Vaccine
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Dengue has become the most rapidly expanding mosquito-borne infectious disease on the planet, surpassing malaria and infecting at least 390 million people per year. There is no effective treatment for dengue illness other than supportive care, especially for severe cases. Symptoms can be mild or life-threatening as in dengue hemorrhagic fever and dengue shock syndrome. ⋯ This review summarizes the current status of all dengue vaccine candidates in clinical evaluation. Currently five candidate vaccines are in human clinical trials. One has completed two Phase III trials, two are in Phase II trials, and three are in Phase I testing.
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To examine barriers to childhood immunisation experienced by parents in Australia. ⋯ Using the most recent data available for examining these issues in Australia, we found that the majority of incompletely immunised infants (in 2004) did not have a mother who disagreed with immunisation. Barriers to immunisation are heterogeneous, suggesting a need for tailored interventions.
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Comparative Study
Long term population impact of seven-valent pneumococcal conjugate vaccine with a "3+0″ schedule-How do "2+1″ and "3+1″ schedules compare?
Significant reductions in invasive pneumococcal disease (IPD) following 7-valent pneumococcal conjugate vaccine (7vPCV) are well documented, but population-level data comparing different schedules are sparse. We compared data from long-term stable surveillance in one Australian region (3 primary doses (3+0) schedule) with similar data from England and Wales (2+1 schedule) and the United States (3+1 schedule). ⋯ Differences in direct and indirect reductions in VT IPD with a "3+0″ 7vPCV schedule versus "2+1″ or "3+1″ were small. All 3 countries moved to 13vPCV by 2011; data post 13vPCV will be important to assess IPD impact using more similar baseline incidence and comparison periods.
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WHO recommends the use of rubella-containing vaccine (RCVs) to prevent rubella and congenital rubella syndrome (CRS). Most licensed rubella vaccines in use globally are based on RA27/3 strains and have estimated vaccine effectiveness (VE) rates of 95-100%. In contrast, China uses a BRD-II strain-based rubella vaccine. Few field studies have been conducted that estimate VE of China's RCV. On March 17, 2014, a rubella outbreak was reported in a middle school in Guangzhou city, China. We conducted an investigation to understand reasons for the outbreak, and we used that investigation to estimate vaccine effectiveness of China's rubella vaccine. ⋯ The rubella vaccines used in China that are based on the BRD-II rubella vaccine strain have VE of 94%, which is similar to the more commonly used RA27/3-based RCVs. Low vaccination coverage contributed to this outbreak; early reporting of an outbreak is necessary for effective outbreak response immunization.
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Community-acquired pneumonia (CAP) is one of the most common acute infections associated with a substantial clinical and economic burden. There have been few studies assessing incidence rate, duration of hospitalization, and costs of hospitalized CAP by age and care-setting. ⋯ There is a large variation in terms of incidence, disease burden and costs across different age groups and the treatment setting. Effective interventions, targeted at older adults, to prevent pneumonia could reduce the (financial) burden due to pneumonia.