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Infectious Disease · River Blindness

Is There a Vaccine for River Blindness? | Inciteful Med

At a Glance

Currently, there is no approved vaccine or preventative medication available for river blindness (onchocerciasis). Prevention relies entirely on avoiding daytime bites from infected blackflies by using DEET-based repellents, wearing long clothing, and using permethrin-treated gear.

Currently, there is no approved vaccine available to prevent river blindness (onchocerciasis) in humans [1][2]. For travelers, there are also no preventative medications (chemoprophylaxis) you can take beforehand to avoid getting infected [3]. Instead, protecting yourself relies entirely on taking practical steps to avoid being bitten by the blackflies that carry the disease [4][5].

Protecting Yourself Without a Vaccine

Because there is no vaccine, large-scale prevention efforts focus on community-wide treatments and controlling the blackfly population [4]. Public health programs use Mass Drug Administration (MDA), which involves regularly distributing the medication ivermectin to people living in high-risk areas [6][7]. While ivermectin helps control the spread of the disease and prevents symptoms from worsening, it is a treatment, not a vaccine, and is not prescribed as a preventative measure for short-term travelers [6][3].

For travelers and people living in affected areas, the best defense is preventing blackfly bites [4][8]. Because blackflies bite during the day, you must be protected during daylight hours. If you are traveling to an area where river blindness is found, you should focus on:

  • Using insect repellents containing DEET, picaridin, or other effective ingredients on exposed skin during the day
  • Wearing long-sleeved shirts and long pants to minimize exposed skin
  • Treating clothing with permethrin for extra protection
  • Being especially cautious or avoiding spending significant time near fast-flowing rivers or streams where blackflies typically breed [8][5]

The Status of Vaccine Research

While you cannot get a vaccine today, researchers have been working for decades to develop one [1][2]. Creating a vaccine against the parasitic worm that causes river blindness (Onchocerca volvulus) is difficult because the worm is very good at hiding from and suppressing the human immune system [9][10].

However, scientists are making progress on experimental vaccines, such as the Ov-103 vaccine candidate. This candidate, often studied alongside another protein called Ov-RAL-2, has shown promise in laboratory tests by creating strong immune responses [11][12]. Right now, these candidates are in the preclinical development stage, meaning they are still being tested in the lab and have not yet entered clinical trials in humans [10][11][2]. A successful vaccine is seen as a critical future tool to help eliminate the disease worldwide [6][13].

Common questions in this guide

Is there a vaccine to prevent river blindness?
No, there is currently no approved vaccine available to prevent river blindness in humans. While scientists are making progress on experimental vaccines, they are still in the early laboratory testing stages and are not yet available for public use.
Can I take medication before traveling to prevent river blindness?
No, there are no preventative medications or pills you can take before traveling to avoid getting infected. While the medication ivermectin is used in affected communities to control the disease, it is a treatment and is not prescribed as a preventative measure for short-term travelers.
How can I protect myself from river blindness while traveling?
The most effective way to protect yourself is to avoid being bitten by blackflies. You should use insect repellents containing DEET or picaridin, wear long-sleeved shirts and long pants, and treat your clothing with permethrin.
When and where is the risk of getting river blindness the highest?
The risk is highest during the daytime, especially near fast-flowing rivers and streams. The blackflies that transmit the disease breed in these waters and actively bite during daylight hours, so you must use bite protection throughout the day.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Since there is no vaccine, what specific daytime bite prevention strategies do you recommend for my travel destination?
  2. 2.Do you recommend treating my travel clothing with permethrin before I leave?
  3. 3.Are there any other insect-borne diseases in the area I'm traveling to that I should be vaccinated against?
  4. 4.What symptoms should I watch out for after returning from my trip that might indicate a parasitic infection?

Questions For You

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References

References (13)
  1. 1

    Advancing a Human Onchocerciasis Vaccine From Antigen Discovery to Efficacy Studies Against Natural Infection of Cattle With Onchocerca ochengi.

    Zhan B, Bottazzi ME, Hotez PJ, Lustigman S

    Frontiers in cellular and infection microbiology 2022; (12()):869039 doi:10.3389/fcimb.2022.869039.

    PMID: 35444961
  2. 2

    Onchocerca volvulus: The Road from Basic Biology to a Vaccine.

    Lustigman S, Makepeace BL, Klei TR, et al.

    Trends in parasitology 2018; (34(1)):64-79 doi:10.1016/j.pt.2017.08.011.

    PMID: 28958602
  3. 3

    Is imported onchocerciasis a truly rare entity? Case report and review of the literature.

    Antinori S, Parravicini C, Galimberti L, et al.

    Travel medicine and infectious disease 2017; (16()):11-17 doi:10.1016/j.tmaid.2017.02.006.

    PMID: 28232074
  4. 4

    Community Perceptions of Blackfly Nuisance and Acceptability of the "Slash and Clear" Vector Control Approach in the Ntui Health District of Cameroon: A Qualitative Study.

    Siewe Fodjo JN, Ekome SRE, Njamnshi JNT, et al.

    International journal of environmental research and public health 2024; (21(6)) doi:10.3390/ijerph21060658.

    PMID: 38928904
  5. 5

    Prevalence and incidence of nodding syndrome and other forms of epilepsy in onchocerciasis-endemic areas in northern Uganda after the implementation of onchocerciasis control measures.

    Gumisiriza N, Mubiru F, Siewe Fodjo JN, et al.

    Infectious diseases of poverty 2020; (9(1)):12 doi:10.1186/s40249-020-0628-3.

    PMID: 32114979
  6. 6

    The case for vaccine development in the strategy to eradicate river blindness (onchocerciasis) from Africa.

    Makepeace BL, Babayan SA, Lustigman S, Taylor DW

    Expert review of vaccines 2015; (14(9)):1163-5 doi:10.1586/14760584.2015.1059281.

    PMID: 26091691
  7. 7

    Human Onchocerciasis: Modelling the Potential Long-term Consequences of a Vaccination Programme.

    Turner HC, Walker M, Lustigman S, et al.

    PLoS neglected tropical diseases 2015; (9(7)):e0003938 doi:10.1371/journal.pntd.0003938.

    PMID: 26186715
  8. 8

    Community-directed vector control to supplement mass drug distribution for onchocerciasis elimination in the Madi mid-North focus of Northern Uganda.

    Jacob BG, Loum D, Lakwo TL, et al.

    PLoS neglected tropical diseases 2018; (12(8)):e0006702 doi:10.1371/journal.pntd.0006702.

    PMID: 30148838
  9. 9

    The Functional Parasitic Worm Secretome: Mapping the Place of Onchocerca volvulus Excretory Secretory Products.

    Vanhamme L, Souopgui J, Ghogomu S, Ngale Njume F

    Pathogens (Basel, Switzerland) 2020; (9(11)) doi:10.3390/pathogens9110975.

    PMID: 33238479
  10. 10

    Antibody responses against the vaccine antigens Ov-103 and Ov-RAL-2 are associated with protective immunity to Onchocerca volvulus infection in both mice and humans.

    George PJ, Hess JA, Jain S, et al.

    PLoS neglected tropical diseases 2019; (13(9)):e0007730 doi:10.1371/journal.pntd.0007730.

    PMID: 31525197
  11. 11

    Predictive immunoinformatics reveal promising safety and anti-onchocerciasis protective immune response profiles to vaccine candidates (Ov-RAL-2 and Ov-103) in anticipation of phase I clinical trials.

    Nebangwa DN, Shey RA, Shadrack DM, et al.

    PloS one 2024; (19(10)):e0312315 doi:10.1371/journal.pone.0312315.

    PMID: 39432476
  12. 12

    Linear epitopes in Onchocerca volvulus vaccine candidate proteins and excretory-secretory proteins.

    Lagatie O, Verheyen A, Van Dorst B, et al.

    Parasite immunology 2018; (40(11)):e12587 doi:10.1111/pim.12587.

    PMID: 30188578
  13. 13

    Does Increasing Treatment Frequency Address Suboptimal Responses to Ivermectin for the Control and Elimination of River Blindness?

    Frempong KK, Walker M, Cheke RA, et al.

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2016; (62(11)):1338-1347 doi:10.1093/cid/ciw144.

    PMID: 27001801

This information about river blindness prevention is for educational purposes only. Always consult a travel medicine specialist or your healthcare provider for personalized advice before traveling to areas where insect-borne diseases are present.

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