Archive for April, 2011

European efforts to wipe out measles by 2015 are in jeopardy as outbreaks continue to sweep across the continent

Friday, April 29th, 2011 (last updated)

A series of measles epidemics in Western Europe and a major polio outbreak in Central Asia served to focus minds as senior officials met in Brussels to launch European Immunization Week.

The WHO had hoped to eradicate poliomyelitis by next year and to do the same for measles and rubella by the middle of the decade but recent events are seen as a serious setback.

Launching the EIW, Zsuzsanna Jakab, Regional Director, WHO Europe, described the measles figures as “sombre” but committed to stepping up the fight in the face of waning immunisation rates.

“In 2010, we witnessed explosive measles outbreaks continuing in the western part of the region and the re-emergence of poliomyelitis at a time when we would have been preparing to celebrate 10 years of polio-free status in 2012,” she said.

Twenty four European countries have reported more than 4,000 cases in the first quarter of 2011, sparking concerns of a further surge in the wake of the Easter holiday.

Europe on a ‘slippery slope’

“It disheartens me to see our strong region facing this slippery slope of losing the significant gains, knowing what the consequences will be: increased illness, lifelong disability and deaths.

However, on the positive side, we have witnessed countries mount effective responses to many of these outbreaks, by applying lessons learned, conducting joint planning and ensuring strong collaboration between all countries in the region,” Ms Jakab said.

She said strong partnerships between countries are needed to prevent and control vaccine-preventable diseases.

“I want to assure everyone that we have effective tools, and we will continue to engage political leaders, public health experts, academia, institutes and the public to reach these goals. This is a marathon with the finish line now in sight – we need to urgently press on to meet the milestones we have set and to win. It can be done!”

Victim of own success

John Ryan, a senior official at the European Commission’s health and consumers’ directorate, said that despite the proven safety and efficacy of vaccines, too few children are protected against preventable diseases.

“Perhaps vaccines are a victim of their own success. Some parents lack information on vaccination while others are not familiar with the diseases they protect against,” he said.

Continuity of immunisation is a major difficulty for healthcare providers and the EU is looking at ways to better document vaccination status of children in Europe, according to Mr Ryan. He indicated that health ministers will adopt a series of measures in June which could help tackle these problems.

Reaching out to minorities and migrant populations will be particularly important, Mr Ryan said, and guidelines on how to do this can be developed at European level.

European Immunization Week Regional Launch

Inhaled protein may aid in the fight against influenza

Monday, April 25th, 2011 (last updated)

A protein that boosts the immune system may be able to aid in the fight against the flu, a new report says, by reducing symptoms and even preventing death despite lethal doses of the flu.

In a study led by Dr. Homayoun Shams from the University of Texas, scientists tested the effect of the protein granulocyte macrophage-colony stimulating factor (GM-CSF) against a lethal dose of the flu in mice.

Mice treated with GM-CSF survived the lethal dose of the flu virus, while those untreated died within a few days. This nasal aerosol treatment may help to protect against the flu, of which there are three to five million cases worldwide each year, reports the BBC.

“Such unique and unambiguous results demonstrate the great potential of GM-CSF and may be the remedy for a critical public health priority – developing strategies to reduce the morbidity and mortality from influenza,” Shams said. “Despite the widespread use of vaccines, influenza causes significant morbidity and mortality throughout the world, and those with poor immune systems are particularly more susceptible—such as very young, elderly or immunocompromised individuals.

“Unlike a vaccine, GM-SCF does not rely heavily on the body’s ability to mount an immune counter-attack against a specific antigen or virus strain, but enhances the speed of local responses to virus infection and delicately balances the host immune responses.

“

GM-SCF has already been used to treat patients who have the blood disorder neutropenia. The protein is known to boost the activity of what are called alveolar macrophages, which act as a first line of defense against inhaled molecules and organisms.

Professor John Oxford, a virologist based at Queen Mary, University of London, said that even if the work is not directly transferable to humans, it may be helpful in directing research.

Development of a vaccine for Chlamydia

Friday, April 22nd, 2011 (last updated)

A Wayne State University School of Medicine researcher has developed a potential first ever vaccine for Chlamydia, the world’s most prevalent sexually transmitted disease and the leading cause of new cases of blindness.

Judith Whittum-Hudson, Ph.D., professor of immunology and microbiology, internal medicine and ophthalmology, has identified three peptides that have demonstrated a vaccine effect to inoculate against Chlamydia successfully in an animal model. Those findings could soon result in a vaccine for humans.

While Chlamydia infection can be readily addressed with a regimen of antibiotics, the treatment does not prevent re-infection.

“There is no vaccine and the disease is widely rampant,” Whittum-Hudson said. “Antibiotics, while effective in treatment, offer no protection against re-infection.”

The technology developed by Dr. Whittum-Hudson consists of novel peptide immunogens selected from a random phage display library by an antibody against a Chlamydial glycolipid exoantigen, or GLXA, or peptides that correspond to antigen-binding regions of an anti-idiotypic antibody mimic of GLXA. The peptides comprising the vaccine would induce antibodies and other immune responses to the entire spectrum of genus-wide Chlamydia. Whittum-Hudson said colleagues have developed a method to encapsulate the vaccine, so that it can be delivered orally rather than through injection, a boon to developing nations that lack the infrastructure to support inoculations through needle injection.

Chlamydial infections are the leading cause of pelvic inflammatory disease (PID), because Chlamydia infects the lower genital track and then may ascend into the fallopian tubes. PID can lead to infertility, ectopic pregnancy and chronic pelvic pain. Because an estimated 85 percent of women infected with Chlamydia are asymptomatic, the disease can wreak its permanent damage before they even become aware of the infection.

More than 6,500 measles cases reported in Europe so far this year

Thursday, April 21st, 2011 (last updated)

The World Health Organization reported on Wednesday that at least 6,500 cases of measles have been confirmed in 12 European countries so far this year.

A staggering 4,937 cases were officially reported in France from January to March, according to the WHO. Most of the people who got the disease were not immunized with the measles vaccination.

In an effort to quell the outbreak, more than 50 countries will take part in the European Immunization Week, which runs from April 23 to April 30. The initiative will come during the Easter holidays, a busy traveling time that could further increase the risk of exportation and importation of the highly contagious disease.

Some health officials fear that the lack of immunization is due to the persistent rumor that the measles, mumps and rubella vaccine is harmful.

“The vaccine is a safe vaccine,” Dr. Rebecca Martin, head of the Vaccine Preventable Disease program for the WHO’s European region, said. “The disease is much more severe than any possible side effects that might be caused by the vaccine.”

Although preventable by vaccine, measles remains one of the leading causes of death among young children globally. For every 1,000 children who get measles, one or two will die, according to the CDC.

Evaluating Dengue vaccines

Wednesday, April 20th, 2011 (last updated)

A vaccine for dengue fever may be available in 4 years, and experts have identified key issues needing to be addressed for regulatory review and licensure of such a vaccine.

Investigators from the Dengue Vaccine Initiative Consortium hosted by the International Vaccine Institute, Seoul, carried out the study in collaboration with the World Health Organization and institutions from the United States.

The investigators emphasize that a vaccine effective against all 4 dengue-causing viruses is the best approach for disease control. Clinical trials should be carried out in different countries and in populations in which the disease is endemic.

Dengue is prevalent in tropical countries, where it causes 34 million cases of disease, with 6% of cases developing into life-threatening forms. No drugs to treat infection are available and mosquito-control vectors have not been highly effective.

(Friedrich  M. The World in Medicine. Evaluating Dengue Vaccines. JAMA 2011; 305 (15): 1527.)

Help save 4 million lives in the next 5 years

Monday, April 18th, 2011 (last updated)

ONE (www.one.org) is a grassroots advocacy and campaigning organization that fights extreme poverty and preventable disease, particularly in Africa, by raising public awareness and pressuring political leaders to support smart and effective policies and programs that are saving lives, helping to put kids in school and improving futures.

ONE is not a grant-making organization and does not solicit funding from the general public. As ONE has always said: ‘we’re not asking for your money, we’re asking for your voice.’

One of the campaigns of ONE is to ask world leaders to fund two proven, new vaccines that will help stop pneumonia and diarrhoea – two of the biggest killers of children in poor countries. Click here to fill in the form.

Countries would share virus samples in return for affordable vaccines derived from them under plan

Saturday, April 16th, 2011 (last updated)

Virus samples will be shared globally in exchange for vaccines produced from them under a landmark deal to improve preparedness for an influenza pandemic, diplomats at the World Health Organization said Saturday.

Negotiators ended an all-night session with a draft agreement accepted by all countries, including the United States, which was the last to join the consensus, they said.

Health ministers were expected to adopt the framework deal, which lays down participation by the drug industry, at the WHO’s annual meeting being held May 16-24.

“The negotiations are finished. The framework was agreed,” an aide to Mexico’s ambassador Juan Jose Gomez Camacho, co-chairman of the closed-door talks.

Countries would share virus samples with the WHO’s network of laboratories in return for affordable vaccines derived from them.

The industry has pledged to donate drugs and know-how, covering half of the $58 million annual cost of boosting defenses in the poorest nations, according to senior envoys.

Negotiations began four years ago among the WHO’s 193 members after the deadly H5N1 bird flu virus emerged in southeast Asia. A year later, Indonesia stopped sharing flu virus samples with the WHO’s network, demanding its share of vaccines.

Indonesia’s delegation supported the consensus reached in the round of talks this week, diplomats said.

Complaints during pandemic

During the H1N1 swine flu pandemic in 2009-2010, many developing countries complained that they had no life-saving antivirals or vaccines to combat the new virus. The WHO helped distribute 78 million vaccines, donated by rich nations and drug makers, to 77 developing countries, but regulatory and other hurdles slowed the process.

The pharmaceutical industry has pledged to step up its role.

“Industry agreed what its role will be. They will be able to choose between donations and intellectual property,” a diplomatic source told Reuters.

This meant drug companies could donate significant amounts of vaccines or antivirals, or transfer technology for manufacturing pandemic vaccines, he said.

Drug company executives say current production capacity for pandemic flu vaccine is 1.1 billion doses. GlaxoSmithKline, Novartis and Sanofi-Aventis are among the major flu vaccine makers.

Under the deal, 10 percent of production would be earmarked for developing countries, diplomats said. But the WHO would decide where the doses were best deployed to combat outbreaks.

“It gives flexibility to the WHO to think strategically on how resources should be spent,” a senior diplomat said.

Anti-vaccine ad on a jumbotron in Times Square (New York City)

Monday, April 11th, 2011 (last updated)

Anti-vaccine groups are still working hard to spread their scientifically-unsupported message to the masses, this time via an ad on a jumbotron in Times Square, New York City. This ad has the potential to reach many tens of thousands of people between now and April 28 (it runs once an hour, every hour) when its time is up.

The short ad, which you can see at the end of this article, doesn’t explicitly advocate not getting children vaccinated, but makes it clear they think there’s a choice to be made, and directing people to the websites of the National Vaccine Information Center (NVIC) and Mercola. Two websites which both have very clear anti-vaccine agendas. Mercola is the website of Dr. Joe Mercola, a noted anti-vaccine proponent. The NVIC, which sounds like a government agency, is in fact the exact opposite, having been described as the “most powerful anti-vaccine organization in America” by respected journalist Michael Specter.

Persistent misinformation and misconceptions about vaccination threaten the health of all members of our society, but especially children. For example, fears of an alleged link between the measles/mumps/rubella vaccine and autism, though the purported link has been soundly discredited, still persist, causing parents to opt out of the MMR vaccine.

We have seen the sad results with the current spread of measles in e.g. Europe.

Travel warning issued following European measles outbreak

Monday, April 11th, 2011 (last updated)

A large measles outbreak in parts of Europe, including France, Italy, Germany and Bulgaria, has caused the Health Protection Agency to send letters to schools warning them to be cautious.

Currently, there have been 4,000 people who have been diagnosed with measles in France. The threat comes weeks before the Easter holidays, a time when traveling between countries is high. Last month, the National Travel Health Network and Centre issued advice stating that “overseas travel is an important factor in the international spread of measles.”

Spread via droplets from the nose, mouth or throat of infected persons, measles is a highly contagious viral disease that mostly affects children. Vaccinations, however, can render one immune to the disease. The HPA letter encouraged families check to make sure they are up-to-date with their measles, mumps and rubella vaccinations prior to traveling.

Initial symptoms of measles usually include a high fever, a runny nose and a cough. Within seven to 18 days of exposure, a rash will can be expected to erupt all over the body. According to the World Health Organization, measles vaccination resulted in a 78 percent drop in measles deaths between 2000 and 2008 worldwide.

Effects of pneumococcal vaccination program on pneumococcal carriage and invasive disease

Wednesday, April 6th, 2011 (last updated)

Using a cross-sectional study, Stefan Flasche and colleagues investigated the effects of the UK pneumococcal vaccination program on serotype-specific carriage and invasive pneumococcal disease.

There are more than 90 Streptococcus pneumoniae serotypes that can cause invasive pneumococcal disease (IPD). The pneumococcal conjugate vaccine PCV7 contains antigens from seven serotypes responsible for IPD. Immunization with PCV7 prevents both IPD disease and carriage of these seven serotypes, but after vaccination non-vaccine serotypes could colonize the nasopharynx. There are concerns that this “serotype replacement” could reduce the benefits of vaccination. This cross-sectional study examined nasopharyngeal swabs taken from PCV7-vaccinated children and their families for S. pneumoniae, determined the serotype of any bacteria found, and compared the proportion of people carrying S. pneumoniae (carrier prevalence) and the distribution of serotypes in this study population with a similar population that was studied in 2000/1, before the PCV vaccination program began. Carriage of vaccine serotypes decreased in vaccinated children and their contacts whereas carriage of non-vaccine serotypes increased. The invasiveness of the replacing serotypes was generally lower than those of the original serotypes, which resulted in a net reduction in IPD in children. But three serotypes not present in the vaccine had emerged that had high invasiveness potential.

Although the recent introduction of PCV13 into UK vaccination schedules is likely to have an incremental benefit on the reduction of IPD compared to PCV7, this benefit might be offset by increases in the carriage of some high invasiveness serotypes. These emerging serotypes should be considered for inclusion in future vaccines.