Christine Marie George, PhD, an associate professor in International Health, is turning to the ubiquitous mobile phone to help reduce infection rates in Bangladesh, one of the planet’s poorest countries with one of the highest risks for cholera. Cholera is spread, in part, by poor sanitation and inadequate hygiene; handwashing is one way to reduce the likelihood of transmission. 

“The time when family members are at highest risk is the one-week period after the cholera patient presents in the hospital,” George says.

The Cholera Hospital-Based Intervention for 7 Days, or CHoBI7, aims to reduce that risk by sending text and voice messages to remind a patient’s family to wash their hands with soap. Ninety percent of Bangladeshi homes have access to mobile phones. 

The largest cholera vaccination drive in history targeting two million people across Africa is underway, the United Nations announced on Monday, in response to a series of recent deadly outbreaks of the water-borne disease. 

“Oral cholera vaccines are a key weapon in our fight against cholera,” said Tedros Adhanom Ghebreyesus, head of the World Health Organization (WHO) in a statement, “but there are many other things we need to do to keep people safe. WHO and our partners are saving lives every day by improving access to clean water and sanitation, establishing treatment centres, delivering supplies, distributing public health guidance, training health workers, and working with communities on prevention,” he added.

The drive targets Zambia, Uganda, Malawi, South Sudan and Nigeria, and will be completed by mid-June. The vaccines are funded by the Vaccine Alliance, a public-private partnership known as Gavi, and were sourced from the global stockpile. 

The burden of cholera remains high in many African countries. As of 7 May, there are at least 12 areas or countries, reporting active cholera transmission in sub-Saharan Africa. 

Since the beginning of this year, WHO has led the way providing technical expertise and guidance, working closely with Health Ministries and other partners in the five target countries to plan and implement the vaccination campaigns. The ambitious effort is part of a global push to reduce cholera deaths by 90 percent by 2030.

In the 15 years between 1997 and 2012, a modest 1.5 million doses of cholera vaccines were used worldwide. In just the first four months of this year, more than 15 million doses have been approved for use globally.

Oral cholera vaccine is normally administered in two doses. The first gives protection for six months, the second for between three and five years. 

“Every rainy season, cholera springs up and brings devastation to communities across Africa,” said Matshidiso Moeti, WHO’s Regional Director for Africa. “With this historic cholera vaccination drive, countries in the region are demonstrating their commitment to stopping cholera from claiming more lives. We need to build on this momentum through a multisectoral approach and ensure that everyone has access to clean water and sanitation, no matter where they are located.”

A resolution on further action to combat cholera will be proposed by Zambia and Haiti at this month’s World Health Assembly in Geneva, calling for renewed political will and an integrated global approach to eliminate cholera, including more investment in clean water, sanitation and hygiene.

Published in Global initiatives

A dose of oral vaccine provides effective short-term protection against the cholera during an outbreak, a study in Zambia shows.
According to researchers, because of a shortage of global stockpile of cholera vaccines, an outbreak in Lusaka, Zambia, in February 2016 necessitated a need for single-dose vaccination.
An emergency single-dose oral vaccination campaign was implemented in April 2016, around Lusaka, targeting more than 500,000 people in the city’s overcrowded township areas.
Francisco Luquero, a co-author of the study and an expert in preventable diseases at the France-based Epicentre, the research arm of the Médecins Sans Frontières (MSF) or Doctors without Borders, says that studies have already proved that one oral cholera vaccine dose works, but they were conducted in countries that had recently experienced cholera.

Shantha Biotechnics, an affiliate of Sanofi Pasteur, has received approval of World Health Organisation (WHO), permitting a change in the storage label of its oral cholera vaccine Shanchol.

The vaccine may now be kept for single period of time of upto 14 days at temperature of upto 40° C prior to administration. The approval thus eliminates challenges of maintaining the vaccine cold chain (between +2° C and +8° C to maintain vaccine potency) during transport.

The approval is of great significance to regions where the vaccine is used, including India, a release from Sanofi on Monday said. The WHO approval for use of Shanchol in controlled temperature chain (CTC) was granted after a review of its stability data.

Tuesday, 13 February 2018 08:25

10 threats to global health in 2018

From Mosul to Cox’s Bazar, cholera to plague, 2017 was full of health emergencies caused by conflict, natural disasters and disease outbreaks. But 2018 could be even worse if we don’t prepare, prevent and respond in time. The World Health Organization continues to tackle disease outbreaks and other health emergencies worldwide in 2018, but operations are underfunded and needs continue to grow. These are just some of the threats to global health that we are likely to face. Many of these crises are entirely preventable, and often man-made.

Published in Announcements

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.

But a countermeasure is gaining momentum as well. A vaccine against Vibrio cholerae, the causative bacterium, has been around for 20 years, but questions have long swirled about its usefulness in outbreaks, and it has been in short supply. That is changing. The global cholera vaccine stockpile, established by the World Health Organization (WHO) and partners in 2013, has attracted additional manufacturers, and now an easier to use formulation should help health workers respond to outbreaks. Many think this may be the year in which the stockpile starts to reduce cholera's overall toll. "We are reaching an extremely important point where the scale of the campaigns may be sufficiently large to show impact in controlling the disease," says Francisco Luquero, an epidemiologist with Doctors without Borders in Geneva, Switzerland.

Published in Global initiatives

Orbiting satellites can warn us of bad weather and help us navigate to that new taco joint. Scientists are also using data satellites to solve a worldwide problem: predicting cholera outbreaks.

Cholera infects millions of people each year, leading to thousands of deaths. Often communities do not realize an epidemic is underway until infected individuals swarm hospitals. Advanced warning for impending epidemics could help health workers prepare for the onslaught—stockpiling rehydration supplies, medicines and vaccines—which can save lives and quell the disease’s spread. Back in May 2017 a team of scientists used satellite information to assess whether an outbreak would occur in Yemen, and they ended up predicting an outburst that spread across the country in June.

Published in Announcements
Tuesday, 17 October 2017 11:40

Cholera: ending a 50-year pandemic

The global annual cholera burden is estimated at around 2·9 million cases per year, resulting in 95 000 deaths. In 2017, these estimates could be far exceeded due to a number of devastating outbreaks, including those in Yemen and northern Nigeria. So far this year, 750 000 suspected cases, causing over 2000 deaths, have occurred in Yemen alone. Currently, there is concern about the risk of a cholera epidemic among Rohingya refugees in the Cox's Bazar region of Bangladesh. In response to this public health threat, the Global Task Force on Cholera Control (GTFCC), has brought together representatives from cholera-affected countries, donors, and technical experts to develop a Global Roadmap to 2030. Published on Oct 3, the document describes a multisectoral strategy that could reduce cholera deaths by 90% and eliminate the disease from a further 20 countries by 2030....

Improvements in WASH systems can eliminate cholera, but although the rate of return on investment is good, these are initially expensive, and the slow expansion of WASH provision has failed to tackle the burden of cholera and other water-borne diarrhoeal diseases. The pivotal change in cholera control has been the development of oral cholera vaccines (OCV), underpinned by an improved understanding of the mechanism of cholera immunity. In a series of landmark research developments over the past 10 years, the efficacy, safety, acceptability, and feasibility of these vaccines have been demonstrated. The creation of a growing global OCV stockpile by WHO, with long-term funding support from Gavi, signalled the step-change in cholera prevention strategies and, since 2013, 13 million vaccine doses have been deployed, mostly in the emergency control of epidemics.

Published in Global initiatives
Friday, 06 October 2017 06:00

First global pledge to end cholera by 2030

Health officials from around the world are meeting in France to commit to preventing 90% of cholera deaths by 2030.

The disease, which is spread through contaminated water, kills about 100,000 people every year.

It is the first time governments, the World Health Organization, aid agencies and donors have made such a pledge.

It comes as Yemen continues to fight one of the worst cholera outbreaks on record. Cholera has been spreading in the war-torn country due to deteriorating hygiene and sanitation conditions and disruptions to the water supply.

More than 770,000 people have been infected with the disease, which is easily treatable with the right medical equipment, and 2,000 have died. Many of the victims are children. These huge outbreaks tend to grab the headlines, but there are also frequent outbreaks in so-called cholera "hotspots".

Published in Global initiatives