DOCSLIB.ORG

Progress Toward Rubella Elimination and CRS Prevention in Europe Symposium

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Progress Toward Rubella Elimination and CRS Prevention in Europe Symposium PROCEEDINGS The Symposium Organizing Committee would like to thank the following organizations for their support of the Progress Toward Rubella Elimination and CRS Prevention in Europe symposium: Abbott Diagnostics Albert B. Sabin Vaccine Institute BioMerieux DiaSorin World Health Organization Regional Office for Europe March of Dimes Foundation Merck Roche sanofi-pasteur Serum Institute of India U.S. Centers for Disease Control and Prevention 2 Progress Toward Rubella Elimination And CRS Prevention in Europe Proceedings Table of Contents Executive Summary .............................................................4 Introduction ..........................................................................7 SESSION I: Measles Elimination in Europe ..................8 SESSION II: Background Information ..........................19 SESSION III: Diagnostics................................................24 SESSION IV: Global Epidemiology ................................28 SESSION V: Burden of Rubella and CRS in Europe ...31 SESSION VI: Country Experiences ................................36 SESSION VII: Strategies, Policy Implementation and Documentation of Rubella/CRS .......41 SESSION VIII: Surveillance Strategies ............................47 SESSION IX: Issues to be Addressed ...........................52 Concluding Remarks .........................................................57 Speakers .............................................................................58 Delegates ............................................................................59 Rome, Italy, 8-10 February 2012 3 Foreword From 8-10 February 2012, over 150 people from 47 countries met in Rome, Italy, to discuss the strategies and work needed to eliminate measles and rubella from the European region by 2015. It was the first major global meeting on rubella in 40 years. Participants shared lessons from the successes already achieved in rubella elimination around the world. By bringing together public health authorities and pediatric societies, the conference embodied the types of partnerships that will support successful elimination campaigns. Participants tackled the complexity of the immunization enterprise – from the basic sciences to the laboratories, from the role of clinicians to the community and the media. As Dr. Louis Cooper said, “It may seem on the surface very simple to vaccinate a child, but the truth is that it is exceedingly complex.” Symposium Organizing Committee Dr. Louis Cooper, American Academy of Pediatrics and International Pediatric Association Dr. Nedret Emiroglu, World Health Organization Regional Office for Europe Dr. Michael Katz, March of Dimes Dr. Stanley Plotkin, University of Pennsylvania Dr. Ciro de Quadros, Albert B. Sabin Vaccine Institute Dr. Maria Grazia Revello, Fondazione IRCCS Policlinico San Matteo Dr. Susan Reef, U.S. Centers for Disease Control and Prevention Executive Summary The rubella virus threatens children and adults, but poses the highest risk to pregnant women and their developing fetuses. Once known as “German measles,” rubella infection early in pregnancy may result in miscarriage, fetal death, or the birth of an infant with Congenital Rubella Syndrome (CRS). CRS can cause blindness, deafness, mental retardation, heart defects and a range of other conditions from diabetes to autism. An estimated 112,000 babies around the world are born with CRS every year. Many of these children need a life-time of medical and social support. Although the European Region has significantly reduced cases of rubella and of CRS, it has not eliminated them. Babies are still born with the condition, and expectant mothers must still make irrevocable choices when learning of their infected status. Yet, this situation is completely avoidable. For more than 40 years, a vaccine has been available to prevent rubella and CRS. The Americas have succeeded in eliminating both rubella and CRS through mass immunization. “In countries like the U.S., where we’ve eliminated congenital rubella, we’ve been able to close schools of the deaf,” Dr. Louis Cooper told the gathering. Rubella vaccine is most commonly administered as part of combination vaccines with measles (MR vaccine) or with measles and mumps (MMR vaccine). The use of measles vaccine has already reduced measles deaths, which fell 78 percent between 2000 and 2008. Yet, this disease continues to claim the lives of nearly 164,000 people a year, and sporadic outbreaks and imported cases threaten the progress already made. Thus, the use of rubella- and measles-containing vaccines could eliminate these two viruses and their huge burdens of disease, death, and disability. 4 Progress Toward Rubella Elimination And CRS Prevention in Europe Proceedings In 2010, the European Region set a goal of eliminating measles and rubella and preventing CRS by 2015. Dragan Jankovic, with the World Health Organization Regional Office for Europe, described four strategies for achieving this goal: • Reach at least 95 percent coverage of the population with two doses of measles-containing vaccine and one dose of rubella-containing vaccine (RCV); • Use mass campaigns and other supplementary vaccination activities to provide “catch-up” vaccination and reach everyone who is susceptible; • Establish case-based surveillance with strong laboratory involvement component; and • Make evidence-based information on immunization’s benefits and risks available to experts and the public. Throughout the two-and-a-half-day meeting, pediatricians, epidemiologists, and others involved in public health and health policies shared information on progress in implementing these strategies in the European Region, and the challenges that must be met to eliminate rubella. Presenters reported on significant progress already made: between 2001 and 2010, the WHO Europe Region achieved a 99 percent decline in reported cases of rubella. Major advances took place in the Central and Eastern parts of the Region, and the Newly Independent States. Nonetheless, outbreaks continue, and some countries have coverage of less than 80 percent. Pockets of susceptible populations are scattered throughout the region, and large gaps in surveillance mean that the region does not yet have an accurate picture of the extent of rubella and CRS. Every country is different, however. Representatives from Italy, Russia, Finland, Poland and France summarized their own histories, current status and challenges in rubella elimination. Consistent themes emerged in global, regional and national reports. One of the key challenges countries face is the need to significantly improve surveillance. This surveillance must be case-based, allowing the investigation of contacts, identification of cause (e.g. importation, failure to vaccinate, or vaccine failure); identification of populations at risk; and ensuring a public health response. Strong surveillance is also essential for the verification of elimination. Despite the importance of case-based surveillance reporting, in 2011 in the WHO European Region, it was provided by only 28 countries; 10 provided aggregate data and 15 provided no data. Once potential cases are identified, they need to be laboratory confirmed. But in 2010, only 22 percent of reported cases were confirmed. Speakers addressed the challenges of diagnosis, the confounding factors in assessing immune status, and the opportunities presented by molecular epidemiology. Country representatives also shared lessons from their vaccination experience, including the impact of targeting girls only for vaccination. Countries including Poland, Lithuania, Finland and France reported on the limitations of their initial approaches of only vaccinating girls and young women. This left circulation of the virus intact, outbreaks affected unvaccinated boys and men, and pregnant women who had not been vaccinated remained vulnerable to circulating virus. More recently, countries have been grappling with the need for mass catch-up campaigns that vaccinate older children, adolescents and even adults. Some fear that limited resources and competing public health demands may stand in the way, despite the importance of such campaigns for achieving elimination. Another common challenge was the ever-growing numbers of vaccine skeptics. “Vaccine safety is increasing, vaccine coverage is increasing, disease incidence is decreasing, and then public trust is decreasing,” said Pier Luigi Lopalco from the European Centre for Disease Prevention and Control (ECDC). The source of opposition is not only largely unfounded fears about vaccine safety, but also suspicions aroused by anything that appears to be a major change in policy from the top. Therefore, vaccine campaigns can bring their own headwinds, said Jan Bonhoeffer from the Brighton Collaboration. Discussants addressed the need for the public health community to utilize some of the same social and digital media tools now used so adroitly by vaccine opponents, and the need for trusted health providers, starting with pediatricians, to more visibly support the need for vaccination. To do so, however, they need access to the most up-to-date and credible evidence of vaccine impacts, safety and risks. Rome, Italy, 8-10 February 2012 5 The meeting also considered global issues of vaccine cost-effectiveness and vaccine demand, supply and cost. The cost-effectiveness of rubella vaccine is apparent. Jon Kim Andrus from the Pan American Health Organization (PAHO) reported on studies in the PAHO region that show the benefit-cost ratio was
Load more

Recommended publications
  • Independent Monitoring Board of the Global Polio Eradication Initiative Report
    Independent Monitoring Board of the Global Polio Eradication Initiative Report July 2011 Independent This second report follows our third meeting, held in London on 30 June and 1 July 2011. Monitoring Board of the At present the needs are: Global Polio • To concisely understand the global situation Eradication Initiative • To maintain clear and energetic focus in each country with ongoing transmission July 2011 • To see the wood for the trees in identifying and dealing with the programme’s key risks • To find innovative solutions that break through entrenched problems • To surface fundamental problems that need urgent attention We are grateful to the many partners of the Global Polio Eradication Initiative who have provided us with information, logistical support, and valuable insights. We are grateful for their help, and commend their commitment. Our role remains to speak with a clear, objective voice that is independent of any of these partners. We each sit on this board in a personal capacity. We remain resolutely independent, and will continue to present our frank view without fear or favour. Sir Liam Donaldson (Chair) Dr Mushtaque Chowdhury* Former Chief Medical Officer, England Associate Director, Rockefeller Foundation Dr Nasr El Sayed Dr Ciro de Quadros Assistant Minister of Health, Egypt Executive Vice President, Sabin Vaccine Institute Dr Jeffrey Koplan Dr Sigrun Mogedal Vice President for Global Health Special Advisor, Norweigan Knowledge Centre Director, Emory Global Health Institute for the Health Services Professor Ruth Nduati Dr Arvind Singhal Chairperson, Department of Paediatrics and Child Health Marston Endowed Professor of Communication University of Nairobi University of Texas at El Paso Professor Michael Toole Head, Centre for International Health *Dr Chowdhury was unable to participate in the meeting but Burnet Institute, Melbourne endorses this report The Independent Monitoring Board was convened at the request of the World Health Assembly to monitor and guide the progress of the Global Polio Eradication Initiative’s 2010-12 Strategic Plan.
    [Show full text]
  • THE ERADICATION of POLIOMYELITIS (Fhe Albert V.• Sabin Lecture)
    THE ERADICATIONOF POLIOMYELITIS (fhe Albert V.•Sabin Lecture) by Donald Henderson, M.D., M.P.H. University Distinguished Service Professor The JohnsHopkins University Baltimore, Maryland 21205 Cirode Quadros, M.D., M.P.H. Regional Advisor Expanded Programme on lmmunii.ation Pan American Health Organization 525 23rd Street, N. W. Washington, D.C. 20037 Introduction The understanding and ultimate conquest of poliomyelitis was Albert Sabin's life­ long preoccupation, beginning with his earliest work in 1931. (Sabin and Olitsky, 1936; Sabin, 1965) The magnitude of that effort was aptly summarized by Paul in his landmark history of polio: "No man has ever contributed so much effective information - and so continuously over so many years - to so many aspects of poliomyelitis." (Paul, 1971) Thus, appropriately, this inaugural Sabin lecture deals with poliomyelitis and its eradication. Polio Vaccine Development and Its Introduction In the quest for polio control and ultimately eradication, several landmarks deserve special mention. At the outset, progress was contingent on the development of a vaccine and the production of a vaccine, in turn, necessitated the discovery of new methods to grow large quantities of virus. The breakthrough occurred in 1969 when Enders and his colleagues showed that large quantities of poliovirus could be grown in a variety of human cell tissue cultures and that the virus could be quantitatively assayed by its cytopathic effect. (Enders, Weller and Robbins, 1969) Preparation of an inactivated vaccine was, in principle, a comparatively straightforward process. In brief, large quantities of virus were grown. then purified, inactivated with formalin and bottled. Assurance that the virus had been inactivated could be demonstrated by growth in tissue.
    [Show full text]
  • Energy Efficiency And
    Progress with The Energy Policy Review: A Perspective OIES Seminars 7 October 2003 John Bower Overview What the White Paper Said Reality Dawns An alternative 20:20 Vision John Bower Progress on UK Energy White Paper 2 What the White Paper Said UKEWP refocused energy policy away from a UK driven liberalisation agenda… GOALS AND POLICIES 1. Reduce CO2 emissions by 60% by 2050 Reduce amount of energy we consume Central to future market and policy will be emissions trading Raise efficiency standards in home appliances and housing Encourage low carbon fuels and renewables through grants and subsidy 2. Maintain reliability of energy supplies Right infrastructure / regulatory systems in UK and liberalisation of Europe Pursue regional stability and economic reform in producing areas Promote understanding of markets and conditions for FDI in producing areas Forward prices will signal the need for investment Improve contingency planning in dealing with major incidents John Bower Progress on UK Energy White Paper 3 What the White Paper Said …. towards an EU driven multifaceted agenda GOALS AND POLICIES 3. Promote competitive markets in UK and beyond Raise rate of sustainable economic growth Support business and competitiveness through reliable / affordable energy Encourage firms to innovate, reduce cost, deliver better goods and services Use market based instruments to deliver policy goals Work with business to prepare them for the low carbon economy of the future 4. Ensure that every home is adequately and affordably heated Reduce poverty by lowering prices and raising social security payments Improve quality of housing stock via insulation and energy efficiency grants John Bower Progress on UK Energy White Paper 4 What the White Paper Said UKEWP relied on carbon trading and uneconomic/unproven technology… ENERGY SYSTEM IN 2020 1.
    [Show full text]
  • MI4A Vaccine Purchase Data for Countries This Note Is Intended to Guide Countries in Their Use of the MI4A Vaccine Purchase Data
    MI4A Vaccine Purchase Data for Countries This note is intended to guide countries in their use of the MI4A vaccine purchase data. What data is available? new vaccine introductions, but also for product switches – and to understand the status of product The WHO vaccine market intelligence database registrations. Fifty-six Member States responded compiles vaccine purchase (product, price and to these new questions. procurement) data as reported by countries via the WHO/UNICEF Joint Reporting Form (JRF) over the This information is essential to WHO’s efforts to period of 2013–2018. While country names are not improve global market forecasts and inform displayed, data is publicly available on the MI4A suppliers’ and global policy-makers’ investment website and provides information by country decisions. WHO encourages all countries to characteristics (e.g. region, income group…) by report information on new introduction plans and vaccine and by year of purchase, along with price planned product changes as well as to respond to per dose (USD), procurement mechanism and questions related to registration. annual volumes. 1 The number of countries reporting vaccine How can my country use this data? purchase data through the JRF continues to Countries can use the vaccine purchase data in increase year after year, with 182 Member States several different ways, such as to: (93%) reporting some vaccine procurement information in 2019 – including 158 (81%) fully • Understand how the price of vaccines in their reporting on vaccine purchase data. Price reporting immunization schedule relate to other this year marks a 3% increase from last year and products on the market, or compare the more than triple the reporting from 2016.
    [Show full text]
  • Contribution of Podoviridae and Myoviridae Bacteriophages
    www.nature.com/scientificreports OPEN Contribution of Podoviridae and Myoviridae bacteriophages to the efectiveness of anti‑staphylococcal therapeutic cocktails Maria Kornienko1*, Nikita Kuptsov1, Roman Gorodnichev1, Dmitry Bespiatykh1, Andrei Guliaev1, Maria Letarova2, Eugene Kulikov2, Vladimir Veselovsky1, Maya Malakhova1, Andrey Letarov2, Elena Ilina1 & Egor Shitikov1 Bacteriophage therapy is considered one of the most promising therapeutic approaches against multi‑drug resistant bacterial infections. Infections caused by Staphylococcus aureus are very efciently controlled with therapeutic bacteriophage cocktails, containing a number of individual phages infecting a majority of known pathogenic S. aureus strains. We assessed the contribution of individual bacteriophages comprising a therapeutic bacteriophage cocktail against S. aureus in order to optimize its composition. Two lytic bacteriophages vB_SauM‑515A1 (Myoviridae) and vB_SauP‑ 436A (Podoviridae) were isolated from the commercial therapeutic cocktail produced by Microgen (Russia). Host ranges of the phages were established on the panel of 75 S. aureus strains. Phage vB_ SauM‑515A1 lysed 85.3% and vB_SauP‑436A lysed 68.0% of the strains, however, vB_SauP‑436A was active against four strains resistant to vB_SauM‑515A1, as well as to the therapeutic cocktail per se. Suboptimal results of the therapeutic cocktail application were due to extremely low vB_SauP‑436A1 content in this composition. Optimization of the phage titers led to an increase in overall cocktail efciency. Thus, one of the efective ways to optimize the phage cocktails design was demonstrated and realized by using bacteriophages of diferent families and lytic spectra. Te wide spread of multidrug-resistant (MDR) bacterial pathogens is recognized by the World Health Organi- zation (WHO) as a global threat to modern healthcare1.
    [Show full text]
  • List of Registred Drugs in Armenia (01.03.2017-31.03.2017)
    LIST OF REGISTRED DRUGS IN ARMENIA (01.03.2017-31.03.2017) International nonproprietary name Dose and Registration Term of Legal Status N Trade name Drug form Manufacturer Country ATC1 code License holder (generic) or active packaging number registration for Supply ingredients name Eli Lilly Regional Lilly France S.A.S., Operations GmbH., solution for 100IU/ml, Zone Industrielle, 2 17.03.2017 1 Abasaglar insulin glargine France A10AE04 16535 PoM2 Koelblgasse 8-10, injection 3ml cartridges (5) rue du Colonel Lilly, 17.03.2022 1030, Vienna, 67640 Fegersheim Austria Olainfarm JSC, 5 300mg, Olainfarm JSC, 5 06.03.2017 Rupnicu Str., 2 Adaptol mebicar capsules hard in blister (20/2x10/, Rupnicu Str., Olaine, Latvia N06BX21 16440 PoM 06.03.2022 Olaine, LV-2114, 30/3x10/, 40/4x10/) LV-2114 Latvia Olainfarm JSC, 5 Olainfarm JSC, 5 500mg, 06.03.2017 Rupnicu Str., 3 Adaptol mebicar tablets Rupnicu Str., Olaine, Latvia N06BX21 16441 PoM in blister (20/2x10/) 06.03.2022 Olaine, LV-2114, LV-2114 Latvia 10mg, Pharmstandard- OTCPharm PJSC, fabomotizole in blisters Leksredstva JSC, 27.03.2017 123317, Moscow, 4 Afobazol (fabomotizole tablets (30/1x30/, 60/3x20/, 305022, Kursk, Russia N05BX04 14729/2 PoM 30.07.2020 Testovskaya str., 10, dihydrochloride) 60/2x30/, 90/3x30/, Agregatnaya 2nd str., Russia 120/4x30/) 1a/18 Gedeon Richter 15mg/g, Gedeon Richter PLC, 17.03.2017 PLC, Gyomroi ut 5 Airtal aceclofenac cream 60g aluminium Gyomroi ut 19-21, Hungary M01AB16 16514 OTC3 17.03.2022 19-21, 1103 tube 1103 Budapest Budapest, Hungary 1 Gedeon Richter PLC, Gyomroi ut 19-21, 1103 Budapest - batch releaser, Industrias Gedeon Richter Farmaceuticas powder for oral 100mg, 17.03.2017 PLC, Gyomroi ut 6 Airtal aceclofenac Almirall S.L., Ctra.
    [Show full text]
  • Annex 2 Composition of Oral and Injectable Estrogen–Progestogen Contraceptives
    ANNEX 2 COMPOSITION OF ORAL AND INJECTABLE ESTROGEN–PROGESTOGEN CONTRACEPTIVES Annex 2 lists the composition of brands of estrogen–progestogen preparations used in combined injectables (Table 1), combined oral (Table 2) and phasic oral (Table 3) contraceptives. The countries in which these formulations are used are noted. Are listed only those brands for which availability was reported. The source of these tables is the International Planned Parenthood Foundation (IPPF). Data have been taken from the IPPF 2002 website [http://contraceptive.ippf.org] at the time of the monograph meeting (June 2005). This online site is regularly updated. Table 1. Combined injectables Brand name Composition Countries of availability Acefil Dihydroxyprogesterone acetophenide 150 mg Paraguay + estradiol enanthate 10 mg Agurin Dihydroxyprogesterone acetophenide 150 mg Chile + estradiol enanthate 10 mg Anafertin Dihydroxyprogesterone acetophenide 75 mg El Salvador, Mexico + estradiol enanthate 5 mg Ciclofem Medroxyprogesterone acetate 25 mg Guatemala + estradiol cypionate 5 mg Ciclofemina Medroxyprogesterone acetate 25 mg El Salvador + estradiol cypionate 5 mg Ciclomes Dihydroxyprogesterone acetophenide 150 mg Paraguay + estradiol enanthate 10 mg Ciclovular Dihydroxyprogesterone acetophenide 150 mg Brazil + estradiol enanthate 10 mg Clinomin Dihydroxyprogesterone acetophenide 150 mg Paraguay + estradiol enanthate 10 mg Cyclofem Medroxyprogesterone acetate 25 mg Chile, Indonesia, Malaysia, Mexico, + estradiol cypionate 5 mg Panama, Zimbabwe Cyclofemina Medroxyprogesterone
    [Show full text]
  • Vaccine Purchase Data and Cover Note for Countries
    MI4A Vaccine Purchase Data for Countries The MI4A Vaccine Purchase How can my country use this data?1 Database What data is available? • • • • WORKING DOCUMENT - MI4A Vaccine Purchase Data Note [December 2020] | 1 Immunization Agenda IA 2030 Reporting Vaccine Purchase Data Documenting use of MI4A data WORKING DOCUMENT - MI4A Vaccine Purchase Data Note [December 2020] | 2 Key messages to countries • • • 7 WORKING DOCUMENT - MI4A Vaccine Purchase Data Note [December 2020] | 3 • • • • • . / WORKING DOCUMENT - MI4A Vaccine Purchase Data Note [December 2020] | 4 • • • • • • • 12 WORKING DOCUMENT - MI4A Vaccine Purchase Data Note [December 2020] | 5 • • • • • • • • 13 WORKING DOCUMENT - MI4A Vaccine Purchase Data Note [December 2020] | 6 • • • • • WORKING DOCUMENT - MI4A Vaccine Purchase Data Note [December 2020] | 7 What is MI4A? • • • WORKING DOCUMENT - MI4A Vaccine Purchase Data Note [December 2020] | 8 A. Available Products List - as known to WHO The MI4A Products List provides a snapshot overview of vaccine products available for procurement – irrespective of their WHO prequalification status – as of November 2020. This list reflects information reported by countries through the 2020 Joint Reporting Form (JRF) and is supplemented with available information gathered through separate consultations. As part of the MI4A project, WHO conducts in-depth global market studies where the list of available vaccines can be considered comprehensive and up to date. Studies conducted so far include BCG, D&T-containing, measles-containing, meningococcal, HPV, pneumococcal, rabies, and typhoid vaccines. For all the other vaccines it should be noted that this list may not be complete and may be missing some products whose availability is not documented through public reported data and sources.
    [Show full text]
  • Biotechnology in Russia: Why Is It Not a Success Story?
    Biotechnology in Russia: Why is it not a success story? Biotechnology inRussia:Whyisitnotasuccessstory? ROGER ROFFEY Biotechnology in Russia: Why is it not a success story? According to President Medvedev 2009 ‘By and large, our industry continues to make the same outdated products and, as a rule, imported generics from substances bought abroad. There is practically no work to create original medicines and technologies.’…‘We must begin the modernisation and technological upgrading of our entire industrial sector. I see this as a question of our country’s survival in the modern world’… ‘These are the key tasks for placing Russia on a new technological level and making it a global leader’. Many states including Russia see biotechnology and its commercialization as a key driver for their future growth. The biotechnology area is characterized by being a very knowledge-intensive activity where there is increasing global competition for know-how. Russia had a very good historical base of R&D and know- how in biotechnology from the previous Soviet military programme. There have been many attempts since 2000 to revive the Russian biotechnology industry not least in 2005 but without much success. In 2009 there were again very ambitious programmes and strategies developed as well as techno-parks for the ROGERROFFEY development of the biotechnology and pharmaceuticals industry up to 2020. It has also been announced by President Medvedev the creation of a Russian equivalent to ‘Silicon Valley’ to include R&D also in biotechnology outside Moscow. There have been many such grand plans but so far they have not been very successful and the question for this study was if it would be different this time? Why are scientists still leaving Russia and foreign investors still hesitating to invest in Russian biotechnology or pharmaceuticals? Why is Russia still not able to compete on the global biotechnology market and is ranked only as number 70 in the world? The current problems and prospects for the biotechnology and pharmaceuticals industries are analysed.
    [Show full text]
  • Leadership in Global Health: the Case of Ciro De Quadros, a Testament to Values, Valor, and Vision
    Pan American Journal Profile of Public Health When Dr. Bill Foege wrote “When Words Fail,” he was referring to how difficult Leadership in it was for him to describe adequately, in written words, all the effort that is involved from the scientific conceptualization of a new vaccine, to eventual bench discovery global health: and development, to the training and supply chain logistics, and ultimately to the moment the needle pricks the skin to save a life of a child (1). He called it the “chain the case of Ciro of perfection”. He was “at a loss” to describe this cascade of events with due justice. I have been asked to describe the leadership attributes of Dr. Ciro de Quadros as a de Quadros, a case study in best practice and lessons to be learned. Similarly, I too am at a loss. Simply put, Ciro broke the mold. testament to I should disclose that what I am about to write is influenced by decades of either working directly for Ciro, as was the case during the polio eradication era in the Americas, to collaborating with Ciro more recently on various projects that in- values, valor, cluded measles and rubella elimination, the introduction of new vaccines, and sur- veillance of infectious diseases. The work evolved into a relationship that bridged and vision from professional mentorship, to actual friends with a deep sense of admiration, love, and mutual respect. In global health, leadership is somewhat like the “self-actualization” of public Jon Kim Andrus1 health practice. The “leader” must have all those attributes that embodies a fully realized individual, positioned in the system to make things happen, such as in Ciro’s case, to help create a world of equitable access to life-saving vaccines.
    [Show full text]
  • PR-Bird Flu-CCX-[MASTER]
    Avian Flu D-125TM H5N1 It's not a matter of if... it's a matter of WHEN BELIEVED BY US EPA TO KILL AVIAN FLU D-125 is a US EPA-registered sanitizer, disinfectant and cleaner effective against several strains of the Avian Flu. The US EPA does not currently have any products that are regis- tered against the particular H5N1 strain of Avian Flu; however, the US EPA has indicated that they believe D-125 will prove effective against H5N1 once testing is completed. These products are available in an economical concentrate and ready-to-use spray and wipe formulation. Both the concentrate and the ready-to-use are US EPA-registered to kill an extraor- dinary range of 120 plus microbial organisms including all of the pan-demic human influenza strains of the 20th century including: Influenza A / Brazil Virus Influenza A / Victoria (H3N2) Virus Influenza A2-Asian Virus Influenza B Virus (Allen Strain) Influenza C Virus (Taylor Strain) D-125 is a registered tademark of Microgen Inc. Parainfluenza Type 1 In addition to being among a select group of products believed effective against H5N1 Avian Flu Virus, D-125 registered for use in and has specific instructions for disinfecting poultry houses as well as meat, poultry and food processing plants. Microgen Inc. D-125 is also registered for use on both hard, non-porous Clinton Square Executive Center surfaces and on porous surfaces. West Caldwell, NJ 07006 USA www.microgeninc.com With such versatility and efficacy D-125 is the ultimate choice 1-800-420-7522 or 973-575-9025 when disinfecting and sanitizing.
    [Show full text]
  • Live Attenuated Influenza Vaccines Against
    ccines & a V f V a o c l c i a n n a Larionova et al., J Vaccines Vaccin 2013, 4:8 r t u i o o n DOI: 10.4172/2157-7560.1000208 J Journal of Vaccines & Vaccination ISSN: 2157-7560 Research Article Open Access Live Attenuated Influenza Vaccines against Highly Pathogenic H5N1avian Influenza: Development and Preclinical Characterization Natalie Larionova1*, Irina Kiseleva1, Irina Isakova-Sivak1, Andrey Rekstin1, Irina Dubrovina1, Ekaterina Bazhenova1, Ted M Ross2, David Swayne3, Larisa Gubareva4, Vadim Tsvetnitsky5, Ekaterina Fedorova1, Elena Doroshenko1 and Larisa Rudenko1 1Institute of Experimental Medicine, St. Petersburg, Russia 2University of Pittsburgh, Pittsburgh, PA, USA 3Southeast Poultry Research Laboratory, Athens, GA, USA 4Centers for Disease Control and Prevention, Atlanta, GA, USA 5PATH (Program for Appropriate Technologies in Health), USA Abstract In this paper we describe the development and the outcomes of the preclinical studies of temperature-sensitive and cold-adapted candidates for live attenuated influenza vaccine (LAIV) based on highly pathogenic avian influenza viruses A/H5N1 with pandemic potential. The LAIV candidates were developed by methods of classical re- assortment between H2N2 Master Donor Virus for Russian LAIV and H5N1 viruses generated by reverse genetics for inactivated vaccine. These reverse genetically generated viruses were chosen as a source of H5 hemagglutinin and contained a modified protease cleavage site believed to be associated with high virulence. The progeny of re- assortment had 7:1 gene composition and were characterized by antigen specificity of the HA of the pandemic virus, a high growth rate in chicken embryos and their parameters of temperature sensitivity and cold adaptation confirmed preserved attenuation of the Master Donor Virus.
    [Show full text]