RISING CHOLERA CASES

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Context

• Global Outbreaks: 24 countries reported nearly 200,000 cholera cases in 2024, highlighting a significant rise in the disease.
• Vaccine Demand: 16 countries requested 92 million doses of oral cholera vaccine (OCV) since January 2023, nearly double the production of 49 million doses in the same period.

Details

Vaccine Supply Challenges

• Shortage and Response: In March 2024, the WHO reported a shortfall in the global OCV stockpile, recommending a single-dose regimen instead of the usual two doses.
• Stockpile Improvement: By June 2024, the stockpile exceeded its emergency target of five million doses, reaching 6.2 million doses.

Historical Context

• Seventh Cholera Pandemic: Ongoing since the 1960s, with a notable increase in cases since 2021.
• WHO Emergency Classification: In January 2023, the WHO classified the cholera spike as a grade 3 emergency, demanding maximal response efforts.
• Increased Vaccine Demand: More doses requested between 2021 and 2023 than in the entire previous decade.

Vaccine Prequalification

• WHO has prequalified three vaccines produced by EuBiologics Co Limited (Euvichol, Euvichol-Plus, and Euvichol-S) and Shanchol from India's Shantha Biotechnics, although Shanchol was discontinued in 2023.

Prevention and Treatment

• Preventive Measures: Improving water, sanitation, and hygiene (WaSH) is critical. Vaccines serve as an additional preventive tool, particularly in endemic areas and during outbreaks.
• Expert Opinion: Shanta Dutta of the National Institute of Cholera and Enteric Diseases (NICED) emphasizes the importance of using OCVs preventively.

Cholera Situation in India

• Reported Cases and Deaths: From 2011 to 2020, India reported 565 outbreaks resulting in 45,759 cases and 263 deaths. Between January 1 and May 26, 2024, there were 1,320 cases and four deaths.
• Under-reporting Issue: Cholera remains under-recognized and under-reported in India.
• Clinical Trials: Trials of an OCV developed by Korea’s International Vaccine Institute showed 65% protection efficacy, with no serious adverse events reported.
• Protection Duration: The vaccine offers up to five years of protection.
• Ongoing Studies: NICED is conducting a pilot study in West Bengal, testing the Euvichol vaccine on 50,000 people, including children.

Must read articles:

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Sources:

Downtoearth