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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/15115
Title: Melioidosis vaccines: A systematic review and appraisal of the potential to exploit biodefense vaccines for public health purposes
Authors: Sharon J. Peacock
Direk Limmathurotsakul
Yoel Lubell
Gavin C K W Koh
Lisa J. White
Nicholas P J Day
Richard W. Titball
Mahidol University
University of Cambridge
Nuffield Department of Clinical Medicine
University of Exeter
Keywords: Medicine;Pharmacology, Toxicology and Pharmaceutics
Issue Date: 1-Jan-2012
Citation: PLoS Neglected Tropical Diseases. Vol.6, No.1 (2012)
Abstract: Background: Burkholderia pseudomallei is a Category B select agent and the cause of melioidosis. Research funding for vaccine development has largely considered protection within the biothreat context, but the resulting vaccines could be applicable to populations who are at risk of naturally acquired melioidosis. Here, we discuss target populations for vaccination, consider the cost-benefit of different vaccination strategies and review potential vaccine candidates. Methods and Findings: Melioidosis is highly endemic in Thailand and northern Australia, where a biodefense vaccine might be adopted for public health purposes. A cost-effectiveness analysis model was developed, which showed that a vaccine could be a cost-effective intervention in Thailand, particularly if used in high-risk populations such as diabetics. Cost-effectiveness was observed in a model in which only partial immunity was assumed. The review systematically summarized all melioidosis vaccine candidates and studies in animal models that had evaluated their protectiveness. Possible candidates included live attenuated, whole cell killed, sub-unit, plasmid DNA and dendritic cell vaccines. Live attenuated vaccines were not considered favorably because of possible reversion to virulence and hypothetical risk of latent infection, while the other candidates need further development and evaluation. Melioidosis is acquired by skin inoculation, inhalation and ingestion, but routes of animal inoculation in most published studies to date do not reflect all of this. We found a lack of studies using diabetic models, which will be central to any evaluation of a melioidosis vaccine for natural infection since diabetes is the most important risk factor. Conclusion: Vaccines could represent one strand of a public health initiative to reduce the global incidence of melioidosis. © 2012 Peacock et al.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84856565602&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/15115
ISSN: 19352735
19352727
Appears in Collections:Scopus 2011-2015

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