Vaccines and Global Health: The Week in Review 24 September 2016

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

pdf version A pdf of the current issue is available here: vaccines-and-global-health_the-week-in-review_24-september-2016

blog edition: comprised of the approx. 35+ entries posted below.

Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
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Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

Support this knowledge-sharing service: Your financial support helps us cover our costs and to address a current shortfall in our annual operating budget. Click here to donate and thank you in advance for your contribution.

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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

Vaccines and Global Health: The Week in Review 17 September 2016

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

pdf version A pdf of the current issue is available here: vaccines-and-global-health_the-week-in-review_17-september-2016

blog edition: comprised of the approx. 35+ entries posted below.

Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
.
Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

.
David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

Vaccines and Global Health : The Week in Review 10 September 2016

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

pdf version A pdf of the current issue is available here: vaccines-and-global-health_the-week-in-review_10-september-2016

blog edition: comprised of the approx. 35+ entries posted below.

Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
.
Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

.
David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

Zika virus [to 10 September 2016]

Zika virus [to 10 September 2016]
Public Health Emergency of International Concern (PHEIC)
http://www.who.int/emergencies/zika-virus/en/

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Zika situation report – 8 September 2016
Full report: http://www.who.int/emergencies/zika-virus/situation-report/8-september-2016/en/

Key Updates
:: Countries and territories reporting mosquito-borne Zika virus infections for the first time in the past week:
…None
…Malaysia has reported one locally acquired mosquito-borne Zika infection in the past week. Prior to this, the only evidence of Zika in Malaysia had been a scientific publication that had reported a case of Zika infection identified in Germany in an individual with travel history to Malaysia.

:: Countries and territories reporting microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection for the first time in the past week:
…None

:: Countries and territories reporting Guillain-Barré syndrome (GBS) cases associated with Zika virus infection for the first time in the past week:
…None
The Netherlands reported evidence of person-to-person transmission of Zika virus (probably via a sexual route) for the first time in the past week.

:: Operational updates from the WHO Regional Office for the Americas:
…WHO convened a workshop in Barbados on clinical management of neurological complications.
…A technical mission to Brazil by WHO/PAHO for laboratory assessment and strengthening of Zika diagnostic capacity of State laboratories was completed in August.
…WHO facilitated two meetings in Panama for updating the strategic plan for vector surveillance and control.
…WHO/PAHO carried out missions to Colombia and El Salvador to organize and help launch “Mosquito Awareness Week”.
…In Haiti, WHO and the Ministry of Public Health and Population’s Division of Epidemiology, Laboratory and Research (DELR) held three train-the-trainer workshops on epidemiological surveillance of Zika and its complications in August.

:: The results from the sequencing analysis of Zika virus cases in Singapore indicate that the virus belongs to the Asian lineage and likely evolved from the strain that was previously circulating in Southeast Asia. The recent cases in Singapore do not appear to be the result of imported virus from South America.
:: The 2016 Summer Paralympic Games opened in Rio de Janeiro, Brazil, on 7 September. WHO continues to provide technical support to the Ministry of Health to ensure the 2016 Summer Paralympic Games are as safe as possible for all athletes, volunteers, visitors and residents. There is a low, but not zero, risk of Zika transmission in this setting. All persons should continue to follow guidance on avoiding Zika infection.
:: The fourth meeting of the Emergency Committee was held on 1 September 2016. Having considered the evidence presented, the Committee agreed that due to continuing geographic expansion and considerable gaps in understanding of the virus and its consequences, Zika virus infection and its associated congenital and other neurological disorders continues to be a Public Health Emergency of International Concern.
:: Based on a systematic review of the literature, WHO has concluded that Zika virus infection during pregnancy is a cause of congenital brain abnormalities, including microcephaly, and that Zika virus is a trigger of GBS.
:: Revised guidance on the prevention of sexual transmission was published on 6 September 2016.

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Zika Open [to 10 September 2016]
[Bulletin of the World Health Organization]
:: All papers available here
No new papers identified.

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WHO
Updated guidance on prevention of sexual transmission of Zika virus
6 September 2016 – The interim guidance on prevention of sexual transmission of Zika virus has been updated with new evidence and advice. The primary transmission route of Zika virus is via the Aedes mosquito, however mounting evidence shows that sexual transmission of Zika virus is possible and more common than previously assumed. This is of concern due to an association between the Zika virus and adverse pregnancy outcomes.
Read the guidance

Information for travellers
Updated 6 September 2016

Information for health authorities
Updated 6 September 2016

Fact sheet: Zika virus
Updated 6 September 2016

Q&A: Zika virus
Updated 6 September 2016

POLIO [to 10 September 2016]

POLIO [to 10 September 2016]
Public Health Emergency of International Concern (PHEIC)

Please see the extended excerpts from the IMB’s 13th Report below in the “Reports…” section.

Polio this week as of 7 September 2016
: In Nigeria, one new wild poliovirus type 1 (WPV1) case has been reported, from Borno state, following confirmation of two cases in August. Regional outbreak response across north-eastern Nigeria and the Lake Chad sub-region is continuing within the broader humanitarian emergency context. Detection of new cases at this point is not unexpected or unusual, particularly as surveillance is being strengthened (including by conducting retrospective acute flaccid paralysis case searches).

:: The polio outbreak has been declared a national public health emergency by the Government of Nigeria and a regional public health emergency by the Governments of the Lake Chad sub-region, to ensure all-of-government, all-of-society approaches to the outbreak response. See ‘Nigeria’ section below for more.

: The Global Polio Eradication Initiative has launched an emergency appeal to respond to the polio outbreak across the region. Against the planned outbreak response budget of US$116 million, a critical funding gap of US$33 million must be urgently filled. More.
[excerpt from appeal]
KEY FACTS
:: Wild poliovirus type 1 outbreak in Nigeria: 2 cases
:: High risk of poliovirus spread in the Lake Chad area
:: Ongoing Polio Outbreak Response in Northern Nigeria and Lake Chad area implemented as part of the broader humanitarian response effort
:: WHO has declared Northern Nigeria a Grade 3 Humanitarian Emergency
:: UNICEF has activated its Level 3 Corporate Emergency Procedure for North – East Nigeria
:: Budget requirements: US116 million
:: Funding gap: US$33 million

:: Selected Country Updates [excerpts]
Pakistan
:: One new case of wild poliovirus type 1 (WPV1) was reported in the past week, from South Waziristan, Federally Administered Tribal Areas (FATA), with onset of paralysis on 27 July. It is the most recent case in the country, bringing the total number of WPV1 cases for 2016 to 14.

Nigeria
:: One new case of wild poliovirus type 1 (WPV1) was reported in the past week, from Monguno Local Government Area (LGA), Borno state, with onset of paralysis on 6 August. It is the most recent case in country and brings the total number of WPV1 cases for 2016 to three.
:: Detection of new cases at this point is not unexpected or unusual, particularly as surveillance is being strengthened (including by conducting retrospective acute flaccid paralysis case searches).
:: A full case investigation of the third case is ongoing, however the child had onset of paralysis on 6 August and was detected in an accessible internally-displaced persons camp in Monguno LGA. The child’s family had originally arrived from Marte LGA (as had the family of the case from Jere LGA reported in August).
:: An emergency regional outbreak response is continuing under the guidance of the Emergency Operations Committee, led by the Government of Nigeria and with support from WHO and GPEI partners, including with inactivated polio vaccine (IPV). The outbreak response is being coordinated with neighbouring countries and in the broader humanitarian emergency response context affecting the region. Similar approaches to outbreak response were successfully implemented in previous years in the Middle East and the Horn of Africa.

Yellow Fever [to 10 September 2016]

Yellow Fever [to 10 September 2016]
http://www.who.int/emergencies/yellow-fever/en/

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Yellow Fever – Situation Report – 9 September 2016
Full Report:
http://apps.who.int/iris/bitstream/10665/250077/1/yellowfeversitrep9Sep16-eng.pdf?ua=1

Key updates
Angola epidemiological update (as of 1 September):
:: There have been no new confirmed cases since 23 June.
:: Phase I of the preventive vaccination campaign in Angola was completed and, as of 1 September, 2,807,628 people had been vaccinated. Phase II of the campaign is being prepared and will target more than three million people in 12 provinces.

Democratic Republic of The Congo (DRC) epidemiological update (as of 8 September):
:: There have been no confirmed cases related to the current outbreak since 12 July.
:: The first notified case reported in Bominenge Health Zone in Sud Ubangi province is still under investigation. A second case was notified from Budjala Health Zone, a different zone within Sud Ubangui province, in the week to 8 September and is being investigated.
:: The pre-emptive vaccination campaign in DRC has concluded. The preliminary results indicate that the administrative immunization coverage reached 103.1% in Kinshasa, 101% in Kasai Central, 98.3% in Kongo Central, 101% in Kasai, 101% in Kwango, and 100.8% in Lualaba. Independent monitoring assessed that vaccination coverage is 98.2% in Kinshasa.

Uganda declared the end of their yellow fever outbreak on 6 September 2016. This outbreak was not linked to the outbreak in Angola and DRC.

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Updated strategy for the Elimination of Yellow fever Epidemics (EYE)
Partners’ meeting
Date: 12 September 2016
Place: Geneva, Switzerland
Purpose
Bring together partners involved in development and implementation of the updated strategy for the Elimination of Yellow fever Epidemics.
Objectives
:: Update partners on objectives and strategic axis of the new strategy.
:: Engage with partners on development and implementation.
:: Define immediate and long-term steps to support the strategy.
Preliminary agenda pdf, 380kb

MERS-CoV [to 10 September 2016]

MERS-CoV [to 10 September 2016]
http://www.who.int/emergencies/mers-cov/en/

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WHO statement on the tenth meeting of the IHR Emergency Committee regarding MERS
3 September 2015
[Editor’s text bolding]
The tenth meeting of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (2005) (IHR 2005) regarding the Middle East respiratory syndrome 1 was held by teleconference on 2 September 2015, from 1300 to 1620 Central European Summer Time (UTC +2). During the meeting the WHO Secretariat provided an update to the Committee on epidemiological and scientific developments, including recent cases and transmission patterns in the Kingdom of Saudi Arabia (KSA), Jordan and the United Arab Emirates. The Secretariat also provided current risk assessments with regard to these events, and information on control and prevention measures…

Members of the EC agreed that the situation still does not constitute a Public Health Emergency of International Concern (PHEIC). At the same time, they emphasized that they have a heightened sense of concern about the overall MERS situation. Although it has been three years since the emergence of MERS in humans was recognized, the global community remains within the grip of this emerging infectious disease. There is continued virus transmission from camels to humans in some countries and continued instances of human-to-human transmission in health care settings. Nosocomial outbreaks have most often been associated with exposure to persons with unrecognized MERS infection. The major factors contributing to the ongoing situation are insufficient awareness about the urgent dangers posed by this virus, insufficient engagement by all relevant sectors, and insufficient implementation of scalable infection control measures, especially in health care settings such as emergency departments. The Committee recognizes that tremendous efforts have been made and some progress has been achieved in these areas. However, the Committee also notes that the progress is not yet sufficient to control this threat and until this is achieved, individual countries and the global community will remain at significant risk for further outbreaks.

Moreover, the current outbreak is occurring close to the start of the Hajj and many pilgrims will return to countries with weak surveillance and health systems. The recent outbreak in the Republic of Korea demonstrated that when the MERS virus appears in a new setting, there is great potential for widespread transmission and severe disruption to the health system and to society….