Media

1. World Health Assembly passes resolution to prevent and treat childhood pneumonia
In a landmark move to protect children's health around the world, the World Health Assembly passed the first-ever resolution for the prevention and treatment of child pneumonia. The resolution passed on May 21 during the WHO governing body's 63rd session. The decision was praised by the Pneumococcal Awareness Council of Experts (PACE) as a major step in uniting international organizations, governments, and civil society in the fight against pneumonia. The World Pneumonia Day Coalition announced, “We thank the WHO and its member states for their leadership, and we urge all parties to work together to fulfill the promise that aggressive pneumonia protection, prevention and treatment efforts hold for the world's children.”
 
 
2. Updated global disease burden estimates for child mortality from CHERG
This month in The Lancet, the Child Health Epidemiology Reference Group (CHERG) of WHO and UNICEF released new disease specific estimates of the causes of child mortality.Of the 8.795 million under-five deaths that occurred in 2008, the majority (5.970 million, 68%) were caused by infectious diseases. Pneumonia (1.575 million, 18%) and diarrhea (1.336 million, 15%) were the leading causes of under-five mortality. Nearly half (4.294 million, 49%) of all under-five deaths occurred in the one of the following countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China. Authors note that changes in the total number and distribution of child deaths is likely due to a combination of real changes in mortality rates as well as changes in survey methodology. CHERG is in the process of completing a trend analysis allowing for a more direct comparison between the current estimates and those from past years. Visit the PneumoACTION site for a graphic illustrating global causes of child deaths.
 
 
3. Save the Children report highlights the role of female health workers in child survival
A new report from Save the Children surveys the critical gap in child health services that is being filled by female health workers worldwide. As frontline health workers who may or may not have a formal education, these women can save children's and mothers' lives by increasing access to simple and cost-effective interventions. Case studies from countries like Nepal, Bangladesh, Ethiopia, and Afghanistan demonstrate the ability of female health workers to provide pre- and post-natal care, midwifery, immunizations, and treatment for diseases like child pneumonia and diarrhea. The study coincides with a new public service campaign, "See Where the Good Goes™," which is cosponsored by The Ad Council to showcase the accomplishments of female health workers.
 

4. New Zealand sports star raises awareness and funding for pneumonia control in Vicks campaign
New Zealand squash champion Susan Devoy is the leading figure in a new campaign to donate vaccines for children in low-income countries. The Vicks-sponsored Road to Recovery initiative promises to match purchases of specially-marked products with funding for measles vaccination in high-burden countries. Devoy, a four-time winner of the World's Open Squash Championship and also a mother of four, reports, "I was surprised to learn that pneumonia was the cause of so many child deaths in developing countries – especially considering it is something that, in many cases, could be prevented through a simple measles immunization." The program aims to provide 2 million vaccines in 2010 through UNICEF's distribution systems.
 

Research

5. Review of the evidence base and introduction status of Hib and pneumococcal vaccines globally
Researchers from the International Vaccine Access Center reviewed the background and status of Hib and pneumococcal conjugate vaccine introductions in the June edition of Current Opinions in Infectious Diseases. The review included a summary on the burden of the diseases worldwide and the evidence base and policy recommendations from the WHO and others for vaccine introduction. Researchers also highlighted the high efficacy and cost-effectiveness of the vaccines in diverse settings. Hib vaccines have been introduced into national immunization programs in 160 countries, while 32 countries lack a current program for universal access. Pneumococcal vaccines have been introduced universally in 41 countries, for risk groups only in 16 countries, and not yet introduced in 134 countries. Progress in PCV introductions is expected for low-income countries over the next few years through support from the GAVI Alliance.
 

6. S. pneumoniae transmission patterns in The Gambia
In ClinicalInfectious Diseases, Hill et al presented a longitudinal carriage study of S. pneumoniae among children and adults in rural Gambian communities. The study surveyed 158 participants in 19 households in two villages of the Western Division of The Gambia. Nasopharyngeal swab specimens were collected every two weeks for the one year study period. Nearly all participants—97% of children and 85% of adults—were found to carry S. pneumoniae at one point or more during the year. Carriage duration varied by serotype with types 14, 3, and 11 achieving the highest mean carriage in weeks (P<.05 among all distinct serotypes). The study supported evidence that household transmission is an important factor in acquisition of S. pneumoniae, with children most often serving as the first point of household introduction.
 

7. Multiple studies demonstrate the safety and immunogenicity of PCV13
In the wake of the recent licensure of 13-valent PCV in the U.S., several new studies reaffirmed the vaccine's safety and immunogenicity. Bryant et al from The University of Louisville demonstrated comparable safety and immune response levels among children vaccinated with the PCV13 and PCV7, as reported in the May 2010 edition of Pediatrics. The study randomized 249 infants to receipt of a three-dose schedule of the PCV13 or PCV7. Among those receiving the PCV13, 88% to 98% of infants had antibody concentrations of at least 0.35 microg/mL for shared PCV7 serotypes, and 97% to 100% had antibody concentrations of at least 0.35 microg/mL for the additional six serotypes.
 

In addition, Esposito et al completed a randomized trial among 606 subjects in Italy, which was published in Clinical Vaccine and Immunology. The two vaccines showed similar safety profiles, and the PCV13 led to functional OPA responses for all 13 serotypes without interfering with the effect of other childhood vaccines. This month, Kieninger et al also published the results of a trial comparing PCV13 to PCV7 under a four-dose regimen in Vaccine. The study of 604 subjects in Germany also demonstrated the safety and immunogenicity of PCV13, though a slightly lower proportion of PCV13 recipients reached threshold IgG levels for serotype 6B (87.1% compared to 77.5%).
 

8. Trends and implications of S. pneumoniae antimicrobial resistance
Several recent pieces of work have looked at trends in pneumococcal resistance to antibiotics. Linares et al traced the history of S. pneumoniae antimicrobial resistance in this month's Clinical Microbiology and Infection. First reported in 1967 in Australia, resistance patterns have spread throughout the world and are most common in serotypes 6B, 6A, 9V, 14, 15A, 19F, 19A, and 23F. The introduction of PCV7 along with reduced antimicrobial usage resulted in reductions in pneumococcal disease and antibiotic resistance. Looking forward, authors recommend controlled antibiotic use as well as introduction of PCVs offering expanded serotype coverage.
 

Lynch and Zhanel from the UCLA School of Medicine also reviewed historical changes in pneumococcal resistance in Current Opinion in Pulmonary Medicine. While outlining the epidemiology and risk factors for antimicrobial resistance, the authors similarly called for continued surveillance of resistance patterns as well as the development of vaccines with increased serotype coverage. Research from GSK Belgium presented modeled results of the retrospective and prospective impact of multiple PCVs on IPD incidence in this month's Vaccine. In the same issue, Reinert et al from Pfizer, France reviewed the literature regarding pneumococcal disease due to serotype 19A, noting the role that the PCV13—which includes serotype 19A—could play in reducing disease burden.

9. Vaccine serotype coverage and drug susceptibility analyzed in Thai study
Srifeungfung et al from Mahidol University in Thailand presented the results of their survey of 172 S. pneumoniae isolates in Vaccine. Among children under five, 6B, 23F, 14, 19F, and 19A were the most common serotypes. PCV7 would cover 70.3% of isolates (95% CI 58.2%, 80.1%) and PCV13 would cover 81.2% of isolates (95% CI 70.0%, 88.9%). Antibiotic susceptibility among all isolates was 88.7–95.7% for penicillin, 90.6–98.4% for cefotaxime, 92.2–100% for ofloxacin and 100% for ciprofloxacin. Authors note that the Thai licensure process for PCV10 and PCV13 is underway and continued surveillance is necessary as new vaccine introductions are proposed.
 

10. Impact of HIV on pneumonia incidence and mortality in Mozambique
Roca et al reported results from surveillance of severe child pneumonia in Mozambique in the latest issue of Vaccine. From March 2004 to 2006, researchers used WHO protocols to measure pneumonia and pneumococcal disease burden in children under two at a 110-bed hospital in a rural area. Among the target populations, severe pneumonia comprised 15% of hospital admissions and 32% of inpatient mortality. When comparing HIV-positive to HIV-negative infants, the incidence rate ratios of severe clinical pneumonia and radiologically-confirmed pneumonia were 7.3–14.9 and 9.3–19.0 respectively. Additionally, among those tested for HIV, 81% of pneumonia deaths were in HIV-positive children.
 

11. SIVAC Initiative releases Vaccine journal supplement
The SIVAC Initiative (Supporting National Independent Immunization and Vaccine Advisory Committees) announced the release of the Vaccinejournal supplement "The Role of National Advisory Committees in Supporting Evidence-Based Decision Making for National Immunization Programs”; Volume 28, Supplement 1, Pages A1-A110 (19 April 2010). Please access this supplement (open access) by clicking on the following links: http://www.sciencedirect.com/science/issue/5188-2010-999719999.8998-1900719 or http://www.sivacinitiative.org/download/Vaccine_Supplement_NITAGs_19042010.pdf
 

Announcements

Deadline extended: World Pneumonia Day Photo Contest.The deadlineforsubmissions has been extended to June 30. Please take 10 minutes of your time tomake a difference in the fight against childhood pneumonia. Visit here to enter a photo.
 

Grand Challenges Canada: Request for Proposals on Point-of-Care Diagnostics
Grand Challenges Canada has issued an RFP for research in point-of-care diagnostics for use in low-resource settings. The organization expects to award 10-20 grants for a total of up to $12 million Canadian dollars. For further details and to apply, please visit www.grandchallenges.ca.
 

Upcoming Events

The Global Health Council's 37th Annual International Conference on Global Health, Dateline 2010: Global Health Goals & Metrics, will take place in Washington D.C. June 10 to 14, 2010. Additional information on this conference, which will examine metrics, progress and challenges on global health goals, is available at http://www.globalhealth.org/conference_2010/.
 

The 4th Annual World Vaccine Congress Asia will take place on June 8 to 11, 2010 in Singapore. Highlights include sessions on influenza, public-private partnerships, and new vaccines. More information is available at: http://www.terrapinn.com/2010/wvcasia/.
 

On July 11 to 14, 2010, the International Conference on Emerging Infectious Diseases will be held in Atlanta, Georgia. Visit http://www.iceid.org/ for additional information about the conference.
 

From July 11 to 15, 2010 the Association for Professionals in Infection Control and Epidemiology will hold its annual conference in New Orleans, Louisiana. Dr. Atul Gawande will be the keynote speaker at the event. For more information and to register, visit http://conference.apic.org.
 

The 15th Ordinary Session of the Summit of the African Union will be held in Kampala Uganda from July 19 to 27, 2010. This year's theme is "Maternal, Infant and Child Health and Development in Africa." More information can be found at http://www.africa-union.org.
 

The 26th International Pediatric Association Congress of Pediatrics will be held in Johannesburg, South Africa from August 4 to 9, 2010. The session will include a focus on child survival and associated progress towards MDGs, health determinants, issues in neonatal health, and emerging infections. Registration instructions and more information can be found at: http://www2.kenes.com/ipa/pages/home.aspx
 

Smallpox Eradication after 30 years: Lessons, Legacies and Innovations will be held in Rio de Janeiro from 24-27 August 2010. For more details, visit: http://smallpox2010.org/