Adenovirus causes flu-like and respiratory symptoms and, like the flu, it can be fatal – though it usually isn’t. For most Americans, it’s a minor nuisance – but for the Army it can be a back breaker. “The population at risk for adenovirus,” said Jarman, “is one that’s enclosed in a confined space. Students in university dorms and prison inmates, for example, are at risk – but if they’re out of commission for a week, the impact is less significant.” For an Army recruit to miss a week of an eight-week basic training course – which costs more per week than an Ivy League education – is a big deal; every recruit who doesn’t complete the course has to be recycled.

The oral vaccine for the two most predominant types of adenovirus, developed by WRAIR researchers, was discontinued in 1999 after the manufacturer stopped production – and not surprisingly, the rate of infection among Army recruits immediately spiked. When the Army decided to restart production, the manufacturer was no longer interested – “So we had to resubmit the IND [Investigational New Drug application] and do the clinical trials over again, and begin new manufacturing processes,” said Jarman. The second-generation vaccine, rolled out in 2011, has massively reduced adenoviral infections among recruits. “It’s a huge success story.”

Another viral disease that causes little concern among temperate-climate-dwelling Americans – dengue fever – is the most common mosquito-borne disease in the world. A Swahili term meaning, literally, “breakbone fever,” dengue incapacitates a patient for seven to 10 days with flu-like symptoms: fever, headaches, and severe muscle and joint pains. There is, as yet, no known antiviral treatment for dengue; patients are typically hydrated while the infection runs its course.

Largely endemic to the humid tropics, the disease took an extreme toll on U.S. soldiers in World War II’s Pacific Theater and in Vietnam. As the Asia-Pacific region continues to grow in strategic importance, the Army has renewed its focus on dengue fever, both in developing vaccines and treatments and in gathering contemporary data on the disease’s impact among personnel.

WRAIR’s Viral Disease Branch researchers have been conducting dengue vaccine research for more than 20 years – but, as it has been among all dengue researchers, their progress has been unusually painstaking, complicated by the fact that, for reasons not yet understood, a primary infection by one of the virus’s four disease-causing serotypes increases the risk that a later, secondary infection by another serotype may have more severe symptoms – internal hemorrhaging or shock, which both can be fatal.

WRAIR’s Viral Disease Branch researchers have been conducting dengue vaccine research for more than 20 years – but, as it has been among all dengue researchers, their progress has been unusually painstaking, complicated by the fact that, for reasons not yet understood, a primary infection by one of the virus’s four disease-causing serotypes increases the risk that a later, secondary infection by another serotype may have more severe symptoms – internal hemorrhaging or shock, which both can be fatal.

Under these circumstances, a vaccine that contains just one dengue serotype will do much more harm than good, Jarman explained. A live attenuated vaccine would need to contain all four serotypes, and it would need to contain them in the proper ratios, because of their different rates of replication. After testing many different formulations, Army researchers and their research partners at GlaxoSmithKline (GSK) recently shifted focus to a different type of vaccine, developed by WRAIR’s Viral Disease Branch.

The new platform, said Jarman, is “a purified and inactivated vaccine – which is basically all four types in equal amounts, formulated and inactivated with formalin so you don’t have to worry about the replication. The expectation is that you would get an equal immune response, because it’s not biological anymore. The viruses aren’t competing with each other.”