afrol News, 14 January - As the cholera epidemic in central Mozambique is growing into a regional problem, the Maputo government and the World Health Organisation (WHO) are now launching the world's first ever mass cholera vaccination campaign in the city of Beira. WHO talks of "exiting new tools" and a "demonstration project in Mozambique."

This experimental project is being conducted in Beira - Mozambique's second city with a population of 500,000 and a community with particularly high levels of cholera - by WHO in collaboration with the Mozambican Ministry of Health, the non-governmental Médecins sans Frontières (MSF), Epicentre and the International Vaccine Institute.

While current campaigns, which focus on providing care to the sick and providing safe water, can prevent many deaths, the lack of strong preventative measures means the disease is still a major public health problem in some 50 resource-poor countries, the Geneva-based WHO said today.

Though it is unlikely cholera will ever be eliminated by using traditional strategies together with vaccines, there is now greater potential to significantly decrease the disease's incidence in high risk populations, WHO added. The idea of a mass vaccination "is being put to the test in a demonstration project in Mozambique."

- Many lives will certainly be saved, but perhaps even more importantly, the public health system may soon have another tool at its disposal to fight cholera, WHO said. The vaccine itself has been available for ten years, but this is the first time it has been used so broadly to minimise the devastation of a cholera outbreak.

Cholera is mainly contracted through consumption of contaminated food or water and epidemics are linked to poor hygiene, overcrowding, inadequate sanitation and unsafe water.

The Beira campaign will finish by the end of the month with about 50,000 people vaccinated, and the first results of this effort will be obtained within a year, WHO said. It is the first time that WHO has considered the use of the oral cholera vaccine as part of an overall strategy.

In recent years, the number of reported cholera cases worldwide has varied between 110,000 and 200,000 cases annually. Officially 5,000 deaths occur each year, but WHO estimates that the true number is probably significantly higher, due to under-reporting of cases and gaps in surveillance.

Cholera is endemic in Mozambique, in particular in the central and northern parts of the country. On 24 December, however, a cholera outbreak even reached the capital, Maputo, so far infecting about 100 persons and killing six persons. In Maputo, the response to the outbreak focuses on chlorination of wells and treatment of infected patients.

Two types of safe and effective Oral Cholera Vaccines currently exist. The first vaccine consists of killed whole-cell virus with purified cholera toxin. After two doses in two consecutive weeks, patients have high protection lasting for at least one year.

The second vaccine consists of a single dose of attenuated live genetically modified virus strain. It is the first one that is currently being used in the Beira mass vaccination campaign, WHO says.

By staff writer

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