RISING CHOLERA CASES

Source: Downtoearth

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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

PRACTICE QUESTION Q. The rising cholera cases globally, coupled with the demand for vaccines outpacing supply, underscore the need for increased production and strategic use of available doses. Improving WaSH infrastructure and preventive vaccination strategies are essential to combat the ongoing cholera threat effectively. Discuss. (15 marks)