| One-Shot
Vaccine Offers Typhoid Hope
A cheap single-shot
vaccine can protect young children from typhoid, new research
shows.
The vaccine, originally developed by Indian
company Biological E in 1999, costs as little as 50 US cents
per dose.
It can protect 80 per cent of children
aged less than five years, according to the study, which was
conducted in a Kolkata slum where the disease is prevalent.
The WHO recommends two anti-typhoid vaccines.
One is an oral vaccine, Ty21a, a capsule that must be taken
three times. The second is an injectable vaccine that can
be given as a single shot.
But despite WHO recommendations, the injection
has not been widely used in public-health programmes in developing
countries because of doubts over its effectiveness.
In addition, "many developing countries
lack sufficient surveillance infrastructure to document burden,
and are therefore unaware of the magnitude of the problem
or even the specific highest-risk age groups", Abdullah
Brooks, head of the infectious diseases unit at the International
Centre for Diarrhoeal Disease Research in Bangladesh, told
SciDev.Net. "Thus, there is no demand from the public
or policymakers."
Typhoid is a deadly bacterial infection,
endemic in the developing world, that is spread through contaminated
water and food. Caused by the bacterium Salmonella enterica
Typhi, it causes up to 600,000 deaths per year. In most countries,
infections peak in school-age children, but in the urban slums
of South Asia they tend to peak in pre-school children.
The study, conducted by the National Institute
of Cholera and Enteric Diseases (NICED) in Kolkata and the
International Vaccine Institute in Seoul, was carried out
on more than 37,000 children aged between two and 18 years.
The initial study was done in 2004, and subjects were followed
up for two years.
The protection rate of 80 per cent in
children under five years old falls to 56 per cent in children
aged 5-14, and 46 per cent in older children.
An additional benefit is 'herd protection'
44 per cent of unvaccinated people living close to
vaccinated people were protected as the spread of infection
stopped.
"This is important new information,"
said Myron Levine, director of the Center for Vaccine Development
at the University of Maryland, in an accompanying commentary
in the New England Journal of Medicine (NEJM). It "further
bolsters the case for school-based immunisation to control
endemic typhoid, since one might expect some indirect protection
of pre-school children as well".
Source: SciDev.Net
Date: 30 July 2009

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