PAHO will pursue cholera vaccination in Haiti

MIAMI, (Reuters) – The Pan American Health  Organization hopes to start a cholera vaccination program in  Haiti by April but must first boost and fund production of the  vaccine that is in short supply, the group said yesterday.  

The diarrheal disease appeared in the poor Caribbean nation  in October for the first time in decades and has sickened  105,000 people and killed more than than 2,000, Haitian health  officials have said. 

PAHO, the American division of the World Health  Organization, had previously opposed vaccination in Haiti on  grounds that it would be too difficult and expensive. It changed course on Friday and recommended using the  vaccine in Haiti, partly because it has discovered a stockpile  of additional vaccine and partly out of recognition that the  outbreak would not be halted any time soon. 
“This is a disease caused by a bacterium that has a  foothold in Haiti and will be in Haiti causing endemic cholera  for many years to come,” Dr. Jon Andrus, deputy director of  PAHO, said in a webcast from Washington. “So if we have options  to better our response we really, really need to study those  carefully.”  

Cholera is caused by a water-borne bacteria called Vibrio  cholera and is transmitted when contaminated human fecal matter  gets into water, food or onto someone’s hands. Many people show  no symptoms but can pass it along and cholera can cause  extremely severe diarrhea and vomiting that will kill within  hours by dehydrating victims. 
There are only about 200,000 to 300,000 doses of cholera  vaccine available in the world at present, and only two  companies produce it, said Dr. Ciro de Quadros, executive vice  president of the Sabin Vaccine Institute. Sanofi Aventis’ India-based division Shantha makes a  vaccine called Shanchol for about $1 a dose, with up to three  doses needed for protection, while Netherlands-based Crucell  makes another called Dukoral.  

PAHO recently discovered a stockpile of more than 1 million  doses of Shanchol that would take several months to pack and  label, de Quadros said. It has not been prequalified for  purchase by the WHO, but that prequalification is expected in  the first or second quarter of 2011, he said.

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