PAHO will pursue cholera vaccination in Haiti

* PAHO changes course as outbreak seen lasting years

* Cholera vaccine is in short supply worldwide, PAHO says

* Sanofi Aventis and Crucell are only makers of vaccine

By Jane Sutton

MIAMI, Dec 17 (BestGrowthStock) – The Pan American Health
Organization hopes to start a cholera vaccination program in
Haiti by April but must first boost and fund production of the
vaccine that is in short supply, the group said on Friday.

The diarrheal disease appeared in the poor Caribbean nation
in October for the first time in decades and has sickened
105,000 people and killed more than than 2,000, Haitian health
officials have said.

PAHO, the American division of the World Health
Organization, had previously opposed vaccination in Haiti on
grounds that it would be too difficult and expensive.

It changed course on Friday and recommended using the
vaccine in Haiti, partly because it has discovered a stockpile
of additional vaccine and partly out of recognition that the
outbreak would not be halted any time soon.

“This is a disease caused by a bacterium that has a
foothold in Haiti and will be in Haiti causing endemic cholera
for many years to come,” Dr. Jon Andrus, deputy director of
PAHO, said in a webcast from Washington. “So if we have options
to better our response we really, really need to study those

Cholera is caused by a water-borne bacteria called Vibrio
cholera and is transmitted when contaminated human fecal matter
gets into water, food or onto someone’s hands. Many people show
no symptoms but can pass it along and cholera can cause
extremely severe diarrhea and vomiting that will kill within
hours by dehydrating victims.

There are only about 200,000 to 300,000 doses of cholera
vaccine available in the world at present, and only two
companies produce it, said Dr. Ciro de Quadros, executive vice
president of the Sabin Vaccine Institute.

Sanofi Aventis’ (SAPL.KA: ) India-based division Shantha
makes a vaccine called Shanchol for about $1 a dose, with up to
three doses needed for protection, while Netherlands-based
Crucell (CRCL.AS: ) makes another called Dukoral.

PAHO recently discovered a stockpile of more than 1 million
doses of Shanchol that would take several months to pack and
label, de Quadros said. It has not been prequalified for
purchase by the WHO, but that prequalification is expected in
the first or second quarter of 2011, he said.

Doctors meeting on Friday under the auspices of PAHO
recommended that it meet with the manufacturers to see if they
could ramp up production and work with organizations that could
help finance the purchase of the vaccines.

“If there would be a (financial) guarantee, both suppliers
could produce 2 to 3 million doses a year,” de Quadros said.

With that in place, PAHO could start a
vaccine-demonstration project in Haiti in March or April, he

The doctors said they do not know how many doses would be
needed in Haiti and that there were many logistical challenges
to work out. Haiti is deeply impoverished and struggling to
rebuild from a catastrophic January earthquake that killed more
than 250,000 people.

Andrus said the vaccine must be considered “an extra tool
in the toolkit” to fight cholera.

Health organizations have so far focused on treating
cholera patients with a rehydration fluid containing special
sugars and salts, and on educating people about how to halt its
spread through hand-washing and sanitation measures.

(Editing by Philip Barbara)

PAHO will pursue cholera vaccination in Haiti