Recombinant viral vectors, virosomes, vaccines, gene therapy

Biosafety Advisory Council
Secretariat
O./ref.: WIV-ISP/15/BAC/2012_0766
Nomination form for the expert group ‘Recombinant viral vectors, virosomes, vaccines, gene therapy’
Version September 2012
Please return the completed and signed form together with a copy of your CV to the SBB by post, fax
or email
Address: Biosafety and Biotechnology Unit, Scientific Institute of Public Health,
rue Juliette Wytsmanstraat, 14 - B 1050 Brussels – BELGIUM
Email: [email protected]
Last name : ..............................................................................................................................................
First name : ..............................................................................................................................................
Gender: ...................................... Year of birth: ........................
Identification number of the national register: ...................................................

Commitment
please tick and delete where appropriate
O I want to participate/to continue participating in the Experts group ‘Recombinant viral vectors,
virosomes, vaccines, gene therapy’. Please complete the form below.
O
I don't want to participate in the Experts group ‘Recombinant viral vectors, virosomes,
vaccines, gene therapy’ any longer.

Contact details
Title(s): O Prof.
O Dr.
O Eng.
Institution : ...........................................................................................................................................
Department : .......................................................................................................................................
Address : .............................................................................................................................................
tel : ......................................................................................................................................................
email : ..................................................................................................................................................

Payment
Please fill in the number of the personal account to which reimbursements should be transferred
IBAN Account number : ......................................................................................................................
Account holder name : ........................................................................................................................
Account holder address : ....................................................................................................................
Wetenschappelijk Instituut Volksgezondheid | Institut Scientifique de Santé Publique
Afdeling Bioveiligheid en Biotechnologie | Section Biosécurité et Biotechnologie
Rue Juliette Wytsmanstraat 14 | B-1050 Brussels | Belgium
T + 32 2 642 52 11 | F + 32 2 642 52 92 | [email protected] | www.bio-council.be
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
Expertise
This section allows you to specify your main area(s) of expertise for contribution to the Expert
Group. Please indicate only the particular subjects in which you have specialized expertise.
 Virology/Recombinant
vectors
 adenovirus
 adeno-associated virus
 RNA virus
 lentivirus
 retrovirus
 parvovirus
 herpesvirus
 poxvirus
 vaccinia virus
 reovirus
 oncolytic viruses
 Unconventional agents
associated with TSEs (prions)
 virus-like particles
 human virus
 animal virus
 bacteriophages
 viral taxonomy, phylogeny
 anti-viral immunity
 virologic diagnostic
 viral ecology
 Genetic engineering
techniques
 lipofection
 gene gun, biolistic
 naked /Plasmid DNA
 Reverse genetics
 RNA transfer
 RNA interference/silencing
 synthetic biology
 Pharmacy
 galenic
 Good Manufacturing Practice
 regulations
 medical devices
 pharmacotherapeutic
information
 pharmacovigilance
 registration of
pharmaceuticals for human use
 registration of veterinary
medicinal products
 quality control for
biotechnology products
 Biology and Genetics
 cell biology
 Epigenetics
 Genetics
 Genetic stability
 Genetics of population
 molecular genetics
 Gene therapy or
 Prophylactic Vaccination or
 Therapeutic vaccination
 design of vectors
 production of vectors
 hybrid vectors
 quality control
 in vitro experiments
 in vivo experiments
 animal models
 humans
 Tissue or Cell therapy
 somatic stem cells
 embryonic stem cells
 dendritic cells
 autologous transplantation
 allogeneic tansplantation
 xenogenic transplantation
 tumour cell hybrids
 MEDICINE:
 Human or  Veterinary
 internal medicine
 cardiology
 endocrinology
 neurology
 oncology
 physiology
 hematology
 immunology
 vaccinology
 virotherapy
 infectiology
 allergology
 public health
 toxicology
 epidemiology
 clinical biology
 clinical trials
 gene therapy in vivo
 gene therapy ex vivo
 genetic disorders
 cell therapy
 wildlife diseases
 zoonoses
 Ethical issues
 bio-ethics
 Good Clinical Practice
 ethical committee
 Biosafety
 biological markers
 recombination properties
 containment measures
 emergency plans
 monitoring/tracing
techniques
 risk assessment of biotech
products
 risk management
 routes of biological
dispersal
 transfer of genetic material
in the ecosystem
 waste management
 workers protection
continues next page
Wetenschappelijk Instituut Volksgezondheid | Institut Scientifique de Santé Publique
Afdeling Bioveiligheid en Biotechnologie | Section Biosécurité et Biotechnologie
Rue Juliette Wytsmanstraat 14 | B-1050 Brussels | Belgium
T + 32 2 642 52 11 | F + 32 2 642 52 92 | [email protected] | www.bio-council.be
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 Other relevant disciplines: …………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
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I hereby confirm that the above information is correct. I have no objection to the fact that my name and
affiliation will be made publicly available on the Biosafety Council website.
Date :
Signature :
Copy of CV added:

Additional comments
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Wetenschappelijk Instituut Volksgezondheid | Institut Scientifique de Santé Publique
Afdeling Bioveiligheid en Biotechnologie | Section Biosécurité et Biotechnologie
Rue Juliette Wytsmanstraat 14 | B-1050 Brussels | Belgium
T + 32 2 642 52 11 | F + 32 2 642 52 92 | [email protected] | www.bio-council.be
WIV-ISP/41/BAC_2012_0766
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