In an interconnected world, viruses aren’t limited by borders. A small outbreak on one side of the globe can spread across continents and across oceans in a matter of hours. The current COVID-19 pandemic is a sobering example of this reality, and though it may feel unprecedented, for infectious disease experts it isn’t a surprise. What’s more, it’s a reminder of the importance of shoring up global health security by advancing vaccines against diseases that have pandemic potential.
Because the next pandemic is never a question of “if.” It’s a question of “when.”
That’s why PATH is collaborating with the Coalition for Epidemic Preparedness Innovations (CEPI) and Auro Vaccines LLC, to develop a vaccine to protect against Nipah virus. That effort just reached a major milestone—the first clinical study of a Nipah virus vaccine candidate in humans. This is a monumental step toward protecting the world from a deadly disease for which there is currently no vaccine and no treatment beyond supportive care.
A looming threat
Nipah virus is a bat-borne virus that causes severe respiratory illness and encephalitis. It has the potential to cause widespread disease and death. It can be spread to humans from infected animals, infected food, or other infected persons, and has an estimated case fatality rate of 40 to 75 percent.
The virus was first identified in Malaysia in 1999 when an outbreak among pig farmers (pigs are susceptible to the disease and can transmit it to humans) killed 105 people and led to the slaughter of more than 1 million pigs. In addition to the tragic loss of life, it had a catastrophic impact on a community’s livelihood and the country’s economic security. Since, the disease has popped up throughout south and southeast Asia, particularly in India and Bangladesh, where outbreaks have occurred annually since 2001.
However, the real extent of Nipah virus may be under-reported; initial symptoms are nonspecific and flu-like, which makes early diagnosis and control difficult. Many more countries are at risk, and global health agencies worry about the virus’s potential to spread unchecked. The US Centers for Disease Control and Prevention identifies Nipah virus as a pathogen with bioterrorism potential, and the World Health Organization included it on the 2018 R&D Blueprint list of priority diseases, citing it as one of the most important pathogens to monitor.
A vaccine is critical.
Advancing a new vaccine
The current Phase 1 study is investigating the safety and tolerability of a Nipah virus vaccine candidate. The study is the first in a series of studies that could one day lead to a stockpile of vaccine that would be used to control outbreaks.
The study began in late February in healthy adult volunteers in Cincinnati, Ohio, USA (although in response to the evolving COVID-19 pandemic, PATH and its partners have temporarily suspended in-person study activities, including vaccination). PATH is leading clinical development and conduct of the study; Auro Vaccines is the study sponsor and developer of the vaccine; and CEPI is providing funding.
Efforts like this are critical to the health and safety of the global community—particularly to support those living in low- and middle-income countries, who often face underlying health conditions or limited access to health care. Without interventions, the pandemic threat of virulent diseases like Nipah virus remains. The numerous outbreaks of the virus (and the devastating results) are evidence enough of that, including a recent one in May 2018 in the Indian state of Kerala, where 23 people were infected in the span of a month—and only two people survived.
But it is not hopeless; if public and private sectors commit to working together and pooling their resources and expertise, we can equip the world with new tools to protect against the infectious diseases that have already cropped up, like Nipah virus—and the unknown pathogens that will arise in the future.
PATH and its partners have made that commitment.