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[Acquired immunodeficiency syndrome (AIDS): WHO meeting and consultation on the safety of blood and blood products] Syndrome d'immunodeficit acquis (SIDA): reunion et consultation de l'OMS sur la securite du sang et des produits sanguins.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1986 May; 61(18):138-40.The World Health Organization (WHO) convened a meeting of experts on April 14-16, 1986, to review the available information on the safety of blood and blood products in relation to acquired immunodeficiency syndrome (AIDS). It was attended by over 100 participants from 34 countries and followed by a consultation which took into consideration previous recommendations, new information, and many different circumstances which exist regarding AIDS at the global level. This discussion reports the main conclusions and recommendations of the consultation. Tests to detect antibody to the AIDS virus now are available to assist in the elimination of potentially infectious units of blood and plasma, yet it is important to recognize that information and education remain crucial elements in any AIDS prevention program and that they continue to be relevant to the safety of blood and blood products. In that respect, measures to limit the transmission of LAV/HTLV-III by whatever means will be most effective in communities which are as well informed as possible about the disease, how it is transmitted, and how donors can assist in assuring a safe blood supply by being alert to donor suitability criteria. In some countries risk factors for AIDS have been identified in homosexual and bisexual men, intravenous drug abusers, and their sexual partners. Self-exclusion systems in which persons with risk factors refrain from giving blood, and blood screening programs for virus antibody have been effective in contributing to a safe blood supply. Experience also has shown that frequently when persons infected with the AIDS virus have donated blood, risk factors could later be identified, but many of those donors may not have recognized or acknowledged that they carried a risk. The value of specific screening and control measures which have been found useful in many developed countries should be assessed by other countries in the context of their overall health programs and the availability of human and material resources. Well-accepted general principles concerning the use of blood and blood products need to be emphasized since they can contribute to the control of AIDS. The most important principles are: strategies of health services such as improved antenatal care can reduce the demand for blood and should be encouraged; when appropriate and safer components and derivatives can be produced and are available, they are preferable to whole blood or plasma; and whole blood or plasma should be transfused only when medically justified. Decisions to institute laboratory screening of donors should be made with full awareness that there are several essential components of such a program. Information and education for donors about AIDS, its risk factors, and blood transmission is one of the basic considerations. Exclusion based on a current history of possible exposures to known risk factors as well as symptoms can help to reduce the number of infected donors.
[Expanded Programme on Immunization: Global Advisory Group] Programme Elargi de Vaccination: Groupe consultatif mondial.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1984 Mar 23; 59(12):85-9.In addition to the conclusions and recommendations reached at the 6th meeting of the Expanded Program on Immunization (EPI) Global Advisory Group and summarized in this report, the Group reviewed at length the status of the program in the Western Pacific Region and made a series of recommendations specifically directed to activities in the Region. Of particular significance for the operational progress of the global program are the recommendations concerning "Administration of EPI Vaccines," which were subsequently endorsed by the Precongress workshop on Immunization held before the XVIIth International Congress of Pediatrics in Manila in November 1983. These recommendations are not listed here. In his report to the World Health Assembly in 1982, the Director-General summarized the major problems which threaten the success of efforts to achieve the World Health Organization (WHO) goal of reducing morbidity and mortality by providing immunization for all children of the world by 1990. The 5-Point Action Program adopted at that time remains a relevant guide for countries and for WHO as they work to resolve those problems. The EPI is concerned about the prevention of the target diseases, not merely with the administration of vaccine. In addition to working toward increases in immunization coverage, the EPI must assure the strenghtening of surveillance systems so that the magnitude of the health problem represented by the target diseases is known at the community, district, regional, and national levels; immunization strategies are continuously adapted in order to reach groups at highest risk; and the target diseases are reduced to a minimum. The development of surveillance systems is one of the priorities in the development of effective primary health care services. Disease surveillance in its various forms should be used at all management levels for monitoring immunization programs performance and for measuring program impact. Specific recommendations regarding disease surveillance to be undertaken at global and regional levels and at the national level are listed. The results of more than 100 lameness surveys conducted in 25 developing countries confirm that paralytic poliomyelitis constitutes an important public health problem in any area in which the disease is endemic. In most programs, initial emphasis should be placed on the develpment of sentinel surveillance sites to monitor disease incidence trends. Some progress has been made in acting on the recommendations made at the meeting on the prevention of neonatal tetanus held in Lahore in 1982, but intensification of activities is required. In many developing countries, the surveillance and control of diphtheria must be improved. All aspects of progress and problems in the global program are reflected at least somewhere in the Western Pacific Region, and most of the findings and recommendations generally are valid beyond the regional boundaries.
[Expanded Programme on Immunization: stability of freeze dried measles vaccine] Programme Elargi de Vaccination: stabilite du vaccin antirougeoleux lyophilise.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1981 Jun 12; 56(23):177-9.This report brings up to date those data summarized previously regarding the stability of freeze-dried measles vaccine and is based on information obtained from the London School of Hygiene and Tropical Medicine. The World Health Organization (WHO) intends to establish a requirement for the stability of freeze-dried measles vaccine, and a draft of such a requirement is represented along with an analysis of how such a requirement would influence WHO acceptance of the vaccine included in this report. A plaque assay method was used to determine the potency of measles vaccine which had been stored in a freeze-dried state at 37 degrees Centigrade for varying intervals. Vaccine containers were exposed at 37 degrees Centigrade in a water bath and duplicate samples transferred to -70 degrees Centigrade at intervals ranging from 1 to 28 days. The residual infectious virus was determined by the plaque assay method in parallel with vaccine that had not been incubated. The results from 16 patches produced by 9 manufacturers are summarized in a table, which includes recent data a well as the results from the previous report. 2 criteria of stability are included: the number of days required for the live virus titer to drop to an acceptable minimum level when stored at 37 degrees Centigrade (Criterion 1); and the loss of live virus titer when stored for 7 days at 37 degrees Centigrade (Criterion 2). Neither criterion is sufficient on its own. A quite unstable vaccine might still have the required potency after being stored for a week at 37 degrees Centigrade if the vaccine had a high virus titer initially. Yet, a product with satisfactory stability might still fail the potency requirement if its initial virus titer was borderline. A figure shows how the vaccines would be rated according to the proposed requirements. The proposed requirement for the stability of freeze-dried measles vaccine will be presented to the Expert Committee on Biological Standardization during its meeting in September 1981. If accepted, it would become effective by March 1982.