Global & Disaster Medicine

Archive for June, 2016

PAHO reports 9,400 new chikungunya cases; outbreak total tops 2 million


FDA approves vaccine to prevent cholera for travelers

FDA

The U.S. Food and Drug Administration today approved Vaxchora, a vaccine for the prevention of cholera caused by serogroup O1 in adults 18 through 64 years of age traveling to cholera-affected areas. Vaxchora is the only FDA-approved vaccine for the prevention of cholera.

Cholera, a disease caused by Vibrio cholerae bacteria, is acquired by ingesting contaminated water or food and causes a watery diarrhea that can range from mild to extremely severe. Often the infection is mild; however, severe cholera is characterized by profuse diarrhea and vomiting, leading to dehydration. It is potentially life threatening if treatment with antibiotics and fluid replacement is not initiated promptly. According to the World Health Organization, serogroup O1 is the predominant cause of cholera globally.

“The approval of Vaxchora represents a significant addition to the cholera-prevention measures currently recommended by the Centers for Disease Control and Prevention for travelers to cholera-affected regions,” said Peter Marks, M.D., Ph.D., director of the FDA’s Center for Biologics Evaluation and Research.

While cholera is rare in the U.S., travelers to parts of the world with inadequate water and sewage treatment and poor sanitation are at risk for infection. Travelers to cholera-affected areas have relied on preventive strategies recommended by the CDC to protect themselves against cholera, including safe food and water practices and frequent hand washing.

Vaxchora is a live, weakened vaccine that is taken as a single, oral liquid dose of approximately three fluid ounces at least 10 days before travel to a cholera-affected area.

Vaxchora’s efficacy was demonstrated in a randomized, placebo-controlled human challenge study of 197 U.S. volunteers from 18 through 45 years of age. Of the 197 volunteers, 68 Vaxchora recipients and 66 placebo recipients were challenged by oral ingestion of Vibrio cholerae, the bacterium that causes cholera. Vaxchora efficacy was 90 percent among those challenged 10 days after vaccination and 80 percent among those challenged three months after vaccination.  The study included provisions for administration of antibiotics and fluid replacement in symptomatic participants. To prevent transmission of cholera into the community, the study included provisions for administration of antibiotics to participants not developing symptoms.

Two placebo-controlled studies to assess the immune system’s response to the vaccine were also conducted in the U.S. and Australia in adults 18 through 64 years of age. In the 18 through 45 year age group, 93 percent of Vaxchora recipients produced antibodies indicative of protection against cholera. In the 46 through 64 years age group, 90 percent produced antibodies indicative of protection against cholera. The effectiveness of Vaxchora has not been established in persons living in cholera-affected areas.

The safety of Vaxchora was evaluated in adults 18 through 64 years of age in four randomized, placebo-controlled, multicenter clinical trials; 3,235 study participants received Vaxchora and 562 received a placebo. The most common adverse reactions reported by Vaxchora recipients were tiredness, headache, abdominal pain, nausea/vomiting, lack of appetite and diarrhea.

The FDA granted the Vaxchora application fast track designation and priority review status. These are distinct programs intended to facilitate and expedite the development and review of medical products that address a serious or life-threatening condition. In addition, the FDA awarded the manufacturer of Vaxchora a tropical disease priority review voucher, under a provision included in the Food and Drug Administration Amendments Act of 2007. This provision aims to encourage the development of new drugs and biological products for the prevention and treatment of certain tropical diseases.

Vaxchora is manufactured by PaxVax Bermuda Ltd., located in Hamilton, Bermuda.


Qatar’s health ministry reported a MERS-CoV infection, its third of the year, and Saudi Arabia confirmed a new case linked to camel exposure

Qatar

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The “Stop the Bleed” Program

DHS

Stop the Bleed

Stop the Bleed Logo

No matter how rapid the arrival of professional emergency responders, bystanders will always be first on the scene.  A person who is bleeding can die from blood loss within five minutes, therefore it is important to quickly stop the blood loss.

“Stop the Bleed” is a nationwide campaign to empower individuals to act quickly and save lives.

Remember to be aware of your surroundings and move yourself and the injured person to safety, if necessary.

Call 911.

Bystanders can take simple steps to keep the injured person alive until appropriate medical care is available.  Here are three actions you can take to help save a life:

Compress

Compress

Find where the bleeding is coming from and apply firm, steady pressure to the bleeding site with bandages or clothing

Tourniquet

Tourniquet

If the bleeding doesn’t stop, place a tourniquet 2-3 inches closer to the torso from the bleeding. (The tourniquet may be applied and secured over clothing.)

Pull the strap through the buckle, twist the rod tightly, clip and secure the rod with the clasp or the Velcro strap.

Compress Again

Compress again

If the bleeding still doesn’t stop, place a second tourniquet closer to the torso from the first tourniquet.

Pull the strap through the buckle, twist the rod tightly, clip and secure the rod with the clasp or the Velcro strap.

* One type of tourniquet is depicted in the illustrations.

More Information

You can learn more about how to “Stop the Bleed” and help save a life by accessing these training and resources:

You Are The Help They Need - Watch the Video

FEMA Video | Watch on YouTube

To learn more or to get involved in the Stop the Bleed Campaign, contact us at stopthebleed@hq.dhs.gov.

Last Published Date: November 20, 2015

Orlando Regional Medical Center admitted 44 patients after the mass shooting at the Pulse nightclub, and an additional 9 people were declared dead shortly after arriving at the hospital

Orlando Sentinel

“Many of the gun shot wounds were fairly severe…..Many trunk, abdomen and extreme gun shot wounds. Our operating room has been quite busy all day long with those injuries. ”

 


The Worst Mass Shooting in American History: 50 dead so far

CNN

At least 53 more people were wounded;  many in critical condition

 


Orlando, FL: Nightclub mass shooting leaves at least 20 dead and over 40 wounded

CNN

 


Two suicide bombers struck close to Damascus Saturday, killing at least 12 and wounding dozens more

Boston Herald

 

 

 


Stop The Bleeding Coalition

Stop The Bleeding

Coalition Mission: To help ensure prompt access to life-saving, easy-to-use hemorrhage control resources. Whether a professional rescuer or a layperson immediate responder, anyone can administer simple medical care to victims that stops hemorrhaging. The Stop the Bleeding Coalition aims to:

  • Educate on how immediate hemorrhage control saves lives
  • Raise awareness among key decision makers in both the public and private sectors
  • Promote legislation to help ensure the availability of hemorrhage control tools and training to save lives

Picture

Issue:  Far too many deaths occur as a result of the inability to quickly stop hemorrhaging and the time it takes to transport an injured person to a medical facility. However, this can be prevented with on-site Bleeding Control Kits that are worn as belts on each law enforcement officer and located in K-12 schools. Therefore, we have created a coalition to educate government on this problem and the need for universal access and use of these kits.

Picture

The High Risk of Low Survivability:  Since 2008 the number of active shooting events (ASEs) tripled from five on average per year to almost 16 on average per year with almost one-half occurring at businesses and one-third occurring in schools, according to the Federal Bureau of Investigation. Over the past fifteen years we have witnessed these horrific ASEs at Columbine High School, Virginia Tech, Fort Hood Army Base, the Aurora Movie Theater, the Boston Marathon, and the Columbia Mall, among others. While the locations range from schools to malls, one thing is in common – those on-site when the shooting occurs and law enforcement who are the first to arrive are in the best position to stop hemorrhaging that can save lives and limbs. The average response time by law enforcement for a mass casualty incident (MCI) is three minutes whereas medical professionals can take much longer or can’t be reached at all unless a police car delivers the patients to a medical facility. In fact, 80% of mass casualty patients are delivered to medical facilities by non-ambulances, according to the Special Operations Medical Association 2013 Conference. If no care is provided to stop bleeding on-site, the likelihood for surviving drops significantly.

Stopping Bleeding Saves Lives:  According to the National Trauma Institute, hemorrhaging is responsible for almost 35% of pre-hospital deaths and 40% of deaths in the first twenty-four hours after a traumatic event and the U.S. Army considers hemorrhage as the number one preventable cause of death on the battlefield.  As a result, the Department of Defense introduced gauze containing hemostatic agents in warzones in 2003 and by 2008 all warfighters were armed with their own trauma kit containing Combat Gauze upon deployment.  The rapid response required on the battlefield mirrors the response needed in ASEs.

 


FDA approves Vaxchora, a vaccine for the prevention of cholera caused by serogroup O1 in adults 18 through 64 years of age traveling to cholera-affected areas.

FDA

FDA approves vaccine to prevent cholera for travelers

For Immediate Release

June 10, 2016

Release

The U.S. Food and Drug Administration today approved Vaxchora, a vaccine for the prevention of cholera caused by serogroup O1 in adults 18 through 64 years of age traveling to cholera-affected areas. Vaxchora is the only FDA-approved vaccine for the prevention of cholera.

Cholera, a disease caused by Vibrio cholerae bacteria, is acquired by ingesting contaminated water or food and causes a watery diarrhea that can range from mild to extremely severe. Often the infection is mild; however, severe cholera is characterized by profuse diarrhea and vomiting, leading to dehydration. It is potentially life threatening if treatment with antibiotics and fluid replacement is not initiated promptly. According to the World Health Organization, serogroup O1 is the predominant cause of cholera globally.

“The approval of Vaxchora represents a significant addition to the cholera-prevention measures currently recommended by the Centers for Disease Control and Prevention for travelers to cholera-affected regions,” said Peter Marks, M.D., Ph.D., director of the FDA’s Center for Biologics Evaluation and Research.

While cholera is rare in the U.S., travelers to parts of the world with inadequate water and sewage treatment and poor sanitation are at risk for infection. Travelers to cholera-affected areas have relied on preventive strategies recommended by the CDC to protect themselves against cholera, including safe food and water practices and frequent hand washing.

Vaxchora is a live, weakened vaccine that is taken as a single, oral liquid dose of approximately three fluid ounces at least 10 days before travel to a cholera-affected area.

Vaxchora’s efficacy was demonstrated in a randomized, placebo-controlled human challenge study of 197 U.S. volunteers from 18 through 45 years of age. Of the 197 volunteers, 68 Vaxchora recipients and 66 placebo recipients were challenged by oral ingestion of Vibrio cholerae, the bacterium that causes cholera. Vaxchora efficacy was 90 percent among those challenged 10 days after vaccination and 80 percent among those challenged three months after vaccination.  The study included provisions for administration of antibiotics and fluid replacement in symptomatic participants. To prevent transmission of cholera into the community, the study included provisions for administration of antibiotics to participants not developing symptoms.

Two placebo-controlled studies to assess the immune system’s response to the vaccine were also conducted in the U.S. and Australia in adults 18 through 64 years of age. In the 18 through 45 year age group, 93 percent of Vaxchora recipients produced antibodies indicative of protection against cholera. In the 46 through 64 years age group, 90 percent produced antibodies indicative of protection against cholera. The effectiveness of Vaxchora has not been established in persons living in cholera-affected areas.

The safety of Vaxchora was evaluated in adults 18 through 64 years of age in four randomized, placebo-controlled, multicenter clinical trials; 3,235 study participants received Vaxchora and 562 received a placebo. The most common adverse reactions reported by Vaxchora recipients were tiredness, headache, abdominal pain, nausea/vomiting, lack of appetite and diarrhea.

The FDA granted the Vaxchora application fast track designation andpriority review status. These are distinct programs intended to facilitate and expedite the development and review of medical products that address a serious or life-threatening condition. In addition, the FDA awarded the manufacturer of Vaxchora a tropical disease priority review voucher, under a provision included in the Food and Drug Administration Amendments Act of 2007. This provision aims to encourage the development of new drugs and biological products for the prevention and treatment of certain tropical diseases.

Vaxchora is manufactured by PaxVax Bermuda Ltd., located in Hamilton, Bermuda.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

###

Inquiries

Media

  Tara Goodin
  240-402-31578


Consumers

  OCOD@fda.hhs.gov 
  888-INFO-FDA

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Page Last Updated: 06/10/2016 


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