Vaccination schedule

In what officials called a major public health breakthrough, the Food and Drug Administration yesterday approved the first vaccine developed to protect women against cervical cancer.

A Bethesda foundation developing vaccines for tuberculosis plans to announce a deal today with a large drug company to move forward with human tests of a promising new injection it hopes will prove useful in poor countries.

A pioneering vaccination programme for children has virtually wiped out a killer bug in the Gambia - and could save hundreds of thousands of young lives across Africa.

Dan Wilson remembers being a frightened 5-year-old, hearing grown-ups talking about tests as he lay on a daybed in the screened porch of his central Wisconsin home in 1955.

Polio has spread to two more countries in West Africa, further jeopardizing the World Health Organization's goal of wiping out the disease by next year. The WHO has come t close to reaching its goal, having reduced the number of new polio cases to the lowest level since it began its program in 1988 to eliminate the disease. The WHO said there were 667 paralytic cases in 2003, about 1 percent of the number in 1988. But the spread of polio to Benin and Cameroon is a discouraging setback in its $4.6 billion effort to have po lio join smallpox as the only diseases to be eliminated from the human population. WHO officials are placing the blame squarely with Nigeria, which is Africa's most populous nation and the home of 300 of the new polio cases in 2003, nearly half the world total. The chief obstacle is opposition to polio immunization by some Islamic leaders in the state of Kano, in the northern part of the country. These opponents contend that the vaccine contains hormones that sterilize girls, Dr. Heymann said. The W.H.O. strongly disputes the contention. Ridding the world of its last cases of a disease is one of the most formidable challenges in public health. As long as one polio case exists anywhere, an infected traveler can export the disease to start outbreaks elsewhere in the world. Nigeria and Niger were the only two West African countries that had never wiped out polio in their own population. Nigeria has exported polio to at least six West African countries in recent months, Dr. Heymann said. His team is awaiting molecular tests to determine whether the viruses isolated from the Benin and Cameroon cases came from Nigeria or one of the seven neighboring countries that have reported cases- Benin, Burkina Faso, Cameroon, Chad, Ghana, Niger and Togo. The number of paralytic polio cases is a small fraction of the number of people infected with the polio virus and capable of transmitting it to other people who may become crippled. Outside of West Africa, the five countries affected by polio and the number of cases are: India (214); Pakistan (96); Afghanistan (8); Egypt (1); Lebanon (1). To prevent any further spread of the disease, the W.H.O. is taking two major steps. One is to conduct what it calls mop-up campaigns to immunize all susceptible children in an area where a new case has occurred. Cameroon and Benin are now conducting such campaigns in an effort to prevent the imported cases from spreading further. But the immunization campaigns are costly and put an added burden oncountries that had previously eradicated polio because they take money from other important health programs, Dr. Heymann said. In a second move, the W.H.O. has invited the health ministers from affected countries to discuss polio eradication in Geneva. Nigeria's national health minister has made a commitment to attend the meeting, as has a representative of the state of Kano, where the opposition to polio vaccination programs is centered, Dr. Heymann said. Dr. Heymann said he expected the ministers to sign a public commitment that their countries would do all they could to stop transmission of polio by the end of 2004. In Kano, Muslim and political officials contend that tests performed there found that polio vaccine contains a dangerous level of the fertility hormone, estrogen, and that this would cause girls who receive the vaccine to become sterile, according to Agence France-Presse. But the W.H.O. says the vaccine contains only the Sabin polio virus that protects against the disease. The Nigerian government appointed a panel of experts that sent the polio vaccine to two laboratories in the WH.O network for testing. These laboratories found no elements of family planning or any hormones or any infectious agents other than the Sabin polio virus, Dr. Heymann said. So it has become a real issue between the central government and the state government, and an issue that is very difficult to deal with. The Nigerian president, Olusegun Obasanjo, has announced that the polio vaccine is safe, Dr. Heymann said. Earlier setbacks forced the WHO to revise to 2005 its original goal of eradicating polio by 2000. Dr. Jong Wook Lee, the WHO.'s director general, has pledged to meet that goal with the aid of Unicef, Rotary International, the United States and other partners. The WHO says it does not now intend to change the date again and that it fears that many donors and polio-free countries where imported cases are occurring will abandon the goal of eradication. (Source: http://www.nytimes.com/2004/01/11/international/africa/11POLI.html 11 January 2004.)

The national Immunisation Awareness Week began on Monday, with various district activities designed to inform the public about the success and benefits of the early childhood vaccination programme in controlling vaccine preventable diseases. In a statement, the health department on Friday said the awareness week coincided with Child Health Week (also 6 - 12 August), and is an integral part of the Expanded Programme on Immunisation in South Africa (EPI(SA)) implemented by the national Department of Health. National Immunisation Awareness Week follows a recent strategic EPI workshop, which also formed part of the initiative sponsored by Aventis Pasteur. This workshop identified some of the critical issues to the continual improvement of EPI (SA) which were presented in an EPI action plan. The department said South Africa had already adopted the global strategies for polio eradication and measles elimination based on three principles. Firstly, routine immunisation of children under one year of age against polio and measles should reach at least 90 percent of this age group, in all provinces. Secondly, mass immunisation campaigns are conducted from time to time, to interrupt transmission of Polio and Measles viruses rapidly in the target age group. The third principle of the strategy to achieve polio eradication and measles elimination is to actively detect, report and investigate suspected cases of polio, also called acute flaccid paralysis (AFP) and measles. In order to meet the criteria for polio free certification and measles elimination, investigation of cases include laboratory support to confirm or discard each suspected case of AFP and measles. It added that measles decreased dramatically from about 22 000 cases and 53 deaths in 1992, to 37 laboratory confirmed cases and no deaths in 2000, a direct result of the measles elimination strategy. (Source: SAPA, 3 August 2001)