Publications by authors named "David M Morens"

104 Publications

A Centenary Tale of Two Pandemics: The 1918 Influenza Pandemic and COVID-19, Part II.

Am J Public Health 2021 Jun 10:e1-e6. Epub 2021 Jun 10.

David M. Morens and Anthony S. Fauci are with the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Jeffery K. Taubenberger is with the Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases.

Both the 1918 influenza pandemic and the 2019‒2021 COVID-19 pandemic are among the most disastrous infectious disease emergences of modern times. In addition to similarities in their clinical, pathological, and epidemiological features, the two pandemics, separated by more than a century, were each met with essentially the same, or very similar, public health responses, and elicited research efforts to control them with vaccines, therapeutics, and other medical approaches. Both pandemics had lasting, if at times invisible, psychosocial effects related to loss and hardship. In considering these two deadly pandemics, we ask: what lessons have we learned over the span of a century, and how are we applying those lessons to the challenges of COVID-19? (. Published online ahead of print June 10, 2021: e1-e8. https://doi.org/10.2105/AJPH.2021.306326).
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http://dx.doi.org/10.2105/AJPH.2021.306326DOI Listing
June 2021

Seasonal Influenza Prevention and Control Progress in Latin America and the Caribbean in the Context of the Global Influenza Strategy and the COVID-19 Pandemic.

Am J Trop Med Hyg 2021 May 10. Epub 2021 May 10.

4Center for Global Health, Colorado School of Public Health, Aurora, Colorado.

Each year in Latin America and the Caribbean, seasonal influenza is associated with an estimated 36,500 respiratory deaths and 400,000 hospitalizations. Since the 2009 influenza A(H1N1) pandemic, the Region has made significant advances in the prevention and control of seasonal influenza, including improved surveillance systems, burden estimates, and vaccination of at-risk groups. The Global Influenza Strategy 2019-2030 provides a framework to strengthen these advances. Against the backdrop of this new framework, the University of Colorado convened in October 2020 its Immunization Advisory Group of Experts to review and discuss current surveillance, prevention, and control strategies for seasonal influenza in Latin America and the Caribbean, also in the context of the COVID-19 pandemic. This review identified five areas for action and made recommendations specific to each area. The Region should continue its efforts to strengthen surveillance and impact evaluations. Existing data on disease burden, seasonality patterns, and vaccination effectiveness should be used to inform decision-making at the country level as well as advocacy efforts for programmatic resources. Regional and country strategic plans should be prepared and include specific targets for 2030. Existing investments in influenza prevention and control, including for immunization programs, should be optimized. Finally, regional partnerships, such as the regional networks for syndromic surveillance and vaccine effectiveness evaluation (SARInet and REVELAC-i), should continue to play a critical role in continuous learning and standardization by sharing experiences and best practices among countries.
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http://dx.doi.org/10.4269/ajtmh.21-0339DOI Listing
May 2021

A Centenary Tale of Two Pandemics: The 1918 Influenza Pandemic and COVID-19, Part I.

Am J Public Health 2021 06;111(6):1086-1094

David M. Morens and Anthony S. Fauci are with Office of the Director, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Bethesda, MD. Jeffery K. Taubenberger is with Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, NIAID.

Separated by a century, the influenza pandemic of 1918 and the COVID-19 pandemic of 2019-2021 are among the most disastrous infectious disease emergences of modern times. Although caused by unrelated viruses, the two pandemics are nevertheless similar in their clinical, pathological, and epidemiological features, and in the civic, public health, and medical responses to combat them. Comparing and contrasting the two pandemics, we consider what lessons we have learned over the span of a century and how we are applying those lessons to the challenges of COVID-19.
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http://dx.doi.org/10.2105/AJPH.2021.306310DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101587PMC
June 2021

A glossary of pandemic-related terms.

J Am Acad Dermatol 2021 Mar 19;84(3):e141. Epub 2020 Nov 19.

Department of Dermatology, George Washington University, Washington, District of Columbia; Department of Pediatrics, George Washington University, Washington, District of Columbia. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2020.10.092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836784PMC
March 2021

Reply to Tournier, "Pandemic Legion History More Complex than Previously Thought".

mBio 2020 10 9;11(5). Epub 2020 Oct 9.

Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA

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http://dx.doi.org/10.1128/mBio.02654-20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547205PMC
October 2020

Emerging Pandemic Diseases: How We Got to COVID-19.

Cell 2020 09 15;182(5):1077-1092. Epub 2020 Aug 15.

Office of the Director, National Institute of Allergy & Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.

Infectious diseases prevalent in humans and animals are caused by pathogens that once emerged from other animal hosts. In addition to these established infections, new infectious diseases periodically emerge. In extreme cases they may cause pandemics such as COVID-19; in other cases, dead-end infections or smaller epidemics result. Established diseases may also re-emerge, for example by extending geographically or by becoming more transmissible or more pathogenic. Disease emergence reflects dynamic balances and imbalances, within complex globally distributed ecosystems comprising humans, animals, pathogens, and the environment. Understanding these variables is a necessary step in controlling future devastating disease emergences.
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http://dx.doi.org/10.1016/j.cell.2020.08.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428724PMC
September 2020

Influenza Neuraminidase: A Neglected Protein and Its Potential for a Better Influenza Vaccine.

Vaccines (Basel) 2020 Jul 23;8(3). Epub 2020 Jul 23.

LID Clinical Studies Unit, Laboratory of Infectious Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.

Neuraminidase (NA) is an influenza surface protein that helps to free viruses from mucin-associated decoy receptors and to facilitate budding from infected cells. Experiments have demonstrated that anti-NA antibodies protect animals against lethal influenza challenge by numerous strains, while decreasing pulmonary viral titers, symptoms, and lung lesions. Studies in humans during the influenza A/H3N2 pandemic and in healthy volunteers challenged with influenza A/H1N1 showed that anti-NA immunity reduced symptoms, nasopharyngeal viral shedding, and infection rates. Despite the benefits of anti-NA immunity, current vaccines focus on immunity against hemagglutinin and are not standardized to NA content leading to limited and variable NA immunogenicity. Purified NA has been shown to be safe and immunogenic in humans. Supplementing current vaccines with NA may be a simple strategy to improve suboptimal effectiveness. Immunity against NA is likely to be an important component of future universal influenza vaccines.
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http://dx.doi.org/10.3390/vaccines8030409DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564061PMC
July 2020

The Origin of COVID-19 and Why It Matters.

Am J Trop Med Hyg 2020 Sep;103(3):955-959

Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

The COVID-19 pandemic is among the deadliest infectious diseases to have emerged in recent history. As with all past pandemics, the specific mechanism of its emergence in humans remains unknown. Nevertheless, a large body of virologic, epidemiologic, veterinary, and ecologic data establishes that the new virus, SARS-CoV-2, evolved directly or indirectly from a β-coronavirus in the sarbecovirus (SARS-like virus) group that naturally infect bats and pangolins in Asia and Southeast Asia. Scientists have warned for decades that such sarbecoviruses are poised to emerge again and again, identified risk factors, and argued for enhanced pandemic prevention and control efforts. Unfortunately, few such preventive actions were taken resulting in the latest coronavirus emergence detected in late 2019 which quickly spread pandemically. The risk of similar coronavirus outbreaks in the future remains high. In addition to controlling the COVID-19 pandemic, we must undertake vigorous scientific, public health, and societal actions, including significantly increased funding for basic and applied research addressing disease emergence, to prevent this tragic history from repeating itself.
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http://dx.doi.org/10.4269/ajtmh.20-0849DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470595PMC
September 2020

Pre-existing immunity to influenza virus hemagglutinin stalk might drive selection for antibody-escape mutant viruses in a human challenge model.

Nat Med 2020 08 29;26(8):1240-1246. Epub 2020 Jun 29.

Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.

The conserved region of influenza hemagglutinin (HA) stalk (or stem) has gained attention as a potent target for universal influenza vaccines. Although the HA stalk region is relatively well conserved, the evolutionarily dynamic nature of influenza viruses raises concerns about the possible emergence of viruses carrying stalk escape mutation(s) under sufficient immune pressure. Here we show that immune pressure on the HA stalk can lead to expansion of escape mutant viruses in study participants challenged with a 2009 H1N1 pandemic influenza virus inoculum containing an A388V polymorphism in the HA stalk (45% wild type and 55% mutant). High level of stalk antibody titers was associated with the selection of the mutant virus both in humans and in vitro. Although the mutant virus showed slightly decreased replication in mice, it was not observed in cell culture, ferrets or human challenge participants. The A388V mutation conferred resistance to some of the potent HA stalk broadly neutralizing monoclonal antibodies (bNAbs). Co-culture of wild-type and mutant viruses in the presence of either a bNAb or human serum resulted in rapid expansion of the mutant. These data shed light on a potential obstacle for the success of HA-stalk-targeting universal influenza vaccines-viral escape from vaccine-induced stalk immunity.
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http://dx.doi.org/10.1038/s41591-020-0937-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450362PMC
August 2020

Pandemic COVID-19 Joins History's Pandemic Legion.

mBio 2020 05 29;11(3). Epub 2020 May 29.

Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA

With great apprehension, the world is now watching the birth of a novel pandemic already causing tremendous suffering, death, and disruption of normal life. Uncertainty and dread are exacerbated by the belief that what we are experiencing is new and mysterious. However, deadly pandemics and disease emergences are not new phenomena: they have been challenging human existence throughout recorded history. Some have killed sizeable percentages of humanity, but humans have always searched for, and often found, ways of mitigating their deadly effects. We here review the ancient and modern histories of such diseases, discuss factors associated with their emergences, and attempt to identify lessons that will help us meet the current challenge.
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http://dx.doi.org/10.1128/mBio.00812-20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267883PMC
May 2020

New coronavirus outbreak: Framing questions for pandemic prevention.

Sci Transl Med 2020 03;12(534)

Scott P. Layne is emeritus professor in the Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA 90095, USA. Email:

We need to understand and quantify the dominant variables that govern the SARS-CoV-2 outbreak, rather than relying exclusively on confirmed cases and their geospatial spread.
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http://dx.doi.org/10.1126/scitranslmed.abb1469DOI Listing
March 2020

Escaping Pandora's Box - Another Novel Coronavirus.

N Engl J Med 2020 Apr 26;382(14):1293-1295. Epub 2020 Feb 26.

From the Office of the Director (D.M.M.) and the Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases (J.K.T.), National Institute of Allergy and Infectious Diseases, Bethesda, MD; and EcoHealth Alliance, New York, New York (P.D.).

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http://dx.doi.org/10.1056/NEJMp2002106DOI Listing
April 2020

The 1918 Influenza Pandemic and Its Legacy.

Cold Spring Harb Perspect Med 2020 10 1;10(10). Epub 2020 Oct 1.

Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.

Just over a century ago in 1918-1919, the "Spanish" influenza pandemic appeared nearly simultaneously around the world and caused extraordinary mortality-estimated at 50-100 million fatalities-associated with unexpected clinical and epidemiological features. The pandemic's sudden appearance and high fatality rate were unprecedented, and 100 years later still serve as a stark reminder of the continual threat influenza poses. Sequencing and reconstruction of the 1918 virus have allowed scientists to answer many questions about its origin and pathogenicity, although many questions remain. Several of the unusual features of the 1918-1919 pandemic, including age-specific mortality patterns and the high frequency of severe pneumonias, are still not fully understood. The 1918 pandemic virus initiated a pandemic era still ongoing. The descendants of the 1918 virus remain today as annually circulating and evolving influenza viruses causing significant mortality each year. This review summarizes key findings and unanswered questions about this deadliest of human events.
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http://dx.doi.org/10.1101/cshperspect.a038695DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7528857PMC
October 2020

Eastern Equine Encephalitis Virus - Another Emergent Arbovirus in the United States.

N Engl J Med 2019 Nov;381(21):1989-1992

From the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.

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http://dx.doi.org/10.1056/NEJMp1914328DOI Listing
November 2019

The 1918 influenza pandemic: 100 years of questions answered and unanswered.

Sci Transl Med 2019 07;11(502)

Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.

The 2018-2019 period marks the centennial of the "Spanish" influenza pandemic, which caused at least 50 million deaths worldwide. The unprecedented nature of the pandemic's sudden appearance and high fatality rate serve as a stark reminder of the threat influenza poses. Unusual features of the 1918-1919 pandemic, including age-specific mortality and the high frequency of severe pneumonias, are still not fully understood. Sequencing and reconstruction of the 1918 virus has allowed scientists to answer many questions about its origin and pathogenicity, although many questions remain. This Review summarizes key findings and still-to-be answered questions about this deadliest of human events.
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http://dx.doi.org/10.1126/scitranslmed.aau5485DOI Listing
July 2019

Influenza A Reinfection in Sequential Human Challenge: Implications for Protective Immunity and "Universal" Vaccine Development.

Clin Infect Dis 2020 02;70(5):748-753

Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, Division of Intramural Research, Bethesda, Maryland.

Background: Identification of correlates of protection against human influenza A virus infection is important in development of broadly protective ("universal") influenza vaccines. Certain assumptions underlie current vaccine developmental strategies, including that infection with a particular influenza A virus should offer long-term or lifelong protection against that strain, preventing reinfection. In this study we report observations made when 7 volunteers participated in sequential influenza challenge studies where they were challenged intranasally using the identical influenza A(H1N1)pdm09 virus approximately 1 year apart. We evaluate and describe the outcomes of these 7 rechallenge participants and discuss what these results may suggest about correlates of protection and development of more broadly protective influenza vaccines.

Methods: Seven participants were enrolled in 2 viral challenge studies at 7.5- to 18.5-month intervals. Both challenge studies used the identical lot of influenza A (H1N1)pdm09 virus administered intranasally. We evaluated pre- and postchallenge hemagglutination inhibition, neuraminidase inhibition, and stalk antibody titers; peripheral blood leukocyte host gene expression response profiles; daily viral detection via nasal wash; and clinical signs and symptoms.

Results: At least 3 of 7 participants demonstrated confirmed laboratory evidence of sequential infection, with 5 of 7 demonstrating clinical evidence.

Conclusions: The data presented in this report demonstrate that sequential infection with the identical influenza A virus can occur and suggest it may not be rare. These data raise questions about immune memory responses in an acute superficial respiratory mucosal infection and their implications in development of broadly protective influenza vaccines. Further investigation of these observations is warranted.

Clinical Trials Registration: NCT01646138; NCT01971255.
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http://dx.doi.org/10.1093/cid/ciz281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319262PMC
February 2020

Acute Flaccid Myelitis: Something Old and Something New.

mBio 2019 04 2;10(2). Epub 2019 Apr 2.

National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA

Since 2014, acute flaccid myelitis (AFM), a long-recognized condition associated with polioviruses, nonpolio enteroviruses, and various other viral and nonviral causes, has been reemerging globally in epidemic form. This unanticipated reemergence is ironic, given that polioviruses, once the major causes of AFM, are now at the very threshold of global eradication and cannot therefore explain any aspect of AFM reemergence. Instead, the new AFM epidemic has been temporally associated with reemergences of nonpolio enteroviruses such as EV-D68, until recently thought to be an obscure virus of extremely low endemicity. This perspective reviews the enigmatic epidemiologic, virologic, and diagnostic aspects of epidemic AFM reemergence; examines current options for clinical management; discusses future research needs; and suggests that the AFM epidemic offers important clues to mechanisms of viral disease emergence.
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http://dx.doi.org/10.1128/mBio.00521-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445942PMC
April 2019

Making Universal Influenza Vaccines: Lessons From the 1918 Pandemic.

J Infect Dis 2019 04;219(Suppl_1):S5-S13

Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

The year 2018 marked the 100th anniversary of the deadliest event in human history. In 1918-1919, pandemic influenza spread globally and caused an estimated 50-100 million deaths associated with unexpected clinical and epidemiological features. The descendants of the 1918 virus continue to circulate as annual epidemic viruses causing significant mortality each year. The 1918 influenza pandemic serves as a benchmark for the development of universal influenza vaccines. Challenges to producing a truly universal influenza vaccine include eliciting broad protection against antigenically different influenza viruses that can prevent or significantly downregulate viral replication and reduce morbidity by preventing development of viral and secondary bacterial pneumonia. Perhaps the most important goal of such vaccines is not to prevent influenza, but to prevent influenza deaths.
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http://dx.doi.org/10.1093/infdis/jiy728DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452324PMC
April 2019

Influenza Cataclysm, 1918.

N Engl J Med 2018 Dec;379(24):2285-2287

From the Office of the Director (D.M.M.) and the Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases (J.K.T.), National Institute of Allergy and Infectious Diseases, Bethesda, MD.

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http://dx.doi.org/10.1056/NEJMp1814447DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558650PMC
December 2018

The Mother of All Pandemics Is 100 Years Old (and Going Strong)!

Am J Public Health 2018 11 25;108(11):1449-1454. Epub 2018 Sep 25.

David M. Morens and Jeffery K. Taubenberger are with the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. David M. Morens is Senior Adsvisor to the Director in the Office of the Director, and Jeffery K. Taubenberger is Chief, Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases.

This year marks the 100th anniversary of the deadliest event in human history. In 1918-1919, pandemic influenza appeared nearly simultaneously around the globe and caused extraordinary mortality (an estimated 50-100 million deaths) associated with unexpected clinical and epidemiological features. The descendants of the 1918 virus remain today; as endemic influenza viruses, they cause significant mortality each year. Although the ability to predict influenza pandemics remains no better than it was a century ago, numerous scientific advances provide an important head start in limiting severe disease and death from both current and future influenza viruses: identification and substantial characterization of the natural history and pathogenesis of the 1918 causative virus itself, as well as hundreds of its viral descendants; development of moderately effective vaccines; improved diagnosis and treatment of influenza-associated pneumonia; and effective prevention and control measures. Remaining challenges include development of vaccines eliciting significantly broader protection (against antigenically different influenza viruses) that can prevent or significantly downregulate viral replication; more complete characterization of natural history and pathogenesis emphasizing the protective role of mucosal immunity; and biomarkers of impending influenza-associated pneumonia.
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http://dx.doi.org/10.2105/AJPH.2018.304631DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6187799PMC
November 2018

Neuraminidase as an influenza vaccine antigen: a low hanging fruit, ready for picking to improve vaccine effectiveness.

Curr Opin Immunol 2018 08 16;53:38-44. Epub 2018 Apr 16.

Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, NIH, 33 North Dr, Bethesda, MD, USA.

Neuraminidase (NA) plays an essential role in influenza virus replication, facilitating multicycle infection predominantly by releasing virions from infected cells. NA-inhibiting antibodies provide resistance to disease and NA-specific antibodies contribute to vaccine efficacy. The primary reason NA vaccine content and immunogenicity was not routinely measured in the past, was the lack of suitable assays to quantify NA and NA-specific antibodies. These are now available and with recent appreciation of its contribution to immunity, NA content of seasonal and pandemic vaccines is being considered. An added benefit of NA as a vaccine antigen is that many NA-specific antibodies bind to domains that are well conserved within a subtype, protecting against heterologous viruses. This suggests NA may be a good choice for inclusion in universal influenza vaccines.
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http://dx.doi.org/10.1016/j.coi.2018.03.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141346PMC
August 2018

Mosquito Saliva: The Hope for a Universal Arbovirus Vaccine?

J Infect Dis 2018 06;218(1):7-15

Laboratory of Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

Arthropod-borne viruses (arboviruses) are taxonomically diverse causes of significant morbidity and mortality. In recent decades, important mosquito-borne viruses such as West Nile, chikungunya, dengue, and Zika have re-emerged and spread widely, in some cases pandemically, to cause serious public health emergencies. There are no licensed vaccines against most of these viruses, and vaccine development and use has been complicated by the number of different viruses to protect against, by subtype and strain variation, and by the inability to predict when and where outbreaks will occur. A new approach to preventing arboviral diseases is suggested by the observation that arthropod saliva facilitates transmission of pathogens, including leishmania parasites, Borrelia burgdorferi, and some arboviruses. Viruses carried within mosquito saliva may more easily initiate host infection by taking advantage of the host's innate and adaptive immune responses to saliva. This provides a rationale for creating vaccines against mosquito salivary proteins, rather than against only the virus proteins contained within the saliva. As proof of principle, immunization with sand fly salivary antigens to prevent leishmania infection has shown promising results in animal models. A similar approach using salivary proteins of important vector mosquitoes, such as Aedes aegypti, might protect against multiple mosquito-borne viral infections.
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http://dx.doi.org/10.1093/infdis/jiy179DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989627PMC
June 2018

Vaccination Strategies During Shortages of Yellow Fever Vaccine.

JAMA 2018 03;319(12):1280

Office of the Director, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland.

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http://dx.doi.org/10.1001/jama.2018.0200DOI Listing
March 2018

Pandemic Zika: A Formidable Challenge to Medicine and Public Health.

J Infect Dis 2017 12;216(suppl_10):S857-S859

National Institute of Allergy and Infectious Diseases, Bethesda, Maryland.

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http://dx.doi.org/10.1093/infdis/jix383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5853239PMC
December 2017

The Pathogenesis of Ebola Virus Disease.

Annu Rev Pathol 2017 Jan;12:387-418

Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892; email:

For almost 50 years, ebolaviruses and related filoviruses have been repeatedly reemerging across the vast equatorial belt of the African continent to cause epidemics of highly fatal hemorrhagic fever. The 2013-2015 West African epidemic, by far the most geographically extensive, most fatal, and longest lasting epidemic in Ebola's history, presented an enormous international public health challenge, but it also provided insights into Ebola's pathogenesis and natural history, clinical expression, treatment, prevention, and control. Growing understanding of ebolavirus pathogenetic mechanisms and important new clinical observations of the disease course provide fresh clues about prevention and treatment approaches. Although viral cytopathology and immune-mediated cell damage in ebolavirus disease often result in severe compromise of multiple organs, tissue repair and organ function recovery can be expected if patients receive supportive care with fluids and electrolytes; maintenance of oxygenation and tissue perfusion; and respiratory, renal, and cardiovascular support. Major challenges for managing future Ebola epidemics include establishment of early and aggressive epidemic control and earlier and better patient care and treatment in remote, resource-poor areas where Ebola typically reemerges. In addition, it will be important to further develop Ebola vaccines and to adopt policies for their use in epidemic and pre-epidemic situations.
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http://dx.doi.org/10.1146/annurev-pathol-052016-100506DOI Listing
January 2017

Meeting the Challenge of Epidemic Chikungunya.

J Infect Dis 2016 12;214(suppl 5):S434-S435

National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

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http://dx.doi.org/10.1093/infdis/jiw291DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137243PMC
December 2016

Richard M. Krause: Avuncular avatar of microbial science.

Authors:
David M Morens

Proc Natl Acad Sci U S A 2016 Feb 1;113(7):1681-3. Epub 2016 Feb 1.

Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-2520

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http://dx.doi.org/10.1073/pnas.1525722113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763793PMC
February 2016

Zika Virus in the Americas--Yet Another Arbovirus Threat.

N Engl J Med 2016 Feb 13;374(7):601-4. Epub 2016 Jan 13.

From the National Institute of Allergy and Infectious Diseases, Bethesda, MD.

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http://dx.doi.org/10.1056/NEJMp1600297DOI Listing
February 2016

Vaccination and the Lasker Awards: Enduring Legacies.

JAMA 2015 Sep;314(11):1119-20

National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

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http://dx.doi.org/10.1001/jama.2015.9807DOI Listing
September 2015