The cholera bacterium has undergone important mutations in recent years, causing longer outbreaks of the disease with increased fatalities, researchers reported on Wednesday.
In a package of papers published in the journal PLoS Neglected Tropical Diseases, they said mass vaccinations should be considered as a solution even after outbreaks have begun.
Experts have differed over the usefulness of cholera vaccine once an outbreak has occurred, a debate reignited by a recent epidemic in Haiti.
Edward Ryan, a researcher at Massachusetts General Hospital and Harvard University in the US, said a hybrid strain of cholera underwent two major changes in the last 20 years.
The first resulted in the bacterium infecting patients thought to be immune because of previous exposure to an older strain. The second made it more dangerous.
“Cholera caused by the hybrid strain may be more clinically severe and ... may explain why we are seeing case fatality rates of 1 to 5 percent in recent outbreaks as opposed to under 1 percent historically accepted as the goal for response teams,” Ryan wrote in an editorial.
Many experts oppose cholera vaccines, saying resources in an outbreak should focus on rehydrating the sick and providing safe water and improved sanitation.
The controversy re-emerged in Haiti when cholera broke out in October in the aftermath of an earthquake last January that killed more than 250,000. The cholera epidemic has since killed more than 2,000.
But with the new cholera strain posing a greater threat, lasting longer and with the availability of improved vaccines, the time has come for a rethink, Ryan wrote.
Caused by a water-borne bacteria called vibrio cholera, the disease is transmitted when contaminated human fecal matter gets into water, food or onto someone’s hands. It can cause severe diarrhea and vomiting that dehydrates victims and can kill within hours.
Most patients can be treated with oral rehydration solution and, if these are not tolerated, intravenous fluids. Antibiotics are used for severe cases.
The PLoS package also included a study from Vietnam, which showed how mass vaccination helped control the disease in Hanoi even after an outbreak occurred in 2007.
Fifteen percent of patients given the oral vaccine came down with cholera subsequently, compared to 30 percent of those not vaccinated, wrote the team led by Dang Duc Anh at the National Institute of Hygiene and Epidemiology in Hanoi..
CONFRONTATION: The water cannon attack was the second this month on the Philippine supply boat ‘Unaizah May 4,’ after an incident on March 5 The China Coast Guard yesterday morning blocked a Philippine supply vessel and damaged it with water cannons near a reef off the Southeast Asian country, the Philippines said. The Philippine military released video of what it said was a nearly hour-long attack off the Second Thomas Shoal (Renai Shoal, 仁愛暗沙) in the contested South China Sea, where Chinese ships have unleashed water cannons and collided with Philippine vessels in similar standoffs in the past few months. The China Coast Guard and other vessels “once again harassed, blocked, deployed water cannons, and executed dangerous maneuvers” against a routine rotation and resupply mission to
GLOBAL COMBAT AIR PROGRAM: The potential purchasers would be limited to the 15 nations with which Tokyo has signed defense partnership and equipment transfer deals Japan’s Cabinet yesterday approved a plan to sell future next-generation fighter jets that it is developing with the UK and Italy to other nations, in the latest move away from the country’s post-World War II pacifist principles. The contentious decision to allow international arms sales is expected to help secure Japan’s role in the joint fighter jet project, and is part of a move to build up the Japanese arms industry and bolster its role in global security. The Cabinet also endorsed a revision to Japan’s arms equipment and technology transfer guidelines to allow coproduced lethal weapons to be sold to nations
Thousands of devotees, some in a state of trance, gathered at a Buddhist temple on the outskirts of Bangkok renowned for sacred tattoos known as Sak Yant, paying their respects to a revered monk who mastered the practice and seeking purification. The gathering at Wat Bang Phra Buddhist temple is part of a Thai Wai Khru ritual in which devotees pay homage to Luang Phor Pern, the temple’s formal abbot, who died in 2002. He had a reputation for refining and popularizing the temple’s Sak Yant tattoo style. The idea that tattoos confer magical powers has existed in many parts of Asia
ON ALERT: A Russian cruise missile crossed into Polish airspace for about 40 seconds, the Polish military said, adding that it is constantly monitoring the war to protect its airspace Ukraine’s capital, Kyiv, and the western region of Lviv early yesterday came under a “massive” Russian air attack, officials said, while a Russian cruise missile breached Polish airspace, the Polish military said. Russia and Ukraine have been engaged in a series of deadly aerial attacks, with yesterday’s strikes coming a day after the Russian military said it had seized the Ukrainian village of Ivanivske, west of Bakhmut. A militant attack on a Moscow concert hall on Friday that killed at least 133 people also became a new flash point between the two archrivals. “Explosions in the capital. Air defense is working. Do not