Marburg virus particles (blue) on the surface of infected cultured cells (red). Credit: NIAID/Science Photo Library
Researchers are racing against time to roll out vaccines and treatments for a deadly virus that has exploded in Rwanda.
As of September 30, the Central African country had recorded 27 cases and nine deaths from Marburg virus, a highly deadly relative of the Ebola virus that causes hemorrhagic fevers. Most infections have occurred among health care workers in the capital, Kigali.
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There are no approved treatments or vaccines for Marburg virus. But if current outbreaks continue (most of which are small and quickly contained), health officials and researchers hope to collect valuable data on the safety and potential effectiveness of vaccines and treatments. are.
On September 30, in Geneva, Switzerland, the World Health Organization (WHO) announced that Rwandan scientists appointed by the government to conduct potential trials of vaccines and treatments, as well as the Marburg Virus Vaccine Consortium, a group of companies. (MARVAC) hosted a conference call with the participation of members. Nonprofit organizations and researchers are also participating, a WHO spokesperson said.
ring vaccination
Broadbrush’s clinical trial plan was abruptly halted following the 2023 outbreak of Marburg virus in Equatorial Guinea, resulting in 12 deaths out of 17 confirmed cases and 23 more probable deaths. . However, no experimental drugs were tested during the epidemic.
Ira Longini, a biostatistician at the University of Florida in Gainesville and a MARVAC member, said if Rwanda continues to spread, the country plans to test at least one vaccine in a strategy known as ring vaccination. This approach, which showed the effectiveness of the Ebola vaccine in Guinea during the 2014-2016 West African outbreak, involves vaccinating contacts of infected people.
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The WHO ethics committee has so far reviewed plans for vaccine trials, as well as treatment plans such as remdesivir, an antiviral drug tested against Ebola and COVID-19, and studies showing promise in animals. It had approved plans such as monoclonal antibody therapy as indicated. A WHO spokesperson said the next urgent step was approval for a trial in Rwanda.
Several Marburg vaccines are in various stages of development. The most advanced candidate is led by the Sabin Vaccine Institute in Washington, D.C., which uses a modified chimpanzee adenovirus to instruct cells to make Marburg virus proteins. A trial involving 40 healthy participants in the United States found the vaccine was safe and produced an immune response to the virus in most people,1 and larger trials are underway in Uganda and Kenya. .
A spokeswoman for Mr. Sabin said the group was working with the Rwandan government, but declined to say how many doses of the vaccine are currently available. In 2023, a WHO advisory committee named the Sabin vaccine as a top candidate for testing during the Marburg virus outbreak.
quick production
A similar vaccine being developed at the University of Oxford in the UK is also listed as a priority test in the event of a Marburg disease outbreak. Teresa Lambe, a vaccinologist at the University of Oxford who is leading the Marburg vaccine development, said the vaccine had so far proven safe in the small number of participants who received it in ongoing trials in the UK. .
Mark Feinberg, CEO of the International AIDS Vaccine Initiative in New York City, said there are currently no doses available for the Marburg vaccine his organization is developing (similar to the approved Ebola vaccine). , said production is expected to begin this week.
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“Rwandan health authorities are very capable and we are hopeful that they can quickly contain this outbreak,” Feinberg added. “The risk of spreading the infection to neighboring countries is not small, and the consequences could be serious.”
Nancy Sullivan, a viral immunologist at Boston University in Massachusetts, said the fact that a clinical trial plan is in place and other groundwork is in place makes it more likely that the Marburg vaccine and treatment will be introduced in Rwanda. says. However, data on vaccines and treatments in Marburg will likely need to be obtained during multiple outbreaks.
“The idea right now is to just move forward and not worry about whether the epidemic will end,” Sullivan added. “That’s just a small part of the whole exam.”
