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Communicable diseases
Published in Jan de Boer, Marcel Dubouloz, Handbook of Disaster Medicine, 2020
Once the general strategy has been defined, all practical, organisational details must be arranged: – who will inform the population?– what is the desired time-frame for the campaign? Different human resources will be required depending on whether immunisation is to take place in a day, a week, or longer.– how will the cold chain be organised?– mechanisms for the follow-up
Application of Lactic Acid Bacteria in Time-Temperature Integrators
Published in Marcela Albuquerque Cavalcanti de Albuquerque, Alejandra de Moreno de LeBlanc, Jean Guy LeBlanc, Raquel Bedani, Lactic Acid Bacteria, 2020
Amélie Girardeau, Vanessa Biscola, Sophie Keravec, Georges Corrieu, Fernanda Fonseca
The applicability of Cryolog’s commercialized TTI was therefore evaluated with both durability studies and challenge tests using ground beef, cooked chicken and smoked salmon (Ellouze et al. 2010, 2011). These food products and their corresponding TTI labels were exposed to three dynamic temperature profiles (Figure 5): A reference profile that was used to estimate shelf-life: one third of the time at 4°C and the rest of the time at 8°C.A well-managed cold chain scenario with temperature fluctuations averaging below the reference condition (4°C).A cold-chain failure scenario with temperature fluctuations averaging well above reference condition.
Developments in equipment and therapeutics
Published in Ian Greaves, Military Medicine in Iraq and Afghanistan, 2018
The cold chain requirements needed to maintain the low temperatures at which blood is stored are problematic, especially in an environment in which temperatures can be as high as 50°C. It was not practical to put a blood fridge on board the aircraft, and even then, a power supply would have been required. An alternative solution was sought, and the ‘Golden Hour Boxes’ were developed. These look like simple cardboard boxes and hold thermal plates that keep the products at the correct temperature for up to 72 hours without the need for external power (Figure 23.14). This technology remains extant and has not only facilitated blood on the MERT but also has the potential to allow the use of blood products in supporting small-scale forward operations.33
Myocarditis following COVID-19 vaccination: incidence, mechanisms, and clinical considerations
Published in Expert Review of Cardiovascular Therapy, 2022
John R. Power, Lucas K. Keyt, Eric D. Adler
While the data on vaccine-associated myocarditis strongly favor vaccination in terms of both patient- and population-level benefits, further work is needed to minimize this adverse event. Some have suggested that mRNA vaccine dose reduction, a strategy that implemented vaccines for children under 12, may decrease risk for myocarditis in vulnerable populations without sacrificing immune response [110,111]. Recent VAERS surveillance data showing fewer reports of myocarditis in children 5–11 compared to teenagers further support a dose-reduction strategy [112]. Alternatively, a longer interval between doses could theoretically decrease IFNγ-associated Th1-type inflammatory response [113]. Others have suggested that addressing shortcomings in production or maintenance of cold chain could minimize the rate of myocarditis [114]. Ultimately, more research into the mechanisms of vaccine-associated myocarditis is needed to reduce myocarditis with mRNA vaccines. Further work is also needed to identify patients at highest risk for vaccine-associated myocarditis.
Modern biologics for rabies prophylaxis and the elimination of human cases mediated by dogs
Published in Expert Opinion on Biological Therapy, 2020
Terapong Tantawichien, Charles E. Rupprecht
In general, the CCEEV were intended originally for a single-use application and are not supplied in multidose vials for administration. Also, vaccines prequalified by the WHO do not contain preservatives, such as thiomersal [https://extranet.who.int/gavi/PQ_Web]. Shelf-life is ≥3 years, provided CCEEV are stored at 2–8°C and protected from sunlight. Depending upon the manufacturer, some products have been evaluated for greater thermostability under tropical conditions, but the maintenance of a cold chain remains desirable. After reconstitution with sterile diluent, the vaccines should be used immediately or within ~6 h if kept at 2–8ºC, as partially used vials may become contaminated. These CCEEV are intended for both PrEP and PEP and have been administered to hundreds of millions of people worldwide. Prompt administration after exposure, combined with proper wound management and simultaneous administration of RIG where indicated in naïve individuals, is almost invariably effective in preventing rabies, even after high-risk exposures, such as recipients of RABV-infected tissues and organs [67].
Introducing new vaccines in low- and middle-income countries: challenges and approaches
Published in Expert Review of Vaccines, 2019
Adrienne Guignard, Nicolas Praet, Viviane Jusot, Marina Bakker, Laurence Baril
There have been a number of further initiatives to address these challenges, including an appraisal of their economic cost [66]. In 2007, the WHO and PATH, with the support of the Bill & Melinda Gates Foundation, launched Project Optimize, a program aiming to make use of technological and scientific advances to help guide the development of new products and ensure maximum efficiency and safety in the vaccination field [67]. This program has performed wide-ranging evaluations of newer cold-chain and controlled-temperature technologies across a number of different LMICs and settings [68]. Other examples are listed in Table 4 [1,21,67,69–76]. These include: 1) in-depth assessment by countries of their cold chain and waste management system, use of computerized tools to estimate the additional storage capacities needed or estimate the frequency at which regions, districts, and peripheral health facilities should be supplied, 2) evaluation of alternative techniques for maintenance at the adequate temperature and evaluation of the possibility of temperature excursion in view of the field constraints and 3) development of presentations and packaging, adapted to the requirements of specific LMICs.