title: Cholera in disasters: do vaccines prompt new hopes?
abstract: Humanitarian aid workers regularly encounter the challenge of setting up functioning surveillance systems immediately after a disaster. Detecting potential outbreaks of diseases, such as cholera, that might arise from disturbed living conditions, displacement and lack of clean water and sanitation is, therefore, extremely difficult. Fears of cholera outbreaks are often rife in such conditions and the pertinence of using cholera vaccines, now available on the market, merit attention. The case of Aceh province, Indonesia, following the 2004 tsunami is examined here: the government of Indonesia decided to carry out a mass vaccination campaign using oral cholera vaccines, a two-dose product that has not been used widely in the particular circumstances of complex emergencies. The preparation and implementation of this campaign faced many hindrances that unfavorably impacted on the time taken to vaccinate the target population and the costs involved. An estimated 69.3% of the target population received immunization. Evidence gathered during the Aceh campaign could be compared with those of a campaign held in another emergency context--Darfur (Sudan). In spite of many dissimilarities, both experiences illustrate the fact that the question of feasibility and relevance of interventions, as well as prioritization of health needs in complex emergencies, remain crucial to alleviate the affected population's suffering in the most efficient way. Following these two campaigns, WHO recommendations on the use of oral cholera vaccines in complex emergencies were issued in 2006.
authors.affiliation: Global Task Force on Cholera Control, Department of Neglected Tropical Diseases, Communicable Diseases Cluster, World Health Organization, 20, av. Appia, 1211 Geneva 27, Switzerland. chaignatc@who.int
authors.forename: Claire-Lise
authors.initials: CL
authors.lastname: Chaignat
authors.forename: Victoria
authors.initials: V
authors.lastname: Monti
authors.forename: Jane
authors.initials: J
authors.lastname: Soepardi
authors.forename: Georg
authors.initials: G
authors.lastname: Petersen
authors.forename: Eigil
authors.initials: E
authors.lastname: Sorensen
authors.forename: Jai
authors.initials: J
authors.lastname: Narain
authors.forename: Marie Paule
authors.initials: MP
authors.lastname: Kieny
mesh_terms: D002771:Cholera / Q000517:prevention & control*; D022121:Cholera Vaccines / Q000276:immunology*; D004190:Disasters; D004196:Disease Outbreaks / Q000517:prevention & control*; D017408:Guidelines as Topic; D007214:Indonesia; D032541:Mass Vaccination; D013397:Sudan
chemical_list: D022121:Cholera Vaccines