WHO, Cyclone Nargis: Myanmar
Vaccination recommendations:
Essential:
Diptheria 10 years Can be combined with tetanus
Tetanus 10 years Booster dose is recommended if not taken in the last 10 years
Polio 10 years Potential risk of importation of wild virus with displaced
populations.
Typhoid 3 years
Hepatitis A life If there is no proof of immunity by vaccine or illness, even if
departure at short notice.
Can be combined with Hepatitis B
Hepatitis B 15 years
Cholera 6 months If there is sufficient time to receive the 2 oral doses to be
taken at one week interval before departure.
(Immunity is obtained one week after the second dose of a
combination Oral cholera & ETEC (enterotoxigenic, E.Coli)
vaccine (Brand name DUKORAL).
Given the structural damage caused by the cyclone and flooding of water supplies there is an additional
risk of waterborne diseases affecting large numbers of the urban, rural and displaced populations. In
addition, extensive damage to infrastructure and distribution systems, as well as power supplies, will make
it virtually impossible to prepare food safely, posing an additional risk of foodborne diseases. Chlorine
powder, water purification units, plastic sheeting for shelter, cooking utensils, ready-to-eat survival food
rations, essential medicines, cholera kits, antimalarial drugs, long lasting insecticide-treated bednets and
supplies for the management of corpses are urgently needed.
The populations affected by the cyclone in Myanmar are at immediate risk from outbreaks of waterborne
and foodborne diseases, particularly cholera, typhoid, Shigella dysenteriae type 1(Sd1). There is
increasing evidence of significant antimicrobial resistance, including multi-drug resistance (resistance to
more than three antimicrobials) in Sd1 isolates from the region.
Cholera and shigellosis are endemic in the region. Usual water sources can become unsafe for drinking
for several reasons: the incursion of floodwaters, faecal contamination caused by overflow of latrines,
inadequate sanitation and upstream contamination of interconnected water sources.