Diluent mix-up not vaccine most probable cause of Syrian deaths says WHO

By Gareth Macdonald

- Last updated on GMT

Picture credit/Measles Control Taskforce Facebook page
Picture credit/Measles Control Taskforce Facebook page

Related tags Vaccine

Use of the muscle relaxant atracuriam to resuspend freeze-dried measles vaccines instead of the proper diluent almost certainly caused the death of more than a dozen Syrian infants according to the WHO.

Late yesterday, the World Health Organisation (WHO) and United Nations Children’s Fund (UNICEF) confirmed the deaths of 15 children who were vaccinated in Idlib province in North East Syria as part of a joint measles prevention programme.

The statement backed up an early announcement (in Arabic) by the measles control taskforce on its Facebook page​.

A WHO spokesman told in-Pharmatechnologist.com that unconfirmed reports suggest a batch of atracuriam stored in the same fridge as the diluent was mistakenly used to resuspend the freeze dried vaccine.

As yet this information is unconfirmed and WHO experts are on their way to the region to establish the precise cause of the children’s deaths​” he said and confirmed that the joint WHO-UNICEF vaccination programme in both Idlib and Deir Ezzour has been halted.

He explained that, if the unconfirmed reports are accurate, it would explain why the 15 confirmed casualties were all under the age of 18 months, adding that older children who were also given the vaccine have recovered.

The WHO spokesman declined to name the vaccine manufacturer and stressed that, at this stage, there does not appear to any problem with either the product or the diluent.

UNICEF lists a variety of firms including Sanofi Pasteur, the Serum Institute of India and Tannabe​ as previous suppliers of freeze-dried measels vaccines, however it is not clear if any of the firms supplied the vaccines used in the Syrian vaccination programme.

A UNICEF spokeswoman told us the organisation is working to identify the origin of the vaccine, explaining that its role is to procure such products on behalf of governments and as yet it is too early to identify the source.

She also told us that the vaccine was prepared at a site in Southern Turkey before being distributed to sites over the border in Northern Syria.

Communication programme

Coverage​ of the tragedy has focused on whether atracuriam was used due to human error or in an act of sabotage designed to disrupt heath programmes in Syria, which is a tactic already used by the opposition forces that control the region according to the New York Times​.

Various earlier reports​ suggested that the death toll could be as high as 36 children given vaccinated at sites in eight cities in the Idlib region, however, this has not been confirmed.

In parallel with trying to find out what happened, the WHO and UNICEF are running a health communication programme to underline the importance of the vaccination programmes in the region.

The WHO spokesman told us“We realise it is important to restore trust in the vaccination programmes in Syria,”​ he said adding that measles is among the leading causes of infant death in the region.

This was echoed by the UNICEF spokeswoman who told us the programme in Syria is vital to public health, citing a parallel polio vaccination effort launched in response to 38 cases of the disease that were confirmed in 2013.

"As a result of the polio programme we are close to re-eradicating the disease in the region​."

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