Cholera: WHO warns of outbreaks due to lack of vaccine

Science cholera

WHO warns of outbreaks due to vaccine shortages

Illustration of the bacterium "Vibrio cholerae"that triggers the disease

Illustration of the Vibrio cholerae bacterium that causes the disease

Source: Getty Images/Science Photo Library RF

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The infectious disease cholera is on the rise in numerous countries, partly because of floods, droughts and conflicts. At the same time there is a global vaccine shortage, to which the WHO is now reacting with a drastic step.

WBecause of numerous cholera outbreaks and a global shortage of vaccines, the World Health Organization (WHO) is temporarily recommending just one cholera vaccine dose instead of two. “This change in strategy makes it possible to deliver doses to more countries at the time of an unprecedented increase in the outbreaks of infection worldwide,” the WHO said in Geneva on Wednesday. Cholera outbreaks have been reported in 29 countries since the beginning of the year, including Haiti and Syria. The epidemics of gastrointestinal infection became more and more frequent and severe.

cholera is a bacterial infection transmitted by contaminated water that affects the intestinal tract and causes symptoms such as vomiting, dehydration and fatigue. The disease can be fatal if not treated in time. To avoid outbreaks of cholera, the supply of clean drinking water and clean sanitary facilities are crucial.

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According to the WHO, floods, droughts and conflicts are increasingly preventing people from having access to clean drinking water and toilets. As a result, cholera epidemics are becoming “more frequent, widespread and severe,” the UN organization said.

Since the beginning of the year, outbreaks have been reported in 29 countries, particularly severe ones in the Caribbean country of Haiti, East African Malawi and Syria. According to the WHO, fewer than 20 cholera outbreaks have been registered on average over the past five years.

Vaccine manufacturers have reached capacity

The WHO, which is part of the International Coordinating Group (ICG) for emergency vaccine distribution, said the strategy of a one-off cholera vaccination had “proven to be effective”. However, it is unclear how long the protection against infection lasts with just one vaccination. In addition, children seem to be significantly less protected against the infection with just one cholera vaccination than with two doses.

With two cholera vaccinations in a period of six months the protection holds according to the WHO for three years. Even if the temporary switch to only one vaccine dose reduces and shortens immunity, this strategy is preferable in view of the broader protection of vulnerable populations in the event of insufficient vaccine.

Vibrio cholerae attaches itself to the epithelial cells of the small intestine and releases a toxin that causes severe diarrhea, among other things

Vibrio cholerae attaches itself to the epithelial cells of the small intestine and releases a toxin that causes severe diarrhea, among other things

Source: Getty Images/Science Photo Library RF

Cholera vaccine is currently in extremely short supply. According to the WHO, 24 million doses of the 36 million doses to be produced this year have already been delivered. 83 percent of this was used to respond to cholera outbreaks, and the remaining 17 percent were used in preventive cholera vaccination campaigns. The ICG has approved vaccine doses for second vaccinations for four countries.

Since vaccine manufacturers have already reached their current capacity limit, there is “no short-term solution to increase production,” the WHO said. One of a number of reasons for the current bottlenecks is the decision of an Indian vaccine manufacturer, which belongs to the French Sanofi group, to stop producing cholera vaccines by the end of the year.

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The organization Doctors Without Borders, also a member of the ICG, said switching to just one dose of cholera vaccine was a “decision of last resort”. It prevents those responsible from being forced into the decision to “send the doses to one country or the other,” explained Daniela Garone of Doctors Without Borders. However, the restriction should only be a short-term emergency solution.

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