We are NOT authorized by Govt of India for Yellow Fever Vaccination

Tuesday, August 15, 2017

Extreme Shortage of Yellow Fever Vaccine YF Vax in USA, Aug 2017 - CDC

15/08/2017
Announcement: Temporary Total Depletion of US Licensed Yellow Fever Vaccine Addressed by Availability of Stamaril Vaccine at Selected Clinics

Sanofi Pasteur, the manufacturer of the only yellow fever vaccine (YF-Vax) licensed in the United States, has announced that YF-Vax for civilian use is now totally unavailable from the manufacturer until mid-2018 because of delays in the production process. However, YF-VAX might be available at some clinics for several months, until remaining supplies at those sites are used up. Sanofi Pasteur applied and received approval from the US Food and Drug Administration (FDA) to make another yellow fever vaccine available in the United States under an investigational new drug (IND) program.*Manufactured by Sanofi Pasteur in France, this vaccine, Stamaril, is registered and distributed in more than 70 countries. It is comparable in safety and efficacy to YF-Vax.
In order to meet the requirements of the IND program, Sanofi Pasteur can provide Stamaril to only a limited number of clinics. Sanofi has identified sites throughout the United States to include in the program so patients can have continued access to yellow fever vaccine.
Travelers and health care providers can find locations that can administer Stamaril, and those clinics with remaining doses of YF-VAX, by visiting theyellow fever vaccination clinic search page. For information about which countries require yellow fever vaccination for entry and which countries the CDC recommends yellow fever vaccination, visit the CDC Travelers’ Health website (www.cdc.gov/travel).
For more information, contact Sanofi Pasteur at 1-800-VACCINE (1-800-822-2463).
*Although the name of the FDA program is "investigational new drug," Stamaril is not investigational or experimental. Stamaril has been used in European and other countries for decades but is not licensed in the United States. IND is the mechanism through which FDA gives approval for Stamaril to be imported.

More Information

Monday, August 14, 2017

How to avoid yellow fever, August 2017

Yellow fever is a viral disease of typically short duration. The disease is caused by the yellow fever virus and is spread by the bite of an infected female mosquito. It infects humans, other primates and several species of mosquitoes. In cities, it is spread primarily by Aedes aegypti, a type of mosquito found throughout the tropics and subtropics. Aedes aegypti also transmits the viruses that cause dengue fever, West Nile fever, chikungunya, eastern equine encephalitis and Zika virus.
In areas where yellow fever is common and vaccination is uncommon, early diagnosis of cases and immunisation of large parts of the population is important to prevent outbreaks. Death occurs in up to half of those who get severe disease.

Avoid mosquito bites    

When you go outdoors, use oil of lemon eucalyptus on exposed skin. Wear proper clothing to avoid mosquito bites. When weather permits, wear long-sleeves, long pants and socks when outdoors. Mosquitoes may bite through thin clothing, so spraying clothes with repellent containing Permethrin gives extra protection. Mosquito repellents containing Permethrin are not approved for application directly to skin. Be aware of peak mosquito hours. The peak biting time for many mosquito species is dusk to dawn. However, Aedes aegypti feeds during the daytime.

Get vaccinated if recommended              

Yellow fever vaccine is recommended for persons aged ≥ 9 months who are travelling to or living in areas at risk for yellow fever virus transmission in South America and Africa. Mosquitoes acquire the virus by feeding on infected primates (monkeys), and then can transmit the virus to other primates (human or non-human). People infected with yellow fever virus are infectious to mosquitoes (referred to as being ‘viraemic’) shortly before the onset of fever and up to 5 days after onset.

Symptoms

The majority of persons infected with yellow fever virus have no illness or only mild illness. In persons who develop symptoms, the incubation period is typically 3–6 days. The initial symptoms include sudden onset of fever, chills, severe headache, back pain, general body ache, nausea, vomiting, fatigue and weakness. Most persons improve after the initial presentation. Roughly 15% of cases progress to develop a more severe form of the disease. The severe form is characterised by high fever, jaundice, bleeding and eventually shock and failure of multiple organs.

Treatment

No specific treatments have been found to benefit patients with yellow fever. Whenever possible, yellow fever patients should be hospitalised for supportive care and close observation. Treatment is symptomatic. Rest, fluids, and use of pain relievers and medication to reduce fever may relieve symptoms of aching and fever. Yellow fever patients should be protected from further mosquito exposure (staying indoors and/or under a mosquito net) for up to 5 days after the onset of fever.

Outcome

The majority of infected persons will be asymptomatic or have mild disease with complete recovery. In persons who become symptomatic but recover, weakness and fatigue may last several months. Those who recover from yellow fever generally have lasting immunity against subsequent infection.
The writer is a physician, public health specialist & a gerontologist.

Saturday, August 12, 2017

New Yellow Fever Virus Recombinant Protein for Diagnostic Testing Launched, August 2017

Aalto Bio Reagents have announced the availability of its first-to-market recombinant Yellow Fever virus (YFV) protein (code CA 6325) for diagnostic test manufacturers, vaccine developers and researchers globally. This His-tagged, recombinant protein is expressed in HEK293 cells and is derived from strain 17D. YFV, a potentially fatal mosquito-borne flavivirus, is prevalent in tropical and subtropical locations in South America and Africa.
YFV is transmitted to humans mainly by sylvatic mosquito vectors of the genera Haemagogus and Sabethes, but has also been known to be spread by the sinister Aedes aegypti mosquito which is responsible for the current Zika virus epidemic. In humans, the majority of YFV infections are asymptomatic; however approximately 15% of infected patients enter what is known as the toxic phase and this can lead to severe complications such as jaundice, multi-organ failure and even death.
Laboratory diagnosis is generally accomplished by means of serological testing for the detection of antibodies during the postviremic phase of the disease (i.e. from the 5th day since the onset of symptoms). YFV is difficult to diagnose, especially in the early stages, as cross-reaction with other flavivirus infections is common. There are no validated IgM ELISA kits commercially available at present and in order for YFV infection to be confirmed by serologically techniques, a differential diagnosis with other flavivirus infections must be carried out.
Philip Noone, CEO of Aalto Bio Reagents, said “Brazil is currently experiencing its largest YFV outbreak in decades. There is an urgent need for a specific and sensitive serological YFV assay in countries such as Brazil, where co-circulation with other flaviviruses is high. Our industry has an unrelenting requirement for access to the most scientifically proven raw materials, a broader range of flexible controls and faster diagnostics. With our Zika, Chikungunya, Dengue Triplex and now our Yellow Fever solution we are truly building a comprehensive tropical product listing to meet this need. We envisage that our YFV protein will provide the critical element to further diagnostic companies’ research and development of IgG and potentially IgM assays. We will continue to focus on the expansion of our tropical disease products with even more additions in 2017-18 to enable our customers to bring superior, best-in-class diagnostic products to market faster, and aid in the development of life-saving vaccines.”

Saturday, July 22, 2017

Polio in Syria, July 2017

What is the current situation?

Cases of vaccine-derived polio have been reported in Syria, according to the Global Polio Eradication Initiative. Most cases have been reported in Mayadeen District, in Dayr az Zawr Province.
Vaccine-derived polio can occur in places with low vaccination rates and poor sanitation where oral polio vaccine is used. Oral polio vaccine contains a live, weakened version of the virus. In such circumstances, this weakened virus can circulate for an extended period of time and change into a form that can cause paralysis. This form of the vaccine is not used in the United States and most other developed countries.
CDC recommends that all travelers to Syria be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine.

What is polio?

Polio is a disease caused by a virus that affects the nervous system. It is spread by person-to-person contact, mainly through exposure to the feces of an infected person. You could also get polio by drinking water or other drinks or eating raw or undercooked food that has been contaminated by the feces of an infected person.
Most people with polio do not feel sick. Some people have only minor symptoms, such as fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. Most people recover completely. In rare cases, polio infection causes permanent loss of muscle function in the arms or legs (usually the legs); if there is loss of function of the muscles used for breathing or an infection of the brain, death can occur.

What can travelers do to prevent polio?

  • Get the polio vaccine:
    • Ask your doctor or nurse to find out if you are up to date with your polio vaccination and whether you need a booster dose before traveling. Even if you were vaccinated as a child or have been sick with polio before, you may need a booster dose to make sure that you are protected. See individual destination pages for vaccine recommendation information.
    • Make sure children are vaccinated.
    • See the Polio Vaccine Information Statement (VIS) for more information.
  • Eat foods and drink beverages that are considered safe: Follow the Food and Water Safety tips to avoid eating or drinking things that could be contaminated with polio virus.
  • Practice hygiene and cleanliness:
    • Wash your hands often.
    • If soap and water aren’t available, clean your hands with hand sanitizer (containing at least 60% alcohol).
    • Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
    • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
    • Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups, with people who are sick.

Traveler Information

Clinician Information

All travelers to any country should be up to date on routine vaccinations, including polio vaccine. CDC recommends a single lifetime IPV booster dose for travelers to certain countries. See the Vaccine section in Chapter 3, PoliomyelitisCDC Health Information for International Travel, for specific vaccination details.
Additional Information

Polio in Democratic Republic of the Congo, July 2017

What is the current situation?

Cases of vaccine-derived polio have been reported in the Democratic Republic of the Congo, according to the World Health Organization. The cases occurred in Haut-Lomami Province and in Maniema Province.
Vaccine-derived polio can occur in places with low vaccination rates and poor sanitation where oral polio vaccine containing a weakened version of the virus is used. In such circumstances, this weakened virus can circulate for an extended period of time and change into a form that can cause paralysis.
CDC recommends that all travelers to the Democratic Republic of the Congo be fully vaccinated against polio. In addition, adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine.

What is polio?

Polio is a disease caused by a virus that affects the nervous system. It is spread by person-to-person contact, mainly through exposure to the feces of an infected person. You could also get polio by drinking water or other drinks or eating raw or undercooked food that has been contaminated by the feces of an infected person.
Most people with polio do not feel sick. Some people have only minor symptoms, such as fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. Most people recover completely. In rare cases, polio infection causes permanent loss of muscle function in the arms or legs (usually the legs); if there is loss of function of the muscles used for breathing or an infection of the brain, death can occur.

What can travelers do to prevent polio?

  • Get the polio vaccine:
    • Ask your doctor or nurse to find out if you are up to date with your polio vaccination and whether you need a booster dose before traveling. Even if you were vaccinated as a child or have been sick with polio before, you may need a booster dose to make sure that you are protected. See individual destination pages for vaccine recommendation information.
    • Make sure children are vaccinated.
    • See the Polio Vaccine Information Statement (VIS) for more information.
  • Eat foods and drink beverages that are considered safe: Follow the Food and Water Safety tips to avoid eating or drinking things that could be contaminated with polio virus.
  • Practice hygiene and cleanliness:
    • Wash your hands often.
    • If soap and water aren’t available, clean your hands with hand sanitizer (containing at least 60% alcohol).
    • Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
    • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
    • Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups, with people who are sick.

Traveler Information

Clinician Information

All travelers to any country should be up to date on routine vaccinations, including polio vaccine. CDC recommends a single lifetime IPV booster dose for travelers to certain countries. See the Vaccine section in Chapter 3, PoliomyelitisCDC Health Information for International Travel, for specific vaccination details.
Additional Information

Friday, June 23, 2017

North American shortage of Yellow fever vaccine prompts changes in Saskatchewan

Due to a shortage of Yellow Fever vaccine across North America, Saskatchewan clinics will be providing partial doses of the vaccine to residents travelling to affected areas.
Full doses will be made available only if residents are travelling to a country where there is a current outbreak of Yellow Fever; they will be living for more than a year in a country where the risk of contracting the disease is high or they are travelling to a country where they might be at high risk and they require an international Certificate of Vaccination or prophylaxis for entry and/or visa requirements.
The criteria is subject to change at any time depending on availability of the vaccine. 
A partial dose of the vaccine will be provided to those who do not meet the criteria for a full dose. 
When a vial of Yellow Fever vaccine has been opened, it must be used within an hour. 
Therefore, people requiring a partial dose might have to make two visits to their travel clinic. On the first visit, they will receive a travel health assessment and the second to receive the vaccine. This will help ensure no part of the vaccine is wasted. 
In Saskatchewan, Yellow Fever vaccine is only available through travel clinics in Saskatoon, Regina and Prince Albert. 
Some clinics in Alberta, Manitoba and British Columbia have already moved to offering partial doses of Yellow Fever vaccine to maximize the supply.
The vaccine shortage could extend until 2018. 
Anyone who has received the Yellow Fever vaccine in the past is considered protected for life. It is important to find and keep the vaccination documents for border proof. 
The risk of transmission of Yellow Fever does not necessarily occur throughout a country. This is important to consider when planning travel to countries, such as Brazil, where the risk of the disease is present. 
If you have not booked your travel, determine if Yellow Fever vaccination is required for your trip. You can access this information from the Public Health Agency of Canada website:http://www.phac-aspc.gc.ca/tmp-pmv/countries-pays/index-eng.php

Friday, June 9, 2017

Act Swiftly To Prevent Possible Yellow Fever Outbreak, Public Health Officials Urged

Well-known medical practitioner, Dr Winston Dawes, is raising fears that there may be an outbreak of Yellow Fever and other mosquito-borne illnesses if local public health officials do not act swiftly in the aftermath of the recent heavy rains and flooding.
Dawes says public health officials need to go beyond fogging and intensify public education since the mosquitos that transmit the diseases are normally found in and around homes.
The former senior medical officer of the May Pen Hospital says there is a reported increase in the mosquito population in Clarendon.
The parish was the worst affected by the recent heavy rains that triggered widespread flooding.
He says with reports of an outbreak of Yellow Fever in the South and Central America, there is an urgent need for local officials to act now.
Dawes says a similar occurrence here would have a devastating impact on the economy.

Friday, June 2, 2017

Areas & Maps for Africa & South America for Yellow Fever Vaccine recommended countries, courtesy CDC, June 2017


Areas of recommended yellow fever vaccine (yellow), vaccine generally not recommended (dark green) and not recommended (light green). Courtesy of the CDC.
Areas of recommended yellow fever vaccine (yellow), vaccine generally not recommended (dark green) and not recommended (light green). Courtesy of the CDC.
Areas of recommended yellow fever vaccine (yellow), vaccine generally not recommended (dark green) and not recommended (light green). Courtesy of the CDC.



Areas of recommended yellow fever vaccine (yellow), vaccine generally not recommended (dark green) and not recommended (light green). Courtesy of the CDC.
Areas of recommended yellow fever vaccine (yellow), vaccine generally not recommended (dark green) and not recommended (light green). Courtesy of the CDC.



Areas of recommended yellow fever vaccine (yellow), vaccine generally not recommended (dark green) and not recommended (light green). Courtesy of the CDC.
Areas of recommended yellow fever vaccine (yellow), vaccine generally not recommended (dark green) and not recommended (light green). Courtesy of the CDC.
Areas of recommended yellow fever vaccine (yellow), vaccine generally not recommended (dark green) and not recommended (light green). Courtesy of the CDC.
Source

Yellow fever outbreak emphasizes travel-related infections, prevention, AAP News, June 2017

Deborah Bloch, M.D., FAAP and Larry K. Pickering, M.D., FIDSA, FPIDS, FAAP
  • MMWR in Review
Yellow fever is an arthropod-borne flavivirus transmitted in urban outbreaks primarily byAedes aegypti mosquitoes. In April 2016, a yellow fever outbreak was declared in the Democratic Republic of the Congo (DRC) (see map at bottom). From Jan. 4 to Aug. 18, 2016, 410 suspected cases of yellow fever including 42 deaths were reported from the Kongo Central Province, which borders Angola, where another outbreak had occurred five months prior. As a result, the DRC ministry of health initiated mass vaccination campaigns in the Kongo Central Province where approximately 1.5 million doses of yellow fever vaccine were administered. Of note, DRC requires proof of yellow fever vaccine in anyone 9 months of age and older upon entering the country.
Paules and Fauci reported on a yellow fever outbreak in southeast Brazil this year and warned of possible travel-related cases in the United States (N Engl J Med. 2017;376:1397-1399, http://www.nejm.org/doi/full/10.1056/NEJMp1702172).
Preventing travel-associated infections
Pediatricians and other health care professionals should be familiar with travel-associated infectious diseases, including arthropod-borne infections, and the areas in which they are endemic, especially as families embark on international travel this summer.
Yellow fever is one of the few vaccine-preventable arboviruses. Yellow fever vaccine confers life-long immunity, and patients are given a “Yellow Card” to show proof of vaccination. Practitioners should be comfortable with the indications and contraindications of yellow fever vaccine and other travel vaccines and know the availability of travel vaccines in their area (see resources). At time of publication, there was a shortage of yellow fever vaccine.
Public health and clinical applications of travel-related illness
Up to 60% of children will become ill during international travel, and up to 19% will require medical care. Medical planning for international travel requires six to eight weeks.
Pre-travel consultation with a primary care physician or in a travel clinic should include a review of the child’s or adolescent’s medications, allergies and prior vaccinations. Providers should ensure all routinely recommended immunizations are up to date with special consideration for vaccines that may be given earlier or on an accelerated schedule to infants, children or adolescents depending on place of travel. Specifically, measles-mumps-rubella vaccine should be administered to infants 6 through 12 months of age before international travel. Additional vaccines to prevent yellow fever, meningococcal disease, typhoid fever, rabies and Japanese encephalitis may be indicated depending on destination and type of travel.
Information on location-specific infection risks provided in the AAP Red Book and the CDC Yellow Book can further direct preventive measures (see resources). It is important to discuss planned activities to offer anticipatory guidance, such as infectious exposures related to water sports and spelunking, and to give tips related to food and water hygiene. Travel vaccines, malaria prophylaxis and self-treatment for traveler’s diarrhea should be considered. Advice about mosquito bite prevention should be given, including using nets, screens and repellent.
Additionally, prescription renewals of medications (including epinephrine auto-injectors if appropriate) should be given accounting for additional quantity depending on length of travel. A brief letter explaining the medications could be helpful for overseas travelers who may be stopped by customs at their destinations.
Which of the following vaccines are available to prevent travel-related infections, depending on the destination of international travel?
A. Yellow fever vaccine
B. Japanese encephalitis vaccine
C. Rabies vaccine
D. Typhoid vaccine
E. All of the above
Answer: E
Dr. Bloch is a pediatric infectious diseases fellow, PGY-4, at Emory University. Dr. Pickering was editor of the AAP Red Book from 2000-’12. He is adjunct professor of pediatrics at Emory University School of Medicine.
Source

FDA Approves Investigational Yellow Fever Vaccine for Travelers, June 2017

A yellow fever outbreak in Brazil that began in December of 2016 has continued to grow in this and several other South American countries, leading to shortages of the conventional vaccine for the virus for Americans looking to travel Brazil and other affected areas. Now an alternative vaccine available in other countries has received approval in the United States, and can be found in vaccination clinics around the country.

Yellow fever is a mosquito-borne virus which has caused outbreaks in North America centuries ago and is now mostly isolated to tropical and subtropical parts of Africa and South America. Aedes and Haemagogus mosquitos transmit the virus from infected humans and non-human primates. Most people who become infected with yellow fever do not present with symptoms or only exhibit mild illness. When symptoms do occur, they typically develop within 3 to 6 days of infection and can include fever, severe headache, chills, back and body aches, and nausea. While symptoms clear in most infected individuals, infection can become more severe in about 15% of cases after a brief remission period. This can result in high fever, jaundice, bleeding, and even organ failure. Up to half of those who develop severe yellow fever symptoms die from the virus.

In Brazil, a large outbreak of yellow fever has continued to grow. According to a recent situation summary from the Pan American Health Organization (PAHO), Brazil has reported 3,192 suspected cases since December. Of those, health officials have confirmed 758 cases, discarded 1812, and is continuing to investigate 622 cases. Brazil’s Ministry of Health has reported 426 deaths linked to the outbreak, making it a 34% fatality rate among confirmed cases. In addition, the country has reported 3,660 deaths in non-human primates since the start of the outbreak, with yellow fever confirmed to be the cause of 565 deaths, and 1467 deaths still under investigation.

While the outbreak has largely remained in low population areas of Brazil, the recent PAHO update notes that health officials have directed available reserves of the yellow fever vaccine, YF-VAX, to preventing these outbreaks from spreading into more populated, urban areas. In recent months 24.5 million doses of YF-VAX have gone to a selective vaccination strategy in more than 1,000 Brazilian municipalities. As a result, 285 municipalities in the country have achieved more than 95% vaccination coverage, while 375 municipalities have achieved between 74% and 94.9% coverage. However, this outbreak in Brazil coupled with the ongoing outbreak in Angola have led to the depletion of the vaccine supply. In fact, the Centers for Disease Control and Prevention (CDC) recently stated that YF-VAX maker Sanofi Pasteur announced that the vaccine will be unavailable until mid-2018. For American travelers visiting countries requiring yellow fever vaccination, Sanofi Pasteur has recently received approval from the US Food and Drug Administration to distribute Stamaril, an alternative vaccine that offers active immunization against the virus in a single-dose injection. Stamaril is already available in more than 70 countries. Now, in the United States the vaccine has been FDA-approved through an Expanded Access Investigational New Drug Application, meaning that it is still considered investigational. Due to this limitation, “Sanofi Pasteur can support only a limited number of sites,” including several US vaccination clinics; however, the pharmaceutical company is working with the CDC to expand distribution of and access to the vaccine.

The CDC recommends one dose of the yellow fever vaccine for those ages 9 months or older who are traveling to areas experiencing outbreaks of the virus, or to countries in sub-Saharan Africa and tropical South America where the virus is endemic and intermittently epidemic. Those travelling to Brazil or other countries with active yellow fever outbreaks should receive the Stamaril vaccineat least 10 days before entering an affected area to ensure they’ve receive protective immunity. The World Health Organization Advisory Group of Experts on Immunization notes that one dose of the vaccine offers lifelong protection from the yellow fever virus.
Source