The Centre for Vaccines and Immunology comprises the National and World Health Organisation regional referral laboratories for acute flaccid paralysis and measles surveillance. The centre provides epidemiological, virological and immunological support to the National Department of Health (NDoH) for vaccine preventable diseases. Additionally the centre conducts projects on viral hepatitis and rubella. The centre is a resource for immunology research including cellular immunology of vaccine preventable diseases and mechanisms of immunity and tolerance to infectious disease.
The Centre for was established in 2012 by merging existing polio and measles laboratories. The Centre forms an integral part of the Global Polio Laboratory Network and the Global Measles Laboratory Network. We are the only laboratory in South Africa and one of only a handful of reference laboratories world-wide who process samples containing wild type polio viruses.
The Acute Flaccid Paralysis (AFP) laboratory, within the Centre for Vaccines and Immunology serves as a national reference laboratory for poliovirus isolation as part of the Global Polio Eradication initiative (GPEI). The laboratory serves seven countries within the southern African region in this capacity: Angola, Botswana, Lesotho, Mozambique, Namibia, Swaziland and South Africa. World Health Organization (WHO) protocols are strictly followed to ensure standardization of methods globally. Samples are inoculated into cell cultures and any sample with suggestive poliovirus cytopathic effects are subjected to molecular typing and characterization to confirm poliovirus serotype and differentiate poliovirus intratype. Serology for immunity to poliovirus type 1 or type 3 is also performed by neutralisation assay.
Data is shared on a weekly basis with WHO and the National Department of Health (NDoH) and specific cases are subjected to classification by the National Polio Expert Committee based on history, clinical notes and laboratory findings. The centre also provides expertise to the National Task Force and National Certification Committees for polio containment in all laboratories nationally.
The centre serves as a Regional Reference Laboratory for poliovirus identification and characterisation for the WHO African region. In April 2016, a global switch was implemented from trivalent oral polio vaccine to bivalent oral polio vaccine as wild poliovirus type 2 has been certified globally eradicated in September 2015. Following this declaration, any isolation of type 2 polioviruses are events of global significance.
To continue to support the WHO and the surrounding countries as a Regional Reference Laboratory, the NICD applied to the National Department of Health (NDoH) to host a Polio Essential Facility. This Polio essential facility will enable the NICD to work with poliovirus type 2 under high containment following global certification of eradication and the vaccine switch.
National measles and rubella surveillance
The Centre for Vaccines and Immunology is the national reference laboratory for measles and rubella (German measles) surveillance. In support of the global measles elimination initiative, which has an African measles elimination goal of 2020, the centre provides serological and molecular testing for measles virus.
Serology, specifically the detection of measles-specific IgM antibodies, and molecular methods (rRT-PCR and genotyping) are used in conjunction with epidemiologic case investigations in the diagnosis of acute measles infection.
The Centre for Vaccines and Immunology established a sentinel site surveillance program for congenital rubella syndrome in 2015. The aim is to obtain baseline data on the burden of CRS in South Arica prior to the introduction of the rubella vaccine in the national Expanded Program for Immunisation and to monitor the impact of the vaccine thereafter. There are 29 study sites in all nine provinces of South Africa.
Understanding Immune tolerance for infectious diseases
The Centre conducts research into mechanisms of immune tolerance and susceptibility for infectious diseases. We have a fully equipped flow cytometric laboratory with an 18-colour instrument and two bead based Luminex instruments.
The immuno-regulatory enzyme, indoleamine 2, 3 –dioxygenase, is under investigation as a host derived biomarker for active Tuberculosis. We are also studying the effect of antibodies against human leucocyte antigents (anti-HLA antibodies) in viral diseases including HIV.