Cholera and OCV in the News

February 2018: Prolonging herd immunity to cholera via vaccination: Accounting for human mobility and waning vaccine effects

Oral cholera vaccines can be powerful tools for quickly protecting a population for a period of time that depends critically on vaccine coverage, vaccine efficacy over time, and the rate of population turnover through human mobility.

See the research results (28-Feb-2018)

One Dose at a Time: Advancing Oral Cholera Vaccine Use Globally

Anuj Bhattachan, MD

Associate Research Scientist | International Vaccine Institute (IVI)
Cholera Coalition Blog Photo 1

Checking the cold chain and gearing up for vaccinations

This post originally appeared on The Coalition for Cholera Prevention and Control (CCPC)

There were several milestones in 2015 for the oral cholera vaccine (OCV).  Originally based on a vaccine developed in Vietnam, the OCV was reformulated by the International Vaccine Institute (IVI) with support from the Bill & Melinda Gates Foundation, and the governments of Sweden and South Korea. Shanchol was finally WHO-prequalified in 2011 and is an example of successful international public-private partnership.

The StopCholera Toolkit is Now Available in Arabic

Abdinasir Abubakar

MD, MPH, Team Lead, Infectious Hazard Management (IHM) Unit | WHO Health Emergencies Department (WHE), World Health Organization, Regional Office for Eastern Mediterranean
Screenshot Arabic Toolkit

I am happy to inform you that most of the StopCholera Toolkit documents are now available in Arabic.

The StopCholera Toolkit is a one-stop shop for cholera and oral cholera vaccine information. The Toolkit contains valuable information for cholera focal points and immunization program managers, Ministries of Health and health care workers who respond to cholera and/or administer the vaccine. The aim of the toolkit is to help decide if, when, where, and how to use oral cholera vaccine to reduce cholera mortality, prevent cases, and halt outbreaks.

Stakeholder's Conference on Prevention, Control and Elimination of Cholera in Uganda

David A. Sack, MD

Professor | Johns Hopkins Bloomberg School of Public Health
Uganda Stakeholders Meeting. Photo: (2018).

Uganda Stakeholders Meeting. Photo: (2018).

Cholera is a major public health problem in Uganda, leading to over 1,000 cases annually. In order to tackle the threat of cholera globally, the WHO released a global strategy, titled Ending Cholera: A Global Roadmap to 2030. Achieving the overall objective of the renewed strategy—reducing cholera mortality by 90% by 2030—relies on strong commitments from countries, partners, and donors to collectively engage in the fight against cholera. Therefore, in June 2017, the Uganda Ministry of Health (MOH) launched a National Integrated Comprehensive Cholera Prevention and Control Plan, which includes the strategic use of oral cholera vaccine (OCV) to prevent cholera among at-risk populations.

How a Surging Stockpile of Vaccines Could Help Conquer Cholera

As stocks of oral cholera vaccine rise, mass campaigns, like this one in South Sudan in 2014, become more feasible. Photo: AFP/STRINGER/GETTY IMAGES

As stocks of oral cholera vaccine rise, mass campaigns, like this one in South Sudan in 2014, become more feasible. Photo: AFP/STRINGER/GETTY IMAGES

This post, written by Kai Kupferschmidt, originally appeared in Science Magazine.

Around the world, cholera is on the march. In Yemen, which is mired in a civil war, the devastating waterborne illness has sickened more than a million people since October 2016 and continues to spread. Outbreaks are ravaging Zambia, Tanzania, Zimbabwe, and several other African countries. Haiti is still suffering from an epidemic that began in 2010. And last month, after torrential rains flooded parts of Kinshasa, the capital of the Democratic Republic of the Congo (DRC), cases spiked there. "For reasons we do not understand, cholera seems to go through cycles of severe seasons," says David Sack, an infectious disease expert at Johns Hopkins University's Bloomberg School of Public Health in Baltimore, Maryland.

Stop the Guessing: Fighting Cholera through Better Formative Research

Tom Davis, MPH

Global Sector Lead for Sustainable Health, World Vision International
Little girl practices safe hand washing
Little girl practices safe hand washing

In order to be successful in our efforts to stop cholera, we need to better understand why some people adopt behaviors that stop cholera, while others do not. Although we all have pet theories on why people decide to do things based on our own anecdotal experience, we can often be wrong. To decide if vaccines and antibiotics are effective, we don’t sit around a table and guess - we would consider this highly unethical and unscientific. Yet when it comes to promoting behaviors, that’s what many projects end up doing. We need to stop the guessing, and conduct better formative research on the behavioral determinants for WASH behaviors and cholera immunization.

Stop Yelling: Using Neighbors to Mobilize Communities to Stop Cholera

Tom Davis, MPH

Global Sector Lead for Sustainable Health, World Vision International
Man speaks into loudspeaker during vaccination campaign. Photo: WHO/C. Black
Man speaks into loudspeaker during vaccination campaign. Photo: WHO/C. Black

Achieving high levels of coverage of multiple-dose vaccines – such as the cholera vaccine – takes more than good logistics. Promoting turnout for immunization requires the use of evidence-based community mobilization methods. In 1983, I was involved with some of the early mass immunization efforts in Haiti while working for International Child Care, an organization that led the first mass immunization in Haiti years earlier.

The Incomplete Report

Among the many affected by cholera throughout Yemen, these infected children lie on the ground in a hospital in Sanaa. Photo: KHALED ABDULLAH/REUTERS/Newscom
Among the many affected by cholera throughout Yemen, these infected children lie on the ground in a hospital in Sanaa. Photo: KHALED ABDULLAH/REUTERS/Newscom

An article in the World Health Organization (WHO) August Weekly Epidemiological Record (WER) reported that since the creation of the global stockpile for oral cholera vaccine (OCV) in 2013, 55 campaigns have been conducted using nearly 13 million doses [1]. A majority of the OCV doses (73%), were used in emergency settings, while 27% were used in non-emergency settings to control endemic cholera. The report described OCV deployments in terms of the setting, targeted populations, campaign timelines, and coverage. The increasing trend in OCV use in affected countries is an achievement that the WHO can be proud of.

Oral Cholera Vaccine Recommendations through the Years

Anna Lena Lopez, MD

Research Associate Professor | Inst. of Child Health & Human Development, Univ. of the Philippines Manila-National Inst. of Health
Three-year-old Salomon looks on as he undergoes treatment for cholera at the general hospital in Minova. Photo: Arjun Claire
Three-year-old Salomon looks on as he undergoes treatment for cholera at the general hospital in Minova. Photo: Arjun Claire

On April 25-27, 2017, the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on vaccines and immunization took up oral cholera vaccination during its meeting, with a view of updating the 2010 WHO position paper [1]. WHO regularly releases position papers to guide member states on vaccines and immunization that have global public health importance.

Yemen’s Cholera Crisis: Fighting Disease During Armed Conflict

Doctors treat patients with cholera in Yemen, Photo Courtesy of Harvard Humanitarian Initiative’s Advanced Training Program on Humanitarian Action
Doctors treat patients with cholera in Yemen, Photo Courtesy of Harvard Humanitarian Initiative’s Advanced Training Program on Humanitarian Action

This podcast was produced by the Harvard Humanitarian Initiative’s Advanced Training Program on Humanitarian Action and originally appeared here."

Yemen is currently facing the world's worst cholera epidemic. As of August, the WHO reported that over 500,000 suspected cholera cases and nearly 2,000 associated deaths had occurred since the end of April alone.  One of many factors that has caused such a large-scale outbreak is the ongoing armed conflict. How do you fight disease during an armed conflict?

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