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<TABLE id=apex_layout_271110100662109808 class=formlayout border=0 summary=""><TBODY><TR><TD noWrap align=right>Archive Number</TD><TD noWrap align=left>20101214.4441</TD></TR><TR><TD noWrap align=right>Published Date</TD><TD noWrap align=left>14-DEC-2010</TD></TR><TR><TD noWrap align=right>Subject</TD><TD noWrap align=left>PRO/EDR> Cholera - Haiti (28): update & Dominican Rep.</TD></TR></TBODY></TABLE>
CHOLERA - HAITI (28): UPDATE & DOMINICAN REPUBLIC****************************************** *******A ProMED-mail post<http://www.promedmail.org>ProMED-mail is a program of theInternational Society for Infectious Diseases<http://www.isid.org>
</PRE>Excerpt:
*****
[3] Potential vaccination program
Date: Fri 10 Dec 2010
Source: National Public Radio (NPR) [edited]
<http://www.npr.org/2010/12/10/131950133/doctors-urge-cholera-vaccine-for-haiti-neighbors>
Leading public health officials and researchers are calling for a
crash vaccination campaign against cholera in Haiti and neighboring
countries. A vaccine is needed, they say, to control what researchers
say is a more lethal strain of cholera circulating widely in Haiti and
starting to affect the Dominican Republic.
Until now, experts felt that there wasn't enough vaccine to be
effective and that a vaccination campaign would distract from efforts
to treat the thousands with the disease. But a consensus is emerging
around the idea that the vaccine is urgently needed.
One factor behind the shift: The Pan American Health Organization
(PAHO) has discovered far more vaccine is out there than previously
thought. Dr. John Andrus, deputy director of PAHO, tells National
Public Radio (NPR) that there may be more than one million doses in
manufacturers' storehouses. "That's new information to us and that
basically changes our thinking," Andrus says.
Both countries should be considered for a vaccination campaign, Andrus
says. But he wouldn't limit it to Hispaniola. "I see a real
opportunity to vaccinate vulnerable groups in countries that have yet
to see the outbreak but we know would be very vulnerable if cholera
was imported," Andrus says. "I worry about some of the poorer
countries of the Caribbean. I worry about Central America."
Another factor leading to the emerging call for vaccination are new
studies out this week showing the Haiti strain appears to be more
lethal than 1st thought. "Nearly half of the people who died, died
outside of the hospital, before they got to the hospital," says Dr.
Thomas Frieden, director of the Centers for Disease Control and
Prevention (CDC). "They die in as little as 2 hours after 1st becoming
ill with cholera."
The CDC says the death rate in Haiti is 12 times higher than it was in
the cholera epidemic that hit Peru in 1991. That epidemic spread to
many countries in the Western Hemisphere, though not to the Caribbean.
The death rate is going down in Haiti, Frieden says, but he warns that
there are discouraging signs from the new studies that the disease
will persist in Haiti for many years to come.
Meanwhile, Harvard researchers announced Thursday [9 Dec 2010] that
they have worked out the entire genetic code of the Haitian strain.
Their findings appear in the New England Journal of Medicine. They
also found that this strain of Vibrio cholera produces a toxin that's
genetically identical to the toxin produced by an especially lethal
strain of cholera that popped up in India 4 or 5 years ago. That
explains why the Haitian bug can kill so fast, says Dr. Matthew Waldor
of Brigham and Women's Hospital, who led the research.
The Haiti strain also lacks a string of genetic material in the same
place as the Indian strain. "That's a fingerprint," he says. "A very
strong fingerprint."
[Byline: Richard Knox]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The more virulent East Asia strain mentioned is the so-called Matlab
variant which has phenotypic characteristics of both the El Tor strain
as well as the Classical biotype and does appear to be more
pathogenic. The 2 established biotypes of _Vibrio cholerae_, classical
and El Tor, can be distinguished from one another by a number of
phenotypic properties including hemolysis of sheep red blood cells,
agglutination of chicken red blood cells, the Voges-Proskauer
reaction, as well as susceptibility to polymyxin B and to
biotype-specific viral bacteriophages. Hybrid biotypes, so-called
Matlab variants, are also described (1).
In addition to vaccination, it has been shown (2) that a simple
filtration system (a sari cloth folded 4 to 8 times) can remove at
least 2 logs of _V. cholerae_ bacilli and was shown to decrease by 48
percent the incidence of cholera as compared to control. The technique
is effective because the environmental cholera bacilli are associated
with water zooplankton which can be filtered by the technique.
1. Nair GB, Faruque SM, Bhuiyan NA, et al: New variants of _Vibrio
cholerae_ O1 biotype El Tor with attributes of the classical biotype
from hospitalized patients with acute diarrhea in Bangladesh. J Clin
Microbiol 2002; 40: 3296-9.
2. Colwell RR, Huq A, Sirajul Islam M, et al: Reduction of cholera in
Bangladeshi villages by simple filtration. Proc Natl Acad Sci
2003;100: 1051-1055.
- Mod.LL]
[...]
CHOLERA - HAITI (28): UPDATE & DOMINICAN REPUBLIC****************************************** *******A ProMED-mail post<http://www.promedmail.org>ProMED-mail is a program of theInternational Society for Infectious Diseases<http://www.isid.org>
</PRE>Excerpt:
*****
[3] Potential vaccination program
Date: Fri 10 Dec 2010
Source: National Public Radio (NPR) [edited]
<http://www.npr.org/2010/12/10/131950133/doctors-urge-cholera-vaccine-for-haiti-neighbors>
Leading public health officials and researchers are calling for a
crash vaccination campaign against cholera in Haiti and neighboring
countries. A vaccine is needed, they say, to control what researchers
say is a more lethal strain of cholera circulating widely in Haiti and
starting to affect the Dominican Republic.
Until now, experts felt that there wasn't enough vaccine to be
effective and that a vaccination campaign would distract from efforts
to treat the thousands with the disease. But a consensus is emerging
around the idea that the vaccine is urgently needed.
One factor behind the shift: The Pan American Health Organization
(PAHO) has discovered far more vaccine is out there than previously
thought. Dr. John Andrus, deputy director of PAHO, tells National
Public Radio (NPR) that there may be more than one million doses in
manufacturers' storehouses. "That's new information to us and that
basically changes our thinking," Andrus says.
Both countries should be considered for a vaccination campaign, Andrus
says. But he wouldn't limit it to Hispaniola. "I see a real
opportunity to vaccinate vulnerable groups in countries that have yet
to see the outbreak but we know would be very vulnerable if cholera
was imported," Andrus says. "I worry about some of the poorer
countries of the Caribbean. I worry about Central America."
Another factor leading to the emerging call for vaccination are new
studies out this week showing the Haiti strain appears to be more
lethal than 1st thought. "Nearly half of the people who died, died
outside of the hospital, before they got to the hospital," says Dr.
Thomas Frieden, director of the Centers for Disease Control and
Prevention (CDC). "They die in as little as 2 hours after 1st becoming
ill with cholera."
The CDC says the death rate in Haiti is 12 times higher than it was in
the cholera epidemic that hit Peru in 1991. That epidemic spread to
many countries in the Western Hemisphere, though not to the Caribbean.
The death rate is going down in Haiti, Frieden says, but he warns that
there are discouraging signs from the new studies that the disease
will persist in Haiti for many years to come.
Meanwhile, Harvard researchers announced Thursday [9 Dec 2010] that
they have worked out the entire genetic code of the Haitian strain.
Their findings appear in the New England Journal of Medicine. They
also found that this strain of Vibrio cholera produces a toxin that's
genetically identical to the toxin produced by an especially lethal
strain of cholera that popped up in India 4 or 5 years ago. That
explains why the Haitian bug can kill so fast, says Dr. Matthew Waldor
of Brigham and Women's Hospital, who led the research.
The Haiti strain also lacks a string of genetic material in the same
place as the Indian strain. "That's a fingerprint," he says. "A very
strong fingerprint."
[Byline: Richard Knox]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The more virulent East Asia strain mentioned is the so-called Matlab
variant which has phenotypic characteristics of both the El Tor strain
as well as the Classical biotype and does appear to be more
pathogenic. The 2 established biotypes of _Vibrio cholerae_, classical
and El Tor, can be distinguished from one another by a number of
phenotypic properties including hemolysis of sheep red blood cells,
agglutination of chicken red blood cells, the Voges-Proskauer
reaction, as well as susceptibility to polymyxin B and to
biotype-specific viral bacteriophages. Hybrid biotypes, so-called
Matlab variants, are also described (1).
In addition to vaccination, it has been shown (2) that a simple
filtration system (a sari cloth folded 4 to 8 times) can remove at
least 2 logs of _V. cholerae_ bacilli and was shown to decrease by 48
percent the incidence of cholera as compared to control. The technique
is effective because the environmental cholera bacilli are associated
with water zooplankton which can be filtered by the technique.
1. Nair GB, Faruque SM, Bhuiyan NA, et al: New variants of _Vibrio
cholerae_ O1 biotype El Tor with attributes of the classical biotype
from hospitalized patients with acute diarrhea in Bangladesh. J Clin
Microbiol 2002; 40: 3296-9.
2. Colwell RR, Huq A, Sirajul Islam M, et al: Reduction of cholera in
Bangladeshi villages by simple filtration. Proc Natl Acad Sci
2003;100: 1051-1055.
- Mod.LL]
[...]
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