Tuesday, 14 February 2017

History of Cholera and its burden on Developing Countries

In modern history, cholera occupies an important place as a public health challenge. It was the first pandemic of the 19th century. It’s an infectious and life-threatening diarrheal disease which is endemic in many Asian and African countries. Initially originated in the swamps of Bangladesh, it spread across the world from its reservoir which is part of the Ganges River Delta. The existent brackish waters were the birthplace of vibrio cholerae, a bacterium that infects the waters and when ingested emits a toxin so virulent that all the human body’s fluids are forced to flush out.  Deprived of electrolytes, people begin to die of shock and organ failure, sporadically, within six hours of the first abdominal rumbling. 

History of Cholera and its burden on Developing Countries 

Since 1871, pandemics of cholera has affected millions. As per researchers at World Health Organization, cholera contributes to 1.3 to 4 million cases each year. (WHO, 2016) The increase in access to safe drinking water and sanitation facilities has eliminated the transmission in high-income countries. However, the causative agent, Vibrio cholerae continues to affect millions of people in less developed countries where, unfortunately, clean water and sanitation infrastructure is not available in abundance. 

Over the last 25 years, major cholera epidemics have seen to originate in coastal areas. Currently, the regions of cholera endeminity include the coasts surrounding the Bay of Bengal, both Bangladesh and the Indian subcontinent. In these geographical regions, the patterns of the frequency of the disease show a similar trend that are explained by same physical or environmental drivers. The diarrheal disease, caused by bacteria that lives in water and faeces, is not spread by contact with an infected person. A large number of the population is infected due to drinking this contaminated water. Experts suggest an occurrence of 4,50,000 - 1,000,000 cases of cholera in Bangladesh each year, whereas Data from population-based diarrhea surveillance in an endemic area of Kolkata, India, revealed a cholera incidence of 2.2 cases per 1000 person-years.  

For effective aversion of cholera transmission, it’s imperative the afflicted countries are provided with safe drinking water through a well-maintained water and sanitary infrastructure. Oral cholera vaccines are additional ways to control the disease but should be used in conjunction with improvements in water & sanitation. Even though the disease is preventable and can be controlled despite the existence of a vaccine, many countries still remain affected.

“HILLCHOLTM  - This low-cost Cholera vaccine can be used to create a healthy stockpile to be used in epidemic situations.”  Says Dr Tarun Sharma, Associate Director, R&D, Hilleman Laboratories

Representing a significant healthcare burden globally, Hilleman Laboratories is awarded global patents for Oral Cholera Vaccine (OCV) in offices including USA, European Union, Australia, China, Canada and South Africa. Mass vaccination would be made a reality in cholera endemic zones due to ease of manufacturing and low cost. Hilleman Labs single-strain vaccine with process and manufacturing optimisation significantly reduces the cost of the vaccine production, thus, aiding in improving vaccine affordability and accessibility.
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Tuesday, 31 January 2017

Immunization against Measles – Rubella in India

The World Health Organization has congratulated India for launching the world’s largest immunization campaign against Measles – Rubella. The campaign targets Measles, a highly contagious disease caused by a virus. The virus is from the paramyxovirus family and it is normally passed through direct contact and through the air. It is spread by sneezing, coughing or direct contact with infected nasal or throat secretions, infecting the respiratory tract. The campaign is additionally targeting, the congenital rubella syndrome (CRS); responsible for permanent effects such as irreversible birth defects, deafness and cataracts.  

In India, Measles affect 2.5 million children annually whereas the congenital rubella infection, also known as the German Measles, affects 25,000 children born in the country. In recent years, due to consistent efforts, the mortality rate has declined by 51% from the year 2000 to 49,000 in the year of 2015.

The Union Health Ministry has launched the Measles – Rubella (MR) vaccination campaign
in Bengaluru on 5th February, proving India’s commitment to improve the country’s health by protecting children against vaccine preventable diseases. The campaign targeting two diseases will cover nearly 3.6 crore children will start from five states and union territories (UTs), namely, Karnataka, Tamil Nadu, Puducherry, Goa and Lakshadweep. 

In the nationwide campaign, the ministry will reach out to and cover 41 crore children in the age group of 9 months to 15 years,” says MoS Health Faggan Singh Kulaste.  

A specified age group will get a single shot of Measles - Rubella vaccine irrespective of the previously introduced Measles/rubella vaccine status or disease status. The Measles Rubella vaccine will be provided free of cost across states from schools as well as to health facilities. Earlier, in 1985, Measles vaccine was part of the Universal Immunization Programme (UIP), but due to the introduction of the Measles - Rubella vaccine, the monovalent vaccine (Measles) will be discontinued and replaced by the bivalent vaccine (Measles - Rubella).    

The World Health Organization has set a Sustainable Goal Target, which aims to prevent the deaths of newborns and children under five years of age by 2030. Thus, the elimination of Measles and congenital rubella syndrome by the bivalent vaccine will contribute to the achievement of the set goal.
We, at Hilleman Laboratories, believe that by not getting vaccinated you are not only putting yourself at risk but also the people around you. To ensure the effectiveness of the campaign, it’s important that throughout its duration, no individual is left behind. An important learning taken away from the polio eradication programme was to further the strengthening of surveillance for Measles- Rubella and to identify infected and vulnerable areas. The parents, caregivers, community leaders, teachers and the frontline healthcare providers are urged to become active participants and advocates for the campaign. Consistent efforts are the only way to rapidly build up immunity and thereby reducing the huge socio-economic burden on the susceptible cohort.

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