Cheap vaccines prevent cholera

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Cheap vaccines prevent cholera

• 2 hours ago
  
• From the sectionHealth

Cholera is more dangerous in young children
A cheap oral vaccine has prevented cases of deadly cholera in a huge trial in Bangladesh.

The infection is spread through contaminated food or water and causes diarrhoea and severe dehydration.

More than 260,000 people took part in the study, which showed that the vaccine cut cases by 37% and halved the number of the most serious ones.

Experts welcomed the findings, published in the Lancet, but said it was crucial to tackle poor sanitation.

The World Health Organization estimates there are between three and five million cases of cholera, and up to 120,000 deaths, each year.

Oral vaccines have been available for years, but had been untested in countries where the disease is being constantly spread.

The study took place near the capital of Bangladesh, Dhaka, where there are outbreaks of the disease during every monsoon season.

A third of people had the vaccine, a further third had the vaccine and were encouraged to wash their hands with free soap while the remaining third had no change to their normal lifestyle.

The vaccine on its own cut cases by 37% and by 45% when combined with hand-washing.

The most severe and deadly cases were cut by 53% and 58% respectively.

Dr Firdausi Qadri, the lead researcher from the International Centre for Diarrhoeal Disease Research Bangladesh, said: "Our findings show that a routine oral cholera vaccination programme, in cholera-endemic countries, could substantially reduce the burden of disease and greatly contribute to cholera control efforts."

"Ultimately, the key to controlling cholera is clean water and adequate sanitation, which half the developing world lack, but this remains a rather difficult reality for the world's poorest nations as well as those affected by climate change, war, and natural disasters."

The vaccine costs $3.70 (£2.40) for two doses.

Dr Maureen O'Leary, from the London School of Hygiene and Tropical Medicine, said: "Cholera is a huge problem, particularly if there is a natural disaster."

"You have to view a vaccine as part of an overall package of interventions to reduce cholera, it won't have a huge impact on its own - but alongside clean water then it can make a big difference."

Dr Simon Clarke, a microbiologist from the University of Reading, said: "This is an indication that mass vaccination might have benefits, but it's no good if you don't deal with the root cause, which is poor sanitation - it is not a replacement for cleaning up people's living standards."

http://www.bbc.com/news/health-33442821

 

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1899-1923
At the turn of the century, the sixth pandemic killed more than 800,000 in India before moving into the Middle East, northern Africa, Russia and parts of Europe. By 1923, cholera had receded from most of the world, although many cases were still present in India.

1881-1896
The fifth pandemic originated in the Bengal region of India and swept through Asia, Africa, South America and parts of France and Germany. Cholera claimed 200,000 lives in Russia between 1893 and 1894; and 90,000 in Japan between 1887 and 1889. Quarantine measures based on the findings of John Snow kept cholera out of Britain and the United States.

In 1892, Waldemar Haffkine, a Ukrainian bacteriologist who worked mostly in India, developed a human vaccine for cholera.

1863-1879
The fourth pandemic began in the Bengal region from which Indian Muslim pilgrims visiting Mecca spread the disease to the Middle East. From there it migrated to Europe, Africa and North America. At least 30,000 of the 90,000 Mecca pilgrims fell victim to the disease.

Cholera claimed 90,000 lives in Russia in 1866.

1852-1859
The third pandemic, generally considered the most deadly, originated once again in India. It devastated large swaths of Asia, Europe, North America and Africa.

In 1854, the worst year, 23,000 died in Britain alone. In that same year, British physician John Snow succeeded in identifying contaminated water as the transmitter of the disease, a breakthrough in eventually bringing it under control.

Snow carefully mapped the cases of cholera in the Soho area in London and traced the source to a water pump. After convincing officials to remove the pump handle, the number of cholera cases in the area immediately declined.

1829-1849
The second pandemic started in India and reached Russia by 1830 before continuing into Finland and Poland. A two-year outbreak began in England in October 1831 and claimed 22,000 lives.

Irish immigrants, fleeing poverty and the potato famine, carried the disease from Europe to North America. On their arrival in the summer of 1832, 1,220 died in Montreal and another thousand across Quebec.

The disease then entered the U.S. through Detroit and New York, and reached Latin America by 1833. Another outbreak across England and Wales began in 1848, killing 52,000 over two years.

1817-1823
The first known pandemic of cholera originated in the Ganges River delta in India. The disease broke out near Calcutta and spread through the rest of the country. By the early 1820s, colonization and trade had carried the disease to Southeast Asia, central Asia, the Middle East, eastern Africa, and the Mediterranean coast.

The death toll from this outbreak is not known, but based on the 10,000 recorded deaths among British troops, researchers estimate that hundreds of thousands across India succumbed to the disease. In 1820, 100,000 people died on the Indonesian island of Java alone. By 1823, cholera had disappeared from most of the world, except around the Bay of Bengal.


http://www.cbc.ca/news/technology/cholera-s-seven-pandemics-1.758504
https://en.wikipedia.org/wiki/Cholera_outbreaks_and_pandemics further reading


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