Vaccines and Global Health: The Week in Review 29 Oct 2013

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 “29 June 2013″
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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy
a program of the
– Division of Medical Ethics, NYU Medical School
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– Children’s Hospital of Philadelphia Vaccine Education Center
Associate Faculty, Division of Medical Ethics, NYU Medical School

World Polio Day – 24 October 2013

World Polio Day – 24 October 2013
“Events worldwide mark World Polio Day, as efforts to eradicate the disease intensify”

Special World Polio Day event:
World Polio Day: Making History, a special Livestream (24 October, 22.30hrs GMT) event presented by Rotary and Northwestern University’s Center for Global Health with speakers including Dr. Bruce Aylward, WHO Assistant Director-General for polio, emergencies and country collaboration, and Dr. Robert Murphy, Director of the Center for Global Health at Northwestern University Feinberg School of Medicine

Update: Polio this week – As of 23 October 2013

Update: Polio this week – As of 23 October 2013
Global Polio Eradication Initiative
Full report:

[Editor’s extract and bolded text]
:: In Syria, reports of suspected polio cases have emerged. A cluster of hot cases is currently being investigated, and has prompted planning for a comprehensive outbreak response across the region. See ‘Syrian Arab Republic’ section below for more.
:: One wild poliovirus type 1 (WPV1) case has been confirmed in Cameroon. This is the first WPV in the country since 2009. WPV1 was isolated from an acute flaccid paralysis (AFP) case from Ouest province, with onset of paralysis on 1 October 2013. Genetic sequencing is on-going to determine origin of the isolated virus. See ‘Chad, Cameroon and Central African Republic’ section for more
:: One new WPV1 case was reported in the past week. The total number of WPV cases for 2013 is now eight (all WPV1), all of which were reported from Eastern Region, close to the Pakistan border. The most recent WPV1 case had onset of paralysis on 19 September, from Kunar province.
:: Three new WPV1 cases were reported in the past week. All were reported from Federally Administered Tribal Areas (FATA – two from FR Bannu and one from North Waziristan). The total number of WPV1 cases for Pakistan in 2013 is now 46. The most recent WPV1 case had onset of paralysis on 1 October (from FR Bannu). The majority of WPV1 cases in Pakistan this year, 34 (74%), are from FATA, of which 14 from Khyber Agency and 14 from North Waziristan.
:: The situation in North Waziristan is becoming increasingly severe, as it is the area with the largest number of children being paralysed by wild poliovirus (14 cases) and cVDPV2s (22) in all of Asia. It is in an area where immunization activities have been suspended by local leaders since June 2012. It is critical that children in these areas are vaccinated and protected from poliovirus. Immunizations in neighbouring high-risk areas are being intensified, to further boost population immunity levels in those areas and prevent further spread of this outbreak.
Chad, Cameroon and Central African Republic
:: In Cameroon, one WPV1 was reported this week from Ouest province. This is the first WPV in Cameroon since 2009 and had onset of paralysis on 1 October 2013.
:: An outbreak response is now being planned. In 2013, five large-scale supplementary immunization activities (SIAs) have already been conducted in Cameroon (in April, May, August, September and October), as the country was considered at high-risk of re-infection due to its proximity with Nigeria. The latest NIDs were conducted 11-13 October.
Syrian Arab Republic
:: See WHO GAR below

WHO: Global Alert and Response (GAR) – Disease Outbreak News
Report of suspected polio cases in the Syrian Arab Republic
26 October 2013 – On 17 October 2013, WHO received reports of a cluster of acute flaccid paralysis (AFP) cases in the Syrian Arab Republic. This cluster of ‘hot’ AFP was detected in early October 2013 in Deir Al Zour province and is currently being investigated. Initial results from the national polio laboratory in Damascus indicate that two of the cases could be positive for polio – final results are awaited from the regional reference laboratory of the Eastern Mediterranean Region of WHO. Wild poliovirus was last reported in Syria in 1999.

The Ministry of Health of the Syrian Arab Republic confirms that it is treating this event as a cluster of ‘hot’ AFP cases, pending final laboratory confirmation, and an urgent response is currently being planned across the country. Syria is considered at high-risk for polio and other vaccine-preventable diseases due to the current situation.

A surveillance alert has been issued for the region to actively search for additional potential cases. Supplementary immunization activities in neighbouring countries are currently being planned.

WHO’s International Travel and Health recommends that all travelers to and from polio-infected areas be fully vaccinated against polio.

UNICEF: Millions of children in Syria and region to be vaccinated against polio, measles, mumps and rubella
Major immunisation campaign under way now in Syria
AMMAN, GENEVA, 25 October 2013 – As Syria awaits confirmation of suspected polio cases in the east of the country, UNICEF has joined the World Health Organisation and other partners in mounting a large-scale immunisation effort aimed at protecting as many children as possible both in the country and across the region against polio, as well as other vaccine-preventable diseases.

Inside Syria, a campaign led by the Ministry of Health began on October 24 targeting 2.4 million children with vaccines against polio, measles, mumps and rubella.

Around 500,000 children in Syria have not been vaccinated against polio in the past two years due to insecurity and access constraints. Prior to the conflict, immunisation coverage in Syria was about 95 per cent.

The conflict in Syria has caused immense displacement, with millions of children on the move, either inside the country or across borders into neighbouring countries and beyond. As a result, routine immunisation systems so critical to preventing childhood diseases have been disrupted     or broken down, and children are now at far higher risk of diseases such as polio and measles.

UNICEF is mobilising a huge supply operation to make sure that vaccines are in place across the region, and reaching out to partners across all sectors to help raise community awareness of the importance of vaccinating children.

Multiple, supplemental immunisation campaigns against polio and other vaccine-preventable diseases will take place inside Syria and across the region through the end of the year.

WHO/Europe: Support for Turkish polio operations from a new field presence in Gaziantep

24 October 2013


As part of the cross-regional response to a suspected poliomyelitis (polio) outbreak in the Syrian Arab Republic, Turkey is scaling up surveillance of suspected cases and vaccination of Syrian citizens under temporary protection in Turkey. A newly established WHO presence in Gaziantep, Turkey, near the border of the Syrian Arab Republic, is serving as an important centre of operations. 24 October is World Polio Day.

Of the 2 million Syrians displaced in neighbouring countries, over 500 000 have found shelter in 21 Turkish camps and private accommodation in 10 provinces. Turkish health authorities plan two rounds of supplementary immunization activities by the end of the year for all children under 5 years of age in selected provinces and for refugee children elsewhere in Turkey. Along with improved surveillance, an active search is being conducted to provide additional doses of vaccine to un- and under immunized resident children nationwide…

Fear of violence slows polio immunization drive in Kano, Nigeria

IRIN – UN Office for the Coordination of Humanitarian Affairs


KANO, 22 October 2013 (IRIN) – Fear and secrecy have cloaked the roll-out of a polio campaign currently underway in northern Nigeria. Vaccinators are concealing their identities, hiding vaccinations under their veils and visiting some areas only with undercover armed guards, following the February murder by Boko Haram of nine polio workers in the northern city of Kano.
“The [polio] campaign is done under an atmosphere of fear and secrecy, with vaccinators hiding their identity and moving around furtively for fear of being attacked,” a source at the World Health Organization (WHO) office in Kano, who is involved in polio immunization campaigns, told IRIN.
The Ministry of Health temporarily suspended the immunization campaign in March 2013, as vaccinators were too frightened to continue, said Shehu Abdullahi, executive secretary of Kano State’s Primary Healthcare Management Board (PHMB) in charge of polio immunizations. The campaign resumed in April…

…For the current campaign, vaccinator Jamila Ahmad told IRIN: “We conceal the polio kit under our hijab [veil] and move around as if we are going for a wedding or naming ceremony, while the supervisor trails behind us at a safe distance that will not raise any suspicion that he is with us.”
Most door-to-door polio immunizations are performed by women, who can typically access homes unhindered; men would have to seek the consent of male family heads to enter homes – but male supervisors usually form part of the team…

Global Fund: Tahir Foundation to donate US$65 million

The Global Fund said the Tahir Foundation, based in Indonesia, will invest US$65 million in Global Fund programs. The contribution is being matched by the Bill & Melinda Gates Foundation for a total US$130 million in support. The Tahir Foundation’s contribution is “…by far the largest ever made to the Global Fund by a private foundation in an emerging economy, (and) will support efforts to diagnose, treat, and prevent AIDS, TB and malaria, leading causes of death and disability in Indonesia.

PATH names Ashley Birkett, PhD as director of Malaria Vaccine Initiative (MVI),

PATH announced the appointment of Ashley Birkett, PhD as director of its Malaria Vaccine Initiative (MVI), which “drives the development of safe and effective vaccines for the fight against malaria.”  Dr. Birkett is a five-year veteran of MVI, and was most recently the program’s deputy director, serving simultaneously as director of research and development (R&D)—the latter a position he has held since joining PATH in 2008. Dr. David C. Kaslow, vice president of product development at PATH, said, “Since 2008, Ashley has contributed significantly to every major R&D initiative at MVI.  His technical expertise, tireless passion, and indomitable leadership make him the ideal person to lead MVI in the exciting journey that lies ahead for malaria vaccine development. I am also pleased that PATH can attract and grow top talent and is able to promote such talent from within the organization.”

Weekly Epidemiological Record (WER) for 25 October 2013

The Weekly Epidemiological Record (WER) for 25 October 2013, vol. 88, 43 (pp. 465–476) includes:
:: Progress towards poliomyelitis eradication: Afghanistan, January 2012–August 2013
:: Estimating meningitis hospitalization rates for sentinel hospitals conducting surveillance of invasive bacterial vaccine-preventable diseases

WHO: Global Alert and Response (GAR) – Disease Outbreak News [to 26 October 2013]

WHO: Global Alert and Response (GAR) – Disease Outbreak News

:: Human infection with avian influenza A(H7N9) virus – update 24 October 2013
:: Middle East respiratory syndrome coronavirus (MERS-CoV) – update 24 October 2013

:: Cholera in Mexico26 October 2013
26 October 2013 – The Ministry of Health in Mexico has reported 171 confirmed cases, including one death, of infection with Vibrio cholerae O1 Ogawa toxigenic between 9 September to 18 October 2013.

In the second week of September 2013, Mexico was affected simultaneously by a hurricane and tropical storm which caused heavy rains, floods, landslides and internal displacement of populations, thus increasing the risk of diarrhoeal diseases.

Of the 171 confirmed cases, two are from the Federal District, 157 cases from the state of Hidalgo, nine from the state of Mexico, one from the state of San Luis Potosi and two from the state of Veracruz.

Eighty-six of the total confirmed cases are women and 85 are men with ages ranging from three months to 88 years old. Of these, thirty-nine cases were hospitalised…

…This is the first local transmission of cholera recorded since the 1991-2001 cholera epidemic in Mexico. The genetic profile of the bacterium obtained from patients in Mexico presents high similarity (95 percent) with the strain that is currently circulating in three Caribbean countries (Haiti, Dominican Republic and Cuba), and is different from the strain that had been circulating in Mexico during 1991-2001 epidemic.

WHO does not recommend that any travel or trade restrictions be applied to Mexico with respect to this event.