Categories: Ebola, HIV/AIDS, immunization, infectious disease, malaria
December 29th, 2014 10:30 am ET -
As 2014 draws to a close, one theme that has been continuously present is the importance of a strong public health infrastructure in a country to effectively protect against vaccine-preventable diseases (VPDs). Universal access to immunization is the Decade of Vaccines vision, and in order to achieve this, more efforts are needed to build upon the existing infrastructure developed for immunization programmes and other health interventions, such as for HIV prevention and treatment and malaria control and elimination. With the importation of Ebola virus disease into Nigeria, we saw the country use its Emergency Operations Centre built to support polio eradication to quickly respond to the outbreak supporting case investigation, contact tracing, and bringing government together with national and international partners to stop the outbreak. The infrastructure built in Uganda to collect samples from individuals at the community level for HIV testing and get them to a laboratory for testing in minimal time, can be used to quickly identify cases of epidemic-prone VPDs. We should continue to build upon and use the experiences to save more lives and achieve global goals that have been delayed. The coming year, 2015, marks the halfway point of the Decade of Vaccines—let us use this moment to accelerate efforts by ensuring the public health infrastructure is there to reach every individual with lifesaving vaccines.
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Categories: immunization, polio
October 20th, 2014 5:13 pm ET -
In honor of World Polio Day, the polio communications team sat down with the lead of the CDC Global Immunization Division’s STOP team Yinka Kerr for a little Q & A.
Yinka Kerr, MSPH, STOP Team Lead, Global Immunization Division
Q: Yinka, how did you become involved in the global initiative to end polio?
Yinka: I started in polio in 1997 when I did a 6-month rotation as part of my Public Health Prevention Service training program. My supervisors were Bob Keegan and Denise Johnson, who were amazing mentors. I had a taste of what it would be like working in a global health position through being part of an immunization program review in China and writing a financial report in Zimbabwe for the Africa Region of the World Health Organization.
I was on the second Stop Transmission of Polio (STOP) team in 1999, where I was stationed in Nepal for 3 months. When I finished my training with the Public Health Prevention Service in 2000, CDC’s polio program was the first place that I came to look for a job and I have been with the Global Immunization Division ever since.
Q: What parts of your experience as a STOP volunteer in Nepal remain the most memorable?
Yinka: I worked with Dr. Choudhury, the national surveillance officer, responsible for tracking polio throughout the eastern region. We were based in Biratnagar and would travel up to where the roads ended to talk to health care volunteers, community workers, private doctors and hospital staff about checking for cases of paralysis to test for polio. I remember thinking that this was an amazing program that brings all people together to work towards one goal—ridding the world of polio. It did not matter that I could not speak their language; just bringing the message that we were all working towards this common goal was unforgettable.
One time we went to check on a paralyzed child that the hospital told us had returned to the village. We headed off to the village in the pouring rain. We crossed through a large creek and arrived in the village where the child was, only to be told that the child had gone across the border to seek health care. We turned around and started home only to get stuck in the rising creek coming back across the river. Luckily, I had some cookies and water that I always kept in the car for food emergencies. We sent a villager who was passing by us on a bicycle back to the village to get a tractor and some villagers who helped to get us out of the mud. Thanks to all, we made it home later that night. These have been and will be the trials and tribulations of everyone who is working to find that last case of polio.
Q: What is your favorite part of leading CDC’s STOP Team?
Yinka: I like the depth and breadth of activities that I do as STOP team lead in order to recruit, train, and deploy the STOP teams. The passion the STOP staff and CDC colleagues instill in people during the training is amazing. Our teams are deployed with expertise in their minds and passion in their hearts. Being a part of it is truly an honor.
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July 28th, 2014 11:14 am ET -
On the road to Bukwo District (photo courtesy of George Momanyi)
George Momanyi, Public Health Nurse, START Consultant
George Momanyi, a public health nurse from Kenya, has twice served as a consultant with CDC’s Strengthening Technical Assistance for Routine Immunization Training (START) project in Uganda. START, funded through a grant from the Bill & Melinda Gates Foundation, provides mentoring and on-the-job training to district-level immunization officers and service providers in areas with high numbers of unimmunized children. START consultants make regular visits to district health officers and service providers, delivering training and reinforcing the application of practical job skills. START’s objective is to build the capacity of program staff and thereby strengthen the overall immunization system.
As a START consultant, George worked in eastern Uganda from July-December 2013, and in northern Uganda from February-June 2014. As he was ending his service on the 2nd START team in June, he sent us this blog about his experience.
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Categories: child health, immunization, polio
June 27th, 2014 3:38 pm ET -
A Bugagi child travels by camel near Lake Chad in Borno State, Nigeria. Photo courtesy of Thomas Moran/WHO.
Victoria Gammino, PhD, MPH, Epidemiologist, CDC Global Immunization Division
Geospatial data have been used in public health since John Snow mapped cholera cases around the Broad Street water pump during the London cholera epidemic of 1854. And, while global positioning system technologies (GPS) are so ubiquitous in the United States that virtually all new smartphones, tablets and cars have this technology embedded, in many areas of the world, health care workers in the field are often without the most basic two-dimensional paper maps.
So what do maps and map literacy have to do with polio? Polio is a crippling and potentially fatal infectious disease. There is no cure, but there are safe and effective vaccines. Therefore, the strategy to eradicate polio is based on preventing infection by immunizing every child to stop transmission of the virus that causes polio, and ultimately make the world polio free. The four pillars of polio eradication all rely on “microplans”— detailed logistical blueprints that guide the planning and implementation of vaccination campaigns, routine immunization outreach, and surveillance for polio cases by providing critical data on the size and location of the target population in a given geographic area. These target population numbers determine the amount of vaccine required, the number of health care workers and supervisors to deliver the vaccine, and the cost of transportation to get the vaccine and health care workers where they need to go.
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Categories: child health, immunization, infectious disease, refugee health
June 5th, 2014 4:42 pm ET -
CAR refugees forced from their homes by rebels
Dr. Els Mathieu, Resident Advisor, CAR- FELTP
The Central African Republic (CAR) is a landlocked country in Central Africa, bordered by Chad in the north, Sudan in the northeast, South Sudan in the east, the Democratic Republic of the Congo and the Republic of the Congo in the south and Cameroon in the west. CAR is one of the world’s least developed nations and has experienced several periods of political instability, as well as deadly attacks and violence by rebels that have forced nearly 1 million people from their homes in search of refuge. With so many civilians fleeing to refugee camps in the capital, Bangui, and the provinces, there is an increased need to strengthen disease surveillance and response.
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Categories: child health, immunization, infectious disease, measles
April 21st, 2014 11:39 am ET -
In 2002, I was in Maracaibo, Venezuela assisting with the investigation of the last measles outbreak in South America when the news arrived: Ministers of health from the region agreed that a synchronized week of vaccination in the hemisphere would help prevent future outbreaks and increase access to immunization for many who would miss this opportunity. The idea of Vaccination Week in the Americas ignited 12 years ago and is now a global initiative: World Immunization Week! Since 2003, more than 465 million people in the Americas have been vaccinated under the framework that emerged from the original idea of Vaccination Week in the Americas (VWA), which takes place the last week in April every year.
Carla Lee, MA, Public Health Advisor, CDC Global Immunization Division
VWA is truly a collaborative effort led by countries and territories of the Pan-American Health Organization (PAHO) to improve equity and access to vaccination for families. VWA activities strengthen the national immunization programs in the Americas by reaching out to families with little access to routine immunization programs. The focus is to find people living in urban peripheries, rural and border areas and in indigenous or other hard-to-reach communities and offer them vaccines.
The work has saved lives.
The Region of the Americas encompasses the entire Western Hemisphere (from Canada in the very north all the way down to the southern tip of South America, and all the countries in between), was certified polio-free in 1994. It interrupted the spread of indigenous measles in 2002 and rubella in 2009. However, globally these viruses are still circulating. A huge global sporting event – the World Cup— takes place in Brazil this summer, attracting millions of travelers from around the world. That adds a new element of risk, increasing the risk of importation of vaccine-preventable diseases into the Americas. In light of the World Cup, VWA will highlight the importance of vaccination to protect the health of the people of the Americas, using slogans like “Vaccination: Your best shot,” and “Go on offense: Get vaccinated!”
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Categories: immunization, infectious disease, rubella
February 18th, 2014 9:57 am ET -
Cambodian children show off their purple marked pinkies, showing that they are protected from measles and rubella, during an immunization campaign in 2013. (Photo courtesy of Sue Chu, CDC.)
Pop quiz: What vaccine-preventable disease, whose name means “little red”, can cause severe birth defects if pregnant women become infected? If you answered rubella, also known as German measles, you are right.
Gavin Grant, MD, CDC Global Immunization Division
Susan Reef, MD, CDC Global Immunization Division
It’s okay if you didn’t know, since rubella is mostly a distant memory in the United States thanks to a comprehensive and effective immunization program that’s been in place for decades.
Sadly that’s not true everywhere.
Each year there are thousands of rubella cases around the world, a number that’s made all the more tragic when there is a safe, effective vaccine. And while the number of cases has fallen, the threat remains. Rubella is spread in the same way as the common cold, through sneezing and coughing. In children rubella is typically a mild disease that may include a rash, fever and sore throat. Adults can get rubella as well—usually they experience symptoms such as rash, headache, pink eye, joint pain and general discomfort.
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Categories: child health, immunization, polio
January 13th, 2014 6:13 am ET -
This blog was originally posted in the Huffington Post on January 2, 2014.
CDC Director Dr. Tom Frieden
There are three places in the world where wild poliovirus has never stopped killing and disabling children: Afghanistan, Pakistan, and Nigeria.
As with other health threats, polio doesn’t stay neatly within a country’s borders. In the case of Nigeria, polio has spread from there to 25 polio-free countries in the past 10 years.
The Nigerian government recognizes this as a public health threat that can be tackled. Last year they put a national emergency action plan in place to eradicate polio and activated an emergency operations center for the work.
The Nigerian plan includes improving immunization activities, outreach to underserved populations, special approaches in security-compromised areas, outbreak response, and improved routine immunization and disease tracking.
In December I had the chance to visit Nigeria and observe firsthand the progress they’re making.
What I saw was impressive. Here are a few highlights from the trip:
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Categories: immunization, infectious disease, pneumonia
November 12th, 2013 9:45 am ET -
Last year, in observance of World Pneumonia Day, Cynthia Whitney, Branch Chief for Respiratory Diseases in the Division of Bacterial Diseases (DBD) and I co-authored a commentary for the CDC Journal of Emerging Infectious Diseases in which we urged the global community to consider the massive problems of pneumonia and to take a moment to consider what we each could do to help solve the problem of pneumonia claiming far too many children. Indeed 2013 has been a very busy year for all committed in the fight against pneumonia—which is part of an urgent and historic global effort to save lives and improve health for millions of women, newborns, and children outlined in the United Nations Millennium Development Goals (MDG).
Rana Hajjeh, MD, Director, CDC Division of Bacterial Diseases
The National Center for Immunization and Respiratory Diseases’ (NCIRD) DBD leads the agency’s pneumonia activities by engaging in research and promoting best practices that address pneumonia everywhere.
Through DBD staff collaboration with partners here at CDC and globally with health care providers, researchers, policy makers, and the greater public health community, we are seeing progress toward reducing disease and deaths due to pneumonia. DBD works with the Advisory Committee on Immunization Practices (ACIP)—which provides advice and guidance to CDC’s Director regarding vaccine use and related agents for control of vaccine-preventable diseases in the United States—and was front and center during the Committee’s meetings this year. Our scientists’ research helped inform the ACIP recommendation on pneumococcal conjugate vaccine (PCV13) for immunocompromised children aged 6-18 years. PCV13 covers 13 pneumococcal serotypes which cause the majority of pneumococcal infections in young children. DBD’s research demonstrated an 88% decline in PCV13-type pneumococcal disease among children less than five years of age in the United States, and 45-65% decline in other age groups due to herd immunity. This year, we completed studies of PCV effectiveness against invasive pneumococcal disease in South Africa and Uruguay and completed the review of vaccine schedules to guide global policy makers adopting PCV into childhood immunization programs. The findings of this comprehensive analysis support the use of either 3 or 4 dose schedules of PCV, and will be published in the Pediatric Infectious Disease Journal in the next few months. We continue to collaborate with partners to assess the effectiveness of PCV in the United States and select developing countries.
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Categories: child health, immunization, infectious disease, polio
October 23rd, 2013 12:29 pm ET -
Maimuna Umar, 35, a Volunteer Community Mobilizer with her pictorial flipbook, is trying to convince the community of the importance of polio immunization and other key household practices. Credit: UNICEF Nigeria/2012/Andriamasinoro
October 24th is World Polio Day, a global health observance for the global polio eradication community to renew its promise of a polio-free world to future generations. World Polio Day is held on the birthday of Dr. Jonas Salk, the man who led the first team to develop a vaccine against polio. The development of the polio vaccine reduced polio worldwide by 99% with only Afghanistan, Nigeria, and Pakistan as the remaining polio endemic countries in 2013. In the spirit of World Polio Day, polio eradication program epidemiologist Wick Warren describes his work over the past year in Nigeria.
‘Every last child’ – this is one of the long-running slogans and ideals of the Global Polio Eradication Initiative (GPEI). The Initiative began in 1988, and while incredible progress has been made, (13 million cases of paralytic polio and more than 500,000 deaths prevented in 25 years), the fact that polio has not yet been eradicated proves that we are still not reaching every last child.
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