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Source: http://www.cidrap.umn.edu/news-persp...an-oct-18-2016
News Scan for Oct 18, 2016
More Saudi MERS cases; One-dose cholera vaccination
Filed Under:
MERS-CoV; Cholera
MERS infects 2 more in Saudi Arabia
Saudi Arabia's Ministry of Health (MOH) today announced two new MERS-CoV cases, plus the death of a recently reported patient.
One of the cases involves a 72-year-old Saudi man from Riyadh who had primary exposure to MERS-CoV (Middle East respiratory syndrome coronavirus), meaning he didn't contract his infection from another sick person. The man is hospitalized in critical condition. The second patient is a 47-year-old man who isn't a Saudi citizen from Buraydah in central Saudi Arabia. An investigation revealed the man?listed in stable condition?got sick after direct contact with camels.
The death occurred in a 73-year-old Saudi man from Hofuf whose illness was announced on Oct 15. The MOH said the man had underlying health problems.
Today's new developments push Saudi Arabia's case total to 1,461 and the number of deaths from the disease to 612.
Oct 18 Saudi MOH statement
Promising results noted in single-dose cholera vaccine field trial
One dose of cholera vaccine, rather than the recommended two doses given at least 2 weeks apart, helps prevent infection and may offer some degree of herd protection, according to a case-cohort study conducted during a 2015 outbreak in South Sudan. Researchers based at Johns Hopkins Bloomberg School of Public Health published their findings yesterday in the November issue of The Lancet Global Health.
The strategy could help stretch limited supplies of vaccine and streamline immunization campaigns during crisis situations.
In the face of an outbreak that began in May 2015 in a refugee camp in Juba, South Sudan's capital and largest city, the country's health ministry, Doctors without Borders, and other partners for the first time deployed a single-dose regimen in a field setting and at the same time launched a trial to measure vaccine effectiveness. From Aug 9 to Sep 29 they enrolled 87 people with suspected cholera infections and an 898-person cohort from throughout Juba.
Health officials had only 250,000 doses of Shanchol oral cholera vaccine (Shantha Biotechnics, Hyderabad, India) from the global vaccine stockpile to cover the Juba population, estimated to range from 500,000 to 1 million, so they agreed on a plan to maximize the supply to immunize people in high-risk parts of the city. According to the study, 165,000 people were vaccinated during two campaigns, one in late July and the other in the middle of August.
Of the 87 people with suspected cholera, 34 were confirmed as positive for the disease and 1 had indeterminate results. Of the 858 cohort members who were seen for a follow-up visit, none developed cholera. Researchers calculated the adjusted vaccine effectiveness at 87.3% (95% confidence interval, 70.2% to 100%), much higher than earlier estimates for the single-dose regimen, which ranged from 33% to 67%.
The researchers said vaccine effectiveness could be higher due to indirect effects or because they showed effectiveness over a shorter period than other studies. The group said the findings support the use of a single-dose strategy to help control outbreaks in similar settings.
In a related commentary in the same issue, Louise Ivers, MD, senior health and policy advisor at Partners in Health and associate professor of medicine at Harvard Medical School in Boston, wrote that the study adds more evidence about the role oral cholera vaccines can play in controlling the disease. She added that a study that measures herd protection is helpful for gauging the public health usefulness of the tool.
She also lauded the group's work in an evolving outbreak situation. "More studies like this are needed for us to understand the right approaches for use of cholera vaccine." Ivers echoed the authors' caveat that results for the single-dose vaccine strategy may be different for cholera-naive populations than for groups who have already been exposed to Vibrio cholerae, the bacterium that causes the disease.
Also, questions remain about which other public health activities should be combined with the vaccine to control outbreaks, Ivers wrote.
Nov Lancet Glob Health abstract
Nov Lancet Glob Health commentary
News Scan for Oct 18, 2016
More Saudi MERS cases; One-dose cholera vaccination
Filed Under:
MERS-CoV; Cholera
MERS infects 2 more in Saudi Arabia
Saudi Arabia's Ministry of Health (MOH) today announced two new MERS-CoV cases, plus the death of a recently reported patient.
One of the cases involves a 72-year-old Saudi man from Riyadh who had primary exposure to MERS-CoV (Middle East respiratory syndrome coronavirus), meaning he didn't contract his infection from another sick person. The man is hospitalized in critical condition. The second patient is a 47-year-old man who isn't a Saudi citizen from Buraydah in central Saudi Arabia. An investigation revealed the man?listed in stable condition?got sick after direct contact with camels.
The death occurred in a 73-year-old Saudi man from Hofuf whose illness was announced on Oct 15. The MOH said the man had underlying health problems.
Today's new developments push Saudi Arabia's case total to 1,461 and the number of deaths from the disease to 612.
Oct 18 Saudi MOH statement
Promising results noted in single-dose cholera vaccine field trial
One dose of cholera vaccine, rather than the recommended two doses given at least 2 weeks apart, helps prevent infection and may offer some degree of herd protection, according to a case-cohort study conducted during a 2015 outbreak in South Sudan. Researchers based at Johns Hopkins Bloomberg School of Public Health published their findings yesterday in the November issue of The Lancet Global Health.
The strategy could help stretch limited supplies of vaccine and streamline immunization campaigns during crisis situations.
In the face of an outbreak that began in May 2015 in a refugee camp in Juba, South Sudan's capital and largest city, the country's health ministry, Doctors without Borders, and other partners for the first time deployed a single-dose regimen in a field setting and at the same time launched a trial to measure vaccine effectiveness. From Aug 9 to Sep 29 they enrolled 87 people with suspected cholera infections and an 898-person cohort from throughout Juba.
Health officials had only 250,000 doses of Shanchol oral cholera vaccine (Shantha Biotechnics, Hyderabad, India) from the global vaccine stockpile to cover the Juba population, estimated to range from 500,000 to 1 million, so they agreed on a plan to maximize the supply to immunize people in high-risk parts of the city. According to the study, 165,000 people were vaccinated during two campaigns, one in late July and the other in the middle of August.
Of the 87 people with suspected cholera, 34 were confirmed as positive for the disease and 1 had indeterminate results. Of the 858 cohort members who were seen for a follow-up visit, none developed cholera. Researchers calculated the adjusted vaccine effectiveness at 87.3% (95% confidence interval, 70.2% to 100%), much higher than earlier estimates for the single-dose regimen, which ranged from 33% to 67%.
The researchers said vaccine effectiveness could be higher due to indirect effects or because they showed effectiveness over a shorter period than other studies. The group said the findings support the use of a single-dose strategy to help control outbreaks in similar settings.
In a related commentary in the same issue, Louise Ivers, MD, senior health and policy advisor at Partners in Health and associate professor of medicine at Harvard Medical School in Boston, wrote that the study adds more evidence about the role oral cholera vaccines can play in controlling the disease. She added that a study that measures herd protection is helpful for gauging the public health usefulness of the tool.
She also lauded the group's work in an evolving outbreak situation. "More studies like this are needed for us to understand the right approaches for use of cholera vaccine." Ivers echoed the authors' caveat that results for the single-dose vaccine strategy may be different for cholera-naive populations than for groups who have already been exposed to Vibrio cholerae, the bacterium that causes the disease.
Also, questions remain about which other public health activities should be combined with the vaccine to control outbreaks, Ivers wrote.
Nov Lancet Glob Health abstract
Nov Lancet Glob Health commentary