Tuesday March 26, 2019

Influenza Pandemic Remains Global Threat despite increasing Worldwide supply of Flu Vaccines, warns WHO

The WHO said global production capacity for pandemic vaccines increased from an estimated 1.5 billion doses in 2006 to 6.2 billion last year

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FILE - A boy gets an influenza vaccine injection at a health care clinic in Boston, Massachusetts, Jan. 12, 2013. VOA

The World Health Organization has warned that a global influenza pandemic remains a real threat despite progress made over the past 10 years in increasing the worldwide supply of flu vaccines.

In 2006, the World Health Organization acknowledged that countries around the world were ill-prepared to tackle an influenza pandemic. At the time, there were concerns about an H5N1 bird flu pandemic spreading globally.

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In response, the WHO launched the Global Action Plan (GAP) for influenza vaccines with three main objectives. It aimed to increase evidence-based seasonal vaccine use; increase vaccine production as a protection against pandemics and improve regulatory capacity in developing countries; and promote research and development for better vaccines.

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That initiative has now ended, but Marie-Paule Kieny, WHO assistant-director general for health systems and innovation, observed that global preparation for an influenza pandemic had vastly improved over the past decade.

“We are certainly better prepared for an influenza pandemic than we were 10 years ago,” Kieny said, “but,we must not lose the momentum and we are still facing the threat of an influenza pandemic in 2016.”

More vaccine production

The WHO said global production capacity for pandemic vaccines increased from an estimated 1.5 billion doses in 2006 to 6.2 billion last year. While it’s an impressive achievement, Kieny said, it “still falls short of the GAP goal to immunize 70 percent of the population with two doses of vaccine, potentially for which we would need 10 billion doses.”

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She noted that only rich countries were producing vaccines in 2006, whereas today, 14 mostly upper-middle-income countries were making strides toward manufacturing their own vaccines.

In addition, she said, the number of countries that have national influenza immunization policies in place has increased from 74 to 115 today, “including lower-middle-income countries and one low-income country.”

William Ampofo, a professor at the University of Ghana and an advisory group member of the GAP, said he was encouraged by the progress made, but he told VOA he was disappointed that the creation of the GAP had not resulted in increased vaccine production capacity in Africa.

“As part of the GAP, technology transfer was provided for developing countries, and South Africa and Egypt were part of this initiative,” he said. “Unfortunately, the tech transfer has not resulted in influenza vaccine production capacity as of now.”

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He added, however, that the Ebola epidemic in West Africa had shown that vaccination is an effective tool against a dangerous virus and that the manufacture of a flu vaccine on the continent should be seriously considered.

“Because of what happened with Ebola, now the countries — in West Africa, especially — the ministers of health are now giving attention to vaccine production capacity on the African continent,” he said. “They recognize, however, that it is very difficult, but they feel that something must be started.”

Flu season

The flu season in the Northern Hemisphere is set to start in December, peak in late January or early February and run its course by April or May. The WHO estimates every year there are between 3 million and 5 million forensic cases of influenza, resulting in 150,000 to 500,000 deaths.

A large variety of viruses or subtype influenza viruses are circulating in wild and domestic birds. Only three viruses currently are circulating in humans: influenza A (H1N1), an influenza A variant (H3N2) and an influenza B virus. Traditional flu vaccines, called “trivalent” vaccines, are made to protect against those three flu viruses.

Wenqing Zhang, a scientist in WHO’s Department of Pandemic and Epidemic Diseases, said the influenza viruses are constantly changing. She said one type of change, “antigenic drift,” results in small changes in the genes of influenza viruses. A second way, “antigenic shift,” involves an abrupt, major change.

“With the antigenic drift, it will cause an epidemic, and if there is an antigenic shift, then there will be a pandemic,” she said. “Because the virus is constantly evolving, the threat of influenza pandemic is real. It is very real. It could be tomorrow or in five years’ time. It could be mild like the 2009 H1N1 pandemic, or it could be a very severe one, like in 1918.”

During the 1920s, scientists estimated that 21.5 million people had died as a result of the 1918-19 influenza pandemic. More recent estimates have put the death toll at between 50 million and 100 million. (VOA)

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Health Experts Claim, Tuberculosis Can Reduce Chances Of Pregnancy

"It is also important that people thwart the factors that contribute to TB by making their living conditions more hygienic, improving immunity, and having better access to nutrition,"

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To combat the disease, it is essential that diagnostic facilities reach the farthest areas and people made aware of the consequences of contracting TB, said Rajkumar, Consultant Internal Medicine at New Delhi-based Indian Spinal Injuries Centre. Pixabay

Tuberculosis (TB) bacterium primarily affects the lungs, but can also spread and cause secondary infections to the uterus and even the fallopian tubes, which can reduce chances of pregnancy, health experts warned ahead of the World Tuberculosis Day that falls on March 24.

Usually caused by Mycobacterium tuberculosis (Mtb) bacteria, TB is the top infectious killer worldwide, claiming around 4,400 lives a day.

When the bacteria attacks the uterus, it causes uterine tuberculosis (also known as pelvic TB) which mostly affects women during the child-bearing period and is usually diagnosed during an infertility check-up.

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“Also, with medication, women can be helped to conceive through ART, either IVF of or IUI, where intervention can be done to repair the after-effects.” Pixabay

“Women are more often affected than males and due to uterine tuberculosis, two out of 10 females are unable to bear a child,” Shweta Goswami, Infertility Specialist at Jaypee Hospital in Noida, told IANS.

“In extreme cases, the uterine lining become so thin that it is unable to bear an implantation resulting in miscarriage,” she added.

Mtb bacteria is transported by blood to other organs including reproductive organs and causes infection in fallopian tubes, uterus or in endometrial lining.

“Tuberculosis has the ability to severely damage the fallopian tubes, if not treated at the initial stage.. it can further lead to serious health complications and also result in infertility,” Goswami said.

Symptoms of TB in uterus include irregular menstruation, pelvic pain, continuous discharge which is stained with blood or without blood with a foul smell and bleeding after intercourse.

A 2018 study by the Indian Council of Medical Research (ICMR) showed that over 50 per cent of female patients in India coming for IVF procedure have been reported to have genital TB.

The prevalence of genital TB among Indian women has increased from 19 per cent in 2011 to 30 per cent in 2015.

In over 95 per cent of the cases, the infection was found to affect the fallopian tubes, in 50 per cent the endometrium and 30 per cent the ovaries.

Moreover, nearly 75 per cent of women with genital TB were found to be infertile, and 50-60 per cent of women with infertility were found to have genital TB, the report stated.

“Treating uterine TB should be of the utmost importance as soon as it is detected. There is social stigma attached with TB which makes it difficult for people to come openly and talk about it,” said Shobha Gupta, Medical Director and IVF Specialist from Mother’s Lap IVF Centre, New Delhi.

There are combined tests which are used to investigate whether a person is suffering from TB which are a combination of AFB smear, culture and PCR for tuberculosis.

TB
When the bacteria attacks the uterus, it causes uterine tuberculosis (also known as pelvic TB) which mostly affects women during the child-bearing period and is usually diagnosed during an infertility check-up. Pixabay

“Also, with medication, women can be helped to conceive through ART, either IVF of or IUI, where intervention can be done to repair the after-effects,” Gupta noted.

According to the World Health Organization’s (WHO) ‘Global Tuberculosis Report 2018’, India accounted for 27 per cent of the 10 million people, who had developed TB in 2017, besides making up 32 per cent of global TB deaths among HIV-negative people and 27 per cent of combined TB deaths.

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To combat the disease, it is essential that diagnostic facilities reach the farthest areas and people made aware of the consequences of contracting TB, said Rajkumar, Consultant Internal Medicine at New Delhi-based Indian Spinal Injuries Centre.

“It is also important that people thwart the factors that contribute to TB by making their living conditions more hygienic, improving immunity, and having better access to nutrition,” he added. (IANS)