Download PDF by Institute of Medicine, Board on Global Health, Forum on: Considerations for Viral Disease Eradication

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By Institute of Medicine, Board on Global Health, Forum on Emerging Infections, Leslie A. Pray, Joshua Lederberg, Stacey Knobler

Given that smallpox eradication, the technology of eradication has replaced and with it, our definitions of what illnesses are attainable to eliminate. besides the fact that, eradication must never beget complacency. As has been discovered from previous keep an eye on or eradication makes an attempt with quite a few viral ailments, from yellow fever to influenza, unintended or intentional reintroduction is a true possibility - one who may perhaps strike anyplace and for which we have to be totally ready. the standards for assessing eradicability of polio, measles, and different viral infections were debated commonly. With the removing and eradication of a number of viral illnesses at the horizon, matters surrounding the cessation of immunization actions turn into tremendously very important. so that it will higher comprehend the dynamics of illness eradication and post-immunization rules, the Institute of medication discussion board on rising Infections hosted a two-day workshop (February 1-2, 2001) at the results of Viral disorder Eradication. This booklet explores the rules underlying the organic demanding situations, scientific interventions, the ongoing learn time table, and operational concerns for post-immunization options for vaccine-preventable viral illnesses, and highlights vital efforts which could facilitate clever determination making.

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Cuba started its major campaign against measles in 1987, and the English-speaking Caribbean in 1990—both with a very high degree of success in interrupting indigenous transmission. The strategy for interrupting measles transmission was based on changes in the epidemiology of the disease after the vaccine had been introduced. In the pre-vaccine era, all children contracted measles at an early age; by age five, nearly 90% of all children had contracted the disease. Disease outbreaks occurred every one and a half to two years, as new cohorts of susceptible children were introduced into the population.

Although it has been known for many years that live-attenuated vaccines can revert to virulence, this fact has always been considered of little epidemiological significance. In 1964, for example, Wilna Woods and Fred Robbins wrote in the American Journal of Hygiene that, “The remote possibility exists that a vaccinee, at any particular time, might be excreting a virulent strain. , 1964). Although the occurrence of this phenomenon in Hispaniola is a rare event and has been observed only twice before, in Egypt and China, advances in science—from the monkey virulence test of the 1960s to the genetic sequencing of viruses—are providing newer perspectives on how to deal with these problems.

1These definitions reflect the author’s experience and are not necessarily consistent with those of other authors contributing to this book. 24 CONSIDERATIONS FOR VIRAL DISEASE ERADICATION • There must be political committment in the form of sufficient human and financial resources to carry the initiative from beginning to end. • The burden of disease must be considered of great public health importance with broad international impact. HISTORY: SUCCESSES AND FAILURES Past major attempts at disease eradication are noted in Table 1-1.

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