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The Increasing Threat of Dengue Fever

Dengue FeverAccording to the World Health Organization, dengue fever is one of the ten major global health threats of 2019. The mosquito-borne illness results in flu-like symptoms that can kill up to 20 percent of those infected. Approximately 390 million cases of dengue fever are reported each year across 100 different countries, although, many cases go unreported. Cases of dengue fever have also increased 30 times in the last 50 years, meaning that today, 40 percent of the world’s population is at risk of contracting the disease.

Why the Increase?

While dengue fever used to be concentrated in countries with extreme tropical climates, such as India and Bangladesh, the disease is now prevalent in countries that have more temperate climates, such as Nepal. With higher than average temperatures, rainy seasons are lasting longer which creates the perfect environment for the Aedes mosquito, the carrier of the disease. Unfortunately, the geographic regions that the Aedes mosquito inhabits coincide with low and middle-income countries. Many of these countries do not have sufficient health care systems to cope with this major health issue. Therefore, the effects of dengue are even more severe.

Protection from Mosquitoes

The World Health Organization is leading efforts to reverse the increasing threat of dengue fever. One common tactic used is immunization. The first immunization for dengue fever was approved in 20 countries in 2015. However, follow-up data from 2017 showed that the vaccine was actually harmful to those who had never contracted the disease, putting people at a higher risk of more severe cases of dengue. Now, the vaccination is recommended as a measure for those who have already been affected.

In addition to immunization, people can inhibit the Aedes mosquito’s survival and procreation by properly disposing of human waste, and not leaving out any stagnate, uncovered containers of water, as mosquitoes thrive and lay eggs in both environments. It is also advised to use spray insecticide to repel bugs and invest in screened windows and sleeping nets for protection in homes.

Combatting the Threat

The World Health Organization is partnering with local organizations and governments in affected countries to ensure that the number of deaths caused by dengue fever will decrease by 50 percent in 2020. In order to reach this goal, however, additional funding and research are needed so that the scope of dengue fever is properly understood. Health care providers also need the training and resources to properly address the issue and detect the disease in its early stages as well. If dengue fever is diagnosed before the symptoms become too severe, mortality rates of the disease become much more optimistic.

 

– Madeline Lyons
Photo: Flickr

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UNDP Supports Universal Immunization Program in India

UNDP Supports Universal Immunization Program in IndiaWith high risks of communicable diseases like bacterial diarrhea, malaria, hepatitis A and E and typhoid, there’s a rising necessity for a proper immunization program in India. The United Nations Development Programme (UNDP) has partnered with the Indian government and Ministry of Health and Family Welfare to design and put into effect an Electronic Vaccine Intelligence Network (eVIN). This project, known as Improving Efficiency of Vaccination Systems in Multiple States, has already run since 2014 and is to run until 2021 to strengthen the evidence base for policy-making related to vaccine delivery, procurement and planning, and ensure equity in availability.

As the world’s largest immunization program, eVIN technology has already shown results in enabling real time information on cold chain temperatures and vaccine stocks and flows in all 371 implementing districts in India. It has managed to achieve over a 98 percent reporting rate from vaccine storage areas, with over 2 million transactions logged each month, and developed the skills of over 17,000 government staff in store keeping, data operating or cold chain handling in over 550 batches of training programs.

The eVIN is setup on a mobile application that easily allows cold chain handlers to log stock positions at the end of each routine immunization day, which is then relayed immediately onto a web interface for assessment by health officials. In India, this can come to play an important role as geography and communications can pose an issue, like in the small hill-state of Manipur, where vaccine vials are carried over extensive distances to session sites by auxiliary nurses and midwives. Instances of stock-outs have decreased by more than six times here, and eVIN has enabled staff to learn how to use a smartphone and other technology, improving quality of work and management in the process.

This immunization program in India has also significantly empowered women health workers, giving them the opportunity to work with technology after attending regional and district eVIN training sessions. This allows them to manage stocks and temperatures themselves, bridges the digital divide in rural parts of India and ensures transparency alongside accuracy. Over 50 percent of cold chain handlers are women, and many are from older age groups.

EVin has taken India out of the unproductive days of delayed decision making, shortages and expirations, and has created an efficient health system that allows for valuable state-wide geographic, stock-out or excess stock and temperature overviews on each district’s centers. It also allows for large savings by reducing vaccine wastage and allowing for timely and quality injections, as in Rewa, where around $70,000 was saved after six months of eVIN activation.

Though led by the UNDP and Ministry of Health and Family Welfare in India, the Universal Immunization Program is largely supported by GAVI, a global vaccine alliance established in 2000. With support from GAVI and the Indian government, the Universal Immunization Program in India has immunized at least 65 percent of India‘s children and expects to immunize 27 million more each oncoming year.

– Zar-Tashiya Khan

Photo: Flickr

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New Malaria Vaccine Trial Could Mean the Disease’s End

Malaria Vaccine Trial
Malaria is one of the deadliest diseases afflicting developing countries across the world. In 2015 alone, it took the lives of 429,000 people, with a majority being African children. The most developed malaria vaccine trial is currently scheduled to be used in parts of Africa beginning next year, where the disease is still rampant.

Miguel Prudêncio and his team at iMM Lisboa, a biomedical research nonprofit institution, have been researching solutions to end malaria in the area. They decided to approach malaria as scientist Edward Jenner approached smallpox, by using a less harmful version of it as a shield against deadlier versions. In a similar fashion to how Jenner used cowpox to fight smallpox, Prudêncio and fellow researchers at iMM Lisboa wanted to conduct a malaria vaccine trial using a rodent version of the malaria-causing parasite. iMM Lisboa is going to carry out the trial with the help of the Radbound University Medical Center, based in the Netherlands, and PATH in Seattle.

The new malaria vaccine trial will take place at Radbounumc in the Netherlands. The first half of the trial will involve three groups of six volunteers, with each team enduring a different number of bites from mosquitos exposed to the parasite. Each volunteer will be thoroughly examined after the process because of the risk that comes from exposure. This examination will continue until the researchers can decide that it is safe to begin the second half of their malaria vaccine trial. The goal is that “the modified rodent parasite will help induce a protective response in healthy human volunteers.”

This will be the first time that humans will be purposely introduced to the rodent version of the parasite. The volunteers’ reaction to the first part of this malaria vaccine trial will be a deciding factor as to the effectiveness of this approach. With luck, the second phase will prove that smallpox is not the only disease that can be fought off by genetically modified versions of itself.

The success of this malaria vaccine trial could mean saving the lives of hundreds of thousands of people in the future. Ultimately, the goal is to see malaria eradicated just like smallpox, but in upcoming years it will be a breakthrough if a vaccine is developed with a protective efficacy of at least 75 percent against malaria. Prudêncio and his fellow researchers are hoping to achieve the elimination of malaria once their vaccine trial is complete.

– Mackenzie Fielder

Photo: Flickr

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New Ebola Vaccine Heads to the Congo

Ebola Vaccine
On Monday, May 29 the government of the Democratic Republic of the Congo approved the use of a new Ebola vaccine to address the current outbreak in the northeastern region of the country. According to Reuters, a Medecins Sans Frontieres (Doctors Without Borders) team arrived the same day to validate the protocol with technical teams. Since the beginning of the outbreak in April, the Congo has seen around 19 cases of the Ebola virus, including suspected and probable cases. There have been four deaths reported since the beginning of the outbreak.

The vaccine, rVSV-ZEBOV, has been in development since the 1990s. NPR notes that in the 2000s the Ebola vaccine was not produced due to a lack of funding. It was first tested in Guinea in 2015 in collaboration with the World Health Organization (WHO), Guinea’s Ministry of Health, Medecins Sans Frontieres and the Norwegian Institute of Public Health. In the trial, the vaccine completely protected all 5,837 people it was administered to, with some participants feeling side effects of the vaccine. According to the WHO, “no Ebola cases were recorded 10 or more days after vaccination.” The efficacy of the Ebola vaccine is approximately 70 to 100 percent, although this will likely decrease as more people are vaccinated.

Despite the trial conducted by WHO, the vaccine has not yet been approved by the WHO or the Federal Drug Administration. According to NPR, this approval will likely happen in 2018. Development of the vaccine was largely made possible by funding from the WHO and the Global Alliance for Vaccines and Immunization (GAVI). GAVI provided $5 million in funding to allow for the production of the vaccine by the pharmaceutical company Merck. There are currently 300,000 doses available. Merck will submit the Ebola vaccine for approval by the WHO by the end of 2017.

The efficacy of the Ebola vaccine is so high that it will likely be effective at halting the outbreak in the Congo, thanks to the combined efforts of multiple parties like GAVI and the WHO. The development of rVSV-ZEBOV is a much-needed game-changer in the continued battle against the Ebola virus.

– Anika Lanser

Photo: Flickr

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GAVI Launches Cholera Vaccine Campaign in Somalia

Somalia
One of the world’s leading organizations in the fight for global health has just begun to carry out a nationwide campaign in Somalia to fight Cholera. Gavi, the Vaccine Alliance, issued a press release on March 15 announcing its comprehensive strategy to stop the spread of cholera among Somali citizens. This Gavi cholera vaccine campaign seeks to save potentially thousands of lives in the drought-stricken African country.

According to the Centers for Disease Control, the southern half of the continent (where Somalia resides) is home to the bulk of cholera cases reported worldwide, and those cases have a higher likelihood of causing death than in other regions. This is primarily due to the lack of access to safe, clean water and sanitation as the disease-causing bacteria, Vibrio cholera, thrives in public water sources and is spread through the waste products of those infected.

The situation in Somalia has been worsened by an ongoing harsh drought, which has forced people to use contaminated water and has hastened the spread of the disease.

Notorious for its contagiousness, cholera infected over 170,000 people globally in 2015. Year to date, more than 10,500 cases of cholera have been reported across 12 regions of Somalia, resulting in nearly 270 fatalities. The spread of the epidemic has been swift, with 400 new cases appearing in a single day in early March.

The Gavi cholera vaccine campaign plans to reduce these alarming numbers by delivering 953,000 doses of oral vaccine to a population of more than 450,000 people at risk of being infected. Administration of the vaccines will be completed by the Somali government, focusing on the regions of Somalia with the highest concentration of cases: Banadir, Beledweyne, and Kismayo. The doses will be administered over two waves, the first taking place from March 15-19, and the second from April 18-22.

The campaign marks an alliance between the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO) and Gavi, who has provided the vaccines themselves as well as an additional $550,000 to support the program.

“Cholera is a major health issue in Somalia. The current drought has worsened the situation for many. Therefore we’re very glad to have the support of Gavi to implement the first oral cholera vaccine campaign in Somalia,” said Dr. Ghulam Popal, Somalia’s WHO representative.

Recognizing that cholera is not bound by political borders, Gavi is also launching a simultaneous vaccine campaign of 475,000 doses in South Sudan. This latest campaign is another step in realizing Gavi’s continuous mission to save lives and protect the health of all people in lower-income countries.

– Dan Krajewski

Photo: Flickr

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Saving Lives: A New Rotavirus Vaccine


An Indian company has created a new rotavirus vaccine that could save more than 500 children a day. Rotavirus, a diarrheal disease and the leading cause of death for children under five, kills 200,000 children each year, especially the Middle East and Africa.

Rotavirus causes fever, vomiting and diarrhea. A more serious potential symptom is dehydration. This contagious virus is spread through the fecal matter, and basic handwashing helps prevent infection.

Doctors Without Borders tested the new vaccine in Niger, and it had an effectiveness rate of about 66 percent. The vaccine is in the process of becoming approved by the World Health Organization (WHO). The vaccine, currently in use in India, can be used worldwide once approved. The WHO recommended in 2009 that all nations around the world have a vaccination program for rotavirus.

Rotavirus affects both children and adults in developed and developing countries. However, there are more strains of the rotavirus in developing countries. This makes it more difficult for children in developing countries to build immunity to the virus.

Created in 2006, the two vaccines most commonly used in the U.S. for rotavirus are Rotrix and Roteq. Rotrix is given to children at two and four months of age, while Roteq is used for children at two, four and six months. Medical professionals strongly recommend that children get the vaccination by the time they are eight months old.

The new vaccine, more cost-effective than current Rotavirus vaccines on the market, doesn’t require refrigeration for months. These two benefits make the vaccine especially effective in villages in developing countries, where access to electricity or refrigeration may be unavailable.

The new rotavirus vaccine will save many lives, especially once approved for widespread use.

– Jennifer Taggart

Photo: Flickr

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Sudan Launches New Meningitis Vaccine

Meningitis Vaccine
Meningitis is an infection, either viral or bacterial, that occurs around the brain and spinal cord. The bacterial form of this disease can have very severe consequences. According to PATH, 10 percent of victims die even with antibiotic treatment — 80 percent without any treatment — and survivors can still suffer from hearing loss or paralysis. Thankfully, a new meningitis vaccine offers hope despite these daunting statistics.

Sudan is one of 26 countries in Africa located in the “meningitis belt,” an area with a total population of about 450 million that has been deeply affected by meningitis over the past century. Epidemics arose about once every eight to 12 years according to PATH, and in 1996 twenty-five thousand people were killed in the largest meningitis epidemic.

Addressing meningitis in Africa is difficult because although meningitis A is one of the main causes of epidemics in Africa, most industrialized countries have meningitis C posing the largest problem. As a result, vaccine manufacturers focus on designing vaccines for industrialized countries to net more profit, and unfortunately, African countries then fail to receive the types of vaccines they need to combat meningitis A.

MVP to the Rescue

The creation of the Meningitis Vaccine Project (MVP) via a collaboration between the WHO and PATH in 2001 did much to help the situation. MVP was able to create a meningitis A vaccine, trademarked as MenAfriVac, that could also be cheaply administered for less than 50 cents for one dose.

MVP then introduced the vaccine in mass vaccination campaigns, and as a result 235 million people gained immunity. Amazingly, only 80 cases of meningitis A were recorded in 2015 — a huge improvement compared to the 250,000 reported cases from the 1996 epidemic.

Continuing the Success

So why then is Sudan incorporating the vaccine into its routine immunization program important if so much progress has been made in reducing meningitis outbreaks? Despite the success of the current round of immunizations, if the vaccines are not continually administered in the future, epidemics could begin again in as early as fifteen years.

The fact that the meningitis A vaccine is now part of Sudan’s routine immunization program means that at birth children will automatically receive the vaccine. As long as this program remains in effect, Sudan will likely not have to worry about meningitis. This year, 720,000 Sudanese children less than one year of age are expected to receive the vaccine.

Additionally, another vaccination campaign targeting children between one and five years old will go into effect this September. These children might have missed out on the Sudanese vaccination campaign that took place in 2012 and 2013, so the additional vaccinations provide another precaution against an outbreak.

Other countries should follow Sudan in adopting the meningitis vaccine into routine immunization programs. That way, these countries will be able to suppress meningitis on their own even without vaccination campaigns, and help hundreds to combat the deadly infection.

– Edmond Kim

Photo: Flickr

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World’s First Vaccine for Dengue Fever

Health_vaccineOver the past several decades, the global health community has taken on the challenge of eradicating diseases such as polio, tuberculosis and malaria.

Dengue fever (pronounced den’gee), a mosquito-borne viral infection, is another agenda item, which the World Health Organization (WHO) notes “has rapidly spread in all regions” putting about half of the world’s population at risk.

Similarly, the Center for Disease Control and Prevention (CDC) calls dengue fever a “leading cause of illness and death in the tropics and subtropics.”

The WHO estimates that nearly 400 million people are infected with dengue fever each year. Close to 500,000 individuals who have developed severe dengue fever or dengue hemorrhagic fever will require hospitalization and about “2.5 percent of those affected die.”

Symptoms of severe dengue fever include sharp abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, restlessness and blood in vomit. The WHO highlights that the first 24-48 hours after initial symptoms begin can be lethal without proper medical attention and care.

Currently, there is no cure for dengue fever. However, the WHO has now approved a vaccination called Dengvaxia, which took 20 years to be developed at a cost of $1.8 billion.

Dengvaxia, developed by Sanofi Pasteur is being released in the Philippines this month in the first ever public immunization program for the virus. The Philippines has had the highest rates of dengue fever in the pacific region with over 200,000 cases reported in 2013.

A report in the Seattle Post-Intelligencer notes that the vaccination “prevents dengue hospitalizations by 80 percent and severe dengue cases by 93 percent.” The program was launched in Manila’s Marikina city to hundreds of public school children and is being administered in three courses, separated by six months.

The Philippines Health Secretary Janette Garin called the program a “historic milestone”. Garin continued, “We are the first country to introduce, adopt and implement the first-ever dengue vaccine through (the) public health system and under a public school setting.”

– Michael A. Clark

Photo: Flickr

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6 Facts You Didn’t Know about the Zika Mosquito

Zika Mosquito
In Brazil, Aedes aegypti mosquitoes are rapidly transmitting the Zika virus. Save for common protection against the Zika mosquito, such as chemical repellent or mosquito nets, there is no vaccination or specific treatment to stop the disease from spreading.

Symptoms are not fatal but can cause fevers, rashes and muscle pain. The most damaging aspect of the virus is its link to birth defects among the newborn babies of those who suffered from the disease.

So what do we know about this mosquito that has been causing widespread fear? Here are 6 facts you might not know about the Zika mosquito.

  1. They thrive in urban areas.
    Unlike many mosquitoes that tend to dwell in tropical jungles to breed in natural water sources, the mosquitoes that are spreading the Zika virus love living in built-up areas. There, they find areas of stagnant water to lay eggs, such as gutters, potholes or flower pots that have collected rainwater that has not evaporated. There is also a concentration of humans to feed on in cities.
  2. Only the females bite.
    The females feed on the protein in blood in order to produce eggs. They feed almost exclusively on humans, and if they to pick up a disease from one person, they are likely to pass it on to their next victim.
  3. Mosquitos detect your location by smelling your breath.
    The bugs have receptors on their antennae that detect the carbon dioxide that you exhale. They can also smell your sweat – the more you sweat, the more they bite.
  4. Most mosquitoes like tropical climates.
    The Aedes aegypti resides in tropical and subtropical climates, which is why many worry that this species of mosquito could spread Zika across South America. According to the WHO, the Zika virus is known to circulate in Africa, the Americas, Asia and the Pacific.
  5. The Aedes aegypti has a cousin that could bring Zika to Europe.
    Its cousin, Aedes albopictus, otherwise known as the Asian Tiger mosquito, likes cooler environments. It has been linked to chikungunya virus outbreaks, a disease with similar symptoms to Zika, in Italy and France. Therefore, there is the possibility this species could contribute to the spread of Zika in Europe.
  6. Mosquitoes feed in the day and the night.
    Mosquitos feed in the day and the night. This means mosquito nets are not a very effective prevention method. Insect repellents, such as DEET, have worked in the past, but they are chemical-ridden and toxic for the human skin.

For the most part, symptoms of the Zika virus are relatively mild. Until another preventative measure or vaccine is available, the best way to avoid being bitten by Zika-carrying mosquitoes is to use common protection against mosquitoes, such as repellent, sprays and mosquito nets.

The WHO recommends that those suffering from the disease should rest, drink fluids and use common medicines to treat pain. Some strategies for controlling the spread of the disease are enhancing the surveillance of the virus, providing training on clinical management and strengthening the capacity of laboratories to detect the virus.

– Michelle Simon

Sources: WHO, CDC, Megacatch, BBC
Photo: Flickr

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Tropical Countries to Administer New Dengue Fever Vaccine

Dengue FeverCountries in tropical climates, including Mexico and the Philippines, have started to approve the usage of a vaccine to prevent dengue fever.

Dengue fever is the most rapidly spreading mosquito-borne virus in the world today. The virus is currently present in 150 countries and over 390 million people are infected per year, with many cases being under-reported.

According to the World Health Organization, half of the world’s population is in danger of developing dengue fever. Patients inflicted with the disease are typically advised to rest, drink plenty of fluids and consume paracetamol, a widely used over-the-counter medicine to reduce fever.

Several tropical countries recently announced their plans to help prevent and reduce the number of dengue fever cases, with the world’s first dengue vaccine. Dengvaxia, a live attenuated version of the virus, will combat all four strains of the disease. The drug is scheduled to go on the market this month.

In the Philippines, health officials have started filing orders for Dengvaxia, aiming to bring the vaccine into its national market as soon as possible. Janette L. Garin, the Secretary of the Philippines Department of Health told GMA News that her country “is the only [location] where three phases of the clinical trial were done… it’s a reflection of how good our researchers are.”

Garin stated that officials will initially administer vaccines to students from eight to 10 years old, since they are the most likely candidates to fall victim to dengue fever. The vaccine is also less effective and more unpredictable in older patients.

“We don’t recommend it to [elder individuals] because there would be other interactions… That is why we want to play on the safe side,” Garin explained.

– John Gilmore

Sources: GMA Network, WHO, Impatient Optimists, News Medical
Photo: Scientific American

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