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    A Dengue Vaccine by December?

    By Keith R | August 26, 2008

    Topics: Health Issues, Pharmaceutical Issues | No Comments »

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    During the 60th Annual Meeting of the Brazilian Society for the Advancement of Science (Sociedade Brasileira para o Progresso da CiênciaSBPC) last month held in Campinas, São Paulo, it was announced that Brazil probably will go to market first with a vaccine against dengue and that they may start producing it as early as this December. If so, that’s terrific news for the 100 million dengue sufferers worldwide, particularly for Latin America and the Caribbean (LAC).

    Dengue is a disease caused by four closely related viruses (types 1, 2, 3, 4) transmitted by the Aedes aegypti mosquito. In its normal manifestation, the afflicted get about a week of fever and constant headaches and fiery pain in every joint and muscle (hence its nickname “breakbone fever”). The more virulent form, dengue hemorrhagic fever (DHF), can kill you.

    Dengue has been on the rise in LAC. According to the Pan American Health Organization (PAHO), as of the first week in August, there have been 559,667 cases reported in LAC this year, of these 14,547 were DHF. 472,997 of the dengue cases were in Brazil alone, 9,957 of which were DHF. Venezuela has reported 20,601 dengue cases, Mexico 16,285, Colombia 15,666, Peru 9,528, and Honduras 6,637.

    Fighting dengue effectively without a vaccine can be quite costly. At the First Pan American Dengue Research Meeting recently held in Recife, Pernambuco, Fiocruz researcher Hermman Schatzmayr said that fighting dengue is costing the Brazilian federal government R$1.2 billion per year in insecticide purchases, vector control, medical assistance, aid to states, diagnostic services, etc.

    The Brazilian Vaccine

    Several countries and institutions are working on a vaccine for dengue. One of the chief challenges in developing a vaccine has been that dengue is actually caused by four related but different viruses. Types 1 and 2 first started appearing in the Americas during the 1970s. Type 3 arrived in Central America in the mid-1990s, spreading to South America by this decade. The epidemic is worsening with the appearance in the region of type 4, which so far is limited to Colombia, French Guiana, Honduras and Venezuela.

    In Brazil, work on a vaccine has been undertaken by a state-owned Butantan Institute in São Paulo and the Institute of Technology in Pharmaceuticals (“Farmanguinhos“), part of the state-owned Oswaldo Cruz Foundation (Fiocruz) complex, in Rio de Janeiro. Butantan says that its work with the U.S. National Institutes of Health (NIH) has reached human clinical trials, now being conducted in an unspecified city in the interior of São Paulo state. The Institute hopes to launch a pilot plant in December, with full-fledged production beginning sometime in 2010.

    For its part, Farmanguinhos is also working on a vaccine, but from a different angle. They are utilizing a technique known as a “chimeric genome” utilizing the related yellow fever virus (Farmanguinhos is the world’s largest maker of the 17D yellow fever vaccine, so it is experienced working with that virus). They extract part of the yellow fever virus and use it to replace the equivalent portion of the dengue virus.

    Does it work? Not yet for all four types of dengue virus. But Farmanguinhos hopes to have one that does ready for clinical trials in 2012.

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