Vaccines and Global Health: The Week in Review 27 June 2015

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

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pdf version A pdf of the current issue is available here:  Vaccines and Global Health_The Week in Review_27 June 2015

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

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
a program of the
– Division of Medical Ethics, NYU Medical School
– Children’s Hospital of Philadelphia Vaccine Education Center
Associate Faculty, Division of Medical Ethics, NYU Medical School

MERS-CoV [to 27 June 2015]

MERS-CoV [to 27 June 2015]

Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea
Disease outbreak news
23 June 2015

Situation in Korea
Between 20 and 23 June 2015, the National IHR Focal Point of the Republic of Korea notified WHO of 9 additional confirmed cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) alongside 3 additional deaths.

Additional information on the outbreak in Korea
To date, a total of 175 MERS-CoV cases, including 27 deaths, have been reported. One of the 175 cases is the case that was confirmed in China and also notified by the National IHR Focal Point of China.

The median age of the cases is 56 years old (ranging from 16 to 87 years old). The majority of cases are men (60%). Twenty-three cases (13%) are health care professionals. To date, all cases (excluding the index case) have been linked to a single chain of transmission and are associated with health care facilities.

Detailed information concerning MERS-CoV cases in the Republic of Korea can be found in a separate document (see related links).

Public health response
The government of the Republic of Korea continues to implement intense case and contact management activities. As of 23 June, 2,805 contacts are being monitored while a total of 10,718 contacts have been released. The downward trend of reported MERS-CoV cases seems to indicate that the containment measures put in place by the national health authorities of Korea are beginning to work.

Global situation
Globally, since September 2012, WHO has been notified of 1,348 laboratory-confirmed cases of infection with MERS-CoV, including at least 479 related deaths.

WHO advice
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because, like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS‐CoV infection. General hygiene measures, such as regular hand washing, should be adhered to.

WHO remains vigilant and is monitoring the situation. Given the lack of evidence of sustained human-to-human transmission in the community, WHO does not recommend travel or trade restrictions with regard to this event. Raising awareness about MERS-CoV among travellers to and from affected countries is good public health practice.

:: Summary of MERS statistics in the Republic of Korea (translated from the website) as of 27 June 2015

Global Alert and Response (GAR) – Disease Outbreak News (DONs)
:: 26 June 2015 – Middle East respiratory syndrome coronavirus (MERS-CoV) – United Arab Emirates
:: 23 June 2015 – Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea
:: 23 June 2015 – Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia

After MERS, South Korea Authorizes Prison for Quarantine Scofflaws
New York Times, JUNE 26, 2015
SEOUL, South Korea — Stung by the outbreak of Middle East respiratory syndrome, South Korea has passed a law authorizing prison terms of up to two years for people who defy quarantine orders or lie about their possible exposure to an infectious disease.
South Korea has had 181 confirmed cases of the disease known as MERS, including 31 deaths. The outbreak, which began last month, is the worst seen outside Saudi Arabia, where the disease was first identified.
The spread of MERS here has been attributed mainly to poor infection control at the country’s hospitals, as well as failures of communication and coordination on the government’s part. But the public has also been angered by reports of people flouting orders to stay home while they were being monitored for symptoms. One such person went golfing; another went to China, where he was detained and later tested positive for MERS. Under current law, such defiance can result in a fine but not imprisonment.
The new law, which was passed on Thursday and takes effect in six months, gives more authority to public health investigators, empowering them to close down the site of a possible outbreak of infectious disease and to place people there under quarantine. People who defy the orders can be sentenced to up to two years in prison or fined up to 20 million won, or about $18,000. The same penalties can be imposed for lying about one’s possible exposure to infectious disease…

ASEAN Ascertains Region’s Information Network in Response to MERS
JAKARTA, 22 June 2015 – “ASEAN is concerned about the widening spread of Middle East Respiratory Syndrome (MERS),” said H.E. Le Luong Minh, Secretary-General of ASEAN. “ASEAN is taking initiatives on preparedness in responding to the MERS coronavirus (MERS CoV) disease,” he added.
Today, a video conference took place among health experts in ASEAN together with their counterparts from the World Health Organisation and from China and Japan in response to this health concern. The conference was held to help ascertain the region’s information network and share information and experience on the current situation and what is being done in ASEAN and other countries towards MERS. In this video conference, it was re-affirmed that sharing of lessons learned or sharing of important and updated information in preparedness and response to MERS is very useful to the internal preparations and response plans of the respective countries in the region…

EBOLA/EVD [to 27 June 2015]

EBOLA/EVD [to 27 June 2015]
Public Health Emergency of International Concern (PHEIC); “Threat to international peace and security” (UN Security Council)

WHO: Ebola Situation Report – 24 June 2015
:: There were 20 confirmed cases of Ebola virus disease (EVD) reported in the week to 21 June, compared with 24 cases the previous week. Weekly case incidence has stalled at between 20 and 27 cases since the end of May, whilst cases continue to arise from unknown sources of infection, and to be detected only after post-mortem testing of community deaths. In Guinea, 12 cases were reported from the same 4 prefectures as reported cases in the previous week: Boke, Conakry, Dubreka, and Forecariah. In Sierra Leone, 8 cases were reported from 3 districts: Kambia, Port Loko, and the district that includes the capital, Freetown, which reported :: Although cases have been reported from the same 4 prefectures in Guinea for the past 3 weeks, the area of active transmission within those prefectures has changed, and in several instances has expanded…

:: There have been a total of 27,443 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1), with 11207 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). A total of 12 new confirmed cases were reported in Guinea and 8 in Sierra Leone in the 7 days to 21 June. The outbreak in Liberia was declared over on 9 May…

WHO: News
Helping Guinean communities fight Ebola
26 June 2015
In May 2015, cases of Ebola began to appear in Tanene, Dubreka Prefecture, Guinea, an area that had previously been unaffected.

One of Sierra Leone’s toughest slums beats Ebola
22 June 2015
On a stretch of scenic coastline at the edge of the Atlantic Ocean sits one of Freetown, Sierra Leone’s, toughest neighbourhoods – Moa Wharf.

:: The UN will continue to support prevention and response efforts against Ebola in Guinea-Bissau – UNMEER SRSG 25 Jun 2015

POLIO [to 27 June 2015]

POLIO [to 27 June 2015]
Public Health Emergency of International Concern (PHEIC)

GPEI Update: Polio this week – As of 24 June 2015
Global Polio Eradication Initiative
[Editor’s Excerpt and text bolding]
Full report:
:: In June an outbreak response assessment took place in the Horn of Africa. The team concluded that transmission in Kenya and Ethiopia has been interrupted, however, undetected low level transmission cannot be ruled out in Somalia. They outlined key measures to continue to strengthen immunity and surveillance, and to put risk mitigation plans in place.
:: Five cases of circulating vaccine derived poliovirus type 1 (cVDPV1) have been reported in Madagascar, with dates of onset of paralysis in April and May 2015. These cases are genetically linked to that from September 2014, indicating prolonged and widespread circulation of cVDPV1. The emergency outbreak response is now being intensified to build immunity against the virus in the country, as 25 % of children across Madagascar remain un- or under- immunized.

Selected excerpts from Country-specific Reports
:: One new polio case was reported in the past week, in Bakwa district of Farah province on the 21 April. The most recent case had onset of paralysis on 05 May, in Gulestan district, Farah. The total number of WPV1 cases for 2015 is now four.
Horn of Africa
:: An international outbreak response assessment took place last week in the Horn of Africa, to examine the impact of the regional emergency outbreak response activities. The team concluded that transmission in Kenya and Ethiopia has been interrupted, however, undetected low level transmission cannot be ruled out in Somalia. They outlined key measures to continue to strengthen immunity and surveillance, and to put risk mitigation plans in place.
:: Subnational Immunization Days (SNIDs) are planned in Ethiopia from 1 – 3 July and in Somalia for August, with dates to be confirmed. In September, National Immunization Days are planned in Eritrea and Somalia, and SNIDs in Ethiopia, Kenya and Uganda.

WHO & Regionals [to 27 June 2015]

WHO & Regionals [to 27 June 2015]
A commentary on “Health and climate change: policy responses to protect public health”
June 2015 — Dr Margaret Chan, WHO Director-General, comments on 3 recommendations where WHO will make direct contributions: financing for climate-resilient health systems; policy recommendations on energy systems that contribute to cleaner air; and monitoring and assessing progress.

Striving to prevent collapse of Yemen’s health system during conflict
June 2015 — In Yemen, more than 15 million people are in dire need of health services. WHO and Health Cluster partners have been responding by providing supplies, services and support to national and regional authorities.

In public health emergencies, risk communication is essential
26 June 2015 — Risk communication is an integral part of any public health emergency response. In epidemics and pandemics, in humanitarian crises and natural disasters, risk communication allows people at risk to understand and adopt protective behaviours.
More on risk communication during emergencies

New film showcasing the Controlled Temperature Chain (CTC)
24 June 2015
The Controlled Temperature Chain, or CTC is an innovative approach to vaccine management and distribution which allows certain vaccines to be kept at ambient temperatures outside of the traditional vaccine cold chain.
The 3-episode film promotes the CTC approach. Episode 1 explains what is CTC, why it is useful and how it is feasible; episode 2 features a case study on CTC implementation; and episode 3 looks at the options for countries and what manufacturers can do to support countries.


The Weekly Epidemiological Record (WER) 26 June 2015, vol. 90, 26 (pp. 321–336)
:: Index of countries/areas
:: Index, Volume 90, 2015, Nos. 1–26
:: Yellow fever in Africa and the Americas, 2014
:: Monthly report on dracunculiasis cases, January–May 2015
:: WHO Regional Offices
WHO African Region AFRO
:: Strong partnerships needed to tackle health challenges faced by Small Island Developing States in the African Region
Mauritius, 24 June 2015 – Health Ministers from Small Island Developing States (SIDS) in the African Region have begun a meeting today in Mauritius to take stock of the health of their people and chart a way forward on possible approaches and actions that will promote sustainable health development. The meeting, organized by the World Health Organization is attended by Health Ministers from Cape Verde, Comoros, Seychelles, Sao Tome & Principe, Mauritius, high ranking officials of the health ministry, representatives of the Indian Ocean Commission and public health experts.In a message read on her behalf by Dr Francis Kasolo, Coordinator…
:: Staying at zero: Keeping Liberia Ebola free – 22 June 2015

WHO Region of the Americas PAHO
:: Women’s health needs still not adequately met, according to new articles in the Pan American Journal of Public Health (06/24/2015)
:: Health Coverage Reaches 46 Million More in Latin America and the Caribbean, says new PAHO/WHO–World Bank report (06/22/2015)

WHO South-East Asia Region SEARO
:: WHO calls for stepping up vigil for MERS, Thailand confirms case  18 June 2015

WHO European Region EURO
:: Health ministers in South-eastern Europe commit to achieving universal health coverage 26-06-2015
:: Special report on Healthy Cities in Europe launched 22-06-2015

WHO Eastern Mediterranean Region EMRO
No new digest content identified.

WHO Western Pacific Region
No new digest content identified.

CDC/MMWR/ACIP Watch [to 27 June 2015]

CDC/MMWR/ACIP Watch [to 27 June 2015]

MMWR June 26, 2015 / Vol. 64 / No. 24
:: National HIV Testing Day — June 27, 2015
:: Prevalence of Diagnosed and Undiagnosed HIV Infection — United States, 2008–2012
:: Identifying New Positives and Linkage to HIV Medical Care — 23 Testing Site Types, United States, 2013
:: Notes from the Field: Measles Transmission in an International Airport at a Domestic Terminal Gate — April–May 2014

Advocacy for Immunisation Platform Launches

Advocacy for Immunisation Platform Launches

The new web-based platform – developed by PATH and IVAC/Johns Hopkins University with significant input from WHO, Unicef, and Gavi, the Vaccine Alliance and the support of many immunisation partners at global and country level – is intended “to further collective efforts to improve immunisation and help ensure life-saving vaccines reach children everywhere…”

The online advocacy platform “provides guidance and tools to in-country stakeholders in developing their advocacy strategies and implementation plans in support of strengthened immunisation programmes and increased coverage and equity. The platform has been developed in response to a high demand from in-country stakeholders for advocacy capacity and skills strengthening. It contains self-guided tools, resources and information about advocacy and communications, vaccines and immunisation…” In October the tool will also be available in French.