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Dengue Vaccine Should Not Be Used Widely: UN Health Agency

UN Health Agency issued an important statement regarding the dengue vaccine

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Dengue vaccine.
A Manila Health officer shows off a pair of vials of the anti-dengue vaccine Dengvaxia after being recalled from local government health centers Tuesday, Dec. 5, 2017 in Manila, Philippines. The World Health Organization says the first-ever vaccine for dengue needs to be dealt with in "a much safer way," meaning that the shot should mostly be given to people who have previously been infected with the disease. VOA

The World Health Organization says the first-ever vaccine for dengue needs to be dealt with in “a much safer way,” meaning that the shot should mostly be given to people who have previously been infected with the disease.

In November, the vaccine’s manufacturer, Sanofi Pasteur, said people who had never been sickened by dengue before were at risk of developing a more serious disease after getting the shot.

After a two-day meeting this week, WHO’s independent vaccines group said it now had proof the vaccine should only be used “exclusively or almost exclusively in people who have already been infected with dengue.”

Also Read: Anti-dengue Antibody Drug May Neutralize Zika Virus

The U.N. health agency said a test should be developed so doctors would be able to quickly tell if people had previously been sickened by dengue – but the group acknowledged doing that so isn’t straightforward.

“We see significant obstacles in using the vaccine this way, but we are confident this also spurs the development of a rapid diagnostic test,” said Dr. Joachim Hombach, executive secretary of WHO’s expert group, during a news conference Thursday.

Representational image for dengue vaccination
Representational image. Wikimedia Commons

Sanofi said last year that doctors should consider whether people might have been previously infected with dengue before deciding whether they should risk getting immunized. The company said it expected to take a 100 million euro ($118 million) loss based on that news.

People who catch dengue more than once can be at risk of a hemorrhagic version of the disease. The mosquito-spread virus is found in tropical and sub-tropical climates across Latin and South America, Asia, Africa and elsewhere. It causes a flu-like disease that can cause joint pain, nausea, vomiting and a rash. In severe cases, dengue can result in breathing problems, hemorrhaging and organ failure.

About half the world’s population is at risk of dengue; WHO estimates that about 96 million people are sickened by the viral infection every year.

Also Read: Dengue fever may increase risk of stroke: Study

Following Sanofi’s announcement last year, the Philippines halted its dengue immunization program, the world’s first national vaccination program for dengue. The government also demanded a refund of more than 3 billion pesos ($59 million) from Sanofi and is considering further legal action.

In February, the Philippines said the vaccine was potentially linked to the deaths of three people: all of them died of dengue despite having received the vaccine.

The country imposed a symbolic fine of $2,000 on Sanofi and suspended the vaccine’s approval, charging that the drugmaker broke rules on how the shot was registered and marketed.

More than 730,000 children aged 9 and above in the Philippines have received at least one dose of the dengue vaccine, usually delivered in three doses.

There is no specific treatment for dengue and there are no other licensed vaccines on the market.  VOA

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20 Genes That Can Predict Severity of Dengue Identified

The genes could serve as a basis for a targeted therapy for dengue, Einav said - but that's far on the horizon

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Researchers, including one of an Indian-origin, have identified 20 genes that can predict an individual’s likelihood of developing a severe form of dengue fever with about 80 per cent accuracy.

The team from Standford University in the US, identified a gene-expression pattern that predicts which people infected with dengue — a mosquito-borne virus that can cause fever and joint pain, among other symptoms — are at highest risk for developing a severe form of the illness.

Every year, between 200 million and 400 million people in tropical and subtropical regions of the world contract dengue fever, and about 500,000 of those cases are fatal.

For the most part, people with the disease recover after receiving some fluids and a few days’ rest, said Purvesh Khatri, Associate Professor at the varsity.

“But there’s a smaller subset of patients who get severe dengue, and right now we don’t know how to tell the difference,” Khatri said.

Aedes
Dengue is transmitted by the bite of the Aedes mosquito that typically attacks during day time. Pixabay

Anywhere from 5 to 20 per cent of dengue cases will advance to severe.

Currently, to diagnose severe dengue the doctors wait to observe specific symptoms and results of laboratory tests that typically emerge in the late stages of the disease.

“These practices are not nearly sensitive or accurate enough, and some patients end up admitted to the hospital unnecessarily, while others are discharged prematurely,” said Shirit Einav, Associate Professor.

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The new set of genes, reported in the Cell Reports journal, can help identify predictive biomarkers that can help doctors reliably gauge the likelihood of severe dengue in patients who are newly symptomatic and use that information to provide more accurate care to help guide therapeutic clinical studies and, in the future, to guide treatment decisions.

The genes could serve as a basis for a targeted therapy for dengue, Einav said – but that’s far on the horizon. (IANS)