Global & Disaster Medicine

Archive for the ‘Neglected Tropical Diseases’ Category

WHO reinstates snake-bite envenoming to its list of category A neglected tropical diseases

Lancet

Every year, more than 95 000 people die from snake bite, and a further 300 000 survive but with permanent disability or disfigurement.

An estimated 1·8–2·7 million people a year develop serious clinical illness (envenoming) after snake bite.

Most victims of snake bite live in the world’s poorest communities, with agricultural workers, children, and rural dwellers most at risk. About half of documented deaths from snake bite are in India but data from sub-Saharan Africa are fragmentary, and the burden of disease and the poverty it causes is likely to be underestimated. In Africa, a young farmer bitten by a puff adder might suffer terrible disfigurement rendering him fit only to beg, or the stigmatisation of scars from a spitting cobra bite might lead to a girl being unmarriageable.

WHO added snake bite to the list of NTDs in 2009, but it was later removed without explanation. …..”


WHO’s new list of neglected tropical diseases

 

WHO

Neglected tropical diseases (NTDs)– a diverse group of communicable diseases that prevail in tropical and subtropical conditions in 149 countries – affect more than one billion people and cost developing economies billions of dollars every year. Populations living in poverty, without adequate sanitation and in close contact with infectious vectors and domestic animals and livestock are those worst affected.

Effective control can be achieved when selected public health approaches are combined and delivered locally. Interventions are guided by the local epidemiology and the availability of appropriate measures to detect, prevent and control diseases. Implementation of appropriate measures with high coverage will contribute to achieving the targets of the WHO NTD Roadmap on neglected tropical diseases, resulting in the elimination of many and the eradication of at least two by 2020.

In May 2013, the 66th World Health Assembly resolved to intensify and integrate measures against neglected tropical diseases and to plan investments to improve the health and social well-being of affected populations. WHO is working with Member States to ensure the implementation of resolution WHA66.12.

In 2016, the 69th Assembly adopted resolution WHA69.21 on addressing the burden of mycetoma and requested WHO, through the Strategic and Technical Advisory for Neglected Tropical Diseases, “to define a systematic, technically-driven process for evaluation and potential inclusion of additional diseases among the ‘neglected tropical diseases’”.

Accordingly, in 2017 the 10th meeting of the Strategic and Technical Advisory Group for Neglected Tropical Diseases received proposals for the addition of diseases and, pursuant to the required procedures, chromoblastomycosis and other deep mycosesscabies and other ectoparasites and snakebite envenoming have been added to the NTD portfolio:


CDC’s Emergency Drugs for US Clinicians and Hospitals

CDC

Our Formulary

The following information is provided as an informational resource for guidance only. It is not intended as a substitute for professional judgment. These highlights and any hyperlinks may not include all the information needed to use each respective drug or biologic safely and effectively. See full prescribing information (package insert) or IND protocol for each respective drug or biologic, which accompany the product when it is delivered to the treating physician and/or pharmacist.

The Drug Service formulary is subject to change based on current public health needs, updates to treatment guidelines, and/or drug availability. For historical reference, we have included products no longer supplied by the Drug Service.

Product & Supplier Indication & Eligibility How Supplied
Anthrax Vaccine Absorbed

(Also known as “AVA”; BioThrax®, Emergent BioSolutions)

For the active immunization for the prevention of disease caused by Bacillus anthracis, in persons 18 through 65 years of age at high risk for exposure

Because the risk for anthrax infection in the general population is low, routine immunization is not recommended

The safety and efficacy of BioThrax® in a post-exposure setting have not been established.

Suspension for injection in 5 mL multidose vials, each containing 10 doses
Artesunate, intravenous

(Supplied to CDC by the Walter Reed Army Institute of Research)

For the treatment of severe malaria in patients who require parenteral (IV) therapy

Patient must meet the eligibility criteria in the IND protocol

110 mg; sterile dry-filled powder with phosphate buffer diluent for reconstitution
Benznidazole

(Benznidazol, Manufactured by LAFEPE)

For the treatment of American trypanosomiasis (Chagas disease)

Patient must meet the eligibility criteria in the IND protocol

100 mg double-scored tablet

12.5 mg dispersible tablet for pediatric use

Botulism Antitoxin Heptavalent (Equine), Types A-G

(Also known as “HBAT”; Manufactured by Cangene Corp. – BAT™)

For the treatment of symptomatic botulism following documented or suspected exposure to botulinum neurotoxin 20 mL or 50 mL single-use glass vial

May be received frozen or thawed

Diethylcarbamazine

(Also known as “DEC”; Supplied to CDC by the World Health Organization; Manufactured by E.I.P.I.C.O.)

For the treatment of certain filarial diseases, including lymphatic filariasis caused by infection with Wuchereria bancrofti, Brugia malayi, or Brugia timori; tropical pulmonary eosinophilia; and loiasis

For prophylactic use in persons determined to be at increased risk for Loa loa infection

Patient must meet the eligibility criteria in the IND protocol

100 mg tablet
Diphtheria Antitoxin (Equine)

(Also known as “DAT”; Manufactured by Instituto Butantan)

For prevention or treatment of actual or suspected cases of diphtheria

Patient must meet the eligibility criteria in the IND protocol

1 mL single-use ampule containing 10,000 units
Eflornithine

(Also known as “DFMO”; Supplied to CDC by the World Health Organization; Manufactured by Sanofi Aventis – Ornidyl®)

For the treatment of second-stage African trypanosomiasis (sleeping sickness) caused by Trypanosoma brucei gambiense, with involvement of the central nervous system 20 g/100 mL hypertonic solution for IV infusion

Must be diluted with Sterile Water for Injection before use

Melarsoprol

(Supplied to CDC by the World Health Organization; Manufactured by Sanofi Aventis – Arsobal®)

For the treatment of second-stage African trypanosomiasis (sleeping sickness), with involvement of the central nervous system

Patient must meet the eligibility criteria in the IND protocol

5 mL glass ampule containing 180 mg/5 mL (36 mg/mL)
Nifurtimox

(Supplied to CDC by the World Health Organization; Manufactured by Bayer – Lampit®)

For the treatment of American trypanosomiasis (Chagas disease)

Patient must meet the eligibility criteria in the IND protocol

120 mg double-scored tablet
Sodium Stibogluconate

(Manufactured by GlaxoSmithKline, UK – Pentostam®)

For the treatment of leishmaniasis

Patient must meet the eligibility criteria in the IND protocol

Solution for injection in 100 mL multidose bottle

100 mg pentavalent antimony (Sb) per mL

Suramin

(Supplied to CDC by the World Health Organization; Manufactured by Bayer – Germanin)

For the treatment of first-stage African trypanosomiasis (sleeping sickness) caused by Trypanosoma brucei rhodesiense, without involvement of the central nervous system

Patient must meet the eligibility criteria in the IND protocol

1 gram of suramin for injection in a 10 mL vial (100 mg/mL solution of suramin sodium)

Must be reconstituted with 10 mL Sterile Water for Injection before use

Vaccinia Vaccine

(Also known as the “Smallpox Vaccine”; Manufactured by Sanofi Aventis – ACAM2000®)

For active immunization against smallpox disease for persons determined to be at high risk for smallpox infection Lyophilized powder reconstituted with diluent (provided)

Contains 100 doses per vial

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Anthrax Vaccine Adsorbed

Anthrax Vaccine Adsorbed (AVA) is indicated for the active immunization for the prevention of disease caused by Bacillus anthracis, in persons 18 through 65 years of age at high risk for exposure. The safety and efficacy of AVA in a post-exposure setting have not been established.

CDC provides anthrax vaccine for laboratory workers conducting research under federally funded projects who require preexposure vaccination based on their occupational risk.

Preexposure vaccination is recommended for laboratorians at risk for repeated exposure to fully virulent B. anthracis spores, such as those who 1) work with high concentrations of spores with potential for aerosol production; 2) handle environmental samples that might contain powders and are associated with anthrax investigations; 3) routinely work with pure cultures of B. anthracis; 4) frequently work in spore-contaminated areas after a bioterrorism attack; or 5) work in other settings where repeated exposures to B. anthracis aerosols may occur. Read more[PDF – 36 pages](https://www.cdc.gov/mmwr/pdf/rr/rr5906.pdf).

More Information for Clinicians

CDC’s Anthrax Vaccination Website

Educational Toolkit for Clinicians (from Department of Defense Anthrax Immunization Program)

Vaccine Information Statement (VIS) for Anthrax Vaccine[PDF – 2 pages](https://www.cdc.gov/vaccines/hcp/vis/vis-statements/anthrax.pdf)

Full Prescribing Information for BioThrax®

How to Request

Anthrax vaccine must be administered by or under the supervision of the physician who registers with CDC.

Contact the CDC Drug Service for more information.

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Artesunate, Intravenous

Artesunate is in the class of medications known as artemesinins, which are derivatives from the “qinghaosu” or sweet wormwood plant (Artemisia annua). Artesunate is not currently licensed by FDA but is made available in the United States under a CDC-sponsored IND protocol for treatment of documented cases of severe malaria(https://www.cdc.gov/malaria/about/index.html) that require parenteral therapy. Read more(https://www.cdc.gov/malaria/diagnosis_treatment/artesunate.html).

More Information for Clinicians

Diagnostic assistance for malaria is available through DPDx.

How to Request

Clinicians who wish to obtain artesunate for severe malaria should contact the CDC Malaria Hotline at 770-488-7788 (M-F, 8am-4:30pm, Eastern time) or, after hours, the CDC Emergency Operations Center (EOC) at 770-488-7100, and request to speak with a CDC Malaria Branch clinician. A Malaria Branch clinician will provide clinical consultation by telephone and, if indicated, authorize the emergency release of artesunate from one of the CDC Quarantine Stations located in major airports around the nation, ensuring delivery to any location in the United States within hours.

Requests for unapproved uses cannot be granted.

For non-emergency questions related to artesunate IV, contact the CDC Drug Service.

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Benznidazole

Benznidazole is a 2-nitroimidazole trypanocidal agent that was introduced in 1971 for the treatment of Trypanosoma cruzi infection—i.e., Chagas disease, also known as American trypanosomiasis(https://www.cdc.gov/parasites/chagas/). Benznidazole is one of two drugs available from CDC for the treatment of Chagas disease (the other is nifurtimox). In the United States, the need to have drugs available for treating Chagas disease has been increasing, largely because of implementation of T. cruzi blood-donor screening in 2007, which has identified chronically infected persons (mainly Latin American immigrants) who might benefit from treatment and has heightened awareness of Chagas disease.

More Information for Clinicians

Evaluation and Treatment of Chagas Disease in the United States: A Systematic Review (JAMA 2007: 298:2171-81)

Screening and Treatment of Chagas Disease in Organ Transplant Recipients in the United States: Recommendations from the Chagas in Transplant Working Group (American Journal of Transplantation, 2011: 672–680)

Diagnostic assistance for American trypanosomiasis is available through DPDx.

How to Request

Contact the CDC Drug Service for more information.

Questions regarding treatment of Chagas disease should be directed to CDC Parasitic Diseases Inquiries (404-718-4745; email chagas@cdc.gov) M-F 7:30am-4pm EST.

For emergencies (for example, acute Chagas disease with severe manifestations, Chagas disease in a newborn, or Chagas disease in an immunocompromised person) outside of regular business hours, call the CDC Emergency Operations Center (770-488-7100) and ask for the person on call for Parasitic Diseases.

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Botulism Antitoxin Heptavalent (Equine), Types A-G

Botulism Antitoxin Heptavalent (HBAT) contains equine-derived antibody to the seven known botulinum toxin types (A-G). HBAT is composed of <2% intact immunoglobulin G (IgG) and ≥90% Fab and F(ab’)2 immunoglobulin fragments. These fragments are created by the enzymatic cleavage and removal of Fc immunoglobulin components in a process sometimes referred to as despeciation. HBAT is supplied on an emergency basis for the treatment of persons thought to be suffering from botulism and works by neutralizing unbound toxin molecules. In 2010, HBAT became the only botulism antitoxin available in the United States for naturally occurring non-infant botulism.

It is available only from CDC because of its limited use and its relatively short expiration date. The antitoxin is stored at CDC Quarantine Stations located in major airports around the nation, ensuring delivery to any location in the United States within hours.

BabyBIG® (botulism immune globulin) remains available for infant botulism through the California Infant Botulism Treatment and Prevention Program.

More Information for Clinicians

Clinical Guidance

How to Request

Clinicians who suspect a diagnosis of botulism in a patient should immediately call their state health department’s 24-hour telephone number(https://www.cdc.gov/mmwr/international/relres.html) to maintain effective botulism surveillance and to facilitate rapid detection of outbreaks. The state health department will contact CDC to arrange for a clinical consultation by telephone and, if indicated, release of botulism antitoxin. State health departments requesting botulism antitoxin should contact the CDC Emergency Operations Center (EOC) at 770-488-7100. Read more(https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5232a8.htm).

For non-emergency questions concerning botulism antitoxin, contact the CDC Drug Service.

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Diethylcarbamazine (DEC)

DEC is an antihelminthic agent used for treatment of lymphatic filariasis (caused by infection with Wuchereria bancrofti, Brugia malayi, or Brugia timori), tropical pulmonary eosinophilia, and loiasis(https://www.cdc.gov/parasites/loiasis/); DEC also has prophylactic benefit for Loa loa infection. DEC has been used worldwide for more than 50 years. In the past, Wyeth-Ayerst Laboratories made DEC available as a licensed drug; in the late 1990s, because of unavailability of a bulk chemical supplier, Wyeth-Ayerst discontinued distribution of DEC in the United States.

More Information for Clinicians

Diagnostic assistance for filarial diseases is available through DPDx.

How to Request

Contact the CDC Drug Service for more information.

Questions regarding treatment of filarial diseases should be directed to CDC Parasitic Diseases Inquiries (404-718-4745; email parasites@cdc.gov) M-F 7:30am-4pm EST.

After-hours emergencies: 1-770-488-7100

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Diphtheria Antitoxin (Equine)

Diphtheria antitoxin (DAT) is used to prevent or treat diphtheria by neutralizing the toxins produced by Corynebacterium diphtheriae. DAT is a sterile, aqueous solution of the refined and concentrated proteins, chiefly globulins, containing antibodies obtained from the serum of horses that have been immunized against diphtheria toxin. DAT is available under an IND protocol sponsored by CDC and is released only for actual or suspected cases of diphtheria(https://www.cdc.gov/diphtheria/about/index.html). The antitoxin is stored at CDC Quarantine Stations located in major airports around the nation, ensuring delivery to any location in the United States within hours.

More Information for Clinicians

CDC’s Vaccine-Related Topics: Diphtheria Antitoxin(https://www.cdc.gov/diphtheria/dat.html)

How to Request

Clinicians who suspect a diagnosis of respiratory diphtheria can obtain DAT by contacting the Emergency Operations Center at 770-488-7100. They will be connected with the diphtheria duty officer, who will provide clinical consultation and, if indicated, initiate the release of diphtheria antitoxin.

For non-emergency questions concerning diphtheria antitoxin, contact the CDC Drug Service.

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Eflornithine

Eflornithine is an antitrypanosomal agent that inhibits the enzyme ornithine decarboxylase. Antitrypanosomal treatment is indicated for all persons diagnosed with African trypanosomiasis (sleeping sickness)(https://www.cdc.gov/parasites/sleepingsickness/); the choice of therapy depends on the infecting subspecies of the parasite and on the stage of the infection. Eflornithine is considered the drug of choice for the treatment of second-stage Trypanosoma brucei gambiense (West African) infection, with involvement of the central nervous system. It is not effective against T. b. rhodesiense (East African) infection (see melarsoprol). Although the manufacturer, Aventis, maintains its US licensure, eflornithine is not commercially available in the United States.

More Information for Clinicians

Human African trypanosomiasis, WHO

Diagnostic assistance for African trypanosomiasis is available through DPDx.

How to Request

Contact the CDC Drug Service for more information.

Questions regarding treatment of African trypanosomiasis should be directed to CDC Parasitic Diseases Inquiries (404-718-4745; email parasites@cdc.gov) M-F 7:30am-4pm EST.

For emergencies outside of regular business hours, call the CDC Emergency Operations Center (770-488-7100) and ask for the person on call for Parasitic Diseases.

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Melarsoprol

Melarsoprol is an organoarsenic compound with trypanocidal effects that has been used outside the United States since 1949. Antitrypanosomal treatment is indicated for all persons diagnosed with African trypanosomiasis (sleeping sickness)(https://www.cdc.gov/parasites/sleepingsickness/); the choice of therapy depends on the infecting subspecies of the parasite and on the stage of the infection. Melarsoprol is used for the treatment of second-stage infection (involving the central nervous system). It is the only available therapy for second-stage Trypanosoma brucei rhodesiense (East African) infection, whereas eflornithine typically is used for second-stage T. b. gambiense (West African) infection.

More Information for Clinicians

Human African trypanosomiasis, WHO

Diagnostic assistance for African trypanosomiasis is available through DPDx.

How to Request

Contact the CDC Drug Service for more information.

Questions regarding treatment of African trypanosomiasis should be directed to CDC Parasitic Diseases Inquiries (404-718-4745; email parasites@cdc.gov) M-F 7:30am-4pm EST.

For emergencies outside of regular business hours, call the CDC Emergency Operations Center (770-488-7100) and ask for the person on call for Parasitic Diseases.

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Nifurtimox

Nifurtimox is a nitrofuran analog that was introduced in 1965 for the treatment of Trypanosoma cruzi infection—i.e., Chagas disease, also known as American trypanosomiasis(https://www.cdc.gov/parasites/chagas/). Nifurtimox is one of two drugs available from CDC for the treatment of Chagas disease (the other is benznidazole). In the United States, the need to have drugs available for treating Chagas disease has been increasing, largely because of implementation of T. cruzi blood-donor screening in 2007, which has identified chronically infected persons (mainly Latin American immigrants) who might benefit from treatment and has heightened awareness of Chagas disease.

More Information for Clinicians

Evaluation and Treatment of Chagas Disease in the United States: A Systematic Review (JAMA 2007: 298:2171-81)

Screening and Treatment of Chagas Disease in Organ Transplant Recipients in the United States: Recommendations from the Chagas in Transplant Working Group (American Journal of Transplantation, 2011: 672–680)

Diagnostic assistance for American trypanosomiasis is available through DPDx.

How to Request

Contact the CDC Drug Service for more information.

Questions regarding treatment of Chagas disease should be directed to CDC Parasitic Diseases Inquiries (404-718-4745; email chagas@cdc.gov) M-F 7:30am-4pm EST.

For emergencies (for example, acute Chagas disease with severe manifestations, Chagas disease in a newborn, or Chagas disease in an immunocompromised person) outside of regular business hours, call the CDC Emergency Operations Center (770-488-7100) and ask for the person on call for Parasitic Diseases.

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Sodium Stibogluconate

Sodium stibogluconate (Pentostam®) is a pentavalent antimony compound used for treatment of leishmaniasis(https://www.cdc.gov/parasites/leishmaniasis). The three main clinical syndromes in humans are visceral, cutaneous, and mucosal leishmaniasis. Pentostam is a well-established antileishmanial agent that has been used in many countries of the world for more than half a century.

More Information for Clinicians

Recommendations for Treating Leishmaniasis with Sodium Stibogluconate (Pentostam) and Review of Pertinent Clinical Studies (Am J Trop Med 1992:46(3):296-306)[PDF, 11 pages]

Diagnostic assistance for leishmaniasis is available through DPDx.

Practical Guide for Laboratory Diagnosis of Leishmaniasis[PDF, 4 pages](https://www.cdc.gov/parasites/leishmaniasis/resources/pdf/cdc_diagnosis_guide_leishmaniasis.pdf)

How to Request

Contact the CDC Drug Service for more information.

Questions regarding treatment of leishmaniasis should be directed to CDC Parasitic Diseases Inquiries (404-718-4745; email parasites@cdc.gov) M-F 7:30am-4pm EST.

After-hours emergencies: 1-770-488-7100

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Suramin

Suramin is a negatively charged, high-molecular-weight sulfated naphthylamine. It was introduced in the 1920s for the treatment of African trypanosomiasis (sleeping sickness)(https://www.cdc.gov/parasites/sleepingsickness/). Suramin generally is considered the drug of choice for first-stage Trypanosoma brucei rhodesiense (East African) infection, without involvement of the central nervous system. Pentamidine typically is used for first-stage T. b. gambiense (West African) infection.

More Information for Clinicians

Human African trypanosomiasis, WHO

Diagnostic assistance for African trypanosomiasis is available through DPDx.

How to Request

Contact the CDC Drug Service for more information.

Questions regarding treatment of African trypanosomiasis should be directed to CDC Parasitic Diseases Inquiries (404-718-4745; email parasites@cdc.gov) M-F 7:30am-4pm EST.

For emergencies outside of regular business hours, call the CDC Emergency Operations Center (770-488-7100) and ask for the person on call for Parasitic Diseases.

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Vaccinia Vaccine, “Smallpox Vaccine”

Smallpox vaccine is made of live vaccinia virus derived from plaque purification cloning of Dryvax® (calf lymph vaccine, New York City Board of Health Strain) and grown in African Green Monkey kidney (Vero) cells and tested to be free of adventitious agents. It contains approximately 2.5 – 12.5 x 105 plaque-forming units per dose.

Smallpox was declared globally eradicated in 1980. In 1982, Wyeth Laboratories, the only active manufacturer of licensed vaccinia vaccine in the United States, discontinued production; and, in 1983, distribution to the civilian population was discontinued. Since January 1982, smallpox vaccination has not been required for international travelers, and International Certificates of Vaccination no longer include smallpox vaccination. ACAM2000® is a new-generation smallpox vaccine that was licensed in 2010 for use as a medical countermeasure held by the Strategic National Stockpile.

CDC recommends vaccinia vaccine for laboratory workers who directly handle a) cultures or b) animals contaminated or infected with nonhighly attenuated vaccinia virus, recombinant vaccinia viruses derived from nonhighly attenuated vaccinia strains, or other orthopoxviruses that infect humans (e.g., monkeypox, cowpox, vaccinia, and variola). Other health-care workers (e.g., physicians and nurses) whose contact with nonhighly attenuated vaccinia viruses is limited to contaminated materials (e.g., dressings) and who adhere to appropriate infection control measures are at lower risk for inadvertent infection than laboratory workers. However, because a theoretical risk for infection exists, vaccination can be offered to this group. Read more[PDF – 930KB](https://www.cdc.gov/mmwr/pdf/rr/rr5010.pdf).

More Information for Clinicians

Full Prescribing Information for ACAM2000®[PDF – 11 pages]

ACAM2000® Medication Guide[PDF – 6 pages]

MMWR Notice to Readers: Newly Licensed Smallpox Vaccine to Replace Old Smallpox Vaccine(https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a6.htm)

CDC’s Vaccine-Related Topics: Smallpox Vaccine

How to Request

Smallpox vaccine must be administered by or under the supervision of the physician who registers with CDC.

Ancillary supplies, such as bifurcated needles (for administration) and 1 mL tuberculin syringes with 25 gauge x 5/8″ needles (for reconstitution), are supplied with the vaccine.

Contact the CDC Drug Service for more information.

Requests for unapproved uses cannot be granted.

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Products No Longer Supplied by Drug Service*

Botulinum Toxoid

Pentavalent (ABCDE) botulinum toxoid is a combination of aluminum phosphate-adsorbed toxoid derived from formalin-inactivated types A, B, C, D, and E botulinum toxins, with formaldehyde and thimerosal used as preservatives. Botulinum toxoid was distributed by CDC under an IND protocol for at-risk persons who were actively working or expected to be working with cultures of Clostridium botulinum or the toxins; in 2011, CDC discontinued its program to supply this vaccine. Read more(https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6042a3.htm).

Botulinum Antitoxin Types AB & E

In March 2010, CDC announced the availability of a new heptavalent botulinum antitoxin (HBAT, Cangene Corporation). HBAT replaced the licensed bivalent botulinum antitoxin AB and an investigational monovalent botulinum antitoxin E (BAT-AB and BAT-E, Sanofi Pasteur), becoming the only botulinum antitoxin available in the United States for naturally occurring non-infant botulism. Read more(https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5910a4.htm).

Vaccinia Immune Globulin (VIG)

Vaccinia immune globulin (VIG) is released from the CDC Strategic National Stockpile, if indicated, for the treatment of complications associated with vaccinia vaccination. Clinicians wishing to obtain VIG should contact the Emergency Operations Center (EOC) at 770-488-7100. They will be connected with CDC medical staff who can assist them in the diagnosis and management of patients with suspected complications of vaccinia vaccination.

*this list is not all-inclusive

Use of trade names is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.


WHO: Fact sheets relating to NTD

WHO

WHO maintains a complete list of fact sheets.


WHO’s overview of neglected tropical diseases (NTD)

WHO

Below is a short description of the neglected tropical diseases:

Dengue: mosquito-borne viral disease causing flu-like illness. Occasionally develops into a lethal complication called severe dengue.

Rabies: viral disease transmitted to humans through the bites of infected dogs. Invariably fatal once symptoms develop.

Trachoma: infection transmitted through direct contact with eye or nasal discharge. Causes irreversible corneal opacities and blindness.

Buruli ulcer: debilitating skin infection causing severe destruction of the skin, bone and soft tissue.

Yaws: chronic bacterial infection affecting mainly the skin and bone.

Leprosy: caused by infection mainly of the skin, peripheral nerves, mucosa of the upper respiratory tract and eyes.

Chagas disease: infection transmitted through contact with vector insects, ingestion of contaminated food, infected blood transfusion, congenital transmission, organ transplantation or laboratory accidents.

Human African trypanosomiasis (sleeping sickness): parasitic infection spread by bites of tsetse flies. Almost 100% fatal without prompt diagnosis and treatment.

Leishmaniases: transmitted through the bites of infected female sandflies. In its most severe (visceral) form, it attacks the internal organs. The most prevalent (cutaneous) form causes face ulcers, disfiguring scars and disability.

Taeniasis and neurocysticercosis: infection by adult tapeworms in human intestines; cysticercosis occurs when humans ingest tapeworm eggs that develop as larvae in tissues.

Dracunculiasis (guinea-worm disease): nematode infection transmitted by drinking-water contaminated with parasite-infected water fleas.

Echinococcosis: infection caused by larval stages of tapeworms forming pathogenic cysts. Transmitted to humans through ingestion of eggs, shed in faeces of dogs and wild animals.

Foodborne trematodiases: infection acquired by consuming fish, vegetables and crustaceans contaminated with larval parasites.

Lymphatic filariasis: Infection transmitted by mosquitoes causing abnormal enlargement of limbs and genitals from adult worms inhabiting and reproducing in the lymphatic system.

Mycetoma: debilitating, disabling bacterial/fungal skin infection thought to be caused by the inoculation of fungi or bacteria into the subcutaneous tissue.

Onchocerciasis (river blindness): parasitic eye and skin disease, transmitted by the bite of infected blackflies. Causes severe itching and eye lesions, leading to visual impairment and permanent blindness.

Schistosomiasis: larval worm infection. Transmission occurs when larval forms released by freshwater snails penetrate human skin during contact with infested water.

Soil-transmitted helminthiases: group of intestinal helminth infections transmitted through soil contaminated by human faeces.


WHO Reports ‘Record-breaking’ Progress: About 1.5 billion people in 149 countries, down from 1.9 billion in 2010, are affected by neglected tropical diseases (NTD)

VOA

WHO

Unprecedented progress against neglected tropical diseases, WHO reports

WHO reports remarkable achievements in tackling neglected tropical diseases (NTDs) since 2007. An estimated 1 billion people received treatment in 2015 alone.

“WHO has observed record-breaking progress towards bringing ancient scourges like sleeping sickness and elephantiasis to their knees,” said WHO Director-General, Dr. Margaret Chan. “Over the past 10 years, millions of people have been rescued from disability and poverty, thanks to one of the most effective global partnerships in modern public health”.

The WHO report, Integrating neglected tropical diseases in global health and development, demonstrates how strong political support, generous donations of medicines, and improvements in living conditions have led to sustained expansion of disease control programs in countries where these diseases are most prevalent.

Since 2007, when a group of global partners met to agree to tackle NTDs together, a variety of local and international partners have worked alongside ministries of health in endemic countries to deliver quality-assured medicines, and provide people with care and long-term management.

In 2012, partners endorsed a WHO NTD roadmap, committing additional support and resources to eliminating 10 of the most common NTDs.

Key achievements include:

  • 1 billion people treated for at least one neglected tropical disease in 2015 alone.
  • 556 million people received preventive treatment for lymphatic filariasis (elephantiasis).
  • More than 114 million people received treatment for onchocerciasis (river blindness: 62% of those requiring it.
  • Only 25 human cases of Guinea-worm disease were reported in 2016, putting eradication within reach.
  • Cases of human African trypanosomiasis (sleeping sickness) have been reduced from 37 000 new cases in 1999 to well under 3000 cases in 2015.
  • Trachoma – the world’s leading infectious cause of blindness – has been eliminated as a public health problem in Mexico, Morocco, and Oman. More than 185 000 trachoma patients had surgery for trichiasis worldwide and more than 56 million people received antibiotics in 2015 alone.
  • Visceral leishmaniasis: in 2015 the target for elimination was achieved in 82% of sub-districts in India, 97% of sub-districts in Bangladesh, and in 100% of districts in Nepal.
  • Only 12 reported human deaths were attributable to rabies in the WHO Region of the Americas in 2015, bringing the region close to its target of eliminating rabies in humans by 2015.

However, the report highlights the need to further scale up action in other areas.

“Further gains in the fight against neglected tropical diseases will depend on wider progress towards the Sustainable Development Goals,” said Dr Dirk Engels, Director of the Department of Control of Neglected Tropical Diseases. Meeting global targets for water and sanitation will be key. WHO estimates that 2.4 billion people still lack basic sanitation facilities such as toilets and latrines, while more than 660 million continue to drink water from “unimproved” sources, such as surface water.

Meanwhile, global concern about the recent outbreaks of Zika virus disease, and its associated complications, has re-energized efforts to improve vector control. In May this year, the World Health Assembly will review proposals for a new Global vector control response. There are also brighter prospects to prioritize cross-sectoral collaboration to promote veterinary public health.

Global Partners’ Meeting

Integrating neglected tropical diseases in global health and development is being released at the Global Partners’ Meeting on Neglected Tropical Diseases (NTDs) in Geneva, on 19 April 2017.

The Meeting will celebrate efforts to “Collaborate. Accelerate. Eliminate”, and will be attended by health ministers, industry representatives, partners and a host of well-known personalities, including philanthropists, donors and stakeholders.

Besides celebrating 10 years of multi-stakeholder collaboration, the event will also mark the 5th anniversary of the WHO NTD Roadmap which established targets and milestones for the global control, elimination, and eradication of many of these diseases as well as that of the London Declaration.

Note to editors:

Neglected tropical diseases blind, maim, disfigure and debilitate hundreds of millions of people in urban slums and in the poorest parts of the world.

Once widely prevalent, these diseases are now restricted to tropical and sub-tropical regions with unsafe water, inadequate hygiene and sanitation, and poor housing conditions. Poor people living in remote, rural areas, urban slums, or conflict zones are most at risk.

More than 70% of countries and territories that report the presence of NTDs are low or lower-middle income economies.

 


Drugs for Neglected Diseases initiative (DNDi): A collaborative, patients’ needs-driven, non-profit drug research and development (R&D) organization that is developing new treatments for neglected diseases.

Drugs for Neglected Diseases initiative (DNDi) is a collaborative, patients’ needs-driven, non-profit drug research and development (R&D) organization that is developing new treatments for neglected patients.

DNDI

DNDi is working on the following diseases:

In 2015, DNDi handed over its Malaria portfolio.

Achievements

Working in partnership with private industry, public institutions, academia and NGOs, DNDi has built the largest ever R&D portfolio for kinetoplastid diseases.

To date, DNDi has successfully delivered, recommended and implemented:


Neglected tropical diseases are finally getting the attention they deserve

STAT

“…Yet one of the most inspiring success stories is perhaps the one most overlooked: the global effort to eliminate neglected tropical diseases, or NTDs.

Much of the recent success stems from a meeting in London on Jan. 30, 2012 ……

NTDs affect nearly 1.5 billion of the poorest and most marginalized people around the world. And while 500,000 people lose their lives to NTDs every year, these diseases are more likely to disable and disfigure than to kill. …….These agonizing conditions keep children from school and adults from work, trapping families and communities in cycles of poverty……

Today, the landscape is dramatically different. In 2015, nearly 1 billion people received NTD treatments — 20 percent more than just two years before. As a result, fewer people are suffering from these diseases than at any point in history. ……Much of this success can be traced to the 2012 meeting in London. There, the World Health Organization, pharmaceutical companies, donors, governments, and non-governmental organizations committed to work together to control and eliminate 10 NTDs. …”

 


London Declaration on Neglected Tropical Diseases

London Declaration

THE LONDON DECLARATION

For decades, partners including pharmaceutical companies, donors, endemic countries and non-government organisations have contributed technical knowledge, drugs, research, funding and other resources to treat and prevent Neglected Tropical Diseases (NTDs) among the world’s poorest populations. Great progress has been made, and we are committed to build on these efforts. 

Inspired by the World Health Organization’s 2020 Roadmap on NTDs, we believe there is a tremendous opportunity to control or eliminate at least 10 of these devastating diseases by the end of the decade. But no one company, organization or government can do it alone. With the right commitment, coordination and collaboration, the public and private sectors will work together to enable the more than a billion people suffering from NTDs to lead healthier and more productive lives-helping the world’s poorest build self-sufficiency. As partners, with our varied skills and contributions, we commit to doing our part to:

We commit to doing our part to:

  • Sustain, expand and extend programmes that ensure the necessary supply of drugs and other interventions to help eradicate Guinea worm disease, and help eliminate by 2020 lymphatic filariasis, leprosy, sleeping sickness (human African trypanosomiasis) and blinding trachoma.
  • Sustain, expand and extend drug access programmes to ensure the necessary supply of drugs and other interventions to help control by 2020 schistosomiasis, soil-transmitted helminthes, Chagas disease, visceral leishmaniasis and river blindness (onchocerciasis).
  • Advance R&D through partnerships and provision of funding to find next-generation treatments and interventions for neglected diseases.
  • Enhance collaboration and coordination on NTDs at national and international levels through public and private multilateral organisations.
  • Enable adequate funding with endemic countries to implement NTD programmes necessary to achieve these goals, supported by strong and committed health systems at the national level.
  • Provide technical support, tools and resources to support NTD-endemic countries to evaluate and monitor programmes.
  • Provide regular updates on the progress in reaching the 2020 goals and identify remaining gaps.

To achieve this ambitious 2020 vision, we call on all endemic countries and the international; community to join us in the above commitments to provide the resources necessary across sectors to remove the primary risk factors for NTDs-poverty and exposure-by ensuring access to clean water and basic sanitation, improved living conditions, vector control, health and  education, and stronger health systems in endemic areas.

We believe that, working together, we can meet our goals by 2020 and chart a new course toward health and sustainability among the world’s poorest communities to a stronger, healthier future. 


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