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When, How, and Where can Oral Cholera Vaccines be Used to Interrupt Cholera Outbreaks?

Artikel i vetenskaplig tidskrift
Författare John Clemens
Jan Holmgren
Publicerad i Cholera Outbreaks
Volym 379
Sidor 231-258
ISSN 0070-217X
Publiceringsår 2014
Publicerad vid Institutionen för biomedicin
Sidor 231-258
Språk en
Länkar dx.doi.org/10.1007/82_2013_353
Ämnesord KILLED WHOLE-CELL, TOXIN-B-SUBUNIT, CVD 103-HGR, FIELD TRIAL, VACCINATION STRATEGIES, COST-EFFECTIVENESS, MASS VACCINATION, DEVELOPING-WORLD, IMMUNIZATION, BANGLADESH, Infectious Diseases, Microbiology, CKET CO, 1992, JOURNAL OF INFECTIOUS DISEASES, V166, P837, B BC, 1986, BULLETIN OF THE WORLD HEALTH ORGANIZATION, V64, P127
Ämneskategorier Klinisk medicin, Hälsovetenskaper

Sammanfattning

Cholera continues to be a major global health problem, at times causing major and prolonged outbreaks in both endemic and nonendemic settings in developing countries. While improved water quality, sanitation, and hygiene (WASH) will provide the ultimate solution to prevention of this disease burden, this is a far-off goal for most developing countries. Oral cholera vaccines (OCVs) have been demonstrated to be effective in the control of cholera outbreaks, and constitute useful tools to be used in conjunction with efforts to improve WASH. Two killed OCVs are prequalified by WHO for purchase by UN agencies for international use. Recently, WHO has launched a global stockpile of killed OCVs for use to control outbreaks. Rational deployment of OCV from this stockpile will require consideration of costs, feasibility, disease epidemiology, and the protective characteristics of the vaccine deployed, as well as effective and rapid coordination of processes and logistics used to make decisions on deployment and delivery of the vaccine to the population in need. Despite not having data on all the questions of relevance as to how to use OCVs to control cholera outbreaks in different settings, there is clearly more than enough evidence to initiate their use, as answers to remaining questions and refinement of policies will mainly come with experience.

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