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A novel gamma radiation-inactivated sabin-based polio vaccine | PLOS ONE.

[Open Access] [Received: June 27, 2019; Accepted: January 5, 2020; Published: January 30, 2020]

Abstract.

A concerted action on the part of international agencies and national governments has resulted in the near-eradication of poliomyelitis. However, both the oral polio vaccine (OPV) and the inactivated polio vaccine (IPV) have deficiencies which make them suboptimal for use after global eradication. OPV is composed of attenuated Sabin strains and stimulates robust immunity, but may revert to neurovirulent forms in the intestine which can be shed and infect susceptible contacts. The majority of IPV products are manufactured using pathogenic strains inactivated with formalin. Upon eradication, the production of large quantities of pathogenic virus will present an increased biosecurity hazard. A logical ideal endgame vaccine would be an inactivated form of an attenuated strain that could afford protective immunity while safely producing larger numbers of doses per unit of virus stock than current vaccines. We report here the development of an ionizing radiation (IR)-inactivated Sabin-based vaccine using a reconstituted Mn-decapeptide (MDP) antioxidant complex derived from the radioresistant bacterium Deinococcus radiodurans. In bacteria, Mn2+-peptide antioxidants protect proteins from oxidative damage caused by extreme radiation exposure. Here we show for the first time, that MDP can protect immunogenic neutralizing epitopes in picornaviruses. MDP protects epitopes in Polio Virus 1 and 2 Sabin strains (PV1-S and PV2-S, respectively), but viral genomic RNA is not protected during supralethal irradiation. IR-inactivated Sabin viruses stimulated equivalent or improved neutralizing antibody responses in Wistar rats compared to the commercially used IPV products. Our approach reduces the biosecurity risk of the current PV vaccine production method by utilizing the Sabin strains instead of the wild type neurovirulent strains. Additionally, the IR-inactivation approach could provide a simpler, faster and less costly process for producing a more immunogenic IPV. Gamma-irradiation is a well-known method of virus inactivation and this vaccine approach could be adapted to any pathogen of interest.


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Pakistan: UC Gadamar Elders Agree To End Boycott Of Polio Vaccination | UrduPoint.

[31st January 2020] Umer Jamshaid writes:

BAJAUR, (UrduPoint / Pakistan Point News - 31st Jan, 2020 ) :Local tribal elders of Union Council (UC) Gadamar, Tehsil Barang have agreed to end their boycott of polio vaccination for their children after holding a successful 'jirga' with the officials of local administration here on Friday.

The locals have announced unconditional vaccination of their children after assurance of administration to address their concerns. Addressing the jirga, local elders said that they have no objection over anti-polio drive, adding that they boycotted the drive owing to apathy of local administration in addressing core issues confronted by the citizens.

The government officials termed the boycott unjust and assured that their problems would be addressed timely.


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Pakistan: Govt panel to probe murder of polio vaccinators in Swabi district | DAWN.

[January 31, 2020]

PESHAWAR/SWABI: The Khyber Pakhtunkhwa government has constituted a three-member committee to probe the firing and killing of two lady health workers during the polio campaign in Swabi district on Wednesday.

The committee has been told to submit its report within three days.

A notification, issued by home and tribal affairs department on Thursday, said that a fact-finding committee on the directives of Chief Minister Mahmood Khan was formed to hold probe into the killing of vaccinators in the limits of Parmoli union council in Swabi.

The special secretary of home department, Islam Zeb, DIG Kashif Alam of police department and Sharif Hussain, the additional secretary of home department, are members of the committee. The panel has been tasked to identify security lapse during the incident and also propose suitable action to avoid such mishaps in future.

On Wednesday, two lady health workers were shot dead by unidentified motorcyclists in Swabi district.

Meanwhile, the coordinator of National Emergency Operations Centre for Polio, Dr Rana Muhammad Safdar, who visited the place where incident took place in Swabi, reviewed the situation with regard to the ongoing drive. He said that campaign was postponed in few selected union councils after the incident.

“The place where the incident happened is on the edge of cluster of houses quite close to basic health unit and the residence of one of the two LHWs, killed in the attack,” Dr Safdar told Dawn.

“Along with deputy commissioner, district police officer and Khyber Pakhtunkhwa polio programme and national security adviser, we shall go to the depth of the causes of the incident,” he said. He said that was been further mounted to provide safe environment to the vaccinators and safeguard children against disabilities.

“Since 2012, a total of 47 people have been killed in polio-related incidents but the workers are undeterred by such threats,” he said.

Dr Safdar said that documentation for awarding Shuhada Package to the two killed lady workers was in progress.

Meanwhile, Swabi DPO Imran Shahid told Dawn that after IGP Sanaullah Abbasi’s visit to the district and inspection of the spot where the health workers were killed, it was decided that every polio team would be guarded by security personnel during the ongoing campaign.

On the other hand, lady health workers put forward their demands and sought adequate security mechanism and financial assistance for the families of the two killed vaccinators.

The slain vaccinators were laid to rest at their ancestral graveyard and the funeral was attended by officials of the district administration and health department, politicians and local people in a large number.

Officials said that Deputy Commissioner Shahid Mahmood, health officials and district police officials were engaged in consultation to adopt a new line of action to achieve the desired objectives and continued the campaign. They vowed to continue the campaign and assured the campaigners of all possible help, especially security.

A detailed presentation was given to the IGP about the security of the campaigners, normal, sensitive and most sensitive regions in the district and the previous operations conducted against terrorists in Razaar tehsil.

DPO Imran said that there were 1,000 polio teams and every team would be guarded. “Among them, 130 teams that run the campaign in the most sensitive regions would now have two security personnel while the remaining 870 each would be provided with one security person,” he remarked.

Keeping in mind the sensitivity of the campaign, about 200 security personnel have been deployed from Hazara division to Swabi to perform duty during the drive.

The DPO said that operations against militants had been conducted since 2013 to 2016 and Parmuli region had been declared peaceful. That’s why the killed vaccinators were without security personnel, he added.

The LHWs held a meeting in tehsil headquarters hospital Kalu Khan. The district health officer, Mohammad Tariq told the meeting that he had demanded complete security for the campaigners. “Without perfect security mechanism you (LHWs) would not perform polio duty,” he added.

The LHWs said that for three days they would mourn the death of their colleagues. They also asked the government to provide job to one person from each victim family and arrest the killers. They said that the campaign should be held once a month.

In Kohat, security measures were taken for the foolproof safety of polio teams.

In a statement, police said that special control and monitoring rooms were established to provide security to the field staff. The statement said police were being assisted by intelligence agencies and army.

Meanwhile, Kohat deputy commissioner while chairing an assessment meeting of the ongoing polio vaccination drive said that no hurdle should come in the way of vaccination of the children and all the targets should be achieved.


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Pakistan: Anti-polio campaigners security increased in Swabi | The News International.

[January 31, 2020] Muhammad Farooq writes:

SWABI: Security for the anti-polio campaigners was enhanced here in the Swabi district on Thursday to ensure the continuation of the ongoing campaign after the killing of two female vaccinators by gunmen the previous day.

The two workers were killed by suspected militants during their duty in Parmuli area. “It has been decided that every polio team will be guarded by the security personnel during the campaign in the district, Imran Shahid, district police officer, told reporters. The DPO said about 200 security personnel have been deployed from Hazara division to Swabi, adding they would perform duty during the campaign.

The campaign was affected in different parts of the Razaar Tehsil on Thursday because some of the campaigners were reluctant to work after the killing the two polio workers a day before. On the other hand, Lady Health Workers sought adequate security mechanism and provision of financial assistance to the families of two slain vaccinators.

Officials said that Swabi Deputy Commissioner Shahid Mahmood, Health and district police officials continued consultations to adopt a new line of action to achieve the desired objectives and continue with the campaign. They vowed to continue the campaign and assured the campaigners of all possible help, especially security. A detailed presentation was given to Inspector General of Police Sanaullah Abbasi about the security of the campaigners, normal, sensitive and most sensitive regions in the district and the previous operations conducted against terrorists in the Razaar Tehsil. Meanwhile, two slain vaccinators were laid to rest at ancestral graveyards. The funeral was attended by officials of the district administration and Health Department, politicians and local people.


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Pakistan: Over 1.1 Million Children To Be Vaccinated Against Polio In Benazirabad Division | UrduPoint.

[Thu 30th January 2020] Fahad Shabbir writes:

NAWABSHAH, (UrduPoint / Pakistan Point News - 30th Jan, 2020 ) :The Commissioner Shaheed Benazirabad Division, Syed Mohsin Ali Shah, expressing concern over presence of Polio virus in the country has called for focusing special attention to anti Polio campaign to prevent youth from disastrous diseases.

Presiding over a meeting of the Divisional Task Force for Polio held here on Thursday, the Commissioner directed for devising integrated strategies for administering Polio vaccine to all the children under the age of five years during next round of anti-polio campaign to be organized from February 17 to Feb 21.

He said that apart from training of vaccinating teams, Micro Plan be made according to guide lines of WHO in order to prevent children from the attack of Polio virus.

Commissioner appreciated the performance of polio teams during the previous anti-polio campaign and advised for further improvement in immunization work.

On the occasion Divisional Coordinator WHO Dr Alam Azad briefed the meeting and said that the anti-polio campaign is being launched in the division from Feb 17 to Feb 21, 2020 during which more than 1.1 million children would be administered polio drops.

He said that for that purpose 2775 teams have been formed while training of teams and preparation of Micro-plan and other arrangements are underway.

Divisional Surveillance officer Dr. Aziz Ahmed said that submitting of reports regarding disabilities in children caused by polio and other diseases was in progress satisfactorily.


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US flu rebound, kids' deaths; Recent DRC Ebola cases; Pathogen-spewing hospital toilets; MERS in the UAE; Polio in 4 countries | CIDRAP News Scan for Jan 31, 2020.

Flu levels rising again in US as 14 more pediatric deaths reported.

After US flu activity peaked at the end of 2019 and fell for 2 straight weeks, it has now increased measurably for the second straight week, while the number of flu-related deaths in children rose by 14, to 68, the Centers for Disease Control and Prevention (CDC) said in its weekly FluView report today.

The CDC estimated that so far this season flu has sickened 19 million people, hospitalized 180,000, and killed 10,000.

Clinic visits for influenza-like illness (ILI) rose from 5.1% the week before to 5.7% last week, the CDC said. The national baseline is 2.4%. And the number of states reporting high ILI activity jumped from 35 to 41. In addition, every state but Hawaii reported widespread flu, compared with 48 states the week before.

Eight of the 14 new pediatric deaths were caused by influenza B, the season's predominant strain, and 6 were caused by influenza A. Three "A" strains were subtyped, and all were 2009 H1N1 strains. The percentage of deaths attributed to pneumonia and flu was 6.7%, the same as the week before and below the epidemic threshold of 7.2%.

For the season, influenza B viruses have accounted for 54.0% of flu-positive respiratory specimens analyzed at public health labs, compared with 46.0% for influenza A. For the most recent week, however, A strains outpaced B strains 55.7% to 44.3%. Among specimens from clinical labs, however, influenza B made up 50.2% of flu viruses last week and 62.6% for the season. Public health labs assess circulating strains, while clinical labs assess those infecting patients.

The overall hospitalization rate was 29.7 per 100,000 population last week, compared with 24.1 the week before, which the CDC said is at expected levels. As is typical, people 65 and older are the hardest-hit group, with a flu hospitalization rate of 71.3 per 100,000, up from 58.1 per 100,000 the week before.
Jan 31 CDC FluView update

WHO links recent Ebola cases to earlier transmission chain.

In its weekly snapshot of the Ebola outbreak, the World Health Organization (WHO) said yesterday that five new cases were reported from Beni health zone in the Democratic Republic of the Congo (DRC) from Jan 22 to Jan 28. The cases had epidemiologic links to a transmission chain that originated in Mabalako health zone, and most likely occurred through exposure to a traditional healer.

In addition, the WHO said that one case-patient confirmed on Jan 20 stayed in the community for 4 days before going to an Ebola treatment center and infected two additional people in the community. Because those two patients, and another confirmed patient, stayed in the community for several days prior to isolation, the WHO warned that further cases can be expected in the coming 2 weeks in Bundji and Kanzulinzuli health areas and neighboring health areas in Beni Health Zone.

The WHO said 28 cases were confirmed from Jan 8 to Jan 28, and that Beni health zone remains the current hot spot of the outbreak, having confirmed 64% of confirmed cases over the past 21 days. But the agency noted that encouraging trends have been observed in the past 21 days, as well, with the most recent epidemiologic week (Jan 20 to Jan 26) seeing the fewest cases since the beginning of the response. Contact tracing has also improved, the WHO said.

Meanwhile, the WHO online Ebola dashboard reported no new cases today, keeping the total at 3,427 cases, of which 2,245 were fatal. Yesterday's daily update from the DRC's Ebola technical committee (CMRE) said a recently confirmed new case in North Kivu was in Mabalako. CMRE also updated its vaccination numbers, reporting that 8,828 people have been vaccinated with Johnson & Johnson's Ebola vaccine, and 280,426 have received Merck's rVSV-ZEBOV.
Jan 30 WHO situation report
WHO Ebola dashboard
Jan 30 CMRE update

Study: Toilet flushing could aid spread of pathogens in hospitals.

A pilot study by researchers with the University of Iowa has found that bioaerosols from flushed toilets in the rooms of patients with Clostridioides difficile infection (CDI) may contribute to the spread of healthcare-associated bacteria in hospitals. The research was published today in Infection Control and Hospital Epidemiology.

In the study, which was conducted at the University of Iowa Hospitals and Clinics, researchers collected bioaerosols on plates placed 0.15 meters (m), 0.5 m, and 1.0 m from the rims of toilets in 24 rooms of patients hospitalized with CDI and collected bathroom air continuously with a bioaerosol sampler before and after toilet flushing. They then cultured and identified bacteria on the plates (focusing on C difficile), measured bacterial density, and calculated the difference in bioaerosol production before and after flushing.

Bacteria were positively cultured from 8 of 24 rooms (33%). In total, 72 preflush and 72 postflush samples were collected, with healthcare-associated bacteria found in 9 of the preflush samples (12.5%) and 19 of the postflush samples (26.4%); postflush plates had a significantly higher probability of culturing positive than preflush plates (P = .0309). The predominant species cultured were Enterococcus faecalisE faecium, and C difficile. Compared with the preflush air samples, the postflush samples showed significant increases in the concentrations of the two large particle-size categories: 5.0 micrometers (P = .0095) and 10.0 micrometers (P = .0082).

The authors conclude, "This study potentially supports the hypothesis that toilet flushing may lead to the spread of clinically significant pathogens in healthcare settings. More information is needed to determine the risk factors associated with toilet flushing and environmental contamination by pathogens."
Jan 31 Infect Control Hosp Epidemiol abstract

UAE reports 2 MERS cases involving camel contact.

The WHO today said the United Arab Emirates (UAE) has reported two more MERS-CoV cases, both in men who had contact with camels.

Both of the men are from Abu Dhabi. One is a 51-year-old man whose symptoms began on Dec 26 and the other is a 53-year-old man with underlying health conditions whose symptoms began on Dec 18. Both were hospitalized on Dec 31 and survived their Middle East respiratory syndrome coronavirus (MERS-CoV) infections.

The WHO said the UAE has now reported 91 cases, 12 of them fatal. It said as of Jan 15, the global total of MERS-CoV cases reported since the virus was first detected in humans in 2012 is 2,506, at least 862 of them fatal. Saudi Arabia has been the hardest hit country.
Jan 31 WHO statement

Four countries report more polio cases, including 6 in Pakistan.

The Global Polio Eradication Initiative (GPEI) in its latest weekly update said four countries have reported new cases: Pakistan, the Democratic Republic of Congo (DRC), Angola, and the Philippines.

Pakistan reported six wild poliovirus type 1 (WPV1) cases, including four from Sindh province and one each from Balochistan and Khyber Pakhtunkhwa province. Some had 2019 illness onsets, raising that annual total to 139, a steep increase from previous years. The new cases with January paralysis onsets lift the 2020 total so far to 4 cases.

Earlier this week, two polio workers were killed in an attack on a team in Swabi district in Khyber Pakhtunkhwa province, according to a Jan 29 report from Dawn, an English-language newspaper based in Pakistan.

Two African countries reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases, including two from the DRC (from Sankuru and Kwilu provinces) that lift the total for 2019 to 75. The other is Angola, which reported 15 cases from eight different provinces, putting the total for 2019 at 103 cases from seven different outbreaks.

Elsewhere, the Philippines reported a second cVDPV1 case for 2019, which involves a patient from Southern Mindanao province. The country is also experiencing a cVDPV2 outbreak that totaled 13 cases for 2019.
Jan 31 GPEI report
Jan 29 Dawn story


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Strengthening routine immunization in Papua New Guinea: a cross-sectional provincial assessment of front-line services | BMC Public Health.

[Open Access] [Received 02 June 2019; Accepted 07 January 2020; Published 23 January 2020]

Abstract.

Background.

Routine immunization programs face many challenges in settings such as Papua New Guinea with dispersed rural populations, rugged geography and limited resources for transport and health. Low routine coverage contributes to disease outbreaks such as measles and the polio that re-appeared in 2018. We report on an in-depth local assessment that aimed to document immunization service provision so as to review a new national strategy, and consider how routine immunization could be better strengthened.

Methods.

In East New Britain Province, over 2016 and 17, we carried out a cross-sectional assessment of 12 rural health facilities, staff and clients. The study was timed to follow implementation of a new national strategy for strengthening routine immunization. We used interview, structured observation, and records review, informed by theory-based evaluation, a World Health Organization quality checklist, and other health services research tools.

Results.

We documented strengths and weaknesses across six categories of program performance relevant to national immunization strategy and global standards. We found an immunization service with an operational level of staff, equipment and procedures in place; but one that could reach only half to two thirds of its target population. Stronger routine services require improvement in: understanding of population catchments, tracking the unvaccinated, reach and efficiency of outreach visits, staff knowledge of vaccination at birth and beyond the first year of life, handling of multi-dose vials, and engagement of community members. Many local suggestions to enhance national plans, included more reliable on-demand services, integration of other family health services and increased involvement of men.

Conclusions.

The national strategy addresses most local gaps, but implementation and resourcing requires greater commitment. Long-term strengthening requires a major increase in centrally-allocated resources, however there are immediate locally feasible steps within current resources that could boost coverage and quality of routine immunization especially through better population-based local planning, and stronger community engagement. Our results also suggest areas where vaccination campaigns in PNG can contribute to routine immunization services.


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