Resurgence of Vaccine-Preventable Diseases in Venezuela as a Regional Public Health Threat in the Americas

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Emerging Infectious Diseases
17 Apr 2019, 25(4)] Original Publication Date: 1/30/2019

Resurgence of Vaccine-Preventable Diseases in Venezuela as a Regional Public Health Threat in the Americas
Alberto E. Paniz-Mondolfi , Adriana Tami, Maria E. Grillet, Marilianna Márquez, Juan Hernández-Villena, María A. Escalona-Rodríguez, Gabriela M. Blohm, Isis Mejías, Huníades Urbina-Medina, Alejandro Rísquez, Julio Castro, Ana Carvajal, Carlos Walter, María G. López, Philipp Schwabl, Luis Hernández-Castro, Michael A. Miles, Peter J. Hotez, John Lednicky, J. Glenn Morris, James Crainey, Sergio Luz, Juan D. Ramírez, Emilia Sordillo, Martin Llewellyn, Merari Canache, María Araque, and José Oletta
Venezuela’s tumbling economy and authoritarian rule have precipitated an unprecedented humanitarian crisis. Hyperinflation rates now exceed 45,000%, and Venezuela’s health system is in free fall. The country is experiencing a massive exodus of biomedical scientists and qualified healthcare professionals. Reemergence of arthropod-borne and vaccine-preventable diseases has sparked serious epidemics that also affect neighboring countries. In this article, we discuss the ongoing epidemics of measles and diphtheria in Venezuela and their disproportionate impact on indigenous populations. We also discuss the potential for reemergence of poliomyelitis and conclude that action to halt the spread of vaccine-preventable diseases within Venezuela is a matter of urgency for the country and the region. We further provide specific recommendations for addressing this crisis.

According to the evaluation approach recommended by WHO, the risk level of the ongoing outbreaks in Venezuela is high. A correspondingly strong response is needed to curtail the expanse of these epidemics. We propose the following measures.
:: Global and hemispheric health authorities should urge the Venezuela government to allow the establishment of a humanitarian channel to provide immediate relief efforts addressing extreme food and medicine shortages.

:: Epidemiologic surveillance programs, early reporting, and rapid response systems should be restored immediately. Strengthening of infection control practices in healthcare facilities should be implemented with the aid of international agencies while ensuring public health neutrality.

:: Emergency relief operations should be put into effect across borders along with authorities in Colombia and Brazil to ameliorate the effects of massive migration by implementation of early nutritional and immunization interventions.

:: International agencies should support regional efforts in neighboring countries to promote simultaneous massive vaccination campaigns and vaccination of all refugees from Venezuela arriving in host community populations.

:: Adequate supplies for mass vaccination and routine immunization should be ensured, and additional adjunct supplies (e.g., diphtheria antitoxin) should be stockpiled to assist in the establishment of standard treatment protocols and epidemic rapid response measures. These methods are crucial for healthcare delivery and mass vaccination catch-up campaigns to head off the resurgence of vaccine-preventable diseases in Venezuela.

:: In areas with low vaccination coverage, improving surveillance for early case detection and increasing vaccination coverage in high-risk age groups should be mandatory. Furthermore, Venezuela is in urgent need to reconstruct its devastated healthcare system, secure sustainable food and medication access, and reinstall proper sanitation policies to reduce the burden of diseases.

On September 27, 2018, the United Nations Human Rights Council adopted a resolution on Venezuela signaling the gravity of the human rights situation and the growing concern by governments worldwide about the country’s humanitarian crisis, including aspects such as malnutrition and the upsurge of preventable diseases (50). PAHO–WHO faces an enormous challenge in attending, without interference, to the complex emergency that affects Venezuela. Emergency funds must be released to acquire medicines, vaccines, laboratory reagents, and other supplies for health programs. As Venezuela rapidly becomes a regional nidus for the emergence of vaccine-preventable diseases, it must take decisive action now alongside regional and national partners to target this emerging regional crisis.