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WHO IB-VPD and Rotavirus Surveillance Bulletin - June 2017


Dear Colleagues,
 

We are pleased to share the latest bulletin of the World Health Organization (WHO)-coordinated Global Rotavirus and Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance Networks. This bulletin reports the most up-to-date global surveillance data reported to WHO on pediatric diarrhea, meningitis, and pneumonia from the calendar year 2016. Please note that data included in this bulletin are preliminary and may be subject to change.
 
Surveillance for vaccine-preventable diseases such as rotavirus and pneumococcus is critical to generate data on disease burden before vaccines are introduced and to monitor the short- and long-term impact of vaccines on disease and immunization programs. The data generated through surveillance should be used at a country, regional, and global level. In this edition, we highlight Armenia, a country who has been conducting high-quality surveillance that has generated data to help inform vaccine policy decisions. This example adds to the case study published in the last bulletin highlighting the use of sentinel surveillance data in another part of the world in Bangladesh.
 
If you have trouble viewing the graphics in this bulletin, please open the bulletin in your browser or change your settings to allow image download (instructions here). Please forward the bulletin to other interested parties or share on social media. We appreciate feedback on the bulletin, and you can subscribe or unsubscribe using the link at the bottom. We also welcome new countries who would like to join the network.
 
Thank you to everyone from staff at the sentinel surveillance hospitals to the country, regional and global partners who make this surveillance possible.

 
We hope you enjoy the bulletin!
The WHO Vaccine-Preventable Disease Sentinel Surveillance team
 

In 2016, the WHO Global Rotavirus Surveillance Network had data reported from 58 member states and 134 sentinel surveillance hospitals.

* Graphs 1 & 2 include sites/countries meeting these performance criteria: Sentinel sites must report cases for at least 10 months of the year 2016 (including zero reporting, if reported to WHO HQ) Countries must report a minimum of 80 cases (all sites combined) in 2016 unless rotavirus vaccine was introduced in the country prior to 2016 (in 2015 or earlier).

Global Invasive Bacterial Vaccine-Preventable Disease Surveillance Network

In 2016, the WHO Global Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance Network had data reported from 56 member states and 123 sentinel surveillance hospitals.

** Graphs 5 & 6 include sites/countries meeting these performance criteria: Sentinel sites must report cases for at least 10 months of the year 2016 (including zero reporting, if reported to WHO HQ) Tier 1 countries (conducting meningitis surveillance only) and Tier 2 countries (also conducting pneumonia/sepsis surveillance) must report respectively a minimum of 80 and 400 cases (all sites combined) in 2016 unless the pneumococcal conjugate vaccine was introduced in the country prior to 2016 (in 2015 or earlier).
Armenia is a lower middle-income country with a population of 3 million people including around 200,000 children under-five years of age (1). In collaboration with the WHO, the country has been conducting sentinel surveillance for rotavirus which has played a key role in the national vaccine policy and decision making process. A great example of this is the successful use of WHO Global Rotavirus Surveillance Network (GRSN) data in the final decision to introduce monovalent rotavirus vaccine in the country in 2012.
 
Sentinel surveillance data and data from other agencies were used in the economic evaluation of rotavirus vaccine introduction in Armenia, which showed that the vaccine would reduce health care costs and would be cost saving for the country in the long-term (2). Surveillance data were also used to show the dramatic impact of rotavirus vaccine in reducing rotavirus positivity by 48% in the first year and by ≥75% in the second and third year after rotavirus vaccine introduction among children hospitalized for acute gastroenteritis (1). Results of this study also showed ≥30% reduction of rotavirus positivity among children who are too old to be vaccinated indicating indirect protection provided by the vaccine (1).  The vaccine efficacy for 2 doses of rotavirus vaccine against severe rotavirus hospitalization was 79% among children 6-23 months of age.
 
A study conducted in GRSN sites in Armenia also detected a significant burden of disease for other gastroenteritis viruses especially norovirus among patients who tested negative for rotavirus (3). Armenia continues to leverage the GRSN platform to monitor other gastroenteritis viruses through participation in the Global Pediatric Diarrhea TAC study. These steps are very important in the ongoing monitoring of gastroenteritis pathogens especially after rotavirus introduction and to prepare for future introduction of additional enteric vaccines already in the pipeline.

Armenia has also conducted surveillance for invasive bacterial vaccine-preventable disease that is key to the country monitoring pneumococcal disease before and after the introduction of pneumococcal conjugate vaccine.
 
Armenia is currently in the accelerated transition phase of Gavi support and funding terminates at the end of 2017. Since Gavi has been the primary external funder of immunization, self-financing and sustainability of immunization activities including surveillance are matters of primary importance in the country.

 
 
References:
 
1)   Sahakyan, G., Grigoryan, S., Wasley, A., Mosina, L., Sargsyan, S., Asoyan, A., … Cortese, M. M. (2016). Impact and Effectiveness of Monovalent Rotavirus Vaccine in Armenian Children. Clinical Infectious Diseases, 62(suppl 2), S147–S154. https://doi.org/10.1093/cid/ciw045

2) Jit, M., Yuzbashyan, R., Sahakyan, G., Avagyan, T., & Mosina, L. (2011). The cost-effectiveness of rotavirus vaccination in Armenia. Vaccine, 29(48), 9104–9111. https://doi.org/10.1016/j.vaccine.2011.08.127

3) Chhabra, P., Samoilovich, E., Yermalovich, M., Chernyshova, L., Gheorghita, S., Cojocaru, R., Shugayev N., Sahakyan G., Lashkarashvili M., Chubinidze M., Zakhashvili K., Videbaek D., Wasley A.,Vinjé, J. (2014). Viral gastroenteritis in rotavirus negative hospitalized children <5 years of age from the independent states of the former Soviet Union. Infection, Genetics and Evolution, 28, 283–288. https://doi.org/10.1016/j.meegid.2014.10.013
 

Weekly Email Update on Vaccine-Related Literature 

The International Vaccine Access Center (IVAC) at Johns Hopkins University conducts a weekly Pubmed literature search on the following antigens: pneumococcus, rotavirus, Hib, meningococcus and HPV. The general topics included in the search for the above listed antigens are disease burden, vaccine impact, vaccine introductions, vaccine programs and optimization, and economics.  The recurring search began in 2013 to keep partners up to date on emerging literature and findings. IVAC has made this literature search more accessible in an effort to reach larger audiences with up to date research and findings on important vaccine antigens. You can subscribe here: http://goo.gl/forms/naoyfXhlZ5 
 

Upcoming Meetings and Events

Global Sentinel Vaccine-Preventable Disease Surveillance Network Meetings
November 13-17, 2017 - Geneva, Switzerland

WHO New Vaccine Surveillance Poster

Acknowledgements

WHO gratefully acknowledges the dedicated efforts of the numerous individuals and organizations involved with compiling this surveillance information, including Ministries of Health, sentinel hospitals, as well as the network of global, regional and national reference laboratories. WHO also gratefully acknowledges the financial support from Gavi, the Vaccine Alliance, that is provided to eligible countries and additional support from the U.S. Centers for Disease Control and Prevention and the Bill & Melinda Gates Foundation.

Please contact us at This email address is being protected from spambots. You need JavaScript enabled to view it. or reply to this email for questions and feedback on the bulletin. Feel free to share with colleagues, friends and on social media!