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Genetically stable poliovirus vectors activate dendritic cells and prime antitumor CD8 T cell immunity | Nature Communications via PMC.

[Open Access] [Published online 2020 Jan 27]

Abstract.

Viruses naturally engage innate immunity, induce antigen presentation, and mediate CD8 T cell priming against foreign antigens. Polioviruses can provide a context optimal for generating antigen-specific CD8 T cells, as they have natural tropism for dendritic cells, preeminent inducers of CD8 T cell immunity; elicit Th1-promoting inflammation; and lack interference with innate or adaptive immunity. However, notorious genetic instability and underlying neuropathogenicity has hampered poliovirus-based vector applications. Here we devised a strategy based on the polio:rhinovirus chimera PVSRIPO, devoid of viral neuropathogenicity after intracerebral inoculation in human subjects, for stable expression of exogenous antigens. PVSRIPO vectors infect, activate, and induce epitope presentation in DCs in vitro; they recruit and activate DCs with Th1-dominant cytokine profiles at the injection site in vivo. They efficiently prime tumor antigen-specific CD8 T cells in vivo, induce CD8 T cell migration to the tumor site, delay tumor growth and enhance survival in murine tumor models.


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Eleven-year surveillance of acute flaccid paralysis in southwestern Iran | The Turkish Journal of Pediatrics.

[Open Access PDF] [2019 , Vol 61 , Num 4]

Abstract.

The purpose of the study was to report the results of acute flaccid paralysis (AFP) surveillance in the southwestern Iran in the 11 years' period. This is a retrospective descriptive study based on WHO guidelines. The collected data includes all pediatric AFP cases reported between of January 2006 to December 2016 by all health centers of Khuzestan province in Southwest of Iran. During an eleven-year period, 274 cases of AFP were reported in Khuzestan Province. Among them, 56.9% were younger than five years of age, and 55.9% were male. None of these cases was confirmed as poliomyelitis. The annual incidence of non-polio AFP ranged from 1.46/100,000 to 3.11/100,000 (Mean: 2.04 cases/100,000). The incidence rate of AFP in children under five years of age was significantly higher compared to older children (p=0.001), and the most common cause of paralysis (74.5%) was Guillain-Barre syndrome. All performance indicators met the WHO-specified targets. The follow-up of patients with AFP is essential to the eradication of poliomyelitis.


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Acute Posterior Multifocal Placoid Pigment Epitheliopathy After Immunization With Multiple Vaccines | Retinal Cases and Brief Reports.

[Pay to View Full Text] [January 27, 2020 - Volume Publish Ahead of Print]

Abstract.

Purpose: 

To report a case of acute posterior multifocal placoid pigment epitheliopathy occurring in temporal association with multiple immunizations in a previously healthy 25-year-old woman.

Methods: 

Acute posterior multifocal placoid pigment epitheliopathy was diagnosed based on ophthalmological findings of bilateral placoid subretinal lesions complicated by a serous retinal detachment in the left eye.

Results: 

Through HLA typing, the patient was found to possess the HLA-B*40 and HLA-DB1*15 alleles. She was treated with topical prednisolone acetate 1% and monitored for several months. The serous retinal detachment resolved, and visual acuity returned to normal.

Conclusion: 

This case report adds to the body of knowledge regarding possible atypical interplay between vaccines and specific T-cell receptors of the host immune system and adds Polio and Tetanus to the growing list of vaccines potentially triggering acute posterior multifocal placoid pigment epitheliopathy. Increased awareness of the presentation of acute posterior multifocal placoid pigment epitheliopathy and that it may arise after immunization may also improve evaluation of acute changes in visual acuity.


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DRC: Inclusive Education Still Evades People with Disabilities | Inter Press Service.

Idriss Moumin, president of the Association for the Physically Disabled in Djibouti, says that understanding, dignity and honouring of rights of the disabled are very important for inclusive education. Credit: Stella Paul/IPS

Stella Paul writes:

DJIBOUTI CITY, Jan 29 2020 (IPS) - Neema Namdamu, 42, grew up in the village of Bukavu in eastern Democratic Republic of Congo where children with disabilities were considered a curse.

As a child Namdamu contracted polio, leaving her paralysed from the waist down. Her neighbours advised her mother to do what they felt was the “right thing”: to leave the child alone in a hut until she died of starvation.

However, thanks to her mother who refused to give in to the community’s demand, Namdamu lived and went on to attend school and pursue her studies all the way to post graduate level.

But, all through the years of her education, she struggled just to get to her classrooms.

“Not a single educational institute – be that school or college or university – had a disabled-friendly building. I cried while climbing the stairs everyday,” recalls Nmadamu. She has since founded Mama Shuja – an NGO which gives vocational training including computer operating, data entry, digital story telling, tailoring and handicrafts to young girls and women with disabilities living in eastern DRC’s conflict areas.

Nmadamu is attending the 3rd International Summit on Balanced and Inclusive Education currently being held in Djibouti City, Djibouti. Organised by the Education Relief Foundation (ERF), there are over 200 delegates and government representatives from over 35 countries currently in the Horn of Africa nation.

But the government representative from the DRC is absent. And Namadamu says that this reflects the overall lack of awareness about the importance of education in her country.

Making more learning institutions disability-friendly is key for inclusive education.

Idriss Moumin is a passionate advocate of inclusiveness. As the President of the Association for People with Disabilities in Djibouti, and someone who lives with total visual impairment, he strongly wants all the disabled people in his country to be able to access education as their right.

Understanding the special needs and rights of people with disabilities is one of the issues discussed at the summit, but Moumin feels the level of understanding hasn’t matched his expectations.

“I have been hearing several speakers say phrases and terms like ‘we are doing this for them (disabled) and ‘normal people’’. I want to remind them, this is not about giving a handout, but providing (for those with disabilities) what is their right. And who are these normal people? Am I then an abnormal person?” asks Moumin.

  • In Djibouti – a country of less than a million people, there are 10,500 people with various degrees of disabilities, according to an ongoing population survey. The complete data from the survey will be released only in February, but for now it is assumed that there are about 600 students and about 300 are in early years of school.

“Our main issues are accessibility, equipment and social acceptance. We lack transportation and roads and learning materials. We definitely need resources to fill these gaps. But, there is an equal need for providing these facilities as a right. For example, we should get jobs because we have our rights to employment, not because we need compassion,” Moumin tells IPS.

  • According to the World Bank estimates, globally one billion people experience some form of disability. Of those, it is estimated that 93 to 150 million are children. According to Plan International these children are 10 times less likely to go to school than other children.
  • And when they do attend, it is likely to be in a segregated setting. Historically, children with disabilities have been excluded from the general education system and placed in ‘special schools’. In some cases, they are separated from their families and placed in long-term residential institutions where they are educated in isolation from the community, if they are educated at all.

Investing in disabled-friendly schools in Niger

But, according to UNESCO, one of the biggest reasons why children with disabilities don’t access education, even if education policies are inclusive, is because of the lack of disabled-friendly school buildings and suitable learning materials.

However, despite political conflicts and extreme poverty, several organisations are working to improve education in Niger. One such organisation is Remember Niger Coalition (RNC) – an American charity that has stepped in to help children with disabilities attend school.

In 2019, the RNC partnered with the Maradi Association for People with Disabilities and the Hosanna Institute to establish the School of Hope, a school specifically designed for children with disabilities. The three-classroom building was completed in November 2019 with one class ready for use in October when the school year began with 20 kindergarten students.

According to Julie Frye, director of marketing and communications at RNC, this is the first phase in establishing a primary through high school complex for all children, including students with learning differences and unique needs. When complete, the school will have classes from kindergarten all the way to high school for over 600 students.

The design of the School of Hope classrooms takes into consideration issues of accessibility and barrier-free spaces such as handrails, wide doorways, and access ramps. Construction included the installation of four accessible toilets and hand-washing stations, customised to meet the special needs of the disabled community.

“School infrastructure is pivotal to our mission to create quality educational opportunities in Niger. In order for quality learning to take place, students and teachers must have facilities that are safe and adapted to their needs,” Frye tells IPS. The RNC has invested a total of $50,000 so far, she reveals.

DRC: Education curbs violent crimes against the disabled.

In DRC, especially in Bukavu and other eastern towns and villages, there remains significantly high levels of violence against women and girls, who are often beaten, raped and tortured. Those who are disabled cannot run away, making them more vulnerable.

The solution, Namadamu says, lies in education for the disabled and joint financing by the government and private sector funders.

“If we invest $1 million, we can build a large school, hostels, toilets, vocational skill training,  special learning materials for the blind and other technologies like computer, TV camera etc. Such a facility can provide total, inclusive education to a large community. But where is that money? We need external investment,” says Namadamu.

Sheikh Manssour Bin Mussallam, the president of ERF, says that though there is space for private investors in inclusive education, it needs to happen in a more collective and cohesive way. It should not be fragmented, but confederated.

“Regardless of whether its private sectors or philanthropists or academic bodies, we need to act through coordination. The main issue or tragedy is that where there is regional lack of initiatives, organisations or individuals, they do not communicate. When they do communicate, they do not cooperate. And when they do cooperate, its not very efficient,” Mussallam tells IPS in a special interview.


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Malaysia: Over 5,000 children in Kunak targeted for polio vaccine | TheSunDaily.

[29 JAN 2020]

KUNAK: The Kunak Health Office targets 5,736 children aged below five years, who are citizens and non-citizens, for free polio immunisation between this January and March.

Communicable Disease Control medical officer here, Dr Izaidi Salman Yazid said the big-scale immunisation campaign was aimed at protecting children against polio in Sabah and Malaysia, in general.

“Up to yesterday, 25% of the targeted figure had been given the vaccine since the first phase of the immunisation campaign started on Jan 22 and it will end on Feb 21.

“This will be followed by the second phase from Feb 22 until March 21 involving the same children who will receive another dose of the vaccine,“ he said at a ceremony marking the Sabah polio immunisation campaign, here today.

Dr Izaidi said parents who missed taking their children for polio immunisation today, could straight away take them to Kunak Hospital, Women and Children Health Clinic 1 and 2, Madai Rural Health Clinic and Lormalong Rural Health Clinic.

“Children usually who not exhibit symptoms for polio but it starts with fever, coughing and in more serious cases, could cause paralysis preceded by numbness of the legs and arms,” he said.

Meanwhile, state Assistant Minister of Health and People’s Wellbeing, Norazlinah Arif said the people should observe basic hygiene such as washing their hands.

“This is because polio could spread through food and drinks touched by dirty hands or through soiled toys,“ she added.

She also reminded the residents of Kunak to keep their surroundings clean by not disposing garbage indiscriminately. - Bernama


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Pakistan: 2 polio workers killed as team comes under attack in Swabi | DAWN.

[January 29, 2020] Zahid Imdad writes:

Two polio workers were killed on Wednesday when their team came under attack in Swabi's Parmoli area.

According to Swabi's District Police Officer Imran Shahid, unidentified men opened fire at the polio team while they were on duty.

As a result of the firing, a lady health worker was killed on the spot while another was severely injured, the DPO said.

The injured lady health worker was rushed to the Kalu Khan Hospital. She was later shifted to the Lady Reading Hospital in Peshawar, where she succumbed to her injuries during the course of treatment, according to LRH Medical Director Dr Khalid Masood.

Police have collected three bullet shells from the site of the shooting, the DPO said, adding that security in the area where the incident occurred was not on high alert.

Taking notice of the attack, Khyber Pakhtunkhwa Chief Minister Mahmood Khan directed the Inspector General of Police Sanaullah Abbasi to submit a report on the incident.

He further directed police to take strict action against the perpetrators of the attack.

Attacks on polio workers are common in various parts of Khyber Pakhtunkhwa and Balochistan. This is one of the biggest hindrances to the eradication of polio from the country.

Last year, the government formed the National Strategic Advisory Group (NSAG) to tackle polio eradication. The NSGA has representatives from leading political parties who have worked on polio eradication programmes in previous governments. The broad-based body was constituted in consultation with Prime Minister Imran Khan and is led by Special Assistant to the Prime Minister on Health Dr Zafar Mirza.


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Pakistan: Two female workers die in attack on polio team in Swabi | The Express Tribune.

[January 29, 2020]

PESHAWAR / ISLAMABAD / QUETTA: Two female polio workers were gunned down in Razar Tehsil of Swabi district on Wednesday when unknown assailants attacked them.

Local police sources informed The Express Tribune that the victims were administering polio vaccination in Mir Ali Area of Swabi when the men opened fire on the workers.

The deceased were identified as Shakeela, a resident of Parmoli village while the other victim was Ghuncha who belonged to Bukki area of Swabi.

Sindh adds to 2020 polio tally

Shakeela died on the spot while Ghuncha was seriously injured and has been shifted to Mardan Medical Complex for further treatment. Later, she was also pronounced dead.

Meanwhile, three new cases of polio has been emerged one each from Sindh, Balochistan and Khyber-Pakhtunkhwa making the total count to six in the first month of 2020.

Case registered against health workers for child’s death

A 20-month-old child belonged to Dera Murad Jamali tehsil of Naseerabad district has been a confirmed case of polio from Balochistan.

The child has been administered polio drops three times but severity of the paralysed diseases gripped her. Her samples were obtained on January 3, 2020.

Another polio case was confirmed from Jumo Agham, a union council of Ratodero, Sindh where a 26-month-old child was affected by the disease. His samples were obtained on Dec 24, 2019.

Polio virus has also affected an 11-month-old child of Tank distric of KP.

In 2019, total cases of polio have reached to 140 with highest number of cases in KP, 92; 28 cases were confirmed from Sindh, 12 from Balochistan and eight from Punjab.


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Pakistan: Anti-polio drive begins in 15 KPK districts | The Nation.

[January 29, 2020]

A three-day special anti-polio campaign began in fifteen districts of Khyber Pakhtunkhwa today.

The districts include Peshawar, Charsadda, Mardan, Swabi, Nowshera, Buner, Torghar, Malakand, Swat, Kohat, Bannu, Lakki Marwat, Mohmand, Khyber and Bajaur.

More than four million children up to five years of age will be administered anti-polio drops.

Twelve thousand and seventy-three teams have been constituted which will administer anti-polio vaccine to each and every child.

Elaborate security measures are being taken for security of polio teams.


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Pakistan: Another polio case confirmed in Sindh | The Express Tribune.

[January 29, 2020]

KARACHI: The Sindh Emergency Operation Centre (EOC) on Wednesday confirmed the 28th polio case of the year 2019 in the province, taking the total count to 140.

A three-and-half-year-old child from Union Council Jumo Agham in Ratodero tested positive for polio. The child is currently experiencing weakness in her right arm and leg. The onset of this case was in December 24, 2019.

The Expanded Programme on Immunization (EPI) card has verified that three doses of anti-polio vaccine were administered to the child. The case is under further investigation.

The EOC has blamed long gaps in door-to-door campaigns during 2019 for the creating “a large pool of vulnerable children”.

At least six million children have been vaccinated in January alone, claimed EOC. Another national campaign will begin in February.

“These campaigns and their success is extremely important to reduce polio cases and remove the virus from the environment,” it added.

The federal and provincial EOCs have urged parents to immunize

The total number of polio cases registered in Sindh during 2019 has soared to 28, increasing the polio tally for the year in the country to 140.

Similarly, with the surfacing of Sindh’s second polio case in the current year, the number of total cases reported in Pakistan during the first few weeks of 2020 has climbed to six.


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Pakistan: Two polio cases emerge in KP, Balochistan | The News International.

[January 29, 2020]

PESHAWAR: The National Institute of Health (NIH) on Tuesday reported two more polio cases, making it six this year, officials said.

One case was reported from Khyber Pakhtunkhwa and another in Balochistan.

In Khyber Pakh-tunkhwa, the new polio case was reported from Tank district. According to officials, an 11 months old boy became the latest victim of poliovirus.

The child has no travel history and received two dozes. He is believed to be among the refusals.

The second child was reported from Dera Murad Jamali in Balochistan. The child is 20 months boy and has reportedly received seven doses.


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Needle-free injectors for mass administration of fractional dose inactivated poliovirus vaccine in Karachi, Pakistan: A survey of caregiver and vaccinator acceptability | Vaccine.

[Pay to View Full Text] [Received 10 October 2019, Revised 22 December 2019, Accepted 25 December 2019, Available online 23 January 2020] [In Press, Corrected Proof]

Highlights.

* First large-scale fIPV vaccination campaign using needle-free jet injectors, Pakistan 2019.

* 97.6% of vaccinators prefer jet injectors to needle and syringe.

* 99.6% of caretakers prefer jet injectors to needle and syringe.

* Mean coverage over previous IPV campaign improved by 18.4%.

Abstract.

The first large-scale vaccination campaign using needle-free jet injectors to administer fractional doses of inactivated poliovirus vaccine (fIPV) was conducted in Karachi, Pakistan, in February 2019. Data on acceptability of jet injectors were collected from 610 vaccinators and 4898 caregivers during the first four days of the campaign. Of those with prior needle and syringe experience, both vaccinators and caregivers expressed a strong preference for jet injectors (578/592 [97.6%] and 4792/4813 [99.6%], respectively), citing ease of use, appearance, and child’s response to vaccination. Among caregivers, 4638 (94.7%) stated they would be more likely to bring their child for vaccination in a future campaign that used jet injectors. Mean vaccine coverage among towns administering fIPV was 98.7% – an increase by 18.4% over the preceding campaign involving full-dose IPV. Our findings demonstrate the strong acceptability of fIPV jet injectors and highlight the potential value of this method in future mass campaigns.


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