazi, PhD, DSc, the Frances Winship Walters Professor of Pediatrics, Director of the Laboratory of Biochemical Pharmacology and Co-Director of the GVN Center of Excellence, is working with the U.S. Center for Disease Control and Prevention (CDC) on repurposed drug therapy for Ebola.  “Working with colleagues at the CDC, we recently discovered some really interesting, new, safe and potent repurposed drugs that are approved for human use for other indications that are highly effective against Ebola virus in culture,” said Dr. Schinazi.

At the Rega Institute for Medical Research at the University of Leuven, Johan Neyts, PhD, Professor of Virology and Director of the GVN Center of Excellence, is developing a novel technology that allows for the rapid production of inexpensive vaccines against the yellow fever virus.  This vaccine no longer needs to be kept cold for storage and transport. Dr. Neyts said, “The technology allows us to easily design vaccines that protect not just against yellow fever but also a second pathogen.  Our team is currently working towards the construction of a dual yellow fever/Ebola vaccine using this technology.  The fact that such a vaccine would, in contrast to current Ebola virus vaccine (candidates), no longer need a cold-chain, would be an important asset.”

GVN Centers of Excellence are working closely with GOARN on a variety of issues including diagnostic, epidemiological studies and clinical management in conjunction with other Centers of Excellence such as the Robert Koch Institute in Germany, University of Texas Medical Branch-Galveston National Laboratory in the USA, Erasmus Medical Center in the Netherlands, the Institute for Virology at the University of Marburg in Germany, the National Institute for Communicable Diseases in South Africa, several French Pasteur Institutes of the International Network of the Institut Pasteur, and the Fondation Mérieux in France.

The GVN is a global authority and resource for the identification and investigation, interpretation and explanation, control and suppression, of viral diseases posing threats to mankind.  It enhances the international capacity for reactive, proactive and interactive activities that address mankind-threatening viruses and addresses a global need for coordinated virology training through scholarly exchange programs for recruiting and training young scientists in medical virology.  The GVN also serves as a resource to governments and international organizations seeking advice about viral disease threats, prevention or response strategies, and GVN advocates for research and training on virus infections and their many disease manifestations.

Update on the Nipah Virus Outbreak in Kerala, India

Update on the Nipah Virus Outbreak in Kerala, India

 May 30, 2018

 By Benhur Lee, MD, Professor, Department of Microbiology at the Icahn School of Medicine at Mount Sinai, a Global Virus Network (GVN) Center of Excellence and Linfa Wang, PhD, Professor & Director, Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore

What is Nipah virus and why should we be concerned about the Nipah virus outbreak?

  • Nipah virus was first detected during a major infectious disease outbreak in Malaysia in 1998-9 and the virus was named after the Sungai Nipah village on the banks of Nipah River in Malaysia.
  • Nipah virus belongs to a genus of paramyxoviruses (Henipavirus), including the highly pathogenic Hendra virus found in Australia that can cause acute respiratory distress and encephalitis with mortality rates in excess of 70%.
  • Since its first detection in Malaysia, a closely related Nipah virus has emerged in Bangladesh/India region since 2001. The Nipah Bangladesh strain (Nipah virus-BD) is approximately 91% identical in genome sequence to the Nipah Malaysia strain (Nipah virus-MY).
  • In 2015, there was a Nipah virus outbreak in the Philippines which affected 17 individual with a case mortality reaching 80% for those developing neurological symptoms. Preliminary serological and molecular data indicated it was caused by the Nipah virus-MY strain or a closely related virus.
  • Pteropus bats (fruit eating bats) are likely the main animal reservoir for Nipah virus, although there is evidence suggesting that other bat species are also susceptible to Nipah virus infection in nature. Various bat species ranging from Australia to West Africa can carry viruses genetically closely related to henipaviruses.
  • Studies from the known human infection outbreaks in Australia, Malaysia, Singapore, Bangladesh, India, and the Philippines, show that the virus can be transmitted to human by three different routes: 1) from bats to humans who come in contact with virus-contaminated material (e.g., date palm sap); 2) from intermediate hosts such as pigs and horses; and 3) from infected humans.
  • There is also epidemiological evidence that companion animals (including dogs and cats) can be infected with these viruses and they can in theory transmit viruses to humans as well.

What do we know about the Kerala outbreak?

  • The current Nipah virus outbreak in Kerala was first alerted when three members of a family, two brothers (age 26 and 28) and their aunt (age 50), died on May 5th, May 18th, and May 19th, respectively, in the private Baby Memorial Hospital (Kozhikode district, Kerala). They died with signs of viral encephalitis. Laboratory testing was initially conducted at the Manipal Centre for Viral Research using blood and fluid samples from this patient. The etiologic cause of their death due to Nipah virus encephalitis was confirmed by the National Institute of Virology in Pune.
  • The father of the two siblings died on May 24 after fighting for his life for about three weeks. In total, four family members died in this “index case” cluster.
  • As the incubation period of Nipah virus infection varies from 4 to 14 days1, it was difficult to definitively determine who was the true “index case” and how was the infection acquired.
  • Although more studies are required to prove or disprove that all the human cases are related and resulted from a single spillover event, early genetic analysis seems to indicate that the outbreak was caused by a virus closely related to the Nipah virus-BD strain.
  • It is interesting to note that the distance from Kerala to the known “Nipah belt” in western/northwestern Bangladesh and the bordering areas of west Bengal is ~2,600 km (1600 miles).
  • As of this writing (Sun May 27), there are 17 confirmed cases with 14 deaths giving a presumptive mortality rate of ~80%. Dozens of samples remain to be tested.
  • At least 31 species of bats have been documented in Kerala (including 5 species of fruit bats)2 .
  • The recent report that 21 samples of bats and pigs from the affected area tested negative for Nipah Virus should be interpreted with caution with regards to expected reservoir.
  • The sample size is too small and the quality of the specimen (especially those from the dead bats in the well near the “index case” cluster) might also be an issue. Contrary to local news reports, it is impossible to rule out bats as a reservoir species based on these 21 samples.
  • As a reservoir species, bats are not supposed to be affected, much less killed by the virus.
  • The bats tested so far are insectivorous bats. A fruit bat colony 4-5 km from the site of the outbreak has yet to be tested.
  • Longitudinal studies of Hendra virus in Australia revealed that the viral load in the bat population could go through short periods of “spikes”. As the timing of the assumed initial spillover event could not be conclusively determined, it is also possible that the viral load in the bat population has dropped recently, hence leading to negative findings.
  • There is a vast literature showing that bats are the natural reservoirs for henipaviruses.

 

What is the risk of wide spread transmission?

  • From past Nipah virus outbreaks, the R0 was estimated to be ~0.43. R0 is mathematical term quantifying the average number of new infections that one infected individual can generate, in an otherwise naïve population. For an infection to spread through a population, R0 needs to >1. When R0 is <1, the infection will eventually die out.
  • Human-to-human transmission requires intimate contact with high levels of bodily secretions (respiratory secretions, saliva, urine, etc.). The risk of wide-spread transmission is therefore low. This is also reflected in estimated R0 ~0.4 for Nipah virus.
  • The current outbreak appears to be small, and the appropriate public health measures have been rapidly implemented to contain its spread. To put the current Nipah virus outbreak in context, consider the following two vignettes:
  • The 2001 outbreak in Siliguri, India, involved 66 people. The index case transmitted the virus to 11 additional patients at the hospital. These secondarily infected patients were transferred to other facilities – in two facilities, subsequent transmission involved 25 staff and 8 visitors4. This was likely before the implementation of universal precautions— personal protective equipment (PPE) such as gloves, masks and/or face shields.
  • 50% of Pteropus bats sampled in an outbreak area (Thakurgaon district) in Northwest Bangladesh were seropositive for Nipah virus antibodies5. Yet transmission is still very sporadic. Thus, the drivers of virus spillover remain relatively unknown (other than drinking of virus contaminated date palm sap).

What can we do to contain the outbreak?

  • Contact tracing, aggressive monitoring and quarantining of suspect cases are effective forms of infection control and containment. These have been appropriately implemented by the responsible government agencies responding to this outbreak in Kerala.
  • Educational efforts combined with preventive measures appear to be effective. Examples include:
  • The use of universal precautions and appropriate PPE (gloves, masks and/or face shield) is sufficient to limit the spread of Nipah virus to patient caretakers including family relatives and healthcare workers.
  • Funeral practices that avoid direct contact with the deceased can cut the train of transmission.
  • Avoiding direct contact with bodily fluids, especially respiratory secretions of infected individuals.
  • Counsel relatives to avoid prolonged close contact with the infected individual (e.g. sleeping beside patient, sharing of foods, etc.).
  • All the above require culturally sensitive educational campaigns targeted to the affected community.
  • There is evidence that Nipah virus RNA+ patients are more likely to contaminate towels, bedsheets, and bed rails6. A previous study also showed that Nipah virus RNA could also be detected on the surrounding walls and bedframe of a deceased Nipah virus infected patient7. Thus, infection controls should target hospital surfaces, which will reduce the risk of formite transmission.

 

What’s the latest development in diagnosis, treatment and prevention?

  • Clinical symptoms include fever and headaches, which can progress to drowsiness, disorientation, mental confusion, and finally encephalitis (brain swelling) in less than a week.
  • Molecular tests (both qPCR and next generation sequencing) are the most rapid and accurate tools available to confirm Nipah virus infection. Acute-phase serum, CSF, throat swabs, saliva, and urine can be used for these tests.

There is also an IgM ELISA test based on whole viral antigen.

  • Live virus isolation should be conducted in a high level biocontainment facility.
  • Ribovirin was used during the Nipah virus outbreak in Malaysia, but its effect is non-conclusive. A targeted recombinant human monoclonal antibody therapy has proven to be effective in animal models and has passed Phase I clinical trial.  The relevant Indian government agency is in the process of acquiring this therapeutics from the Australian supplier with the help of WHO.
  • There are several forms of recombinant vaccines proven to be effective in animal models. These include a recombinant G-protein based vaccine and viral vector-delivered vaccines. The recombinant G-protein vaccine has been licensed for use in horses. With the founding from the Coalition for Pandemics Preparedness Innovations (CEPI), there is an effort to fast track the development of a Nipah virus vaccine for human use.

What is GVN doing for Nipah virus?

  • In the past, various GVN members have played a key role in laying the ground work for a good understanding of virology, epidemiology and pathogenesis of Nipah virus.
  • GVN member teams are currently helping the Kerala outbreak investigation by providing advices, reagents (when needed), and are ready to deploy field and laboratory experts should the need arise.
  • In future, GVN will focus on the following:
    • Better understanding the drivers of spillover events.
    • Identifying and understanding the ecology of its reservoir, so as to guide preventive measures.
    • Identifying potential unknown intermediate/amplifying hosts in different ecological, social, cultural and farming settings.
    • Developing a rapid point-of-care test(s) for deployment in developing nations.
    • Conducting education that is consistent with conservation biology regarding the importance of bats for a healthy ecosystem.
    • Stockpiling therapeutics and vaccines which are not economically viable for private companies – CEPI model sets the stage for future proactive response to outbreaks of highly pathogenic emerging viruses.

References

1          Wong, K. T. & Tan, C. T. Clinical and pathological manifestations of human henipavirus infection. Curr Top Microbiol Immunol 359, 95-104, doi:10.1007/82_2012_205 (2012).

2          Srinivasulu, B. & Srinivasulu, C. A first record of three hitherto unreported species of bats from Kerala, India with a note on Myotis peytoni (Mammalia: Chiroptera: Vesperttillionidae). J Threatened Taxa 9, 10216-11022 (2017).

3          Luby, S. P. The pandemic potential of Nipah virus. Antiviral Res 100, 38-43, doi:10.1016/j.antiviral.2013.07.011 (2013).

4          Chadha, M. S. et al. Nipah virus-associated encephalitis outbreak, Siliguri, India. Emerg Infect Dis 12, 235-240, doi:10.3201/eid1202.051247 (2006).

5          Homaira, N. et al. Nipah virus outbreak with person-to-person transmission in a district of Bangladesh, 2007. Epidemiol Infect 138, 1630-1636, doi:10.1017/S0950268810000695 (2010).

6          Hassan, M. Z. et al. Nipah Virus Contamination of Hospital Surfaces during Outbreaks, Bangladesh, 2013-2014. Emerg Infect Dis 24, 15-21, doi:10.3201/eid2401.161758 (2018).

7          Gurley, E. S. et al. Person-to-person transmission of Nipah virus in a Bangladeshi community. Emerg Infect Dis 13, 1031-1037, doi:10.3201/eid1307.061128 (2007).

 

Global Virus Network Adds Uganda Virus Research Institute as Newest Center of Excellence

Baltimore, Maryland, USA, and Entebbe, Uganda, May 29, 2018: The Global Virus Network (GVN) and the Uganda Virus Research Institute (UVRI) announced today the induction of the Institute as GVN’s newest Center of Excellence. The GVN represents 41 Centers of Excellence and 7 affiliates in 26 countries and comprises foremost experts in every class of virus causing disease in humans.

Prof. Pontiano Kaleebu, PhD, MBChB.

 

The announcement was made by Prof. Robert Gallo, MD, Co-founder and International Scientific Advisor of the Global Virus Network, Prof. Pontiano Kaleebu, PhD, MBChB, director of UVRI and director of the Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, and Prof. Christian Bréchot, MD, PhD, president of the Global Virus Network.  Prof. Kaleebu will be director of UVRI’s GVN Center of Excellence.

 

“We are pleased to grow our reach in Africa, and look forward to working with Prof. Kaleebu and UVRI, particularly on emerging and re-emerging viruses,” said Gallo, also The Homer and Martha Gudelsky Distinguished Professor in Medicine and co-founder and director of the Institute of Human Virology at the University of Maryland School of Medicine, a GVN Center of Excellence.  “My colleagues and I felt strongly that UVRI would contribute greatly to the depth of the GVN, not only in its significant expertise but to Uganda’s surrounding region.”

 

UVRI is internationally recognized for research on arboviruses, HIV infection, and emerging and re-emerging infections.  The Institute provides routine surveillance of arboviral infections and their vectors, including epidemic outbreak investigations and research, and it contributes knowledge on the evolving HIV epidemic, innovative health care options, including treatment and prevention, and, studies on HIV vaccine research and development. UVRI’s mandate includes control of vector-borne diseases, such as Viral Hemorrhagic Fevers (VHFs), surveillance of viral diseases at the human and wild animal interface, and, mapping of human and animal populations at risk of viral infections. The Institute is also involved in surveillance and research on vaccine-preventable diseases, including enteroviruses, with a focus on polio, rotaviruses, measles, and measles-like illnesses such as rubella.

 

“We are very excited to join this international community of medical virologists,” said Prof. Kaleebu.  “We are hopeful this will provide our Institute and its scientists better opportunities to fulfil the mandate to conduct research and surveillance into viral diseases in order to promote a healthy and productive life, but also to strengthen research capacity.”

 

“This partnership recognizes the scientific and public health impact of UVRI and is an important step for the development of the GVN in Africa,” said Bréchot. “The partnership also builds upon GVN’s difficult and necessary work in merging the efforts of French, English, and Portuguese-speaking scientific and medical communities in Africa and other regions of the world.”

 

UVRI was established in 1936 by the Rockefeller Foundation to study the transmission of Yellow Fever. Before being renamed UVRI, the Institute’s founding name was the Yellow Fever Research Institute, and later the East African Virus Research Institute, when new viruses such as West Nile, Semliki Forest, Zika and Bunyamwera were first isolated at this Institute. Currently, UVRI hosts many national and regional reference laboratories including the national reference laboratories for HIV testing and quality assurance, the HIV drug resistance national and regional reference laboratory, the national and regional reference laboratory for the Expanded Programme on Immunization, and, viral heamorrhagic fever national laboratories.  Recently, UVRI was assessed to become the World Health Organization (WHO) Yellow fever reference laboratory.

 

The GVN is a global authority and resource for the identification and investigation, interpretation and explanation, control and suppression, of viral diseases posing threats to mankind.  It enhances the international capacity for reactive, proactive and interactive activities that address mankind-threatening viruses and addresses a global need for coordinated virology training through scholarly exchange programs for recruiting and training young scientists in medical virology.  The GVN also serves as a resource to governments and international organizations seeking advice about viral disease threats, prevention or response strategies, and GVN advocates for research and training on virus infections and their many disease manifestations.

 

The GVN, in partnership with the Fondation Mérieux (FM) and the University of Veterinary Medicine Hannover (TiHo), will convene the 10th International Global Virus Network Meeting on Eradication and Control of (Re-)Emerging Viruses in Annecy, France November 28-30. More information can be found at www.gvn.org.

 

About the Global Virus Network (GVN)

The Global Virus Network (GVN) is a non-profit, 501(c)(3) organization, comprised of leading medical virologists from 26 countries. The GVN’s mission is to combat current and emerging pandemic viral threats through international collaborative research, training the next generation of medical virologists, and advocacy.

Global Virus Network Issues Open Letter to WHO On Potent Human Carcinogen – Human T Cell Leukemia Virus-1

The Lancet publishes letter from top scientists and advocates from around the world to eradicate HTLV-1, a debilitating and deadly virus

Baltimore, MD, USA, May 10, 2018: The Global Virus Network (GVN), an international coalition of the world’s foremost medical virologists, comprising 41 Centers of Excellence and 7 Affiliates in 26 countries, dedicated to identifying and researching, combatting and preventing, current and emerging pandemic viruses that pose a critical threat to public health and well-being, held its 9th International Meeting in Melbourne, Australia on September 25-27, 2017 in partnership with the Peter Doherty Institute and the Institut Pasteur. Following the meeting’s impressive session on one of the most potent human carcinogens, human T cell leukemia virus subtype 1 (HTLV-1), a group of renowned scientists and activists are calling on the World Health Organization (WHO) to support the promotion of proven, effective transmission prevention strategies on this debilitating and deadly virus. An abbreviated version of the letter, Time to eradicate HTLV-1: an open letter to WHO, was published in The Lancet online and will be published in Lancet’s May 12 issue. The full letter was published on the GVN website.

As reported in PNAS by Poiesz et al. in 1980, images A-D show HTLV-I in the stages of budding and image E shows an ATL leukemic cell.

Said Robert C. Gallo, MD, Co-Founder and Director, Global Virus Network (GVN) and The Homer & Martha Gudelsky Distinguished Professor in Medicine, Co-Founder and Director, Institute of Human Virology, University of Maryland School of Medicine, a GVN Center of Excellence, “Since my colleagues and I discovered HTLV-1, the first known human retrovirus in 1980 and the first virus shown to directly cause human cancer and later shown also to cause neurological and immune disorders, we have learned that this destructive and lethal virus is causing much devastation in communities with high prevalence. The GVN created an HTLV-1 Task Force over three years ago, recognizing that there are no effective vaccines against this virus nor antiviral drugs to treat infections. During the GVN meeting last September, I was astounded to learn of the hyper-endemic numbers in the Aboriginal population of Australia. HTLV-1 is endemic in other regions including several islands of the Caribbean, and in countries such as Brazil, Iran, Japan and Peru. We hope that the WHO will agree with us, and begin to take action in promoting prevention strategies against HTLV-1.” Prof. Gallo is also Co-Chair of GVN’s HTLV-1 Task Force.

HTLV-1 is transmitted via the same routes as HIV-1, which was co-discovered as the cause of AIDS by Prof. Gallo and his colleagues, along with scientists at Institut Pasteur. HIV and HTLV-1 infect via infected body fluids including unprotected sexual intercourse, breastfeeding, sharing of needles, and the transfusion and transplantation of infected blood and organ donations. They are ancient viruses originating from non-human primates. HTLV-1 prevalence is more complex than HIV-1, in that it is highly endemic in some parts of the world, while surveillance data in many regions are not comprehensive and unknown for 6 billion persons.

“As with most sexually transmitted viruses, the majority of HTLV positive people transmit the virus unknowingly and are unaware that they are at risk of developing HTLV-1 associated diseases,” said Fabiola Martin, MD, MDRes, FRCP, FHEA, Sexual Health, HIV and HTLV Physician and scientist based in Brisbane/Australia. “The statistics speak for themselves and with it the support of the World Health Organization we will be able to support patients and promote effective HTLV-1 prevention strategies internationally.”

In a recent hospital-based cohort study by Lloyd Einsiedel, MD of the Baker Institute, in Central Australia, 33.6 % of Indigenous people tested HTLV-1 positive, reaching 48.5 % in older men. Further, the following infection rates are reported worldwide:

    • Brazil – a prevalence rate of 1.3% in blood donors in certain regions, 1.8% in the general population and 1.05% in pregnant women with 33% of their family members including children found to be positive.
    • Central African Republic – 7% of older, female Pygmies in the Southern region infected.
      Gabon – a HTLV-1 prevalence of 5–10% has been observed in adults.
    • Iran – up to 3% of adults are infected in the Mashhad area while HTLV-1 is found across the country.
      Jamaica – 6.1% in the general population and other Caribbean islands that have been studied have similar prevalence rates.
    • Japan – 1,000,000 are HTLV-1 positive and in Southern regions 10% of adults more than 50 years of age carry this virus.
    • Nigeria – 850,000 to 1.7 million infected.
    • Romania – infection rates include 5.3/10,000 among first-time blood donors, and 3-25% in poly-transfused patients.

According to Graham P. Taylor, MDMB, DSc, Professor of Human Retrovirology, Imperial College London, Honorary Consultant, National Centre for Human Retrovirology, St. Mary’s Hospital, London and member, GVN HTLV-1 Task Force, “The general neglect, globally, of the importance of HTLV-1 as a sexually transmitted infection that causes a range of debilitating inflammatory diseases does our patients, who request a sexual health screen, a disservice. It is also important to recognize the importance of mother-to-child transmission of HTLV-1 in the development of adult T-cell leukemia/lymphoma decades later. Despite the availability of highly sensitive and specific diagnostic tests for infection and a proven intervention, except for Japan, there are no antenatal screening programs. Evaluating the cost-effectiveness of such programs should now be a priority.”

In non-endemic areas, due to the migration of people and the sexual transmission of the virus, HTLV-1 and 2 have also been detected. Though most people remain undiagnosed, In the UK an estimated 20,000 – 30,000 people live with the virus, whilst in metropolitan France an estimated 10,000 – 25,000 people are HTLV-1 infected. In the USA, it is estimated that approximately 266,000 individuals are infected with HTLV-1 or -2, and that 3,600 people with HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) remain undiagnosed.

Yoshi Yamano, MD, PhD, Professor at St. Marianna University School of Medicine, Kawasaki, Japan and member of the GVN HTLV-1 Task Force, said, “To prevent mother to child infection, the Japanese government has been offering HTLV-1 screening for all pregnant women without cost. Taking a leadership role to promote research, it also provides grants for clinical trials and patient registries focused on ATLL and HAM/TSP.”

In addition to co-organizing the impactful sessions on HTLV during the GVN meeting last September, Prof. Gallo and Sharon Lewin, MD, PhD, director of The Peter Doherty Institute for Infection and Immunity, a GVN Center of Excellence, announced Christian Bréchot, MD, PhD, as the new President of the GVN. Prof. Bréchot is shaping the vision and strategy of the GVN and believes this call to action is an important step in catalyzing action initiated by GVN’s members.

“GVN offers a unique resource to leading public health officials including those at the WHO,” said Prof. Bréchot. “We look forward to developing significant partnerships with WHO and others to provide resources from our vast network to help bring to light urgent needs and close gaps in information such as this urgent crisis regarding HTLV-1. The GVN has begun to grow its network, including in Africa, and we hope that with this outreach that we will be better positioned to successfully combat neglected viral threats such as HTLV-1.”

Said William Hall, MD, PhD, Co-founder of the GVN and Professor of Microbiology at the University College Dublin and Member of the GVN HTLV-1 Task Force, “This virus has been underestimated since the time of its discovery, perhaps because it is restricted to certain regions, or because it is not terribly infectious. However, for decades it has been known that HTLV-1 is highly carcinogenic and causes severe paralytic neurologic disease and immune disorders that can lead to bacterial infections. It is time that the WHO publicize prevention strategies against this devastating virus.”

The GVN will hold its 10th International Meeting November 28-30 in Annecy, France with the theme, “Eradication and Control of (Re-)Emerging Viruses.” The meeting will be co-hosted by GVN Centers of Excellence, the Fondation Mérieux (FM) and the University of Veterinary Medicine Hannover (TiHo), and led by FM’s Prof. Hubert Endtz, TiHo’s Prof. Ab Osterhaus and GVN’s Prof. Christian Bréchot.

About the Global Virus Network (GVN)

The Global Virus Network (GVN) is a non-profit, 501(c)(3) organization, comprised of leading medical virologists from 26 countries. The GVN’s mission is to combat current and emerging pandemic viral threats through international collaborative research, training the next generation of medical virologists, and advocacy. For more information, please visit www.gvn.org. Follow us on Twitter @GlobalVirusNews

Media Contact:
Nora Samaranayake, GVN
410-706-8614
[email protected]