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PH still polio-free country: DOH

MANILA -- The Philippines remains a polio-free country, an official of the Department of Health (DOH) said Thursday.

“Technically, the WHO (World Health Organization) clarified that Philippines is still polio-free kasi ang polio-free means na-eradicate natin ang (because polio-free means we have eradicated the) wild polio virus or the naturally occurring virus. The two cases we had are vaccine-derived and not wild polio virus,” DOH Undersecretary Rolando Enrique Domingo said on the sidelines of the Generics Month press conference.

On Sept. 19, the DOH declared the reemergence of polio in the country, 19 years after the WHO declared Philippines polio-free.

“A vaccine-derived polio is from the vaccine we have taken and eliminated from our body tapos napunta sa tubig tapos nakain natin uli, naidumi ulit (then it goes to the water and then we eat it, and eliminate again), which after several years undergo a bit of mutations when the process is repeated,” Domingo said.

He added the mutations cause the virus in the vaccine, which does not cause disease, to “eventually regain its ability to cause disease especially among the children”.

While Domingo stressed that there is no case of wild polio in the country, he said the government is consistent with its efforts to immunize all children under five years to protect them from the disease.

“We’re meeting with the WHO and the UNICEF for the vaccines they will be providing us. We have routine vaccination for the other areas but we will be implementing extra vaccination in areas where there is active circulation since we have environmental monitoring of the whole country,” he said.

When asked about the polio case in Cotabato, Domingo clarified that it is an acute flaccid paralysis (AFP) case and not polio.

“Our surveillance of polio includes AFP which includes kids who will get sick and experience sudden weakening of the lower extremities. We have their stool samples taken and then tested to check if it is positive with polio because AFP can also be caused by other diseases,” he said.

Domingo added there are only two confirmed cases in the country -- one each in Lanao del Sur and Calamba, Laguna -- but the DOH is monitoring seven AFP cases in Zamboanga and one case in Cotabato.

“We’re making a more intensive campaign against polio to make sure it won’t come back. It will be an outbreak response type of immunization,” he said.

On Oct. 14 and 15, the DOH will give all kids under five years old in Lanao del Sur, Davao City, Davao del Sur and Marawi extra dose of polio vaccine whether they have been vaccinated or not.

“The polio vaccination in the National Capital Region is part of the routine vaccination we do in schools and in communities together with measles vaccines which is ongoing,” Domingo said. (PNA)

Sources:https://www.pna.gov.ph/articles/1081515/ By Ma. Teresa Montemayor; September 26, 2019, 2:12 pm

Polio outbreak – The Philippines: Disease outbreak news, 24 September 2019

On 19 September 2019, the Philippines declared an outbreak of polio. Two cases have been reported to date, both caused by vaccine-derived poliovirus type 2 (VDPV2). Environmental samples taken from sewage in Manila on 13 August and a waterway in Davao on 22 August have also tested positive for VDPV2.

The first case was confirmed on 14 September following testing by the National Polio Laboratory at the Research Institute for Tropical Medicine, the Japan National Institute of Infectious Diseases (NIID) and the United States Centers for Disease Control and Prevention (CDC). The case-patient is a 3-year-old girl from Lanao del Sur in the southern Philippines. The virus isolated is genetically linked to VDPV2 previously isolated from environmental samples in Manila and Davao. This indicates that the virus is circulating.

The second case was confirmed on 19 September and is a 5-year-old boy from Laguna Province, approximately 100 km south-east of Metro Manila. Investigations and further characterization of the virus are ongoing.

In addition, VDPV1 has also been isolated from environmental samples collected on 1 July, 22 July, 13 August, and 27 August from Manila.

Vaccine-derived polioviruses are rarely occurring forms of the poliovirus that have genetically changed from the attenuated (weakened) virus contained in oral polio vaccine. They only occur when the vaccine virus is allowed to pass from person to person for a long time, which can only happen in places with limited immunization coverage and inadequate sanitation and hygiene. Over time, as it is passed between unimmunized people, it can regain the ability to cause disease. When the population is fully immunized with both oral polio vaccine and inactivated polio vaccine, this kind of transmission cannot take place. The gut immunity in people immunized with oral polio vaccine stops the virus from being passed on. Full immunization therefore protects against both vaccine-derived and wild polio viruses.

Public health response

1.- Acute flaccid paralysis (AFP) and environmental surveillance are being enhanced to detect poliovirus.
2.- Field investigation is currently underway in Lanao del Sur to define the geographic scope of the circulation of the virus and inform planning for outbreak response including mass immunization campaigns.
3.- The Department of Health (DOH) reinforced its recommendation that all children should be vaccinated according to the routine immunization schedule.
4.- WHO and other partners of the Global Polio Eradication Initiative (GPEI) are supporting the Department of Health and local health authorities in their detailed investigations and supporting efforts to enhance surveillance, strengthen routine immunization, communicate risk to the public and implement outbreak response in line with internationally agreed polio outbreak response guidelines.

WHO risk assessment

WHO currently assesses the risk of international spread from the Philippines to be low. However, the risk of further spread within the Philippines is high due to limited population immunity (coverage of bivalent oral polio vaccine (OPV) and inactivated polio vaccine (IPV) was at 66% and 41% respectively in 2018) and suboptimal AFP surveillance.

WHO advice

It is important that all countries, in particular those with frequent travel and contact with polio-affected countries and areas, strengthen surveillance for AFP cases in order to detect virus importation and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage to minimize the consequences of any possible polio virus introduction or transmission.

WHO recommends that all travellers and residents in polio-affected areas be fully vaccinated against polio.

As per the advice of an Emergency Committee convened under the International Health Regulations (2005), the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC). Countries affected by poliovirus transmission are subject to Temporary Recommendations . To comply with the Temporary Recommendations issued under the PHEIC, any country infected by poliovirus should declare the outbreak as a national public health emergency.

In addition, VDPV1 has also been isolated from environmental samples collected on 1 July, 22 July, 13 August, and 27 August from Manila.

Public health response

WHO risk assessment

WHO advice

WHO recommends that all travellers and residents in polio-affected areas be fully vaccinated against polio.

Sources: https://www.who.int/csr/don/24-september-2019-polio-outbreak-the-philippines/en/; https://reliefweb.int/report/philippines/polio-outbreak-philippines-disease-outbreak-news-24-september-2019/ REPORT from World Health Organization

DOST-PCHRD’s two-way approach to build start-ups and research-based health industry

The Department of Science and Technology – Philippine Council for Health Research and Development (DOST-PCHRD) looks at two ways to fast-track its technology transfer program, thus, spawn the growth of start-up companies by innovators in health technologies and the health industry, in general. One is shared investment in research by industry and the Council, like the Axis Knee System for knee replacement, in which the DOST-PCHRD co-invested with Orthopaedic International, Inc. This proved to be the quickest route to the market of a product from research.

Second, with its biomedical devices program, in particular the Institute of Biomedical Engineering and Health Technologies (IBEHT) at De La Salle University- Laguna Campus, the plan is to build a biomedical device region within the Calabarzon industrial complex in which IBEHT serves as a research and technology business incubator (TBI) hub for start-up companies. Similar set-up for other research programs in other regions are also planned.

On the other hand, social innovations in health generated by innovators working in communities, a regular inventory, documentation and exchange of best practices will be worked out with the regional consortia so that these innovations can be shared with those in similar situations. The Council’s Dr. Gelia Castillo Award for Social Innovation in Health will serve as the vehicle for this program.

On a continuing basis, the DOST-PCHRD supports capacity building program for researchers, project managers and technology transfer staff of higher education institutions and RDIs in the areas of technology assessment, intellectual property policy development and protection, licensing assistance, establishment of technology transfer processes and patent landscape report generation.

The DOST-PCHRD is a pioneer in technology transfer and commercialization. From the work of the National Integrated Research Program on Medicinal Plants, lagundi as cough remedy and sambong for kidney stones were licensed to pharmaceutical companies in the 90s.

As well, the first start-up company out of a DOST-PCHRD-supported project is the Manila HealthTek Inc., led by Dr. Raul Destura of the University of the Philippines – National Institutes of Health (UP-NIH) – home to the award-winning Biotek M dengue aqua kit. After years of clinical trials, the kit is now available in the market and is already used by some hospitals in the country at a much lower cost with sensitivity and specificity comparable to the standard test. Following this success, commercial scale prototype and testing is now underway for Biotek M Typhi Kit for typhoid fever, Biotek M Lepto Kit for leptospirosis, and Biotek M Schisto Kit for schistosomiasis.

Source: http://pchrd.dost.gov.ph/index.php/news/6492-dost-pchrd-s-two-way-approach-to-build-start-ups-and-research-based-health-industry/ Written by:J. Macan

National Lung Month: Tuberculosis as a persistent health concern in the Philippines

Tuberculosis claims more lives than HIV/AIDS.

Despite being a preventable and curable disease, tuberculosis or TB kills an average of 70 Filipinos daily according to the Department of Health. It is considered as one of the most pressing health concerns not only in the country but globally as well.

Tuberculosis is caused by the bacterium called Mycobacterium tuberculosis and is spread when a person with active TB expels microscopic, bacteria-carrying droplets when they cough or sneeze. A person can contract the bacteria by inhaling these droplets in extended periods of time. Symptoms of the disease include: severe coughs that lasts 3 weeks or longer, chest pains, coughing up blood, unintended weight loss, fever, night sweats, loss of appetite, and fatigue.

One of the major challenges in decreasing TB burden in the country is that the disease is highly prevalent in urban poor communities with little access to health care, according to an article on TB detection and patient care in Payatas and Tondo published in the journal Public Health Action in 2017. Although local government units (LGUs) implement programs to bring TB-patient care services to those who need them, there are several factors that hinder TB presumptive patients to undergo diagnosis and seek appropriate treatment. In Payatas and Tondo, poor communication by healthcare workers as well as inconsistent follow ups contribute to late diagnosis and delayed treatment of the disease.

Moreover, there is a tendency of inaccurate diagnosis due to the symptoms being similar to those of other diseases. To address this problem, the Philippine Council for Health Research and Development under the Department of Science and Technology supports projects that provide more accurate diagnosis of the disease. One such PCHRD-funded project is the Newton Agham Tuberculosis Filipino Impact Testing (TB FIT) by the Liverpool School of Tropical Medicine (LSTM) and De La Salle Medical and Health Sciences Institute (DLSMHSI) which developed a local mathematical model to determine the cost-effectiveness of new TB diagnostics and predicted a new point-of-care. Another project is the Low-cost Point-of-care Diagnostics for Simultaneous Detection of Paragonimus westermani and Mycobacterium tuberculosis using RPA technology being developed by the University of the Philippines Manila- Institute of Molecular Biology and Biotechnology.

However, the challenges on TB management do not end with early detection. It is followed by the need to undergo consistent medication for a minimum of six months according to the Department of Health. If treatment is interrupted, there is a risk of developing drug-resistant tuberculosis which progresses faster and is harder to cure. In this regard, training healthcare workers and educating patients are key to increasing TB detection among presumptive patients, allowing them to receive appropriate treatment as early as possible.

As the National Unified Health Research Agenda (NUHRA) 2017-2022 identifies communicable diseases such as tuberculosis as one of its research priorities, the DOST-PCHRD is also funding projects that aim to strengthen TB-control efforts in communities by initiating systemic improvements. One of these is the project “Cavite for a community approach study to control and halt Drug Resistant TB (COACH-DRTC)” of the De La Salle Health Science Institute. This promotes a multi-sectoral involvement in reinforcing the TB-control programs in the province by fostering collaborations between its LGUs and health offices.

Through DOST-PCHRD, the Philippines is also involved in international initiatives on TB control and mitigation through research. The Philippines established a consortium under the Regional Prospective Observational Research for Tuberculosis (RePORT) which is a network of international consortia comprising of high TB burden areas around the world. This promotes collaboration among its members to advance tuberculosis research in their respective countries.

For more information on projects and programs for tuberculosis diagnosis and treatments supported by the DOST-PCHRD, you may browse through the PCHRD website at www.pchrd.dost.gov.ph

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753779/
https://www.who.int/philippines/news/detail/23-04-2019-doh-who-call-for-all-out-war-against-tb
https://www.rappler.com/newsbreak/iq/228777-things-to-know-tuberculosis-philippines
http://www.wpro.who.int/philippines/areas/communicable_diseases/tb/story_continuation_tb_area_page/en/

PNHRS Research Utilization Committee holds HIV/AIDS campaign workshop

Members and representatives of the PNHRS Research Utilization Committee from the 17 regional health research and development consortia participated in the 13^th Philippine National Health Research System (PNHRS) Week pre-conference session, “Campaigning towards AIDS-free Society,” held last 13 August 2019 in Cagayan de Oro City.

Highlights of the morning session are discussions which aims to raise awareness on the growing HIV/AIDS concern in the country by developing effective information campaigns. Three notable speakers were invited to discuss HIV/AIDS research, share experiences in handling patients with HIV, and lecture on the skills and techniques in developing information campaigns.

Dr. Emmanuel Baja, a PCHRD Balik Scientist awardee from UP Manila, discussed his study on HIV Gaming, Engaging, and Testing. He shared that through his research, they were able to develop a mobile application, Battle in the Blood, which became a very powerful tool in advocating towards the elimination of stigma on HIV and encouraged people to get themselves tested for HIV. Dr. Baja emphasized that in campaigning towards a certain cause, people engagement is crucial to truly make them relate to the advocacy.

Dr. Bernadeth Gerodias, a psychologist at the Southern Philippines Medical Center, shared her experiences in handling patients suffering from HIV. She explained that professionals supporting patients living with HIV need to make space for their patients to process the emotional effect of their diagnosis, but not to make assumptions about what it means to them. Dr. Gerodias explained that because HIV’s psychological effects vary with every person, the approach into developing mental care and support for them also vary.

The discussion of Ms. Nini Santos, Consultant and Communication Expert from USAID STRIDE, underscores some of the strategies in developing information campaigns. According to Ms. Santos, highlighting the mission in the content, exploring partnerships and engagements with different groups, and using appropriate channel for distribution are key elements into ensuring a successful campaign.

In the afternoon, the participants were grouped and assigned to work on their group’s campaign strategy applying all that they have learned during the morning session. After the workshop, the RUC held a business meeting to harmonize the RU Committee name and functions across the regions.

Source: http://pchrd.dost.gov.ph/index.php/news/6476-pnhrs-research-utilization-committee-holds-hiv-aids-campaign-workshop/written by: J.Dimailig