Considerations for oral cholera vaccine use during outbreak after earthquake in Haiti, 2010-2011.
Considerations for oral cholera vaccine use during outbreak after earthquake in Haiti, 2010-2011.
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DOI：
10.3201/eid1711.110822
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发表时间：
2011-11
影响因子：
11.8
通讯作者：
Dietz V
中科院分区：
文献类型：
--
作者：
Date KA;Vicari A;Hyde TB;Mintz E;Danovaro-Holliday MC;Henry A;Tappero JW;Roels TH;Abrams J;Burkholder BT;Ruiz-Matus C;Andrus J;Dietz V
许多后勤和业务方面的挑战阻碍了疫苗接种运动的实施。口服霍乱疫苗（ocv）已被推荐用于霍乱流行地区，并在疫情暴发和复杂紧急情况期间进行预防。然而，在疫情开始后进行反应性使用的经验和指南是有限的。2010年，在一个多世纪没有出现霍乱疫情之后，海地地震后爆发了霍乱疫情。随着密集的非疫苗霍乱控制措施的启动，考虑了使用OCV的可行性。我们审查了OCV的特点和使用建议，并评估了全球疫苗供应情况和实施疫苗接种运动的能力。进行实时建模以估计疫苗的影响。最终，没有实施霍乱疫苗接种，因为疫苗供应有限，多剂量方案在后勤和操作方面存在复杂挑战，以及在人口流离失所和内乱的环境中开展运动存在障碍。使用ocv是霍乱控制的一种选择；迫切需要在流行病和紧急情况下适当使用这些药物的准则。
Many logistical and operational challenges prevented implementation of a vaccination campaign. Oral cholera vaccines (OCVs) have been recommended in cholera-endemic settings and preemptively during outbreaks and complex emergencies. However, experience and guidelines for reactive use after an outbreak has started are limited. In 2010, after over a century without epidemic cholera, an outbreak was reported in Haiti after an earthquake. As intensive nonvaccine cholera control measures were initiated, the feasibility of OCV use was considered. We reviewed OCV characteristics and recommendations for their use and assessed global vaccine availability and capacity to implement a vaccination campaign. Real-time modeling was conducted to estimate vaccine impact. Ultimately, cholera vaccination was not implemented because of limited vaccine availability, complex logistical and operational challenges of a multidose regimen, and obstacles to conducting a campaign in a setting with population displacement and civil unrest. Use of OCVs is an option for cholera control; guidelines for their appropriate use in epidemic and emergency settings are urgently needed.
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