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Treatments vs. Vaccines

A TREATMENT is defined as, “Administration or application of remedies to a patient or for a disease or an injury; medicinal or surgical management; therapy.”*  Further, a treatment indicates, the care and management of a patient to combat, ameliorate, or prevent a disease, disorder or injury.”**  A treatment or cure is applied after a medical problem has already begun. Treatment, in the medical field, is synonymous with the word Therapy, which literally means “curing, healing” and is the attempted remediation of a health problem, usually following a diagnosis.

DENGUE Treatment Today:

ActRx TriAct® is a new treatment for Dengue, based on decades of study, years of research and advanced medical innovation. This "first-of-its-kind" combination treatment for Dengue has recently proven to be safe and effective in Clinical Trials.

A VACCINE is defined as, “A suspension of attenuated or killed microorganisms (viruses, bacteria, or rickettsiae), or of antigenic proteins derived from them, administered for prevention, amelioration, or treatment of infectious diseases.”***  Further, a vaccine is, “A preparation of a weakened or killed pathogen, such as a bacterium or virus, or a portion of the pathogen’s structure that upon administration stimulates antibody production against the pathogen but is incapable of causing severe infection."* A vaccine is viewed as a preventative measure to avoid the complications of a more serious disease or infection.

DENGUE Vaccines Today:

Today’s most recent developments toward a potential Dengue vaccine only offers a modest results. In 2012, efficacy was shown at 33%, with a failure to protect against one of the four known types of Dengue, which is still the case. The three-dose injectable vaccine (1 shot taken every 6 months over an 18 months period) has an increased efficacy of 56% as of this time, but note that most common vaccines, like those for measles and polio are more than 95% effective. In the recent studies, the vaccine provided only 35% protection against Dengue serotype 2.

People infected with one type of Dengue develop antibodies that may protect them from further infections of that type. However, if they are infected by another Dengue type, those same antibodies appear to make them far more susceptible to more severe forms of Dengue that could include hemorrhaging. Scientists worry that the antibodies from a Dengue vaccine might have the same effect and say that vaccinated children should be monitored for several years. 

“We don't understand the antibody response in dengue well enough to know if this (problem) would also occur with a vaccine," said Martin Hibberd, a professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine, who wasn't part of the study. The vaccine injection appears to work by boosting pre-existing antibodies in people previously infected with Dengue, since younger children didn't appear to get much protection from the shot. "It's a bit scary that it looks like the vaccine only works in people who have already had Dengue, which would make the vaccine useless for Western tourists traveling to dengue-endemic countries", he said. 

The results suggest that the new vaccine acts best as an immune booster for patients with some previous exposure, and therefore may be most useful in tropical regions where Dengue is common, rather than as a vaccination for travelers.

The vaccine offers poor to no protection to young children – who are most at risk from Dengue. Most patients survive dengue but it kills more than tens of thousands of people each year. Most of the deaths are children, which this latest vaccine does not appear to work very well on.

Dengue causes one hospitalization every minute around the globe. Nearly half the world's population is at risk of contracting Dengue - also known as "breakbone fever" because of the severe pain it can cause. The disease infects some 100 million people each year, according to the World Health Organization (WHO), and some experts aggregate the actual number infected at over $392 million worldwide.

Questions remain as to what the threshold of Dengue incidence might be for countries to decide that it is worth launching costly vaccination programs. Whether the vaccine’s efficacy is enough for countries to invest in is a question for economists. Nonetheless, the logistics for such national programs are highly complex.

For the moment, this latest vaccine “is the best we have,” Annelies Wilder-Smith, a professor of infectious diseases at Nanyang Technological University in Singapore, wrote in a commentary accompanying the study. “However, with a 56% efficacy, this vaccine will never be a single solution.” The vaccine was more effective in people who had been exposed to dengue previously than those who had never been exposed, suggesting it may be “of limited use in countries with low Dengue endemicity, or in international travelers from non- dengue-endemic countries,” Wilder-Smith said.

“It’s still not an optimal vaccine,”said Scott Halstead, a senior adviser to the Dengue Vaccine Initiative, a group of four organizations that encourages the development of vaccines. “We’re all accustomed to efficacy rates of 95 percent, which is what you get when you have the measles, mumps and rubella vaccine.”

Potential Dengue vaccines are being developed by a number of international pharmaceutical companies, as well as the U.S. National Institutes of Health. To date, no vaccine has stood out as a viable total solution to the growing Dengue epidemic or as a proven preventative for Dengue.  (07-2014)

*   The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

**  Medical Dictionary, 8th edition © 2009, Elsevier.

*** Dorland's Medical Dictionary for Health Consumers. © 2007 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

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