Post-exposure prophylaxis with rVSV-ZEBOV following exposure to a patient with Ebola virus disease relapse in the UK: an operational, safety and immunogenicity report

Davis, C. et al. (2019) Post-exposure prophylaxis with rVSV-ZEBOV following exposure to a patient with Ebola virus disease relapse in the UK: an operational, safety and immunogenicity report. Clinical Infectious Diseases, (doi: 10.1093/cid/ciz1165) (PMID:31784751) (Early Online Publication)

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Abstract

Background: In October 2015, 65 people came into direct contact with a healthcare worker presenting with a late reactivation of Ebola virus disease (EVD) in the UK. Vaccination was offered to 45 individuals with an initial assessment of high exposure risk. Methods: Approval for rapid expanded access to the recombinant vesicular stomatitis virus–Zaire Ebola virus vaccine (rVSV-ZEBOV) as an unlicensed emergency medicine was obtained from the relevant authorities. An observational follow-up study was carried out for 1 year following vaccination. Results: 26/45 individuals elected to receive vaccination between October 10th and 11th 2015 following written informed consent. By day 14, 39% had seroconverted, rising to 87% by day 28 and 100% by 3 months, although these responses were not always sustained. Neutralising antibody responses were detectable in 36% by day 14 and 73% at 12 months. Common side effects included fatigue, myalgia, headache, arthralgia and fever. These were positively associated with glycoprotein (GP)-specific T-cell but not IgM or IgG antibody responses. No severe vaccine-related adverse events were reported. No-one exposed to the virus became infected. Conclusions: This paper reports the use of the rVSV-ZEBOV vaccine given as an emergency intervention to individuals exposed to a patient presenting with a late reactivation of EVD. The vaccine was relatively well tolerated but a high percentage developed a fever ≥37.5oC necessitating urgent screening for Ebola virus and a small number developed persistent arthralgia.

Item Type:Articles
Additional Information:This work was supported by the US Food and Drug Administration (HHSF223201510104C), the German Research Foundation (197785619/SFB 1021), the MRC (MC_UU_12014/1), and Wellcome (102789/Z/13/A).
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Evans, Professor Tom and McMenamin, Dr James and Sabir, Dr Suleman and Thorburn, Dr Fiona and Gunson, Dr Rory and Thomson, Professor Emma and White, Dr Beth and Davis, Dr Chris
Authors: Davis, C., Tipton, T., Sabir, S., Aitken, C., Bennett, S., Becker, S., Evans, T., Fehling, S. K., Gunson, R., Hall, Y., Jackson, C., Johanssen, I., Kieny, M. P., McMenamin, J., Spence, E., Strecker, T., Sykes, C., Templeton, K., Thorburn, F., Peters, E., Restrepo, A. M. H., White, B., Zambon, M., Carroll, M. W., and Thomson, E. C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Clinical Infectious Diseases
Publisher:Oxford University Press
ISSN:1058-4838
ISSN (Online):1537-6591
Published Online:30 November 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:Accepted manuscript first published in Clinical Infectious Diseases, 30 Nov 2019
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
169538T-cell mediated evolution of hepatitis C virus during acute infectionEmma ThomsonWellcome Trust (WELLCOTR)102789/Z/13/ZIII-MRC-GU Centre for Virus Research
MC_UU_12014/1