Immunization highlights: 2010
Vaccination in emergencies
Earthquake in Haiti
For Haiti’s health sector, 2010 was a year of huge challenges. The 12 January earthquake claimed the lives of more than 200 000 Haitians, including some 300 health workers, and injured many thousands more, while causing serious damage and disruption to health infrastructure, services and supply lines.
The cholera epidemic added new difficulties just as the health sector was beginning to recover. With support from the WHO Regional Office for the Americas (PAHO/WHO) and partners, Haiti's health sector is making progress.
Days after the earthquake, the Ministry of Health, with support from PAHO/WHO, established a surveillance system for six critical communicable diseases: measles, diphtheria, meningitis, acute hemorrhagic fever syndrome, flaccid paralysis and rabies. The system collects data and provides analysis based on weekly reporting from 52 sites. Building on this effort, in November 2010 an early warning system was implemented to investigate rumours of new cases and deaths and to facilitate prompt action in response.
Less than four months after the earthquake, Haiti participated in Vaccination Week in the Americas, with a launching event in Fond Parisien, near the border with the Dominican Republic. More than 980 000 vaccines were administered to vulnerable groups in earthquake-affected areas. In addition, a five-year strategic plan has been developed to strengthen the immunization programme and accelerate the introduction of the 5-in-1 vaccine (diphtheria-tetanus-pertussis-hepatitis B-haemophilus influenzae type b) and other new vaccines.
The Ministry of Health's medical warehouse, PROMESS, which is managed by PAHO/WHO, oversaw the distribution of quality medicines, vaccines and medical supplies to treat more than 100 000 cholera patients. PROMESS also maintained the temperature-controlled supply chain (cold chain) for vaccines and drugs, despite fuel shortages throughout the year.
PAHO/WHO has a long-term commitment to Haiti and will continue to help coordinate recovery efforts, provide technical cooperation, and strengthen national leadership, with a focus on promoting equity in health, combating disease, and improving the quality of life for the Haitian people.
Flooding in Pakistan
Pakistan was hit with devastating floods in August and September 2010. About one-fifth of the country was flooded with over 20 million people at risk of death and diseases. Millions of people were without the most basic necessities and services as their homes, livelihoods and service infrastructure such as schools and health facilities were washed away.
Concurrent to the flood emergency, polio re-emerged in the north-west of the country and in a few districts in Punjab and Sindh. Recognizing the potential for spread of disease, the Pakistani health authorities, with support from WHO, vaccinated an estimated 3.5 million children against measles, polio and other vaccine-preventable diseases.
“Over 60 years of development and investment in the health sector washed away” Dr Hussein A.Gezairy, Regional Director, WHO Eastern Mediterranean Region
In addition, WHO assisted in the establishment of an extensive surveillance system for timely detection of and response to epidemics. Widespread outbreaks of life-threatening diseases such as cholera, bloody diarrhoea, measles and malaria have been averted. Health education and communication campaigns were also carried out to disseminate health protection messages.
Cyclone Tomas hits Fiji and other Pacific Islands
Following cyclone Tomas in March 2010, a large outbreak of typhoid fever occurred in the highlands of the main island of Viti Levu. A typhoid vaccination campaign was launched to protect all persons over two years of age living in areas at high risk of typhoid fever, particularly those living in areas where hygiene and sanitation as well as clean water are severely limited.
The campaign ― undertaken by the Ministry of Health in Fiji with technical and funding support from WHO and the Australian Agency for International Development (AusAID) ― vaccinated more than 70 000 people with Vi-polysacchride typhoid vaccine.
Outbreaks of typhoid fever often occur following natural disasters such as cyclones which are known to cause flooding and damage water and sanitary facilities. Prior to the devastating cyclone, typhoid fever was already endemic in the highlands of Fiji, with several hundred cases confirmed every year. Fiji and some pacific island countries have one of the highest rates of typhoid fever in the world.
Typhoid fever is transmitted by ingestion of food or water contaminated by stools or urine of people who carry the bacteria. The main symptoms of typhoid fever are a high fever, severe headache, and often constipation. If the disease is diagnosed early, treatment with antibiotics can be life-saving. However, symptoms are often non-specific, leading to missed diagnosis.
People can protect themselves and others by washing their hands with soap after each visit to the toilet and before touching food or eating. People should have access to proper sanitation. Water from rivers or creeks should be boiled or treated with chlorine before drinking. As part of Fiji's control measures to combat typhoid, the country plans to introduce typhoid vaccine into their national immunization programme.