Global & Disaster Medicine

Archive for the ‘Kids-Infants’ Category

An explosion at the gates of a Chinese kindergarten that killed 8 and injured more than 60 was caused by a 22-year-old suicide bomber

BBC


7 people were killed and 59 injured Thursday in an explosion at the front gate of a kindergarten in eastern China

CBS News

 


Circulating vaccine-derived poliovirus type 2 – Democratic Republic of the Congo

WHO

Disease outbreak news
13 June 2017

In the Democratic Republic of the Congo (DRC), two separate circulating vaccine-derived poliovirus type 2s (cVDPV2s) have been confirmed. The first cVDPV2 strain has been isolated from two acute flaccid paralysis (AFP) cases from two districts in Haut-Lomami province, with onset of paralysis on 20 February and 8 March 2017. The second cVDPV2 strain has been isolated from Maniema province, from two AFP cases (with onset of paralysis on 18 April and 8 May 2017) and a healthy contact in the community.

Public health response

The Ministry of Health, supported by WHO and partners of the Global Polio Eradication Initiative (GPEI), has completed a risk assessment, including evaluating population immunity and the risk of further spread.

Outbreak response plans are currently being finalized, consisting of strengthening surveillance, including active case searching for additional cases of AFP, and supplementary immunization activities (SIAs) with monovalent oral polio vaccine type 2 (mOPV2), in line with internationally-agreed outbreak response protocols.

Surveillance and immunization activities are being strengthened in neighbouring countries.

WHO risk assessment

WHO assesses the risk of further national spread of these strains to be high, and the risk of international spread to be medium.

The detection of cVDPV2s underscores the importance of maintaining high routine vaccination coverage everywhere, to minimize the risk and consequences of any poliovirus circulation. These events also underscore the risk posed by any low-level transmission of the virus. A robust outbreak response as initiated is needed to rapidly stop circulation and ensure sufficient vaccination coverage in the affected areas to prevent similar outbreaks in the future. WHO will continue to evaluate the epidemiological situation and outbreak response measures being implemented.

WHO advice

It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for AFP cases in order to rapidly detect any new virus importation and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.

WHO’s International Travel and Health recommends that all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than four weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within four weeks to 12 months of travel. As per the advice of the Emergency Committee convened under the International Health Regulations (2005), efforts to limit the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC). Countries affected by poliovirus transmission are subject to Temporary Recommendations. To comply with the Temporary Recommendations issued under the PHEIC, any country infected by poliovirus should declare the outbreak as a national public health emergency and consider vaccination of all international travellers.


Circulating vaccine-derived poliovirus type 2 – Syrian Arab Republic

WHO

Disease outbreak news
13 June 2017

A circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak has been confirmed in the Deir Al Zour Governorate of the Syrian Arab Republic. There is evidence of genetic linkage among three isolates of type-2 vaccine-derived polioviruses (VDPV2) isolated in the stool specimens of two acute flaccid paralysis (AFP) cases with dates of onset of paralysis on 5 March and 6 May 2017, and the contact specimen of an AFP case collected on 17 April 2017. Al Mayadeen was also the epi-centre of the wild poliovirus type 1 (WPV1) outbreak in Syrian Arab Republic in 2013. Aggressive multi-country polio outbreak response effectively controlled the WPV1 outbreak and no WPV1 case has been reported in Syrian Arab Republic since 21 January 2014.

Public health response

Since the confirmation of the first VDPV2 during May 2017, AFP surveillance has been intensified in the Governorate, especially in the Al Mayadeen district. As of 6 June 2017, a total of 58 AFP cases have been reported from the Governorate this year. In addition to the two cases that have tested positive for VDPV2, a further 11 have tested negative for polioviruses, with the remaining samples being under process in the laboratories or being transported to the laboratories.

Subsequent to the confirmation of the cVDPV2 outbreak, outbreak response planning is underway, including planning for supplementary immunization activities (SIAs) with monovalent oral polio vaccine type 2 (mOPV2), in line with internationally-agreed outbreak response protocols.

Although access for vaccination is compromised due to prevailing insecurity in Deir Al Zour, the Governorate has been partially reached by several vaccination campaigns against polio and other vaccine-preventable diseases since the beginning of 2016. Most recently, two campaigns have been conducted in March and April 2017 using bivalent oral polio vaccine (bOPV). The most recent full trivalent oral polio vaccine (tOPV) round was conducted in October 2015; while tOPV rounds conducted in the first four months of 2016 only reached part of the target population of the Deir Al Zour Governorate. It is pertinent to mention that Syrian Arab Republic introduced two doses of inactivated polio vaccine (IPV) in the routine infant immunization schedule in 2008. Syrian Arab Republic switched from tOPV to bOPV for routine immunization on 1 May 2016.

A detailed risk analysis is currently being updated, including assessing overall population immunity levels and strengthening active searches for additional cases of AFP. Surveillance and immunization activities are being strengthened in neighbouring countries as well.

WHO risk assessment

The detection of cVDPV2 underscores the importance of maintaining high levels of routine vaccination coverage at all levels to minimize the risk and consequences of any poliovirus circulation. Such events also underscore the risk in areas or regions with continued substantial insecurity that hampers maintaining high population immunity through routine vaccination. A robust outbreak response is needed to rapidly stop the VDPV2 transmission. WHO will continue to evaluate the epidemiological situation and outbreak response measures being implemented.

WHO advice

It is important to complete the ongoing risk assessment as soon as possible to inform the vaccination response with mOPV2 and IPV. The geographical scale of the vaccination response will be in accordance with the findings of the risk assessment. It will be critical to achieve the highest possible coverage during the vaccination response. Given the difficult and challenging security situation in the area, appropriate strategies will be identified and utilized to implement the response. Intensified AFP surveillance should continue.

It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for AFP cases in order to rapidly detect any new virus importation and to facilitate a rapid response. Countries, territories, and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.

WHO’s International Travel and Health recommends that all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than four weeks) from infected areas should receive an additional dose of OPV or IPV within four weeks to 12 months prior to the travel.

As per the advice of an Emergency Committee convened under the International Health Regulations (2005), efforts to limit the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC). Countries affected by poliovirus transmission are subject to Temporary Recommendations. To comply with the Temporary Recommendations issued under the PHEIC, any country infected by poliovirus should declare the outbreak as a national public health emergency and consider vaccination of all international travellers.


South Sudan: 15 children die in botched measles vaccine campaign

ITV

  • The health ministry blamed the deaths on human error.
  • One syringe was used for all the children
  • The vaccine was not stored properly.
  • All of the children who died were under the age of 5.

 


UNICEF: As many as 150 children die every day in Myanmar before they reach their fifth birthday

The Guardian

  • The child mortality rate is estimated at about 50 per 1,000 live births in Myanmar. In the UK, the rate is four per 1,000.
  • Child rights violations, including the use of children as soldiers.
  • Nearly 30% of children under five suffer from moderate or severe malnutrition
  • More than half of all children live below the poverty line.
  • In western Rakhine state, 120,000 internally displaced people live in camps as a result of inter-communal conflict that erupted in 2012.
  • Violence against Rohingya Muslims, for whom the government does not provide full citizenship rights, has surged since October following attacks on border guard posts.

 


WHO: More than 1.2 million adolescents die every year around the world — an average of 3,000 deaths per day — from causes that are largely preventable

CNN

  • The leading cause of death among 10- to 19-year-olds globally in 2015 was road injury, which killed more than 115,000 people, followed by lower respiratory infections and self-harm.
  • Two-thirds of deaths among adolescents occur in Southeast Asia and Africa.

 


CDC: Global Vaccination Data

- 19.4 million infants didn't complete the basic series of vaccinations needed for protection in 2015. 60% of these babies live in 10 countries: India, Nigeria, Indonesia, Pakistan, Philippines, DR Congo, Iraq, Ethiopia, Ukraine, Angola

- Immunization prevents between 2 & 3 million deaths every year. Yet 1 in 7 kids are missing out. World Immunization Week www.cdc.gov/global

 


Syria: A suicide bomber who killed more than 120 people in Syria lured children toward him by handing out crisps before detonating his explosives.

Daily Mail

“….The bomb….killed at least 126 people including 68 children [as it] tore through buses carrying evacuees from besieged government-held towns….”

 


A new vaccine against rotavirus (kills about 600 children a day) worked well in a large trial in Africa and appears to be a practical way to protect millions of children.

NY Times

  • The vaccine is expected to be as cheap as or cheaper than current alternatives.
  • It can last for months without refrigeration, which makes it far easier to use in remote villages with no electricity
  • It must be approved by the World Health Organization before it can be widely distributed
  • About 215,000 children under 5 die each year of rotavirus, almost half of them in just four countries: India, Pakistan, Nigeria and the Democratic Republic of Congo


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