12.11.15 By Sanofi Le Hub
Dengue is a mosquito-borne illness known for its high fevers, intense joint and muscle pain and crushing headaches. The pain can be such that dengue is sometimes referred to as “breakbone fever”. Severe cases can lead to dengue hemorrhagic fever, a potentially life-threatening condition that requires hospitalization. There is no specific treatment for dengue, only care that helps alleviate symptoms.
Dengue has grown thirtyfold in the last fifty years, becoming the fastest growing infectious disease transmitted by mosquitoes. The World Health Organization (WHO) estimates that it affects 96 million people each year, with half the world’s population, or 3.9 billion in over 128 countries, at risk.
Dengue vector control operation in a Mexican house
In Mexico alone, the Pan American Health Organization (PAHO) has put the number of reported dengue cases in 2013 at 231 400. What’s more, in a 2015 study researchers* estimated there are roughly 5.6 times more cases than those reported to health authorities. The study puts the amount of money spent per hospitalization in Mexico at USD 1 327, with more than six days lost at work or school on average. In total the disease resulted in USD 87 million in direct and indirect medical costs in 2013 alone.
The countries faced with these mounting costs are, for the most part, developing countries, with healthcare systems that are strained to begin with. According to the WHO, some 500 000 people are hospitalized every year with dengue hemorrhagic fever. Direct medical costs and indirect costs related to absenteeism and lost productivity are estimated to total USD 9 billion worldwide
In one of Mexico City’s medical research laboratories, Sanofi Pasteur and an international team of scientists have been busy working to offer hope for future generations in the form of a vaccine. After decades of development, Sanofi Pasteur conducted clinical trials for the vaccine in Mexico, Brazil, Colombia, Honduras and Puerto Rico in Latin America, as well as in dozens of countries in other dengue-endemic regions around the world.
In July 2015, the New England Journal of Medicine published a report on the first 25 months of the vaccine’s two phase III studies. It showed that among people nine years of age and older, the vaccine prevented two out of three cases of symptomatic dengue and nine out of 10 severe cases. Moreover, eight out of 10 hospitalizations were prevented.
With broad vaccination programs in those aged nine and older, Sanofi Pasteur has estimated that dengue-endemic countries can aim to reduce the burden of dengue by 50% in five years.
“Our company set out more than 20 years ago to develop a dengue vaccine to address the significant unmet public health need in Latin America and Asia, where dengue is endemic,” said Olivier Charmeil, President and CEO, Sanofi Pasteur. “We remain focused on bringing this innovative vaccine first to these countries where it can have the greatest impact on the disease burden.”.
The first authorization of a vaccine against dengue in Mexico on Dec 9 is an historic milestone paving the way to significantly impact dengue burden in endemic countries.
“Dengue is a major public health priority in Mexico and many other tropical and subtropical countries in both Latin America and Asia. Therefore, the first approval of a dengue vaccine is a major breakthrough that will help to prevent dengue. The dengue vaccine will be a welcome addition to integrated dengue prevention and control efforts and a critical tool to boost on-going community efforts to relieve the long-standing suffering that this disease continues to bring to people in endemic countries like ours,” asserts José Luis Arredondo García, MD, director clinical studies and coordinator master and PhD program in medicine at the National Institute of Pediatrics, Mexico.
The successful authorization of dengue vaccine in Mexico is settinga precedent for governments of endemic countries faced with the challenge of beating the disease. They will have more power to take control of dengue. Moreover, their healthcare systems will have resources freed up to focus on improving standards of care and attracting further investment.
Developing a dengue vaccine is already a major health breakthrough, but it is just the first step in protecting people living in endemic countries. The key to success will be to combine mass immunization and continued vector control. Sanofi’s long-term goal is to supply one billion doses over the next 10 years, with the aim of helping the WHO achieve its target for 2020 of reducing dengue mortality by 50% and morbidity by 25%.
“Our vision is of a world where no one suffers or dies from a disease that can be prevented by vaccination,” stressed Charmeil. “Our development of a dengue vaccine shows our determination to make that vision a reality.”
*Undurraga EA, Betancourt-Cravioto M, et al., Economic and disease burden of dengue in Mexico. PloS Negl Trop Dis. 2015 Mar 18;9(3): e0003547.
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