27 FEBRUARY 2015, 90th YEAR / 27 FEVRIER 2015, 90° ANNEE No. 9, 2015, 90, 69-88 http://)www.who.int/wer
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", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 0, - "coordinates": [ - { - "x0": 168.62, - "y0": 218.96, - "x1": 341.73, - "y1": 337.62 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "3d0b06e1bd615b624438413dfb20259e", - "text": "Conformément a son mandat qui est de four- nir des recommandations aux Etats Membres sur les questions de politique sanitaire, OMS publie une série de notes de synthése régulié- rement actualisées sur les vaccins et les asso- ciations vaccinales utilisés contre des maladies qui ont une incidence sur la santé publique internationale. Ces notes portent essentielle- ment sur l’utilisation des vaccins dans le cadre de programmes de vaccination a grande échelle; elles résument les informations géné- rales essentielles dont on dispose sur les mala- dies et les vaccins et présentent en conclusion la position actuelle de OMS concernant l’uti- lisation de ces derniers dans le monde.", - "metadata": { - "category_depth": 1, - "page_number": 1, - "parent_id": "2fbff8f9a16c19bdd43454e9ac17296c", - "text_as_html": "Conformément a son mandat qui est de four- nir des recommandations aux Etats Membres sur les questions de politique sanitaire, OMS publie une série de notes de synthése régulié- rement actualisées sur les vaccins et les asso- ciations vaccinales utilisés contre des maladies qui ont une incidence sur la santé publique internationale. Ces notes portent essentielle- ment sur l’utilisation des vaccins dans le cadre de programmes de vaccination a grande échelle; elles résument les informations géné- rales essentielles dont on dispose sur les mala- dies et les vaccins et présentent en conclusion la position actuelle de OMS concernant l’uti- lisation de ces derniers dans le monde.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 0, - "coordinates": [ - { - "x0": 362.32, - "y0": 218.7, - "x1": 551.34, - "y1": 356.06 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-5", - "text": "\n\n\nWORLD HEALTH ORGANIZATION Geneva\nThe papers have been reviewed by exter- nal experts and WHO staff, and are reviewed and endorsed by the WHO Stra- tegic Advisory Group of Experts on Immunization (SAGE) (http://www.who. int/immunization/sage/en). The GRADE methodology is used to systematically assess the quality of available evidence. A description of the process followed for the development of vaccine position papers is available at: http://www.who.int/immuni- zation/position_papers/position_paper_ process.pdf. The position papers are in- tended for use mainly by national public health officials and managers of immuni- zation programmes. They may also be of interest to international funding agencies, vaccine advisory groups, vaccine manu- facturers, the medical community, scien- tific media and the public.\nCes notes ont été examinées par des experts extérieurs et par des membres du personnel de POMS et sont examinées et approuvées par le Groupe stratégique consultatif d’experts (SAGE) de POMS sur la vaccination (http:// www.who.int/immunization/sage/fr). La méthodologie GRADE est utilisée pour évaluer de maniére systématique la qualité des preuves disponibles. Le lecteur trouvera une descrip- tion du processus suivi dans l’élaboration des notes de synthése sur les vaccins a l’adresse: http://www.who.int/immunization/position_ papers/position_paper_process.pdf. Ces notes de synthése sont principalement destinées aux responsables nationaux de la santé publique et aux administrateurs des programmes de vaccination, mais elles peuvent également présenter un intérét pour les organismes internationaux de financement, les groupes consultatifs 4 propos des vaccins, les fabri- cants de vaccins, le monde médical, les médias scientifiques et le grand public.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "af8b872e8ffada75956baa2a69a9f1dc", - "text": "WORLD HEALTH ORGANIZATION Geneva", - "metadata": { - "category_depth": 1, - "page_number": 1, - "parent_id": "", - "text_as_html": "The papers have been reviewed by exter- nal experts and WHO staff, and are reviewed and endorsed by the WHO Stra- tegic Advisory Group of Experts on Immunization (SAGE) (http://www.who. int/immunization/sage/en). The GRADE methodology is used to systematically assess the quality of available evidence. A description of the process followed for the development of vaccine position papers is available at: http://www.who.int/immuni- zation/position_papers/position_paper_ process.pdf. The position papers are in- tended for use mainly by national public health officials and managers of immuni- zation programmes. They may also be of interest to international funding agencies, vaccine advisory groups, vaccine manu- facturers, the medical community, scien- tific media and the public.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 0, - "coordinates": [ - { - "x0": 168.2, - "y0": 362.93, - "x1": 341.93, - "y1": 546.78 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "f01467db6f5da78b8e24a7f08f64ab4a", - "text": "Ces notes ont été examinées par des experts extérieurs et par des membres du personnel de POMS et sont examinées et approuvées par le Groupe stratégique consultatif d’experts (SAGE) de POMS sur la vaccination (http:// www.who.int/immunization/sage/fr). La méthodologie GRADE est utilisée pour évaluer de maniére systématique la qualité des preuves disponibles. Le lecteur trouvera une descrip- tion du processus suivi dans l’élaboration des notes de synthése sur les vaccins a l’adresse: http://www.who.int/immunization/position_ papers/position_paper_process.pdf. Ces notes de synthése sont principalement destinées aux responsables nationaux de la santé publique et aux administrateurs des programmes de vaccination, mais elles peuvent également présenter un intérét pour les organismes internationaux de financement, les groupes consultatifs 4 propos des vaccins, les fabri- cants de vaccins, le monde médical, les médias scientifiques et le grand public.", - "metadata": { - "category_depth": 1, - "page_number": 1, - "parent_id": "af8b872e8ffada75956baa2a69a9f1dc", - "text_as_html": "Ces notes ont été examinées par des experts extérieurs et par des membres du personnel de POMS et sont examinées et approuvées par le Groupe stratégique consultatif d’experts (SAGE) de POMS sur la vaccination (http:// www.who.int/immunization/sage/fr). La méthodologie GRADE est utilisée pour évaluer de maniére systématique la qualité des preuves disponibles. Le lecteur trouvera une descrip- tion du processus suivi dans l’élaboration des notes de synthése sur les vaccins a l’adresse: http://www.who.int/immunization/position_ papers/position_paper_process.pdf. Ces notes de synthése sont principalement destinées aux responsables nationaux de la santé publique et aux administrateurs des programmes de vaccination, mais elles peuvent également présenter un intérét pour les organismes internationaux de financement, les groupes consultatifs 4 propos des vaccins, les fabri- cants de vaccins, le monde médical, les médias scientifiques et le grand public.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 0, - "coordinates": [ - { - "x0": 361.3, - "y0": 363.59, - "x1": 552.67, - "y1": 565.31 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-6", - "text": "\n\n\nORGANISATION MONDIALE DE LA SANTE Genéve\nAnnual subscription / Abonnement annuel Sw. ft. / Fr. s. 346.—\n02.2015 ISSN 0049-8114 Printed in Switzerland\nThis updated position paper on Japanese encephalitis (JE) vaccines replaces the 2006 position paper on this subject; it fo- cuses on new information concerning the availability, safety, immunogenicity and effectiveness of JE vaccines and the\nCette note de synthése actualisée sur les vaccins contre l’encéphalite japonaise (EJ) remplace la note de 2006 résumant la posi- tion de POMS sur le méme sujet; elle renferme principalement des informations nouvelles concernant la disponibilité, ’inno-\nduration of protection they confer. Recent data on global prevalence and burden of disease caused by JE and cost-effectiveness considerations regarding JE vac- cination are also summarized. Recommendations on the use of JE vaccines were discussed by SAGE in October 2014; evidence presented at this meeting can be ac- cessed at: http://www.who.int/immunization/sage/previ- ous/en/index.html.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "6fb1fad8e32ebfa97a20e1349251b9e7", - "text": "ORGANISATION MONDIALE DE LA SANTE Genéve", - "metadata": { - "category_depth": 1, - "page_number": 1, - "parent_id": "", - "text_as_html": "Annual subscription / Abonnement annuel Sw. ft. / Fr. s. 346.—
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", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 0, - "coordinates": [ - { - "x0": 63.65, - "y0": 604.7, - "x1": 118.5, - "y1": 625.48 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "e4647ba5701f86956fa9feb054e51f8b", - "text": "This updated position paper on Japanese encephalitis (JE) vaccines replaces the 2006 position paper on this subject; it fo- cuses on new information concerning the availability, safety, immunogenicity and effectiveness of JE vaccines and the", - "metadata": { - "category_depth": 1, - "page_number": 1, - "parent_id": "6fb1fad8e32ebfa97a20e1349251b9e7", - "text_as_html": "This updated position paper on Japanese encephalitis (JE) vaccines replaces the 2006 position paper on this subject; it fo- cuses on new information concerning the availability, safety, immunogenicity and effectiveness of JE vaccines and the
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 0, - "coordinates": [ - { - "x0": 169.25, - "y0": 572.41, - "x1": 341.5, - "y1": 626.5 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "232287c0540c809af15dd1fa7f37cded", - "text": "Cette note de synthése actualisée sur les vaccins contre l’encéphalite japonaise (EJ) remplace la note de 2006 résumant la posi- tion de POMS sur le méme sujet; elle renferme principalement des informations nouvelles concernant la disponibilité, ’inno-", - "metadata": { - "category_depth": 1, - "page_number": 1, - "parent_id": "6fb1fad8e32ebfa97a20e1349251b9e7", - "text_as_html": "Cette note de synthése actualisée sur les vaccins contre l’encéphalite japonaise (EJ) remplace la note de 2006 résumant la posi- tion de POMS sur le méme sujet; elle renferme principalement des informations nouvelles concernant la disponibilité, ’inno-
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 0, - "coordinates": [ - { - "x0": 361.78, - "y0": 572.16, - "x1": 552.7, - "y1": 626.38 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "b26d097158c4447a68406cffd2bc8d08", - "text": "duration of protection they confer. Recent data on global prevalence and burden of disease caused by JE and cost-effectiveness considerations regarding JE vac- cination are also summarized. Recommendations on the use of JE vaccines were discussed by SAGE in October 2014; evidence presented at this meeting can be ac- cessed at: http://www.who.int/immunization/sage/previ- ous/en/index.html.", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "6fb1fad8e32ebfa97a20e1349251b9e7", - "text_as_html": "duration of protection they confer. Recent data on global prevalence and burden of disease caused by JE and cost-effectiveness considerations regarding JE vac- cination are also summarized. Recommendations on the use of JE vaccines were discussed by SAGE in October 2014; evidence presented at this meeting can be ac- cessed at: http://www.who.int/immunization/sage/previ- ous/en/index.html.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 45.29, - "y0": 56.24, - "x1": 273.15, - "y1": 146.08 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-7", - "text": "\n\n\nBackground", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "f4b5cfe99b9cab00ad610f958d21bf82", - "text": "Background", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "", - "text_as_html": "Japanese encephalitis (JE) is a vector-borne zoonotic viral disease. JE virus (JEV) is the leading cause of viral encephalitis in Asia. JE occurs in nearly all Asian coun- tries, whether temperate, subtropical, or tropical, and has intruded into new areas through importation of infected vectors. Currently, an estimated 3 billion people live in the 24 countries, mainly in the WHO South-East Asia and Western Pacific Regions, considered at risk of JE.!
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 44.67, - "y0": 225.53, - "x1": 273.88, - "y1": 326.68 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "1c8c90733d6b031c8652527dea713385", - "text": "JEV is transmitted primarily by Culex mosquitoes, and circulates in an enzootic cycle in pigs and wading birds which serve as amplifying hosts. Culex tritaeniorhyn- chus, the most important vector species, breeds in water pools and flooded rice fields and bites mainly during the night. Due to the animal reservoirs, JEV cannot be eliminated but disease could potentially be controlled by universal human vaccination in endemic areas. Hu- mans are considered dead-end hosts, with viraemia too low to allow further transmission.’", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "c9fce9d6466257f63299b494be0fe9d4", - "text_as_html": "JEV is transmitted primarily by Culex mosquitoes, and circulates in an enzootic cycle in pigs and wading birds which serve as amplifying hosts. Culex tritaeniorhyn- chus, the most important vector species, breeds in water pools and flooded rice fields and bites mainly during the night. Due to the animal reservoirs, JEV cannot be eliminated but disease could potentially be controlled by universal human vaccination in endemic areas. Hu- mans are considered dead-end hosts, with viraemia too low to allow further transmission.’
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 45.02, - "y0": 345.93, - "x1": 273.41, - "y1": 459.27 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "65d2bbfed3722a75707aa3ab514eb9a4", - "text": "In temperate locations, the period of transmission of JEV typically starts in April or May, and lasts until Sep- tember or October. In tropical and subtropical areas, transmission exhibits less seasonal variation, or intensi- fies with the rainy season. Where irrigation permits mosquito breeding throughout the year, transmission may occur even in the dry season.", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "c9fce9d6466257f63299b494be0fe9d4", - "text_as_html": "In temperate locations, the period of transmission of JEV typically starts in April or May, and lasts until Sep- tember or October. In tropical and subtropical areas, transmission exhibits less seasonal variation, or intensi- fies with the rainy season. Where irrigation permits mosquito breeding throughout the year, transmission may occur even in the dry season.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 44.75, - "y0": 490.12, - "x1": 273.45, - "y1": 568.8 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "2f2f6476e1aa62060ac947f7bd3f25f3", - "text": "As JE surveillance is not well established in many coun- tries, and laboratory confirmation is challenging, the true extent and prevalence of the virus and burden of disease are not well understood. It is estimated that 67900 clinical cases of JE occur annually despite wide- spread availability of vaccine, with approximately 13600 to 20400 deaths, and an overall incidence rate of 1.8/100000 in the 24 countries with JE risk.’ Although infection is common, severe disease is rare but can be", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "c9fce9d6466257f63299b494be0fe9d4", - "text_as_html": "As JE surveillance is not well established in many coun- tries, and laboratory confirmation is challenging, the true extent and prevalence of the virus and burden of disease are not well understood. It is estimated that 67900 clinical cases of JE occur annually despite wide- spread availability of vaccine, with approximately 13600 to 20400 deaths, and an overall incidence rate of 1.8/100000 in the 24 countries with JE risk.’ Although infection is common, severe disease is rare but can be
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 45.35, - "y0": 576.09, - "x1": 272.98, - "y1": 677.81 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "41197eadbedb0994d5021090a4f2d924", - "text": "Background paper on JE Vaccines- SAGE working group. Available at http://www. who.int/immunization/sage/meetings/2014/october/1_JE_Vaccine_Background_. Paper.pdf?ua=1, accessed November 2014.", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "c9fce9d6466257f63299b494be0fe9d4", - "text_as_html": "70
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 45.35, - "y0": 779.62, - "x1": 52.19, - "y1": 784.66 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "fdcf418e6da0c065cf7966a0c2325b0c", - "text": "cuité, Pimmunogénicité et l’efficience des vaccins contre l’EJ et la durée de la protection quils conférent. Elle résume également des données récentes sur la prévalence dans le monde de l’EJ et sur la charge de morbidité due a cette mala- die ainsi que des considérations relatives au rapport cotit/ efficacité de la vaccination contre l’encéphalite japonaise. Le SAGE a discuté de recommandations relatives 4 l'utilisation des vaccins contre cette maladie en octobre 2014; les éléments présentés lors de cette réunion sont consultables a l’adresse: http://www.who.int/immunization/sage/previous/en/index. html.", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "c9fce9d6466257f63299b494be0fe9d4", - "text_as_html": "cuité, Pimmunogénicité et l’efficience des vaccins contre l’EJ et la durée de la protection quils conférent. Elle résume également des données récentes sur la prévalence dans le monde de l’EJ et sur la charge de morbidité due a cette mala- die ainsi que des considérations relatives au rapport cotit/ efficacité de la vaccination contre l’encéphalite japonaise. Le SAGE a discuté de recommandations relatives 4 l'utilisation des vaccins contre cette maladie en octobre 2014; les éléments présentés lors de cette réunion sont consultables a l’adresse: http://www.who.int/immunization/sage/previous/en/index. html.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 293.72, - "y0": 55.75, - "x1": 553.19, - "y1": 180.44 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-9", - "text": "\n\n\nConsidérations générales", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "5ef820ada4b1cb5df1e42d495c2e00e2", - "text": "Considérations générales", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "", - "text_as_html": "Lencéphalite japonaise (EJ) est une maladie zoonotique virale a transmission vectorielle. Le virus responsable de cette mala- die (VEJ) est la principale cause d’encéphalite virale en Asie. LE}J est présente dans tous les pays d’Asie, quils soient tempé- rés, subtropicaux ou tropicaux, et a fait son introduction dans de nouvelles zones suite a importation de vecteurs infectés. Actuellement, on estime a 3 milliards le nombre de personnes vivant dans les 24 pays, appartenant principalement aux Régions OMS de l’Asie du Sud-Est et du Pacifique occidental, considérés comme a risque d’E]J.'
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 294.47, - "y0": 225.22, - "x1": 553.94, - "y1": 338.56 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "7dd83afa4b31eaa0712fdbd8f54e61f0", - "text": "Le VEJ se transmet principalement par le biais des moustiques du genre Culex et parcourt un cycle enzootique chez les porcs et des échassiers, qui servent d’hétes amplificateurs. Culex tritaeniorhynchus, l’espéce vectrice la plus importante, se repro- duit dans les étendues d’eau et les riziéres inondées et pique principalement pendant la nuit. En raison de lexistence des réservoirs humains, le VEJ ne peut étre éliminé, mais cette maladie pourrait potentiellement étre endiguée par la vaccina- tion universelle des étres humains dans les zones d’endémie. Les humains sont considérés comme des hétes culs-de-sac, avec une virémie trop faible pour autoriser la poursuite de la trans- mission.’", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "0d1505f516ecd491032479bc1c58b778", - "text_as_html": "Le VEJ se transmet principalement par le biais des moustiques du genre Culex et parcourt un cycle enzootique chez les porcs et des échassiers, qui servent d’hétes amplificateurs. Culex tritaeniorhynchus, l’espéce vectrice la plus importante, se repro- duit dans les étendues d’eau et les riziéres inondées et pique principalement pendant la nuit. En raison de lexistence des réservoirs humains, le VEJ ne peut étre éliminé, mais cette maladie pourrait potentiellement étre endiguée par la vaccina- tion universelle des étres humains dans les zones d’endémie. Les humains sont considérés comme des hétes culs-de-sac, avec une virémie trop faible pour autoriser la poursuite de la trans- mission.’
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 293.55, - "y0": 346.52, - "x1": 554.1, - "y1": 481.48 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "8dfb3e0fa5e8176e28ed0643ab370931", - "text": "Dans les lieux tempérés, la période de transmission de lEJ débute en avril ou en mai et dure jusquen septembre ou octobre. Dans les zones tropicales ou subtropicales, la transmis- sion subit moins de variations saisonniéres ou s’intensifie avec la saison des pluies. Lorsque l’irrigation permet la reproduction des moustiques tout au long de l’année, la transmission peut s’opérer méme pendant la saison séche.", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "0d1505f516ecd491032479bc1c58b778", - "text_as_html": "Dans les lieux tempérés, la période de transmission de lEJ débute en avril ou en mai et dure jusquen septembre ou octobre. Dans les zones tropicales ou subtropicales, la transmis- sion subit moins de variations saisonniéres ou s’intensifie avec la saison des pluies. Lorsque l’irrigation permet la reproduction des moustiques tout au long de l’année, la transmission peut s’opérer méme pendant la saison séche.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 293.35, - "y0": 489.62, - "x1": 554.11, - "y1": 568.57 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "9f96e1c67b4476d5182fb728387cbb56", - "text": "Etant donné que la surveillance de l’EJ n’est pas bien en place dans nombre de pays et que la confirmation en laboratoire de cette maladie est difficile, ’ampleur véritable de la propagation du virus et sa prévalence, ainsi que la charge de morbidité due a EJ ne sont pas pleinement connues. On estime que 67 900 cas cliniques d’EJ se produisent chaque année, malgré la large disponibilité du vaccin, avec environ 13600 a 20400 décés et un taux d’incidence global de 1,8/100 000 dans les 24 pays exposés a un risque d’EJ.’ Si Pinfection par le VEJ est courante, l’encé-", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "0d1505f516ecd491032479bc1c58b778", - "text_as_html": "Etant donné que la surveillance de l’EJ n’est pas bien en place dans nombre de pays et que la confirmation en laboratoire de cette maladie est difficile, ’ampleur véritable de la propagation du virus et sa prévalence, ainsi que la charge de morbidité due a EJ ne sont pas pleinement connues. On estime que 67 900 cas cliniques d’EJ se produisent chaque année, malgré la large disponibilité du vaccin, avec environ 13600 a 20400 décés et un taux d’incidence global de 1,8/100 000 dans les 24 pays exposés a un risque d’EJ.’ Si Pinfection par le VEJ est courante, l’encé-
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 293.73, - "y0": 575.97, - "x1": 552.84, - "y1": 678.25 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "431b231e73569ce61e73450261964f3f", - "text": "Document de référence sur les vaccins contre I’EJ — Groupe de travail du SAGE. Disponible a l'adresse: http://www.who.int/immunization/sage/meetings/201 4/october/1_JE_Vaccine_ Background_Paper.pdf?ua=1, consulté en novembre 2014.", - "metadata": { - "category_depth": 1, - "page_number": 2, - "parent_id": "0d1505f516ecd491032479bc1c58b778", - "text_as_html": "WEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 1, - "coordinates": [ - { - "x0": 383.82, - "y0": 778.87, - "x1": 549.79, - "y1": 786.39 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "8daefcc4b3a2fc12c7a746487558db14", - "text": "devastating with a high rate of residual disability [709000 disability-adjusted life years (DALY)].’", - "metadata": { - "category_depth": 1, - "page_number": 3, - "parent_id": "0d1505f516ecd491032479bc1c58b778", - "text_as_html": "devastating with a high rate of residual disability [709000 disability-adjusted life years (DALY)].’
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 2, - "coordinates": [ - { - "x0": 44.34, - "y0": 55.7, - "x1": 272.56, - "y1": 77.26 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "e1b7205582ff0ab540f5105c18dd16df", - "text": "The annual incidence of JE differs considerably between and within affected countries. In endemic countries, many of which already have JE vaccination programmes, annual incidence also varies by age group. Overall an- nual incidence in endemic countries has been estimated at 5.4/100000 in the 0-14 year age group, and 0.6/100000 in those aged 215 years.’ These values mask significant variations in reported incidence across regions, with incidence in the younger age group estimated as high as 12.6/100000 in some high-incidence areas (e.g. parts of China, and Democratic People’s Republic of Korea). While traditionally considered a childhood disease, JE can occur at all ages, particularly when the virus is in- troduced in new areas where the population has no pre-existing immunity. As cases in children decrease due to successful vaccination programmes, there is fre- quently a shift to a greater proportion of cases in older, unvaccinated age groups. Data from some countries suggest that a substantial proportion of adults are still susceptible. In some countries, such as Bangladesh which has no JE vaccination programme, over 50% of cases occur in adults.’", - "metadata": { - "category_depth": 1, - "page_number": 3, - "parent_id": "0d1505f516ecd491032479bc1c58b778", - "text_as_html": "The annual incidence of JE differs considerably between and within affected countries. In endemic countries, many of which already have JE vaccination programmes, annual incidence also varies by age group. Overall an- nual incidence in endemic countries has been estimated at 5.4/100000 in the 0-14 year age group, and 0.6/100000 in those aged 215 years.’ These values mask significant variations in reported incidence across regions, with incidence in the younger age group estimated as high as 12.6/100000 in some high-incidence areas (e.g. parts of China, and Democratic People’s Republic of Korea). While traditionally considered a childhood disease, JE can occur at all ages, particularly when the virus is in- troduced in new areas where the population has no pre-existing immunity. As cases in children decrease due to successful vaccination programmes, there is fre- quently a shift to a greater proportion of cases in older, unvaccinated age groups. Data from some countries suggest that a substantial proportion of adults are still susceptible. In some countries, such as Bangladesh which has no JE vaccination programme, over 50% of cases occur in adults.’
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 2, - "coordinates": [ - { - "x0": 44.62, - "y0": 96.93, - "x1": 272.51, - "y1": 345.53 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "6d053fce11651d52fec3ff18299538af", - "text": "Risk factors for JE include living in close proximity to rice fields and family or neighbour ownership of pigs.’ JE is predominantly, although not exclusively, a rural dis- ease. Cases have been detected in cities, such as Kath- mandu and New Delhi, in the absence of rural travel,®” possibly suggesting expansion of the area of JEV trans- mission due to changing land use patterns or vector adaptation.", - "metadata": { - "category_depth": 1, - "page_number": 3, - "parent_id": "0d1505f516ecd491032479bc1c58b778", - "text_as_html": "Risk factors for JE include living in close proximity to rice fields and family or neighbour ownership of pigs.’ JE is predominantly, although not exclusively, a rural dis- ease. Cases have been detected in cities, such as Kath- mandu and New Delhi, in the absence of rural travel,®” possibly suggesting expansion of the area of JEV trans- mission due to changing land use patterns or vector adaptation.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 2, - "coordinates": [ - { - "x0": 45.12, - "y0": 377.59, - "x1": 272.97, - "y1": 468.01 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-11", - "text": "\n\n\nPathogen\nJEV is a single-stranded RNA virus, one of 70 viruses in the Flavivirus genus of the family Flaviviridae. JEV is antigenically related to West Nile, Murray Valley en- cephalitis and St. Louis encephalitis viruses. JEV is cat- egorized in 5 genotypes. The major JEV genotypes have varying overlap in geographical distribution but all belong to the same serotype and are similar in terms of virulence and host preference.’ While genotype 3 used to be the predominantly circulating genotype, there has been a shift towards circulation of geno-\nMathers CD et al. Measuring the burden of neglected tropical diseases: the global burden of disease framework. PLoS Negl Trop Dis,2007;1(2) e114.\nHossain MJ et al. Hospital-based surveillance for Japanese encephalitis at four sites in Bangladesh,2003-2005. Am J Trop Med Hyg, 2010;82(2):344-349.\nLiu W et al. Risk factors for Japanese encephalitis: a case-control study. Epidemiol Infect, 2010;138(9):1292-1297.\nPartridge J et al. Endemic Japanese encephalitis in the Kathmandu valley, Nepal. Am J Trop Med Hyg. 2007;77(6):1146-1149.\nKumari R et al. First indigenous transmission of Japanese Encephalitis in urban areas of National Capital Territory of Delhi, India. Trop Med Int Health. 2013;18(6):743-749.\nGriffiths MJ et al. Japanese encephalitis virus infection. In Tselis A, Booss J, editors. Handbook of Clinical Neurology. Vol 123 (3rd series) Neurovirology, pp. 551-576.\nRELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,\nphalite japonaise grave est rare, mais peut avoir des consé- quences dévastatrices, avec un taux élevé d’incapacité résiduelle [709000 années de vie ajustées sur l’incapacité (DALY)].’\nVincidence annuelle de l’EJ varie considérablement entre les pays touchés et a l’intérieur de ces pays. Parmi les pays d’endé- mie, dont un grand nombre disposent déja de programmes de vaccination contre cette maladie, l’incidence annuelle de l’EJ fluctue aussi selon les tranches d’4ge. On a estimé incidence annuelle globale dans les pays d’endémie a 5,4/100000 dans la tranche d’age 0-14 ans et a 0,6/100000 chez les individus de 215 ans. Ces valeurs masquent des variations importantes de l’incidence rapportée selon les Régions, avec une valeur esti- mée de ce paramétre dans la tranche d’ge inférieure atteignant jusqu’a 12,6/100 000 dans des zones de forte incidence (certaines parties de la Chine et la République populaire démocratique de Corée, par exemple). Méme si elle est traditionnellement consi- dérée comme une maladie de l’enfance, l’EJ peut se déclarer a tout age, notamment lorsque le VEJ est introduit dans de nouvelles zones ou la population est dépourvue d’immunité préexistante. Avec la diminution du nombre de cas chez les enfants grace a la mise en ceuvre avec succés des programmes de vaccination, on observe souvent un transfert de la plus forte proportion de cas vers les enfants plus 4gés non vaccinés. Les données pour certains pays laissent 4 penser qu'un pourcentage substantiel des adultes reste susceptible. Dans certains cas, comme le Bangladesh qui ne dispose d’aucun programme de vaccination contre l’EJ, >50% des cas concernent des adultes.‘\nLes facteurs de risque d’EJ incluent le fait de vivre a proximité de riziéres et la possession de porcs par la famille ou les voisins.° Lencéphalite japonaise est de maniére prédominante, mais non exclusivement, une maladie rurale. Des cas ont été détectés dans des grandes villes comme Katmandou et New Delhi, en absence de déplacement des populations rurales,*’ ce qui suggére la possibilité d'une expansion de la zone de transmission du VEJ en raison de I’évolution des schémas d’uti- lisation des terres et de adaptation des vecteurs.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "d61c64de0a1e313e47d801108ec865d9", - "text": "Pathogen", - "metadata": { - "category_depth": 1, - "page_number": 3, - "parent_id": "", - "text_as_html": "JEV is a single-stranded RNA virus, one of 70 viruses in the Flavivirus genus of the family Flaviviridae. JEV is antigenically related to West Nile, Murray Valley en- cephalitis and St. Louis encephalitis viruses. JEV is cat- egorized in 5 genotypes. The major JEV genotypes have varying overlap in geographical distribution but all belong to the same serotype and are similar in terms of virulence and host preference.’ While genotype 3 used to be the predominantly circulating genotype, there has been a shift towards circulation of geno-
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 2, - "coordinates": [ - { - "x0": 44.88, - "y0": 505.62, - "x1": 272.66, - "y1": 618.46 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "578fdfa3a9ad7ae2aa86b1018efe67db", - "text": "Mathers CD et al. Measuring the burden of neglected tropical diseases: the global burden of disease framework. PLoS Negl Trop Dis,2007;1(2) e114.", - "metadata": { - "category_depth": 1, - "page_number": 3, - "parent_id": "d61c64de0a1e313e47d801108ec865d9", - "text_as_html": "RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 2, - "coordinates": [ - { - "x0": 43.46, - "y0": 779.16, - "x1": 225.69, - "y1": 786.12 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "872fc8d70b34b5ff351f81ac85d8604a", - "text": "phalite japonaise grave est rare, mais peut avoir des consé- quences dévastatrices, avec un taux élevé d’incapacité résiduelle [709000 années de vie ajustées sur l’incapacité (DALY)].’", - "metadata": { - "category_depth": 1, - "page_number": 3, - "parent_id": "d61c64de0a1e313e47d801108ec865d9", - "text_as_html": "phalite japonaise grave est rare, mais peut avoir des consé- quences dévastatrices, avec un taux élevé d’incapacité résiduelle [709000 années de vie ajustées sur l’incapacité (DALY)].’
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 2, - "coordinates": [ - { - "x0": 293.95, - "y0": 56.35, - "x1": 550.04, - "y1": 88.54 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "356326986a3b7eb24c51ca5228cc9818", - "text": "Vincidence annuelle de l’EJ varie considérablement entre les pays touchés et a l’intérieur de ces pays. Parmi les pays d’endé- mie, dont un grand nombre disposent déja de programmes de vaccination contre cette maladie, l’incidence annuelle de l’EJ fluctue aussi selon les tranches d’4ge. On a estimé incidence annuelle globale dans les pays d’endémie a 5,4/100000 dans la tranche d’age 0-14 ans et a 0,6/100000 chez les individus de 215 ans. Ces valeurs masquent des variations importantes de l’incidence rapportée selon les Régions, avec une valeur esti- mée de ce paramétre dans la tranche d’ge inférieure atteignant jusqu’a 12,6/100 000 dans des zones de forte incidence (certaines parties de la Chine et la République populaire démocratique de Corée, par exemple). Méme si elle est traditionnellement consi- dérée comme une maladie de l’enfance, l’EJ peut se déclarer a tout age, notamment lorsque le VEJ est introduit dans de nouvelles zones ou la population est dépourvue d’immunité préexistante. Avec la diminution du nombre de cas chez les enfants grace a la mise en ceuvre avec succés des programmes de vaccination, on observe souvent un transfert de la plus forte proportion de cas vers les enfants plus 4gés non vaccinés. Les données pour certains pays laissent 4 penser qu'un pourcentage substantiel des adultes reste susceptible. Dans certains cas, comme le Bangladesh qui ne dispose d’aucun programme de vaccination contre l’EJ, >50% des cas concernent des adultes.‘", - "metadata": { - "category_depth": 1, - "page_number": 3, - "parent_id": "d61c64de0a1e313e47d801108ec865d9", - "text_as_html": "Vincidence annuelle de l’EJ varie considérablement entre les pays touchés et a l’intérieur de ces pays. Parmi les pays d’endé- mie, dont un grand nombre disposent déja de programmes de vaccination contre cette maladie, l’incidence annuelle de l’EJ fluctue aussi selon les tranches d’4ge. On a estimé incidence annuelle globale dans les pays d’endémie a 5,4/100000 dans la tranche d’age 0-14 ans et a 0,6/100000 chez les individus de 215 ans. Ces valeurs masquent des variations importantes de l’incidence rapportée selon les Régions, avec une valeur esti- mée de ce paramétre dans la tranche d’ge inférieure atteignant jusqu’a 12,6/100 000 dans des zones de forte incidence (certaines parties de la Chine et la République populaire démocratique de Corée, par exemple). Méme si elle est traditionnellement consi- dérée comme une maladie de l’enfance, l’EJ peut se déclarer a tout age, notamment lorsque le VEJ est introduit dans de nouvelles zones ou la population est dépourvue d’immunité préexistante. Avec la diminution du nombre de cas chez les enfants grace a la mise en ceuvre avec succés des programmes de vaccination, on observe souvent un transfert de la plus forte proportion de cas vers les enfants plus 4gés non vaccinés. Les données pour certains pays laissent 4 penser qu'un pourcentage substantiel des adultes reste susceptible. Dans certains cas, comme le Bangladesh qui ne dispose d’aucun programme de vaccination contre l’EJ, >50% des cas concernent des adultes.‘
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 2, - "coordinates": [ - { - "x0": 292.85, - "y0": 96.5, - "x1": 552.81, - "y1": 369.44 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "67ca06341356e5b9dcc98d53106143ea", - "text": "Les facteurs de risque d’EJ incluent le fait de vivre a proximité de riziéres et la possession de porcs par la famille ou les voisins.° Lencéphalite japonaise est de maniére prédominante, mais non exclusivement, une maladie rurale. Des cas ont été détectés dans des grandes villes comme Katmandou et New Delhi, en absence de déplacement des populations rurales,*’ ce qui suggére la possibilité d'une expansion de la zone de transmission du VEJ en raison de I’évolution des schémas d’uti- lisation des terres et de adaptation des vecteurs.", - "metadata": { - "category_depth": 1, - "page_number": 3, - "parent_id": "d61c64de0a1e313e47d801108ec865d9", - "text_as_html": "Les facteurs de risque d’EJ incluent le fait de vivre a proximité de riziéres et la possession de porcs par la famille ou les voisins.° Lencéphalite japonaise est de maniére prédominante, mais non exclusivement, une maladie rurale. Des cas ont été détectés dans des grandes villes comme Katmandou et New Delhi, en absence de déplacement des populations rurales,*’ ce qui suggére la possibilité d'une expansion de la zone de transmission du VEJ en raison de I’évolution des schémas d’uti- lisation des terres et de adaptation des vecteurs.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 2, - "coordinates": [ - { - "x0": 293.8, - "y0": 377.38, - "x1": 552.34, - "y1": 479.08 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-12", - "text": "\n\n\nL'agent pathogéne\nLe VEJ est un virus 4 ARN monocaténaire et représente l’un des 70 membres de la famille des Flaviviridae, au sein du genre Flavivirus. Il est apparenté sur le plan antigénique au virus West Nile et aux virus des encéphalites de la Murray Valley et de Saint-Louis. Il peut appartenir a 5 génotypes. Les principaux génotypes ont des répartitions géographiques qui se recoupent de facon variable, mais ils appartiennent tous au méme séro- type et présentent des similitudes en termes de virulence et @hétes préférentiels.* Alors que le génotype 3 était auparavant le génotype circulant prédominant, on a relevé une transition\nMathers CD et al. Measuring the burden of neglected tropical diseases: the global burden of disease framework. PLoS Neg Trop Dis,2007;1(2) e114.\nHossain MJ et al. Hospital-based surveillance for Japanese encephalitis at four sites in Bangla- desh,2003-2005. Am J Trop Med Hyg, 2010;82(2):344-349.\nLiu W et al. Risk factors for Japanese encephalitis: a case-control study. Epidemiol Infect, 2010;138(9):1292-1297.\nPartridge J et al. Endemic Japanese encephalitis in the Kathmandu valley, Nepal. Am J Trop Med Hyg. 2007;77(6):1146-1149.\nKumari R et al. First indigenous transmission of Japanese Encephalitis in urban areas of National Capital Territory of Delhi, India. Trop Med Int Health. 2013;18(6):743-749.\nGriffiths MJ et al. Japanese encephalitis virus infection. In Tselis A, Booss J, editors. Handbook of Clinical Neurology. Vol 123 (3rd series) Neurovirology, pp. 551-576.\n71\ntype 1.° The envelope glycoprotein of JEV contains the major epitopes recognized by neutralizing antibodies.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "4ab612fed88da045d6f14c4688215fa0", - "text": "L'agent pathogéne", - "metadata": { - "category_depth": 1, - "page_number": 3, - "parent_id": "", - "text_as_html": "Le VEJ est un virus 4 ARN monocaténaire et représente l’un des 70 membres de la famille des Flaviviridae, au sein du genre Flavivirus. Il est apparenté sur le plan antigénique au virus West Nile et aux virus des encéphalites de la Murray Valley et de Saint-Louis. Il peut appartenir a 5 génotypes. Les principaux génotypes ont des répartitions géographiques qui se recoupent de facon variable, mais ils appartiennent tous au méme séro- type et présentent des similitudes en termes de virulence et @hétes préférentiels.* Alors que le génotype 3 était auparavant le génotype circulant prédominant, on a relevé une transition
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 2, - "coordinates": [ - { - "x0": 293.62, - "y0": 505.34, - "x1": 551.84, - "y1": 618.68 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "d4c7a4df32beb811de3ef43d012e4cfc", - "text": "Mathers CD et al. Measuring the burden of neglected tropical diseases: the global burden of disease framework. PLoS Neg Trop Dis,2007;1(2) e114.", - "metadata": { - "category_depth": 1, - "page_number": 3, - "parent_id": "4ab612fed88da045d6f14c4688215fa0", - "text_as_html": "71
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 2, - "coordinates": [ - { - "x0": 542.73, - "y0": 779.62, - "x1": 548.85, - "y1": 784.66 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "65a75cc8e9c0412327490171f026a254", - "text": "type 1.° The envelope glycoprotein of JEV contains the major epitopes recognized by neutralizing antibodies.", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "4ab612fed88da045d6f14c4688215fa0", - "text_as_html": "type 1.° The envelope glycoprotein of JEV contains the major epitopes recognized by neutralizing antibodies.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 43.08, - "y0": 55.73, - "x1": 272.94, - "y1": 77.28 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-13", - "text": "\n\n\nDisease\nMost JEV infections are asymptomatic. Severe disease is estimated to occur in about 1 case per 250 JEV infec- tions.’° After an incubation period of 4-14 days clinical symptoms follow, mostly characterized by sudden onset of high fever, chills, headache, myalgia, mental confu- sion and opisthotonus, and acute flaccid paralysis may occur. Convulsions occur in >75% of paediatric patients, though less frequently in adults.\" In children, gastroin- testinal pain and vomiting may be the dominant initial symptoms.\nDisease may rapidly progress to severe encephalitis with mental disturbances, general or focal neurological abnormalities and progressive decline in consciousness to coma. Patients may require ventilator support.\nAmong severe cases, about 30% of the surviving pa- tients have serious residual neurologic, psychosocial, intellectual and/or physical disabilities, with a higher rate of sequelae reported for children. Case-fatality in clinical cases is estimated to be around 20%-30%, with young children (<10 years) having a greater risk of se- vere disease and a higher case-fatality rate.’", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "5671eb85ab611cc15ed1d4524acafde8", - "text": "Disease", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "", - "text_as_html": "Most JEV infections are asymptomatic. Severe disease is estimated to occur in about 1 case per 250 JEV infec- tions.’° After an incubation period of 4-14 days clinical symptoms follow, mostly characterized by sudden onset of high fever, chills, headache, myalgia, mental confu- sion and opisthotonus, and acute flaccid paralysis may occur. Convulsions occur in >75% of paediatric patients, though less frequently in adults.\" In children, gastroin- testinal pain and vomiting may be the dominant initial symptoms.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 44.89, - "y0": 115.1, - "x1": 273.18, - "y1": 228.05 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "bdf8dd55159f145539d340620618cd13", - "text": "Disease may rapidly progress to severe encephalitis with mental disturbances, general or focal neurological abnormalities and progressive decline in consciousness to coma. Patients may require ventilator support.", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "5671eb85ab611cc15ed1d4524acafde8", - "text_as_html": "Disease may rapidly progress to severe encephalitis with mental disturbances, general or focal neurological abnormalities and progressive decline in consciousness to coma. Patients may require ventilator support.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 44.56, - "y0": 258.47, - "x1": 271.82, - "y1": 302.21 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "892963260cdc4bb54614138485eccae3", - "text": "Among severe cases, about 30% of the surviving pa- tients have serious residual neurologic, psychosocial, intellectual and/or physical disabilities, with a higher rate of sequelae reported for children. Case-fatality in clinical cases is estimated to be around 20%-30%, with young children (<10 years) having a greater risk of se- vere disease and a higher case-fatality rate.’", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "5671eb85ab611cc15ed1d4524acafde8", - "text_as_html": "Among severe cases, about 30% of the surviving pa- tients have serious residual neurologic, psychosocial, intellectual and/or physical disabilities, with a higher rate of sequelae reported for children. Case-fatality in clinical cases is estimated to be around 20%-30%, with young children (<10 years) having a greater risk of se- vere disease and a higher case-fatality rate.’
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 43.67, - "y0": 321.54, - "x1": 273.75, - "y1": 400.06 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-14", - "text": "\n\n\nNaturally-acquired immunity\nInfection with JEV is believed to confer lifelong immu- nity. The different flaviviruses share antigens and in- duce cross-reacting antibodies. Previous infections with related flaviviruses may provide some cross-protection and may reduce incidence and severity of sequelae from subsequent infections with JEV, though the available data are limited.*", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "6ec4f1ebeab061dd49e742c83dc440b7", - "text": "Naturally-acquired immunity", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "", - "text_as_html": "Infection with JEV is believed to confer lifelong immu- nity. The different flaviviruses share antigens and in- duce cross-reacting antibodies. Previous infections with related flaviviruses may provide some cross-protection and may reduce incidence and severity of sequelae from subsequent infections with JEV, though the available data are limited.*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 45.54, - "y0": 437.52, - "x1": 273.89, - "y1": 515.37 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-15", - "text": "\n\n\nDiagnosis\nBecause JE cannot be distinguished clinically from other causes of encephalitis, cases of acute encephalitis syndrome (AES) or suspected JE should be tested. As the preferred method for laboratory confirmation, WHO recommends testing for JEV-specific IgM antibody in a single sample of cerebrospinal fluid (CSF) or serum, us- ing an IgM-capture ELISA. A serum sample should be obtained at admission. An early initial serum sample may have been taken before antibody is produced. If the first sample is negative for JEV-specific IgM, a sec- ond serum sample should be collected and tested at\n® Schuh AJ et al. Phylogeography of Japanese encephalitis virus: genotype is associa- ted with climate.PLoS Negl Trop Dis,2013;7(8):e2411.\n'0 Halstead S et al. Japanese Encephalitis Vaccines. In Plotkin S, Orenstein W, Offit P editors. Vaccines 6th: Saunders Elsevier; 2013, pp. 312-351.\n\" Solomon T et al. Seizures and raised intracranial pressure in Vietnamese patients with Japanese encephalitis. Brain: a journal of neurology, 2002;125:1084—-1093.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "125d3577c8369a9545f16827d2b04e7d", - "text": "Diagnosis", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "", - "text_as_html": "Because JE cannot be distinguished clinically from other causes of encephalitis, cases of acute encephalitis syndrome (AES) or suspected JE should be tested. As the preferred method for laboratory confirmation, WHO recommends testing for JEV-specific IgM antibody in a single sample of cerebrospinal fluid (CSF) or serum, us- ing an IgM-capture ELISA. A serum sample should be obtained at admission. An early initial serum sample may have been taken before antibody is produced. If the first sample is negative for JEV-specific IgM, a sec- ond serum sample should be collected and tested at
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 44.94, - "y0": 553.98, - "x1": 273.12, - "y1": 678.73 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "617e72060e314cf7b645b73c1031046e", - "text": "® Schuh AJ et al. Phylogeography of Japanese encephalitis virus: genotype is associa- ted with climate.PLoS Negl Trop Dis,2013;7(8):e2411.", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "125d3577c8369a9545f16827d2b04e7d", - "text_as_html": "vers la circulation du génotype 1. La glycoprotéine d’enveloppe du VEJ renferme les principaux épitopes reconnus par les anti- corps neutralisants.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 294.95, - "y0": 55.59, - "x1": 551.17, - "y1": 88.21 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-17", - "text": "\n\n\nLa maladie\nLa plupart des infections 4 VEJ sont asymptomatiques. On estime quune maladie grave se déclare chez environ un cas pour 250 infections par le VEJ.\"° Aprés une période d’incubation de 4 a 14 jours, apparaissent les symptémes cliniques, dont les plus caractéristiques sont une forte fiévre d’installation brutale, des frissons, des céphalées, une myalgie, un état de confusion mentale et un opisthotonos. Une paralysie flasque aigué peut alors parfois intervenir. Des convulsions se manifestent chez >75% des patients pédiatriques, mais moins fréquemment chez les adultes.\"' Chez l’enfant, les douleurs gastro-intestinales et les vomissements peuvent étre les symptémes initiaux domi- nants.\nLa maladie est susceptible de progresser rapidement vers une encéphalite sévére, avec des troubles mentaux, des anomalies neurologiques générales ou focales et un déclin progressif de Pétat de conscience vers le coma. Les patients peuvent nécessi- ter une assistance ventilatoire.\nParmi les cas sévéres, environ 30% des patients survivants présentent de graves incapacités neurologiques, psychosociales, intellectuelles et/ou physiques résiduelles, avec un taux encore plus élevé de séquelles signalées dans le cas des enfants. On a estimé que le taux de létalité chez les cas cliniques se situait autour de 20-30%, les jeunes enfants (<10 ans) présentant un plus grand risque de maladie grave et un taux de létalité plus important.”", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "2d633003a8f3dd7bf63712ac27703827", - "text": "La maladie", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "", - "text_as_html": "La plupart des infections 4 VEJ sont asymptomatiques. On estime quune maladie grave se déclare chez environ un cas pour 250 infections par le VEJ.\"° Aprés une période d’incubation de 4 a 14 jours, apparaissent les symptémes cliniques, dont les plus caractéristiques sont une forte fiévre d’installation brutale, des frissons, des céphalées, une myalgie, un état de confusion mentale et un opisthotonos. Une paralysie flasque aigué peut alors parfois intervenir. Des convulsions se manifestent chez >75% des patients pédiatriques, mais moins fréquemment chez les adultes.\"' Chez l’enfant, les douleurs gastro-intestinales et les vomissements peuvent étre les symptémes initiaux domi- nants.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 294.19, - "y0": 114.61, - "x1": 553.75, - "y1": 249.86 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "eb3607776d164660c2bd52606bc8b1ed", - "text": "La maladie est susceptible de progresser rapidement vers une encéphalite sévére, avec des troubles mentaux, des anomalies neurologiques générales ou focales et un déclin progressif de Pétat de conscience vers le coma. Les patients peuvent nécessi- ter une assistance ventilatoire.", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "2d633003a8f3dd7bf63712ac27703827", - "text_as_html": "La maladie est susceptible de progresser rapidement vers une encéphalite sévére, avec des troubles mentaux, des anomalies neurologiques générales ou focales et un déclin progressif de Pétat de conscience vers le coma. Les patients peuvent nécessi- ter une assistance ventilatoire.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 293.78, - "y0": 257.78, - "x1": 551.88, - "y1": 313.82 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "8f898b5055937aedbf51861bb5431538", - "text": "Parmi les cas sévéres, environ 30% des patients survivants présentent de graves incapacités neurologiques, psychosociales, intellectuelles et/ou physiques résiduelles, avec un taux encore plus élevé de séquelles signalées dans le cas des enfants. On a estimé que le taux de létalité chez les cas cliniques se situait autour de 20-30%, les jeunes enfants (<10 ans) présentant un plus grand risque de maladie grave et un taux de létalité plus important.”", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "2d633003a8f3dd7bf63712ac27703827", - "text_as_html": "Parmi les cas sévéres, environ 30% des patients survivants présentent de graves incapacités neurologiques, psychosociales, intellectuelles et/ou physiques résiduelles, avec un taux encore plus élevé de séquelles signalées dans le cas des enfants. On a estimé que le taux de létalité chez les cas cliniques se situait autour de 20-30%, les jeunes enfants (<10 ans) présentant un plus grand risque de maladie grave et un taux de létalité plus important.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 293.66, - "y0": 321.05, - "x1": 553.88, - "y1": 410.93 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-18", - "text": "\n\n\nImmunité naturellement acquise\nOn pense quune infection par le VEJ confére une immunité durant la vie entiére. Les différents flavivirus ont en commun des antigénes et induisent la formation d’anticorps présentant une réactivité croisée. Les infections antérieures par des flavi- virus apparentés peuvent fournir une certaine protection croisée et réduire lincidence et la gravité des séquelles des éventuelles infections ultérieures par le VEJ, méme si les données disponibles a ce sujet sont limitées.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "522c994d893f9da1d387c23c79fcf5d9", - "text": "Immunité naturellement acquise", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "", - "text_as_html": "On pense quune infection par le VEJ confére une immunité durant la vie entiére. Les différents flavivirus ont en commun des antigénes et induisent la formation d’anticorps présentant une réactivité croisée. Les infections antérieures par des flavi- virus apparentés peuvent fournir une certaine protection croisée et réduire lincidence et la gravité des séquelles des éventuelles infections ultérieures par le VEJ, méme si les données disponibles a ce sujet sont limitées.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 294.97, - "y0": 436.9, - "x1": 552.99, - "y1": 527.66 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-19", - "text": "\n\n\nDiagnostic\nComme il est impossible de différencier par un examen clinique PE] d’encéphalites dues a d’autres causes, les cas de syndrome encéphalique aigu (SEA) ou les cas suspectés d’EJ devront subir un test de dépistage. Comme méthode 4 privilégier pour la confirmation en laboratoire, 1OMS recommande de rechercher les anticorps IgM spécifiques du VE] dans un échantillon unique de liquide céphalorachidien (LCR) ou de sérum, en utilisant le test ELISA de capture des IgM. Un échantillon de sérum devra étre obtenu lors de l’admission. Un échantillon initial précoce de sérum peut avoir été prélevé avant que la production d’an- ticorps ne s’opére. Si le premier échantillon est négatif pour les\n* Schuh AJ et al. Phylogeography of Japanese encephalitis virus: genotype is associated with climate.PLoS Negl Trop Dis,2013;7(8):e2411.\n10 Halstead $ et al. Japanese Encephalitis Vaccines. In Plotkin S, Orenstein W, Offit P, editors. Vaccines 6th: Saunders Elsevier; 2013, pp. 312-351.\nSolomonT et al. Seizures and raised intracranial pressure in Vietnamese patients with Japanese encephalitis. Brain: a journal of neurology, 2002;125:1084-1093.\n\"\nWEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015\ndischarge or on the 10th day of illness onset (usually around 7 days after admission) or at the time of death.\nIn areas highly endemic for JE, where there are many asymptomatic JEV infections, JEV-specific IgM may be present in the serum of non-JE AES cases: to avoid im- plicating JEV as the cause, sterile collection and testing of a CSF sample from all persons with AES is recom- mended when feasible. As IgM induced by recent JE vaccination may be detectable in the serum - but not the CSF - testing of serum only from a recently JE vac- cinated patient may wrongly implicate JEV as the cause of illness, underscoring the importance of CSF testing where possible.”\nOther methods of diagnosis suitable for use in the field include haemagglutination inhibition (HI) and plaque reduction neutralization assay (PRNT), carried out on paired sera for the demonstration of a significant rise in JEV-specific antibody. More detailed information on diagnostics for surveillance is provided in the WHO guidelines for JE surveillance.\"", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "d094fd6af738bcfea0a23752f5783008", - "text": "Diagnostic", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "", - "text_as_html": "Comme il est impossible de différencier par un examen clinique PE] d’encéphalites dues a d’autres causes, les cas de syndrome encéphalique aigu (SEA) ou les cas suspectés d’EJ devront subir un test de dépistage. Comme méthode 4 privilégier pour la confirmation en laboratoire, 1OMS recommande de rechercher les anticorps IgM spécifiques du VE] dans un échantillon unique de liquide céphalorachidien (LCR) ou de sérum, en utilisant le test ELISA de capture des IgM. Un échantillon de sérum devra étre obtenu lors de l’admission. Un échantillon initial précoce de sérum peut avoir été prélevé avant que la production d’an- ticorps ne s’opére. Si le premier échantillon est négatif pour les
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 294.34, - "y0": 553.63, - "x1": 551.26, - "y1": 678.82 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "a1d96453a94bf35390765b12a5975c19", - "text": "* Schuh AJ et al. Phylogeography of Japanese encephalitis virus: genotype is associated with climate.PLoS Negl Trop Dis,2013;7(8):e2411.", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "d094fd6af738bcfea0a23752f5783008", - "text_as_html": "\"
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 293.68, - "y0": 757.31, - "x1": 296.56, - "y1": 760.18 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "e4f5e1195288aebb5460dc3f5d57ce37", - "text": "WEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015", - "metadata": { - "category_depth": 1, - "page_number": 4, - "parent_id": "d094fd6af738bcfea0a23752f5783008", - "text_as_html": "WEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 3, - "coordinates": [ - { - "x0": 383.54, - "y0": 779.0, - "x1": 550.36, - "y1": 786.39 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "f8ebfd673b0629a8bb93ea2ad9393172", - "text": "discharge or on the 10th day of illness onset (usually around 7 days after admission) or at the time of death.", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "d094fd6af738bcfea0a23752f5783008", - "text_as_html": "discharge or on the 10th day of illness onset (usually around 7 days after admission) or at the time of death.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 43.16, - "y0": 56.08, - "x1": 272.51, - "y1": 77.13 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "bcb40013f6fdf465aebb2b1166e2ac56", - "text": "In areas highly endemic for JE, where there are many asymptomatic JEV infections, JEV-specific IgM may be present in the serum of non-JE AES cases: to avoid im- plicating JEV as the cause, sterile collection and testing of a CSF sample from all persons with AES is recom- mended when feasible. As IgM induced by recent JE vaccination may be detectable in the serum - but not the CSF - testing of serum only from a recently JE vac- cinated patient may wrongly implicate JEV as the cause of illness, underscoring the importance of CSF testing where possible.”", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "d094fd6af738bcfea0a23752f5783008", - "text_as_html": "In areas highly endemic for JE, where there are many asymptomatic JEV infections, JEV-specific IgM may be present in the serum of non-JE AES cases: to avoid im- plicating JEV as the cause, sterile collection and testing of a CSF sample from all persons with AES is recom- mended when feasible. As IgM induced by recent JE vaccination may be detectable in the serum - but not the CSF - testing of serum only from a recently JE vac- cinated patient may wrongly implicate JEV as the cause of illness, underscoring the importance of CSF testing where possible.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 44.06, - "y0": 108.17, - "x1": 272.45, - "y1": 231.59 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "7c626c117a191e5900cb9fbeaf1028c1", - "text": "Other methods of diagnosis suitable for use in the field include haemagglutination inhibition (HI) and plaque reduction neutralization assay (PRNT), carried out on paired sera for the demonstration of a significant rise in JEV-specific antibody. More detailed information on diagnostics for surveillance is provided in the WHO guidelines for JE surveillance.\"", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "d094fd6af738bcfea0a23752f5783008", - "text_as_html": "Other methods of diagnosis suitable for use in the field include haemagglutination inhibition (HI) and plaque reduction neutralization assay (PRNT), carried out on paired sera for the demonstration of a significant rise in JEV-specific antibody. More detailed information on diagnostics for surveillance is provided in the WHO guidelines for JE surveillance.\"
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 44.12, - "y0": 262.57, - "x1": 273.03, - "y1": 340.98 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-20", - "text": "\n\n\nTreatment\nThere is no specific antiviral treatment for JE. Support- ive clinical care is important as it relieves symptoms and stabilizes the patient. The main causes of JE-related mortality are aspiration, seizures, raised intracranial pressure and hypoglycaemia.\"*", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "93aacfd2210af513f9dffaf48f90d191", - "text": "Treatment", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "", - "text_as_html": "There is no specific antiviral treatment for JE. Support- ive clinical care is important as it relieves symptoms and stabilizes the patient. The main causes of JE-related mortality are aspiration, seizures, raised intracranial pressure and hypoglycaemia.\"*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 44.95, - "y0": 378.66, - "x1": 272.19, - "y1": 434.29 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-21", - "text": "\n\n\nVaccines\nAll of the approximately 15 JE vaccines currently in use are based on genotype 3 virus strains. JE vaccines fall into 4 classes: inactivated mouse brain-derived vaccines, inactivated Vero cell-derived vaccines, live attenuated vaccines, and live recombinant (chimeric) vaccines.\nThe 2006 position paper stated that mouse brain- derived vaccines should be gradually replaced by new generation JE vaccines, given their advantageous safety profile. This position paper focuses on new generation JE vaccines available internationally. The immunogenic- ity, efficacy and safety of inactivated Vero cell-derived, live attenuated and live recombinant JE vaccines were assessed on the basis of systematic searches of the available evidence.\nInactivated Vero cell-derived vaccines: Inactivated, Vero cell-derived, alum adjuvanted vaccine (SA 14-14-2 strain,\n\" Hills S et al. Japanese Encephalitis Core Working Group. Evidence and rationale for the World Health Organization recommended standards for Japanese encephalitis surveillance. BMC Infect Dis,2009;9:214.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "46f9fd022a0aecc3a65854ae66eeba6c", - "text": "Vaccines", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "", - "text_as_html": "All of the approximately 15 JE vaccines currently in use are based on genotype 3 virus strains. JE vaccines fall into 4 classes: inactivated mouse brain-derived vaccines, inactivated Vero cell-derived vaccines, live attenuated vaccines, and live recombinant (chimeric) vaccines.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 45.53, - "y0": 472.49, - "x1": 273.37, - "y1": 528.71 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "9030892a7fbc67a5159d7d64c34a5428", - "text": "The 2006 position paper stated that mouse brain- derived vaccines should be gradually replaced by new generation JE vaccines, given their advantageous safety profile. This position paper focuses on new generation JE vaccines available internationally. The immunogenic- ity, efficacy and safety of inactivated Vero cell-derived, live attenuated and live recombinant JE vaccines were assessed on the basis of systematic searches of the available evidence.", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "46f9fd022a0aecc3a65854ae66eeba6c", - "text_as_html": "The 2006 position paper stated that mouse brain- derived vaccines should be gradually replaced by new generation JE vaccines, given their advantageous safety profile. This position paper focuses on new generation JE vaccines available internationally. The immunogenic- ity, efficacy and safety of inactivated Vero cell-derived, live attenuated and live recombinant JE vaccines were assessed on the basis of systematic searches of the available evidence.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 45.0, - "y0": 547.1, - "x1": 272.51, - "y1": 649.32 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "1a2e064b0464c35a2850a40c7aa1a1e8", - "text": "Inactivated Vero cell-derived vaccines: Inactivated, Vero cell-derived, alum adjuvanted vaccine (SA 14-14-2 strain,", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "46f9fd022a0aecc3a65854ae66eeba6c", - "text_as_html": "Inactivated Vero cell-derived vaccines: Inactivated, Vero cell-derived, alum adjuvanted vaccine (SA 14-14-2 strain,
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 44.14, - "y0": 668.54, - "x1": 271.64, - "y1": 689.01 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "38f8fe12a6d72491a02a9047b203ac3f", - "text": "\" Hills S et al. Japanese Encephalitis Core Working Group. Evidence and rationale for the World Health Organization recommended standards for Japanese encephalitis surveillance. BMC Infect Dis,2009;9:214.", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "46f9fd022a0aecc3a65854ae66eeba6c", - "text_as_html": "RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 46.65, - "y0": 778.4, - "x1": 223.52, - "y1": 786.35 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "d74473ff914f1d24d4858e036ae94c29", - "text": "IgM spécifiques du VEJ, un deuxiéme échantillon devra étre collecté et testé lors de la sortie du patient ou au 10° jour de maladie (habituellement environ 7 jours aprés l’admission) ou encore au moment du décés.", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "e75740b90d1765a9d8d1ea75af258afd", - "text_as_html": "IgM spécifiques du VEJ, un deuxiéme échantillon devra étre collecté et testé lors de la sortie du patient ou au 10° jour de maladie (habituellement environ 7 jours aprés l’admission) ou encore au moment du décés.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 293.61, - "y0": 56.07, - "x1": 551.04, - "y1": 100.03 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "74349b623a744def22696167bb64acf3", - "text": "Dans les zones de forte endémie de l’EJ ot interviennent de nombreuses infections 4 VEJ asymptomatiques, des IgM spéci- fiques de ce virus peuvent étre présentes dans le sérum de cas de SEA non dus a EJ: pour éviter de mettre en cause inutile- ment le VEJ, il est recommandé, lorsque cela est faisable, de prélever de maniére stérile et d’analyser un échantillon de LCR chez toutes les personnes présentant un SEA. Comme des IgM dont la formation a été induite par une vaccination récente contre EJ peuvent étre détectables dans le sérum, mais pas dans le LCR, l’analyse du sérum d’une personne récemment vaccinée est susceptible de désigner a tort le VEJ comme cause de la maladie, ce qui souligne importance de l’analyse du LCR lorsquelle est possible.”", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "e75740b90d1765a9d8d1ea75af258afd", - "text_as_html": "Dans les zones de forte endémie de l’EJ ot interviennent de nombreuses infections 4 VEJ asymptomatiques, des IgM spéci- fiques de ce virus peuvent étre présentes dans le sérum de cas de SEA non dus a EJ: pour éviter de mettre en cause inutile- ment le VEJ, il est recommandé, lorsque cela est faisable, de prélever de maniére stérile et d’analyser un échantillon de LCR chez toutes les personnes présentant un SEA. Comme des IgM dont la formation a été induite par une vaccination récente contre EJ peuvent étre détectables dans le sérum, mais pas dans le LCR, l’analyse du sérum d’une personne récemment vaccinée est susceptible de désigner a tort le VEJ comme cause de la maladie, ce qui souligne importance de l’analyse du LCR lorsquelle est possible.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 293.32, - "y0": 107.82, - "x1": 554.0, - "y1": 254.26 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "f1225456e23b6e839a515e83f672d33c", - "text": "Parmi les autres méthodes de diagnostic utilisables sur le terrain, on peut mentionner l’inhibition de Phémagglutination (IH) et les épreuves de neutralisation par réduction des plages de lyse (PRNT) sur des échantillons de sérum appariés en vue de mettre en évidence une augmentation notable des anticorps spécifiques du VEJ. Le lecteur trouvera des informations plus détaillées sur les moyens diagnostiques disponibles pour la surveillance dans les WHO guidelines for JE surveillance.", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "e75740b90d1765a9d8d1ea75af258afd", - "text_as_html": "Parmi les autres méthodes de diagnostic utilisables sur le terrain, on peut mentionner l’inhibition de Phémagglutination (IH) et les épreuves de neutralisation par réduction des plages de lyse (PRNT) sur des échantillons de sérum appariés en vue de mettre en évidence une augmentation notable des anticorps spécifiques du VEJ. Le lecteur trouvera des informations plus détaillées sur les moyens diagnostiques disponibles pour la surveillance dans les WHO guidelines for JE surveillance.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 294.03, - "y0": 262.01, - "x1": 552.48, - "y1": 352.97 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-24", - "text": "\n\n\nLe traitement\nIl n’existe aucun traitement antiviral spécifique contre |’EJ. Les soins cliniques de soutien sont importants car ils atténuent les symptémes et stabilisent le patient. Les principales causes de la mortalité associée a l’EJ sont les fausses routes, les convul- sions, l’augmentation de la pression intracranienne et l’hypo- glycémie.\"", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "f013a94bcb9ca73ca5502e4573aa91e2", - "text": "Le traitement", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "", - "text_as_html": "Il n’existe aucun traitement antiviral spécifique contre |’EJ. Les soins cliniques de soutien sont importants car ils atténuent les symptémes et stabilisent le patient. Les principales causes de la mortalité associée a l’EJ sont les fausses routes, les convul- sions, l’augmentation de la pression intracranienne et l’hypo- glycémie.\"
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 292.7, - "y0": 378.03, - "x1": 552.46, - "y1": 445.45 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-25", - "text": "\n\n\nLes vaccins\nLa totalité de la quinzaine de vaccins existants contre |’EJ est préparée a partir de souches du génotype 3. Les vaccins contre PE] se répartissent en 4 classes: les vaccins inactivés préparés sur tissu cérébral murin, les vaccins inactivés préparés sur cellules Vero, les vaccins atténués vivants et les vaccins vivants recombinants (chimériques).\nLa note de 2006 de l’OMS déclarait que les vaccins inactivés préparés sur tissu cérébral murin devraient étre graduellement remplacés par des vaccins contre EJ de nouvelle génération, compte tenu du profil d’innocuité avantageux de ces derniers. La présente note porte principalement sur les vaccins contre PEJ de nouvelle génération, disponibles sur le marché interna- tional. Limmunogénicité, Pefficacité et Pinnocuité de vaccins atténués vivants préparés sur des cellules Vero inactivés et de vaccins vivants recombinants contre l’EJ ont été évaluées a partir de revues systématiques des éléments disponibles.\nVaccins inactivés préparés sur des cellules Vero. Un vaccin inac- tivé, préparé sur des cellules Vero, et adjuvanté avec de alum\n” Hills S et al. Japanese Encephalitis Core Working Group. Evidence and rationale for the World Health Organization recommended standards for Japanese encephalitis surveillance. BMC In- fect Dis,2009;9:214.\n\"3 WHO guidelines for JE surveillance: http://whqlibdoc.who.int/hq/2003/who_v&b_03.01.pdf, consulté en novembre 2014.\n™ Rao PN. Japanese encephalitis. Indian Pediatr,2001;38: 1252-1264.\n73\nattenuated, IXIARO® and JESPECT®) was licensed in 2009 based on non-inferior immunogenicity to a field- effective, mouse brain derived JE vaccine’ and is li- censed in several countries. Production of this vaccine was transferred by technology agreement to another manufacturer and was licensed in 2012 in India JEEV®) and since then in other countries in Asia.'* Other inac- tivated Vero cell-derived vaccines are produced in China, India and Japan using different viral strains;!” these have limited or no international distribution.\nLive attenuated vaccines: A primary hamster kidney (PHK) cell-derived, live attenuated vaccine based on the SA 14-14-2 strain of the JEV is licensed and has been used widely in China since 1988 (CD.JEVAX®). The vac- cine is now licensed and used in an increasing number of countries in Asia. Two other live attenuated vaccines based on the same attenuated strain are manufactured in China but not exported.\nLive recombinant vaccine: A live attenuated, recombi- nant (chimeric) JE vaccine was licensed in Australia in 2010 and since then licensed and used in a growing number of Asian countries (IMOJEV®, JE-CV®, Chime- riVax-JE®). It was created by replacing the premem- brane (prM) and envelope (E) coding sequences of the yellow fever live attenuated 17D vaccine virus with the analogous sequences coding for the antigenic determi- nants from the SA 14-14-2 live attenuated JE vaccine virus. The vaccine virus is produced in Vero cells.\nManufacturers’ recommended dosage, administration and formulation\nInactivated Vero cell-derived vaccines: Primary immu- nization with inactivated, Vero cell-derived, alum-adju- vanted vaccine (SA 14-14-2 strain) requires 2 intramus- cular doses administered 4 weeks apart. The age for the first dose varies. The dose for those aged <3 years is 0.25 ml, and 0.5 ml for those aged 23 years. The manu- facturer states that travellers aged 217 years who have received primary immunization >1 year previously may be given a booster dose if ongoing or re-exposure to JEV is expected. Currently the manufacturer has no pae- diatric booster dose recommendation. No preservative or stabilizers are added to the formulation.\nLive attenuated vaccines: Primary immunization con- sists of 1 dose (0.5ml) given subcutaneously from 8 months of age or older. The live attenuated vaccine (SA 14-14-2 strain) contains gelatin, saccharose, human serum albumin, and sodium glutamate as excipients.\n'® Tauber et al. Safety and immunogenicity of a Vero-cell-derived, inactivated Ja- panese encephalitis vaccine: a non-inferiority, phase III, randomised controlled trial. Lancet,2007;370: 1847-1853.\n16 Public assessment summary report update — Japanese Encephalitis Vaccine (Hu- man) (Purified Inactivated Vaccine-Adsorbed) JEEV®. Available at http://www.who. int/immunization_standards/vaccine_quality/pq_266_je_1dose_biologicale_upda- ted_vpsar.pdf, accessed November 2014.\n17 Inactivated primary hamster kidney (PHK) cell-derived vaccines are no longer manu- factured.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "fec1861d4c57f07d91e410dc8c6e9b24", - "text": "Les vaccins", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "", - "text_as_html": "La totalité de la quinzaine de vaccins existants contre |’EJ est préparée a partir de souches du génotype 3. Les vaccins contre PE] se répartissent en 4 classes: les vaccins inactivés préparés sur tissu cérébral murin, les vaccins inactivés préparés sur cellules Vero, les vaccins atténués vivants et les vaccins vivants recombinants (chimériques).
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 294.43, - "y0": 472.1, - "x1": 552.27, - "y1": 539.47 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "44ee66d80b16660467cc31ebd4d0892e", - "text": "La note de 2006 de l’OMS déclarait que les vaccins inactivés préparés sur tissu cérébral murin devraient étre graduellement remplacés par des vaccins contre EJ de nouvelle génération, compte tenu du profil d’innocuité avantageux de ces derniers. La présente note porte principalement sur les vaccins contre PEJ de nouvelle génération, disponibles sur le marché interna- tional. Limmunogénicité, Pefficacité et Pinnocuité de vaccins atténués vivants préparés sur des cellules Vero inactivés et de vaccins vivants recombinants contre l’EJ ont été évaluées a partir de revues systématiques des éléments disponibles.", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "fec1861d4c57f07d91e410dc8c6e9b24", - "text_as_html": "La note de 2006 de l’OMS déclarait que les vaccins inactivés préparés sur tissu cérébral murin devraient étre graduellement remplacés par des vaccins contre EJ de nouvelle génération, compte tenu du profil d’innocuité avantageux de ces derniers. La présente note porte principalement sur les vaccins contre PEJ de nouvelle génération, disponibles sur le marché interna- tional. Limmunogénicité, Pefficacité et Pinnocuité de vaccins atténués vivants préparés sur des cellules Vero inactivés et de vaccins vivants recombinants contre l’EJ ont été évaluées a partir de revues systématiques des éléments disponibles.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 293.16, - "y0": 546.75, - "x1": 553.76, - "y1": 660.59 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "9ff083c19014390ec8c6c68741d54bb6", - "text": "Vaccins inactivés préparés sur des cellules Vero. Un vaccin inac- tivé, préparé sur des cellules Vero, et adjuvanté avec de alum", - "metadata": { - "category_depth": 1, - "page_number": 5, - "parent_id": "fec1861d4c57f07d91e410dc8c6e9b24", - "text_as_html": "Vaccins inactivés préparés sur des cellules Vero. Un vaccin inac- tivé, préparé sur des cellules Vero, et adjuvanté avec de alum
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", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 4, - "coordinates": [ - { - "x0": 542.73, - "y0": 779.62, - "x1": 549.57, - "y1": 784.66 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "09c94424fa8d63003840c1635f3fdfe4", - "text": "attenuated, IXIARO® and JESPECT®) was licensed in 2009 based on non-inferior immunogenicity to a field- effective, mouse brain derived JE vaccine’ and is li- censed in several countries. Production of this vaccine was transferred by technology agreement to another manufacturer and was licensed in 2012 in India JEEV®) and since then in other countries in Asia.'* Other inac- tivated Vero cell-derived vaccines are produced in China, India and Japan using different viral strains;!” these have limited or no international distribution.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "fec1861d4c57f07d91e410dc8c6e9b24", - "text_as_html": "attenuated, IXIARO® and JESPECT®) was licensed in 2009 based on non-inferior immunogenicity to a field- effective, mouse brain derived JE vaccine’ and is li- censed in several countries. Production of this vaccine was transferred by technology agreement to another manufacturer and was licensed in 2012 in India JEEV®) and since then in other countries in Asia.'* Other inac- tivated Vero cell-derived vaccines are produced in China, India and Japan using different viral strains;!” these have limited or no international distribution.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 44.95, - "y0": 56.15, - "x1": 273.21, - "y1": 169.19 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "cfcb5cdcfc4a5b0f5d4916ebb904ee29", - "text": "Live attenuated vaccines: A primary hamster kidney (PHK) cell-derived, live attenuated vaccine based on the SA 14-14-2 strain of the JEV is licensed and has been used widely in China since 1988 (CD.JEVAX®). The vac- cine is now licensed and used in an increasing number of countries in Asia. Two other live attenuated vaccines based on the same attenuated strain are manufactured in China but not exported.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "fec1861d4c57f07d91e410dc8c6e9b24", - "text_as_html": "Live attenuated vaccines: A primary hamster kidney (PHK) cell-derived, live attenuated vaccine based on the SA 14-14-2 strain of the JEV is licensed and has been used widely in China since 1988 (CD.JEVAX®). The vac- cine is now licensed and used in an increasing number of countries in Asia. Two other live attenuated vaccines based on the same attenuated strain are manufactured in China but not exported.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 44.18, - "y0": 199.86, - "x1": 272.93, - "y1": 289.6 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "8160207388ab894a8ff51e7e7aaa5da2", - "text": "Live recombinant vaccine: A live attenuated, recombi- nant (chimeric) JE vaccine was licensed in Australia in 2010 and since then licensed and used in a growing number of Asian countries (IMOJEV®, JE-CV®, Chime- riVax-JE®). It was created by replacing the premem- brane (prM) and envelope (E) coding sequences of the yellow fever live attenuated 17D vaccine virus with the analogous sequences coding for the antigenic determi- nants from the SA 14-14-2 live attenuated JE vaccine virus. The vaccine virus is produced in Vero cells.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "fec1861d4c57f07d91e410dc8c6e9b24", - "text_as_html": "Live recombinant vaccine: A live attenuated, recombi- nant (chimeric) JE vaccine was licensed in Australia in 2010 and since then licensed and used in a growing number of Asian countries (IMOJEV®, JE-CV®, Chime- riVax-JE®). It was created by replacing the premem- brane (prM) and envelope (E) coding sequences of the yellow fever live attenuated 17D vaccine virus with the analogous sequences coding for the antigenic determi- nants from the SA 14-14-2 live attenuated JE vaccine virus. The vaccine virus is produced in Vero cells.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 44.5, - "y0": 296.97, - "x1": 273.36, - "y1": 410.62 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "bf4d21769fa7fb591706ab187d1fb2f9", - "text": "Manufacturers’ recommended dosage, administration and formulation", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "fec1861d4c57f07d91e410dc8c6e9b24", - "text_as_html": "Manufacturers’ recommended dosage, administration and formulation
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 45.71, - "y0": 422.09, - "x1": 209.05, - "y1": 445.07 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "6c76bfbe8ce8bb4ee90d81a37fedb2d1", - "text": "Inactivated Vero cell-derived vaccines: Primary immu- nization with inactivated, Vero cell-derived, alum-adju- vanted vaccine (SA 14-14-2 strain) requires 2 intramus- cular doses administered 4 weeks apart. The age for the first dose varies. The dose for those aged <3 years is 0.25 ml, and 0.5 ml for those aged 23 years. The manu- facturer states that travellers aged 217 years who have received primary immunization >1 year previously may be given a booster dose if ongoing or re-exposure to JEV is expected. Currently the manufacturer has no pae- diatric booster dose recommendation. No preservative or stabilizers are added to the formulation.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "fec1861d4c57f07d91e410dc8c6e9b24", - "text_as_html": "Inactivated Vero cell-derived vaccines: Primary immu- nization with inactivated, Vero cell-derived, alum-adju- vanted vaccine (SA 14-14-2 strain) requires 2 intramus- cular doses administered 4 weeks apart. The age for the first dose varies. The dose for those aged <3 years is 0.25 ml, and 0.5 ml for those aged 23 years. The manu- facturer states that travellers aged 217 years who have received primary immunization >1 year previously may be given a booster dose if ongoing or re-exposure to JEV is expected. Currently the manufacturer has no pae- diatric booster dose recommendation. No preservative or stabilizers are added to the formulation.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 45.65, - "y0": 448.0, - "x1": 273.25, - "y1": 584.22 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "c66e7ab7405479a27b9f6f14edfd5147", - "text": "Live attenuated vaccines: Primary immunization con- sists of 1 dose (0.5ml) given subcutaneously from 8 months of age or older. The live attenuated vaccine (SA 14-14-2 strain) contains gelatin, saccharose, human serum albumin, and sodium glutamate as excipients.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "fec1861d4c57f07d91e410dc8c6e9b24", - "text_as_html": "Live attenuated vaccines: Primary immunization con- sists of 1 dose (0.5ml) given subcutaneously from 8 months of age or older. The live attenuated vaccine (SA 14-14-2 strain) contains gelatin, saccharose, human serum albumin, and sodium glutamate as excipients.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 45.08, - "y0": 603.93, - "x1": 272.12, - "y1": 659.0 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "cc58e0cb021f31c31140b045f7cbd05d", - "text": "'® Tauber et al. Safety and immunogenicity of a Vero-cell-derived, inactivated Ja- panese encephalitis vaccine: a non-inferiority, phase III, randomised controlled trial. Lancet,2007;370: 1847-1853.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "fec1861d4c57f07d91e410dc8c6e9b24", - "text_as_html": "(souche SA 14-14-2 atténuée, IXIARO® et JESPECT®) a été homologué en 2009, sur la base de la non-infériorité de son immunogénicité par rapport a celle d’un vaccin contre EJ préparé sur tissu cérébral murin et efficace sur le terrain,\" et cette homologation a été obtenue dans plusieurs pays. La produc- tion de ce vaccin a été transférée dans le cadre d’un accord tech- nologique a un autre fabricant et le vaccin ainsi produit a été homologué en 2012 en Inde (JEEV®), puis dans d’autres pays d’Asie.'* D’autres vaccins inactivés préparés sur cellules Vero sont produits en Chine, en Inde et au Japon a partir de différentes souches virales;'” ces derniers vaccins ont une diffusion restreinte ou rvatteignant pas une échelle internationale.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 294.51, - "y0": 56.93, - "x1": 551.53, - "y1": 191.69 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "e80f5f160a05f46c47f2beba6ecd1f0f", - "text": "Vaccins vivants atténués. Un vaccin vivant atténué, préparé sur culture primaire de cellules rénales de hamster (PHK), a partir de la souche SA 14-14-2 du VEJ, a été homologué et fait P’objet d@une large utilisation en Chine depuis 1988 (CD.JEVAX®). Ce vaccin est maintenant homologué et employé dans un nombre croissant de pays asiatiques. Deux autres vaccins vivants atté- nués préparés a partir de la méme souche atténuée sont fabri- qués en Chine, sans étre exportés.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "a2feb5a13a6e91d552a6696647e35ec2", - "text_as_html": "Vaccins vivants atténués. Un vaccin vivant atténué, préparé sur culture primaire de cellules rénales de hamster (PHK), a partir de la souche SA 14-14-2 du VEJ, a été homologué et fait P’objet d@une large utilisation en Chine depuis 1988 (CD.JEVAX®). Ce vaccin est maintenant homologué et employé dans un nombre croissant de pays asiatiques. Deux autres vaccins vivants atté- nués préparés a partir de la méme souche atténuée sont fabri- qués en Chine, sans étre exportés.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 293.7, - "y0": 199.32, - "x1": 553.5, - "y1": 289.48 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "22bc947c56683b638a709b2466f3ab05", - "text": "Vaccin vivant recombinant. Un vaccin vivant recombinant (chimérique) atténué contre PEJ a obtenu ’homologation en Australie en 2010, et depuis est homologué et utilisé dans un nombre grandissant de pays asiatiques (IMOJEV®, JE-CV®, ChimeriVax-JE®). Il a été créé en remplacant les séquences de codage des protéines de prémembrane (prM) et d’enveloppe (E) du vaccin vivant atténué 17D contre la fiévre jaune par des séquences analogues, codant pour les déterminants antigé- niques du virus vaccinal vivant atténué SA 14-14-2 de lEJ. Le virus vaccinal est préparé sur des cellules Vero.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "a2feb5a13a6e91d552a6696647e35ec2", - "text_as_html": "Vaccin vivant recombinant. Un vaccin vivant recombinant (chimérique) atténué contre PEJ a obtenu ’homologation en Australie en 2010, et depuis est homologué et utilisé dans un nombre grandissant de pays asiatiques (IMOJEV®, JE-CV®, ChimeriVax-JE®). Il a été créé en remplacant les séquences de codage des protéines de prémembrane (prM) et d’enveloppe (E) du vaccin vivant atténué 17D contre la fiévre jaune par des séquences analogues, codant pour les déterminants antigé- niques du virus vaccinal vivant atténué SA 14-14-2 de lEJ. Le virus vaccinal est préparé sur des cellules Vero.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 294.29, - "y0": 297.1, - "x1": 552.37, - "y1": 410.6 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "98d8a950b644ce21234ff94d1e22032c", - "text": "Posologie recommandée par les fabricants, administration et formulation", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "a2feb5a13a6e91d552a6696647e35ec2", - "text_as_html": "Posologie recommandée par les fabricants, administration et formulation
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 293.51, - "y0": 422.17, - "x1": 542.21, - "y1": 444.58 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "b3349cf166f1a5047c34cf69aa3a12fa", - "text": "Vaccins inactivés préparés sur des cellules Vero. La primovacci- nation avec un vaccin inactivé, préparé sur cellules Vero et adjuvanté avec de l’alum (souche SA 14 14 2) nécessite 2 doses intramusculaires, administrées 4 4 semaines d’intervalle. Lage d’administration de la premiére dose est variable. Pour les enfants <3 ans, la dose est de 0,25 ml et pour ceux 23 ans, elle est de 0,5 ml. Le fabriquant indique quil est possible d’admi- nistrer aux voyageurs 217 ans ayant recu une primovaccination plus d’1 an auparavant une dose de rappel si l’on s’attend a une poursuite de leur exposition au VEJ ou a une réexposition a ce virus. Actuellement, le fabricant ne recommande pas de dose de rappel pour les enfants. Aucun agent préservatif ou stabilisant nest ajouté a la formulation.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "a2feb5a13a6e91d552a6696647e35ec2", - "text_as_html": "Vaccins inactivés préparés sur des cellules Vero. La primovacci- nation avec un vaccin inactivé, préparé sur cellules Vero et adjuvanté avec de l’alum (souche SA 14 14 2) nécessite 2 doses intramusculaires, administrées 4 4 semaines d’intervalle. Lage d’administration de la premiére dose est variable. Pour les enfants <3 ans, la dose est de 0,25 ml et pour ceux 23 ans, elle est de 0,5 ml. Le fabriquant indique quil est possible d’admi- nistrer aux voyageurs 217 ans ayant recu une primovaccination plus d’1 an auparavant une dose de rappel si l’on s’attend a une poursuite de leur exposition au VEJ ou a une réexposition a ce virus. Actuellement, le fabricant ne recommande pas de dose de rappel pour les enfants. Aucun agent préservatif ou stabilisant nest ajouté a la formulation.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 294.46, - "y0": 448.36, - "x1": 552.16, - "y1": 595.83 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "1d5421c8c88588af6155b13325184142", - "text": "Vaccins vivants atténués. La primovaccination consiste en Padmi- nistration d’une dose (0,5 ml) par voie sous-cutanée a partir de Page de 8 mois. Ce vaccin vivant atténué (souche SA 14-14-2) contient de la gélatine, du saccharose, de l’albumine sérique humaine et du glutamate de sodium en tant qu’excipients.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "a2feb5a13a6e91d552a6696647e35ec2", - "text_as_html": "Vaccins vivants atténués. La primovaccination consiste en Padmi- nistration d’une dose (0,5 ml) par voie sous-cutanée a partir de Page de 8 mois. Ce vaccin vivant atténué (souche SA 14-14-2) contient de la gélatine, du saccharose, de l’albumine sérique humaine et du glutamate de sodium en tant qu’excipients.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 293.06, - "y0": 603.46, - "x1": 551.12, - "y1": 658.95 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "4615fa27d9d36072c3e2539ecc03f1e8", - "text": "'® Tauber et al. Safety and immunogenicity of a Vero-cell-derived, inactivated Japanese encepha- litis vaccine: a non-inferiority, phase Ill, randomised controlled trial. Lancet,2007;370: 1847— 1853.", - "metadata": { - "category_depth": 1, - "page_number": 6, - "parent_id": "a2feb5a13a6e91d552a6696647e35ec2", - "text_as_html": "WEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 5, - "coordinates": [ - { - "x0": 385.01, - "y0": 778.7, - "x1": 548.84, - "y1": 786.44 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "fc69780162a81cebfa6ecb61cddc3f95", - "text": "Live recombinant vaccines: Primary immunization is with 1 dose given subcutaneously at 9 months of age or older. A booster dose is recommended by the manu- facturer 12-24 months later for those <18 years of age (currently, there are no booster recommendation for adults). Each dose contains mannitol, lactose, glutamic acid, potassium hydroxide, histidine, human serum albumin, and sodium chloride as excipient.", - "metadata": { - "category_depth": 1, - "page_number": 7, - "parent_id": "a2feb5a13a6e91d552a6696647e35ec2", - "text_as_html": "Live recombinant vaccines: Primary immunization is with 1 dose given subcutaneously at 9 months of age or older. A booster dose is recommended by the manu- facturer 12-24 months later for those <18 years of age (currently, there are no booster recommendation for adults). Each dose contains mannitol, lactose, glutamic acid, potassium hydroxide, histidine, human serum albumin, and sodium chloride as excipient.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 6, - "coordinates": [ - { - "x0": 45.34, - "y0": 56.09, - "x1": 272.82, - "y1": 146.46 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-27", - "text": "\n\n\nCorrelate of protection\nProtection against JEV is associated with the presence of sufficient levels of neutralizing antibodies. The ac- cepted immunological surrogate of protection is a serum neutralizing antibody titre of at least 1:10 as determined in a 50% plaque reduction neutralization assay (PRNT:0), referred to as seroprotection. Serocon- version is defined as PRNT; titre <10 at baseline and 210 post vaccination, or a 4-fold rise from a baseline titre of 210.\"* Immunogenicity analyses are influenced by the virus strain used in the PRNTs, assay as well as the cell substrate. No international reference serum has yet been established and quantitative immunogenicity results should therefore be considered in the context of the virus strain and cell substrate.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "69125a26427a074987a3bf9f60b2966e", - "text": "Correlate of protection", - "metadata": { - "category_depth": 1, - "page_number": 7, - "parent_id": "", - "text_as_html": "Protection against JEV is associated with the presence of sufficient levels of neutralizing antibodies. The ac- cepted immunological surrogate of protection is a serum neutralizing antibody titre of at least 1:10 as determined in a 50% plaque reduction neutralization assay (PRNT:0), referred to as seroprotection. Serocon- version is defined as PRNT; titre <10 at baseline and 210 post vaccination, or a 4-fold rise from a baseline titre of 210.\"* Immunogenicity analyses are influenced by the virus strain used in the PRNTs, assay as well as the cell substrate. No international reference serum has yet been established and quantitative immunogenicity results should therefore be considered in the context of the virus strain and cell substrate.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 6, - "coordinates": [ - { - "x0": 44.8, - "y0": 172.64, - "x1": 273.17, - "y1": 331.98 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-28", - "text": "\n\n\nImmunoge' y and effectiveness\nInactivated Vero cell-derived vaccines: Across multiple studies in adults and children/adolescents in non-en- demic settings, high seroprotection rates have been found for a Vero cell-derived vaccine one month follow- ing completion of the 2-dose primary series, ranging from 93% to 99%.' Among children aged 1-2 years liv- ing in an endemic setting, seroprotection was 95.7% (95% confidence interval [CI]: 87.3-100) one month fol- lowing the second dose.” In a larger study, also in an endemic setting, among 396 children aged 2 months - 18 years given an age appropriate dose, 299% of chil- dren were seroprotected.”*' There are currently no vaccine effectiveness data from use in endemic settings.\nLive attenuated vaccines: In infants given a single dose of vaccine at 8-12 months of age, seroprotection rates at 28 days post-vaccination ranged from 90.6% (95% CI: 85.3-94.4) to 92.1% (95% CI: 84.3-96.7)” among children in different age groups in one trial and from 80.2% (95% CI: 74.0-85.2) to 86.3% (95% CI: 79.8-91.0) among\n\"8 Hombach J et al. Report on a WHO consultation on immunological endpoints for evaluation of new Japanese encephalitis vaccines, WHO, Geneva, 2-3 September, 2004. Vaccine,2005;23(45):5205-5211.\nKaltenbéck A et al. Immunogenicity and safety of IXIARO (IC51) in a Phase II study in healthy Indian children between 1 and 3 years of age. Vaccine, 201 0;28(3):834-839.\nDubischar-Kastner K et al. Safety and Immunogenicity of the Inactivated Japanese Encephalitis Vaccine IXIARO®, 1C51, in Filipino Children Aged 2 Months to <18 Years. Presented at the Asia Pacific Travel Health Conference, 2012.\nGrading of scientific evidence — table |: What is the effectiveness of 2 doses (pri- mary series) of inactivated Vero cell-derived JE vaccine in preventing JE disease in vaccinees living in JE-endemic areas? Available at http://www.who.int/immuniza- tion/policy/position_papers/je_grad_inactivated_effectiveness.pdf.\nVictor J et al. Corrigendum to “Comparison of the immunogenicity and safety of measles vaccine administered alone or with live, attenuated Japanese encephalitis SA 14-14-2 vaccine in Philippine infants.” Vaccine, 2014;32(2): 306-308.\nRELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,\nVaccins vivants recombinants. La primovaccination s’effectue par administration sous cutanée a partir de 9 mois. Une dose de rappel est recommandée par le fabricant 12 4 24 mois plus tard pour les enfants <18 ans (actuellement, aucune dose de rappel n’est recommandée pour les adultes). Chaque dose contient du mannitol, du lactose, de l’acide glutamique, de Phy- droxyde de potassium, de Vhistidine, de Palbumine sérique humaine et du chlorure de sodium comme excipient.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "922eec252fce835f45dd8b788d42e5cf", - "text": "Immunoge' y and effectiveness", - "metadata": { - "category_depth": 1, - "page_number": 7, - "parent_id": "", - "text_as_html": "Inactivated Vero cell-derived vaccines: Across multiple studies in adults and children/adolescents in non-en- demic settings, high seroprotection rates have been found for a Vero cell-derived vaccine one month follow- ing completion of the 2-dose primary series, ranging from 93% to 99%.' Among children aged 1-2 years liv- ing in an endemic setting, seroprotection was 95.7% (95% confidence interval [CI]: 87.3-100) one month fol- lowing the second dose.” In a larger study, also in an endemic setting, among 396 children aged 2 months - 18 years given an age appropriate dose, 299% of chil- dren were seroprotected.”*' There are currently no vaccine effectiveness data from use in endemic settings.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 6, - "coordinates": [ - { - "x0": 44.45, - "y0": 369.49, - "x1": 272.41, - "y1": 516.89 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "bd167510c9bce2ca987a5d2819497207", - "text": "Live attenuated vaccines: In infants given a single dose of vaccine at 8-12 months of age, seroprotection rates at 28 days post-vaccination ranged from 90.6% (95% CI: 85.3-94.4) to 92.1% (95% CI: 84.3-96.7)” among children in different age groups in one trial and from 80.2% (95% CI: 74.0-85.2) to 86.3% (95% CI: 79.8-91.0) among", - "metadata": { - "category_depth": 1, - "page_number": 7, - "parent_id": "922eec252fce835f45dd8b788d42e5cf", - "text_as_html": "Live attenuated vaccines: In infants given a single dose of vaccine at 8-12 months of age, seroprotection rates at 28 days post-vaccination ranged from 90.6% (95% CI: 85.3-94.4) to 92.1% (95% CI: 84.3-96.7)” among children in different age groups in one trial and from 80.2% (95% CI: 74.0-85.2) to 86.3% (95% CI: 79.8-91.0) among
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 6, - "coordinates": [ - { - "x0": 45.08, - "y0": 535.99, - "x1": 271.71, - "y1": 602.09 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "fcaba3e1758ad6b5af5806b087d887c8", - "text": "\"8 Hombach J et al. Report on a WHO consultation on immunological endpoints for evaluation of new Japanese encephalitis vaccines, WHO, Geneva, 2-3 September, 2004. Vaccine,2005;23(45):5205-5211.", - "metadata": { - "category_depth": 1, - "page_number": 7, - "parent_id": "922eec252fce835f45dd8b788d42e5cf", - "text_as_html": "RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 6, - "coordinates": [ - { - "x0": 44.38, - "y0": 778.99, - "x1": 225.33, - "y1": 786.16 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "a22776016fe740ef28cbd08a726d6503", - "text": "Vaccins vivants recombinants. La primovaccination s’effectue par administration sous cutanée a partir de 9 mois. Une dose de rappel est recommandée par le fabricant 12 4 24 mois plus tard pour les enfants <18 ans (actuellement, aucune dose de rappel n’est recommandée pour les adultes). Chaque dose contient du mannitol, du lactose, de l’acide glutamique, de Phy- droxyde de potassium, de Vhistidine, de Palbumine sérique humaine et du chlorure de sodium comme excipient.", - "metadata": { - "category_depth": 1, - "page_number": 7, - "parent_id": "922eec252fce835f45dd8b788d42e5cf", - "text_as_html": "Vaccins vivants recombinants. La primovaccination s’effectue par administration sous cutanée a partir de 9 mois. Une dose de rappel est recommandée par le fabricant 12 4 24 mois plus tard pour les enfants <18 ans (actuellement, aucune dose de rappel n’est recommandée pour les adultes). Chaque dose contient du mannitol, du lactose, de l’acide glutamique, de Phy- droxyde de potassium, de Vhistidine, de Palbumine sérique humaine et du chlorure de sodium comme excipient.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 6, - "coordinates": [ - { - "x0": 293.65, - "y0": 56.43, - "x1": 552.08, - "y1": 146.57 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-29", - "text": "\n\n\nCorrélat de protection\nLexistence d'une protection contre le VEJ est associée a la présence de titres suffisants d’anticorps neutralisants. Le subs- titut immunologique accepté de la protection est la présence d'un titre sérique d’anticorps neutralisants de 1:10 au moins, tel que déterminé par une épreuve de neutralisation par réduc- tion de 50% des plages de lyse (PRNTs»), que l’on appelle séro- protection. La séroconversion est définie comme un titre, déter- miné par PRNTs, <10 en référence et 210 aprés la vaccination, ou augmenté d’un facteur 4 par rapport a un titre de référence 210.'8 Les analyses dimmunogénicité donnent des résultats qui dépendent de la souche virale employée dans l’épreuve de PRNT:» et du substrat cellulaire. Aucun étalon international n’a été établi pour le sérum et les résultats quantitatifs des tests @immunogénicité devront donc étre examinés en tenant compte de la souche virale et du substrat cellulaire.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "e725f1119d1f2e2daf8fe37da462032e", - "text": "Corrélat de protection", - "metadata": { - "category_depth": 1, - "page_number": 7, - "parent_id": "", - "text_as_html": "Lexistence d'une protection contre le VEJ est associée a la présence de titres suffisants d’anticorps neutralisants. Le subs- titut immunologique accepté de la protection est la présence d'un titre sérique d’anticorps neutralisants de 1:10 au moins, tel que déterminé par une épreuve de neutralisation par réduc- tion de 50% des plages de lyse (PRNTs»), que l’on appelle séro- protection. La séroconversion est définie comme un titre, déter- miné par PRNTs, <10 en référence et 210 aprés la vaccination, ou augmenté d’un facteur 4 par rapport a un titre de référence 210.'8 Les analyses dimmunogénicité donnent des résultats qui dépendent de la souche virale employée dans l’épreuve de PRNT:» et du substrat cellulaire. Aucun étalon international n’a été établi pour le sérum et les résultats quantitatifs des tests @immunogénicité devront donc étre examinés en tenant compte de la souche virale et du substrat cellulaire.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 6, - "coordinates": [ - { - "x0": 293.26, - "y0": 172.22, - "x1": 553.93, - "y1": 342.27 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-30", - "text": "\n\n\nImmunogeénicité et efficience\nVaccins inactivés préparés sur des cellules Vero, Parmi les multiples études réalisées chez des adultes et des enfants/ adolescents dans des situations non endémiques, on a relevé des taux de séroprotection élevés pour un vaccin préparé sur cellules Vero un mois aprés l’achévement de la série primaire de 2 doses, qui allaient de 93% a 99%.' Chez les enfants de 1 a 2 ans vivant dans des zones d’endémie, la séroprotection était de 95,7% (intervalle de confiance (IC) 4 95%: 87,3-100) un mois aprés la seconde dose.'® Dans une étude plus vaste, menée aussi dans un contexte d’endémie, on a constaté que, parmi 396 enfants de 2 mois 4 18 ans ayant recu une dose adaptée a leur age, 299% bénéficiaient d’une séroprotection.”**! On ne dispose pas actuellement de données d’efficacité vaccinale dans le cas d’une utilisation dans une zone d’endémie.\nVaccins vivants atténués. Chez des nourrissons ayant recu une dose unique entre 8 et 12 mois, les taux de séroprotection 28 jours aprés la vaccination se situaient entre 90,6% (IC a 95%: 85,3-94,4) et 92,1% (IC a 95%: 84,3-96,7)” pour des enfants appartenant a différentes tranches d’age dans l’un des essais et entre 80,2% (IC a 95%: 74,0-85,2) et 86,3% (IC a 95%: 79,8-91,0)\n\"® Hombach J et al. Report on a WHO consultation on immunological endpoints for evaluation of new Japanese encephalitis vaccines, WHO, Geneva, 2-3 September, 2004. Vac- cine,2005;23(45):5205-5211.\nKaltenbick A et al. Immunogenicity and safety of IXIARO (I1C51) in a Phase Il study in healthy Indian children between 1 and 3 years of age. Vaccine,2010;28(3):834-839.\nDubischar-Kastner K et al. Safety and Immunogenicity of the Inactivated Japanese Encephalitis Vaccine IXIARO®, IC51, in Filipino Children Aged 2 Months to <18 Years. Presented at the Asia Pacific Travel Health Conference, 2012.\nCotation des preuves scientifiques — tableau |: What is the effectiveness of 2 doses (primary series) of inactivated Vero cell-derived JE vaccine in preventing JE disease in vaccinees living in JE-endemic areas? Disponible uniquement en langue anglaise sur http://www.who.int/immuni- zation/policy/position_papers/je_grad_inactivated_effectiveness.pdf.\nVictor J et al. Corrigendum to “Comparison of the immunogenicity and safety of measles vac- cine administered alone or with live, attenuated Japanese encephalitis SA 14-14-2 vaccine in Philippine infants.” Vaccine, 2014;32(2): 306-308.\n75\nchildren who received different vaccine lots in another trial. 4 The seroprotection rate was 97.3% (95% CI: 93.1-99.2) for the live attenuated vaccine when used as a control in a randomized controlled trial of live re- combinant JE vaccine in children aged 9-18 months* and 99.1% (95% CI: 95.3-100) in children aged 12- 24 months.”*\nGood vaccine effectiveness was demonstrated in chil- dren vaccinated at 1-15 years of age in endemic set- tings, with 99.3% (95% CI: 94.9-100)”’ at 1 week-1 month and 98.5% (95% CI: 90.1-99.2)** at 1 year post-immuni- zation.\nLive recombinant vaccines: High seroprotection rates were reported from children from endemic countries and from adults from non-endemic countries one month after administration of a single dose of live recombinant vaccine. In the youngest age group (9- 18 months), the seroprotection rate was 99.3% (95% CI: 96.2-100.0).25 This was consistent with studies in chil- dren aged 12-24 months (100%, 95% CI: 96.9-100%)”* as well as those aged 12-18 months (95.0%, 95% CI: 93.3- 96.3).”? Among children aged 36-42 months, 89.7% (95% CI: 75.8-97.1) were seroprotected one month post-vac- cination.” Seroprotection rates were also very high in trials among adults aged 18-65 in non-endemic set- tings.’ *! There are currently no vaccine effectiveness data from use in endemic settings.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "39a0e65a9f0d01e383bf1dccaace6de6", - "text": "Immunogeénicité et efficience", - "metadata": { - "category_depth": 1, - "page_number": 7, - "parent_id": "", - "text_as_html": "Vaccins inactivés préparés sur des cellules Vero, Parmi les multiples études réalisées chez des adultes et des enfants/ adolescents dans des situations non endémiques, on a relevé des taux de séroprotection élevés pour un vaccin préparé sur cellules Vero un mois aprés l’achévement de la série primaire de 2 doses, qui allaient de 93% a 99%.' Chez les enfants de 1 a 2 ans vivant dans des zones d’endémie, la séroprotection était de 95,7% (intervalle de confiance (IC) 4 95%: 87,3-100) un mois aprés la seconde dose.'® Dans une étude plus vaste, menée aussi dans un contexte d’endémie, on a constaté que, parmi 396 enfants de 2 mois 4 18 ans ayant recu une dose adaptée a leur age, 299% bénéficiaient d’une séroprotection.”**! On ne dispose pas actuellement de données d’efficacité vaccinale dans le cas d’une utilisation dans une zone d’endémie.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 6, - "coordinates": [ - { - "x0": 293.76, - "y0": 368.96, - "x1": 552.16, - "y1": 528.06 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "3cc1a7783fd9aeb7fd7170c24c78133a", - "text": "Vaccins vivants atténués. Chez des nourrissons ayant recu une dose unique entre 8 et 12 mois, les taux de séroprotection 28 jours aprés la vaccination se situaient entre 90,6% (IC a 95%: 85,3-94,4) et 92,1% (IC a 95%: 84,3-96,7)” pour des enfants appartenant a différentes tranches d’age dans l’un des essais et entre 80,2% (IC a 95%: 74,0-85,2) et 86,3% (IC a 95%: 79,8-91,0)", - "metadata": { - "category_depth": 1, - "page_number": 7, - "parent_id": "39a0e65a9f0d01e383bf1dccaace6de6", - "text_as_html": "Vaccins vivants atténués. Chez des nourrissons ayant recu une dose unique entre 8 et 12 mois, les taux de séroprotection 28 jours aprés la vaccination se situaient entre 90,6% (IC a 95%: 85,3-94,4) et 92,1% (IC a 95%: 84,3-96,7)” pour des enfants appartenant a différentes tranches d’age dans l’un des essais et entre 80,2% (IC a 95%: 74,0-85,2) et 86,3% (IC a 95%: 79,8-91,0)
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 6, - "coordinates": [ - { - "x0": 293.65, - "y0": 535.43, - "x1": 552.35, - "y1": 602.63 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "43aef30e54ec2f49566c8f1e4f1ff98c", - "text": "\"® Hombach J et al. Report on a WHO consultation on immunological endpoints for evaluation of new Japanese encephalitis vaccines, WHO, Geneva, 2-3 September, 2004. Vac- cine,2005;23(45):5205-5211.", - "metadata": { - "category_depth": 1, - "page_number": 7, - "parent_id": "39a0e65a9f0d01e383bf1dccaace6de6", - "text_as_html": "75
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 6, - "coordinates": [ - { - "x0": 542.73, - "y0": 779.62, - "x1": 549.57, - "y1": 784.66 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "a7bde258bd51bbf93be3fc36204b12d2", - "text": "children who received different vaccine lots in another trial. 4 The seroprotection rate was 97.3% (95% CI: 93.1-99.2) for the live attenuated vaccine when used as a control in a randomized controlled trial of live re- combinant JE vaccine in children aged 9-18 months* and 99.1% (95% CI: 95.3-100) in children aged 12- 24 months.”*", - "metadata": { - "category_depth": 1, - "page_number": 8, - "parent_id": "39a0e65a9f0d01e383bf1dccaace6de6", - "text_as_html": "children who received different vaccine lots in another trial. 4 The seroprotection rate was 97.3% (95% CI: 93.1-99.2) for the live attenuated vaccine when used as a control in a randomized controlled trial of live re- combinant JE vaccine in children aged 9-18 months* and 99.1% (95% CI: 95.3-100) in children aged 12- 24 months.”*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 7, - "coordinates": [ - { - "x0": 44.82, - "y0": 56.05, - "x1": 273.73, - "y1": 133.25 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "b3614f51d7c241396ea03b5dbaba94f8", - "text": "Good vaccine effectiveness was demonstrated in chil- dren vaccinated at 1-15 years of age in endemic set- tings, with 99.3% (95% CI: 94.9-100)”’ at 1 week-1 month and 98.5% (95% CI: 90.1-99.2)** at 1 year post-immuni- zation.", - "metadata": { - "category_depth": 1, - "page_number": 8, - "parent_id": "39a0e65a9f0d01e383bf1dccaace6de6", - "text_as_html": "Good vaccine effectiveness was demonstrated in chil- dren vaccinated at 1-15 years of age in endemic set- tings, with 99.3% (95% CI: 94.9-100)”’ at 1 week-1 month and 98.5% (95% CI: 90.1-99.2)** at 1 year post-immuni- zation.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 7, - "coordinates": [ - { - "x0": 44.28, - "y0": 141.85, - "x1": 273.6, - "y1": 196.72 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "43bfcce14f39cfd2e7aff7e5fcbb05ba", - "text": "Live recombinant vaccines: High seroprotection rates were reported from children from endemic countries and from adults from non-endemic countries one month after administration of a single dose of live recombinant vaccine. In the youngest age group (9- 18 months), the seroprotection rate was 99.3% (95% CI: 96.2-100.0).25 This was consistent with studies in chil- dren aged 12-24 months (100%, 95% CI: 96.9-100%)”* as well as those aged 12-18 months (95.0%, 95% CI: 93.3- 96.3).”? Among children aged 36-42 months, 89.7% (95% CI: 75.8-97.1) were seroprotected one month post-vac- cination.” Seroprotection rates were also very high in trials among adults aged 18-65 in non-endemic set- tings.’ *! There are currently no vaccine effectiveness data from use in endemic settings.", - "metadata": { - "category_depth": 1, - "page_number": 8, - "parent_id": "39a0e65a9f0d01e383bf1dccaace6de6", - "text_as_html": "Live recombinant vaccines: High seroprotection rates were reported from children from endemic countries and from adults from non-endemic countries one month after administration of a single dose of live recombinant vaccine. In the youngest age group (9- 18 months), the seroprotection rate was 99.3% (95% CI: 96.2-100.0).25 This was consistent with studies in chil- dren aged 12-24 months (100%, 95% CI: 96.9-100%)”* as well as those aged 12-18 months (95.0%, 95% CI: 93.3- 96.3).”? Among children aged 36-42 months, 89.7% (95% CI: 75.8-97.1) were seroprotected one month post-vac- cination.” Seroprotection rates were also very high in trials among adults aged 18-65 in non-endemic set- tings.’ *! There are currently no vaccine effectiveness data from use in endemic settings.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 7, - "coordinates": [ - { - "x0": 45.27, - "y0": 205.26, - "x1": 272.81, - "y1": 375.39 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-31", - "text": "\n\n\nDuration of protection\nInactivated Vero cell-derived vaccines: Data from adults in non-endemic settings suggest a decline in seroprotection rates and geometric mean titres (GMTs) in the 24 months following primary immu- nization. A study in Germany and Northern Ireland indicated that the seroprotection rate dropped from\n2 Zaman K et al. Lot-to-lot consistency of live attenuated SA 14-14-2 Japanese ence- phalitis vaccine manufactured in a good manufacturing practice facility and non- inferiority with respect to an earlier product. Vaccine,2014;32(46):6061-6066.\nGrading of scientific evidence — table II: What is the effectiveness of live attenuated JE vaccine in preventing JE disease in vaccinees living in JE-endemic areas? Avai- lable at http://www.who.int/immunization/policy/position_papers/je_grad_live_at- tenuated_effectiveness.pdf.\nFeroldi E et al. Primary immunization of infants and toddlers in Thailand with Ja- panese encephalitis chimeric virus vaccine in comparison with SA14-14-2: a rando- mized study of immunogenicity and safety. Pediatr Infect Dis J,2014;33(6):643-649.\nKim DS et al. A randomized study of the immunogenicity and safety of Japanese encephalitis chimeric virus vaccine (JE-CV) in comparison with SA 14-14-2 vaccine in children in South Korea. 8th World Congress of the World Society for Pediatric Infectious Diseases (WSPID),2013, Cape Town, South Africa.\nBista MB et al. Efficacy of single-dose SA 14-14-2 vaccine against Japanese ence- phalitis: a case control study. Lancet,2001;358(9284):791-795.\nOhrr H et al. Effect of single dose of SA 14-14-2 vaccine 1 year after immunisation in Nepalese children with Japanese encephalitis: a case-control study. Lan- cet,2005;366(9494):1375-1378.\nFeroldi E et al. Single-dose, live-attenuated Japanese encephalitis vaccine in child- ren aged 12-18 months: randomized, controlled phase 3 immunogenicity and safety trial. Hum Vaccin Immunother,2012;8(7):929-937.\nFeroldi E et al. Memory immune response and safety of a booster dose of Japanese encephalitis chimeric virus vaccine (JE-CV) in JE-CV-primed children. Hum Vaccin Immunother.2013;9(4):889-897.\nGrading of scientific evidence — table II: What is the effectiveness of chimeric JE vaccine in preventing JE disease in vaccinees living in JE-endemic areas? Available at http://www.who.int/immunization/policy/position_papers/je_grad_chimeric_ effectiveness.pdf.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "805eb555b3e33022ac92036c197f9a9c", - "text": "Duration of protection", - "metadata": { - "category_depth": 1, - "page_number": 8, - "parent_id": "", - "text_as_html": "Inactivated Vero cell-derived vaccines: Data from adults in non-endemic settings suggest a decline in seroprotection rates and geometric mean titres (GMTs) in the 24 months following primary immu- nization. A study in Germany and Northern Ireland indicated that the seroprotection rate dropped from
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 7, - "coordinates": [ - { - "x0": 45.38, - "y0": 413.27, - "x1": 274.08, - "y1": 480.63 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "73374bfd17c2a125bfd83be9127734a5", - "text": "2 Zaman K et al. Lot-to-lot consistency of live attenuated SA 14-14-2 Japanese ence- phalitis vaccine manufactured in a good manufacturing practice facility and non- inferiority with respect to an earlier product. Vaccine,2014;32(46):6061-6066.", - "metadata": { - "category_depth": 1, - "page_number": 8, - "parent_id": "805eb555b3e33022ac92036c197f9a9c", - "text_as_html": "pour des enfants ayant recu des vaccins appartenant a différents lots dans un autre essai. Le taux de séroprotection était de 97,3% (IC a 95%: 93,1-99,2) pour le vaccin vivant atténué lorsque celui-ci était employé comme témoin dans un essai contrdélé randomisé du vaccin vivant recombinant contre l’EJ chez des enfants de 9 a 18 mois” et de 99,1% (IC a 95%: 95,3-100) chez des enfants de 12 4 24 mois.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 7, - "coordinates": [ - { - "x0": 294.01, - "y0": 56.16, - "x1": 551.88, - "y1": 133.93 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "554bf97ecfc17a4169c028b1849c8777", - "text": "Une bonne efficacité vaccinale a été mise en évidence chez des enfants vaccinés entre 1 et 15 ans et vivant dans des zones d’endémie, avec des taux de séroprotection de 99,3% (IC 4 95%: 94,9-100)”” au bout d’une période d’une semaine 4 un mois et de 98,5% (IC a 95%: 90,1-99,2)*8 1 an aprés la vaccination.", - "metadata": { - "category_depth": 1, - "page_number": 8, - "parent_id": "fc6c6a08caa4f3f2fc56707b8a443a9e", - "text_as_html": "Une bonne efficacité vaccinale a été mise en évidence chez des enfants vaccinés entre 1 et 15 ans et vivant dans des zones d’endémie, avec des taux de séroprotection de 99,3% (IC 4 95%: 94,9-100)”” au bout d’une période d’une semaine 4 un mois et de 98,5% (IC a 95%: 90,1-99,2)*8 1 an aprés la vaccination.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 7, - "coordinates": [ - { - "x0": 292.74, - "y0": 142.11, - "x1": 551.32, - "y1": 197.45 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "c79b1ced78d4b3526ff66a9fac7eab35", - "text": "Vaccins vivants recombinants. Des taux de séroprotection élevés ont été rapportés chez des enfants vivant dans des pays d’endé- mie et chez des adultes provenant de pays non endémiques un mois aprés l’administration d’une dose unique de vaccin vivant recombinant. Dans la tranche d’age inférieure (9-18 mois), le taux de séroprotection était de 99,3% (IC a 95%: 96,2-100,0).”> Cette observation était cohérente avec les résultats d’études obtenus chez des enfants de 12-24 mois (100%, IC 4 95%: 96,9- 100%)** et chez des enfants de 12-18 mois (95,0%, IC a 95%: 93,3-96,3).”° Parmi des enfants de 36 a 42 mois, 89,7% (IC a 95%: 75,8-97,1) bénéficiaient d’une séroprotection un mois aprés la vaccination.” Les taux de séroprotection étaient aussi trés élevés dans des essais menés chez des adultes de 18 4 65 ans, vivant dans des environnements exempts d’endémie.’*' On ne dispose actuellement pas de données d’efficacité vaccinale dans le cas dune utilisation dans une zone d’endémie.", - "metadata": { - "category_depth": 1, - "page_number": 8, - "parent_id": "fc6c6a08caa4f3f2fc56707b8a443a9e", - "text_as_html": "Vaccins vivants recombinants. Des taux de séroprotection élevés ont été rapportés chez des enfants vivant dans des pays d’endé- mie et chez des adultes provenant de pays non endémiques un mois aprés l’administration d’une dose unique de vaccin vivant recombinant. Dans la tranche d’age inférieure (9-18 mois), le taux de séroprotection était de 99,3% (IC a 95%: 96,2-100,0).”> Cette observation était cohérente avec les résultats d’études obtenus chez des enfants de 12-24 mois (100%, IC 4 95%: 96,9- 100%)** et chez des enfants de 12-18 mois (95,0%, IC a 95%: 93,3-96,3).”° Parmi des enfants de 36 a 42 mois, 89,7% (IC a 95%: 75,8-97,1) bénéficiaient d’une séroprotection un mois aprés la vaccination.” Les taux de séroprotection étaient aussi trés élevés dans des essais menés chez des adultes de 18 4 65 ans, vivant dans des environnements exempts d’endémie.’*' On ne dispose actuellement pas de données d’efficacité vaccinale dans le cas dune utilisation dans une zone d’endémie.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 7, - "coordinates": [ - { - "x0": 293.8, - "y0": 205.35, - "x1": 553.34, - "y1": 386.5 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-33", - "text": "\n\n\nDurée de la protection\nVaccins inactivés préparés sur des cellules Vero. Des données provenant d’adultes vivant dans des zones exemptes d’endémie laissent entrevoir une baisse des taux de séroprotection et des titres en moyenne géométrique dans les 24 mois suivant la primovaccination. Une étude menée en Allemagne et en Irlande du Nord indique une diminution du taux de séroprotection de\n2 Zaman K et al. Lot-to-lot consistency of live attenuated SA 14-14-2 Japanese encephalitis vac- cine manufactured in a good manufacturing practice facility and non-inferiority with respect to an earlier product. Vaccine,2014;32(46):6061-6066.\nCotation des preuves scientifiques — tableau II: What is the effectiveness of live attenuated JE vaccine in preventing JE disease in vaccinees living in JE-endemic areas? Disponible uniquement en langue anglaise sur http://www.who.int/immunization/policy/position_papers/je_grad_live_ attenuated_effectiveness.pdf.\nFeroldi E et al. Primary immunization of infants and toddlers in Thailand with Japanese ence- phalitis chimeric virus vaccine in comparison with SA14-14-2: a randomized study of immu- nogenicity and safety. Pediatr Infect Dis J,2014;33(6):643-649.\nKim DS et al. A randomized study of the immunogenicity and safety of Japanese encephalitis chimeric virus vaccine (JE-CV) in comparison with SA 14-14-2 vaccine in children in South Korea. 8th World Congress of the World Society for Pediatric Infectious Diseases (WSPID),2013, Cape Town, South Africa.\nBista MB et al. Efficacy of single-dose SA 14-14-2 vaccine against Japanese encephalitis:a case control study. Lancet,2001;358(9284):791-795.\nOhrr H et al. Effect of single dose of SA 14-14-2 vaccine 1 year after immunisation in Nepalese children with Japanese encephalitis: a case-control study. Lancet,2005;366(9494):1375-1378.\nFeroldi E et al. Single-dose, live-attenuated Japanese encephalitis vaccine in children aged 12-18 months: randomized, controlled phase 3 immunogenicity and safety trial. Hum Vaccin Immunother, 2012; 8(7):929-937.\nFeroldi E et al. Memory immune response and safety of a booster dose of Japanese encephalitis chimeric virus vaccine (JE-CV) in JE-CV-primed children. Hum Vaccin Immunother. 2013; 9(4):889-897.\nCotation des preuves scientifiques — tableau III: What is the effectiveness of chimeric JE vaccine in preventing JE disease in vaccinees living in JE-endemic areas? Disponible uniquement en langue anglaise sur http://www.who.intimmunization/policy/position_papers/je_grad_chime- ric_effectiveness.pdf.\n97.3% (95% CI: 94.4-100.0) to 48.3% (95% CI: 39.4- 57.3) over a 2-year period.®*\nOf 198 European adults, 69% were seroprotected 15 months after completion of a 2-dose primary series, prior to a booster dose; 100% were seroprotected one month and 98.5% 12 months after the booster. In a small study, adult participants not seroprotected at 6 or 12 months following the primary series were given a booster dose at month 11 or 23, respectively; 100% were seroprotected one month following the booster dose.*»* In a small study in paediatric western travellers, about 90% of participants (mean age 14 years) remained sero- protected by 7, 12 and 24 months following the primary series.*°\nThere are limited data on duration of protection in chil- dren and from endemic settings. In a study in Asia’ *” after the primary series, given to children aged 22 months to <17 years, the seroprotection rate after 3 years was 90%.\nLive attenuated vaccines: Long-term immunogenicity data are limited. A study measured immunogenicity of a single dose of live attenuated vaccine after a 3-year follow-up.’ *** A single dose in infants aged 8 months elicited a seroprotection rate of 90.4% (95% CI: 81.9- 95.8), 81.1% (95% CI: 71.5-88.6), and 79.3% (69-3-87.2) at 1,2, and 3 years post-vaccination, respectively. Among infants vaccinated at 10 months of age, corresponding seroprotection rates were 86.1% (95% CI: 80.6-90.6), 80.7% (95% CI: 74.6-85.9), and 81.9% (95% CI: 75.8- 87.0). This was consistent with 12-month immunogenic- ity results from Thai infants aged 9-18 months.” A convenience sample of 69 individuals vaccinated with a single dose at ages 1-15 years found seroprotection rates of 89.9% and 63.8% at 4 and 5 years after vaccina- tion, respectively.’” Following a mass vaccination cam-\n22 Schuller E et al. Comparison of a single, high-dose vaccination regimen to the stan- dard regimen for the investigational Japanese encephalitis vaccine, IC51: a rando- mized, observer-blind, controlled Phase 3 study. Vaccine, 2009;27(15):2188-2193.\nDubischar-Kastner K, et al. Long-term immunity and immune response to a booster dose following vaccination with the inactivated Japanese encephalitis vaccine IXIARO, IC51. Vaccine,2010;28(32):5197-5202.\nEder S et al. Long term immunity following a booster dose of the inactivated Japanese Encephalitis vaccine IXIARO®, IC51. Vaccine,2011;29(14):2607-2612.\nGrading of scientific evidence — table IV: Is there a need for a booster dose fol- lowing immunization with the primary series of inactivated Vero cell-derived JE vaccine in individuals living in JE-endemic areas? Available at http:/Awww.who.int/ immunization/policy/position_papers/je_grad_inactivated_booster.pdf\nDubischar-Kastner K et al. Long Term Immunity and Safety Following Vaccination with inactivated Japanese Encephalitis Vaccine in a Pediatric Population in Non endemic Countries. Submitted for presentation at the 14th Conference of the Inter- national Society of Travel Medicine, May 2015.\nDubischar-Kastner K et al. 24-Months Antibody Persistence in Children With and Without a Booster Dose of an Inactivated Japanese Encephalitis Vaccine, JE-VC, IC51. Presented at the Northern European Conference on Travel Medicine, 2014.\nPRNT5O using the non-homologous Beijing-1 strain in LLC-MK2 cells.\nDetermining Long-Term Safety and Efficacy of Japanese Encephalitis Vaccine When Given With Measles Vaccine. Available at https://clinicaltrials.gov/ct2/show/ NCT00412516?term=Nct00412516&rank=1, accessed February 2015.\nFeroldi E. Immunogenicity after one dose of IMOJEV in naive toddlers and children primed with MBDV. ACPID 2014.\nSohn YM et al. A 5-year follow-up of antibody response in children vaccinated with single dose of live attenuated SA14-14-2 Japanese encephalitis vaccine: immu- nogenicity and anamnestic responses. Vaccine,2008;26(13):1638-1643.\nGrading of scientific evidence — table V: Is there a need for a booster dose following immunization with one dose of live attenuated JE vaccine in individuals living in JE-endemic areas? Available at http://www.who.intimmunization/policy/position_ papers/je_grad_live_attenuated_booster.pdf.\nRELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,\n97 ,3% (IC A 95%: 94,4-100,0) a 48,3% (IC a 95%: 39,4-57,3) sur une période de 2 ans.*»*\nSur 198 adultes européens, 69% étaient séroprotégés 15 mois aprés Pachévement d’une série primaire de 2 doses avant une dose de rappel, 100% étaient séroprotégés un mois aprés la dose de rappel et 98,5% 12 mois aprés cette dose.*! Dans le cadre dune étude d’ampleur limitée, les participants adultes non protégés au bout de 6 ou 12 mois aprés la série primaire ont regu une dose de rappel au 11° ou au 23° mois respectivement; 100% se sont avérés séroprotégés un mois aprés cette dose de rappel.**> Dans une étude portant sur un petit nombre de voya- geurs occidentaux d’age pédiatrique, environ 90% des sujets (age moyen: 14 ans) sont restés séroprotégés jusqu’a 7, 12 et 24 mois aprés la série primaire de vaccinations.*\nOn dispose de données limitées sur la durée de la protection chez les enfants et dans les situations d’endémie. Dans le cadre dune étude réalisée en Asie,)*” aprés administration d’une série primaire a des enfants de 22 mois 4 <17 ans, on a relevé un taux de séroprotection de 90% au bout de 3 ans.\nVaccins vivants atténués. Les données sur limmunogénicité a long terme sont limitées. Une étude a mesuré immunogénicité dune dose unique de vaccin vivant atténué a issue d'une période de suivi de 3 ans.’*** Une dose unique administrée a des nourrissons de 8 mois a induit un taux de séroprotection de 90,4% (IC & 95%: 81,9-95,8), de 81,1% (IC a 95%: 71,5-88,6) et de 79,3% (69,3-87,2), respectivement 1, 2 et 3 ans aprés la vaccination. Chez des nourrissons vaccinés a 10 mois, les taux de séroprotec- tion correspondants étaient de 86,1% (IC a 95%: 80,6-90,6), de 80,7% (IC a 95%: 74,6-85,9) et de 81,9% (IC a 95%: 75,8-87,0). Cette observation était cohérente avec les résultats en termes d’immu- nogénicité au bout de 12 mois obtenus chez des nourrissons thais de 9 a 18 mois.“ Dans un échantillon de convenance constitué de 69 individus vaccinés avec une dose unique entre 1 et 15 ans, on a relevé des taux de séroprotection de 89,9% et de 63,8%, respectivement 4 et 5 ans aprés la vaccination.’ Suite a une\n2 Schuller E et al. Comparison of a single, high-dose vaccination regimen to the standard regimen for the investigational Japanese encephalitis vaccine, IC51: a randomized, observer-blind, controlled Phase 3 study. Vaccine, 2009; 27(15):2188-2193.\nDubischar-Kastner K et al. Long-term immunity and immune response to a booster dose fol- lowing vaccination with the inactivated Japanese encephalitis vaccine IXIARO, 1C51. Vaccine, 2010; 28(32):5197-5202.\nEder S, et al. Long term immunity following a booster dose of the inactivated Japanese Ence- phalitis vaccine IXIARO®, IC51. Vaccine, 2011; 29(14):2607-2612.\nCotation des preuves scientifiques — tableau IV: Is there a need for a booster dose following immunization with the primary series of inactivated Vero cell-derived JE vaccine in individuals living in JE-endemic areas? Disponible uniquement en langue anglaise sur http:/Awww.who.int/ immunization/policy/position_papers/je_grad_inactivated_booster.pdf.\nDubischar-Kastner K et al. Long Term Immunity and Safety Following Vaccination with inactiva- ted Japanese Encephalitis Vaccine in a Pediatric Population in Non endemic Countries. Submit- ted for presentation at the 14th Conference of the International Society of Travel Medicine, May 2015.\nDubischar-Kastner K et al. 24-Months Antibody Persistence in Children With and Without a Booster Dose of an Inactivated Japanese Encephalitis Vaccine, JE-VC, IC51. Presented at the Northern European Conference on Travel Medicine, 2014.\nPRNT5O using the non-homologous Beijing-1 strain in LLC-MK2 cells.\nDetermining Long-Term Safety and Efficacy of Japanese Encephalitis Vaccine When Given With Measles Vaccine. Disponible sur https://clinicaltrials.gov/ct2/show/NCT00412516?term=Nct004 12516&rank=1, consulté en février 2015.\nFeroldi E. Immunogenicity after one dose of IMOJEV in naive toddlers and children primed with MBDV. ACPID 2014.\nSohn YM et al. A 5-year follow-up of antibody response in children vaccinated with single dose of live attenuated $A14-14-2 Japanese encephalitis vaccine: immunogenicity and anamnestic responses. Vaccine, 2008;26(13):1638-1643.\nCotation des preuves scientifiques — tableau V: Is there a need for a booster dose following immunization with one dose of live attenuated JE vaccine in individuals living in JE-endemic areas? Disponible uniquement en langue anglaise sur http://www.who.int/immunization/policy/ position_papers/je_grad_live_attenuated_booster.pdf.\n77\npaign in children aged 1-15 years vaccine effectiveness was 96.2% (95% CI: 73.1-99.9) 5 years post-vaccination.*\nLive recombinant vaccine: Among children in endemic settings, long-term data are limited. One study followed participants vaccinated at 12-24 months of age for a period of 5 years. Seroprotection rates fell from 82.2% 1 year post-vaccination to 80.2%, 75.2%, 74.1%, and 65.6% at 2, 3, 4, and 5 years post-vaccination, respec- tively.” Long-term protection among military personnel aged 18-55 years from non-endemic areas was much higher with seroprotection rates of 99% (95% CI: 96- 100) 1 month after vaccination, followed by 95% (95% Cl: 87-99), 90% (95% CI: 81-96), and 93% (95% CI: 82- 99) at 1, 2, and 5 years post-vaccination respectively, though available data were limited at the 5-year time point (45% of the original study population).\nAfter a booster dose, vaccinees develop a rapid anam- nestic response, with GMTs quickly rising to levels much higher than after the first dose. In a study in 345 children aged 12-18 months in the Philippines, a booster dose was given 2 years after the first dose.*° The sero- protection rate was 80% immediately prior to the booster dose, and 96% at 7 days, 100% at 1 month, and 99% at 12 months after the booster dose. Among the 345 JE vaccine primed children, 68 who did not have seroprotective titres 2 years after the first dose were re-vaccinated. It was found that 82.4% (95% CI: 71.2- 90.5) were seroprotected 7 days after the booster com- pared with 15.4% (95% CI: 5.9-30.5) in a previously naive group receiving the live recombinant vaccine for primary immunization. The seroprotection rate in the boosted group was 100% at day 28 (95% CI: 94.7-100.0) and 89.7% (95% CI: 75.8-97.1) in the previously naive group. These data suggest that although some children did not have seroprotective antibody titres 2 years after 1 dose of live recombinant vaccine, they did have a strong anamnestic response following a second dose.*", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text": "Durée de la protection", - "metadata": { - "category_depth": 1, - "page_number": 8, - "parent_id": "", - "text_as_html": "Vaccins inactivés préparés sur des cellules Vero. Des données provenant d’adultes vivant dans des zones exemptes d’endémie laissent entrevoir une baisse des taux de séroprotection et des titres en moyenne géométrique dans les 24 mois suivant la primovaccination. Une étude menée en Allemagne et en Irlande du Nord indique une diminution du taux de séroprotection de
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 7, - "coordinates": [ - { - "x0": 294.34, - "y0": 412.85, - "x1": 551.14, - "y1": 480.58 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "1d7c18234b87ce3d190708d342b6d1eb", - "text": "2 Zaman K et al. Lot-to-lot consistency of live attenuated SA 14-14-2 Japanese encephalitis vac- cine manufactured in a good manufacturing practice facility and non-inferiority with respect to an earlier product. Vaccine,2014;32(46):6061-6066.", - "metadata": { - "category_depth": 1, - "page_number": 8, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "97.3% (95% CI: 94.4-100.0) to 48.3% (95% CI: 39.4- 57.3) over a 2-year period.®*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 8, - "coordinates": [ - { - "x0": 43.96, - "y0": 56.44, - "x1": 271.73, - "y1": 76.74 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "5921c2d098c6347a0be26a9e9e0bafc6", - "text": "Of 198 European adults, 69% were seroprotected 15 months after completion of a 2-dose primary series, prior to a booster dose; 100% were seroprotected one month and 98.5% 12 months after the booster. In a small study, adult participants not seroprotected at 6 or 12 months following the primary series were given a booster dose at month 11 or 23, respectively; 100% were seroprotected one month following the booster dose.*»* In a small study in paediatric western travellers, about 90% of participants (mean age 14 years) remained sero- protected by 7, 12 and 24 months following the primary series.*°", - "metadata": { - "category_depth": 1, - "page_number": 9, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "Of 198 European adults, 69% were seroprotected 15 months after completion of a 2-dose primary series, prior to a booster dose; 100% were seroprotected one month and 98.5% 12 months after the booster. In a small study, adult participants not seroprotected at 6 or 12 months following the primary series were given a booster dose at month 11 or 23, respectively; 100% were seroprotected one month following the booster dose.*»* In a small study in paediatric western travellers, about 90% of participants (mean age 14 years) remained sero- protected by 7, 12 and 24 months following the primary series.*°
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 8, - "coordinates": [ - { - "x0": 45.27, - "y0": 85.18, - "x1": 273.2, - "y1": 219.98 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "c1c2aa0f27ead4e38acc3cd0a3bddf05", - "text": "There are limited data on duration of protection in chil- dren and from endemic settings. In a study in Asia’ *” after the primary series, given to children aged 22 months to <17 years, the seroprotection rate after 3 years was 90%.", - "metadata": { - "category_depth": 1, - "page_number": 9, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "There are limited data on duration of protection in chil- dren and from endemic settings. In a study in Asia’ *” after the primary series, given to children aged 22 months to <17 years, the seroprotection rate after 3 years was 90%.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 8, - "coordinates": [ - { - "x0": 46.03, - "y0": 227.71, - "x1": 272.29, - "y1": 283.04 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "d2586f293e81debff62dd10fbb488ff1", - "text": "Live attenuated vaccines: Long-term immunogenicity data are limited. A study measured immunogenicity of a single dose of live attenuated vaccine after a 3-year follow-up.’ *** A single dose in infants aged 8 months elicited a seroprotection rate of 90.4% (95% CI: 81.9- 95.8), 81.1% (95% CI: 71.5-88.6), and 79.3% (69-3-87.2) at 1,2, and 3 years post-vaccination, respectively. Among infants vaccinated at 10 months of age, corresponding seroprotection rates were 86.1% (95% CI: 80.6-90.6), 80.7% (95% CI: 74.6-85.9), and 81.9% (95% CI: 75.8- 87.0). This was consistent with 12-month immunogenic- ity results from Thai infants aged 9-18 months.” A convenience sample of 69 individuals vaccinated with a single dose at ages 1-15 years found seroprotection rates of 89.9% and 63.8% at 4 and 5 years after vaccina- tion, respectively.’” Following a mass vaccination cam-", - "metadata": { - "category_depth": 1, - "page_number": 9, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "Live attenuated vaccines: Long-term immunogenicity data are limited. A study measured immunogenicity of a single dose of live attenuated vaccine after a 3-year follow-up.’ *** A single dose in infants aged 8 months elicited a seroprotection rate of 90.4% (95% CI: 81.9- 95.8), 81.1% (95% CI: 71.5-88.6), and 79.3% (69-3-87.2) at 1,2, and 3 years post-vaccination, respectively. Among infants vaccinated at 10 months of age, corresponding seroprotection rates were 86.1% (95% CI: 80.6-90.6), 80.7% (95% CI: 74.6-85.9), and 81.9% (95% CI: 75.8- 87.0). This was consistent with 12-month immunogenic- ity results from Thai infants aged 9-18 months.” A convenience sample of 69 individuals vaccinated with a single dose at ages 1-15 years found seroprotection rates of 89.9% and 63.8% at 4 and 5 years after vaccina- tion, respectively.’” Following a mass vaccination cam-
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 8, - "coordinates": [ - { - "x0": 45.28, - "y0": 291.94, - "x1": 272.69, - "y1": 472.69 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "74429144bc46f8a9094968ceb8700917", - "text": "22 Schuller E et al. Comparison of a single, high-dose vaccination regimen to the stan- dard regimen for the investigational Japanese encephalitis vaccine, IC51: a rando- mized, observer-blind, controlled Phase 3 study. Vaccine, 2009;27(15):2188-2193.", - "metadata": { - "category_depth": 1, - "page_number": 9, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 8, - "coordinates": [ - { - "x0": 44.95, - "y0": 778.41, - "x1": 224.51, - "y1": 786.26 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "878c5a788b7bd7ab092c46460d2c56f9", - "text": "97 ,3% (IC A 95%: 94,4-100,0) a 48,3% (IC a 95%: 39,4-57,3) sur une période de 2 ans.*»*", - "metadata": { - "category_depth": 1, - "page_number": 9, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "97 ,3% (IC A 95%: 94,4-100,0) a 48,3% (IC a 95%: 39,4-57,3) sur une période de 2 ans.*»*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 8, - "coordinates": [ - { - "x0": 291.09, - "y0": 55.85, - "x1": 550.2, - "y1": 76.16 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "30532e5880eb847b7c7b3e327b69e885", - "text": "Sur 198 adultes européens, 69% étaient séroprotégés 15 mois aprés Pachévement d’une série primaire de 2 doses avant une dose de rappel, 100% étaient séroprotégés un mois aprés la dose de rappel et 98,5% 12 mois aprés cette dose.*! Dans le cadre dune étude d’ampleur limitée, les participants adultes non protégés au bout de 6 ou 12 mois aprés la série primaire ont regu une dose de rappel au 11° ou au 23° mois respectivement; 100% se sont avérés séroprotégés un mois aprés cette dose de rappel.**> Dans une étude portant sur un petit nombre de voya- geurs occidentaux d’age pédiatrique, environ 90% des sujets (age moyen: 14 ans) sont restés séroprotégés jusqu’a 7, 12 et 24 mois aprés la série primaire de vaccinations.*", - "metadata": { - "category_depth": 1, - "page_number": 9, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "Sur 198 adultes européens, 69% étaient séroprotégés 15 mois aprés Pachévement d’une série primaire de 2 doses avant une dose de rappel, 100% étaient séroprotégés un mois aprés la dose de rappel et 98,5% 12 mois aprés cette dose.*! Dans le cadre dune étude d’ampleur limitée, les participants adultes non protégés au bout de 6 ou 12 mois aprés la série primaire ont regu une dose de rappel au 11° ou au 23° mois respectivement; 100% se sont avérés séroprotégés un mois aprés cette dose de rappel.**> Dans une étude portant sur un petit nombre de voya- geurs occidentaux d’age pédiatrique, environ 90% des sujets (age moyen: 14 ans) sont restés séroprotégés jusqu’a 7, 12 et 24 mois aprés la série primaire de vaccinations.*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 8, - "coordinates": [ - { - "x0": 292.95, - "y0": 84.55, - "x1": 553.39, - "y1": 220.88 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "fb1f3d8d5498426ad49a4e0c96e0dc07", - "text": "On dispose de données limitées sur la durée de la protection chez les enfants et dans les situations d’endémie. Dans le cadre dune étude réalisée en Asie,)*” aprés administration d’une série primaire a des enfants de 22 mois 4 <17 ans, on a relevé un taux de séroprotection de 90% au bout de 3 ans.", - "metadata": { - "category_depth": 1, - "page_number": 9, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "On dispose de données limitées sur la durée de la protection chez les enfants et dans les situations d’endémie. Dans le cadre dune étude réalisée en Asie,)*” aprés administration d’une série primaire a des enfants de 22 mois 4 <17 ans, on a relevé un taux de séroprotection de 90% au bout de 3 ans.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 8, - "coordinates": [ - { - "x0": 293.48, - "y0": 228.19, - "x1": 551.42, - "y1": 283.36 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "320dda2aab823a29b01ef218328849da", - "text": "Vaccins vivants atténués. Les données sur limmunogénicité a long terme sont limitées. Une étude a mesuré immunogénicité dune dose unique de vaccin vivant atténué a issue d'une période de suivi de 3 ans.’*** Une dose unique administrée a des nourrissons de 8 mois a induit un taux de séroprotection de 90,4% (IC & 95%: 81,9-95,8), de 81,1% (IC a 95%: 71,5-88,6) et de 79,3% (69,3-87,2), respectivement 1, 2 et 3 ans aprés la vaccination. Chez des nourrissons vaccinés a 10 mois, les taux de séroprotec- tion correspondants étaient de 86,1% (IC a 95%: 80,6-90,6), de 80,7% (IC a 95%: 74,6-85,9) et de 81,9% (IC a 95%: 75,8-87,0). Cette observation était cohérente avec les résultats en termes d’immu- nogénicité au bout de 12 mois obtenus chez des nourrissons thais de 9 a 18 mois.“ Dans un échantillon de convenance constitué de 69 individus vaccinés avec une dose unique entre 1 et 15 ans, on a relevé des taux de séroprotection de 89,9% et de 63,8%, respectivement 4 et 5 ans aprés la vaccination.’ Suite a une", - "metadata": { - "category_depth": 1, - "page_number": 9, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "Vaccins vivants atténués. Les données sur limmunogénicité a long terme sont limitées. Une étude a mesuré immunogénicité dune dose unique de vaccin vivant atténué a issue d'une période de suivi de 3 ans.’*** Une dose unique administrée a des nourrissons de 8 mois a induit un taux de séroprotection de 90,4% (IC & 95%: 81,9-95,8), de 81,1% (IC a 95%: 71,5-88,6) et de 79,3% (69,3-87,2), respectivement 1, 2 et 3 ans aprés la vaccination. Chez des nourrissons vaccinés a 10 mois, les taux de séroprotec- tion correspondants étaient de 86,1% (IC a 95%: 80,6-90,6), de 80,7% (IC a 95%: 74,6-85,9) et de 81,9% (IC a 95%: 75,8-87,0). Cette observation était cohérente avec les résultats en termes d’immu- nogénicité au bout de 12 mois obtenus chez des nourrissons thais de 9 a 18 mois.“ Dans un échantillon de convenance constitué de 69 individus vaccinés avec une dose unique entre 1 et 15 ans, on a relevé des taux de séroprotection de 89,9% et de 63,8%, respectivement 4 et 5 ans aprés la vaccination.’ Suite a une
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 8, - "coordinates": [ - { - "x0": 294.13, - "y0": 291.48, - "x1": 551.54, - "y1": 473.14 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "6a65f15b9a000f127bb36aafbab29da6", - "text": "2 Schuller E et al. Comparison of a single, high-dose vaccination regimen to the standard regimen for the investigational Japanese encephalitis vaccine, IC51: a randomized, observer-blind, controlled Phase 3 study. Vaccine, 2009; 27(15):2188-2193.", - "metadata": { - "category_depth": 1, - "page_number": 9, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "77
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 8, - "coordinates": [ - { - "x0": 542.73, - "y0": 779.62, - "x1": 549.57, - "y1": 784.66 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "a463e38d0caecaade82e7ea504410f4e", - "text": "paign in children aged 1-15 years vaccine effectiveness was 96.2% (95% CI: 73.1-99.9) 5 years post-vaccination.*", - "metadata": { - "category_depth": 1, - "page_number": 10, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "paign in children aged 1-15 years vaccine effectiveness was 96.2% (95% CI: 73.1-99.9) 5 years post-vaccination.*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 9, - "coordinates": [ - { - "x0": 43.62, - "y0": 56.17, - "x1": 270.81, - "y1": 76.84 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "e21c6570d84fe2facc1dccb93401e009", - "text": "Live recombinant vaccine: Among children in endemic settings, long-term data are limited. One study followed participants vaccinated at 12-24 months of age for a period of 5 years. Seroprotection rates fell from 82.2% 1 year post-vaccination to 80.2%, 75.2%, 74.1%, and 65.6% at 2, 3, 4, and 5 years post-vaccination, respec- tively.” Long-term protection among military personnel aged 18-55 years from non-endemic areas was much higher with seroprotection rates of 99% (95% CI: 96- 100) 1 month after vaccination, followed by 95% (95% Cl: 87-99), 90% (95% CI: 81-96), and 93% (95% CI: 82- 99) at 1, 2, and 5 years post-vaccination respectively, though available data were limited at the 5-year time point (45% of the original study population).", - "metadata": { - "category_depth": 1, - "page_number": 10, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "Live recombinant vaccine: Among children in endemic settings, long-term data are limited. One study followed participants vaccinated at 12-24 months of age for a period of 5 years. Seroprotection rates fell from 82.2% 1 year post-vaccination to 80.2%, 75.2%, 74.1%, and 65.6% at 2, 3, 4, and 5 years post-vaccination, respec- tively.” Long-term protection among military personnel aged 18-55 years from non-endemic areas was much higher with seroprotection rates of 99% (95% CI: 96- 100) 1 month after vaccination, followed by 95% (95% Cl: 87-99), 90% (95% CI: 81-96), and 93% (95% CI: 82- 99) at 1, 2, and 5 years post-vaccination respectively, though available data were limited at the 5-year time point (45% of the original study population).
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 9, - "coordinates": [ - { - "x0": 45.17, - "y0": 97.23, - "x1": 272.92, - "y1": 255.93 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "5029a23b66d8c1a27c0b6b82d876c033", - "text": "After a booster dose, vaccinees develop a rapid anam- nestic response, with GMTs quickly rising to levels much higher than after the first dose. In a study in 345 children aged 12-18 months in the Philippines, a booster dose was given 2 years after the first dose.*° The sero- protection rate was 80% immediately prior to the booster dose, and 96% at 7 days, 100% at 1 month, and 99% at 12 months after the booster dose. Among the 345 JE vaccine primed children, 68 who did not have seroprotective titres 2 years after the first dose were re-vaccinated. It was found that 82.4% (95% CI: 71.2- 90.5) were seroprotected 7 days after the booster com- pared with 15.4% (95% CI: 5.9-30.5) in a previously naive group receiving the live recombinant vaccine for primary immunization. The seroprotection rate in the boosted group was 100% at day 28 (95% CI: 94.7-100.0) and 89.7% (95% CI: 75.8-97.1) in the previously naive group. These data suggest that although some children did not have seroprotective antibody titres 2 years after 1 dose of live recombinant vaccine, they did have a strong anamnestic response following a second dose.*", - "metadata": { - "category_depth": 1, - "page_number": 10, - "parent_id": "fa90c8ebb3f97d04481ebc64303e00b7", - "text_as_html": "After a booster dose, vaccinees develop a rapid anam- nestic response, with GMTs quickly rising to levels much higher than after the first dose. In a study in 345 children aged 12-18 months in the Philippines, a booster dose was given 2 years after the first dose.*° The sero- protection rate was 80% immediately prior to the booster dose, and 96% at 7 days, 100% at 1 month, and 99% at 12 months after the booster dose. Among the 345 JE vaccine primed children, 68 who did not have seroprotective titres 2 years after the first dose were re-vaccinated. It was found that 82.4% (95% CI: 71.2- 90.5) were seroprotected 7 days after the booster com- pared with 15.4% (95% CI: 5.9-30.5) in a previously naive group receiving the live recombinant vaccine for primary immunization. The seroprotection rate in the boosted group was 100% at day 28 (95% CI: 94.7-100.0) and 89.7% (95% CI: 75.8-97.1) in the previously naive group. These data suggest that although some children did not have seroprotective antibody titres 2 years after 1 dose of live recombinant vaccine, they did have a strong anamnestic response following a second dose.*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 9, - "coordinates": [ - { - "x0": 45.06, - "y0": 262.76, - "x1": 272.76, - "y1": 501.91 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-34", - "text": "\n\n\nVaccine safety\nThe WHO Global Advisory Committee on Vaccine Safety (GACVS) has reviewed data on 2 inactivated Vero cell- derived vaccines, the live attenuated vaccine and the live recombinant vaccine. All reviewed vaccines were found to have acceptable safety profiles.“\n* Tandan JB et al. Single dose of SA 14-14-2 vaccine provides long-term protection against Japanese encephalitis: a case-control study in Nepalese children 5 years after immunization. Vaccine,2007;25(27):5041-5045.\n# Nasveld PE et al. Long term immunity to live attenuated Japanese encephalitis chimeric virus vaccine: randomized, double-blind, 5-year phase II study in healthy adults. Hum Vaccin,2010;6(12):1038-1046.\nGrading of scientific evidence — table VI: Is there a need for a booster dose following immunization with a single dose of live-recombinant JE vaccine in vaccinees living in JE-endemic areas? Available at http://www.who.int/immunization/policy/posi- tion_papers/je_grad_live_recombinant_booster.pdf.\n46 Japanese encephalitis (JE) vaccines. Available at http://www.who.int/vaccine_sa- fety/committee/topics/japanese_encephalitis/en/, accessed January 2015).", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "1cc456f7f797e612625f6bbadc0a43ed", - "text": "Vaccine safety", - "metadata": { - "category_depth": 1, - "page_number": 10, - "parent_id": "", - "text_as_html": "The WHO Global Advisory Committee on Vaccine Safety (GACVS) has reviewed data on 2 inactivated Vero cell- derived vaccines, the live attenuated vaccine and the live recombinant vaccine. All reviewed vaccines were found to have acceptable safety profiles.“
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 9, - "coordinates": [ - { - "x0": 44.51, - "y0": 552.15, - "x1": 272.53, - "y1": 606.59 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "7106d43e44577bee7b7fc94df2aeed90", - "text": "* Tandan JB et al. Single dose of SA 14-14-2 vaccine provides long-term protection against Japanese encephalitis: a case-control study in Nepalese children 5 years after immunization. Vaccine,2007;25(27):5041-5045.", - "metadata": { - "category_depth": 1, - "page_number": 10, - "parent_id": "1cc456f7f797e612625f6bbadc0a43ed", - "text_as_html": "campagne de vaccination de masse menée chez des enfants de 14 15 ans, lefficacité du vaccin était de 96,2% (IC a 95%: 73,1- 99,9) 5 ans aprés la vaccination.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 9, - "coordinates": [ - { - "x0": 296.36, - "y0": 55.9, - "x1": 553.67, - "y1": 88.37 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "8403791cea8335d710dc887ec637efa7", - "text": "Vaccin vivant recombinant. Concernant les enfants des zones dendémie, les données a long terme sont limitées. Une étude a suivi sur une période de 5 ans des sujets vaccinés a un age compris entre 12 et 24 mois. Les taux de séroprotection ont chuté de 82,2% un an aprés la vaccination a 80,2%, puis 4 75,2%, a 74,1% et a 65,6%, 2, 3, 4 et 5 ans aprés la vaccination, respec- tivement.” La protection a long terme observée chez des mili- taires de 18 a 55 ans vivant dans des zones non endémiques était bien plus importante, avec des taux de séroprotection de 99% (IC a 95%: 96 100) un mois aprés la vaccination, puis de 95% (IC a 95%: 87-99), de 90% (IC a 95%: 81 96) et de 93% (IC a 95%: 82-99) 1, 2 et 5 ans aprés la vaccination, respectivement; méme si les données sont peu abondantes pour le suivi a 5 ans (45% de la population de départ).“", - "metadata": { - "category_depth": 1, - "page_number": 10, - "parent_id": "3b7365307af5dbe7c703fc3617365e43", - "text_as_html": "Vaccin vivant recombinant. Concernant les enfants des zones dendémie, les données a long terme sont limitées. Une étude a suivi sur une période de 5 ans des sujets vaccinés a un age compris entre 12 et 24 mois. Les taux de séroprotection ont chuté de 82,2% un an aprés la vaccination a 80,2%, puis 4 75,2%, a 74,1% et a 65,6%, 2, 3, 4 et 5 ans aprés la vaccination, respec- tivement.” La protection a long terme observée chez des mili- taires de 18 a 55 ans vivant dans des zones non endémiques était bien plus importante, avec des taux de séroprotection de 99% (IC a 95%: 96 100) un mois aprés la vaccination, puis de 95% (IC a 95%: 87-99), de 90% (IC a 95%: 81 96) et de 93% (IC a 95%: 82-99) 1, 2 et 5 ans aprés la vaccination, respectivement; méme si les données sont peu abondantes pour le suivi a 5 ans (45% de la population de départ).“
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 9, - "coordinates": [ - { - "x0": 294.13, - "y0": 96.68, - "x1": 553.91, - "y1": 255.3 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "69eb9da1dedde639b68bb4edfbf1f56f", - "text": "Aprés une dose de rappel, les personnes vaccinées produisent une réponse anamnestique rapide, avec des titres en moyenne géométrique atteignant vite des niveaux bien plus élevés qu’aprés la premiére dose. Dans le cadre d’une étude portant sur 345 enfants de 12 a 18 ans aux Philippines, on a administré aux sujets une dose de rappel 2 ans aprés la premiére dose.” Le taux de séroprotection était de 80% immédiatement avant cette dose de rappel et de 96% au 7* jour, de 100% au bout d’un mois et de 99% au bout de 12 mois aprés la dose de rappel. Parmi les 345 enfants primovaccinés contre l’EJ, 68 qui ne présentaient pas un titre atteignant le seuil de séroprotection 2 ans aprés la premiére dose ont été revaccinés. On a constaté que 82,4% (IC a 95%: 71,2-90,5) des sujets étaient séroprotégés 7 jours aprés la dose de rappel, contre 15,4% (IC a 95%: 5,9-30,5) dans un groupe auparavant naif ayant regu le vaccin vivant recombinant en tant que primovaccination. Le taux de séropro- tection dans le groupe ayant bénéficié d’une dose de rappel était de 100% au jour 28 (IC a 95%: 94,7-100,0) et de 89,7% (IC a 95%: 75,8 97,1) dans le groupe auparavant naif. Ces données laissent 4 penser que, méme si certains enfants ne présentent pas un titre séroprotecteur 2 ans aprés une dose de vaccin vivant recombinant, ils manifestent une forte réponse anamnes- tique aprés une deuxiéme dose.", - "metadata": { - "category_depth": 1, - "page_number": 10, - "parent_id": "3b7365307af5dbe7c703fc3617365e43", - "text_as_html": "Aprés une dose de rappel, les personnes vaccinées produisent une réponse anamnestique rapide, avec des titres en moyenne géométrique atteignant vite des niveaux bien plus élevés qu’aprés la premiére dose. Dans le cadre d’une étude portant sur 345 enfants de 12 a 18 ans aux Philippines, on a administré aux sujets une dose de rappel 2 ans aprés la premiére dose.” Le taux de séroprotection était de 80% immédiatement avant cette dose de rappel et de 96% au 7* jour, de 100% au bout d’un mois et de 99% au bout de 12 mois aprés la dose de rappel. Parmi les 345 enfants primovaccinés contre l’EJ, 68 qui ne présentaient pas un titre atteignant le seuil de séroprotection 2 ans aprés la premiére dose ont été revaccinés. On a constaté que 82,4% (IC a 95%: 71,2-90,5) des sujets étaient séroprotégés 7 jours aprés la dose de rappel, contre 15,4% (IC a 95%: 5,9-30,5) dans un groupe auparavant naif ayant regu le vaccin vivant recombinant en tant que primovaccination. Le taux de séropro- tection dans le groupe ayant bénéficié d’une dose de rappel était de 100% au jour 28 (IC a 95%: 94,7-100,0) et de 89,7% (IC a 95%: 75,8 97,1) dans le groupe auparavant naif. Ces données laissent 4 penser que, méme si certains enfants ne présentent pas un titre séroprotecteur 2 ans aprés une dose de vaccin vivant recombinant, ils manifestent une forte réponse anamnes- tique aprés une deuxiéme dose.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 9, - "coordinates": [ - { - "x0": 293.81, - "y0": 262.82, - "x1": 553.05, - "y1": 523.46 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-36", - "text": "\n\n\nInnocuité du vaccin\nLe Comité consultatif mondial de la sécurité vaccinale (GACVS) a examiné les données concernant 2 vaccins inactivés préparés sur cellules Vero, le vaccin vivant atténué et le vaccin vivant recombinant. Pour tous les vaccins examinés, le profil d’inno- cuité a été trouvé acceptable.”\n® Tandan JB et al. Single dose of SA 14-14-2 vaccine provides long-term protection against Japanese encephalitis: a case-control study in Nepalese children 5 years after immunization. Vaccine,2007;25(27):5041-5045.\n“ Nasveld PE et al. Long term immunity to live attenuated Japanese encephalitis chimeric virus vaccine: randomized, double-blind, 5-year phase II study in healthy adults. Hum Vaccin, 2010; 6(12):1038-1046.\n* Cotation des preuves scientifiques — tableau VI: Is there a need for a booster dose following immunization with a single dose of live-recombinant JE vaccine in vaccinees living in JE-ende- mic areas? Disponible uniquement en langue anglaise sur http://www.who.int/immunization/ policy/position_papers/je_grad_live_recombinant_booster.pdf.\n“6 Vaccins anti-encéphalite japonaise (EJ). Disponible a l'adresse http://www.who.int/vaccine_sa- fety/committee/topics/japanese_encephalitis/fr/, consulté en janvier 2015.\nWEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015\nAmong adults in a pooled safety analysis of an inacti- vated Vero cell-derived vaccine (IXIARO®) there was comparable tolerability and reactogenicity with placebo (adjuvant alone) or inactivated mouse brain-derived JE vaccine, with the exception of local reactions which were more common in the mouse brain-derived JE vac- cine group. Severe local reactions occurred in 3.2% (in- activated Vero cell-derived vaccine), 3.1% (placebo) and 13.8% (mouse-brain derived vaccine).”” Solicited sys- temic adverse events occurred within a week after the first dose in a similar proportion of participants (33% inactivated Vero cell-derived vaccine, 29% mouse brain- derived vaccine, 31% placebo). The Adverse events fol- lowing immunization (AEFIs) most commonly reported in 4043 vaccinees were headache (19%), myalgia (13%), fatigue (10%), influenza-like illness (9%), and nausea (5%).\nThe safety profile observed in 1411 children aged between 2 months and 18 years was found comparable to control vaccines in the study (7-valent pneumococcal polysaccharide conjugate vaccine and inactivated hepa- titis A vaccine).' Post-marketing data for the first 12 months following market introduction in Europe, USA, and Australia did not identify any safety signals of concern (25 reports overall, AEFI rate 10.1/100000 doses distributed, consistent with reporting rates for other new vaccines). The most frequently reported AEFIs were rash, fever and headache. The reporting rate for serious AEFIs was 1.6 per 100000 doses distributed (4 serious AEFIs reported: neuritis, meningism, oropha- ryngeal spasm, and iritis). Hypersensitivity reactions were observed at a rate of 3.6 per 100000 doses com- pared to 8.4 per 100000 doses reported for the mouse brain-derived vaccine. ”\nData from multiple studies (including primary vaccina- tion, booster vaccination, and co-administration stud- ies) have shown an acceptable safety profile for the live attenuated vaccine.® Studies in a few hundred children in Thailand and the Republic of Korea examined the safety of the vaccine and found only mild local and systemic reactions. No serious AEFIs or deaths were reported in any study, except for 2 cases of pyrexia in children aged 12-23 months.****! In a large but non- blinded trial conducted in China with 26 239 partici-\nDubischar-Kastner K et al. Safety analysis of a Vero-cell culture derived Japanese encephalitis vaccine, IXIARO (IC51), in 6 months of follow-up. Vac- cine,2010;28(39):6463-6469.\nSchuller E et al. Safety profile of the Vero cell-derived Japanese encephalitis virus (JEV) vaccine IXIARO®. Vaccine,2011;29(47):8669-8676.\nGrading of scientific evidence — table VII: What is the risk of serious adverse events following vaccination with inactivated Vero cell JE vaccine? Available at — http:/Awww.who.int/immunization/policy/position_papers/je_grad_aefi_ inactivated.pdf.\nChokephaibulkit K et al. Safety and immunogenicity of a single administration of live-attenuated Japanese encephalitis vaccine in previously primed 2- to 5-year-olds and naive 12- to 24-month-olds: multicenter randomized controlled trial. Pediatr Infect Dis J,2010;29(12):1111-1117.\nGrading of scientific evidence — table VIII: What is the risk of serious adverse events following vaccination with the live attenuated JE vaccine? Available at http://www. who.int/immunization/policy/position_papers/je_grad_aefi_live_attenuated.pdf.\nRELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,\nChez les sujet adultes d’une analyse d’innocuité poolée concer- nant un vaccin inactivé préparé sur cellules Vero (IXIARO®), on a observé une tolérabilité et une réactogénicité comparables a celles obtenues avec un placebo (adjuvant administré seul) ou a celles du vaccin contre l’EJ inactivé préparé sur tissu céré- bral murin, a exception de réactions locales courantes dans le groupe ayant recu ce dernier vaccin. Des réactions locales sévéres se sont manifestées chez 3,2% (vaccin inactivé préparé sur cellules Vero), 3,1% (placebo) et 13,8% (vaccin préparé sur tissu cérébral murin) des sujets.7 Des manifestations indési- rables systémiques provoquées sont apparues dans la semaine suivant la premiére dose chez un pourcentage similaire de sujets (33% pour le vaccin inactivé préparé sur cellules Vero, 29% pour le vaccin préparé sur tissu cérébral murin et 31% pour le placebo). Les manifestations postvaccinales indésirables (MAPI) les plus courantes chez les 4043 sujets vaccinés étaient les céphalées (19%), les myalgies (13%), la fatigue (10%), les syndromes de type grippal (9%) et les nausées (5%).\nLe profil @innocuité observé chez 1411 enfants de 2 mois a 18 ans a été trouvé comparable a celui relevé pour des vaccins témoins (vaccin antipneumococcique polysaccharidique conju- gué heptavalent et vaccin inactivé contre lhépatite A).' Les données postcommercialisation pour les 12 premiers mois suivant la mise sur le marché en Europe, aux Etats-Unis d’Amé- rique et en Australie n’ont identifié aucun signal préoccupant mettant en cause l’innocuité du vaccin (25 notifications en tout, taux de MAPI: 10,1/100 000 doses distribuées, soit une valeur similaire aux taux de notification pour d’autres nouveaux vaccins). Les MAPI les plus fréquemment notifiées étaient des éruptions cutanées, de la fiévre et des céphalées. Le taux de notification de MAPI graves était de 1,6 pour 100000 doses distribuées (4 MAPI graves notifiées: névrite, méningisme, spasmes oropharyngés et iritis). On a observé un taux de réac- tions d@’hypersensibilité de 3,6 pour 100000 doses contre un taux de 8,4 pour 100000 doses rapporté pour le vaccin préparé sur tissu cérébral murin.*”\nLes données provenant de plusieurs études (portant notamment sur la primovaccination, la vaccination de rappel et la coadmi- nistration) ont montré que le vaccin vivant atténué avait un profil d’innocuité acceptable.* Des études menées chez quelques centaines d’enfants en Thailande et en République de Corée ont examiné linnocuité de ce vaccin et nont relevé que des réac- tions locales et systémiques bénignes. Aucune MAPI grave ou aucun décés n’a été signalé dans l’une quelconque de ces études, excepté 2 cas de pyrexie chez des enfants de 12-23 mois.*»***! Dans un essai de grande ampleur, mais non mené en double\n47 Dubischar-Kastner K et al. Safety analysis of a Vero-cell culture derived Japanese encephalitis vaccine, IXIARO (IC51), in 6 months of follow-up. Vaccine,2010;28(39):6463-6469.\nSchuller E et al. Safety profile of the Vero cell-derived Japanese encephalitis virus (JEV) vaccine IXIARO®. Vaccine,201 1;29(47):8669-8676.\nCotation des preuves scientifiques — tableau VII: What is the risk of serious adverse events fol- lowing vaccination with inactivated Vero cell JE vaccine? Disponible uniquement en langue anglaise sur http://www.who.int/immunization/policy/position_papers/je_grad_aefi_inactiva- ted.pdf.\nChokephaibulkit K et al. Safety and immunogenicity of a single administration of live-attenua- ted Japanese encephalitis vaccine in previously primed 2- to 5-year-olds and naive 12- to 24-month-olds: multicenter randomized controlled trial. Pediatr Infect Dis J,2010;29(12):1111- 1117.\nCotation des preuves scientifiques — tableau VII: What is the risk of serious adverse events fol- lowing vaccination with inactivated Vero cell JE vaccine? Disponible uniquement en langue anglaise sur http://www.who.int/immunization/policy/position_papers/je_grad_aefi_live_atte- nuated.pdf.\n79\npants (in which no placebo or control vaccine was given to participants in the control group), rates of adverse events were comparable in vaccinated and unvaccinated children.”\nDue to its extensive use for >20 years, a large amount of post-marketing surveillance data has been gathered for JE vaccines in China. Post-marketing surveillance carried out by the Chinese Centre for Drug Evaluation during 2009-2012 reported 6024 AEFIs of which 70 were considered severe. The severe events included febrile convulsions, thrombocytopenic purpura and encepha- litic/meningitic illness. Of the 9 encephalitis cases, one was considered vaccine-related while the others were classified as coincidental illnesses. There were 4 re- corded deaths, none of which were considered related to vaccination on expert review. The GACVS reviewed these data and noted that although there was no evi- dence of a safety signal, the number of events recorded in the AEFI reporting system was low given that >70 million doses of vaccine have been administered.*\nThe safety profile of the live recombinant vaccine was evaluated in various studies in children and adults in- cluding primary vaccination, booster vaccination, and co-administration studies. In children aged 12- 18 months receiving the live recombinant vaccine, the safety profile was comparable with that of other licensed vaccines (live attenuated JE, MMR, hepatitis A and var- icella zoster vaccine).'* 54\nAmong adults, a significantly lower frequency of local adverse reactions was reported for live recombinant vaccine than mouse brain-derived vaccine. Otherwise, there was comparable tolerability and reactogenicity, with the majority of adverse events being mild to mod- erate and resolving within a few days. Two serious AEFIs (high-grade pyrexia, acute viral illness) were re- ported within the first month of vaccination and none during the 6-month follow-up.*\nFor the live recombinant vaccine, a variety of non-clin- ical and clinical studies have been undertaken to estab- lish genetic stability, low risk of reversion to a neuro- tropic virus, low levels of viraemia in vaccinated sub- jects, lack of transmission by mosquitoes, and lack of replication in JEV animal hosts.* In adults viraemia was\n% Liu ZL. Short-term safety of live attenuated Japanese encephalitis vaccine (SA14- 14-2): results of a randomized trial with 26,239 subjects. J Infect Dis,1997;176(5):1366-1369.\n53 See No. 7, 2014, pp. 53-60.\n54 Grading of scientific evidence — table IX: What is the risk of serious adverse events following vaccination with the live-recombinant JE vaccine? Available at http:// www.who.int/immunization/policy/position_papers/je_grad_aefi_live_recombi- nant.pdf.\n55 Torresi J et al. Immunogenicity, safety and tolerability in adults of a new single-dose, live-attenuated vaccine against Japanese encephalitis: Randomised controlled phase 3 trials. Vaccine,2010;28(50):7993-8000.\n56 Guy B et al. Preclinical and clinical development of YFV 17D-based chimeric vac- cines against dengue, West Nile and Japanese encephalitis viruses. Vac- cine,2010;28(3):632-649.\naveugle, ayant pour cadre la Chine et impliquant 26239 parti- cipants (aucun placebo ou vaccin de comparaison métait admi- nistré aux participants dans le groupe témoin), les taux de manifestations indésirables relevés étaient comparables chez les enfants vaccinés et non vaccinés.”\nEn raison de lusage extensif du vaccin contre EJ en Chine depuis >20 ans, des données de surveillance postcommerciali- sation ont été collectées en grandes quantités. Cette surveillance exercée sur la période 2009-2012 par le Centre chinois pour Pévaluation des médicaments a donné lieu a la notification de 6024 MAPI, dont 70 considérées comme sévéres. Ces manifes- tations sévéres incluaient des convulsions fébriles, un purpura thrombopénique et des encéphalite/méningites. Sur les 9 cas dencéphalite, un a été considéré comme lié au vaccin, tandis que les autres étaient classés comme coincidents. Il a été enre- gistré 4 décés, dont aucun n’a été considéré comme associé a la vaccination d’aprés l’examen des experts. Le GACVS a étudié ces données et a noté que, malgré l’absence d’élément relevant un signal concernant l’innocuité du vaccin, le nombre de mani- festations enregistrées par le systéme de notification des MAPI était faible compte tenu des >70 millions de doses de vaccin administrées.*\nLe profil @innocuité du vaccin vivant recombinant a été évalué dans diverses études menées chez l’enfant et chez l’adulte, consacrées notamment a la primovaccination, a la vaccination de rappel et a la coadministration. Chez les enfants de 12 a 18 mois recevant ce vaccin recombinant, le profil d’innocuité sest révélé comparable a celui d’autres vaccins homologués (vaccin vivant atténué contre l’EJ, ROR, vaccins contre l’hépatite A et la varicelle).' °° *4\nChez les adultes, les réactions indésirables locales ont été noti- fiées avec une fréquence significativement plus basse pour le vaccin vivant recombinant que pour le vaccin préparé sur tissu cérébral murin. Par ailleurs, on a relevé une tolérabilité et une réactogénicité comparables, avec des manifestations indési- rables qui, dans leur majorité, se classaient comme bénignes a modeérées et se résolvaient en quelques jours. Deux MAPI graves (pyrexie de haut grade, maladie virale aigué) ont été notifiées au cours du premier mois suivant la vaccination, tandis qu’au- cune MAPI rrétait signalée pendant le suivi sur 6 mois.*\nDans le cas du vaccin vivant recombinant, diverses études cliniques et non cliniques ont été entreprises pour confirmer la stabilité génétique, le faible risque de retour du virus a état neurotrope, les bas niveaux de virémie chez les sujets vaccinés, Pabsence de transmission par les moustiques et absence de réplication chez des hétes animaux du VEJ.* Chez l’adulte, la\n2 Liu ZL. Short-term safety of live attenuated Japanese encephalitis vaccine (SA14-14-2): results of a randomized trial with 26,239 subjects. J Infect Dis,1997;176(5):1366—-1369.\n® Voir N° 7, 2014, pp. 53-60.\n54 Cotation des preuves scientifiques — tableau IX: What is the risk of serious adverse events fol- lowing vaccination with the live-recombinant JE vaccine? Disponible uniquement en langue anglaise sur http://www.who.int/immunization/policy/position_papers/je_grad_aefi_live_re- combinant.pdf.\n5 Torresi J et al. Immunogenicity, safety and tolerability in adults of a new single-dose, live-atte- nuated vaccine against Japanese encephalitis: Randomised controlled phase 3 trials. Vac- cine,2010;28(50):7993-8000.\n56 Guy B et al. Preclinical and clinical development of YFV 17D-based chimeric vaccines against dengue, West Nile and Japanese encephalitis viruses. Vaccine,201 0;28(3):632-649.\nWEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015\nof short duration and low titre.*’ In children, JE vaccine- naive children had low titre viraemia, while JE vaccine- primed children had no detectable viraemia.”", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "02c458eb87df2323b58aaebe1093ac01", - "text": "Innocuité du vaccin", - "metadata": { - "category_depth": 1, - "page_number": 10, - "parent_id": "", - "text_as_html": "Le Comité consultatif mondial de la sécurité vaccinale (GACVS) a examiné les données concernant 2 vaccins inactivés préparés sur cellules Vero, le vaccin vivant atténué et le vaccin vivant recombinant. Pour tous les vaccins examinés, le profil d’inno- cuité a été trouvé acceptable.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 9, - "coordinates": [ - { - "x0": 292.48, - "y0": 551.5, - "x1": 552.1, - "y1": 606.03 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "2d77350e2d9d0dce30e40102255e55b9", - "text": "® Tandan JB et al. Single dose of SA 14-14-2 vaccine provides long-term protection against Japanese encephalitis: a case-control study in Nepalese children 5 years after immunization. Vaccine,2007;25(27):5041-5045.", - "metadata": { - "category_depth": 1, - "page_number": 10, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "WEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 9, - "coordinates": [ - { - "x0": 383.92, - "y0": 779.26, - "x1": 550.33, - "y1": 786.26 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "b586520b886d6b1c663d5c4b59c5be52", - "text": "Among adults in a pooled safety analysis of an inacti- vated Vero cell-derived vaccine (IXIARO®) there was comparable tolerability and reactogenicity with placebo (adjuvant alone) or inactivated mouse brain-derived JE vaccine, with the exception of local reactions which were more common in the mouse brain-derived JE vac- cine group. Severe local reactions occurred in 3.2% (in- activated Vero cell-derived vaccine), 3.1% (placebo) and 13.8% (mouse-brain derived vaccine).”” Solicited sys- temic adverse events occurred within a week after the first dose in a similar proportion of participants (33% inactivated Vero cell-derived vaccine, 29% mouse brain- derived vaccine, 31% placebo). The Adverse events fol- lowing immunization (AEFIs) most commonly reported in 4043 vaccinees were headache (19%), myalgia (13%), fatigue (10%), influenza-like illness (9%), and nausea (5%).", - "metadata": { - "category_depth": 1, - "page_number": 11, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "Among adults in a pooled safety analysis of an inacti- vated Vero cell-derived vaccine (IXIARO®) there was comparable tolerability and reactogenicity with placebo (adjuvant alone) or inactivated mouse brain-derived JE vaccine, with the exception of local reactions which were more common in the mouse brain-derived JE vac- cine group. Severe local reactions occurred in 3.2% (in- activated Vero cell-derived vaccine), 3.1% (placebo) and 13.8% (mouse-brain derived vaccine).”” Solicited sys- temic adverse events occurred within a week after the first dose in a similar proportion of participants (33% inactivated Vero cell-derived vaccine, 29% mouse brain- derived vaccine, 31% placebo). The Adverse events fol- lowing immunization (AEFIs) most commonly reported in 4043 vaccinees were headache (19%), myalgia (13%), fatigue (10%), influenza-like illness (9%), and nausea (5%).
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 10, - "coordinates": [ - { - "x0": 44.65, - "y0": 57.54, - "x1": 272.38, - "y1": 249.31 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "b6d29803432c09be6b2f2322fcf00d7a", - "text": "The safety profile observed in 1411 children aged between 2 months and 18 years was found comparable to control vaccines in the study (7-valent pneumococcal polysaccharide conjugate vaccine and inactivated hepa- titis A vaccine).' Post-marketing data for the first 12 months following market introduction in Europe, USA, and Australia did not identify any safety signals of concern (25 reports overall, AEFI rate 10.1/100000 doses distributed, consistent with reporting rates for other new vaccines). The most frequently reported AEFIs were rash, fever and headache. The reporting rate for serious AEFIs was 1.6 per 100000 doses distributed (4 serious AEFIs reported: neuritis, meningism, oropha- ryngeal spasm, and iritis). Hypersensitivity reactions were observed at a rate of 3.6 per 100000 doses com- pared to 8.4 per 100000 doses reported for the mouse brain-derived vaccine. ”", - "metadata": { - "category_depth": 1, - "page_number": 11, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "The safety profile observed in 1411 children aged between 2 months and 18 years was found comparable to control vaccines in the study (7-valent pneumococcal polysaccharide conjugate vaccine and inactivated hepa- titis A vaccine).' Post-marketing data for the first 12 months following market introduction in Europe, USA, and Australia did not identify any safety signals of concern (25 reports overall, AEFI rate 10.1/100000 doses distributed, consistent with reporting rates for other new vaccines). The most frequently reported AEFIs were rash, fever and headache. The reporting rate for serious AEFIs was 1.6 per 100000 doses distributed (4 serious AEFIs reported: neuritis, meningism, oropha- ryngeal spasm, and iritis). Hypersensitivity reactions were observed at a rate of 3.6 per 100000 doses com- pared to 8.4 per 100000 doses reported for the mouse brain-derived vaccine. ”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 10, - "coordinates": [ - { - "x0": 44.73, - "y0": 269.29, - "x1": 272.55, - "y1": 461.39 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "b8728836e290de5f0281b95f3facae27", - "text": "Data from multiple studies (including primary vaccina- tion, booster vaccination, and co-administration stud- ies) have shown an acceptable safety profile for the live attenuated vaccine.® Studies in a few hundred children in Thailand and the Republic of Korea examined the safety of the vaccine and found only mild local and systemic reactions. No serious AEFIs or deaths were reported in any study, except for 2 cases of pyrexia in children aged 12-23 months.****! In a large but non- blinded trial conducted in China with 26 239 partici-", - "metadata": { - "category_depth": 1, - "page_number": 11, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "Data from multiple studies (including primary vaccina- tion, booster vaccination, and co-administration stud- ies) have shown an acceptable safety profile for the live attenuated vaccine.® Studies in a few hundred children in Thailand and the Republic of Korea examined the safety of the vaccine and found only mild local and systemic reactions. No serious AEFIs or deaths were reported in any study, except for 2 cases of pyrexia in children aged 12-23 months.****! In a large but non- blinded trial conducted in China with 26 239 partici-
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 10, - "coordinates": [ - { - "x0": 45.39, - "y0": 481.18, - "x1": 272.27, - "y1": 594.26 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "215a4222767a4b24033d8c28c79e68c9", - "text": "Dubischar-Kastner K et al. Safety analysis of a Vero-cell culture derived Japanese encephalitis vaccine, IXIARO (IC51), in 6 months of follow-up. Vac- cine,2010;28(39):6463-6469.", - "metadata": { - "category_depth": 1, - "page_number": 11, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 10, - "coordinates": [ - { - "x0": 44.82, - "y0": 778.84, - "x1": 224.13, - "y1": 786.09 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "c16bb38e3509844d853f5c9c31d544d6", - "text": "Chez les sujet adultes d’une analyse d’innocuité poolée concer- nant un vaccin inactivé préparé sur cellules Vero (IXIARO®), on a observé une tolérabilité et une réactogénicité comparables a celles obtenues avec un placebo (adjuvant administré seul) ou a celles du vaccin contre l’EJ inactivé préparé sur tissu céré- bral murin, a exception de réactions locales courantes dans le groupe ayant recu ce dernier vaccin. Des réactions locales sévéres se sont manifestées chez 3,2% (vaccin inactivé préparé sur cellules Vero), 3,1% (placebo) et 13,8% (vaccin préparé sur tissu cérébral murin) des sujets.7 Des manifestations indési- rables systémiques provoquées sont apparues dans la semaine suivant la premiére dose chez un pourcentage similaire de sujets (33% pour le vaccin inactivé préparé sur cellules Vero, 29% pour le vaccin préparé sur tissu cérébral murin et 31% pour le placebo). Les manifestations postvaccinales indésirables (MAPI) les plus courantes chez les 4043 sujets vaccinés étaient les céphalées (19%), les myalgies (13%), la fatigue (10%), les syndromes de type grippal (9%) et les nausées (5%).", - "metadata": { - "category_depth": 1, - "page_number": 11, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "Chez les sujet adultes d’une analyse d’innocuité poolée concer- nant un vaccin inactivé préparé sur cellules Vero (IXIARO®), on a observé une tolérabilité et une réactogénicité comparables a celles obtenues avec un placebo (adjuvant administré seul) ou a celles du vaccin contre l’EJ inactivé préparé sur tissu céré- bral murin, a exception de réactions locales courantes dans le groupe ayant recu ce dernier vaccin. Des réactions locales sévéres se sont manifestées chez 3,2% (vaccin inactivé préparé sur cellules Vero), 3,1% (placebo) et 13,8% (vaccin préparé sur tissu cérébral murin) des sujets.7 Des manifestations indési- rables systémiques provoquées sont apparues dans la semaine suivant la premiére dose chez un pourcentage similaire de sujets (33% pour le vaccin inactivé préparé sur cellules Vero, 29% pour le vaccin préparé sur tissu cérébral murin et 31% pour le placebo). Les manifestations postvaccinales indésirables (MAPI) les plus courantes chez les 4043 sujets vaccinés étaient les céphalées (19%), les myalgies (13%), la fatigue (10%), les syndromes de type grippal (9%) et les nausées (5%).
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 10, - "coordinates": [ - { - "x0": 292.6, - "y0": 57.2, - "x1": 552.69, - "y1": 261.85 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "944d62c229380b0d79ababaafdce6fc0", - "text": "Le profil @innocuité observé chez 1411 enfants de 2 mois a 18 ans a été trouvé comparable a celui relevé pour des vaccins témoins (vaccin antipneumococcique polysaccharidique conju- gué heptavalent et vaccin inactivé contre lhépatite A).' Les données postcommercialisation pour les 12 premiers mois suivant la mise sur le marché en Europe, aux Etats-Unis d’Amé- rique et en Australie n’ont identifié aucun signal préoccupant mettant en cause l’innocuité du vaccin (25 notifications en tout, taux de MAPI: 10,1/100 000 doses distribuées, soit une valeur similaire aux taux de notification pour d’autres nouveaux vaccins). Les MAPI les plus fréquemment notifiées étaient des éruptions cutanées, de la fiévre et des céphalées. Le taux de notification de MAPI graves était de 1,6 pour 100000 doses distribuées (4 MAPI graves notifiées: névrite, méningisme, spasmes oropharyngés et iritis). On a observé un taux de réac- tions d@’hypersensibilité de 3,6 pour 100000 doses contre un taux de 8,4 pour 100000 doses rapporté pour le vaccin préparé sur tissu cérébral murin.*”", - "metadata": { - "category_depth": 1, - "page_number": 11, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "Le profil @innocuité observé chez 1411 enfants de 2 mois a 18 ans a été trouvé comparable a celui relevé pour des vaccins témoins (vaccin antipneumococcique polysaccharidique conju- gué heptavalent et vaccin inactivé contre lhépatite A).' Les données postcommercialisation pour les 12 premiers mois suivant la mise sur le marché en Europe, aux Etats-Unis d’Amé- rique et en Australie n’ont identifié aucun signal préoccupant mettant en cause l’innocuité du vaccin (25 notifications en tout, taux de MAPI: 10,1/100 000 doses distribuées, soit une valeur similaire aux taux de notification pour d’autres nouveaux vaccins). Les MAPI les plus fréquemment notifiées étaient des éruptions cutanées, de la fiévre et des céphalées. Le taux de notification de MAPI graves était de 1,6 pour 100000 doses distribuées (4 MAPI graves notifiées: névrite, méningisme, spasmes oropharyngés et iritis). On a observé un taux de réac- tions d@’hypersensibilité de 3,6 pour 100000 doses contre un taux de 8,4 pour 100000 doses rapporté pour le vaccin préparé sur tissu cérébral murin.*”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 10, - "coordinates": [ - { - "x0": 292.62, - "y0": 268.68, - "x1": 553.91, - "y1": 472.53 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "d038e20b477ea65a24552a1904df5825", - "text": "Les données provenant de plusieurs études (portant notamment sur la primovaccination, la vaccination de rappel et la coadmi- nistration) ont montré que le vaccin vivant atténué avait un profil d’innocuité acceptable.* Des études menées chez quelques centaines d’enfants en Thailande et en République de Corée ont examiné linnocuité de ce vaccin et nont relevé que des réac- tions locales et systémiques bénignes. Aucune MAPI grave ou aucun décés n’a été signalé dans l’une quelconque de ces études, excepté 2 cas de pyrexie chez des enfants de 12-23 mois.*»***! Dans un essai de grande ampleur, mais non mené en double", - "metadata": { - "category_depth": 1, - "page_number": 11, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "Les données provenant de plusieurs études (portant notamment sur la primovaccination, la vaccination de rappel et la coadmi- nistration) ont montré que le vaccin vivant atténué avait un profil d’innocuité acceptable.* Des études menées chez quelques centaines d’enfants en Thailande et en République de Corée ont examiné linnocuité de ce vaccin et nont relevé que des réac- tions locales et systémiques bénignes. Aucune MAPI grave ou aucun décés n’a été signalé dans l’une quelconque de ces études, excepté 2 cas de pyrexie chez des enfants de 12-23 mois.*»***! Dans un essai de grande ampleur, mais non mené en double
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 10, - "coordinates": [ - { - "x0": 293.12, - "y0": 480.85, - "x1": 551.75, - "y1": 594.33 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "7d6862d3c4a8675aee34678cffe54589", - "text": "47 Dubischar-Kastner K et al. Safety analysis of a Vero-cell culture derived Japanese encephalitis vaccine, IXIARO (IC51), in 6 months of follow-up. Vaccine,2010;28(39):6463-6469.", - "metadata": { - "category_depth": 1, - "page_number": 11, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "79
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 10, - "coordinates": [ - { - "x0": 542.73, - "y0": 779.62, - "x1": 549.57, - "y1": 784.66 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "e8127875f25aedbbe2c935708a0653f1", - "text": "pants (in which no placebo or control vaccine was given to participants in the control group), rates of adverse events were comparable in vaccinated and unvaccinated children.”", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "pants (in which no placebo or control vaccine was given to participants in the control group), rates of adverse events were comparable in vaccinated and unvaccinated children.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 43.82, - "y0": 55.94, - "x1": 272.58, - "y1": 99.13 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "76a8cf62b8f4264389592299aef9b44b", - "text": "Due to its extensive use for >20 years, a large amount of post-marketing surveillance data has been gathered for JE vaccines in China. Post-marketing surveillance carried out by the Chinese Centre for Drug Evaluation during 2009-2012 reported 6024 AEFIs of which 70 were considered severe. The severe events included febrile convulsions, thrombocytopenic purpura and encepha- litic/meningitic illness. Of the 9 encephalitis cases, one was considered vaccine-related while the others were classified as coincidental illnesses. There were 4 re- corded deaths, none of which were considered related to vaccination on expert review. The GACVS reviewed these data and noted that although there was no evi- dence of a safety signal, the number of events recorded in the AEFI reporting system was low given that >70 million doses of vaccine have been administered.*", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "Due to its extensive use for >20 years, a large amount of post-marketing surveillance data has been gathered for JE vaccines in China. Post-marketing surveillance carried out by the Chinese Centre for Drug Evaluation during 2009-2012 reported 6024 AEFIs of which 70 were considered severe. The severe events included febrile convulsions, thrombocytopenic purpura and encepha- litic/meningitic illness. Of the 9 encephalitis cases, one was considered vaccine-related while the others were classified as coincidental illnesses. There were 4 re- corded deaths, none of which were considered related to vaccination on expert review. The GACVS reviewed these data and noted that although there was no evi- dence of a safety signal, the number of events recorded in the AEFI reporting system was low given that >70 million doses of vaccine have been administered.*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 44.77, - "y0": 119.29, - "x1": 271.72, - "y1": 301.36 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "4866fcbe3e761542737c02f4ac68dcb1", - "text": "The safety profile of the live recombinant vaccine was evaluated in various studies in children and adults in- cluding primary vaccination, booster vaccination, and co-administration studies. In children aged 12- 18 months receiving the live recombinant vaccine, the safety profile was comparable with that of other licensed vaccines (live attenuated JE, MMR, hepatitis A and var- icella zoster vaccine).'* 54", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "The safety profile of the live recombinant vaccine was evaluated in various studies in children and adults in- cluding primary vaccination, booster vaccination, and co-administration studies. In children aged 12- 18 months receiving the live recombinant vaccine, the safety profile was comparable with that of other licensed vaccines (live attenuated JE, MMR, hepatitis A and var- icella zoster vaccine).'* 54
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 44.62, - "y0": 319.81, - "x1": 273.21, - "y1": 409.49 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "50bb498505a6394550b0e3c1c68d416b", - "text": "Among adults, a significantly lower frequency of local adverse reactions was reported for live recombinant vaccine than mouse brain-derived vaccine. Otherwise, there was comparable tolerability and reactogenicity, with the majority of adverse events being mild to mod- erate and resolving within a few days. Two serious AEFIs (high-grade pyrexia, acute viral illness) were re- ported within the first month of vaccination and none during the 6-month follow-up.*", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "Among adults, a significantly lower frequency of local adverse reactions was reported for live recombinant vaccine than mouse brain-derived vaccine. Otherwise, there was comparable tolerability and reactogenicity, with the majority of adverse events being mild to mod- erate and resolving within a few days. Two serious AEFIs (high-grade pyrexia, acute viral illness) were re- ported within the first month of vaccination and none during the 6-month follow-up.*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 45.06, - "y0": 417.49, - "x1": 273.23, - "y1": 519.37 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "9b173ec5cda5c2b0085497fe36edd06f", - "text": "For the live recombinant vaccine, a variety of non-clin- ical and clinical studies have been undertaken to estab- lish genetic stability, low risk of reversion to a neuro- tropic virus, low levels of viraemia in vaccinated sub- jects, lack of transmission by mosquitoes, and lack of replication in JEV animal hosts.* In adults viraemia was", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "For the live recombinant vaccine, a variety of non-clin- ical and clinical studies have been undertaken to estab- lish genetic stability, low risk of reversion to a neuro- tropic virus, low levels of viraemia in vaccinated sub- jects, lack of transmission by mosquitoes, and lack of replication in JEV animal hosts.* In adults viraemia was
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 45.48, - "y0": 538.7, - "x1": 274.1, - "y1": 605.86 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "c00b01286c45619ee2aacb2d1e846b87", - "text": "% Liu ZL. Short-term safety of live attenuated Japanese encephalitis vaccine (SA14- 14-2): results of a randomized trial with 26,239 subjects. J Infect Dis,1997;176(5):1366-1369.", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "aveugle, ayant pour cadre la Chine et impliquant 26239 parti- cipants (aucun placebo ou vaccin de comparaison métait admi- nistré aux participants dans le groupe témoin), les taux de manifestations indésirables relevés étaient comparables chez les enfants vaccinés et non vaccinés.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 295.68, - "y0": 55.87, - "x1": 551.47, - "y1": 111.03 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "2b79b08250b05b0d8c360b9e4cfcb1d6", - "text": "En raison de lusage extensif du vaccin contre EJ en Chine depuis >20 ans, des données de surveillance postcommerciali- sation ont été collectées en grandes quantités. Cette surveillance exercée sur la période 2009-2012 par le Centre chinois pour Pévaluation des médicaments a donné lieu a la notification de 6024 MAPI, dont 70 considérées comme sévéres. Ces manifes- tations sévéres incluaient des convulsions fébriles, un purpura thrombopénique et des encéphalite/méningites. Sur les 9 cas dencéphalite, un a été considéré comme lié au vaccin, tandis que les autres étaient classés comme coincidents. Il a été enre- gistré 4 décés, dont aucun n’a été considéré comme associé a la vaccination d’aprés l’examen des experts. Le GACVS a étudié ces données et a noté que, malgré l’absence d’élément relevant un signal concernant l’innocuité du vaccin, le nombre de mani- festations enregistrées par le systéme de notification des MAPI était faible compte tenu des >70 millions de doses de vaccin administrées.*", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "En raison de lusage extensif du vaccin contre EJ en Chine depuis >20 ans, des données de surveillance postcommerciali- sation ont été collectées en grandes quantités. Cette surveillance exercée sur la période 2009-2012 par le Centre chinois pour Pévaluation des médicaments a donné lieu a la notification de 6024 MAPI, dont 70 considérées comme sévéres. Ces manifes- tations sévéres incluaient des convulsions fébriles, un purpura thrombopénique et des encéphalite/méningites. Sur les 9 cas dencéphalite, un a été considéré comme lié au vaccin, tandis que les autres étaient classés comme coincidents. Il a été enre- gistré 4 décés, dont aucun n’a été considéré comme associé a la vaccination d’aprés l’examen des experts. Le GACVS a étudié ces données et a noté que, malgré l’absence d’élément relevant un signal concernant l’innocuité du vaccin, le nombre de mani- festations enregistrées par le systéme de notification des MAPI était faible compte tenu des >70 millions de doses de vaccin administrées.*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 294.4, - "y0": 118.44, - "x1": 554.44, - "y1": 312.15 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "718a3e329224fec45845a648b9c5f604", - "text": "Le profil @innocuité du vaccin vivant recombinant a été évalué dans diverses études menées chez l’enfant et chez l’adulte, consacrées notamment a la primovaccination, a la vaccination de rappel et a la coadministration. Chez les enfants de 12 a 18 mois recevant ce vaccin recombinant, le profil d’innocuité sest révélé comparable a celui d’autres vaccins homologués (vaccin vivant atténué contre l’EJ, ROR, vaccins contre l’hépatite A et la varicelle).' °° *4", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "Le profil @innocuité du vaccin vivant recombinant a été évalué dans diverses études menées chez l’enfant et chez l’adulte, consacrées notamment a la primovaccination, a la vaccination de rappel et a la coadministration. Chez les enfants de 12 a 18 mois recevant ce vaccin recombinant, le profil d’innocuité sest révélé comparable a celui d’autres vaccins homologués (vaccin vivant atténué contre l’EJ, ROR, vaccins contre l’hépatite A et la varicelle).' °° *4
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 294.62, - "y0": 319.65, - "x1": 552.34, - "y1": 408.57 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "1bfbd6860a0e631ca52f496363ad4b2a", - "text": "Chez les adultes, les réactions indésirables locales ont été noti- fiées avec une fréquence significativement plus basse pour le vaccin vivant recombinant que pour le vaccin préparé sur tissu cérébral murin. Par ailleurs, on a relevé une tolérabilité et une réactogénicité comparables, avec des manifestations indési- rables qui, dans leur majorité, se classaient comme bénignes a modeérées et se résolvaient en quelques jours. Deux MAPI graves (pyrexie de haut grade, maladie virale aigué) ont été notifiées au cours du premier mois suivant la vaccination, tandis qu’au- cune MAPI rrétait signalée pendant le suivi sur 6 mois.*", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "Chez les adultes, les réactions indésirables locales ont été noti- fiées avec une fréquence significativement plus basse pour le vaccin vivant recombinant que pour le vaccin préparé sur tissu cérébral murin. Par ailleurs, on a relevé une tolérabilité et une réactogénicité comparables, avec des manifestations indési- rables qui, dans leur majorité, se classaient comme bénignes a modeérées et se résolvaient en quelques jours. Deux MAPI graves (pyrexie de haut grade, maladie virale aigué) ont été notifiées au cours du premier mois suivant la vaccination, tandis qu’au- cune MAPI rrétait signalée pendant le suivi sur 6 mois.*
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 293.93, - "y0": 417.53, - "x1": 553.2, - "y1": 530.87 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "58089b381c2e2193951804c3ad4d9646", - "text": "Dans le cas du vaccin vivant recombinant, diverses études cliniques et non cliniques ont été entreprises pour confirmer la stabilité génétique, le faible risque de retour du virus a état neurotrope, les bas niveaux de virémie chez les sujets vaccinés, Pabsence de transmission par les moustiques et absence de réplication chez des hétes animaux du VEJ.* Chez l’adulte, la", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "Dans le cas du vaccin vivant recombinant, diverses études cliniques et non cliniques ont été entreprises pour confirmer la stabilité génétique, le faible risque de retour du virus a état neurotrope, les bas niveaux de virémie chez les sujets vaccinés, Pabsence de transmission par les moustiques et absence de réplication chez des hétes animaux du VEJ.* Chez l’adulte, la
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 294.07, - "y0": 538.79, - "x1": 551.18, - "y1": 605.81 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "a6cc7d18fbb53c6c410b98d851b28a1b", - "text": "2 Liu ZL. Short-term safety of live attenuated Japanese encephalitis vaccine (SA14-14-2): results of a randomized trial with 26,239 subjects. J Infect Dis,1997;176(5):1366—-1369.", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "® Voir N° 7, 2014, pp. 53-60.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 291.46, - "y0": 676.67, - "x1": 373.02, - "y1": 684.24 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "c67fe5fd6cca4ad5846671038d03eeef", - "text": "54 Cotation des preuves scientifiques — tableau IX: What is the risk of serious adverse events fol- lowing vaccination with the live-recombinant JE vaccine? Disponible uniquement en langue anglaise sur http://www.who.int/immunization/policy/position_papers/je_grad_aefi_live_re- combinant.pdf.", - "metadata": { - "category_depth": 1, - "page_number": 12, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "WEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 11, - "coordinates": [ - { - "x0": 383.45, - "y0": 779.01, - "x1": 549.82, - "y1": 786.23 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "8700c0ec5f1ad546f942195f795f91c2", - "text": "of short duration and low titre.*’ In children, JE vaccine- naive children had low titre viraemia, while JE vaccine- primed children had no detectable viraemia.”", - "metadata": { - "category_depth": 1, - "page_number": 13, - "parent_id": "02c458eb87df2323b58aaebe1093ac01", - "text_as_html": "of short duration and low titre.*’ In children, JE vaccine- naive children had low titre viraemia, while JE vaccine- primed children had no detectable viraemia.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 12, - "coordinates": [ - { - "x0": 44.21, - "y0": 56.56, - "x1": 272.37, - "y1": 88.51 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-37", - "text": "\n\n\nCo-administration with other vaccines\nCo-administration of inactivated Vero cell-derived JE vaccine with hepatitis A vaccine, with quadrivalent me- ningococcal conjugate vaccine, and with inactivated rabies vaccine in healthy adults showed comparable seroconversion rates when vaccines were administered alone or concomitantly, and no safety concerns were identified.* * © The live attenuated vaccine co-admin- istered with measles vaccine at 9 months of age showed no significant differences between groups in immuno- genicity or safety concerns when the vaccines were given on the same day or separated by one month, with high seroprotection rates of 91.8% (95% CI 87.3-95.1) (measles) and 90.5% (95% CI 85.9-94.1)(JE).” No safety signals for co-administration with live attenuated vac- cine have been identified by post-marketing surveil- lance.\" For the live recombinant JE vaccine, a study with MMR co-administration in Taiwanese children (aged 12-18 months) demonstrated comparable immune re- sponses for all antigens at 6 weeks,” though JE sero- protection rate was slightly lower at one year (88.6% in co-administered group vs 96.6%-98.8% when adminis- tered before or after MMR). Co-administration did not adversely affect the safety or reactogenicity profile com- pared with separate vaccinations and no safety con- cerns were identified.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "65986c2a664711a3832c2e66ccf6e82b", - "text": "Co-administration with other vaccines", - "metadata": { - "category_depth": 1, - "page_number": 13, - "parent_id": "", - "text_as_html": "Co-administration of inactivated Vero cell-derived JE vaccine with hepatitis A vaccine, with quadrivalent me- ningococcal conjugate vaccine, and with inactivated rabies vaccine in healthy adults showed comparable seroconversion rates when vaccines were administered alone or concomitantly, and no safety concerns were identified.* * © The live attenuated vaccine co-admin- istered with measles vaccine at 9 months of age showed no significant differences between groups in immuno- genicity or safety concerns when the vaccines were given on the same day or separated by one month, with high seroprotection rates of 91.8% (95% CI 87.3-95.1) (measles) and 90.5% (95% CI 85.9-94.1)(JE).” No safety signals for co-administration with live attenuated vac- cine have been identified by post-marketing surveil- lance.\" For the live recombinant JE vaccine, a study with MMR co-administration in Taiwanese children (aged 12-18 months) demonstrated comparable immune re- sponses for all antigens at 6 weeks,” though JE sero- protection rate was slightly lower at one year (88.6% in co-administered group vs 96.6%-98.8% when adminis- tered before or after MMR). Co-administration did not adversely affect the safety or reactogenicity profile com- pared with separate vaccinations and no safety con- cerns were identified.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 12, - "coordinates": [ - { - "x0": 45.31, - "y0": 137.39, - "x1": 271.81, - "y1": 422.63 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-38", - "text": "\n\n\nVaccine interchangeability\nAs countries transition from the use of inactivated mouse brain-derived vaccine to the newer products, those vaccinated more than once could potentially re- ceive more than one product. Limited data exist on vac- cine interchangeability, based on few studies with small numbers of participants.! However, available data do not raise concerns for those previously vaccinated with mouse brain-derived vaccine subsequently receiving any of the 3 newer JE vaccines.\nMonath TP et al. Chimeric live, attenuated vaccine against Japanese encephalitis (ChimeriVax-JE): phase 2 clinical trials for safety and immunogenicity, effect of vac- cine dose and schedule, and memory response to challenge with inactivated Japanese encephalitis antigen. J Infect Dis, 2003;188(8):1213-1230.\nKaltenbéck A et al. Safety and immunogenicity of concomitant vaccination with the cell-culture based Japanese Encephalitis vaccine IC51 and the hepatitis A vaccine HAVRIX1440 in healthy subjects: A single-blind, randomized, controlled Phase 3 study. Vaccine, 2009;27(33):4483-4489.\nAlberer M et al. Co-administration of a meningococcal glycoconjugate ACWY vac- cine with travel vaccines: A randomized, open-label, multi-center study. Travel Med Infect Dis.2014.\nJelinek T et al. Immunogenicity and safety of an accelerated dosing regimen of Ja- panese Encephalitis inactivated absorbed vaccine for travelers: A phase III rando- mized study in healthy adults. Abstract P 2.9 presented at the 5th Northern European Conference on Travel Medicine,2014,Norway.\nLiuY et al. Safety of Japanese encephalitis live attenuated vaccination in post-marke- ting surveillance in Guangdong, China, 2005-2012. Vaccine,2014;32(15):1768-1773.\nHuang LM et al. Concomitant administration of live attenuated Japanese encepha- litis chimeric virus vaccine (JE-CV) and measles, mumps, rubella (MMR) vaccine: Randomized study in toddlers in Taiwan. Vaccine.2014;32(41):5363-5369.\nRELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,\nvirémie était présente sur une courte durée et a un faible titre. Pour ce qui concerne les enfants, ceux jusque-la naifs de vacci- nation contre lEJ présentaient une virémie de faible titre,” tandis que ceux déja primovaccinés contre cette maladie, ne manifestaient aucune virémie détectable.”", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "009a7a3ebed4a71784682fdbdbd10361", - "text": "Vaccine interchangeability", - "metadata": { - "category_depth": 1, - "page_number": 13, - "parent_id": "", - "text_as_html": "As countries transition from the use of inactivated mouse brain-derived vaccine to the newer products, those vaccinated more than once could potentially re- ceive more than one product. Limited data exist on vac- cine interchangeability, based on few studies with small numbers of participants.! However, available data do not raise concerns for those previously vaccinated with mouse brain-derived vaccine subsequently receiving any of the 3 newer JE vaccines.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 12, - "coordinates": [ - { - "x0": 45.35, - "y0": 472.79, - "x1": 272.95, - "y1": 573.82 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "92a07e213df71f4a40992ed197e615ea", - "text": "Monath TP et al. Chimeric live, attenuated vaccine against Japanese encephalitis (ChimeriVax-JE): phase 2 clinical trials for safety and immunogenicity, effect of vac- cine dose and schedule, and memory response to challenge with inactivated Japanese encephalitis antigen. J Infect Dis, 2003;188(8):1213-1230.", - "metadata": { - "category_depth": 1, - "page_number": 13, - "parent_id": "009a7a3ebed4a71784682fdbdbd10361", - "text_as_html": "RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 12, - "coordinates": [ - { - "x0": 44.11, - "y0": 778.89, - "x1": 225.78, - "y1": 786.15 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "dcb876ff3be93ed1635bdf9687e97818", - "text": "virémie était présente sur une courte durée et a un faible titre. Pour ce qui concerne les enfants, ceux jusque-la naifs de vacci- nation contre lEJ présentaient une virémie de faible titre,” tandis que ceux déja primovaccinés contre cette maladie, ne manifestaient aucune virémie détectable.”", - "metadata": { - "category_depth": 1, - "page_number": 13, - "parent_id": "009a7a3ebed4a71784682fdbdbd10361", - "text_as_html": "virémie était présente sur une courte durée et a un faible titre. Pour ce qui concerne les enfants, ceux jusque-la naifs de vacci- nation contre lEJ présentaient une virémie de faible titre,” tandis que ceux déja primovaccinés contre cette maladie, ne manifestaient aucune virémie détectable.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 12, - "coordinates": [ - { - "x0": 295.57, - "y0": 56.4, - "x1": 552.68, - "y1": 111.39 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-39", - "text": "\n\n\nCoadministration avec d’autres vaccins\nLa coadministration d’un vaccin contre l’EJ inactivé et préparé sur cellules Vero avec un vaccin contre l’hépatite A, un vaccin antiméningococcique conjugué quadrivalent ou un vaccin anti- rabique inactivé chez des adultes en bonne santé a mis en évidence des taux de séroconversion comparables lorsque les vaccins étaient administrés seuls ou de facon concomitante et ma révélé aucun probléme de sécurité. * La coadministra- tion du vaccin vivant atténué avec un vaccin antirougeoleux a Page de 9 mois ma pas fait apparaitre de différence significative entre les groupes sur le plan de ’immunogénicité ou de l’inno- cuité lorsque les vaccins étaient administrés le méme jour ou a intervalle d'un mois, avec des taux de séroprotection élevés atteignant 91,8% (IC a 95%: 87,3-95,1) (antirougeoleux) et 90,5% (IC a 95%: 85,9-94,1) (contre l’EJ).” Aucun signal mettant en cause linnocuité de la coadministration avec le vaccin vivant atténué n’a été repéré par la surveillance postcommercialisa- tion. Pour le vaccin vivant recombinant, une étude de sa coad- ministration avec le ROR a des enfants taiwanais (de 12 a 18 mois) a mis en évidence des réponses immunitaires compa- rables pour ensemble des antigénes au bout de 6 semaines,” méme si le taux de séroprotection contre l’EJ se révélait légé- rement plus bas a un an (88,6% dans le groupe avec coadmi- nistration contre 96,6%-98,8% dans le groupe bénéficiant d’une administration avant ou aprés le ROR). La coadministration n’a pas eu d’incidence négative sur les profils d’innocuité et de réactogénicité par comparaison avec des vaccinations séparées et aucun probléme de sécurité n’a été identifié.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "01fd043e56c4c61a2c340d8810852256", - "text": "Coadministration avec d’autres vaccins", - "metadata": { - "category_depth": 1, - "page_number": 13, - "parent_id": "", - "text_as_html": "La coadministration d’un vaccin contre l’EJ inactivé et préparé sur cellules Vero avec un vaccin contre l’hépatite A, un vaccin antiméningococcique conjugué quadrivalent ou un vaccin anti- rabique inactivé chez des adultes en bonne santé a mis en évidence des taux de séroconversion comparables lorsque les vaccins étaient administrés seuls ou de facon concomitante et ma révélé aucun probléme de sécurité. * La coadministra- tion du vaccin vivant atténué avec un vaccin antirougeoleux a Page de 9 mois ma pas fait apparaitre de différence significative entre les groupes sur le plan de ’immunogénicité ou de l’inno- cuité lorsque les vaccins étaient administrés le méme jour ou a intervalle d'un mois, avec des taux de séroprotection élevés atteignant 91,8% (IC a 95%: 87,3-95,1) (antirougeoleux) et 90,5% (IC a 95%: 85,9-94,1) (contre l’EJ).” Aucun signal mettant en cause linnocuité de la coadministration avec le vaccin vivant atténué n’a été repéré par la surveillance postcommercialisa- tion. Pour le vaccin vivant recombinant, une étude de sa coad- ministration avec le ROR a des enfants taiwanais (de 12 a 18 mois) a mis en évidence des réponses immunitaires compa- rables pour ensemble des antigénes au bout de 6 semaines,” méme si le taux de séroprotection contre l’EJ se révélait légé- rement plus bas a un an (88,6% dans le groupe avec coadmi- nistration contre 96,6%-98,8% dans le groupe bénéficiant d’une administration avant ou aprés le ROR). La coadministration n’a pas eu d’incidence négative sur les profils d’innocuité et de réactogénicité par comparaison avec des vaccinations séparées et aucun probléme de sécurité n’a été identifié.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 12, - "coordinates": [ - { - "x0": 293.2, - "y0": 135.09, - "x1": 553.19, - "y1": 444.08 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-40", - "text": "\n\n\nInterchangeabilité des vaccins\nAvec le passage dans les pays du vaccin inactivé préparé sur tissu cérébral murin a des produits plus récents, les personnes vacci- nées plus d’une fois pourraient recevoir différents produits. On dispose de données limitées sur l’interchangeabilité des vaccins, qui proviennent de quelques études portant sur un nombre réduit de sujets.! Néanmoins, les données disponibles n’inspirent pas de préoccupations pour les personnes vaccinées avec le vaccin préparé sur tissu cérébral murin et ayant recu par la suite Pun quelconque des 3 vaccins plus récents contre EJ.\nMonath TP et al. Chimeric live, attenuated vaccine against Japanese encephalitis (ChimeriVax- JE): phase 2 clinical trials for safety and immunogenicity, effect of vaccine dose and schedule, and memory response to challenge with inactivated Japanese encephalitis antigen. J Infect Dis, 2003;188(8):1213-1230.\nKaltenbick A et al. Safety and immunogenicity of concomitant vaccination with the cell-culture based Japanese Encephalitis vaccine IC51 and the hepatitis A vaccine HAVRIX1440 in healthy subjects: A single-blind, randomized, controlled Phase 3 study. Vaccine, 2009;27(33):4483- 4489.\nAlberer M et al. Co-administration of a meningococcal glycoconjugate ACWY vaccine with tra- vel vaccines: A randomized, open-label, multi-center study. Travel Med Infect Dis.2014.\n© Jelinek T et al. Immunogenicity and safety of an accelerated dosing regimen of Japanese Ence- phalitis inactivated absorbed vaccine for travelers: A phase III randomized study in healthy adults. Abstract P 2.9 presented at the 5th Northern European Conference on Travel Medicine,2014, Norway.\nLiu Y et al. Safety of Japanese encephalitis live attenuated vaccination in post-marketing sur- veillance in Guangdong, China, 2005-2012. Vaccine,2014;32(15):1768-1773.\nHuang LM et al. Concomitant administration of live attenuated Japanese encephalitis chimeric virus vaccine (JE-CV) and measles, mumps, rubella (MMR) vaccine: Randomized study in tod- dlers in Taiwan. Vaccine.2014;32(41):5363-5369.\n81\nA strong anamnestic response and no serious safety signals were found when mouse brain-derived JE vac- cine-primed individuals were given a booster with in- activated Vero cell-derived vaccine. A strong anam- nestic response was also seen when 2 or 3 doses of inactivated mouse brain-derived vaccine were followed by live attenuated vaccine, regardless of whether the recipient had detectable neutralizing antibodies prior to the booster dose.' No vaccine-related serious adverse events and no safety concerns were identified after ad- ministration of 2 doses of inactivated mouse brain- derived vaccine followed by live recombinant vaccine; 100% of recipients were seroprotected at 7 months and 97% at 4 years. *", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "0a68316ad44f30f3fa094a62a6f74f2f", - "text": "Interchangeabilité des vaccins", - "metadata": { - "category_depth": 1, - "page_number": 13, - "parent_id": "", - "text_as_html": "Avec le passage dans les pays du vaccin inactivé préparé sur tissu cérébral murin a des produits plus récents, les personnes vacci- nées plus d’une fois pourraient recevoir différents produits. On dispose de données limitées sur l’interchangeabilité des vaccins, qui proviennent de quelques études portant sur un nombre réduit de sujets.! Néanmoins, les données disponibles n’inspirent pas de préoccupations pour les personnes vaccinées avec le vaccin préparé sur tissu cérébral murin et ayant recu par la suite Pun quelconque des 3 vaccins plus récents contre EJ.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 12, - "coordinates": [ - { - "x0": 293.51, - "y0": 472.24, - "x1": 551.96, - "y1": 573.93 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "03a3efd3cbd4d434a3c8fb3d9a7a4973", - "text": "Monath TP et al. Chimeric live, attenuated vaccine against Japanese encephalitis (ChimeriVax- JE): phase 2 clinical trials for safety and immunogenicity, effect of vaccine dose and schedule, and memory response to challenge with inactivated Japanese encephalitis antigen. J Infect Dis, 2003;188(8):1213-1230.", - "metadata": { - "category_depth": 1, - "page_number": 13, - "parent_id": "0a68316ad44f30f3fa094a62a6f74f2f", - "text_as_html": "81
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 12, - "coordinates": [ - { - "x0": 542.73, - "y0": 779.62, - "x1": 548.85, - "y1": 784.66 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "f1370d41c2bfc4c5466a1efec61b62fb", - "text": "A strong anamnestic response and no serious safety signals were found when mouse brain-derived JE vac- cine-primed individuals were given a booster with in- activated Vero cell-derived vaccine. A strong anam- nestic response was also seen when 2 or 3 doses of inactivated mouse brain-derived vaccine were followed by live attenuated vaccine, regardless of whether the recipient had detectable neutralizing antibodies prior to the booster dose.' No vaccine-related serious adverse events and no safety concerns were identified after ad- ministration of 2 doses of inactivated mouse brain- derived vaccine followed by live recombinant vaccine; 100% of recipients were seroprotected at 7 months and 97% at 4 years. *", - "metadata": { - "category_depth": 1, - "page_number": 14, - "parent_id": "0a68316ad44f30f3fa094a62a6f74f2f", - "text_as_html": "A strong anamnestic response and no serious safety signals were found when mouse brain-derived JE vac- cine-primed individuals were given a booster with in- activated Vero cell-derived vaccine. A strong anam- nestic response was also seen when 2 or 3 doses of inactivated mouse brain-derived vaccine were followed by live attenuated vaccine, regardless of whether the recipient had detectable neutralizing antibodies prior to the booster dose.' No vaccine-related serious adverse events and no safety concerns were identified after ad- ministration of 2 doses of inactivated mouse brain- derived vaccine followed by live recombinant vaccine; 100% of recipients were seroprotected at 7 months and 97% at 4 years. *
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 13, - "coordinates": [ - { - "x0": 44.86, - "y0": 57.32, - "x1": 273.22, - "y1": 213.97 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-41", - "text": "\n\n\nSpecial risk groups\nLimited data are available regarding administration of inactivated, live attenuated or live recombinant JE vaccines to immunocompromised persons. In the one small study of HIV-infected children not receiving anti-retroviral therapy (ART), no safety concerns were identified after administering inactivated mouse brain-derived vaccine, but the seroprotection rate was approximately half the rate in HIV-uninfected chil- dren.® In the other studies in which participants were receiving ART, seroprotection was comparable to that seen in HIV-negative children; GMTs were lower, but within an acceptable range.” Adverse events were similar between HIV-infected and HIV non-infected participants. An earlier study from Japan in which 2 doses of mouse brain-derived vaccine were given to children with neoplastic diseases demonstrated similar responses among the 7 children with neoplas- tic diseases and the other 174 children who were healthy or had non-neoplastic diseases and no ad- verse events were reported.” A recent study was con- ducted in post haematopoietic stem cell transplant subjects given live attenuated vaccine 22 years post- transplant and 26 months post-immunosuppressant\nErra EO et al. A single dose of Vero cell-derived Japanese encephalitis (JE) vaccine (Ixiaro) effectively boosts immunity in travelers primed with mouse brain-derived JE vaccines. Clin Infect Dis,2012;55(6):825-834.\n© WoolpertT et al. Immunogenicity of one dose of Vero cell culture-derived Japanese encephalitis (JE) vaccine in adults previously vaccinated with mouse brain-derived JE vaccine. Vaccine,2012;30(20):3090-3096.\nFeroldi E et al. Long-term neutralizing antibody following a booster dose of JE-CV (IMOJEV®), a novel live attenuates Japanese encephalitis vaccine, in children pre- viously primed with a JE vaccine. 4th ASVAC, 2013.\nRojanasuphot S$ et al. Response to JE vaccine among HIV-infected children, Bang- kok, Thailand. Southeast Asian J Trop Med Public Health, 1998;29(3):443-450.\nPuthanakit T et al. Japanese encephalitis vaccination in HIV-infected children with immune recovery after highly active antiretroviral therapy. Vac- cine,2007;25(49):8257-8261.\nPuthanakitT et al . A 3-year follow-up of antibody response in HIV-infected children with immune recovery vaccinated with inactivated Japanese encephalitis vaccine. Vaccine,201 0;28(36):5900-5902.\nChokephaibulkit K et al. A comparative study of the serological response to Ja- panese encephalitis vaccine in HIV-infected and uninfected Thai children. Vac- Cine,2010;28(20):3563-3566.\nYamada A et al. Trial of inactivated Japanese encephalitis vaccine in children with underlying diseases. Vaccine, 1986;4(1):32-34.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "391fd74b88058831bdc15449ff6eb677", - "text": "Special risk groups", - "metadata": { - "category_depth": 1, - "page_number": 14, - "parent_id": "", - "text_as_html": "Limited data are available regarding administration of inactivated, live attenuated or live recombinant JE vaccines to immunocompromised persons. In the one small study of HIV-infected children not receiving anti-retroviral therapy (ART), no safety concerns were identified after administering inactivated mouse brain-derived vaccine, but the seroprotection rate was approximately half the rate in HIV-uninfected chil- dren.® In the other studies in which participants were receiving ART, seroprotection was comparable to that seen in HIV-negative children; GMTs were lower, but within an acceptable range.” Adverse events were similar between HIV-infected and HIV non-infected participants. An earlier study from Japan in which 2 doses of mouse brain-derived vaccine were given to children with neoplastic diseases demonstrated similar responses among the 7 children with neoplas- tic diseases and the other 174 children who were healthy or had non-neoplastic diseases and no ad- verse events were reported.” A recent study was con- ducted in post haematopoietic stem cell transplant subjects given live attenuated vaccine 22 years post- transplant and 26 months post-immunosuppressant
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 13, - "coordinates": [ - { - "x0": 44.63, - "y0": 265.2, - "x1": 272.81, - "y1": 525.41 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "e94c79ef3f7794326b834bd3032ae273", - "text": "Erra EO et al. A single dose of Vero cell-derived Japanese encephalitis (JE) vaccine (Ixiaro) effectively boosts immunity in travelers primed with mouse brain-derived JE vaccines. Clin Infect Dis,2012;55(6):825-834.", - "metadata": { - "category_depth": 1, - "page_number": 14, - "parent_id": "391fd74b88058831bdc15449ff6eb677", - "text_as_html": "On a constaté une réponse anamnestique forte et l’absence de signaux graves mettant en cause l’innocuité lors de l’adminis- tration a des individus primovaccinés avec le vaccin contre EJ préparé sur tissu cérébral murin d’une dose de rappel conte- nant un vaccin inactivé préparé sur des cellules Vero. On a également observé une forte réponse anamnestique lorsque 2 ou 3 doses de vaccin préparé sur tissu cérébral murin étaient suivies de l’administration du vaccin vivant atténué, que le bénéficiaire de la vaccination présente un titre d’anticorps détectable avant la dose de rappel ou non.’ Aucune manifesta- tion indésirable grave associée au vaccin et aucun probléme dinnocuité n’a été identifié aprés administration de 2 doses de vaccin inactivé préparé sur tissu cérébral murin, puis du vaccin vivant recombinant; 100% des personnes vaccinées béné- ficiaient d’une séroprotection 4 7 mois et 97% d’entre elles a 4 ans. 65
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 13, - "coordinates": [ - { - "x0": 294.3, - "y0": 57.0, - "x1": 552.24, - "y1": 236.9 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-43", - "text": "\n\n\nGroupes 4a risque spéciaux\nOn dispose de peu de données concernant l’administration des vaccins contre l’EJ vivants atténués ou vivants recombinants inactivés 4 des personnes immunodéprimées. Dans le cadre dune des études de faible ampleur, portant sur des enfants infectés par le VIH et ne recevant pas de traitement antirétro- viral (TAR), aucun probléme d’innocuité n’a été identifié aprés Padministration d’un vaccin inactivé préparé sur tissu cérébral murin, mais le taux de séroprotection était approximativement réduit de moitié par comparaison avec des enfants non infectés par le VIH.® Dans d’autres études, dont les sujets recevaient un TAR, la séroprotection observée était comparable a celle relevée chez des enfants négatifs pour le VIH et les moyennes géomé- triques des titres étaient plus basses, mais dans une plage acceptable.” “ ® Les manifestations indésirables observées étaient similaires entre les sujets infectés par le VIH et les sujets non infectés. Une étude antérieure menée au Japon, dans laquelle on avait administré 2 doses de vaccin préparé sur tissu cérébral murin a des enfants atteints de maladies néoplasiques, a mis en évidence des réponses similaires chez les 7 enfants souffrant d’une telle maladie et chez les 174 autres enfants en bonne santé ou exempts de maladie néoplasique. Aucune mani- festation indésirable n’a été signalée.” Une étude récente a été réalisée sur des sujets ayant subi une transplantation de cellules\nErra EO et al. A single dose of Vero cell-derived Japanese encephalitis (JE) vaccine (Ixiaro) effec- tively boosts immunity in travelers primed with mouse brain-derived JE vaccines. Clin Infect Dis,2012;55(6):825-834.\n© WoolpertT et al. Immunogenicity of one dose of Vero cell culture-derived Japanese encephalitis (VE) vaccine in adults previously vaccinated with mouse brain-derived JE vaccine. Vac- cine,2012;30(20):3090-3096.\nFeroldi et al. Long-term neutralizing antibody following a booster dose of JE-CV (IMOJEV®), a novel live attenuates Japanese encephalitis vaccine, in children previously primed with a JE vaccine. 4th ASVAC, 2013.\nRojanasuphot S et al. Response to JE vaccine among HIV-infected children, Bangkok, Thailand. Southeast Asian J Trop Med Public Health, 1998;29(3):443-450.\nPuthanakitT et al. Japanese encephalitis vaccination in HIV-infected children with immune reco- very after highly active antiretroviral therapy. Vaccine,2007;25(49):8257-8261.\nPuthanakit T et al . A 3-year follow-up of antibody response in HIV-infected children with im- mune recovery vaccinated with inactivated Japanese encephalitis vaccine. Vaccine,2010;28(36): 5900-5902.\n© Chokephaibulkit K et al. A comparative study of the serological response to Japanese encepha- litis vaccine in HIV-infected and uninfected Thai children. Vaccine,2010;28(20):3563-3566.\n7 Yamada A et al. Trial of inactivated Japanese encephalitis vaccine in children with underlying diseases. Vaccine, 1986; 4(1):32-34.\nadministration.”’ Among the 18 children not seropro- tected prior to JE vaccination, 9 had seroprotective titres after 1 dose (of which only 3 had sustained protection for 212 months), 7 had seroprotective ti- tres after 2 doses, and 2 did not respond.\nThere are no studies on inactivated Vero cell-derived vaccines, live attenuated vaccine, or live recombinant vaccine in pregnant women. No untoward findings were reported from 24 pregnant women inadvertently vac- cinated during clinical trials of the IXIARO inactivated SA14-14-2 Vero cell-derived vaccine.”", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "a56dcb154dc5a05f915edc969f05bd67", - "text": "Groupes 4a risque spéciaux", - "metadata": { - "category_depth": 1, - "page_number": 14, - "parent_id": "", - "text_as_html": "On dispose de peu de données concernant l’administration des vaccins contre l’EJ vivants atténués ou vivants recombinants inactivés 4 des personnes immunodéprimées. Dans le cadre dune des études de faible ampleur, portant sur des enfants infectés par le VIH et ne recevant pas de traitement antirétro- viral (TAR), aucun probléme d’innocuité n’a été identifié aprés Padministration d’un vaccin inactivé préparé sur tissu cérébral murin, mais le taux de séroprotection était approximativement réduit de moitié par comparaison avec des enfants non infectés par le VIH.® Dans d’autres études, dont les sujets recevaient un TAR, la séroprotection observée était comparable a celle relevée chez des enfants négatifs pour le VIH et les moyennes géomé- triques des titres étaient plus basses, mais dans une plage acceptable.” “ ® Les manifestations indésirables observées étaient similaires entre les sujets infectés par le VIH et les sujets non infectés. Une étude antérieure menée au Japon, dans laquelle on avait administré 2 doses de vaccin préparé sur tissu cérébral murin a des enfants atteints de maladies néoplasiques, a mis en évidence des réponses similaires chez les 7 enfants souffrant d’une telle maladie et chez les 174 autres enfants en bonne santé ou exempts de maladie néoplasique. Aucune mani- festation indésirable n’a été signalée.” Une étude récente a été réalisée sur des sujets ayant subi une transplantation de cellules
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 13, - "coordinates": [ - { - "x0": 293.6, - "y0": 265.2, - "x1": 552.5, - "y1": 525.74 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "ece5c2e5676fc2c6ad1871d178491e4e", - "text": "Erra EO et al. A single dose of Vero cell-derived Japanese encephalitis (JE) vaccine (Ixiaro) effec- tively boosts immunity in travelers primed with mouse brain-derived JE vaccines. Clin Infect Dis,2012;55(6):825-834.", - "metadata": { - "category_depth": 1, - "page_number": 14, - "parent_id": "a56dcb154dc5a05f915edc969f05bd67", - "text_as_html": "administration.”’ Among the 18 children not seropro- tected prior to JE vaccination, 9 had seroprotective titres after 1 dose (of which only 3 had sustained protection for 212 months), 7 had seroprotective ti- tres after 2 doses, and 2 did not respond.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 45.68, - "y0": 56.28, - "x1": 271.68, - "y1": 111.46 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "bea0ed92348a557e03f10b9618e5b3e7", - "text": "There are no studies on inactivated Vero cell-derived vaccines, live attenuated vaccine, or live recombinant vaccine in pregnant women. No untoward findings were reported from 24 pregnant women inadvertently vac- cinated during clinical trials of the IXIARO inactivated SA14-14-2 Vero cell-derived vaccine.”", - "metadata": { - "category_depth": 1, - "page_number": 15, - "parent_id": "a56dcb154dc5a05f915edc969f05bd67", - "text_as_html": "There are no studies on inactivated Vero cell-derived vaccines, live attenuated vaccine, or live recombinant vaccine in pregnant women. No untoward findings were reported from 24 pregnant women inadvertently vac- cinated during clinical trials of the IXIARO inactivated SA14-14-2 Vero cell-derived vaccine.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 45.5, - "y0": 152.96, - "x1": 273.29, - "y1": 221.08 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-44", - "text": "\n\n\nImpact of vaccination\nThere is little evidence to support a reduction in JE disease burden from interventions other than vaccina- tion of humans, such as vaccination of pigs, environ- mental management for vector control, and chemical control of vectors.” Mosquito nets may be important to reduce the risk of other vector-borne diseases, but only one study showed that they provided some protection against JE. Several other studies showed no reduction in the risk of JE.'\nData on the population impact of vaccination pro- grammes show significant reductions in JE cases.' When high coverage is achieved and sustained in populations at risk of disease, JE in humans can be greatly reduced while the virus remains in circulation. With humans being dead-end hosts, vaccination has no impact on the zoonotic transmission cycle, hence susceptible individ- uals will continue to be at risk of disease even when few cases are observed.\nThere is clear evidence of significant impact on JE dis- ease of population vaccination with live attenuated and inactivated mouse brain-derived JE vaccines; as yet no such data are available for the inactivated Vero cell- derived and live recombinant vaccines. In Nepal, mass vaccination campaigns were conducted between 2006 and 2009 among those aged 1-15 years in some districts and among all persons 21 year of age in other districts, with high coverage (94% of the target population) achieved.” Surveillance data from 2004-2009 showed the incidence of laboratory-confirmed JE following the campaigns was 1.3 per 100 000, i.e. 72% lower than the expected incidence of 4.6 per 100 000 when no cam- paigns had taken place. The greatest difference in inci-\nPakakasama S et al. Immunogenicity of a live-attenuated Japanese encephalitis vaccine in children and adolescents after hematopoietic stem cell transplantation. Bone Marrow Transplant, 2014;49(10):1307-1309.\nEMEA. European Public Assessment Summary Report, 2009. Available at http:// www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Summary_for_the_ public/human/001016/WC500036359.pdf, accessed February 2015.\nErlanger TE et al. Past, present, and future of Japanese encephalitis. Emerg Infect Dis,2009;15(1):1-7.\nUpreti SR et al. Estimation of the impact of a Japanese encephalitis immunization program with live, attenuated SA 14-14-2 vaccine in Nepal. Am J Trop Med Hyg,2013;88(3):464—468.\nRELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,\nsouches hématopoiétiques auxquels le vaccin vivant atténué a été administré 22 ans aprés cette transplantation et 26 mois aprés ladministration d’immunosuppresseurs.”’ Chez les 18 enfants non séroprotégés avant la vaccination contre !’EJ, 9 présentaient des titres séroprotecteurs aprés une dose (parmi lesquels 3 ont bénéficié d’une protection durable pendant 212 mois), 7 présentaient de tels titres aprés 2 doses et 2 n’ont pas répondu a la vaccination.\nIl nexiste aucune étude sur les vaccins inactivés préparés sur cellules Vero, le vaccin vivant atténué ou le vaccin vivant recom- binant chez la femme enceinte. Aucun résultat facheux n’a été rapporté chez les 24 femmes enceintes vaccinées par inadver- tance lors des essais cliniques du vaccin préparé sur cellules Vero a partir de la souche SA 14-14-2 inactivée, IXIARO.”", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "e9d4e0c23489de66f00a7c7bc71bc9c2", - "text": "Impact of vaccination", - "metadata": { - "category_depth": 1, - "page_number": 15, - "parent_id": "", - "text_as_html": "There is little evidence to support a reduction in JE disease burden from interventions other than vaccina- tion of humans, such as vaccination of pigs, environ- mental management for vector control, and chemical control of vectors.” Mosquito nets may be important to reduce the risk of other vector-borne diseases, but only one study showed that they provided some protection against JE. Several other studies showed no reduction in the risk of JE.'
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 44.92, - "y0": 246.7, - "x1": 273.3, - "y1": 347.75 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "423a1a7457f52c3cd890a46db2519398", - "text": "Data on the population impact of vaccination pro- grammes show significant reductions in JE cases.' When high coverage is achieved and sustained in populations at risk of disease, JE in humans can be greatly reduced while the virus remains in circulation. With humans being dead-end hosts, vaccination has no impact on the zoonotic transmission cycle, hence susceptible individ- uals will continue to be at risk of disease even when few cases are observed.", - "metadata": { - "category_depth": 1, - "page_number": 15, - "parent_id": "e9d4e0c23489de66f00a7c7bc71bc9c2", - "text_as_html": "Data on the population impact of vaccination pro- grammes show significant reductions in JE cases.' When high coverage is achieved and sustained in populations at risk of disease, JE in humans can be greatly reduced while the virus remains in circulation. With humans being dead-end hosts, vaccination has no impact on the zoonotic transmission cycle, hence susceptible individ- uals will continue to be at risk of disease even when few cases are observed.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 44.54, - "y0": 367.34, - "x1": 272.62, - "y1": 469.32 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "33796314a6c834db674cd55c26b06f9f", - "text": "There is clear evidence of significant impact on JE dis- ease of population vaccination with live attenuated and inactivated mouse brain-derived JE vaccines; as yet no such data are available for the inactivated Vero cell- derived and live recombinant vaccines. In Nepal, mass vaccination campaigns were conducted between 2006 and 2009 among those aged 1-15 years in some districts and among all persons 21 year of age in other districts, with high coverage (94% of the target population) achieved.” Surveillance data from 2004-2009 showed the incidence of laboratory-confirmed JE following the campaigns was 1.3 per 100 000, i.e. 72% lower than the expected incidence of 4.6 per 100 000 when no cam- paigns had taken place. The greatest difference in inci-", - "metadata": { - "category_depth": 1, - "page_number": 15, - "parent_id": "e9d4e0c23489de66f00a7c7bc71bc9c2", - "text_as_html": "There is clear evidence of significant impact on JE dis- ease of population vaccination with live attenuated and inactivated mouse brain-derived JE vaccines; as yet no such data are available for the inactivated Vero cell- derived and live recombinant vaccines. In Nepal, mass vaccination campaigns were conducted between 2006 and 2009 among those aged 1-15 years in some districts and among all persons 21 year of age in other districts, with high coverage (94% of the target population) achieved.” Surveillance data from 2004-2009 showed the incidence of laboratory-confirmed JE following the campaigns was 1.3 per 100 000, i.e. 72% lower than the expected incidence of 4.6 per 100 000 when no cam- paigns had taken place. The greatest difference in inci-
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 44.71, - "y0": 488.32, - "x1": 272.35, - "y1": 648.2 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "6fb57fa531bea1430ac8cb1526638318", - "text": "Pakakasama S et al. Immunogenicity of a live-attenuated Japanese encephalitis vaccine in children and adolescents after hematopoietic stem cell transplantation. Bone Marrow Transplant, 2014;49(10):1307-1309.", - "metadata": { - "category_depth": 1, - "page_number": 15, - "parent_id": "e9d4e0c23489de66f00a7c7bc71bc9c2", - "text_as_html": "souches hématopoiétiques auxquels le vaccin vivant atténué a été administré 22 ans aprés cette transplantation et 26 mois aprés ladministration d’immunosuppresseurs.”’ Chez les 18 enfants non séroprotégés avant la vaccination contre !’EJ, 9 présentaient des titres séroprotecteurs aprés une dose (parmi lesquels 3 ont bénéficié d’une protection durable pendant 212 mois), 7 présentaient de tels titres aprés 2 doses et 2 n’ont pas répondu a la vaccination.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 294.0, - "y0": 55.91, - "x1": 552.23, - "y1": 146.05 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "4423c56a26dbf2fe674a9888947371fd", - "text": "Il nexiste aucune étude sur les vaccins inactivés préparés sur cellules Vero, le vaccin vivant atténué ou le vaccin vivant recom- binant chez la femme enceinte. Aucun résultat facheux n’a été rapporté chez les 24 femmes enceintes vaccinées par inadver- tance lors des essais cliniques du vaccin préparé sur cellules Vero a partir de la souche SA 14-14-2 inactivée, IXIARO.”", - "metadata": { - "category_depth": 1, - "page_number": 15, - "parent_id": "e9d4e0c23489de66f00a7c7bc71bc9c2", - "text_as_html": "Il nexiste aucune étude sur les vaccins inactivés préparés sur cellules Vero, le vaccin vivant atténué ou le vaccin vivant recom- binant chez la femme enceinte. Aucun résultat facheux n’a été rapporté chez les 24 femmes enceintes vaccinées par inadver- tance lors des essais cliniques du vaccin préparé sur cellules Vero a partir de la souche SA 14-14-2 inactivée, IXIARO.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 294.8, - "y0": 153.36, - "x1": 551.35, - "y1": 220.98 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-45", - "text": "\n\n\nImpact de la vaccination\nIl existe peu d’éléments attestant d'une réduction de la charge de morbidité liée 4 ?EJ par des interventions autres que la vaccination des étres humains, comme par exemple la vaccina- tion des porcs, la gestion de l’environnement en faveur de la lutte antivectorielle et la lutte chimique contre les vecteurs.” Lutilisation de moustiquaires peut étre importante pour réduire le risque d’autres maladies 4 transmission vectorielle, mais une seule étude a montré qu'elle fournissait une certaine protection contre l’EJ. Plusieurs autres études n’ont mis en évidence aucune réduction du risque d’EJ.'\nLes données sur l’impact sur la population des programmes de vaccination font apparaitre des diminutions significatives des cas d’EJ.' Lorsqu’on obtient durablement une forte couverture parmi des populations a risque pour cette maladie, il est possible de réduire de fagon importante le nombre de cas humains d’E] pendant que le virus reste en circulation. Les humains étant des hétes culs-de-sac, la vaccination n’a pas d’incidence sur le cycle de transmission zoonotique et les individus susceptibles conti- nueront d’étre exposés au risque de maladie, méme si le nombre de cas observés est faible.\nIl existe des preuves claires d’un impact important sur l’EJ maladie de la vaccination des populations avec le vaccin vivant atténué ou le vaccin inactivé préparé sur tissu cérébral murin, en revanche on ne dispose pas encore de telles données pour le vaccin inactivé préparé sur cellules Vero et le vaccin vivant recombinant. Des campagnes de vaccination de masse ont été menées au Népal entre 2006 et 2009 chez les habitants de 1 a 15 ans de certains districts et l'ensemble des habitants 21 an d’autres districts, en obtenant une forte couverture (94% de la population cible).” Les données de surveillance pour la période 2004-2009 ont montré que l’incidence de l’EJ confirmée en labo- ratoire aprés les campagnes était de 1,3 pour 100000, c’est-a-dire 72% de moins que lincidence attendue de 4,6 pour 100000 lorsquaucune campagne rest intervenue. Les plus fortes varia-\nPakakasama S et al. Immunogenicity of a live-attenuated Japanese encephalitis vaccine in child- ren and adolescents after hematopoietic stem cell transplantation. Bone Marrow Transplant, 2014; 49(10):1307-1309.\nEMEA. European Public Assessment Summary Report, 2009. Disponible sur http://www.ema. europa.eu/docs/en_GB/document_library/EPAR_-_Summary_for_the_public/human/001016/ WC500036359.pdf, consulté en février 2015.\nErlanger TE et al. Past, present, and future of Japanese encephalitis. Emerg Infect Dis, 2009; 15(1):1-7.\nUpreti SR et al. Estimation of the impact of a Japanese encephalitis immunization program with live, attenuated SA 14-14-2 vaccine in Nepal. Am J Trop Med Hyg,2013;88(3):464—468.\n83\ndence was seen in the high-risk districts and where vaccination targeted the entire population 21 years of age.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "2b95bca19a0376da748ec09cc59d99e0", - "text": "Impact de la vaccination", - "metadata": { - "category_depth": 1, - "page_number": 15, - "parent_id": "", - "text_as_html": "Il existe peu d’éléments attestant d'une réduction de la charge de morbidité liée 4 ?EJ par des interventions autres que la vaccination des étres humains, comme par exemple la vaccina- tion des porcs, la gestion de l’environnement en faveur de la lutte antivectorielle et la lutte chimique contre les vecteurs.” Lutilisation de moustiquaires peut étre importante pour réduire le risque d’autres maladies 4 transmission vectorielle, mais une seule étude a montré qu'elle fournissait une certaine protection contre l’EJ. Plusieurs autres études n’ont mis en évidence aucune réduction du risque d’EJ.'
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 293.43, - "y0": 246.54, - "x1": 553.72, - "y1": 359.53 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "fa7df60d81e4111f40f2832476ad1387", - "text": "Les données sur l’impact sur la population des programmes de vaccination font apparaitre des diminutions significatives des cas d’EJ.' Lorsqu’on obtient durablement une forte couverture parmi des populations a risque pour cette maladie, il est possible de réduire de fagon importante le nombre de cas humains d’E] pendant que le virus reste en circulation. Les humains étant des hétes culs-de-sac, la vaccination n’a pas d’incidence sur le cycle de transmission zoonotique et les individus susceptibles conti- nueront d’��tre exposés au risque de maladie, méme si le nombre de cas observés est faible.", - "metadata": { - "category_depth": 1, - "page_number": 15, - "parent_id": "2b95bca19a0376da748ec09cc59d99e0", - "text_as_html": "Les données sur l’impact sur la population des programmes de vaccination font apparaitre des diminutions significatives des cas d’EJ.' Lorsqu’on obtient durablement une forte couverture parmi des populations a risque pour cette maladie, il est possible de réduire de fagon importante le nombre de cas humains d’E] pendant que le virus reste en circulation. Les humains étant des hétes culs-de-sac, la vaccination n’a pas d’incidence sur le cycle de transmission zoonotique et les individus susceptibles conti- nueront d’étre exposés au risque de maladie, méme si le nombre de cas observés est faible.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 293.18, - "y0": 366.91, - "x1": 553.24, - "y1": 480.44 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "145d4fd34691127ab3f5f272d0491357", - "text": "Il existe des preuves claires d’un impact important sur l’EJ maladie de la vaccination des populations avec le vaccin vivant atténué ou le vaccin inactivé préparé sur tissu cérébral murin, en revanche on ne dispose pas encore de telles données pour le vaccin inactivé préparé sur cellules Vero et le vaccin vivant recombinant. Des campagnes de vaccination de masse ont été menées au Népal entre 2006 et 2009 chez les habitants de 1 a 15 ans de certains districts et l'ensemble des habitants 21 an d’autres districts, en obtenant une forte couverture (94% de la population cible).” Les données de surveillance pour la période 2004-2009 ont montré que l’incidence de l’EJ confirmée en labo- ratoire aprés les campagnes était de 1,3 pour 100000, c’est-a-dire 72% de moins que lincidence attendue de 4,6 pour 100000 lorsquaucune campagne rest intervenue. Les plus fortes varia-", - "metadata": { - "category_depth": 1, - "page_number": 15, - "parent_id": "2b95bca19a0376da748ec09cc59d99e0", - "text_as_html": "Il existe des preuves claires d’un impact important sur l’EJ maladie de la vaccination des populations avec le vaccin vivant atténué ou le vaccin inactivé préparé sur tissu cérébral murin, en revanche on ne dispose pas encore de telles données pour le vaccin inactivé préparé sur cellules Vero et le vaccin vivant recombinant. Des campagnes de vaccination de masse ont été menées au Népal entre 2006 et 2009 chez les habitants de 1 a 15 ans de certains districts et l'ensemble des habitants 21 an d’autres districts, en obtenant une forte couverture (94% de la population cible).” Les données de surveillance pour la période 2004-2009 ont montré que l’incidence de l’EJ confirmée en labo- ratoire aprés les campagnes était de 1,3 pour 100000, c’est-a-dire 72% de moins que lincidence attendue de 4,6 pour 100000 lorsquaucune campagne rest intervenue. Les plus fortes varia-
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 292.33, - "y0": 488.14, - "x1": 552.96, - "y1": 648.34 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "09515349b89a06a5f9afa5c38f8db058", - "text": "Pakakasama S et al. Immunogenicity of a live-attenuated Japanese encephalitis vaccine in child- ren and adolescents after hematopoietic stem cell transplantation. Bone Marrow Transplant, 2014; 49(10):1307-1309.", - "metadata": { - "category_depth": 1, - "page_number": 15, - "parent_id": "2b95bca19a0376da748ec09cc59d99e0", - "text_as_html": "83
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 14, - "coordinates": [ - { - "x0": 542.73, - "y0": 779.62, - "x1": 549.57, - "y1": 784.66 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "788b87b7aede2433ef10eb5a1635e2ca", - "text": "dence was seen in the high-risk districts and where vaccination targeted the entire population 21 years of age.", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "2b95bca19a0376da748ec09cc59d99e0", - "text_as_html": "dence was seen in the high-risk districts and where vaccination targeted the entire population 21 years of age.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 42.85, - "y0": 55.48, - "x1": 274.49, - "y1": 88.53 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-46", - "text": "\n\n\nCost-effectiveness\nThe cost-effectiveness of JE vaccination, has been as- sessed for live attenuated and inactivated vaccines in a variety of countries.”*”*””””. The cost per case averted ranged from US$1200 (live attenuated vaccine intro- duced into routine schedule in China*’) to US$21 928 (inactivated mouse brain-derived vaccine introduced through mass campaigns followed by routine use in India”). The cost per DALY averted ranged from US$22 (live attenuated vaccine introduced into the routine pro- gramme in Cambodia’’) to US$ 1247 (inactivated mouse brain-derived vaccine introduced through mass cam- paigns followed by routine use in India”). One dose of live attenuated JE vaccine was very cost-effective by WHO criteria, or cost-saving.\nAlthough cost-effectiveness studies are highly depen- dent upon parameters such as incidence of disease and vaccine price, it has been demonstrated that a variety of JE vaccination strategies are cost-effective or highly cost-effective.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "eb4f74a0f866650b39e69562e42d2d66", - "text": "Cost-effectiveness", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "", - "text_as_html": "The cost-effectiveness of JE vaccination, has been as- sessed for live attenuated and inactivated vaccines in a variety of countries.”*”*””””. The cost per case averted ranged from US$1200 (live attenuated vaccine intro- duced into routine schedule in China*’) to US$21 928 (inactivated mouse brain-derived vaccine introduced through mass campaigns followed by routine use in India”). The cost per DALY averted ranged from US$22 (live attenuated vaccine introduced into the routine pro- gramme in Cambodia’’) to US$ 1247 (inactivated mouse brain-derived vaccine introduced through mass cam- paigns followed by routine use in India”). One dose of live attenuated JE vaccine was very cost-effective by WHO criteria, or cost-saving.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 45.39, - "y0": 114.88, - "x1": 274.07, - "y1": 273.56 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "77c6049c2a088be27557c0b9793d6a20", - "text": "Although cost-effectiveness studies are highly depen- dent upon parameters such as incidence of disease and vaccine price, it has been demonstrated that a variety of JE vaccination strategies are cost-effective or highly cost-effective.", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "eb4f74a0f866650b39e69562e42d2d66", - "text_as_html": "Although cost-effectiveness studies are highly depen- dent upon parameters such as incidence of disease and vaccine price, it has been demonstrated that a variety of JE vaccination strategies are cost-effective or highly cost-effective.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 45.95, - "y0": 280.63, - "x1": 273.2, - "y1": 336.82 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-47", - "text": "\n\n\nWHO position\nGeneral recommendations\nJE vaccination should be integrated into national im- munization schedules in all areas where JE is recognized as a public health priority. Even if the number of JE-confirmed cases is low, vaccination should be con- sidered where there is a suitable environment for JEV transmission, ie. presence of animal reservoirs, eco- logical conditions supportive of virus transmission, and proximity to other countries or regions with known JEV transmission. Adjunctive interventions, such as bednets and mosquito control measures, should not divert ef- forts from childhood JE vaccination.\nAs JE vaccination does not induce herd immunity, high vaccination coverage should be achieved and sustained in populations at risk of the disease. This will allow JE disease in humans to be virtually eliminated despite ongoing virus circulation in the animal cycle.\n7 Yin Z et al; Guizhou JE Study Group. An economic evaluation of the use of Japanese encephalitis vaccine in the expanded program of immunization of Guizhou pro- vince, China. Vaccine,2012;30(37):5569-5577.\n78 Touch S et al. A cost-effectiveness analysis of Japanese encephalitis vaccine in Cam- bodia. Vaccine, 2010;28(29):4593-4599.\n7” Liu W et al. Cost-effectiveness of Japanese encephalitis (JE) immunization in Bali, Indonesia. Vaccine, 2008;26(35):4456-4460.\n78 Siraprapasiri T et al. Cost benefit analysis of Japanese encephalitis vaccination pro- gram in Thailand. Southeast Asian J Trop Med Public Health, 1997;28(1):143-148.\n73 Suraratdecha C et al. A cost-effectiveness analysis of strategies for controlling Ja- panese encephalitis in Andhra Pradesh, India. J Pharm Fin, Econ & Policy,2006;15:21.\n® Ding D et al. Cost-effectiveness of routine immunization to control Japanese ence- phalitis in Shanghai, China. Bull World Health Organ. 2003;81(5):334-342.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "68bed9e2f83789d2fb2515835897e8fd", - "text": "WHO position", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "", - "text_as_html": "General recommendations
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 43.73, - "y0": 367.62, - "x1": 159.05, - "y1": 379.4 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "814f9d384b7bc606da8713503e044297", - "text": "JE vaccination should be integrated into national im- munization schedules in all areas where JE is recognized as a public health priority. Even if the number of JE-confirmed cases is low, vaccination should be con- sidered where there is a suitable environment for JEV transmission, ie. presence of animal reservoirs, eco- logical conditions supportive of virus transmission, and proximity to other countries or regions with known JEV transmission. Adjunctive interventions, such as bednets and mosquito control measures, should not divert ef- forts from childhood JE vaccination.", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "68bed9e2f83789d2fb2515835897e8fd", - "text_as_html": "JE vaccination should be integrated into national im- munization schedules in all areas where JE is recognized as a public health priority. Even if the number of JE-confirmed cases is low, vaccination should be con- sidered where there is a suitable environment for JEV transmission, ie. presence of animal reservoirs, eco- logical conditions supportive of virus transmission, and proximity to other countries or regions with known JEV transmission. Adjunctive interventions, such as bednets and mosquito control measures, should not divert ef- forts from childhood JE vaccination.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 45.0, - "y0": 381.46, - "x1": 274.1, - "y1": 506.26 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "35be70b092ba02fd6d01a01d1bd29e49", - "text": "As JE vaccination does not induce herd immunity, high vaccination coverage should be achieved and sustained in populations at risk of the disease. This will allow JE disease in humans to be virtually eliminated despite ongoing virus circulation in the animal cycle.", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "68bed9e2f83789d2fb2515835897e8fd", - "text_as_html": "As JE vaccination does not induce herd immunity, high vaccination coverage should be achieved and sustained in populations at risk of the disease. This will allow JE disease in humans to be virtually eliminated despite ongoing virus circulation in the animal cycle.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 45.78, - "y0": 525.57, - "x1": 272.77, - "y1": 581.48 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "d81f7118d4c336de6761ef3bcc37f105", - "text": "7 Yin Z et al; Guizhou JE Study Group. An economic evaluation of the use of Japanese encephalitis vaccine in the expanded program of immunization of Guizhou pro- vince, China. Vaccine,2012;30(37):5569-5577.", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "68bed9e2f83789d2fb2515835897e8fd", - "text_as_html": "tions de incidence ont été observées dans les districts 4 haut risque et dans les endroits ou la vaccination avait visé l’en- semble de la population 21 an.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 294.22, - "y0": 55.83, - "x1": 551.06, - "y1": 88.66 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-49", - "text": "\n\n\nRapport coit/efficacité\nLe rapport coit/efficacité de la vaccination contre lEJ a été évalué pour le vaccin vivant atténué et le vaccin inactivé dans divers pays.”> 77%” ® Le coat par cas évité se situait entre US $1200 (vaccin vivant atténué introduit dans le calendrier de vaccination systématique en Chine®) et US$ 21 928 (introduc- tion en Inde du vaccin préparé sur tissu cérébral murin par le biais de campagnes de masse, suivie d’un usage systématique”). Le cotit par DALY évitée allait de US$ 22 (vaccin vivant atténué introduit dans le programme de vaccination systématique au Cambodge’’) 4 US$ 1247 (introduction en Inde du vaccin préparé sur tissu cérébral murin par le biais de campagnes de masse, suivie un usage systématique”). Une dose de vaccin vivant atté- nué contre PEJ présentait un trés bon rapport coidt/efficacité selon les critéres de OMS, ou entrainait des économies.\nMéme si les études coit/efficacité sont fortement dépendantes de paramétres comme l’incidence de la maladie et le prix des vaccins, il a été démontré que diverses stratégies de vaccination contre PEM offraient un rapport coiit/efficacité satisfaisant, voire trés satisfaisant.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "f980ea9de37522970932640f928ec247", - "text": "Rapport coit/efficacité", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "", - "text_as_html": "Le rapport coit/efficacité de la vaccination contre lEJ a été évalué pour le vaccin vivant atténué et le vaccin inactivé dans divers pays.”> 77%” ® Le coat par cas évité se situait entre US $1200 (vaccin vivant atténué introduit dans le calendrier de vaccination systématique en Chine®) et US$ 21 928 (introduc- tion en Inde du vaccin préparé sur tissu cérébral murin par le biais de campagnes de masse, suivie d’un usage systématique”). Le cotit par DALY évitée allait de US$ 22 (vaccin vivant atténué introduit dans le programme de vaccination systématique au Cambodge’’) 4 US$ 1247 (introduction en Inde du vaccin préparé sur tissu cérébral murin par le biais de campagnes de masse, suivie un usage systématique”). Une dose de vaccin vivant atté- nué contre PEJ présentait un trés bon rapport coidt/efficacité selon les critéres de OMS, ou entrainait des économies.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 294.91, - "y0": 114.58, - "x1": 552.76, - "y1": 273.49 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "72b02106b786937a2b3464ce1f0ad018", - "text": "Méme si les études coit/efficacité sont fortement dépendantes de paramétres comme l’incidence de la maladie et le prix des vaccins, il a été démontré que diverses stratégies de vaccination contre PEM offraient un rapport coiit/efficacité satisfaisant, voire trés satisfaisant.", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "f980ea9de37522970932640f928ec247", - "text_as_html": "Méme si les études coit/efficacité sont fortement dépendantes de paramétres comme l’incidence de la maladie et le prix des vaccins, il a été démontré que diverses stratégies de vaccination contre PEM offraient un rapport coiit/efficacité satisfaisant, voire trés satisfaisant.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 295.72, - "y0": 280.79, - "x1": 551.64, - "y1": 337.17 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-50", - "text": "\n\n\nPosition de I'OMS", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "7b812714f02e2b3d9e72ce0527956626", - "text": "Position de I'OMS", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "", - "text_as_html": "La vaccination contre EJ devra étre intégrée aux calendriers nationaux de vaccination dans toutes les zones ow cette maladie est reconnue comme une priorité de santé publique. Méme si le nombre de cas confirmés d’EJ est faible, la vaccination devra étre envisagée partout ow il existe un environnement se prétant a la transmission du VE], c’est-a-dire des réservoirs animaux, des conditions écologiques favorables a la transmission de ce virus et la proximité d’autres pays ou régions dans lesquels on sait qu'une telle transmission s’opére. Les interventions complé- mentaires, telles que Jlutilisation de moustiquaires et les mesures de lutte contre les moustiques, ne devront détourner aucun effort de la vaccination des enfants contre |’EJ.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 294.68, - "y0": 381.37, - "x1": 553.08, - "y1": 517.74 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "98b5cbbbb0f97caee0ac6fedb9e4bf10", - "text": "La vaccination contre l’EJ m’induisant pas d’immunité collective, il faudra obtenir de fagon durable une forte couverture vacci- nale dans les populations exposées au risque de contracter la maladie. Cela permettra d’éliminer virtuellement l’EJ maladie chez Phomme malgré la circulation en cours du virus dans le cycle animal.", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "8d686764f086d3e17603554ff0165edb", - "text_as_html": "La vaccination contre l’EJ m’induisant pas d’immunité collective, il faudra obtenir de fagon durable une forte couverture vacci- nale dans les populations exposées au risque de contracter la maladie. Cela permettra d’éliminer virtuellement l’EJ maladie chez Phomme malgré la circulation en cours du virus dans le cycle animal.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 294.25, - "y0": 525.24, - "x1": 553.11, - "y1": 592.55 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "05a163733533c04873af2949f8a3c3ed", - "text": "* Yin Z et al; Guizhou JE Study Group. An economic evaluation of the use of Japanese encephali- tis vaccine in the expanded program of immunization of Guizhou province, China. Vac- cine,2012;30(37):5569-5577.", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "8d686764f086d3e17603554ff0165edb", - "text_as_html": "®°
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 293.32, - "y0": 757.31, - "x1": 296.92, - "y1": 760.18 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "9e39219b995008d0b0dc559b4b51954f", - "text": "Ding D et al. Cost-effectiveness of routine immunization to control Japanese encephalitis in Shanghai, China. Bull World Health Organ. 2003;81(5):334-342.", - "metadata": { - "category_depth": 1, - "page_number": 16, - "parent_id": "8d686764f086d3e17603554ff0165edb", - "text_as_html": "WEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 15, - "coordinates": [ - { - "x0": 383.38, - "y0": 779.2, - "x1": 550.97, - "y1": 786.24 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "a58a633d280a935b33fefc8dafa2cae7", - "text": "The most effective immunization strategy in JE endemic settings is a one-time campaign in the primary target population, as defined by local epidemiology (typically children aged <15 years), followed by incorporation of JE vaccine into the routine childhood immunization programme. This approach has a greater public health impact than either of these approaches alone, as cam- paigns rapidly reduce disease incidence in a broader age group of susceptible individuals. When possible, campaigns should be scheduled outside periods of high JE disease activity, to prevent as much disease as pos- sible in advance of high transmission and to reduce suspicion of a relationship between encephalitis cases and vaccination. Older groups may be considered for vaccination if the disease burden in such groups is suf- ficiently high.", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "8d686764f086d3e17603554ff0165edb", - "text_as_html": "The most effective immunization strategy in JE endemic settings is a one-time campaign in the primary target population, as defined by local epidemiology (typically children aged <15 years), followed by incorporation of JE vaccine into the routine childhood immunization programme. This approach has a greater public health impact than either of these approaches alone, as cam- paigns rapidly reduce disease incidence in a broader age group of susceptible individuals. When possible, campaigns should be scheduled outside periods of high JE disease activity, to prevent as much disease as pos- sible in advance of high transmission and to reduce suspicion of a relationship between encephalitis cases and vaccination. Older groups may be considered for vaccination if the disease burden in such groups is suf- ficiently high.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 45.08, - "y0": 57.25, - "x1": 272.49, - "y1": 237.33 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "44fdd794e3268cfd3d57af1fc3edaadb", - "text": "The following vaccine dosing schedules and age of ad- ministration are recommended. The need for a booster dose in endemic settings has not been clearly estab- lished for any of the vaccines listed below.", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "8d686764f086d3e17603554ff0165edb", - "text_as_html": "The following vaccine dosing schedules and age of ad- ministration are recommended. The need for a booster dose in endemic settings has not been clearly estab- lished for any of the vaccines listed below.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 44.51, - "y0": 245.22, - "x1": 273.57, - "y1": 290.38 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "17ecb95d35f22855ac1e88e69b314efe", - "text": "Inactivated Vero cell-derived vaccine: Primary series according to manufacturer’s recommenda- tions (these vary by product), generally 2 doses at 4-week intervals starting the primary series at 26 months of age in endemic settings", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "8d686764f086d3e17603554ff0165edb", - "text_as_html": "Preferably, inactivated mouse brain-derived vaccines should be replaced by the newer generation JE vaccines discussed in this position paper. Inactivated mouse brain-derived vaccines may continue to play a role in combatting JE in some countries, but overall these prod- ucts have a less favourable safety profile due to their increased reactogenicity compared to newer JE vac- cines. Other disadvantages include the variability of manufacturing, the cost, the higher number of doses required and the need for boosters.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 45.06, - "y0": 417.66, - "x1": 272.78, - "y1": 531.25 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "8f1347191f5eec01d813478793465138", - "text": "Despite a lack of comprehensive immunogenicity/effec- tiveness and safety data for all possible combinations of JE and other routine vaccines, co-administration for programmatic reasons seems acceptable, even in the context of mass campaigns.", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "12cf167757398c29f02c42dfd76aba11", - "text_as_html": "Despite a lack of comprehensive immunogenicity/effec- tiveness and safety data for all possible combinations of JE and other routine vaccines, co-administration for programmatic reasons seems acceptable, even in the context of mass campaigns.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 43.63, - "y0": 550.49, - "x1": 273.36, - "y1": 605.23 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "2d0aee29a4119cd2299c99c33f48fb2a", - "text": "The value of reactive vaccination campaigns during outbreaks of JE has not been studied. If an outbreak occurs in a country or region where JE vaccination has not been introduced, an assessment needs to be made of whether it is appropriate to implement an immediate vaccine response, including considerations such as size of the outbreak, timeliness of the response, population affected, and programmatic capacity. Due to the need for rapid production of protective antibodies, single- dose live attenuated or live recombinant vaccines should be used. When outbreak response vaccination is con- ducted, planning for introduction into the routine im- munization schedule should follow.", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "12cf167757398c29f02c42dfd76aba11", - "text_as_html": "The value of reactive vaccination campaigns during outbreaks of JE has not been studied. If an outbreak occurs in a country or region where JE vaccination has not been introduced, an assessment needs to be made of whether it is appropriate to implement an immediate vaccine response, including considerations such as size of the outbreak, timeliness of the response, population affected, and programmatic capacity. Due to the need for rapid production of protective antibodies, single- dose live attenuated or live recombinant vaccines should be used. When outbreak response vaccination is con- ducted, planning for introduction into the routine im- munization schedule should follow.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 46.35, - "y0": 625.15, - "x1": 272.08, - "y1": 772.92 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "8428722249d397f59cd7b570b7534bfb", - "text": "RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "12cf167757398c29f02c42dfd76aba11", - "text_as_html": "RELEVE EPIDEMIOLOGIQUE HEBDOMADAIRE, N° 9, 27 FEVRIER 2015,
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 45.73, - "y0": 779.25, - "x1": 224.26, - "y1": 786.19 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "4d88341b77bbac40c6a70029417dd807", - "text": "La stratégie la plus efficace de vaccination contre EJ dans les zones d’endémie consiste 4 mener une campagne unique dans la population cible primaire définie par l’épidémiologie locale (habituellement les enfants <15 ans), suivie par l’intégration du vaccin contre lEJ dans le programme de vaccination systéma- tique des enfants. Cette stratégie a un impact plus important sur la population que les 2 démarches qui la composent appli- quées seules, car les campagnes réduisent rapidement l’inci- dence de la maladie dans une tranche d’age plus large d’indi- vidus susceptibles. Dans la mesure du possible, les campagnes devront étre programmées en dehors des périodes de forte activité de PEJ maladie pour limiter les risques de soupgonner une relation entre les cas d’encéphalite et la vaccination. On peut envisager de vacciner des groupes plus Agés si la charge de morbidité dans ces groupes est suffisamment importante.", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "12cf167757398c29f02c42dfd76aba11", - "text_as_html": "La stratégie la plus efficace de vaccination contre EJ dans les zones d’endémie consiste 4 mener une campagne unique dans la population cible primaire définie par l’épidémiologie locale (habituellement les enfants <15 ans), suivie par l’intégration du vaccin contre lEJ dans le programme de vaccination systéma- tique des enfants. Cette stratégie a un impact plus important sur la population que les 2 démarches qui la composent appli- quées seules, car les campagnes réduisent rapidement l’inci- dence de la maladie dans une tranche d’age plus large d’indi- vidus susceptibles. Dans la mesure du possible, les campagnes devront étre programmées en dehors des périodes de forte activité de PEJ maladie pour limiter les risques de soupgonner une relation entre les cas d’encéphalite et la vaccination. On peut envisager de vacciner des groupes plus Agés si la charge de morbidité dans ces groupes est suffisamment importante.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 292.79, - "y0": 57.14, - "x1": 551.64, - "y1": 227.14 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "ec3a76e84d43f9a39f0f756ad38cfd98", - "text": "Il est recommandé de respecter les schémas posologiques vacci- naux et les ages d’administration indiqués ci-aprés. La nécessité dune dose de rappel dans les situations d’endémie n’a été clai- rement établie pour aucun des vaccins figurant dans la liste suivante:", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "12cf167757398c29f02c42dfd76aba11", - "text_as_html": "Il est recommandé de respecter les schémas posologiques vacci- naux et les ages d’administration indiqués ci-aprés. La nécessité dune dose de rappel dans les situations d’endémie n’a été clai- rement établie pour aucun des vaccins figurant dans la liste suivante:
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 292.16, - "y0": 245.34, - "x1": 552.59, - "y1": 301.04 - } - ] - } - }, - { - "type": "ListItem", - "element_id": "e016356725ed735552f831a1d9b67a23", - "text": "@ vaccin inactivé préparé sur cellules Vero: série primaire selon les recommandations du fabricant (variables selon les produits): généralement 2 doses a 4 semaines d’intervalle, en débutant la série primaire a 26 mois dans les situations dendémie,", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "12cf167757398c29f02c42dfd76aba11", - "text_as_html": "Il est préférable de remplacer les vaccins inactivés préparés sur tissu cérébral murin par des vaccins de génération plus récente, examinés dans cette note de synthése. Les vaccins inactivés préparés sur tissu cérébral murin peuvent continuer a jouer un réle dans la lutte contre EJ dans certains pays, mais globalement, ces produits ont un profil d’innocuité moins favorable, en raison de leur plus forte réactogénicité, que les vaccins contre l’EJ plus récents. Parmi leurs autres inconvé- nients, figurent la variabilité de la production, leur cout, le plus grand nombre de doses requises et la nécessité de doses de rappel.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 293.43, - "y0": 417.47, - "x1": 552.37, - "y1": 542.05 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "0bf74bd4d06f20f458b31910e2696395", - "text": "Méme si les données concernant l’immunogénicité/lefficacité et Pinnocuité pour toutes les associations possibles du vaccin contre l’EJ avec les vaccins du programme de vaccination systé- matique ne sont pas complétes, une coadministration semble néanmoins acceptable pour des raisons programmatiques, méme dans le contexte de campagnes de masse.", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "fd50780ebce03eb7b5663443468d14c7", - "text_as_html": "Méme si les données concernant l’immunogénicité/lefficacité et Pinnocuité pour toutes les associations possibles du vaccin contre l’EJ avec les vaccins du programme de vaccination systé- matique ne sont pas complétes, une coadministration semble néanmoins acceptable pour des raisons programmatiques, méme dans le contexte de campagnes de masse.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 293.84, - "y0": 549.92, - "x1": 553.1, - "y1": 617.13 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "b012026839f2220398ababf8f7723e78", - "text": "Lintérét des campagnes de vaccination en réponse aux flambées (EJ n’a pas été étudié. Si une flambée se produit dans un pays ou une région ow la vaccination contre EJ n’a pas été intro- duite, il faudra évaluer la pertinence de mettre en ceuvre une réponse vaccinale immédiate, en prenant en considération l’am- pleur de la flambée, les délais d’intervention de la réponse, la population touchée et les capacités programmatiques. Compte tenu de la nécessité de produire rapidement les anticorps protecteurs, il faudra recourir 4 une dose unique de vaccin vivant atténué ou recombinant. Lorsqu’on entreprend une campagne de vaccination en réponse a une flambée, il faut prévoir par la suite introduction du vaccin dans le calendrier de vaccination systématique.", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "fd50780ebce03eb7b5663443468d14c7", - "text_as_html": "Lintérét des campagnes de vaccination en réponse aux flambées (EJ n’a pas été étudié. Si une flambée se produit dans un pays ou une région ow la vaccination contre EJ n’a pas été intro- duite, il faudra évaluer la pertinence de mettre en ceuvre une réponse vaccinale immédiate, en prenant en considération l’am- pleur de la flambée, les délais d’intervention de la réponse, la population touchée et les capacités programmatiques. Compte tenu de la nécessité de produire rapidement les anticorps protecteurs, il faudra recourir 4 une dose unique de vaccin vivant atténué ou recombinant. Lorsqu’on entreprend une campagne de vaccination en réponse a une flambée, il faut prévoir par la suite introduction du vaccin dans le calendrier de vaccination systématique.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 293.01, - "y0": 624.99, - "x1": 553.22, - "y1": 773.04 - } - ] - } - }, - { - "type": "UncategorizedText", - "element_id": "9f0f99c82bbd44404d0f8c42b32bc07b", - "text": "85", - "metadata": { - "category_depth": 1, - "page_number": 17, - "parent_id": "fd50780ebce03eb7b5663443468d14c7", - "text_as_html": "85
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 16, - "coordinates": [ - { - "x0": 542.73, - "y0": 779.62, - "x1": 549.57, - "y1": 784.66 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "58fb192b9a0b1606365dccd8ff18aa5d", - "text": "Recommendations for special risk groups", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "fd50780ebce03eb7b5663443468d14c7", - "text_as_html": "Recommendations for special risk groups
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 45.77, - "y0": 55.22, - "x1": 220.33, - "y1": 66.31 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-54", - "text": "\n\n\nImmunocompromised persons\nInactivated JE vaccine can be used in immunocompro- mised persons including HIV-infected individuals, but the immune response may be lower than in fully im- munocompetent persons. Inactivated Vero cell-derived vaccines should be used preferentially over live attenu- ated or live recombinant vaccines in immunocompro- mised persons. HIV testing is not a prerequisite for vaccination.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "b5e151277f8dfd599ec19fe986e44bd7", - "text": "Immunocompromised persons", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "", - "text_as_html": "Inactivated JE vaccine can be used in immunocompro- mised persons including HIV-infected individuals, but the immune response may be lower than in fully im- munocompetent persons. Inactivated Vero cell-derived vaccines should be used preferentially over live attenu- ated or live recombinant vaccines in immunocompro- mised persons. HIV testing is not a prerequisite for vaccination.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 45.31, - "y0": 87.45, - "x1": 273.94, - "y1": 177.6 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-55", - "text": "\n\n\nPregnant and lactating women\nIf the JE risk is sufficient to warrant vaccination of preg- nant women, inactivated Vero cell-derived vaccines should be used preferentially over live attenuated or live recombinant vaccines based on the general precaution- ary principle against using live vaccines in pregnant women especially if alternative types of vaccines are available. Pregnancy testing is not a prerequisite for JE vaccination. Inadvertent administration of live attenu- ated or live recombinant JE vaccine to a pregnant woman is not an indication for termination of the preg- nancy.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "cc5f1811a51afd44e6b90d4c972d0474", - "text": "Pregnant and lactating women", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "", - "text_as_html": "If the JE risk is sufficient to warrant vaccination of preg- nant women, inactivated Vero cell-derived vaccines should be used preferentially over live attenuated or live recombinant vaccines based on the general precaution- ary principle against using live vaccines in pregnant women especially if alternative types of vaccines are available. Pregnancy testing is not a prerequisite for JE vaccination. Inadvertent administration of live attenu- ated or live recombinant JE vaccine to a pregnant woman is not an indication for termination of the preg- nancy.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 44.45, - "y0": 204.04, - "x1": 274.02, - "y1": 328.64 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-56", - "text": "\n\n\nHealth-care workers\nHealth-care workers are generally not at special risk of contracting JE. Workers at high-risk in endemic areas, such as those involved in vector control, should be vac- cinated.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "322b533529df38c51cb0c3237f279e1f", - "text": "Health-care workers", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "", - "text_as_html": "Health-care workers are generally not at special risk of contracting JE. Workers at high-risk in endemic areas, such as those involved in vector control, should be vac- cinated.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 44.56, - "y0": 366.35, - "x1": 273.85, - "y1": 409.6 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-57", - "text": "\n\n\nTravellers\nJE vaccination is recommended for travellers to en- demic areas with extensive outdoor exposure during the transmission season. Migrants to JE-endemic areas should be vaccinated. Data on long-term protection fol- lowing primary vaccination of travellers are still being gathered. There are only very limited data currently available from studies conducted among children from non-endemic areas, and it is difficult to extrapolate data from endemic countries where natural boosting or other factors may be influential. Currently, inactivated Vero cell-derived vaccines and live recombinant vac- cines are generally used for travellers from non-en- demic countries. For inactivated Vero cell-derived vac- cines, data support a booster dose at >1 year in adults following the primary schedule if at risk of further exposure to JEV. For live recombinant vaccine, currently available data in adults do not suggest a need for a booster dose. There are no long-term data publically available for either vaccine administered to children in non-endemic settings.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "3931583c51ca2d2bf1a10a61e2beae86", - "text": "Travellers", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "", - "text_as_html": "JE vaccination is recommended for travellers to en- demic areas with extensive outdoor exposure during the transmission season. Migrants to JE-endemic areas should be vaccinated. Data on long-term protection fol- lowing primary vaccination of travellers are still being gathered. There are only very limited data currently available from studies conducted among children from non-endemic areas, and it is difficult to extrapolate data from endemic countries where natural boosting or other factors may be influential. Currently, inactivated Vero cell-derived vaccines and live recombinant vac- cines are generally used for travellers from non-en- demic countries. For inactivated Vero cell-derived vac- cines, data support a booster dose at >1 year in adults following the primary schedule if at risk of further exposure to JEV. For live recombinant vaccine, currently available data in adults do not suggest a need for a booster dose. There are no long-term data publically available for either vaccine administered to children in non-endemic settings.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 44.83, - "y0": 436.89, - "x1": 273.26, - "y1": 664.67 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-58", - "text": "\n\n\nSurveillance\nStrengthened surveillance is needed to assess the burden of JE, inform vaccination strategies, identify breakthrough cases, monitor vaccine safety, and moni- tor the impact and effectiveness of JE vaccines and\nRecommandations concernant les groupes a risque spéciaux", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "c07a89719a1e01bc3627ce1c71026567", - "text": "Surveillance", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "", - "text_as_html": "Strengthened surveillance is needed to assess the burden of JE, inform vaccination strategies, identify breakthrough cases, monitor vaccine safety, and moni- tor the impact and effectiveness of JE vaccines and
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 43.81, - "y0": 728.21, - "x1": 273.56, - "y1": 772.49 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "a87286f68c54be27d0283a65040d43a8", - "text": "Recommandations concernant les groupes a risque spéciaux", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "c07a89719a1e01bc3627ce1c71026567", - "text_as_html": "Recommandations concernant les groupes a risque spéciaux
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 294.44, - "y0": 55.46, - "x1": 547.99, - "y1": 66.22 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-59", - "text": "\n\n\nPersonnes immunodéprimées\nLe vaccin contre EJ inactivé est utilisable chez les personnes immunodéprimées, y compris celles infectées par le VIH, mais la réponse immunitaire suscitée peut étre plus faible que chez des personnes pleinement immunocompétentes. Il faudra pour vacciner ces personnes faire appel a des vaccins inactivés préparés sur cellules Vero de préférence aux vaccins vivants atténués ou recombinants. Le dépistage du VIH rest pas un préalable indispensable a la vaccination.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "9fa8ddca455eb5dcb7cd51096bc8cb09", - "text": "Personnes immunodéprimées", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "", - "text_as_html": "Le vaccin contre EJ inactivé est utilisable chez les personnes immunodéprimées, y compris celles infectées par le VIH, mais la réponse immunitaire suscitée peut étre plus faible que chez des personnes pleinement immunocompétentes. Il faudra pour vacciner ces personnes faire appel a des vaccins inactivés préparés sur cellules Vero de préférence aux vaccins vivants atténués ou recombinants. Le dépistage du VIH rest pas un préalable indispensable a la vaccination.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 293.43, - "y0": 87.9, - "x1": 552.16, - "y1": 178.08 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-60", - "text": "\n\n\nFemmes enceintes ou allaitantes\nSi le risque d’EJ est suffisant pour justifier la vaccination des femmes enceintes, on utilisera pour cela des vaccins inactivés préparés sur cellules Vero de préférence aux vaccins vivants atténués ou aux vivants recombinants sur la base du principe général de précaution qui s’oppose a lutilisation de vaccins vivants chez les femmes attendant un enfant, notamment si dautres types de vaccins sont disponibles. Le dépistage de la grossesse nest pas un préalable indispensable a la vaccination contre TEJ. Ladministration par inadvertance d’un vaccin vivant atténué ou vivant recombinant contre l’EJ 4 une femme enceinte n’est pas une indication pour l’interruption de la gros- sesse.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "fa01e8172940e5722c0b1f1e416515c3", - "text": "Femmes enceintes ou allaitantes", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "", - "text_as_html": "Si le risque d’EJ est suffisant pour justifier la vaccination des femmes enceintes, on utilisera pour cela des vaccins inactivés préparés sur cellules Vero de préférence aux vaccins vivants atténués ou aux vivants recombinants sur la base du principe général de précaution qui s’oppose a lutilisation de vaccins vivants chez les femmes attendant un enfant, notamment si dautres types de vaccins sont disponibles. Le dépistage de la grossesse nest pas un préalable indispensable a la vaccination contre TEJ. Ladministration par inadvertance d’un vaccin vivant atténué ou vivant recombinant contre l’EJ 4 une femme enceinte n’est pas une indication pour l’interruption de la gros- sesse.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 293.84, - "y0": 204.11, - "x1": 552.44, - "y1": 339.75 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-61", - "text": "\n\n\nAgents de santé\nLes agents de santé ne sont généralement pas exposés a un risque particulier de contracter l’EJ. Ceux encourant un risque important dans les zones d’endémie, tels que les agents impli- qués dans la lutte antivectorielle, devront étre vaccinés.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "cbe78f6d3e14bb9fadbcb34f43cd88d2", - "text": "Agents de santé", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "", - "text_as_html": "Les agents de santé ne sont généralement pas exposés a un risque particulier de contracter l’EJ. Ceux encourant un risque important dans les zones d’endémie, tels que les agents impli- qués dans la lutte antivectorielle, devront étre vaccinés.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 293.98, - "y0": 366.27, - "x1": 550.71, - "y1": 410.5 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-62", - "text": "\n\n\nVoyageurs\nLa vaccination contre EJ est recommandée pour les voyageurs se rendant dans les zones d’endémie dans lesquelles une expo- sition extérieure de grande ampleur est possible pendant la saison de transmission. Les migrants vers les zones d’endémie de PEJ devront étre vaccinés. Les données sur la protection a long terme conférée par la primovaccination des voyageurs sont encore en cours de collecte. Les données provenant d’études réalisées chez des enfants dans des zones exemptes d’endémie sont pour le moment trés limitées et il est difficile d’extrapoler les données émanant des pays d’endémie ou le renforcement naturel et d’autres facteurs peuvent jouer. Actuellement, on utilise généralement un vaccin inactivé préparé sur cellules Vero ou un vaccin vivant recombinant pour vacciner les voya- geurs provenant de pays non endémiques. Pour les vaccins inactivés préparés sur cellules Vero, les données confirment la pertinence d’une dose de rappel a >1 an chez les adultes, aprés la primovaccination, s’il existe un risque de prolongement de Pexposition au VEJ. Pour le vaccin vivant recombinant, les données actuellement disponibles pour les adultes ne suggérent pas la nécessité d’une dose de rappel. Il n’y a pas de données a long terme publiquement disponibles pour l'un et l’autre de ces vaccins administrés 4 des enfants dans un contexte non endémique.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "f01c8fdcca46bf5744e823bffa51a4f9", - "text": "Voyageurs", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "", - "text_as_html": "La vaccination contre EJ est recommandée pour les voyageurs se rendant dans les zones d’endémie dans lesquelles une expo- sition extérieure de grande ampleur est possible pendant la saison de transmission. Les migrants vers les zones d’endémie de PEJ devront étre vaccinés. Les données sur la protection a long terme conférée par la primovaccination des voyageurs sont encore en cours de collecte. Les données provenant d’études réalisées chez des enfants dans des zones exemptes d’endémie sont pour le moment trés limitées et il est difficile d’extrapoler les données émanant des pays d’endémie ou le renforcement naturel et d’autres facteurs peuvent jouer. Actuellement, on utilise généralement un vaccin inactivé préparé sur cellules Vero ou un vaccin vivant recombinant pour vacciner les voya- geurs provenant de pays non endémiques. Pour les vaccins inactivés préparés sur cellules Vero, les données confirment la pertinence d’une dose de rappel a >1 an chez les adultes, aprés la primovaccination, s’il existe un risque de prolongement de Pexposition au VEJ. Pour le vaccin vivant recombinant, les données actuellement disponibles pour les adultes ne suggérent pas la nécessité d’une dose de rappel. Il n’y a pas de données a long terme publiquement disponibles pour l'un et l’autre de ces vaccins administrés 4 des enfants dans un contexte non endémique.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 293.64, - "y0": 437.19, - "x1": 552.83, - "y1": 698.88 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-63", - "text": "\n\n\nSurveillance\nIl est nécessaire de renforcer la surveillance pour évaluer la charge de morbidité due a IE], étayer les stratégies de vaccina- tion, identifier les cas d’infection chez les sujets vaccinés, suivre Pinnocuité des vaccins contre EJ, ainsi que leur impact et leur\nWEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015\nassess the potential need for booster doses to close gaps in immunity.”\nAll JE-endemic countries are encouraged to carry out at least sentinel surveillance with laboratory confirma- tion of JE. This will also assist decision making on JE vaccine introduction. While a comprehensive JE surveil- lance system is recommended, countries without a strong system in place but with evidence of JE disease occurrence should not wait to introduce JE vaccine. Comprehensive data are useful to identify target age groups and areas of highest risk; this is particularly important if a phased or sub-national vaccine introduc- tion is considered. Cost-effectiveness analyses specific to the country/region may be informative for decisions about JE vaccine introduction.\nAES surveillance is important for understanding all causes of encephalitis. Even in the absence of JE con- firmatory testing, reporting of AES cases can have value in demonstrating the impact of vaccination pro- grammes. However, low impact of JE vaccination programmes on AES may reflect the burden of non-JE cases of AES. Given the burden of disease in adults in some countries, consideration should be given to cap- turing cases in all age groups in the surveillance system.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "d1152e74e9625c69b2dc52120b2520b9", - "text": "Surveillance", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "", - "text_as_html": "Il est nécessaire de renforcer la surveillance pour évaluer la charge de morbidité due a IE], étayer les stratégies de vaccina- tion, identifier les cas d’infection chez les sujets vaccinés, suivre Pinnocuité des vaccins contre EJ, ainsi que leur impact et leur
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 295.47, - "y0": 728.41, - "x1": 549.57, - "y1": 773.19 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "cb64a3d74b4f54f5e5fb69a4e0ca7c92", - "text": "WEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015", - "metadata": { - "category_depth": 1, - "page_number": 18, - "parent_id": "d1152e74e9625c69b2dc52120b2520b9", - "text_as_html": "WEEKLY EPIDEMIOLOGICAL RECORD, NO. 9, 27 FEBRUARY 2015
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 17, - "coordinates": [ - { - "x0": 383.16, - "y0": 779.28, - "x1": 549.38, - "y1": 786.37 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "f572bf5036b488d63cdb77a12902596d", - "text": "assess the potential need for booster doses to close gaps in immunity.”", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "d1152e74e9625c69b2dc52120b2520b9", - "text_as_html": "assess the potential need for booster doses to close gaps in immunity.”
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 43.39, - "y0": 55.68, - "x1": 272.21, - "y1": 76.01 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "35b1c6cb041fd63d5c3e327cf2bb8153", - "text": "All JE-endemic countries are encouraged to carry out at least sentinel surveillance with laboratory confirma- tion of JE. This will also assist decision making on JE vaccine introduction. While a comprehensive JE surveil- lance system is recommended, countries without a strong system in place but with evidence of JE disease occurrence should not wait to introduce JE vaccine. Comprehensive data are useful to identify target age groups and areas of highest risk; this is particularly important if a phased or sub-national vaccine introduc- tion is considered. Cost-effectiveness analyses specific to the country/region may be informative for decisions about JE vaccine introduction.", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "d1152e74e9625c69b2dc52120b2520b9", - "text_as_html": "All JE-endemic countries are encouraged to carry out at least sentinel surveillance with laboratory confirma- tion of JE. This will also assist decision making on JE vaccine introduction. While a comprehensive JE surveil- lance system is recommended, countries without a strong system in place but with evidence of JE disease occurrence should not wait to introduce JE vaccine. Comprehensive data are useful to identify target age groups and areas of highest risk; this is particularly important if a phased or sub-national vaccine introduc- tion is considered. Cost-effectiveness analyses specific to the country/region may be informative for decisions about JE vaccine introduction.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 44.43, - "y0": 85.14, - "x1": 272.62, - "y1": 232.63 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "5c20ba401a8d3db951796e6f209b0826", - "text": "AES surveillance is important for understanding all causes of encephalitis. Even in the absence of JE con- firmatory testing, reporting of AES cases can have value in demonstrating the impact of vaccination pro- grammes. However, low impact of JE vaccination programmes on AES may reflect the burden of non-JE cases of AES. Given the burden of disease in adults in some countries, consideration should be given to cap- turing cases in all age groups in the surveillance system.", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "d1152e74e9625c69b2dc52120b2520b9", - "text_as_html": "AES surveillance is important for understanding all causes of encephalitis. Even in the absence of JE con- firmatory testing, reporting of AES cases can have value in demonstrating the impact of vaccination pro- grammes. However, low impact of JE vaccination programmes on AES may reflect the burden of non-JE cases of AES. Given the burden of disease in adults in some countries, consideration should be given to cap- turing cases in all age groups in the surveillance system.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 44.27, - "y0": 251.22, - "x1": 273.22, - "y1": 353.0 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-64", - "text": "\n\n\nResearch priorities\nThe following research gaps and questions remain to be addressed:\nSpecific data are missing for some vaccines in some populations (e.g. long-term data in young child travel- lers, immunogenicity and safety data for live attenuated vaccine in adults), Registries are important for pregnant women and people with HIV.\nLong-term immunogenicity studies would inform opti- mal dosing schedules for long-term protection, which may vary by location (based on natural boosting or other factors). Particularly for newer vaccines, vaccine effectiveness and impact studies are important.\nDevelopment of standardized neutralization assay reagents is needed. Further developments of sensitive, specific, affordable commercial serological assays to en- sure access to diagnostic testing in JE-endemic coun- tries should be advanced.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "2c7b19242139cbeac3f589cd6fce33c9", - "text": "Research priorities", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "", - "text_as_html": "The following research gaps and questions remain to be addressed:
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 43.2, - "y0": 382.58, - "x1": 273.1, - "y1": 403.9 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "e86e070d8ee23e799a06cb4661335e18", - "text": "Specific data are missing for some vaccines in some populations (e.g. long-term data in young child travel- lers, immunogenicity and safety data for live attenuated vaccine in adults), Registries are important for pregnant women and people with HIV.", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "2c7b19242139cbeac3f589cd6fce33c9", - "text_as_html": "Specific data are missing for some vaccines in some populations (e.g. long-term data in young child travel- lers, immunogenicity and safety data for live attenuated vaccine in adults), Registries are important for pregnant women and people with HIV.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 45.78, - "y0": 411.25, - "x1": 272.58, - "y1": 467.31 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "3e1a9fd50c1737b7d8cf0533dfc8b713", - "text": "Long-term immunogenicity studies would inform opti- mal dosing schedules for long-term protection, which may vary by location (based on natural boosting or other factors). Particularly for newer vaccines, vaccine effectiveness and impact studies are important.", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "2c7b19242139cbeac3f589cd6fce33c9", - "text_as_html": "Long-term immunogenicity studies would inform opti- mal dosing schedules for long-term protection, which may vary by location (based on natural boosting or other factors). Particularly for newer vaccines, vaccine effectiveness and impact studies are important.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 44.95, - "y0": 475.03, - "x1": 273.28, - "y1": 530.91 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "fd72bdde5fab88bf92949638d237ee89", - "text": "Development of standardized neutralization assay reagents is needed. Further developments of sensitive, specific, affordable commercial serological assays to en- sure access to diagnostic testing in JE-endemic coun- tries should be advanced.", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "2c7b19242139cbeac3f589cd6fce33c9", - "text_as_html": "Development of standardized neutralization assay reagents is needed. Further developments of sensitive, specific, affordable commercial serological assays to en- sure access to diagnostic testing in JE-endemic coun- tries should be advanced.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 44.66, - "y0": 549.91, - "x1": 273.9, - "y1": 605.22 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-65", - "text": "\n\n\nHow to obtain the WER through the Internet\n(1) WHO WWW server: Use WWW navigation software to connect to the WER pages at the following address: http://www.who.int/wer/\n(2) An e-mail subscription service exists, which provides by electronic mail the table of contents of the WER, together with other short epidemiological bulletins. To subscribe, send a message to listserv@who.int. The subject field should be left blank and the body of the message should contain only the line subscribe wer-reh. A request for confirmation will be sent in reply.\nefficacité et évaluer la nécessité éventuelle de doses de rappel pour combler les lacunes immunitaires.\"\nTous les pays d’endémie de EJ sont encouragés a exercer au minimum une surveillance sentinelle, avec confirmation en laboratoire de lEJ. Cela les aidera également a prendre la déci- sion @introduire le vaccin contre l’EJ. Bien qu'un systéme de surveillance complet de EJ soit recommandé, les pays dans lesquels un tel systeme nest pas en place, mais qui disposent de preuves de la survenue de l’EJ maladie, ne devront pas attendre pour introduire le vaccin contre lencéphalite japonaise. Des données exhaustives sont utiles pour identifier les tranches d’age cibles et les zones a plus haut risque; cela est particuligrement important si Pon envisage une introduction par étapes ou a une échelle infranationale. Des analyses coiit/efficacité spécifiques au pays/a la région peuvent contribuer a étayer les décisions concer- nant introduction du vaccin contre |’EJ.\nLa SEA est importante pour connaitre toutes les causes d’encépha- lite. Méme en l’absence de test de confirmation de I’EJ, la notifica- tion de tous les cas de SEA peut avoir un intérét dans la mise en évidence de impact des programmes de vaccination. Cependant, la faible incidence des programmes de vaccination contre l’EJ peut étre le reflet de la charge de cas de SEA non dus a I’EJ. Compte tenu de la charge de morbidité importante chez les adultes dans certains pays, il faudra veiller 4 ce que le systéme de surveillance enregistre les cas intervenant dans toutes les tranches d’age.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "79c20d8f32c0b5c8604f64cfe4c0f443", - "text": "How to obtain the WER through the Internet", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "", - "text_as_html": "efficacité et évaluer la nécessité éventuelle de doses de rappel pour combler les lacunes immunitaires.\"
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 293.8, - "y0": 55.85, - "x1": 550.54, - "y1": 77.15 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "b11b976fb62259a48022132c080c6c47", - "text": "Tous les pays d’endémie de EJ sont encouragés a exercer au minimum une surveillance sentinelle, avec confirmation en laboratoire de lEJ. Cela les aidera également a prendre la déci- sion @introduire le vaccin contre l’EJ. Bien qu'un systéme de surveillance complet de EJ soit recommandé, les pays dans lesquels un tel systeme nest pas en place, mais qui disposent de preuves de la survenue de l’EJ maladie, ne devront pas attendre pour introduire le vaccin contre lencéphalite japonaise. Des données exhaustives sont utiles pour identifier les tranches d’age cibles et les zones a plus haut risque; cela est particuligrement important si Pon envisage une introduction par étapes ou a une échelle infranationale. Des analyses coiit/efficacité spécifiques au pays/a la région peuvent contribuer a étayer les décisions concer- nant introduction du vaccin contre |’EJ.", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "79c20d8f32c0b5c8604f64cfe4c0f443", - "text_as_html": "Tous les pays d’endémie de EJ sont encouragés a exercer au minimum une surveillance sentinelle, avec confirmation en laboratoire de lEJ. Cela les aidera également a prendre la déci- sion @introduire le vaccin contre l’EJ. Bien qu'un systéme de surveillance complet de EJ soit recommandé, les pays dans lesquels un tel systeme nest pas en place, mais qui disposent de preuves de la survenue de l’EJ maladie, ne devront pas attendre pour introduire le vaccin contre lencéphalite japonaise. Des données exhaustives sont utiles pour identifier les tranches d’age cibles et les zones a plus haut risque; cela est particuligrement important si Pon envisage une introduction par étapes ou a une échelle infranationale. Des analyses coiit/efficacité spécifiques au pays/a la région peuvent contribuer a étayer les décisions concer- nant introduction du vaccin contre |’EJ.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 294.21, - "y0": 84.85, - "x1": 552.91, - "y1": 243.31 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "05fd5345a3a7e9d9e16739e835334910", - "text": "La SEA est importante pour connaitre toutes les causes d’encépha- lite. Méme en l’absence de test de confirmation de I’EJ, la notifica- tion de tous les cas de SEA peut avoir un intérét dans la mise en évidence de impact des programmes de vaccination. Cependant, la faible incidence des programmes de vaccination contre l’EJ peut étre le reflet de la charge de cas de SEA non dus a I’EJ. Compte tenu de la charge de morbidité importante chez les adultes dans certains pays, il faudra veiller 4 ce que le systéme de surveillance enregistre les cas intervenant dans toutes les tranches d’age.", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "79c20d8f32c0b5c8604f64cfe4c0f443", - "text_as_html": "La SEA est importante pour connaitre toutes les causes d’encépha- lite. Méme en l’absence de test de confirmation de I’EJ, la notifica- tion de tous les cas de SEA peut avoir un intérét dans la mise en évidence de impact des programmes de vaccination. Cependant, la faible incidence des programmes de vaccination contre l’EJ peut étre le reflet de la charge de cas de SEA non dus a I’EJ. Compte tenu de la charge de morbidité importante chez les adultes dans certains pays, il faudra veiller 4 ce que le systéme de surveillance enregistre les cas intervenant dans toutes les tranches d’age.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 294.02, - "y0": 251.57, - "x1": 551.9, - "y1": 352.81 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-66", - "text": "\n\n\nPriorités de la recherche\nDans le domaine de la recherche, il reste 4 répondre aux lacunes et questions suivantes.\nCertaines données font défaut pour certains vaccins dans certaines populations (données a long terme chez les trés jeunes voyageurs, données d’immunogénicité et dinnocuité pour le vaccin vivant atténué chez l’adulte). Les registres sont importants pour les femmes enceintes et les personnes vivant avec le VIH.\ndonnées permettant d’étayer la définition de schémas posologiques optimaux pour obtenir une protection de longue durée, lesquels pourraient varier selon le lieu (en fonction du renforcement natu- rel ou d’autres facteurs). Tout particuliérement pour les vaccins plus récents, il importe de disposer d’études d’efficacité et d’impact.\nIl est nécessaire de mettre au point des réactifs standardisés pour les épreuves de neutralisation. Il faudrait aussi faire progresser le développement d’épreuves sérologiques commerciales sensibles et spécifiques d’un cot abordable pour garantir l’accés au dépistage diagnostique dans les pays d’endémie de EJ.", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "5f86639b2b66cf12bbeda348b08fbe22", - "text": "Priorités de la recherche", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "", - "text_as_html": "Dans le domaine de la recherche, il reste 4 répondre aux lacunes et questions suivantes.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 293.44, - "y0": 382.87, - "x1": 551.77, - "y1": 404.13 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "7cc5c9132d84002454132bb966ebf5b9", - "text": "Certaines données font défaut pour certains vaccins dans certaines populations (données a long terme chez les trés jeunes voyageurs, données d’immunogénicité et dinnocuité pour le vaccin vivant atténué chez l’adulte). Les registres sont importants pour les femmes enceintes et les personnes vivant avec le VIH.", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "5f86639b2b66cf12bbeda348b08fbe22", - "text_as_html": "Certaines données font défaut pour certains vaccins dans certaines populations (données a long terme chez les trés jeunes voyageurs, données d’immunogénicité et dinnocuité pour le vaccin vivant atténué chez l’adulte). Les registres sont importants pour les femmes enceintes et les personnes vivant avec le VIH.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 294.83, - "y0": 411.71, - "x1": 551.55, - "y1": 467.46 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "bc07c0e78b2eb9734873d645f83dfddf", - "text": "données permettant d’étayer la définition de schémas posologiques optimaux pour obtenir une protection de longue durée, lesquels pourraient varier selon le lieu (en fonction du renforcement natu- rel ou d’autres facteurs). Tout particuliérement pour les vaccins plus récents, il importe de disposer d’études d’efficacité et d’impact.", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "5f86639b2b66cf12bbeda348b08fbe22", - "text_as_html": "données permettant d’étayer la définition de schémas posologiques optimaux pour obtenir une protection de longue durée, lesquels pourraient varier selon le lieu (en fonction du renforcement natu- rel ou d’autres facteurs). Tout particuliérement pour les vaccins plus récents, il importe de disposer d’études d’efficacité et d’impact.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 293.21, - "y0": 474.97, - "x1": 552.15, - "y1": 542.11 - } - ] - } - }, - { - "type": "NarrativeText", - "element_id": "7e49ec82c6da86d1b6d5851eeac67ea1", - "text": "Il est nécessaire de mettre au point des réactifs standardisés pour les épreuves de neutralisation. Il faudrait aussi faire progresser le développement d’épreuves sérologiques commerciales sensibles et spécifiques d’un cot abordable pour garantir l’accés au dépistage diagnostique dans les pays d’endémie de EJ.", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "5f86639b2b66cf12bbeda348b08fbe22", - "text_as_html": "Il est nécessaire de mettre au point des réactifs standardisés pour les épreuves de neutralisation. Il faudrait aussi faire progresser le développement d’épreuves sérologiques commerciales sensibles et spécifiques d’un cot abordable pour garantir l’accés au dépistage diagnostique dans les pays d’endémie de EJ.
", - "languages": [ - "eng" - ], - "filetype": "application/pdf", - "partitioner_type": "vlm_partition", - "filename": "WER9009_69-88.PDF", - "page": 18, - "coordinates": [ - { - "x0": 292.89, - "y0": 549.71, - "x1": 552.68, - "y1": 604.22 - } - ] - } - } - ] - }, - { - "type": "CompositeElement", - "element_id": "chunk-67", - "text": "\n\n\nComment accéder au REH sur Internet?\n1) Par le serveur Web de I'OMS: A l'aide de votre logiciel de navigation WWW, connectez-vous a la page diaccueil du REH al’adresse suivante: http://www.who.int/wer/\n2) Il existe également un service d'abonnement permettant de rece- voir chaque semaine par courrier électronique la table des matiéres du REH ainsi que d'autres bulletins épidémiologiques. Pour vous abonner, merci d’envoyer un message a listserv@who.int en lais- sant vide le champ du sujet. Le texte lui méme ne devra contenir que la phrase suivante: subscribe wer-reh.\n87", - "filename": "WER9009_69-88.PDF", - "filetype": "application/pdf", - "elements": [ - { - "type": "Title", - "element_id": "f4569f24a72dc88a962b11231fae6622", - "text": "Comment accéder au REH sur Internet?", - "metadata": { - "category_depth": 1, - "page_number": 19, - "parent_id": "", - "text_as_html": "87
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