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Erschienen in: Archives of Virology 10/2023

01.10.2023 | Review

Rational approach to vaccination against highly pathogenic avian influenza in Nigeria: a scientific perspective and global best practice

verfasst von: Clement Meseko, Negedu Onogu Ameji, Binod Kumar, Marie Culhane

Erschienen in: Archives of Virology | Ausgabe 10/2023

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Abstract

Since 2006, highly pathogenic avian influenza (HPAI) subtypes H5Nx have adversely affected poultry production in Nigeria. Successive waves of infections in the last two decades have raised concerns about the ability to contain infections by biosecurity alone, and evidence of recurrent outbreaks suggests a need for adoption of additional control measures such as vaccination. Although vaccination can be used to control virus spread and reduce the morbidity and mortality caused by HPAI, no country using vaccination alone as a control measure against HPAI has been able to eliminate or prevent re-infection. To inform policy in Nigeria, we examined the intricacies of HPAI vaccination, government regulations, and scientific data regarding what kind of vaccines can be used based on subtype, whether inactivated or live attenuated should be used, when to deliver vaccine either proactively or reactively, where to apply vaccination either in disease control zones, regionally, or nationally, and how to vaccinate the targeted poultry population for optimum success. A resurgence of HPAI outbreaks in Nigeria since 2018, after the country was declared free of the epidemic following the first outbreak in 2006, has led to enhanced intervention. Controlled vaccination entails monitoring the application of vaccines, the capacity to differentiate vaccinated from infected (DIVA) flocks, and assessing seroconversion or other immune correlates of protection. Concurrent surveillance for circulating avian influenza virus (AIV) and analyzing AIV isolates obtained via surveillance efforts for genetic and/or antigenic mismatch with vaccine strains are also important. Countries with high investment in commercial poultry farms like Nigeria may identify and zone territories where vaccines can be applied. This may include ring vaccination to control HPAI in areas or production systems at risk of infection. Before adoption of vaccination as an additional control measure on commercial poultry farms, two outcomes must be considered. First, vaccination is an admission of endemicity. Secondly, vaccinated flocks may no longer be made accessible to international poultry markets in accordance with WOAH trade regulations. Vaccination must therefore be approached with utmost caution and be guided by science-based evidence throughout the implementation strategy after thorough risk assessment. Influenza vaccine research, development, and controlled application in addition to biosecurity may be a precautionary measure in the evolving HPAI scenario in Nigeria.
Literatur
1.
Zurück zum Zitat Meseko CA, Ehizibolo DO, Vakuru C (2018) Migratory waterfowls from Europe as potential source of highly pathogenic avian influenza infection to Nigeria poultry. Nigerian Veterinary Journal 39(1):1–15CrossRef Meseko CA, Ehizibolo DO, Vakuru C (2018) Migratory waterfowls from Europe as potential source of highly pathogenic avian influenza infection to Nigeria poultry. Nigerian Veterinary Journal 39(1):1–15CrossRef
2.
Zurück zum Zitat Khanna M et al (2012) Pandemic Influenza A H1N1 (2009) Virus: Lessons from the Past and Implications for the Future. Indian J Virol 23(1):12–17PubMedPubMedCentralCrossRef Khanna M et al (2012) Pandemic Influenza A H1N1 (2009) Virus: Lessons from the Past and Implications for the Future. Indian J Virol 23(1):12–17PubMedPubMedCentralCrossRef
3.
Zurück zum Zitat Asha K, Kumar B (2019) Emerging Influenza D Virus Threat: What We Know so Far! J Clin Med, 8(2) Asha K, Kumar B (2019) Emerging Influenza D Virus Threat: What We Know so Far! J Clin Med, 8(2)
4.
Zurück zum Zitat Joannis TM et al (2008) Serologic and virologic surveillance of avian influenza in Nigeria, 2006-7. Eurosurveillance 13(42):19007PubMedCrossRef Joannis TM et al (2008) Serologic and virologic surveillance of avian influenza in Nigeria, 2006-7. Eurosurveillance 13(42):19007PubMedCrossRef
5.
Zurück zum Zitat Coker T et al (2014) Circulation of the low pathogenic avian influenza subtype H5N2 virus in ducks at a live bird market in Ibadan, Nigeria. Infect Dis Poverty 3(1):38PubMedPubMedCentralCrossRef Coker T et al (2014) Circulation of the low pathogenic avian influenza subtype H5N2 virus in ducks at a live bird market in Ibadan, Nigeria. Infect Dis Poverty 3(1):38PubMedPubMedCentralCrossRef
6.
Zurück zum Zitat Lee DH et al (2017) Evolution, global spread, and pathogenicity of highly pathogenic avian influenza H5Nx clade 2.3.4.4. J Vet Sci 18(S1):269–280PubMedPubMedCentralCrossRef Lee DH et al (2017) Evolution, global spread, and pathogenicity of highly pathogenic avian influenza H5Nx clade 2.3.4.4. J Vet Sci 18(S1):269–280PubMedPubMedCentralCrossRef
7.
Zurück zum Zitat Sulaiman L et al (2021) Live Bird Markets in Nigeria: A Potential Reservoir for H9N2 Avian Influenza Viruses. Viruses, 13(8) Sulaiman L et al (2021) Live Bird Markets in Nigeria: A Potential Reservoir for H9N2 Avian Influenza Viruses. Viruses, 13(8)
8.
10.
Zurück zum Zitat Ameji NO et al (2022) Qualitative Assessment of the Clinico-Pathological Features of Highly Pathogenic Avian Influenza H5N1 Outbreaks in Commercial Poultry and Peri-Domestic Birds in Northern Nigeria. J Biosci Med 10:273–288 Ameji NO et al (2022) Qualitative Assessment of the Clinico-Pathological Features of Highly Pathogenic Avian Influenza H5N1 Outbreaks in Commercial Poultry and Peri-Domestic Birds in Northern Nigeria. J Biosci Med 10:273–288
11.
Zurück zum Zitat The Evolution of Highly Pathogenic Avian Influenza A (H5) in Poultry in Nigeria, 2021–2022 Viruses, 2023. 15(6): p. 1387 The Evolution of Highly Pathogenic Avian Influenza A (H5) in Poultry in Nigeria, 2021–2022 Viruses, 2023. 15(6): p. 1387
12.
13.
Zurück zum Zitat Ducatez MF et al (2006) Avian flu: multiple introductions of H5N1 in Nigeria. Nature 442(7098):37PubMedCrossRef Ducatez MF et al (2006) Avian flu: multiple introductions of H5N1 in Nigeria. Nature 442(7098):37PubMedCrossRef
14.
Zurück zum Zitat Adene DF, Oguntade AE (2006) The Structure and the Importance of the Commercial and Village Based Poultry Industry in Nigeria, in FAO, Rome. Adene DF, Oguntade AE (2006) The Structure and the Importance of the Commercial and Village Based Poultry Industry in Nigeria, in FAO, Rome.
15.
Zurück zum Zitat Ijoma SI et al (2020) Biosecurity challenges in the control of avian influenza in Nigeria. Sokoto J Veterinary Sci 18(3):150–157CrossRef Ijoma SI et al (2020) Biosecurity challenges in the control of avian influenza in Nigeria. Sokoto J Veterinary Sci 18(3):150–157CrossRef
16.
Zurück zum Zitat Ameji NO et al (2019) Outbreak of highly pathogenic avian influenza subtype H5N8 in two multi-age chicken farms in Jos, Plateau State, Nigeria. Sokoto J Veterinary Sci 17(3):60–65CrossRef Ameji NO et al (2019) Outbreak of highly pathogenic avian influenza subtype H5N8 in two multi-age chicken farms in Jos, Plateau State, Nigeria. Sokoto J Veterinary Sci 17(3):60–65CrossRef
17.
Zurück zum Zitat Okoli SC (2021) Descriptive epidemiology of the outbreak of avian influenza in Nigeria: a retrospective review, 2015–2017 PAMJ-OH, 6(11) Okoli SC (2021) Descriptive epidemiology of the outbreak of avian influenza in Nigeria: a retrospective review, 2015–2017 PAMJ-OH, 6(11)
18.
Zurück zum Zitat Kwaghe AV et al (2017) Economic Losses and Implications of Highly Pathogenic Avian Influenza (HPAI) H 5 N 1 Resurgence in Nigeria. Kwaghe AV et al (2017) Economic Losses and Implications of Highly Pathogenic Avian Influenza (HPAI) H 5 N 1 Resurgence in Nigeria.
20.
Zurück zum Zitat Bello MB et al (2018) Diagnostic and Vaccination Approaches for Newcastle Disease Virus in Poultry: The Current and Emerging Perspectives BioMed Research International, 2018: p. 7278459 Bello MB et al (2018) Diagnostic and Vaccination Approaches for Newcastle Disease Virus in Poultry: The Current and Emerging Perspectives BioMed Research International, 2018: p. 7278459
21.
Zurück zum Zitat Ravikumar R, Chan J, Prabakaran M (2022) Vaccines against Major Poultry Viral Diseases: Strategies to Improve the Breadth and Protective Efficacy. Viruses 14(6):1195PubMedPubMedCentralCrossRef Ravikumar R, Chan J, Prabakaran M (2022) Vaccines against Major Poultry Viral Diseases: Strategies to Improve the Breadth and Protective Efficacy. Viruses 14(6):1195PubMedPubMedCentralCrossRef
22.
Zurück zum Zitat Lee DH, Criado MF, Swayne DE (2021) Pathobiological Origins and Evolutionary History of Highly Pathogenic Avian Influenza Viruses. Cold Spring Harb Perspect Med, 11(2) Lee DH, Criado MF, Swayne DE (2021) Pathobiological Origins and Evolutionary History of Highly Pathogenic Avian Influenza Viruses. Cold Spring Harb Perspect Med, 11(2)
23.
Zurück zum Zitat Sutton TC (2018) The Pandemic Threat of Emerging H5 and H7 Avian Influenza Viruses. Viruses, 10(9) Sutton TC (2018) The Pandemic Threat of Emerging H5 and H7 Avian Influenza Viruses. Viruses, 10(9)
24.
Zurück zum Zitat Swayne DE (2012) Impact of Vaccines and Vaccination on Global Control of Avian Influenza. Avian Dis 56(4s1):818–828PubMedCrossRef Swayne DE (2012) Impact of Vaccines and Vaccination on Global Control of Avian Influenza. Avian Dis 56(4s1):818–828PubMedCrossRef
25.
Zurück zum Zitat Hill EM et al (2018) The impact of surveillance and control on highly pathogenic avian influenza outbreaks in poultry in Dhaka division, Bangladesh. PLoS Comput Biol 14(9):e1006439PubMedPubMedCentralCrossRef Hill EM et al (2018) The impact of surveillance and control on highly pathogenic avian influenza outbreaks in poultry in Dhaka division, Bangladesh. PLoS Comput Biol 14(9):e1006439PubMedPubMedCentralCrossRef
26.
Zurück zum Zitat Rimi NA et al (2019) A Decade of Avian Influenza in Bangladesh: Where Are We Now? Trop Med Infect Dis, 4(3) Rimi NA et al (2019) A Decade of Avian Influenza in Bangladesh: Where Are We Now? Trop Med Infect Dis, 4(3)
27.
Zurück zum Zitat Tran CC et al (2016) An Alternative Vaccination Approach for The Prevention of Highly Pathogenic Avian Influenza Subtype H5N1 in The Red River Delta, Vietnam -A Geospatial-Based Cost-Effectiveness Analysis. Vet Sci, 3(1) Tran CC et al (2016) An Alternative Vaccination Approach for The Prevention of Highly Pathogenic Avian Influenza Subtype H5N1 in The Red River Delta, Vietnam -A Geospatial-Based Cost-Effectiveness Analysis. Vet Sci, 3(1)
28.
Zurück zum Zitat Le TH, Nguyen NT (2014) Evolutionary dynamics of highly pathogenic avian influenza A/H5N1 HA clades and vaccine implementation in Vietnam. Clin Exp Vaccine Res 3(2):117–127PubMedPubMedCentralCrossRef Le TH, Nguyen NT (2014) Evolutionary dynamics of highly pathogenic avian influenza A/H5N1 HA clades and vaccine implementation in Vietnam. Clin Exp Vaccine Res 3(2):117–127PubMedPubMedCentralCrossRef
29.
Zurück zum Zitat Huynh HTT et al (2019) Individual and flock immunity responses of naïve ducks on smallholder farms after vaccination with H5N1 Avian Influenza vaccine: a study in a province of the Mekong Delta, Vietnam. PeerJ 7:e6268PubMedPubMedCentralCrossRef Huynh HTT et al (2019) Individual and flock immunity responses of naïve ducks on smallholder farms after vaccination with H5N1 Avian Influenza vaccine: a study in a province of the Mekong Delta, Vietnam. PeerJ 7:e6268PubMedPubMedCentralCrossRef
30.
Zurück zum Zitat Aly MM, Arafa A, Hassan MK (2008) Epidemiological findings of outbreaks of disease caused by highly pathogenic H5N1 avian influenza virus in poultry in Egypt during 2006. Avian Dis 52(2):269–277PubMedCrossRef Aly MM, Arafa A, Hassan MK (2008) Epidemiological findings of outbreaks of disease caused by highly pathogenic H5N1 avian influenza virus in poultry in Egypt during 2006. Avian Dis 52(2):269–277PubMedCrossRef
33.
Zurück zum Zitat Sawitri Siregar E et al (2007) The vaccination programme in Indonesia. Dev Biol (Basel) 130:151–158PubMed Sawitri Siregar E et al (2007) The vaccination programme in Indonesia. Dev Biol (Basel) 130:151–158PubMed
34.
Zurück zum Zitat Yupiana Y et al (2010) Risk factors of poultry outbreaks and human cases of H5N1 avian influenza virus infection in West Java Province, Indonesia. Int J Infect Dis 14(9):e800–e805PubMedCrossRef Yupiana Y et al (2010) Risk factors of poultry outbreaks and human cases of H5N1 avian influenza virus infection in West Java Province, Indonesia. Int J Infect Dis 14(9):e800–e805PubMedCrossRef
35.
Zurück zum Zitat Swayne DE et al (2015) Antibody titer has positive predictive value for vaccine protection against challenge with natural antigenic-drift variants of H5N1 high-pathogenicity avian influenza viruses from Indonesia. J Virol 89(7):3746–3762PubMedPubMedCentralCrossRef Swayne DE et al (2015) Antibody titer has positive predictive value for vaccine protection against challenge with natural antigenic-drift variants of H5N1 high-pathogenicity avian influenza viruses from Indonesia. J Virol 89(7):3746–3762PubMedPubMedCentralCrossRef
36.
Zurück zum Zitat Dharmayanti NL et al (2014) Genetic characterization of clade 2.3.2.1 avian influenza A(H5N1) viruses, Indonesia, 2012. Emerg Infect Dis 20(4):671–674PubMedPubMedCentralCrossRef Dharmayanti NL et al (2014) Genetic characterization of clade 2.3.2.1 avian influenza A(H5N1) viruses, Indonesia, 2012. Emerg Infect Dis 20(4):671–674PubMedPubMedCentralCrossRef
37.
Zurück zum Zitat Domenech J et al (2009) Experiences with vaccination in countries endemically infected with highly pathogenic avian influenza: the Food and Agriculture Organization perspective. Revue scientifique et technique (International Office of Epizootics) 28(1):293–305PubMed Domenech J et al (2009) Experiences with vaccination in countries endemically infected with highly pathogenic avian influenza: the Food and Agriculture Organization perspective. Revue scientifique et technique (International Office of Epizootics) 28(1):293–305PubMed
38.
Zurück zum Zitat Bingsheng K, Yijun H (2007) Poultry sector in China: Structural changes during the past decade and future trends Poultry in the 21st century: Avian influenza and beyond, Proceedings of the International Poultry Conference, November, Bangkok, Bingsheng K, Yijun H (2007) Poultry sector in China: Structural changes during the past decade and future trends Poultry in the 21st century: Avian influenza and beyond, Proceedings of the International Poultry Conference, November, Bangkok,
39.
40.
Zurück zum Zitat Li C, Bu Z, Chen H (2014) Avian influenza vaccines against H5N1 ‘bird flu’. Trends Biotechnol 32(3):147–156PubMedCrossRef Li C, Bu Z, Chen H (2014) Avian influenza vaccines against H5N1 ‘bird flu’. Trends Biotechnol 32(3):147–156PubMedCrossRef
41.
Zurück zum Zitat Qiao C et al (2009) Recombinant fowlpox virus vector-based vaccine completely protects chickens from H5N1 avian influenza virus. Antiviral Res 81(3):234–238PubMedCrossRef Qiao C et al (2009) Recombinant fowlpox virus vector-based vaccine completely protects chickens from H5N1 avian influenza virus. Antiviral Res 81(3):234–238PubMedCrossRef
42.
Zurück zum Zitat Qiao CL et al (2003) Protection of chickens against highly lethal H5N1 and H7N1 avian influenza viruses with a recombinant fowlpox virus co-expressing H5 haemagglutinin and N1 neuraminidase genes. Avian Pathol 32(1):25–32PubMedCrossRef Qiao CL et al (2003) Protection of chickens against highly lethal H5N1 and H7N1 avian influenza viruses with a recombinant fowlpox virus co-expressing H5 haemagglutinin and N1 neuraminidase genes. Avian Pathol 32(1):25–32PubMedCrossRef
43.
Zurück zum Zitat Ray K et al (2008) Characterization of the complete genome of influenza A (H5N1) virus isolated during the 2006 outbreak in poultry in India. Virus Genes 36(2):345–353PubMedCrossRef Ray K et al (2008) Characterization of the complete genome of influenza A (H5N1) virus isolated during the 2006 outbreak in poultry in India. Virus Genes 36(2):345–353PubMedCrossRef
45.
Zurück zum Zitat Tosh C et al (2016) Multiple introductions of a reassortant H5N1 avian influenza virus of clade 2.3.2.1c with PB2 gene of H9N2 subtype into Indian poultry. Infect Genet Evol 43:173–178PubMedCrossRef Tosh C et al (2016) Multiple introductions of a reassortant H5N1 avian influenza virus of clade 2.3.2.1c with PB2 gene of H9N2 subtype into Indian poultry. Infect Genet Evol 43:173–178PubMedCrossRef
47.
Zurück zum Zitat Bhat S et al (2018) A two dose immunization with an inactivated reassortant H5N2 virus protects chickens against lethal challenge with homologous 2.3.2.1 clade and heterologous 2.2 clade highly pathogenic avian influenza H5N1 viruses. Vet Microbiol 217:149–157PubMedCrossRef Bhat S et al (2018) A two dose immunization with an inactivated reassortant H5N2 virus protects chickens against lethal challenge with homologous 2.3.2.1 clade and heterologous 2.2 clade highly pathogenic avian influenza H5N1 viruses. Vet Microbiol 217:149–157PubMedCrossRef
50.
Zurück zum Zitat Dimitrov KM et al (2017) Newcastle disease vaccines—A solved problem or a continuous challenge? Vet Microbiol 206:126–136PubMedCrossRef Dimitrov KM et al (2017) Newcastle disease vaccines—A solved problem or a continuous challenge? Vet Microbiol 206:126–136PubMedCrossRef
51.
53.
Zurück zum Zitat Johansson BE, Bucher DJ, Kilbourne ED (1989) Purified influenza virus hemagglutinin and neuraminidase are equivalent in stimulation of antibody response but induce contrasting types of immunity to infection. J Virol 63(3):1239–1246PubMedPubMedCentralCrossRef Johansson BE, Bucher DJ, Kilbourne ED (1989) Purified influenza virus hemagglutinin and neuraminidase are equivalent in stimulation of antibody response but induce contrasting types of immunity to infection. J Virol 63(3):1239–1246PubMedPubMedCentralCrossRef
54.
55.
Zurück zum Zitat Milani A et al (2017) Vaccine immune pressure influences viral population complexity of avian influenza virus during infection. Vet Microbiol 203:88–94PubMedCrossRef Milani A et al (2017) Vaccine immune pressure influences viral population complexity of avian influenza virus during infection. Vet Microbiol 203:88–94PubMedCrossRef
56.
Zurück zum Zitat Huang P et al (2023) Potential cross-species transmission of highly pathogenic avian influenza H5 subtype (HPAI H5) viruses to humans calls for the development of H5-specific and universal influenza vaccines. Cell Discov 9(1):58PubMedPubMedCentralCrossRef Huang P et al (2023) Potential cross-species transmission of highly pathogenic avian influenza H5 subtype (HPAI H5) viruses to humans calls for the development of H5-specific and universal influenza vaccines. Cell Discov 9(1):58PubMedPubMedCentralCrossRef
57.
Zurück zum Zitat Perez-Losada M et al (2015) Recombination in viruses: mechanisms, methods of study, and evolutionary consequences. Infect Genet Evol 30:296–307PubMedCrossRef Perez-Losada M et al (2015) Recombination in viruses: mechanisms, methods of study, and evolutionary consequences. Infect Genet Evol 30:296–307PubMedCrossRef
59.
Zurück zum Zitat Park BR et al (2021) Broad cross protection by recombinant live attenuated influenza H3N2 seasonal virus expressing conserved M2 extracellular domain in a chimeric hemagglutinin. Sci Rep 11(1):4151PubMedPubMedCentralCrossRef Park BR et al (2021) Broad cross protection by recombinant live attenuated influenza H3N2 seasonal virus expressing conserved M2 extracellular domain in a chimeric hemagglutinin. Sci Rep 11(1):4151PubMedPubMedCentralCrossRef
60.
Zurück zum Zitat Janssens Y et al (2022) The role of cell-mediated immunity against influenza and its implications for vaccine evaluation. Front Immunol 13:959379PubMedPubMedCentralCrossRef Janssens Y et al (2022) The role of cell-mediated immunity against influenza and its implications for vaccine evaluation. Front Immunol 13:959379PubMedPubMedCentralCrossRef
61.
Zurück zum Zitat Bull JJ (2015) Evolutionary reversion of live viral vaccines: Can genetic engineering subdue it? Virus Evol, 1(1) Bull JJ (2015) Evolutionary reversion of live viral vaccines: Can genetic engineering subdue it? Virus Evol, 1(1)
62.
Zurück zum Zitat Maas R et al (2011) Maternal immunity against avian influenza H5N1 in chickens: limited protection and interference with vaccine efficacy. Avian Pathol 40(1):87–92PubMedCrossRef Maas R et al (2011) Maternal immunity against avian influenza H5N1 in chickens: limited protection and interference with vaccine efficacy. Avian Pathol 40(1):87–92PubMedCrossRef
63.
Zurück zum Zitat Stills HF Jr. (2005) Adjuvants and antibody production: dispelling the myths associated with Freund’s complete and other adjuvants. Ilar j 46(3):280–293PubMedCrossRef Stills HF Jr. (2005) Adjuvants and antibody production: dispelling the myths associated with Freund’s complete and other adjuvants. Ilar j 46(3):280–293PubMedCrossRef
65.
Zurück zum Zitat Avian Influenza (2018) Vaccine. : Plotkin’s Vaccines (Seventh Edition) Avian Influenza (2018) Vaccine. : Plotkin’s Vaccines (Seventh Edition)
Metadaten
Titel
Rational approach to vaccination against highly pathogenic avian influenza in Nigeria: a scientific perspective and global best practice
verfasst von
Clement Meseko
Negedu Onogu Ameji
Binod Kumar
Marie Culhane
Publikationsdatum
01.10.2023
Verlag
Springer Vienna
Erschienen in
Archives of Virology / Ausgabe 10/2023
Print ISSN: 0304-8608
Elektronische ISSN: 1432-8798
DOI
https://doi.org/10.1007/s00705-023-05888-2

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