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WHO Sending 1 Million Cholera Vaccine Doses to Haiti

           

Haitians wash clothes in a stream in Port-au-Prince. The widespread use of rivers has been linked to the country's deadly cholera outbreak.

cnn.com - by Ivan Watson, Tim Hume and Karla Pequenino - October 11, 2016

Jeremie, Haiti (CNN) - The World Health Organization is sending a million cholera vaccine doses to Haiti, it announced Tuesday, amid concerns over the rising number of cases in the aftermath of Hurricane Matthew.

WHO cholera expert Dominique Legros told reporters in Geneva that the UN's global public health body had decided Monday to send the vaccines to the hurricane-ravaged Caribbean nation, to attempt to prevent an outbreak of the waterborne disease.

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SEE THE FOLLOWING ADDITIONAL RESOURCES ON THE EFFECTIVENESS OF METHODS FOR CHOLERA PREVENTION AND CONTROL . . .

Effectiveness of oral cholera vaccine in Haiti - The Lancet Global Health
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)70015-X/fulltext?rss=yes

Cholera vaccine study in Haiti suggests problems with current booster regimen -- ScienceDaily
https://www.sciencedaily.com/releases/2016/06/160616150729.htm

Results
The population targeted showed much interest in receiving OCV after being presented with information. Of 51,814 persons surveyed during the pre-vaccination phase, 96.7% indicated their interest in receiving the vaccine.
Cholera Vaccination in Urban Haiti
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3795097/

Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-control study and bias-indicator analysis
http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70368-7/fulltext

Modeling the Effect of Water, Sanitation, and Hygiene and Oral Cholera Vaccine Implementation in Haiti
http://www.ajtmh.org/content/89/4/633

Although the 200,000 OCV doses for the 2013 campaign were purchased directly from the manufacturer by the United Nations Children’s Fund, future OCV for use in cholera-endemic and -epidemic settings will be mainly obtained through the OCV stockpile managed by the International Coordinating Group and the Global Task Force on Cholera Control (30–32). Given the limited amount of vaccine available, epidemiologic, technical, and operational evidence, as well as local capacity to conduct OCV campaigns, will be assessed for optimal stockpile vaccine use. Moreover, the International Coordinating Group highlights the need to integrate OCV use with early case detection, appropriate case management, provision of adequate WASH infrastructure, and raising of awareness in the affected communities. Therefore, the cornerstones for cholera prevention and control remain safe water, improved sanitation, and adequate hygiene; WHO recommends that OCV use should complement traditional cholera control measures, including WASH interventions (7).

CDC - Oral Cholera Vaccine Coverage, Barriers to Vaccination, and Adverse Events following Vaccination, Haiti, 2013
http://wwwnc.cdc.gov/eid/article/21/6/14-1797_article

Trivac model; preliminary results for OCV on Dukoral (85% vaccine effectiveness, 3 doses, 10% wastage, US$ 2.7 per dose)

2011 - Challenges of use of cholera vaccines in Haiti and the Americas (14 page .PDF file)
http://www.who.int/immunization/sage/SAGE_April_2011_cholera_haiti_paho.pdf

"Preventing and controlling cholera transmission is a priority and requires sanitation and hygiene measures," said PAHO/WHO Representative in Haiti Jean-Luc Poncelet. "Vaccination is one more tool in the fight against this disease."

The vaccination campaign complements efforts by Haitian health authorities to improve access to safe water and sanitation, promote hand washing, and encourage community participation in cholera prevention. "The long-term goal is to eliminate cholera from Haiti," . . . 2 September 2014

http://www.paho.org/hq/index.php?option=com_content&view=article&id=9875%3A2014-haiti-launches-cholera-vaccination-campaign&Itemid=1926&lang=en

. . . the root cause of cholera is in the unavailability of safe drinking water and of adequate sanitation. In Haiti, a large proportion of the population does not have access to sanitation – only 28 per cent has access to sanitation – and about half of the population has access to safe drinking water. Nobody can resolve the problem of cholera in Haiti and elsewhere until you tackle the question of sanitation . . .

. . . For vaccines to work, we also need WASH (water, sanitation and hygiene) interventions in the area. You need to provide chlorination of the surrounding areas. And finally, we have a policy of rapid response, working with the Ministry of Health . . .

 . . . The Haitian Government has asked for $2.2 billion to implement its 10-year plan to fight cholera. But to date, the plan has been less than 20 per cent funded.

http://www.un.org/apps/news/story.asp?NewsID=54216#.WAB1kDKZPGI

 

PLOS - Major Shift of Toxigenic V. cholerae O1 from Ogawa to Inaba Serotype Isolated from Clinical and Environmental Samples in Haiti

journals.plos.org - Published: October 7, 2016 - http://dx.doi.org/10.1371/journal.pntd.0005045

Abstract

In October of 2010, an outbreak of cholera was confirmed in Haiti for the first time in more than a century. A single clone of toxigenic Vibrio cholerae O1 biotype El Tor serotype Ogawa strain was implicated as the cause. Five years after the onset of cholera, in October, 2015, we have discovered a major switch (ranging from 7 to 100%) from Ogawa serotype to Inaba serotype. Furthermore, using wbeT gene sequencing and comparative sequence analysis, we now demonstrate that, among 2013 and 2015 Inaba isolates, the wbeT gene, responsible for switching Ogawa to Inaba serotype, sustained a unique nucleotide mutation not found in isolates obtained from Haiti in 2012. Moreover, we show that, environmental Inaba isolates collected in 2015 have the identical mutations found in the 2015 clinical isolates. Our data indicate that toxigenic V. cholerae O1 serotype Ogawa can rapidly change its serotype to Inaba, and has the potential to cause disease in individuals who have acquired immunity against Ogawa serotype. Our findings highlight the importance of monitoring of toxigenic V. cholerae O1 and cholera in countries with established endemic disease.

Haiti’s Ministry of Health organizing a vaccination campaign against cholera in areas affected by Hurricane Matthew, supported by PAHO-WHO, UNICEF and other partners

paho.org

Port-au-Prince, Haiti, 27 Oct. 2016-- The Haitian Ministry of Health (MSPP) is setting up  a vaccination campaign against cholera in areas ravaged by Hurricane Matthew, with support from the Pan American Health Organization / World Health Organization (PAHO / WHO). 

The decision of WHO and other member of the Global Task Force for Cholera Control to approve the request of the MSPP to bring 1 million doses of oral vaccine against cholera is based on the goal of reducing the burden of cholera cases on health care facilities, and of reducing deaths in the departments of the Sud and Grand'Anse, the areas most affected by Hurricane Matthew.

The target population is estimated at over 820,000 people over one year of age. The vaccination campaign will begin November 8, 2016.  Activities will focus on the municipalities most vulnerable to cholera outbreaks in the two southern departments of Grand’Anse and Sud, where there has been significant destruction of water and sanitation supply systems.

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huffingtonpost.com - by ResearchGate - December 20, 2016

Oral cholera vaccines are typically administered in two doses, but experience and recent research reveal this may not always be the best approach.

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CLICK HERE - STUDY - ResearchGate - Effectiveness of one dose of oral cholera vaccine in response to an outbreak: a case-cohort study

 

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