Archive for October, 2012

A vaccine against one of the most deadly hospital superbugs Clostridium difficile is being developed by British scientists

Wednesday, October 24th, 2012 (last updated)

The vaccine, which can be taken orally as a pill, could be available within the next five years after preclinical tests have shown it can offer full protection against C. difficile infection.

The bacterium was responsible for at least 2,000 deaths and more than 24,000 infections last year. There is currently no vaccine available against the C. difficile and increasing antibiotic resistance is making it harder to treat.

It has become a major problem in hospitals where infants, the elderly and patients with weakened immune systems are particularly vulnerable to the bacteria, and the number of deaths are far higher those of other superbugs like MRSA.

Dr Simon Cutting, from the school of biological sciences at Royal Holloway University of London, claims to have created a vaccine that could help cut the toll caused by the superbug by combining C. difficile with spores from a bacterium found naturally in the human gut.

He hopes to begin the first trial of the new vaccine in human patients early next year.

He said: “There is currently no vaccine available against C. difficile and it is becoming increasingly resistant to antibiotics, so the ways of combating it are limited. It causes a lot of problems in hospitals however.

“We have found that our vaccine can produce full protection in animal models. We are now in discussions with drug companies and hope to begin initial safety trials in humans early next year.”

There are currently a number of injection based vaccines against C. difficile under development but most have been found to only offer limited protection against the bacteria.

Dr Cutting and his colleagues believe that using an oral vaccine will be more effective.

They genetically modified a bacterium found in the human gut called Bacillus subtilis by introducing genes from C. difficile so that key parts of the superbug would appear on the surface of spores created by the B. subtilis.

Spores are a dormant form of life that can survive in the harsh, acidic environment in the gut.

The spores, which can be killed so they do not cause an infection, carry the C. difficile fragments through the gut wall, triggering a reaction that can produce immunity against future infection by the bacteria.

Dr Cutting said the approach could also help to provide new vaccines against tuberculosis and influenza that can be taken as nasal sprays rather than having to use injections, which can currently put some people off.

He said: “Rather than requiring needle delivery, vaccines based on Bacillus spores can be delivered via a nasal spray, or as on oral liquid or capsule.

“As spores are exceptionally stable, the vaccines do not need to be stored in a refrigerator and have a much longer shelf life.”

A vaccine against one of the most deadly hospital superbugs Clostridium difficile is being developed by British scientists

Source:
The Telegraph

Can we, should we, eradicate the meningococcus?

Wednesday, October 24th, 2012 (last updated)

The eradication of infectious agents is an attractive means of disease control that, to date, has been achieved for only one human pathogen, the smallpox virus. The introduction of vaccines against Neisseria meningitidis into immunisation schedules, and particularly the conjugate polysaccharide vaccines which can interrupt transmission, raises the question of whether disease caused by this obligate human bacterium can be controlled, eliminated, or even eradicated. The limited number of meningococcal serogroups, lack of an animal reservoir, and importance of meningococcal disease are considerations in favour of eradication; however, the commensal nature of most infections, the high diversity of meningococcal populations, and the lack of comprehensive vaccines are all factors that suggest that this is not feasible. Indeed, any such attempt might be harmful by perturbing the human microbiome and its interaction with the immune system. On balance, the control and possible elimination of disease caused by particular disease-associated meningococcal genotypes is a more achievable and worthwhile goal.

Click here

Source:
Vaccine

“Vaccine Exemptions”? Call them what they really are.

Tuesday, October 23rd, 2012 (last updated)

Source:
Medscape

Plugging the vaccination equity gap will save millions

Monday, October 22nd, 2012 (last updated)

Countries in South and Southeast Asia are going through unprecedented economic growth despite uncertainties in the global economic situation. To be able to maintain this upward trend countries need to secure the health of their citizens _ especially the children. A high mortality rate among among the under fives threatens overall economic development in the region. Approximately 10 million children in the World Health Organisation’s (WHO) South-East Asia Region remain at risk from diseases like measles, diphtheria, whooping cough and tetanus, all of which are vaccine preventable.

So why is this region leaving so many children behind? Even in countries with over 80-90% immunisation coverage the challenge is equity. Children who are outside the vaccine protective shelter are often the poor and marginalised. These children are vulnerable to diseases because of malnutrition, unhygienic living conditions, poor water quality etc. Once sick, healthcare costs further impoverish their families. Parents who earn a daily wage have to look after ailing children while they use up their savings and miss out on their daily earnings, pushing them further down the poverty ladder.

Immunisation is one of the most cost-effective health interventions that can prevent disease and death among millions of children. When countries focus on the poorest of the poor, and reach the marginalised with childhood immunisation, they reap rich socioeconomic dividends.

While some reasons why children go unvaccinated are common to all countries, each country has its unique challenges and each has to find its own way to address them. There is a need to adapt delivery of services so that daily wage earners can bring their children for immunisation without losing a day’s wage. We must make vaccines readily available in remote areas. More immunisation centres and the frequency of sessions in conjunction with strengthened infrastructure such as cold chains and logistics would help countries reach immunisation targets.

Realising the impact of this equity gap on childhood immunisations, 11 countries in WHO’s South-East Asia Region have decided to focus their efforts on children in areas where routine immunisation coverage is below 80%.

Conflict and violence have frustrated efforts of some countries to reach and immunise children. Sri Lanka which has an overall national average of 100% coverage is now focusing its immunisation efforts on the two northern districts that were severely affected by conflict. Thailand with a high 98% national coverage was earlier unable to provide full immunisation cover to three of its southernmost provinces of Pattani, Yala, and Narathiwat due to security conditions. It is now committed to focusing on these districts.

Focusing immunisation efforts can make a big difference. Bangladesh has successfully reduced its under five mortality rate by integrating efforts, including immunisation, and focusing on its very young children. With 80% vaccination coverage throughout the country, Bangladesh has now decided boost routine immunisation in 31 districts and four city corporations that needed additional assistance for increasing and sustaining coverage.

Geographic factors impact immunisation coverage in several countries. Nepal is reaching out to 33 of its 75 districts with intensified immunisation efforts and has hired additional vaccinators to reach them. These districts include those in far-flung mountainous areas and some lie in the Terai belt.

The challenges for Indonesia and India are somewhat similar. These countries are among the most populous and are home to over half the birth cohort of WHO’s South-East Asia Region. In Indonesia providing uniform immunisation services to populations scattered over 13,000 islands is both costly and logistically challenging.

For India the biggest challenge lies in the size of its population, including the large number of migrant populations. India is applying best practices from its vast polio eradication programme to intensify routine immunisation. These practices include mapping of migrant populations and risk assessments to guide actions and priorities. India is also providing increased priority for vaccine safety and security. State-level efforts are being made to strengthen the surveillance and reporting of adverse events following immunisation which could otherwise erode public confidence.

Countries are also facing difficulties in financing the routine and new vaccines selected by them for inclusion in their national immunisation schedules. It is vital that adequate funds are allocated for these vaccines.

Inequity in health services slows down a country’s economic progress. Immunisation is an important tool in our arsenal to prevent death and disease in children. The time has come to invest in equity to ensure continued socioeconomic development in South and Southeast Asia.

Source:
Bangkok Post

Single vaccine to beat tick-transmitted diseases comes closer to reality

Sunday, October 21st, 2012 (last updated)

In a new study, researchers have identified the “keys” and “doors” of a bacterium responsible for a series of tick-transmitted diseases.

These findings by Virginia Commonwealth University School of Medicine researchers may point researchers toward the development of a single vaccine that protects against members of an entire family of bacteria that cause disease in humans, domestic animals and livestock.

Survival for many bacteria is dependent on their ability to invade human or animal cells. And it needs to be done in a very precise fashion. Bacteria use a specific set of “keys” on their surfaces to unlock specific “doors”, or entryways into their host cells.

By understanding how these bacteria invade cells, researchers are able to identify potential targets to block the spread of infection, and from there, develop safe and effective vaccines.

In the study, researchers reported that a protein called OmpA on the surface of Anaplasma phagocytophilum is important for invading host cells. Anaplasma phagocytophilum is an Anaplasmataceae bacterium that infects humans to cause granulocytic anaplasmosis.

The team also identified the particular sugar residue on the surfaces of host cells to which OmpA binds.

“In other words, we identified both a key and door that together promote Anaplasma phagocytophilum infection,” Jason A. Carlyon, lead investigator of the study, said.

“These findings are important because our data also establish a direction for development of a single vaccine that protects against members of an entire family of bacteria that cause disease in humans, domestic animals and livestock,” he said.

According to Carlyon, the region of OmpA that mediates infection is shared among other Anaplasmataceae bacteria.

Experts have seen a steady rise in the incidence of human infections caused by tick-transmitted bacterial pathogens in the past several years.

Many tick-transmitted bacterial pathogens are considered “emerging pathogens” because it was only recently discovered that they infect humans.

Moreover, evidence suggests that many of these infections go unrecognized, signifying that the prevalence of human diseases caused by Anaplasmataceae pathogens is even higher, said Carlyon.

Livestock infections carry a significant economic burden, costing the U.S. cattle industry 100 million dollars per year, he added.

Infection and immunity Click here

Source:
Infection and Immunity

Rising TB rates lead to call for new vaccines

Saturday, October 20th, 2012 (last updated)

Oxford-based scientist have called for more and better vaccines ahead of the publication of new figures by the World Health Organisation on the incidence of tuberculosis, which is concentrated in India, China, South Africa, Indonesia and Pakistan.

The first vaccine against TB, Bacille Calmette-Guérin, was used in 1921. It is still the only vaccine in use against a disease that kills nearly 1.5 million people each year. TB is becoming increasingly resistant to the drugs being used against it.

In the years after the second World War, the vaccine saved millions of lives in Eastern Europe after eight million children were vaccinated. The much feared epidemic of TB, seen as inevitable after wartime, was controlled by the widespread vaccination.

Though effective in preventing tuberculous meningitis in infants, BCG has a far patchier record in fending off pulmonary tuberculosis, particularly in adolescents and adults, scientists in London said yesterday.

Hopes now lie in MVA85A, a vaccine developed by Prof Helen McShane, Oxford University’s professor of vaccinology. Extraordinarily, it is the first new TB vaccine to have begun clinical trials since BCG did so 81 years ago.

Work on MVA85A has been under way for more than a decade. Next spring, Prof McShane and her team will learn the results of the first efficacy trial in South Africa – where half of the babies chosen were given the vaccine, and the other half received a placebo.

The vaccine bids to improve the effectiveness of BCG, not replace it, though the team still does not know what responses it needs to provoke in a patient’s immune system to ensure that TB can be held at bay, said Prof McShane at a briefing organised by the Wellcome Trust.

Today, however, greater mobility ensures that every national health system has to cope with TB: nearly 9,000 cases were reported in the United Kingdom in 2010, 6.6 per cent up on the year before. Three-quarters of the cases are reported by recent arrivals.

TB’s greater resistance to drugs has grown because they have often been misused; the disease has been poorly managed; and drug-resistant variations have been transmitted from person to person, said Prof Tim McHugh, director of University College London’s Centre for Clinical Microbiology.

Recently in South Africa, Dr Ann Ginsberg, who works for Aeras, a not-for-profit organisation backed by billionaire Microsoft founder Bill Gates, offered a graphic example of difficult to stop transmission when she spoke of her experience outside Durban’s main bus station.

Hundreds of people with the disease arrive there on early morning buses, before queuing at a nearby clinic for drugs. “They don’t want to be treated locally because they could lose their jobs, or their homes, but TB spreads in close quarters,” she said.

The involvement of people such as Gates has helped to spur investment, says the UK’s parliamentary office for science and technology, noting that there have been no new TB drugs for more than 50 years.

Today, 10 drugs, as distinct from vaccines, are in clinical trials. One of which, Bedaquiline, has already been cleared for use on patients who are suffering from drugs-resistant TB.

The number of drugs-resistant cases found in the UK has risen by half in the past decade. Treatment is more expensive and lasts considerably longer, while the drugs used “are unpleasant with significant side effects”, said Prof McHugh.

Each such case can cost up to £70,000 each – a manageable bill for the National Health Service. However, it is a cost that is entirely beyond the reach of health services in eastern and southern Europe, let alone those elsewhere.

Aids or HIV patients are particularly at risk and make up almost one in seven of all TB cases worldwide. They are 21 to 34 times more likely to develop infection from the mycobacterium tuberculosis bacterium.

Source:
Irish Times

The dangers of the antivaccine movement

Thursday, October 18th, 2012 (last updated)

Paul Offit

Childhood inoculations protect us against deadly infectious diseases like measles, whooping cough and polio. But they are also the source of near constant conflict. In recent years, some parents, influenced by fringe activists who believe vaccinations cause autism, brain damage and other ailments, have begun to refuse them for their children. Dr. Paul Offit, chief of the Division of Infectious Diseases and the director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, has seen the consequences: preventable childhood deaths, community outbreaks of outdated diseases and misinformed, angry parents. In a conversation with TIME and in his recent book, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, Offit describes the origins of our squeamishness with inoculation and why we should fight against it.

I think people will be surprised to learn that antivaccine sentiments go back for centuries.

That was surprising for me too. We’ve been through this before but apparently are failing to learn from history. The fear of vaccines began with the first one, which was for smallpox in the late 1700s. Within a few years, there was a [belief] among people that smallpox could actually turn people into cows. There was a famous James Gilray cartoon [of vaccinated people sprouting cow heads in] 1804, which I always interpreted as people just being concerned about the source or purity of the vaccine. But they weren’t: they were concerned that they or their children would actually turn into cows.

Vaccine refusal also spans non-Western cultures. In Nigeria, some people believe the polio vaccine causes AIDS. Why are vaccines so universally scary?

At the heart of it, vaccination is an aggressive act. You pin the child down, you inject them with a biological agent. And for many, its unclear how the biological agent works. So I think it appeals to people’s fears. Also, vaccines are given to most children but are designed to prevent only specific infections. They aren’t designed to prevent everything that happens in the first few years of life, so there are definitely going to be temporal associations that aren’t necessarily causal associations.

But we do ask a lot of our citizens. We ask them to get 14 vaccinations in the first few years of life and two more in adolescence. That’s a lot of immunizations. If you look at immunization rates in the United States, they are pretty good: in the high 80% or low 90% range. What’s changed is that now some communities are making the choice not to vaccinate — in Southern California, Ashland, Ore., or on Vashon Island, off the coast of Washington State. You have a lot of people in daycare centers or schools who are making the same choice, so there are communities where [infectious disease] outbreaks are starting to occur. We saw that with the whooping-cough epidemic in California this past year. It was the largest in more than 40 years.

Because vaccination is required, it’s one of these places where medicine and government intersect. How much of the reaction to vaccines is government distrust, and how much is medical distrust?

When you combine the nature of the act, which is violent, and then you add to that the fact that its compulsory, that’s what upsets people. The compulsory-vaccination acts in the 1850s and 1860s in England really helped solidify the first antivaccination activity. In fact, the origin of the term conscientious objector comes from refusing vaccine — not from war. When you could conscientiously object to vaccination in England in the 1890s, that’s when it became the epicenter of smallpox in the United Kingdom.

Since your book went to press, Andrew Wakefield — who published a study linking the measles mumps rubella (MMR) vaccine to autism in 1998 — has not only been disgraced for bad science; he was also convicted of fraud and of accepting a large sum of money from a personal-injury firm. Were you surprised?

Well, it’s very disappointing. There’s a certain amount of trust between scientists and journal editors and reviewers that Dr. Wakefield violated. But I think we’re winning for the wrong reasons: his fall from grace, the fact that he was fraudulent, seems to have damaged his hypothesis more than the fact that he was just simply wrong.

Suppose he wasn’t fraudulent — it would have made his hypothesis, frankly, no less damaging. Thousands of children weren’t vaccinated, hundreds were hospitalized and four died. Four children died of measles because their parents were more scared of the vaccine than of the disease it prevented. That paper, you could argue, really caused hospitalizations and suffering and death.

Do you think skepticism about vaccines adds anything valuable to the conversation?

John Salamone, who had a child who suffered polio through a rare consequence of the oral polio vaccine, is a perfect example of a safety activist. He lobbied the American Academy of Pediatrics and the CDC to move from the live oral polio vaccine to the inactivated polio vaccine. He put a face to the children who suffered vaccine-associated paralytic polio every year, and that made a difference. But Salamone’s contentions were science-based. The new antivaccine arguments aren’t. Vaccines don’t cause autism or brain damage, so when Barbara Loe Fisher or J.B. Handley or Jenny McCarthy or Jim Carrey or Bill Maher argue for safer vaccines, you can’t make those vaccines any safer using their definition because vaccines aren’t unsafe using their definition. Vaccines don’t cause autism, so you can’t make them safer by making them not cause autism.

We’ve done studies that show that the MMR vaccine doesn’t cause autism and that thimerosal — the ethyl-mercury preservative in some vaccines — doesn’t cause autism. Antivaccine activists say that people have to listen to them as parents. Well, that’s why we’ve done these studies and spent tens of millions of dollars to do them: to answer the questions raised by parents. And so, once the question is answered, you could argue reasonably that the parent would say, ‘Thank you for paying attention to my question and spending all that money to answer it.’ But that’s not where they are coming from — they have a belief that is nonfalsifiable. It’s a belief system. There is no data that could ever convince them that they are incorrect.

So how can you persuade people to get vaccinations if they don’t believe the science?

In our hospital this past year, we made flu vaccination mandatory. Some people didn’t like that. But we had two children who came into our hospital, both of whom had cancer. They couldn’t be vaccinated because of their chemotherapy, caught influenza while in the hospital and died of that disease. Who is responsible? We think we are, so we took a tougher stance, because we don’t think it’s an inalienable right to transmit a potentially fatal infection to a group of vulnerable, hospitalized children. What I’ve concluded — and I end the book this way because I’ve come to believe it — is that there is this thing in us that compels us to instinctively help our neighbors. I think we have a societal instinct to protect the people around us

Source:
TIME

Should you get the HPV vaccine?

Tuesday, October 16th, 2012 (last updated)

Dr. Mike Evans and the Campaign to Control Cancer are very proud to launch a new video explaining the facts behind the HPV vaccination. “There is a lot of conflicting information out there, we want to present the facts in a simple way allowing people to make their own decision” Dr. Mike Evans

Source:
Dr. Mike Evans (www.myfavouritemedicine.com)

Amanda Peet joins the fight to champion vaccines

Monday, October 15th, 2012 (last updated)

Actor, Activist, and Mother Amanda Peet has joined the fight to champion vaccines. The Every Child By Two Vaccine Ambassador to the Shot@Life campaign speaks out about the importance of increasing access to vaccines in developing countries. Vaccines save lives. Millions of children could be spared from measles, pneumonia, diarrhea, polio and other preventable diseases if we could simply get them the vaccines they need. Many children in developing countries lack access to vaccines — often because they live in hard-to-reach communities. The good news is access to vaccines has grown significantly in the last decade. Vaccines currently help save 2.5 million children from preventable diseases every year. With your help, global vaccination programs implemented by our partners can stop the 1.5 million unnecessary deaths that still happen every year, and ensure that all children, no matter where they live, have a shot at a healthy life.

Source:
Shot@Life

Coeliac disease vaccine being trialled in New Zealand

Sunday, October 14th, 2012 (last updated)

A new vaccine that could be the world’s first ‘cure’ for coeliac disease is being trialled in New Zealand.

Clinical trials are under way in Christchurch to test the revolutionary jab that stops the body reacting to one of the main ingredients in bread.

Coeliac sufferers – about one in every 100 Kiwis – can’t eat anything that contains gluten, a protein found in wheat, barley and rye.

It’s even found in everyday products like pasta, biscuits, beer and sausages.

There is no treatment for coeliac disease and sufferers are at increased risk of osteoporosis, infertility and bowel cancer if they do not stick to a gluten-free diet.

But the experimental US drug, which has already gone through one clinical trial, could allow gluten-intolerant people to enjoy a normal diet.

Coeliac New Zealand backs the research which “gives hope” to people whose only alternative is eating on a strict gluten-free diet for life.

“It would change lives,” said development manager Sue Clay.

“We’re very much keeping our members in the loop. It’s a very credible, well-funded study that looks promising but I stress it is only early days and there is a long way to go yet.”

The NexVax2 trials are being conducted on behalf of private US biotechnology company ImmusanT [EDS: Crrct] by Christchurch Clinical Studies Trust.

Around 30 patients will take part in the randomised, double-blind, placebo-controlled Phase1b clinical trial.

Similar testing is also being done in Australia.

Christchurch coeliac sufferer Shelley Robinson, 31, welcomed the research but was unsure whether she would take the jab herself.

“In terms of cost, it would be a godsend to be able to buy bread for $3 instead of $8, to buy a packet of biscuits for $2 instead of $6.

“But you just get used to it. I’ve been diagnosed since age 18 so to be honest I don’t think I would take an injection. It’s a relatively healthy diet, lots of fresh vegies and fruit, good meats.

“I don’t miss takeout food like McDonald’s, which is what everyone asks me when they find out I’m coeliac.”

Laboratory tests show the vaccine helps the immune system eventually tolerate gluten.

It ‘reprogrammes’ the body’s immune system so that the gluten does not attack the stomach lining.

Over a course of vaccines under controlled medical conditions, the amount of protein introduced into the body is gradually increased.

If successful, it will restore coeliac patients’ immune tolerance to gluten, reduce inflammation in the nutrient-absorbing villi that lines the small intestine, return the intestine to a healthy state, and allow patients to eat a normal diet.

Patrick H. Griffin, chief medical officer of ImmusanT, said he hopes the New Zealand clinical programme will demonstrate that the jab “dramatically reduces” the body’s immune response to dietary gluten so patients can resume a normal diet and return to good health.

Source:
Otago Daily Times