Take On Typhoid Newsletter November 2017

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Taking on Typhoid

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In this issue:

Welcome

Welcome to the inaugural issue of the Taking on Typhoid newsletter. In early October, the Coalition against Typhoid (CaT) and the Typhoid Vaccine Acceleration Consortium (TyVAC) joined forces to Take on Typhoid. We are working together to focus attention on integrated solutions, including typhoid conjugate vaccines and water, sanitation, and hygiene (WASH) interventions, to reduce the burden and impact of typhoid.

With each newsletter, we seek to bring relevant data, outbreak updates, and advocacy tools straight to your inbox. We will feature recent highlights and progress to influence the prioritization of an integrated approach; for example, updates on SAGE meetings, global conferences, and resources, as well as other details relevant to your work.

We are excited to be working together—and with you. Take on Typhoid resources are designed for you, and we want to ensure information and materials you need are readily available online and in your inbox. Now is the perfect time for all of our efforts to come together, with one mission: to take on typhoid.

SAGE recommends typhoid conjugate vaccines for infant and child cohort, catch up campaigns

During the last meeting of the World Health Organization’s Strategic Advisory Group of Experts (SAGE) on Immunization, the agenda included a review of recent evidence on typhoid conjugate vaccines (TCVs). The group considered new data on vaccine safety, efficacy, feasibility, and affordability, as well as emerging issues such as drug resistance trends and their impact on typhoid epidemiology.

Ultimately, SAGE re-emphasized the importance of using typhoid vaccines to control endemic and epidemic disease and recommended that typhoid-endemic countries introduce TCVs in a single dose for infants and children over the age of 6 months, accompanied by catch-up vaccination campaigns for children up to 15 years of age, where feasible. Additionally, SAGE recommended prioritizing TCV introduction in countries with the highest burden of disease and/or growing burden of drug-resistant typhoid. TCVs were also recommended in response to confirmed outbreaks of typhoid fever and in specific groups of people at high risk or with high transmission potential, including travelers from non-endemic to endemic areas.

Newly licensed TCVs have the advantages of providing longer-lasting protection, requiring fewer doses, and being suitable for children younger than two years of age compared to earlier typhoid vaccines. Expanding coverage of TCVs through routine immunization can reduce the need for antibiotics, slow further emergence of drug-resistant typhoid strains, and ultimately save lives.

New website launches

We recently launched a new website to take on typhoid, which we hope become your go-to place for information about typhoid and be a useful resource to complement your work. It includes general pages about typhoid disease, diagnostics, and treatment, along with proven integrated prevention solutions such as vaccines and WASH interventions. It also provides updates on current global policies for typhoid prevention and control alongside advocacy resources, such as key messages and advocacy actions, all designed to equip you—whether a scientist, health care worker, academic, physician, or advocate—with the latest data and information to take action to prioritize typhoid and typhoid control solutions. Finally, we hope that you will check out new resources, the latest news updates and scientific publications, conference information, and our blogs.

Alongside the website, we have launched Facebook and Twitter channels to engage with you, keep the conversation going, and raise the profile of typhoid as a significant public health burden that we need to take on globally, regionally, and nationally. We welcome you to follow us, ask questions, let us know about the work you are doing, and to provide any other feedback.

ASTMH

Next week, more than 4,000 people will arrive in Baltimore, Maryland, for the American Society of Tropical Medicine & Hygiene’s (ASTMH) annual meeting. The five-day conference is packed with exciting presentations, posters, exhibits, and opportunities to network and socialize with typhoid experts from around the world. We are looking forward to meeting, engaging, and sharing our Take on Typhoid initiative.

Please join us for symposia on antimicrobial resistance, where panelists will share data on patterns, risk factors, and economic costs of drug resistance; and on controlling typhoid disease, a discussion on factors that influence typhoid control strategies including data on new conjugate vaccines and chronic carriers. TyVAC Project Director, Dr. Kathy Neuzil, will discuss the application of trial design, outcomes and measures, and regulatory and policy implications using the upcoming typhoid conjugate vaccine trials in Asia and Africa as a case study.

Meet the team and learn more about what role you can play at our reception on Wednesday afternoon, and don’t forget to stop by exhibit booth #408 throughout the conference to meet us and play our interactive game.

Human challenge study finds new typhoid conjugate vaccine 87 percent efficacious

University of Oxford

A new study by Celina Jin et al. at the Oxford Vaccine Group published in The Lancet offers encouraging results for the use of Bharat Biotech’s new typhoid conjugate vaccine (Vi-TCV). In the study, which used a human challenge model to evaluate Vi-TCV efficacy, healthy adult volunteers in the United Kingdom were randomized to receive either Vi-TCV, an older typhoid vaccine (Vi-PS), or a control, non-typhoid vaccine. After vaccination, each participant swallowed typhoid bacteria—known as the “challenge”—and was then followed medically to identify if, and when, typhoid symptoms appeared. The researchers found that, after the challenge, the new Vi-TCV vaccine prevented an estimated 87 percent of typhoid cases marked by a positive blood test and symptoms, compared with only 52 percent for the older Vi-PS vaccine.

These promising results suggest that the new vaccine, which is suitable for children under the age of 2, may dramatically reduce clinical typhoid infections if introduced in high-burden, typhoid-endemic countries. TyVAC is poised to conduct Vi-TCV effectiveness trials in Bangladesh, Malawi, and Nepal to measure how effectively this vaccine can prevent typhoid infections in children living in these high-burden settings. These new trials will build on the findings of this challenge study to illustrate the potential benefits of Vi-TCV as a routine childhood vaccine. Additionally, Bharat Biotech has submitted an application to the World Health Organization for prequalification of Vi-TCV, which would allow for decisions on vaccine introduction and donor financing. Read the full study here and commentary here.

SEAP completes its first year of enrollment

The Surveillance for Enteric Fever in Asia Project (SEAP), a multi-year surveillance project led by the Sabin Vaccine Institute to determine the burden of typhoid and paratyphoid in Bangladesh, Nepal, and Pakistan, recently completed its first year of enrolling participants.

The project, implemented in more than 20 hospitals and laboratory networks in the three countries, has already enrolled more than 7,000 participants and identified more than 1,600 typhoid and paratyphoid cases. In addition to identifying enteric fever patients at hospitals and laboratories, SEAP is conducting household surveys to understand the communities’ health-care seeking behaviors, which will allow for a more accurate interpretation of the hospital-based surveillance results.

Working with country partners to integrate surveillance into existing hospital infrastructure, Sabin has established a comprehensive, low-cost surveillance system that generates baseline data on incidence, clinical spectrum, and long-term impact of enteric fever, including complications and sequelae. As importantly, SEAP can identify outbreaks and patterns of drug resistance. SEAP data will allow for the detection of changes in typhoid burden, providing vital information in the assessment of the impact of typhoid prevention and control interventions, including the new typhoid conjugates vaccines.

Outbreak reports

http://www.coalitionagainsttyphoid.org/typhoid-news-search/

The Fiji Ministry of Health and Medical Services has reported treating at least 13 people diagnosed with typhoid on the island of Moturiki. Health teams are working with the public to encourage preventive measures including safe water, sanitation and hygiene practices.

New cases of typhoid are being reported in the capital of Zimbabwe. The country has been struggling with the disease throughout the year, with more than 2,500 cases of typhoid suspected so far in 2017.

In the United States, nine people in Columbus, Ohio contracted typhoid at a party. Typhoid is rare in the United States, and most cases are caused by travelers returning to the United States from endemic regions.

Several countries across Europe are reporting typhoid cases linked to a recent festival in Italy. To date, a total of eight cases have been identified. Poor hygiene conditions at the event may have contributed to this outbreak.

At least ten paratyphoid cases in New Zealand are linked to contaminated mussels gathered from a marina on the north island. The local health board is working to investigate additional possible causes but is asking the community to avoid gathering shellfish in the affected marina.

Scientific publications

Visit our publications page for more recent research

Blogs

Previous posts available on the blog