The Rockefeller Foundation and the prevention of malaria in Corsica, 1923-1951: support given to the French parasitologist Emile Brumpt

The role of the International Health Board of the Rockefeller Foundation in campaigns for malaria control in many countries has clearly been documented extensively. In contrast, the involvement of the Rockefeller Foundation in the control of malaria in France has not been reported yet. The present paper describes the way in which the Rockefeller Foundation got involved, along with the parasitologist Emile Brumpt, in the anti-malaria campaigns in Corsica, France, between 1924 and 1951. We analyze the scientific and technological strategies used for that purpose and the manner in which the Rockefeller Foundation policy had influenced Brumpt's actions. The unusually long support of the Rockefeller Foundation to Emile Brumpt (1924-1948) and to research and teaching Parasitology in the Faculté de Médecine de Paris is also discussed.     

Emile Brumpt's contribution to the characterization of parasitic diseases in Brazil, 1909-1914

During the first thirty years of the XXth century, parasitologists and epidemiologists who were at the origin of the nosography and etiology of parasitic diseases were faced with several overlapping problems. A person can be infected simultaneoulsy by several different parasites. The delineation of clinical signs is an essential step, in the field and without the help of the laboratory, to identify the various parasitic pathologies and to propose the most likely diagnoses. The use of photography as a nosographic tool enabled the French parasitologist Emile Brumpt (1877-1951) to set up clinical pictures, given the multiplicity of pathologies on a given patient (for instance, goitre and ankylostomiasis, ankylostomiasis and myxoedema, "sylvan" leishmaniasis and palpebral oedema, goitre and Chagas' disease). We will set the paper on a part of Brumpt's photographic archives which he constitued during his missions to South America between 1913 and 1914.     

Yellow fever and dengue—the interactions of virus,vector and host in the re-emergence of epidemic disease

The incidence of the mosquito-borne flavivirus diseases, yellow fever, dengue and dengue hemorrhagic fever has increased dramatically in recent years. Both diseases are characterized by the emergence of explosive epidemics. Yellow fever outbreaks appear to have a periodicity dependent upon fluctuations in sylvatic (enzootic) transmission cycles and the ecological factors that influence these cycles. Spread of the virus from the sylvatic cycle to human settlements, ultimately with interhuman transmission by domestic Aedes aegypti is a repeating event in Africa, and presents a renewed threat in the Americas, where effective Ae. aegypti control collapsed in the 1970s. The incidence of dengue has also increased dramatically in recent years, with up to 80 million persons living in tropical regions of the world now affected annually—an attack rate of 4%. The severe form, dengue hemorrhagic fever (DHF) has become a leading health problem throughout Asia in the last 20 years and is emerging as an epidemic disease in the Americas. Unlike yellow fever, sylvatic dengue transmission cycles are not responsible for disease emergence. The major factors underlying dengue epidemics are changes in human ecology, increasing contact with Ae. aegypti, the co-circulation of multiple dengue serotypes, and a rising prevalence of immunity and immunopathological events that underlie the pathogenesis of DHF. In this review, the complex interplay of virus, host, vector, environment and weather in the ecology of yellow fever and dengue are explored.     

A Flow Cytometry-Based Assay for Quantifying Non-Plaque Forming Strains of Yellow Fever Virus

Primary clinical isolates of yellow fever virus can be difficult to quantitate by standard in vitro methods because they may not form discernable plaques or induce a measurable cytopathic effect (CPE) on cell monolayers. In our hands, the Dakar strain of yellow fever virus (YFV-Dakar) could not be measured by plaque assay (PA), focus-forming assay (FFA), or by measurement of CPE. For these reasons, we developed a YFV-specific monoclonal antibody (3A8.B6) and used it to optimize a highly sensitive flow cytometry-based tissue culture limiting dilution assay (TC-LDA) to measure levels of infectious virus. The TC-LDA was performed by incubating serial dilutions of virus in replicate wells of C6/36 cells and stained intracellularly for virus with MAb 3A8.B6. Using this approach, we could reproducibly quantitate YFV-Dakar in tissue culture supernatants as well as from the serum of viremic rhesus macaques experimentally infected with YFV-Dakar. Moreover, the TC-LDA approach was >10-fold more sensitive than standard plaque assay for quantitating typical plaque-forming strains of YFV including YFV-17D and YFV-FNV (French neurotropic vaccine). Together, these results indicate that the TC-LDA technique is effective for quantitating both plaque-forming and non-plaque-forming strains of yellow fever virus, and this methodology may be readily adapted for the study and quantitation of other non-plaque-forming viruses.     

Flavivirus enzyme-substrate interactions studied with chimeric proteinases: identification of an intragenic locus important for substrate recognition.

The proteins of flaviviruses are translated as a single long polyprotein which is co- and posttranslationally processed by both cellular and viral proteinases. We have studied the processing of flavivirus polyproteins in vitro by a viral proteinase located within protein NS3 that cleaves at least three sites within the nonstructural region of the polyprotein, acting primarily autocatalytically. Recombinant polyproteins in which part of the polyprotein is derived from yellow fever virus and part from dengue virus were used. We found that polyproteins containing the yellow fever virus cleavage sites were processed efficiently by the yellow fever virus enzyme, by the dengue virus enzyme, and by various chimeric enzymes. In contrast, dengue virus cleavage sites were cleaved inefficiently by the dengue virus enzyme and not at all by the yellow fever virus enzyme. Studies with chimeric proteinases and with site-directed mutants provided evidence for a direct interaction between the cleavage sites and the proposed substrate-binding pocket of the enzyme. We also found that the efficiency and order of processing could be altered by site-directed mutagenesis of the proposed substrate-binding pocket.     

Evaluation of thermostable yellow fever vaccine from the Pasteur Institute on international travellers

The authors studied the tolerance and efficacy of the new stabilized 17D yellow fever vaccine produced by Pasteur Vaccins, on 50 international travellers at the University Hospital of Grenoble (France), comparing it with the standard 17D yellow fever vaccine. The short-term and long-term tolerance in all the travellers was excellent. The serological efficacy was estimated by seroneutralization assay with the vaccine virus Rockefeller 17D, which is the most sensitive and the most specific method. The seroconversion rate was 93.8%, the same as the rate obtained with the standard yellow fever vaccine in 50 other travellers. The authors studied also the serological response to the standard yellow fever vaccine associated with other vaccines (diphtheria, tetanus, oral or injectable poliomyelitis, and oral cholera): the seroconversion rates were similar to those obtained with the yellow fever vaccine alone, thus demonstrating that these associated vaccines do not interfere with immunization against yellow fever.     

Insights into human CD8(+) T-cell memory using the yellow fever and smallpox vaccines

Live virus vaccines provide a unique opportunity to study human CD8(+) T-cell memory in the context of a controlled, primary acute viral infection. Yellow fever virus-17D and Dryvax are two such live-virus vaccines that are highly efficacious, used worldwide and provide long-term immunity against yellow fever and smallpox respectively. In this review, we describe the properties of virus-specific memory CD8(+) T cells generated in smallpox and yellow fever vaccinees. We address fundamental questions regarding magnitude, functional quality and longevity of the CD8(+) T-cell response, which are otherwise challenging to address in humans. These findings provide insights into the attributes of the human immune system as well as provide a benchmark for the optimal quality of a CD8(+) T-cell response that can be used to evaluate novel candidate vaccines.     

Oral susceptibility to yellow fever virus of Aedes aegypti from Brazil

The oral susceptibility to yellow fever virus was evaluated in 23 Aedes aegypti samples from Brazil. Six Ae. aegypti samples from Africa, America and Asia were also tested for comparison. Mosquito samples from Asia showed the highest infection rates. Infection rates for the Brazilian Ae. aegypti reached 48.6%, but were under 13% in 60% of sample tested. We concluded that although the low infection rates estimated for some Brazilian mosquito samples may not favor the establishment of urban cycle of yellow fever in some parts of the country, the founding of Ae. aegypti of noteworthy susceptibility to the virus in cities located in endemic and transition areas of sylvatic yellow fever, do pose a threat of the re-emergence of the urban transmission of the disease in Brazil.     

Lassa fever: implications of T-cell immunity for vaccine development.

Lassa fever is a re-emerging viral hemorrhagic fever, which causes significant human morbidity in endemic regions of West Africa. Attempts to vaccinate against this virus in animal models including non-human primates have revealed that eliciting a strong cellular immune response protects from clinical disease, but not infection, in the absence of measurable neutralizing antibodies. As there is renewed interest in developing a vaccine against Lassa fever for use in humans, several questions should be addressed in view of the scarce knowledge of the mechanisms of natural immunity against this disease. MHC-dependency of a vaccine relying mainly on the induction of T-cell immunity and its ability to cross-protect against different Lassa virus strains will be important issues. Furthermore, the question whether the vaccine can prevent human-to-human transmission of the virus should be discussed and the possibility that vaccination could predispose to immunopathology should be excluded. We are addressing some of the above mentioned problems concerning natural immunity through field studies in the Republic of Guinea, West Africa, and are presently studying the CD4 cell responses of Lassa antibody positive subjects on the basis of T-cell proliferation assays using recombinant Lassa virus proteins.     

Safety testing for neurovirulence of novel live, attenuated flavivirus vaccines: infant mice provide an accurate surrogate for the test in monkeys.

Current requirements for control of live viral vaccines, including yellow fever 17D, produced from potentially neurotropic wild-type viruses include tests for neurovirulence in nonhuman primates. We have used yellow fever 17D virus as a live vector for novel flavivirus vaccines (designated ChimeriVax) against dengue, Japanese encephalitis (JE), and West Nile (WN) viruses. For control of these vaccines, it would be preferable to substitute a test in mice for the test in a higher species (monkeys). In this study, we compare the neurovirulence of ChimeriVax vaccine candidates in suckling mice inoculated by the intracerebral (IC) route with graded doses of the test article or yellow fever 17D vaccine as a reference control. Mortality ratio and survival distribution are the outcome measures. The monkey safety test is performed as described for control of yellow fever vaccines. In both mice and monkeys, all chimeric vaccines were significantly less neurovirulent than yellow fever 17D vaccine. The test in suckling mice discriminated between strains of two different vaccines (ChimeriVax-JE and ChimeriVax-DEN1) differing by a single amino acid change, and was more sensitive for detecting virulence differences than the test in monkeys. The results indicate that the suckling mouse test is simple to perform, highly sensitive and, with appropriate validation, could complement or possibly even replace the neurovirulence component of the monkey safety test. The test in infant mice is particularly useful as a means of demonstrating biological consistency across seed virus and vaccine lots.     

Lipases secreted by a gut bacterium inhibit arbovirus transmission in mosquitoes

Arboviruses are etiological agents of various severe human diseases that place a tremendous burden on global public health and the economy; compounding this issue is the fact that effective prophylactics and therapeutics are lacking for most arboviruses. Herein, we identified 2 bacterial lipases secreted by a Chromobacterium bacterium isolated from Aedes aegypti midgut, Chromobacterium antiviral effector-1 (CbAE-1) and CbAE-2, with broad-spectrum virucidal activity against mosquito-borne viruses, such as dengue virus (DENV), Zika virus (ZIKV), Japanese encephalitis virus (JEV), yellow fever virus (YFV) and Sindbis virus (SINV). The CbAEs potently blocked viral infection in the extracellular milieu through their lipase activity. Mechanistic studies showed that this lipase activity directly disrupted the viral envelope structure, thus inactivating infectivity. A mutation in the lipase motif of CbAE-1 fully abrogated the virucidal ability. Furthermore, CbAEs also exert lipase-dependent entomopathogenic activity in mosquitoes. The anti-arboviral and entomopathogenic properties of CbAEs render them potential candidates for the development of novel transmission control strategies against vector-borne diseases.     

Crystal structure of the dengue virus RNA-dependent RNA polymerase catalytic domain at 1.85-angstrom resolution

Dengue fever, a neglected emerging disease for which no vaccine or antiviral agents exist at present, is caused by dengue virus, a member of the Flavivirus genus, which includes several important human pathogens, such as yellow fever and West Nile viruses. The NS5 protein from dengue virus is bifunctional and contains 900 amino acids. The S-adenosyl methionine transferase activity resides within its N-terminal domain, and residues 270 to 900 form the RNA-dependent RNA polymerase (RdRp) catalytic domain. Viral replication begins with the synthesis of minus-strand RNA from the dengue virus positive-strand RNA genome, which is subsequently used as a template for synthesizing additional plus-strand RNA genomes. This essential function for the production of new viral particles is catalyzed by the NS5 RdRp. Here we present a high-throughput in vitro assay partly recapitulating this activity and the crystallographic structure of an enzymatically active fragment of the dengue virus RdRp refined at 1.85-A resolution. The NS5 nuclear localization sequences, previously thought to fold into a separate domain, form an integral part of the polymerase subdomains. The structure also reveals the presence of two zinc ion binding motifs. In the absence of a template strand, a chain-terminating nucleoside analogue binds to the priming loop site. These results should inform and accelerate the structure-based design of antiviral compounds against dengue virus.     

Study of the circulation of Crimean hemorrhagic fever virus in Turkmenistan]

Final results of the virological and serological investigations of the circulation of the Crimean hemorrhagic fever virus in the Turkmenian SSR carried out in 1968-1976 are presented in this report. In the examination of 2294 blood serum samples of human beings complement binding antibodies against the Crimean hemorrhagic fever were revealed in 0.4% of cases. It was revealed that five species of ixodes ticks could he infected with this virus; for the first time its strains were also isolated from the Hyalomma dromedarii ticks. Isolation of the Crimean hemorrhagic fever virus from ticks and determination of the precipitating antibodies against this virus in agricultural animals--from 6.2 to 11.1%--in all the regions of the republic pointed out that the natural nidi zones were widespread at the territory of the Turkmenian SSR, and that it was necessary to carry out further study of the given focus.     

Variation in the biological function of envelope protein epitopes of yellow fever vaccine viruses detected with monoclonal antibodies.

Three different virus strains (17D-204, 17DD and the French neurotropic vaccine) have been used as live attenuated yellow fever (YF) vaccines and are manufactured in different centres around the world. The envelope proteins of these vaccine viruses were examined and compared using mouse monoclonal antibodies (MAbs) in haemagglutination inhibition (HAI) and neutralization (N) tests. The epitopes eliciting HAI and/or N were found to vary depending on the virus examined. Such variation was also found between vaccine viruses of the same strain manufactured in different centres. These data were confirmed by the use of mouse polyclonal antisera. On the basis of the MAb results in HAI tests a dendrogram of the similarity coefficients between the viruses was constructed and showed that the viruses could be placed into three major groups. Thus, it is concluded that YF vaccines manufactured in different centres are antigenically distinct as recognized by the mouse immune system.     

Perspectives in the control of infectious diseases by transgenic mosquitoes in the post-genomic era--a review

Arthropod-borne diseases caused by a variety of microorganisms such as dengue virus and malaria parasites afflict billions of people worldwide imposing major economic and social burdens. Despite many efforts, vaccines against diseases transmitted by mosquitoes, with the exception of yellow fever, are not available. Control of such infectious pathogens is mainly performed by vector management and treatment of affected individuals with drugs. However, the numbers of insecticide-resistant insects and drug-resistant parasites are increasing. Therefore, inspired in recent years by a lot of new data produced by genomics and post-genomics research, several scientific groups have been working on different strategies to control infectious arthropod-borne diseases. This review focuses on recent advances and perspectives towards construction of transgenic mosquitoes refractory to malaria parasites and dengue virus transmission.     

Inhibition of japanese encephalitis virus infection by flavivirus recombinant e protein domain III

Japanese encephalitis virus (JEV) is a mosquito-borne flavivirus closely related to the human pathogens including yellow fever virus, dengue virus and West Nile virus. There are currently no effective antiviral therapies for all of the flavivirus and only a few highly effective vaccines are licensed for human use. In this paper, the E protein domain III (DIII) of six heterologous flaviviruses (DENV1-4, WNV and JEV) was expressed in Escherichia coli successfully. The proteins were purified after a solubilization and refolding procedure, characterized by SDS-PAGE and Western blotting. Competitive inhibition showed that all recombinant flavivirus DIII proteins blocked the entry of JEV into BHK-21 cells. Further studies indicated that antibodies induced by the soluble recombinant flavivirus DIII partially protected mice against lethal JEV challenge. These results demonstrated that recombinant flavivirus DIII proteins could inhibit JEV infection competitively, and immunization with proper folding flavivirus DIII induced cross-protection against JEV infection in mice, implying a possible role of DIII for the cross-protection among flavivirus as well as its use in antigens for immunization in animal models.     

Why dengue and yellow fever coexist in some areas of the world and not in others?

Urban yellow fever and dengue coexist in Africa but not in Asia and South America. In this paper, we examine four hypotheses (and various combinations thereof) to explain the absence of yellow fever in urban areas of Asia and South America. In addition, we examine an additional hypothesis that offers an explanation of the coexistence of the infections in Africa while at the same time explaining their lack of coexistence in Asia. The hypotheses we tested to explain the nonexistence of yellow fever in Asia are the following: (1) the Asian Aedes aegypti is relatively incompetent to transmit yellow fever; (2) there would exist a competition between dengue and yellow fever viruses within the mosquitoes, as suggested by in vitro studies in which the dengue virus always wins; (3) when an A. aegypti mosquito that is infected by or latent for yellow fever acquires dengue, it becomes latent for dengue due to internal competition within the mosquito between the two viruses; (4) there is an important cross-immunity between yellow fever and other flaviviruses, dengue in particular, such that a person recovered from a bout of dengue exhibits a diminished susceptibility to yellow fever. This latter hypothesis is referred to below as the "Asian hypothesis." Finally, we hypothesize that: (5) the coexistence of the infections in Africa is due to the low prevalence of the mosquito Aedes albopictus in Africa, as it competes with A. aegypti. We will refer to this latter hypothesis as the "African hypothesis." We construct a model of transmission that allows all of the above hypotheses to be tested. We conclude that the Asian and the African hypotheses can explain the observed phenomena, whereas other hypotheses fail to do so.     

Mechanism of vertical transmission of the dengue virus in mosquitoes

Both experimental and field data suggest that some tropical mosquito-borne flaviviruses, such as dengue and yellow fever, survive dry seasons by vertical (i.e. transgenerational) transmission in their mosquito hosts. Although vertical transmission of arboviruses in mosquitoes is considered to be transovarial in nature, observations reported here indicate that this is probably not true for dengue virus. Rather, infection of the next generation with this virus apparently takes place when the fully developed egg, enclosed in the chorion, is fertilized at the time of oviposition. In contrast to transovarial transmission, the latter mechanism permits the infection of progeny following a single maternal blood meal.