Short consensus Short consensus 25/1/2018. Dr Ula Maniewski-ITG

Transcription

1 Short consensus Short consensus 25/1/2018 Dr Ula Maniewski-ITG

2 YellowFever

3 Yellow fever map South America Outbreak YF in Brazil several cases in Sao Paulo-city

4 Yellowfever: forhowlong is vaccinationvalid? Amendment to International Health Regulations (2005), Annex 7 (yellow fever): as of 11 July 2016, for both existing or new certificates, revaccination or a booster dose of yellow fever vaccine cannot be required of international travellers as a condition of entry into a State Party, regardless of the date their international certificate of vaccination was initially issued.

5 No new certificate is needed Countries and health care providers continue to be free to make requirements on vaccination, revaccination or boosters for their own populations, or patients, respectively. No WHO guidelines about suboptimal protection in certain subpopulations boosterinjections each country issues its own guidelines

6 Stratification endemic/ non endemic Endemic 97,6% remains seropos Non endemic: 83,6% - almost 1/5 or 1/6 loose measurable antibodies in non endemic setting Protection? Role of memory T cells unclear and certainly not proven: it is not sure if memory T cells can protect against YF in case of neg NT cutoff for PRNT: breaktrough infections in PRNT of 10 and 20 In children seroconversion only 84,8%-88%-and lower if combined with MMR Underreporting of breakthrough YF cases

7 Belgian guidelines 2017

8 Most travelers

9 Children, pregnant

10 HIV, immunosuppressed 10

11 The certificate is lifelong valid In dailypractice BUT in general: a single booster is recommended for most travellers Certificate: remains the same Explain to traveller difference between administrative lifelong and recommandation (in general: single booster once in a lifetime)????? What will WHO do?

12 Exampleof a tool whichcanhelp yourtraveler-toattachin theback of theyellowbook If you wish a PDF/excel version, you can send a mail to us or to lhuyskens@itg.be

13 Cholera

14 Historyof of cholera vaccination/stamp 1961: 7th cholera pandemy, started in Indonesia-> Asia-/Far East 1970: cholera epidemic spreads to Africa 1973: WHO decides that cholera vaccination is not mandatory any more But vaccination against cholera was routinely given to travelers to Africa/ Asia in 80-because proof of vaccination was still checked when entering certain countries 1991: cholera in South America (Peru)- ITM decides not to vaccinate for South America-nor to give a cholera stamp 1995: national scientific studygroup of travel medecine is born; they decide not to vaccination anymore against cholera for the ordinary traveler, but to give a stamp that vaccination is not indicated for Africa, where some coutries still require proof of vaccination

15 Cholera: stamp still needed?

16 Whoelse elseuses usesa cholera stamp? CDC: no mention in yellow book Autriche: no Suisse: non Allemagne: non UK: non France: non Pays-Bas: oui

17 Cholera: stamp still needed? 2018

18 Typhoidfever Typherix : not available any more Typhim Vi : available Vivotif : availabe

19 WHO-SAGE recommended the use of typhoid conjugate vaccines for use in infants between 6 and 23 months of age and catch up vaccinations for children between 2 and 15 years of age.

20 CDC-Yellow book

21 Meningococcal ACW 135 Y vaccine conjugated vaccines: Nimenrix Menveo 5y valid (all indications-also pilgrimage) Nimenrix Registered from the age of 6 weeks For babies between 6 and 12 weeks : M0- m2 and the 3rd dose at m12 For babies between 12 weeks and 12 months: no recommendations of the producer follow the same vaccination scheme as with the younger group of age: m0-m2 (and the 3rd dose at 12m) From the age of 12 months: 1 injection Menveo can be administered from the age of 2 years (off label). Since 2010 in the UK: Menveo is administered from the age of 2 months: m0-m1 m12 (if the risk persists) (off label). >1y: 1 dose. Mencevax : Quadrivalent, not conjugated on the Belgian market again (valid 2-3y)

22 JAPANESE ENCEPHALITIS

23 Ixiaro: notice Conventional vaccination schedule: d0 d28 first booster between 12 and 24 months next boosters: no clear guidelines yet, not sooner than after 10 years. Rapid vaccination schedule: (in adults) d0 d7 first booster between 12 and 24 months next boosters: no clear guidelines yet, not sooner than after 10 years. 23

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25 FSME immune No need to restart vaccination schedule after interruption every injection counts First booster at 3y, next booster 5-10y if < 60y

26 Reminder travelersdiarrea Prescription for antibiotics when? Traveling to Asia/ Africa; longer than 16d Or vulnerable (elderly, child, pregnant, underlying disease, ) What? Azithromycine When to use?: in case of severe diarrhea: High fever > 38, 5 C Heavy cramps Blood/ slimes

27 Thank you for your attention on behalve of the Scientific Studygroup of Travel Medecine Chairman: Patrick Soentjens (ITG / Defensie) Ula Maniewski (ITG) Charlotte Martin Yves Van Laethem Anna Vanderfaeillie (St.-Pierre) Frédérique Jacobs Maya Hîtes (ULB) Willy Peetermans Paul De Munter (KUL) Bernard Vandercam Julien De Greef Dimitri Vanderlinden (St-Luc) Steven Callens Diana Huis in t Veld (UZGent) Patrick Lacor Rembert Mertens (VUB) Jeroen Van der Hilst (Jessa) Philippe Léonard (ULg) Sophie Quolin (WIV/ISP)

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