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Successful control measures have interrupted the local transmission of human infectious diseases such as measles, malaria and polio, and saved and improved billions of lives. Similarly, control efforts have massively reduced the incidence of many infectious diseases of animals, such as rabies and rinderpest, with positive benefits for human health and livelihoods across the globe. However, disease elimination has proven an elusive goal, with only one human and one animal pathogen globally eradicated. As elimination targets expand to regional and even global levels, hurdles may emerge within the endgame when infections are circulating at very low levels, turning the last mile of these public health marathons into the longest mile. In this theme issue, we bring together recurring challenges that emerge as we move towards elimination, highlighting the unanticipated consequences of particular ecologies and pathologies of infection, and approaches to their management.
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PMID:Towards the endgame and beyond: complexities and challenges for the elimination of infectious diseases. 2379 86

Plant-produced vaccines and therapeutic agents offer enormous potential for providing relief to developing countries by reducing the incidence of infant mortality caused by infectious diseases. Vaccines derived from plants have been demonstrated to effectively elicit an immune response. Biopharmaceuticals produced in plants are inexpensive to produce, require fewer expensive purification steps, and can be stored at ambient temperatures for prolonged periods of time. As a result, plant-produced biopharmaceuticals have the potential to be more accessible to the rural poor. This review describes current progress with respect to plant-produced biopharmaceuticals, with a particular emphasis on those that target developing countries. Specific emphasis is given to recent research on the production of plant-produced vaccines toward human immunodeficiency virus, malaria, tuberculosis, hepatitis B virus, Ebola virus, human papillomavirus, rabies virus and common diarrheal diseases. Production platforms used to express vaccines in plants, including nuclear and chloroplast transformation, and the use of viral expression vectors, are described in this review. The review concludes by outlining the next steps for plant-produced vaccines to achieve their goal of providing safe, efficacious and inexpensive vaccines to the developing world.
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PMID:Plant-derived pharmaceuticals for the developing world. 2385 15

Worldwide more than 900 million international journeys are undertaken every year. India is one of the favorite tourist destinations around the world. International travel exposes travelers to a range of health risks. Traveling to India possess a threat to travelers with waterborne diseases like bacterial diarrhea, hepatitis A and E, and typhoid fever; vector borne diseases like dengue fever, Japanese encephalitis, and malaria; animal contact disease like rabies. Furthermore diseases spreading through behavior aspects cannot be ruled out hence posing a risk for hepatitis B, HIV/AIDS, hepatitis C as well. Hence, before travel the travelers are advised about the risk of disease in the country or countries they plan to visit and the steps to be taken to prevent illness. Vaccination offers the possibility of avoiding a number of infectious diseases that may be countered abroad. There is no single vaccination schedule that fits all travelers. Each schedule must be individualized according to the traveler's previous immunizations, countries to be visited, type and duration of travel, and the amount of time available before departure.
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PMID:Vaccination for safe travel to India. 2435 43

The developing world is still endemic to rabies, tetanus, leprosy, and malaria. Globally more than 55000 people die of rabies each year, about 95% in Asia and Africa. Annually, more than 10 million people, mostly in Asia, receive postexposure vaccination against the disease. World Health Organization estimated tetanus-related deaths at 163000 in 2004 worldwide. Globally, the annual detection of new cases of leprosy continues to decline and the global case detection declined by 3.54% during 2008 compared to 2007. Malaria is endemic in most countries, except the US, Canada, Europe, and Russia. Malaria accounts for 1.5-2.7 million deaths annually. Much of the disease burden related to these four infections is preventable.
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PMID:Rabies, tetanus, leprosy, and malaria. 2436 33

Nowhere are the barriers to a functional health infrastructure more clearly on display than in the Goma region of Democratic Republic of Congo. Kaboru et al. report poorly integrated services for HIV and TB in this war-torn region. Priorities in conflict zones include provision of security, shelter, food, clean water and prevention of sexual violence. In Goma, immediate health priorities include emergency treatment of cholera, malaria, respiratory illnesses, provision of maternal care, millions of measles vaccinations, and management of an ongoing rabies epidemic. It is a daunting task to determine an essential package of medical services in a setting where there are so many competing priorities, where opportunity costs are limited and epidemiologic information is scarce. Non-governmental agencies sometimes add to the challenge via an insidious reduction of state sovereignty and the creation of new levels of income inequality. Kaboru et al. have successfully highlighted many of the complexities of rebuilding and prioritizing healthcare in a conflict zone.
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PMID:Prioritizing Healthcare Delivery in a Conflict Zone Comment on "TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo". 2459 72

Rabies is a fatal encephalomyelitis. Most cases occur in developing countries and are transmitted by dogs. The cell culture vaccines as associated with high cost; therefore, have not replaced the unsafe brain-derived vaccines. In the developing countries these brain-derived rabies vaccines still can be seen in action. Moreover, there will be a need for vaccines against rabies-related viruses against which classical vaccines are not always effective. The worldwide incidence of rabies and the inability of currently used vaccination strategies to provide highly potent and cost-effective therapy indicate the need for alternate control strategies. DNA vaccines have emerged as the safest vaccines and best remedy for complicated diseases like hepatitis, HIV, and rabies. A number of recombinant DNA vaccines are now being developed against several diseases such as AIDS and malaria. Therefore, it can be a valuable alternative for the production of cheaper rabies vaccines against its larger spectrum of viruses. In this review we report published data on DNA-based immunization with sequences encoding rabies with special reference to nanotechnology.
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PMID:Applications of nanoparticles for DNA based rabies vaccine. 2473 Mar 5

Clinicians may encounter international travelers returning with exotic infections, emerging infectious diseases, or resurgent old-world infections. Many of these infectious diseases can affect the nervous system directly or indirectly. The contemporary neurologist should therefore be cognizant of the clinical manifestations, potential complications, and appropriate management of common travel-related infections. This chapter focuses on five important infections that affect the central nervous system and that may be encountered in returning travelers: Japanese encephalitis, malaria, rabies, dengue, and neurocysticercosis. The clinical manifestations, suggested evaluation, and treatment are discussed for each infection.
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PMID:NEUROLOGICAL INFECTIONS IN THE RETURNING INTERNATIONAL TRAVELER. 2514 44

Infection ranks alongside cardiovascular disease as the major cause of human death across the world. Word Health Organization data for 2002 shows that 26% of all deaths, almost 15 million in number, were due to infectious disease with HIV/AIDS, TB and malaria being the top three responsible infections. A significant proportion of these deaths were due to lower respiratory infections and diarrheal diseases in children. The worldwide morbidity associated with infectious disease is incalculable. When considered along with the consequences of infection in animals, it is hard to imagine any other disease that has such a significant impact on our lives-on health systems, on agriculture and on world economics. Our understanding of the agents responsible for infections-bacteria, fungi, parasites, prions and viruses-has an interesting history that heralds the great developments in modern biology and demonstrates how an understanding of disease pathogenesis can lead to successful prophylactic and therapeutic interventions. Van Leeuwenhoek's first observation of bacteria under the light microscope, John Snow's investigations tracing the source of a cholera epidemic in Victorian London's Soho and Pasteur's vaccines for rabies and anthrax contributed to an acceptance of the germ theory of disease and to the rational, scientific application of this knowledge to develop innovative disease control measures ranging from hygienic practices to antibiotics. [...].
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PMID:Pathogens: a new open access journal serving all those interested in infectious disease. 2543

Increasing numbers of children are traveling to developing countries where they are often at a higher risk than adults of acquiring vaccine-preventable diseases. Yet, they are less likely to receive pretravel medical advice and preventive care. This article reviews the current recommendations for pediatric travel immunizations, including specific travel vaccines such as typhoid, yellow fever, Japanese encephalitis virus, and rabies as well as prospective vaccines for significant global diseases like malaria, dengue, chikungunya, and Ebola.
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PMID:One more shot for the road: a review and update of vaccinations for pediatric international travelers. 2587 85

Protective immunity to the liver stage of the malaria parasite can be conferred by vaccine-induced T cells, but no subunit vaccination approach based on cellular immunity has shown efficacy in field studies. We randomly allocated 121 healthy adult male volunteers in Kilifi, Kenya, to vaccination with the recombinant viral vectors chimpanzee adenovirus 63 (ChAd63) and modified vaccinia Ankara (MVA), both encoding the malaria peptide sequence ME-TRAP (the multiple epitope string and thrombospondin-related adhesion protein), or to vaccination with rabies vaccine as a control. We gave antimalarials to clear parasitemia and conducted PCR (polymerase chain reaction) analysis on blood samples three times a week to identify infection with the malaria parasite Plasmodium falciparum. On Cox regression, vaccination reduced the risk of infection by 67% [95% confidence interval (CI), 33 to 83%; P = 0.002] during 8 weeks of monitoring. T cell responses to TRAP peptides 21 to 30 were significantly associated with protection (hazard ratio, 0.24; 95% CI, 0.08 to 0.75; P = 0.016).
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PMID:Prime-boost vaccination with chimpanzee adenovirus and modified vaccinia Ankara encoding TRAP provides partial protection against Plasmodium falciparum infection in Kenyan adults. 2594 65


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