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Copenhagen, Denmark, WHO, Regional Office for Europe, 1996.  p. (EUR/ICP/CMDS 96 06 01 03)The WHO/UN Children's Fund Strategy for diphtheria control includes three main recommendations: 1) mass immunization; 2) early diagnosis and proper treatment of cases; and 3) management of close contacts by the use of antibiotics. Whereas the first two recommendations have been implemented in all New Independent States having epidemic diphtheria, in some countries there is a controversial discussion regarding the use of antibiotics for close contacts. Therefore, WHO, with assistance of Centers for Disease Control and Prevention and US Agency for International Development/Basic Support for Institutionalizing Child Survival has drafted guidelines regarding the antibiotic prophylaxis of contacts of diphtheria cases based on international experience. The guidelines include reprints of publications demonstrating the success of this strategy. (author's)
Deaths, severe reactions after DTP not due to vaccine, says study team. Adverse reactions in Kazakhstan.
VACCINE AND IMMUNIZATION NEWS. 1996 Jun; (1):1-2.Kazakhstan's ministry of health recently notified UNICEF of the deaths of 4 children under age 6 months which occurred within 24 hours to 6 days following immunization with diphtheria/pertussis/tetanus (DPT) vaccine. Thinking that the vaccine may have caused the deaths, the ministry was considering halting its national children's immunization program. Within 1 week of the report of the third death, a joint WHO-UNICEF team of experts arrived in Kazakhstan to investigate. Although the team strongly suspected that the deaths were due to defective vaccine, vaccination was quickly ruled out as the cause of death due to a number of reasons. The WHO-UNICEF team instead believes that failure to observe proper immunization procedure may have caused the deaths. Visits to 2 health centers in which 2 of the children were immunized produced no evidence in support of this latter hypothesis. Kazakhstan officials also reject poor immunization practices as a possible cause. Kazakhstan's ministry of health plans to investigate all of the cases, while WHO and UNICEF have recommended a review of the national immunization program and are waiting to see if the recommendation is followed up.